Issue link: https://www.massageandbodyworkdigital.com/i/1501042
For instance, a closed-ended question would be: "Does your shoulder hurt at night?" An open-ended question would be: "Is there a particular time of day when your shoulder hurts?" The latter refrains from putting pain at night into the client's head and helps them think about when the pain is worse. The client is more likely to add information in the answer with an open-ended question, such as offering more about the location and quality of the pain. Probing Questions Start your interview with several open- ended questions to gather the most general information about the complaint. The answers will lead to more probing questions to draw out other significant details. You can help the client formulate descriptions of pain by asking directed questions. However, be careful about influencing their answers. For example, you might start with an open-ended question like, "Describe the pain you are experiencing." You could then assist by further asking, "Is the pain sharp and stabbing, dull and diffuse, prickly, or a deep throbbing, or how else might you describe it?" The client now has several optional descriptors for the pain but can also think of their own words. With the pain's nature and location noted, you can ask about other things, such as activities or positions that worsen or lessen the pain. Reflective Listening You've likely noticed several of these communication techniques come from other fields. Learning strong communication skills taught in these different fields is good business practice. Another skill we can borrow from communication studies or counseling is reflective listening. Reflective listening in the massage profession would mean asking for verification and confirming what you think the client said. For example, you might clarify by saying, "If I understand you correctly, you are having pain in this right side of your forearm," (while pointing to the location). WHAT NOT TO DO IN A HISTORY Taking a quality history is an art developed over time and with practice. However, there are also some important things to avoid when taking a detailed history. These are the most common mistakes made. Failing to Ask Follow-Up Questions An open-ended question will only succeed if you pursue information in the answer. Knowing how to follow up can be intimidating. But learn to listen carefully; practice with a friend. There is no convenient list of questions to consult; assessment is an organic process. Learning more about human anatomy and individual conditions will improve your ability to recognize symptom patterns. The key to any assessment is effective pattern recognition. Making Incorrect Assumptions When talking with clients about their current experience, it is essential to avoid making assumptions about what condition might be in play. Be diligent in taking in information without immediately relating it to another client's experience or what you initially think may be happening. Previous experience and knowledge do inform assessments, but it is crucial to approach each client's situation with an open mind. Conditions may have generalized presentations, but every client experience will be unique. Assuming a Given Diagnosis Is Accurate It is not within the scope of practice for massage therapists to diagnose any medical condition for their clients. And telling the client what you think they "have" is flirting with diagnosis. A massage therapist can, however, explain to the client what tissues seem to be involved and how. The assessment process can bring new information to light. What a massage therapist finds can sometimes differ from what another health-care professional has concluded. Because a client comes in with a particular diagnosis, it should not mean you are free to skip a thorough interview and L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 25 TECHNIQUE investigate the complaint. At a minimum, you will need to assess whether massage is appropriate and how it would best be used. Failing to Refer When Appropriate Similarly, it is a significant error not to refer somebody to an appropriate health-care professional when the critical information they provide in the history indicates massage may be inappropriate or harmful. Assuming the Client Told You Everything Remember that clients may not recognize when something in their history is important. We have probably all had the experience when in the middle of a massage, the client says, "Oh, I forgot to mention I fell on that shoulder when I was a teenager and had to have surgery to fix it." NEVER UNDERESTIMATE THE HISTORY The importance of taking an effective history cannot be overstated. Massage therapists can formulate the most effective treatment plan by gathering detailed information on a client's current problem, relevant medical history, and lifestyle factors. A quality history also enhances the professional credibility of the massage therapist, resulting in trust from other health-care professionals. Finally, clients who feel heard and understood are more likely to trust your expertise, become regular clients, and refer others to you. Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at academyofclinicalmassage.com.