Issue link: https://www.massageandbodyworkdigital.com/i/1358392
decisions (because there are multitudes of right decisions), but in terms of helping readers to more thoughtfully analyze their decision-making process to look for places it could continue to evolve. These are not a final product; they are a starting place that might inspire you to develop your own critical thinking steps. Step 1: Identify the Question/Challenge/Goal This step covers the "client" portion of the evidence-informed practice triad. The client's goals and hopes—for a treatment series and for each single session—must be at the center of the decision-making process. The client's goals may be something they want to achieve ("I'm here because my back hurts, and I want to have less pain"), something they want to avoid ("I'm here because I have back pain, and I don't want to use opioids"), or both. Step 2: Identify the Relevant Variables The ability to weigh risks and benefits for massage therapy—that is, the variables that must inform our choices—is at the heart of our science education. This is where evaluating information for relevance, trustworthiness, and completeness becomes vital. And in a time when a massive amount of information (not all of it equally reliable) is instantly available, it can feel like an overwhelming process. In my work I emphasize what do you ask a client, why are you asking it, and how their answer going to change what you do. —Tracy Walton For our client with back pain, the variables will include their age, occupation, activity levels, onset of symptoms, exacerbating circumstances, underlying conditions, and many others. It is possible to put together algorithms and question lists to compile possible risks and benefits for bodywork, but while these can be a helpful place to start, they cannot anticipate every possible circumstance. We need to be able to think independently to accrue the necessary information. Step 3: Challenge Your Assumptions We cannot eradicate our own biases, but we can become more aware of them. When we recognize that our assumptions may limit how we process important information, we become more able to rise to the challenges set before us. For example, we may observe our client with back pain appears to be overweight and their shoes are worn down unevenly. Obviously (it seems to some people), they must have issues with their feet, knees, and hips that culminate in the back pain. This is an interesting line of inquiry—that this is the cause of their trouble—but not a safe assumption. We make all kinds of assumptions every day, and it is our responsibility to test those assumptions whenever we recognize them. One of the questions I always ask myself is, "And I know this how?" Just asking that question was a defining moment in my own career. —Doug Nelson Step 4: Consider Possible Strategies (and Alternatives) It's time to think about our strategies—and then take another look and reconsider what we might be leaving out. This is where we compare our first impulses to the current research to see what other practitioners or