Issue link: https://www.massageandbodyworkdigital.com/i/1358392
60 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 1 This is an example of what it might look like to conscientiously run through the steps in critical thinking. I have provided a thumbnail sketch of a possible client, with some of the variables that might inform the massage therapist's choices. Leo is a 62-year-old man in generally good health. He is active: He used to be a runner, and now, when he can, he walks and hikes. In the last few years, he has developed osteoarthritis at his right knee, and now it is seriously interfering with his quality of life. His left knee is beginning to bother him too. His doctor says he is "bone on bone," and he is a good candidate for a joint replacement surgery. However, Leo wants to avoid that if at all possible. He had a back surgery for a herniated disk 10 years ago, and he didn't feel it was successful. His back pain has continued to bother him. Now he wants to explore every alternative—including massage therapy— to try to reduce his knee and back pain so he can return to normal activities. ¤ What is this client asking for, and can I provide it? From the description, we know Leo's knee pain is interfering with his quality of life. He would like to be more active, and he really wants to be able to avoid a knee replacement surgery if he can, since his history with orthopedic surgeries has not been successful. He identifies his knee and back pain as the major obstacles to being able to "return to normal activities," which used to include running, but now would involve hiking and walking. It is feasible to suggest massage might help address Leo's knee and back pain, although it would be inappropriate to make any promises about his return to function. What factors affect this client's ability to safely receive massage therapy? We know Leo is fundamentally healthy, but at age 62 it is likely he has accumulated some health challenges that might affect Step 1 Recognize and analyze the question, goal, or challenge. What is this client asking for, and can I provide it? Step 2 Identify relevant variables that must inform your decisions. What factors affect this client's ability to safely receive massage therapy? Step 3 Challenge your preexisting assumptions. What more do I need to learn about this client's situation? Do I have a clear grasp of what he wants and needs? Step 4 Consider possible solutions to challenges—and explore alternatives to those solutions. What skills do I need to bring to this client's session? Do I need to refer this client to another provider? How might other strategies compare with my first choice? What have others done in similar situations? What have I missed? Step 5 Plan and execute a course of action that incorporates relevant variables. Based on all this, what is my session plan? Step 6 Reflect on how things went after you made a decision. What worked well, and didn't work well, in that session? What will I do differently next time? some decisions about massage therapy. He had unsuccessful back surgery, so that is a factor to consider, along with whatever medications he may use. What more do I need to learn about this client's situation? Do I have a clear grasp of what he wants and needs? This step covers anything not explicitly laid out in an initial conversation: Leo's health history and medications, and his goals for massage—with the caveat that those goals may change over time. What skills do I need to bring to this client's session? Do I need to refer this client to another provider? How might other strategies compare with my first choice? What have others done in similar situations? What have I missed? This step covers the massage therapist's homework and preparation. The question of referring out in this situation doesn't seem necessary, but that might change if Leo is not happy with his progress, or if his pain gets worse instead of better. A look at what the research (both published scientific research and textbook sources) says about massage therapy for knee pain and spinal surgery patients may help the therapist make some choices about techniques and strategies. Finally, this is a place to try to think outside the box to see what might be missing from initial impulses. Sample Critical-Thinking/Practical-Application Exercise