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Watch Til Luchau's technique videos and read his past articles in Massage & Bodywork's digital edition, available at,, and on's YouTube channel. Watch Now Assess Your Confidence Take a quick self-assessment of key confidence indicators, or the entire full-practice survey, at were due to a lower number of clients causing practitioners to doubt their skills. However, even when this might be the case, increasing one's skill and confidence clearly brings direct benefits when a practice is smaller than desired, including self-fulfillment, a sense of purpose, client satisfaction, and higher efficacy; all worthy aims, no matter how satisfied or unsatisfied we are with the size and nature of our practices. *This project was supported by ABMP. Thanks to expert advisors Anne Williams, Cherie Sohnen-Moe, Drew Freedman, Eric Brown, and Irene Diamond, and to in-kind contributors, including Advanced-, Body Support Systems, and the World Massage Conference. Notes 1. "Massage Profession Metrics," accessed December 2017, media/metrics_massage_therapists.php. 2. R. H. Gracelay et al., "Clinicians' Expectations Influence Placebo Analgesia," The Lancet 43, no. 1 (1985). Til Luchau is the author of Advanced Myofascial Techniques (Handspring Publishing, 2016), a Certified Advanced Rolfer, practice coach, and a member of the faculty, which offers online learning and in-person seminars throughout the United States and abroad. He invites questions or comments via and's Facebook page. In an influential study of practitioners' confidence in their methods, clinicians (n= 60) gave placebos for dental pain relief. One group of clinicians knew they were giving a placebo; the other group of clinicians believed they were giving active pain medication (but were unknowingly also giving placebos). Pain was significantly less in patients whose practitioners thought they were giving actual pain medication (bottom line), suggesting that practitioner expectation and confidence can have a meaningful impact on patients' subjective results, such as pain. Vertical scale: pain rating (McGill Pain Questionnaire); horizontal scale: min. after placebo administration (Gracely et al., 1985). 8 6 4 2 0 -2 -4 -10 10 60 0 Placebo (not known to practitioner) Placebo (known to practitioner) PAIN less more Of course, not all confidence is good, and not all self-criticism is bad. Over- confidence has its downsides too: egotism, arrogance, grandiosity, insensitivity, and a lack of caution or humility can be thought of as pitfalls of an excess of confidence or self-confidence out of proportion to others' perceptions. And without self-criticism, there would be no drive to improve. But when confidence is too low, or self-criticism too high, the survey's results suggest that our practices suffer. While our survey measured the practitioners' confidence in themselves, there is interesting evidence that practitioners' confidence in the efficacy of their methods can influence their clients' perceived results as well (Chart 2), suggesting that it's important to believe in your modalities and techniques, as well as your own skills. 2 I should point out that though it's quite reasonable to expect that increasing confidence would likely result in more clients and more satisfaction overall, our survey showed only correlation, not cause. In other words, it's also possible that some of the confidence/practice-size correlations Chart 2: Pain change from known and not-known placebos. Enhancing Confidence Here are 12 great ideas for increasing confidence in your skills from our panel of expert advisors,* survey-takers' comments, and from the many stories shared in our discussion forum: 1. Rack up lots of experience. If need be, give sessions away for feedback. Keep working. 2. Stick with it. Our data showed that confidence and practice satisfaction both significantly went up with time. 3. Invest in quality training or additional credentials you value. Without enough of those to believe in your own possibilities, you're wasting the time and money you've already put in. 4. Search for a mentor who believes in you. 5. Find a coach, accountability buddy, or goals group to stay on track. 6. Get even better at providing the results your clients want. Supervision or a good training will help. 7. Collect, share, and celebrate your successes—both small and large—with friends, family, peers, social media, and your professional website. (Get a website.) 8. Trade with peers. Ask for feedback. 9. Ask for specific feedback from your clients. 10. Just do it, even if you're afraid. Action counts. 11. Get help with self-compassion. We all need it. 12. Lighten up. Enjoy what you do.

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