Mosby's Fundamentals of Therapeutic Massage Book

Government certification

-administered by an independent board -voluntary but required for anyone using the protected title -requires specific educational courses and an examination

Government registration

-administered by the state department of registry or other appropriate state agency

Self assessment

-basic academic skills -goal setting skills -time management skills -study skills -critical and creative thinking skills -interpersonal skills

Principles

-basic truths or rules of conduct -generalizations that are accepted as true -can be used as a basis for ethical conduct

Lateral recumbent position

-body is lying horizontally on either the right or left side

Code of ethics and standards of practice for therapeutic massage

-each professional group constitute the massage profession

Progress/session notes

-each visit of client -SOAP methods -consistent entries -best defense against lawsuits -

Asian approaches

-methods of massage that evolve from the ancient Chinese systems

Manual lymph drainage

-methods of massage that influence the movement of interstitial fluid and lymph

Neuromuscular approaches

-methods of massage that influence the reflexive responses of the nervous system and its link to muscular function

Defining massage

-more than one skill -individual laws -more than one style/bodywork -government jurisdiction

Business card

-similar in design to brochure -simple, direct, include license ID number -appt on back of card -name of business, name of therapist, specialization, appt times and locations, contact info

Transitioning

-smooth and enjoyable movement from one type of technique to another type -efficient progression of skills such as the change from undraping a body area to the introduction of the therapist's hands on the client's body

Determining the legal structure of business

-sole proprietorship (one-owner) is simplest -partnerships and corporations are complicated

Charting methods

-SOAP -SOAPIER -PIE

SOAPIER method

-Subjective -Observe -Assessment/analyze -Plan -Intervention (methods) -evaluation (response to interventions) -revision (changes in treatment)

Sister Kenny

-Used massage in the treatment of polio

Website

-dynamic, interactive, inexpensive -specific skills, book appts, educate clients, -create own or professional website designer -includes: quick to load pages, id self and business, best template profile, easy to navigate/read, relevant content/current -contact info, map, location, type of massage skills, -part of business expenses -hosting and domain are the costs ($10-$25 per month)

Financials (part of business plan)

-financial history of enterprise -short/long term goals -forecasts

Static methods

-holding -direct pressure

Foundation of a successful business is

-planning and implementation

Aspirational ethics

-professional strives for highest possible benefit and welfare for the client

Thixotrophy

-property exhibited by certain gels (semisolid, jelly like colloids)

Clinical massage reasons

-stress related issues -palliative care -pain management -aid to physical therapy -mobility/movement training -integration with health care systems

Stroke length in massage and bodywork sessions

-strokes are used that connect body areas together and completely cover appropriate areas without compromising body mechanics -strokes should travel the length of the muscles or muscle groups

Exemption

-a case in which a professional is not required to comply with an existing law b/c of education or professional standing

Coalition

-a group formed for a particular purpose

Erect position

-body is in standing position

Documentation

-client records: all info on clients -documentation: creating and mx client records -charting: systemic form of documenting -progress or session notes: charting process

Broken appointments

-client reminded of missed appt policy -cancel client if needed

Client emotional release and emotional release protocol

-client: anger, anxiety, fear, euphoria, laughing, sadness, tearfulness, irritation -therapist: acknowledgment and normalcy, presence, responsiveness, contact, connect with breath, giving client time to regroup

Ethics

-defines the behavior we expect of ourselves and others and society's expectations of a profession -what is right -social, professional, personal dimensions -dynamic process of reflection and revision -reflection of one's professional and social character -alert to gross and subtle violations in client's welfare

Ways of dealing with conflict

-denial or withdrawal -suppression or smoothing over -power or dominance -compromise or negotiation -integration or collaboration

4 components of information used in effective decision making (I-communication)

-describe the behavior or problem (facts) -state your feelings about situation (effect on people) -state the consequences (logical cause/effect) -request the preferred behavior or action (possibilities)

Directional terms

-describe the way one body part relates to another -superior/cranial cephalad vs inferior/caudal -proximal vs distal -lateral vs medial -anterior/ventral vs posterior/dorsal

Credential

-designation earned by completing a process that verifies a certain level of expertise in a given skill

At will employment

-either company or employee can terminate the employment relationship at any time, with or without cause, with or without notice -usually in US -no fault of their own to qualify for unemployment benefits -depends on individual circumstances

Cartilage (of skeletal system): hyaline cartilage

-elastic, cushiony, slippery, articular surfaces at joints -ribs, nose, larynx, trachea, fetal skeleton -means "glass"

Piezoelectricity

-electric charge that accumulates in certain solid materials such as crystals, ceramics, and biological matter like bone , proteins in response to applied force creating mechanical stress

Business plan elements

-executive summary -market analysis -company overview -description of management and organization of staff -ownership information -funding requests -financials

Autonomic approach

-exerts a therapeutic effect on the autonomic nervous system

Role expectations

-expected behaviors of therapist -what clients expect will happen before, during, and after massage session -assess for realistic and unrealistic client expectations -appropriate conversation -reasonable expectations met

Media

-expensive -target local area (usually clients from 30 minutes away) -location is same for a year at least before advertising -paper advertising is expensive too

Registering for tax purposes

-federal tax info from IRS -state tax info from department of the treasury -local tax info from county/local government offices -advice from attorney or certified public accountant regarding tax requirements -1/3 of gross income to taxes -pay taxes first the others -professional tax preparer (may need quarterly estimates)

Creating resume/cover letter

-gather all data (contact info, employment past/present, education/training) -download templates (careeronestop.org) -plug in info gathered in step 1 -3rd person read your completed resume: seeking help

Problem solving model for decision making

-gather facts to identify and define the situation (what is the problem/facts) -brainstorm possible solutions (what might I do/what if) -logically and objectively evaluate each possible solution (what if) -evaluate the effect of each possible solution on the people involved (how would each person feel?) -choose a solution and develop an implementation plan -implement the plan and set a date for re-evaluation -determine the logical consequences if plan is not followed -re-evaluate and make necessary adjustments/implement refined plan

Cardiovascular system

-heart: 4 chamber pump; blood vessels -arteries (O2 blood to body) -veins (blood to heart) -terms: angio, artery, arteriole, blood pressure, bruise, capillary, edema, phleb,, vasoconstriction, vasodilation, vein, venule

Use of breath during sessions to benefit the client

-help client relax -support the release of tension -reduce sensations of pain -positively influence lymphatic movement

Hysteresis

-if force magnitude (how strong) remains w/in elastic limits, when the force is removed, tissues return to their initial state

Drop-ins

-if opening, then good -if not, make appt

Good samaritan law

-immunity for acts performed by a person who renders care in an emergency situation -incentive to provide medical assistance w/out fear of litigation

Entering appointments

-in pencil, accurate, complete, legible -full name, home/business phone number, time of appt, type of massage, length of massage, special notations

Countertransference

-inability on the part of the professional to separate the therapeutic relationship from personal feelings and expectations for the client; - it is personalization of the professional relationship by the professional

Jurisprudence

-indicate theory and practice of a law

Setting up investments

-individual retirement plan -10% of income to long term growth investment -mutual funds, IRA's, compound bearing interest accounts

Start up costs

-initial expenses required to begin a business -minimum cash reserve equal to the amount of money needed to cover basic business and personal living expenses for 6-12 months -check out employment with the BBB, chamber of commerce, other business owners

Professional growth

-involves change in our knowledge, skills, attitudes, and beliefs

If force is applied to an object

-it will move if it can -if no movement, then the object will change shape (flatter, longer, twisted, bunched up)

Ligaments

-joint or articulation: point where bones of skeleton meet -movable joints covered by cartilage and are held together by ligaments -made up of white fibrous tissue -pliant, flexible, strong, tough

Massage in the eastern world

-kept alive as part of folk culture

The strongest method is delivered through the

-kinesthetic mode or body language

Proprioception

-kinesthetic sense -mx motor tone in muscle -mechanoreceptor, GTO, joint kinesthetic receptors, kinesthetic, muscle spindle cells

Torsion/twisting methods

-kneading -skin rolling -fulling -wringing -fascial torquing -swedish/classical petrissage

Scope of practice

-knowledge base and practice parameters of a profession

Credential and regulations

-licensing -government certification -government registration -voluntary verification -exemptions

Digestive system

-long, muscular tube that travels through the body -peristalsis -accessory organs functions related to digestion via ducts

Evidence informed practice includes

-practice knowledge and experience -opinions of colleagues and other professionals -intuitive or gut feelings -wishes and experience of clients -evidence from research in massage or other, similar disciplines

Mobile/onsite massage practice

-practitioner travels to the client's home/business -set up time and travel added to the fee of service -saves on facility costs, -round trip is 1 hour then double the standard massage fee (clients make $75K-100K)

Fundamental word elements

-prefix:word element, beginning -root:meaning of term -suffix:word element, end, starting pt for interpreting -these are building blocks that are combined to create medical and scientific words

HIPAA requirements

-privacy standards -patient's rights -administrative requirements

Litigation

-process of a lawsuit -legal action in court -plaintiff (start/institutes the suit) -defendant (person accused)

Professional setting decision rules

-professional does not breach sexual boundaries w/client -clients are to be referred when the skills required are out of the scope of practice or training of the professional -all care must focus on giving help and avoiding harm -clients are to be given complete information about the treatment

Viscoeleasticity

-property of a substance that exhibits both viscous and elastic characteristics when undergoing deformation

Business hours

-regular or extended hours

Standing appointments

-regularly scheduled clients; need 100 or more to be profitable

Jurisprudence

-relates to the theory and practice of law

Types of conflict

-relationship conflicts (personality conflicts/strong negative emotions) -data conflicts (people lack info to make decisions) -interest conflicts (competition over incompatible needs) -value conflicts (force one value on another person)

Confidentiality

-respect for privacy of information

Determining the limits of practice

-responses to client are from a body and massage perspective -do not problem solve or provide professional intervention if not qualified -refer as needed

Reflective listening

-restating the information to indicate that you have received and understood the message

What massage therapist can do

-scope of practice

Multiple paths for massage therapy

-self-employment -employed -full time -part time -mobile -in home -franchises -health care -sports environments -different goals/different clients/different methods -evolves with experience

Dealing with suspected unethical or illegal behavior

-self-reflection -mentoring and peer support -talking with those involved -formal reporting

Sequencing

-sequence of strokes (order applied to an area) -overall sequence of massage (order body are massaged)

Disability terms

-service animal or service dog: dog trained -short stature: less than 4'10" -speech disability: limited speech pattern -spinal cord injury: damage to spinal cord, paralysis -substance dependence: substance abuse in 3 areas of life for 1 year -survivor: recovery from adverse health condition

Goal setting

-set after the mission statement is done -provide direction and landmarks for achievement -changes over time -SMART

Professional code of ethics

-set of norms (acceptable behavior) adopted by a professional group to direct choices and behavior in a manner consistent w/professional responsibility

Invasion of privacy

-several wrongs involving the use of otherwise private information -HIPAA

2 categories of force load

-simple loads: one specific load that results in one specific type of stress --primary force load outcomes: compression stress, tension stress, shear stress -combined loads: different types of loads acting at the same time --combined force load outcomes: torsion stress and bending stress

Practices

-skills, techniques, strategies that can be used as a practitioner

Integumentary system

-skin + appendages -epidermis, dermis (true skin, connective tissue/blood vessels), subcutaneous -sebaceous glands: sebum -sweat glands: most areas of body, eccrine gland, apocrine gland

Resistant tissue is not forced

-slow down and wait for the tissue to deform, make sure that the tissue is warmed up sufficiently, find the therapeutic edge, and work in layers

Intimacy

-tender, familiar and understanding experience between human beings

Tension stress

-tensile stress -2 forces pull on an object in opposite directions to stretch it: longer/thinner/tear apart -like tendons

5 types of force load

-tension -compression -shear -bending -torsion

Combined loads

-torsion: force cause a twist on longitudinal axis (sheer, compressive, tensile stresses) causing shear stress inside the material -bending: produce tensile and compressive stresses

MEDLINE Plus

-useful in medical terminology

Certification

-voluntary credentialing process that usually requires education and training -in addition to testing administered privately or by governmental regulatory bodies

Friction

-when any 2 things rub against each other

The target market

-where do you plan to work -what potential client groups/populations are available within a 1/2 drive of the location -what type of massage or bodywork do you enjoy giving -what group or type of people do you ant to help most -how are you going to reach those potential clients -when do you want to be available to do massage -by the 5th year you can usually narrow it down

WHO

-world health organization -identifying, defining, assessing spectrum of life quality -1991

Margaret Knott and Dorothy Voss

-wrote the first major book on proprioceptive neuromuscular facilitation

Reviewing fees

-yearly (april/may) -notify clients 30 days in advance if any price changes

Newtons 3 laws of motion

1) an object at rest tends to stay at rest, an object in motion tends to stay in motion 2) if you exert the same force on 2 objects of different mass, you will get different accelerations (changes in motion) 3) for every action (force), there is an equal and opposite reaction (force)

5 steps to determining licensing needs

1) find out whether your state or province requires licensing (department of licensing and regulation, occupational licensing division) 2) if your state does not have licensing, contact the local government for the area where you intend to work to inquire about local ordinances (clerks office) 3) shop for your school of massage training (licensed/state requirements) 4) contact local government about zoning requirements and building codes (clerk office) 5) public hearing 6) contact local government and apply for any necessary permits or business licenses 7) make sure your employer is in compliance with the previous requirements

Problem solving approach to reach ethical decision making

-critical thinking perspective -clinical reasoning (why and how to provide massage; targets specific therapeutic practice)

Elongation methods

-crossed hands stretch -fascial spreading -pin and stretch -arm pulling -leg pulling -traction

Daily appointment schedule

-daily pull of clients records and complete daily schedule -chronologic listing of activities -call list with times not booked (new or otherwise)

Intake procedures

-database: all info available contributes to therapeutic interaction -history: current/past medical/issue history -physical assessment

Methods of organized thinking elements

-database: pt past/present health status -goals/problems list: massage-related goals, problems -initial plan: plan to achieve goals -progress notes: each session description

Fraud

-deception that is deliberately practiced to secure unfair or unlawful gain -money

Therapeutic alliance

-interpersonal provider-client model that addresses the continuum of compliance, adherence, and collaboration in the therapeutic relationships

The words are

-least effective part of communication pattern -mixed meanings

Clinical massage

-massage therapy practice that involves more extensive use of assessment, specific focused techniques, and applications with the intention of achieving clinical treatment outcomes

Craniosacral and myofascial

-methods of therapeutic massage that work both reflexively and mechanically with fascial network

Legal recognition by licensure

-minimum hours of initial training -passing an exam -most states follow these above requirements -MBLEx (massage and bodywork licensing examination) administered by the FSMTB

Verification of advance training with board certification

-more than licensure -additional, voluntary process in specialty area -2013 National Certification Board launched the Board Certification credential (additional qualifications)

State and local regulation

-most often encounter

Management of prime time

-most often requested time by clients, usually after 1500

Intake procedures

-necessary when addressing defined outcomes will span a series of sessions (not the single session)

Anatomic tools

-palms, forearms, fingertips, knuckles, etc used to apply force to soft tissue

Small Business Association at http://www.sba.gov/

-provides a wide variety of resources including business start up and management, accounting, record keeping

Mechanical/physical force

-push or pull -magnitude (how much, in lbs or newtons) -direction (which way)

Passive movements

-range of motion and stretching performed by a therapist

Begin with ____ expectation

-realistic

Initial treatment plan

-states the : --therapeutic goals --, duration of the sessions --, number of appointments needed to meet the agreed-on goals --, cost --, general classification of intervention to be used --, and an objective methods for measuring progress and identifying when goals have been reached -form sign by client to keep in practitioner's files -mx record of signed consent form vital for legal issues

SOAP format

-subjective, objective, assessment/analysis, plan -system for charting

Elastic

-substances changes shape in response to an applied force but will return to the original shape when the force is removed

Shearing methods

-superficial friction -linear friction -circular friction -cross-fiber friction -muscle layer separation

Charles F Taylor and George H Taylor

-Introduced Swedish movement into the US

Managing transference and countertransference

-redirect transference activity -talk to clients -supervision -mentoring -peer support

Compression method

-approximation (pushing ends of tissues together) -pushing tissue against another tissue -applying pressure into tissue -direct pressure techniques -static compression and ischemic compression

Communication

-art of exchanging thoughts, feelings, and behavior -can be difficult

Cancelling appointments

-as soon as possible in advance -reminded to client if in advance -with reason -rare event

Soft tissue deformation methods

-compression methods -gliding methods -torsion/twisting methods -shearing methods -elongation methods -oscillating methods -percussive methods -static methods -movement methods -hot and cold methods

Gratuities (tips)

-gift/reward for services, usually money -not mandatory, but expected; determined by the client -15-20% of fee -employer cannot receive any of the tip -considered income and must be reported on income taxes -not expected in health care environments

Endocrine system

-glands that produce hormones which are secreted directly into the bloodstream to stimulate cells in a specific way to set a body function into action -regulate/control body

True earnings and real time

-gross and net income apply to self-employed, commissions, wages to to employees -real time: amount of time actually put into the business -first year income is about the same as employee or own business

Hourly wage employment

-hourly wage: about $20K to $35K per year for full time ($10-15 per hour for 40 hour week) regardless of massage done or not -salary wage: completion of certain tasks instead of hours worked, $400 per week for 20 massage sessions per pay period -wages can be hourly, salaried, or percentage based as long as the minimum wage requirement per hour worked is paid to the employee -varies based on location and experience -average pay is $9 to 20 an hour; - if $9-12 then based on commission per massage (not recommended)

Funding requests (part of business plan)

-how much money will be needed for start-up or expansion costs -proposed uses of borrowed funds

Well-being

-includes the presence of positive emotions and moods, absence of negative emotions, satisfaction with life, fulfillment, and positive functioning -massage therapy supports well-being

Additional terms related to ADA

-inclusive society: freely accepts all persons -independent living: right to live in community -intellectual impairment: difficulties learning -ICF disability and health:standard framework for health -mental health condition: alterations in thinking, mood, behavior and personal function -physical and rehabilitation medicine doctors: treats conditions for optimize functions -prosthetist-orthotist: mobility devices improve functions -psychologist: treating brain diseases plus more -quality of life: position in life/culture/value systems

Pressure

-indicate magnitude -light pressure=small magnitude -deep pressure=increased magnitude -the amount of force applied into the tissue -applied at an angle of 45-90 degrees -45 degrees=horizontal -90 degrees=perpendicular

Success depends on many elements

-inspiration (ideas that manifest the dream) -intention (goals) -intuition (following inner guidance, ask questions, quiet, aware of thoughts/dreams)

Esalen and Gestalt

-inspired psychotherapists to explore massage and movement therapies

Career mission statement

-intent of business plan: what will the main focus of my career be? -begins while still in school -1st step: educate in skills needed to carry out mission statement -also development of a financial plan to support the educational process and 1st year of business

Motivation

-internal drive that provides the energy to do what is needed to accomplish a goal -begins with knowing what you want

Felt sense

-internal somatic knowing difficult to express using words

Trickle Up

-international organization -include people with disabilities in economic struggles

Common prefixes

-intro: into, within -leuk: white -macro: large -mal: bad, illness, disease -mega: large -micro: small -mono: 1, single -neo: new -non: not -para: abnormal -per: by, through -peri: around -poly: many, much

Disclosure

-refuse to work with anyone as long as you explain the reasons and the fact that these reasons would affect the quality of care for the client

Reminder calls, emails, or texts

-reminder call or electronic reminders (texts/emails)

Important factors in scheduling appointments

-requires a well defined plan, established appointment sequence, mx strict control over appt book while meeting needs of clients

Licensing

-requires state/provincial board of massage or similar agency -requires all constituents who practice the profession to be licensed -legally defines and limits the scope of practice for a professional -requires specific educational courses/examination -protects the use of a title

Habitually late clients

-address ramifications

Active movements

-commonly called resistive exercises

ELAP

-entry level analysis project

Registering the name of the business

-obtaining a DBA -fee about $20 at county clerks office

Hindrances

-personal prejudices regarding body size, color, gender and attitude

Shear stress

-2 forces acting parallel to each other but in opposite directions so that one part of the tissue is moved or displaced relative to another part -causes 2 objects to slide over one another -like an anatomic tool during massage -sliding causes friction

Spinal nerves

-31 pairs -somatic nerve plexuses: groups of spinal nerves -cervical plexus, brachial plexus, lumbar plexus, sacral plexus

Documents to help develop medical terminology

-MTBOK (common ground for language; www.mtbok.org) -ELAP

Bodywork

-a term used to describe all the various forms of massage, movement, and touch therapy

Common prefixes

-a/an: w/out or not -ab: away from -ad: toward -ante: before, forward -anti: against -auto: self -bi: 2, double -circum: around -contra: against, opposite -de: down/from/away from/not -dia: across, through, apart -dis: separation, away from

Terms related to the nerves

-afferent nerves:carry messages to CNS, sensory nerves -efferent nerves:carry messages away from brain, motor nerves -cranial nerves: 12 pairs, arise from brainstem in cranial -spinal nerves: 31 pairs branch off SC -ganglion: mass of nerve cell bodies outside the CNS

Coordination

-agonist-antagonist-synergist relationship permitting the skeletal muscles to work in a purposeful manner and gives fluidity to motion

Code of ethics

-agreed on set of behaviors developed to promote high standards of practice -no agreement on specific ones to serve entire massage profession

Common suffixes

-algia: pain -asis: condition, usually abnormal -cele: hernia, herniation, pouching -cyte: cell -ectasis: dilation, stretching -ectomy: excision, removal of -emia: blood condition -genesis: development, production, creation -genic: producing, causing -gram: record -graph: diagram, recording instrument -graphy: making a record -iasis: condition of -ism: condition -itis: inflamation -logy: study of -lysis: destruction of, decomposition

The interview

-allows employer to get to know you -preparing: communication, dressing for success, interview questions, closing the interview (why you want the job)

Mathias Roth

-an English physician who studied directly with Ling; -also the leader in the homeopathic movement

Standard of care

-an assessment and treatment process that a clinician (massage therapist) should follow for a certain type of clinical circumstance -performed at the level at which similarly qualified practitioners manage the client's care under the same or similar circumstances

Sexual misconduct

-any sexually oriented behavior that occurs in the professional setting

Popular methods of massage and bodywork

-asian (from Chinese medicine concepts) -structural and postural integration (biomechanics and physiology) -neuromuscular (European approaches/nervous or reflexive) -manual lymphatic drainage -energetic (biofield) (body energy patterns -craniosacral and myofascial (mechanical/reflexive connective tissue) -applied kinesiology (chiropractic/reflexive) -integrated approaches (specific groups/combo methods)

Bodywork (ELAP definition)

-broad term refers to many forms, methods and styes including massage, that positively influence the body through various methods that may or may not include soft-tissue deformation, energy manipulation, movement re-education, and postural re-education

Maintain daily schedule

-calendar of events, to do list, priorities, flexibility, use free time, review the schedule -review with supervisor -electronic or on paper

Posterior regions of body

-cervical region: neck (7 vertebrae) -thoracic region: chest (12 vertebrae) -lumbar region: loin (5 vertebrae) -sacral region: sacrum (5 vertebrae fused in one bone) -coccyx: tailbone (4 vertebrae fused in one bone)

Duplicated movements

-changes abnormal patterns into optimal ones

Active listening

-clarify a feeling attached to the message but does not add to or change the message

Engaging the tissue

-clear communication regarding the agreed-on session goals, the approaches that work best and the agreed on depth of pressure leads to a massage/bodywork session that is therapeutic and satisfying for the client

Informed consent

-client authorization for any service from a professional, based on the premise that the massage professional has provided adequate information to enable the client to make an educated choice

Dr. Boris Chaitow and Dr. Stanley Leif

-cofounders of the neuromuscular technique

Additional terms related to ADA

-condition (comorbid): additional health concern not related to primary -disability: impairments -disability discrimination: restriction on disability to reduce rights of others -disability management: address needs of disabled -disabled people organizations: promote human rights -early intervention:intervene early in life of individual -frail elderly: 75 yrs older health conditions -health: well-being -health condition: disease, disorder, injury, trauma -health promotion: enables people increase health control -impairment: loss body structure/function

Indication

-condition for which an approach would be beneficial for health enhancement, treatment of a particular condition, or support of a treatment modality other than massage

Jargon

-do not use -other definitions besides the dictionary meaning -usually used within a community

3 general categories of adaptation

-effective or good ability to adapt (generally healthy client) -ineffective or moderate and strained ability to adapt (stressed/chronically ill but functioning w/strain/stress) -poor ability to inability to adapt (point of breakdown, comprehensive intervention process, addition training of massage therapist)

Employee vs Self-Employed

-employee: concentrate on being excellent massage therapist and support the business -self-employed: excellent massage therapist, manage business-related responsibilities, control over business

Training in HIPAA requirements

-employment related compliance training to their organizational roles

Respect

-esteem and regard for clients, other professionals and oneself

Evidence based vs evidence informed

-evidence based: assumption is benefit has been confirmed -evidence informed: validity of claimed result is less reliable (massage therapy in this category so far)

Newtons 3rd law of motion

-forces are found in pairs -push a wall, it pushes back -no movement=equal opposite forces -movement=one force is stronger (magnitude) and overpower the weaker force -like moving the box

Alexander lowen

-founded bioenergetics

Questions for evidence once gathered

-how relevant is the evidence to what we are seeking to understand/decide? -how does the evidence represent the population that concerns us? -How reliable and valid is the source of the evidence?

Viscocity

-how thick or thin a fluid substance is

General vs specific work

-idea that broad and general application methods lead to more specific or focused methods and then back to broad, general methods as the session closes -difference between what the client experiences with general work vs specific -focused work in just one area to work in layers

Flow and continuity

-idea that methods flow from one technique to another and from one body area to another through smooth transitions

Rhythm

-idea that strokes should be applied in regular patterns at a regular pace or tempo to elicit the parasympathetic nervous system response -strokes delivered in uneven patterns or at an irregular pace are jarring for the nervous system and the client has more difficulty relaxing

Pacing and leading

-idea that the massage therapist adapts to and matches the client's personal pace (speed) in movement and breathing rate when entering the session to establish connection -then leads the client toward client outcomes by altering the speed and rhythm of massage application and breathing

MTBOK and ELAP

-identify what massage therapy is -what educational requirement need to be to standardize and advance the massage profession -agreed upon terminology (taxonomy)

Zoning ordinances

-land use pre-determined on a master plan to direct the way the local government wants to see the area grow and develop

Medical rehabilitative massage

-level of professional responsibility, based on extensive education -which massage therapists is able to develop, mx, rehabilitate, or augment physical function -to relieve or prevent physical dysfunction; to relieve or prevent physical dysfunction and pain, and to enhance the clients well-being -methods include assessment of the soft tissue and joints and treatment by soft tissue manipulation, hydrotherapy, remedial exercise programs, actinotherapy (light therapy) and client self-care programs

Convex vs concave

-lumbar and cervical posterior is concave -thoracic is convex

Health-care-oriented massage (ELAP definition)

-massage performed in medical or health-care-oriented environments to facilitate therapeutic change, condition management, or symptom management

Wellness-oriented massage (ELAP definition)

-massage performed in wellness or relaxation-oriented environments to facilitate stress reduction, relaxation, or wellness

Goals and problems

-massage sessions are goal oriented -goals (desired outcomes) -measurable, activity based goals meaningful to client, plus improvement to daily living

Service Corps of Retired Executives (SCORE) at www.score.org

-matches volunteer business management counselors with clients in need of expert advice and experts in virtually every area of business

Newtons 1st law

-motion (or lack of motion) cannot change without unbalanced force acting -force has to act on the object stronger (magnitude) than what is moving or keeping it still -i.e. moving a box (kid vs adult)

To succeed at anything, a person must be ____

-motivated

Massage Therapy developments

-moved community toward unification -created clear pathway for the standardized massage education, licensing at entry level, and career development through Board Certification -progress is evident; more to get done

Dilemma

-multiple ways to address a situation and it is difficult to decide what to do

Inventory record keeping

-mx current inventory, the additions and withdrawals to inventory and inventory balances at the end of specified periods -identify the products or materials, the quantities and the value of these products or materials -inventory control is the management of inventory and it relies heavily on information provided by the inventory record keeping system

Documentation in massage therapy practice

-mx of client record is essential -creation of written/electronic record: procedures, assessments, permissions, charting -clients have a right to info in the file

Working at oblique angles

-no greater than 45 degrees -ensures blood vessels, lymph vessels, and nerves will not be pinched

Problem oriented medical record (POMR) system

-organized around problems of client or patient

Chain of trust

-patient/client data shared with a 3rd party, a certain level of trust must be established to ensure that the external party to whom data are passed can guarantee that they will mx data integrity and confidentiality -form of a contract -security measures: --obtain written consent from client for e-mail communication that specifically relates to health records --do not leave files where they are accessible to unauthorized individuals --keep appt books private, and practice password-protected software management --do not discuss any medical information with a 3rd party w/out written authorization from the client

Informed consent

-protection process for the consumer -client understands what will occur, participate voluntarily, competent to give consent -educational procedure for clients -supports professional ethical behavior -client participation/self determination in client-centered approach -evaluate options and risks

American Job Center at http://jobcenter.usa.gov/

-provides a single access point for key federal programs and critical local resources to help people find a job, identify training programs, and tap into resources to gain skills in growing industries

Function of the NS

-receive impressions from the external environment, organize the information, and provide appropriate responses -react to outside influences -info enters NS through receptors (special sense organs) -sent to CNS by PNS then sorts out info and sends back info by PNS via neurotransmitters -also mx internal environment or balance of many activities in the body (homeostasis) -do NOT function independently

Force

-something that internally or externally causes the movement of the body to change or soft-tissue structures to deform -an external effort that causes an object to undergo a certain change concerning its movement, direction, or shape -i.e. muscle contraction or passive movements -a push or a pull

Language is made up of socially shared rules that include

-sounds/symbols to convey meaning -words definitions (vocab) -ability to make new words -agreed upon sequences of words used to communication (grammar) -terminology (language specific to specialized knowledge) -taxonomy (science of classification according to a system of names w/explanations of their meanings) -classification (systemic organization of things

ELAP program

-total 625 program hours --massage therapy theory and principles (27 hours) --massage professional practices (20 hours) --the therapeutic relationship (40 hours) --anatomy, physiology, pathology (80 hours) --assessment and documentation (50 hours) --massage and bodywork application (175 hours) --palpation and movement (71 hours) --adapting sessions for clients (80 hours) --career development (82 hours)

Planes of motion

-transverse plane -frontal/coronal plane -median/sagittal plane

Communicating when dilemmas arise

1) carefully examine the facts, possibilities, logical causes, effects, and your feelings about situation 2) speak with a mentor, peer, or a supervisor about the situation in a peer review or support context 3) plan a time to talk about the situation with the other person or people involved 4) begin the conversation by identifying the problem as you see it 5) use the standard I-message format to provide information and professional disclosure about your inability to work with or be comfortable with the situation -end with open ended question to encourage discussion

Steps for complying with licensing requirements

1) find out whether your state or province requires licensing (department of licensing and regulation, occupational licensing division) 2) if your state does not have licensing, contact the local government for the area where you intend to work to inquire about local ordinances (clerks office) 3) shop for your school of massage training (licensed/state requirements) 4) contact local government about zoning requirements and building codes (clerk office) 5) public hearing 6) contact local government and apply for any necessary permits or business licenses 7) make sure your employer is in compliance with the previous requirements

Membership in a professional association

1) technician (expertise in a technical skill/process) 2) practitioner (practices occupation/profession/paraprofessional) 3)therapist (treats illness or disability, highest education)

Cancellation/no-show fees

-must be disclosed to clients before providing services -reasonable fee is 1/4 to 1/2 of total massage charge

Entrepreneur

-person who organizes, operates, and assumes the risks of a business venture; clients becomes the boss

Being fired

-evaluate reason -honest with self -learn from experience -disqualified from unemployment benefits if will-full misconduct, illegal activity

Advantages and disadvantages of self-employment

-advantage: more net income, less marketing over time, more freedom to self-direct business structure, flexibility in scheduling, long term financial security -disadvantages: increased responsibilities, isolation, lack of peer support and supervision, inability to leave business for short times, income varies, no group benefits -good to have membership in professional associations

Marketing

-advertising and other promotional activities required to sell a product or service -who/what/where/when/how -word of mouth is the best -demonstrations, speaking in groups, visible in community -obstacles: convincing public it is beneficial, justify fees -provide education and experience

Management

-all activities required to mx business (like record keeping and financial disbursement) -KISS (keep it simple specific) -steps: 1) obtain all necessary licenses 2) choose a business location 3) determine the legal structure of the business 4) register the name of the business 5) register for tax purposes 6) arrange for insurances 7) open business banking accounts 8) set up investments 9) keep records 10) develop a client-practitioner agreement and policy statement

Establishing an appointment time

-am or pm?, present 2 choices -best when regularly scheduled, preventive care; schedule standing appts

Massage therapist biologic clock

-massage therapist biologic clock (practitioners best time)

Client reasoning and charting

-gather info, analyze, reason, justify, evaluate, charting (problem solving approach)

Nervous system

-PNS (cranial/spinal nerves) -CNS (brain/S.C., dorsal cavity) -ANS (nervous control over smooth muscle, heart muscle, glands) -neurons (individual nerve cells) -sensory and motor neurons

Articular system

-2 or more bones meet -all of anatomic and functional aspects of the joints -articulations, flexibility, synarthrodial, amphiarthrodial, diarthrodial, symphysis pubis, sacroiliac, symphysis, articular cartilage, articular disks, ligaments, synovial fluid, tendon

Persons able to provide informed consent

-50 year old man taking medication for high blood pressure -21 year old woman in the 3rd trimester of pregnancy

Coalition of National Massage Therapy Organizations

-AFMTE : Alliance for Massage Therapy Education -AMTA : American Massage Therapy Associations -ABMP : Associated Bodywork and Massage Professionals -COMTA : Commission on Massage Therapy Accreditation -FSMTB : Federation of State Massage Therapy Boards -MTF : Massage Therapy Foundation -NCBTMB : National Certification Board for Therapeutic Massage and Bodywork

Disability terms

-Autism spectrum disorder (ASD): brain development issues -blind (loss of sight) -brain injury or traumatic brain injury (TBI):brain injury -cleft palate/lip: lip/gum -congenital disability: since birth not inherited -deaf: hearing loss -developmental disability:physical/mental disability before age 22

Health care setting additional experience/education

-Board Certification by the NCBTMB for advanced level training --750 hours education --pass board certification exam --250 hours hands on between 0-6 months from graduation --pass background check --CPR certification --commitment to NCBTMB standards of practice and code of ethics --commit to opposing human trafficking

Common abbreviations

-CSF: cerebrospinal fluid -CVA: cerebrovascular accident, stroke -DM: diabetes mellitus -DJD: degenerative joint disease -Dx: diagnosis -ext: extract -ft: foot/feet -fx: fracture -GI: gastrointestinal -GU: genitourinary -h (hr): hour -H2O: water -Hx: history

Common abbreviations

-PT: physical therapy -Px: prognosis -R: respiration, right -R/O: rule out -ROM: range of motion -Rx: prescription -SOB: shortness of breath -SP, spir: spirit -Sym: symmetric -T: temperature -TLC: tender loving care -Tx: treatment -URI: upper respiratory infection -WD: well developed -WN: well nourished

Categories of WHO QOL users manual

-Domain 1: physical --pain and discomfort --energy ad fatigue --sleep and rest -Domain 2: psychological --positive feelings --thinking, learning, memory, concentration --self-esteem --body image and appearance --negative feelings -Domain 3: level of independence --mobility --activities of daily living --dependence on medication or treatments --working capacity -Domain 4: social relationships --personal relationships --social support --sexual activity -Domain 5: environment --physical safety and security --home environment --financial resources --health and social care: availability and quality --opportunities for acquiring new information and skills --participation in and opportunities for recreation and leisure --physical environment (pollution/noise/traffic/climate) --transport -Domain 6: spirituality/religion/personal beliefs

Confidentiality of medical records

-HIPAA --pt consent, special considerations, required data elements, id outside parties, fees/charges

HIPAA data storage

-HIPAA declaration that describes the process for management of a client's records available to read --use of client's information --type of storage method used to secure the client's files --situations in which disclosure of information may be required --information on how clients can obtain copies of their records -posted clearly visible to clients

Delivering information with I-messages

-I messages share feelings and concerns -you messages put a person down, blame, criticize, and provoke anger, hurt, embarrassment, and feelings of worthlessness

Common abbreviations

-IBW: ideal body weight -ICT: inflammation of connective tissue -id: the same -L: left, length, lumbar -lig: ligament -M: muscle, meter, myopia -ML: midline -meds: medications -n: normal -NA: nonapplicable -OB: obstetrics -P: pulse -PA: postural analysis -PM (p.m.): afternoon

Scope of practice and regulation

-MTBOK: recommendation -ELAP: infers entry level -MPA recommends -no universal agreement

PIE method

-Problem (issue/intended outcome) -Intervention (type massage/how used) -Evaluation (worked/not worked)

Quality of life

-QOL -broad multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life

Malpractice

-any wrongdoing by a professional -intentional or unintentional

Model Practice Act

-The practice of massage therapy means the manual application of a system of structured touch to the soft tissues of the human body, including but not limited to: 1) assessment, evaluation, or treatment 2) pressure, friction, stroking, rocking, gliding, kneading, percussion or vibration 3) active or passive stretching of the body within the normal anatomic range of motion 4)use of manual methods or mechanical or electrical devices or tools that mimic or enhance the action of human hands 5) use of topical applications such as lubricants, scrubs, or herbal preparations 6) use of hot or cold applications 7) use of hydrotherapy 8) client education

Massage therapy is

-a health care service occupation that embraces professional behavior and development

Dr. John Harvey Kellogg

-a physician from battle creek, Michigan, who used massage and hydrotherapy

The therapeutic alliance

-a way to manage transference and countertransference -developing a trusting relationship through building rapport, establishing a need in client's minds to be actively engaged in self-help activities, and identifying a massage approach and appointment schedule that the client will find beneficial -client-centered approach/client boundaries

Common abbreviations

-abd: abdomen -ADL: activities of daily living -ad lib: as desired -alt dieb: every other day -alt hor: alternate hours -alt noct: alternate nights -AM (a.m.): morning -AMA: against medical advice -ANS: autonomic nervous system -approx: approximately -as tol: as tolerated -BM: bowel movement -BP: blood pressure -Ca: cancer -CC: chief complaint -c/o: complains of -CPR: cardiopulmonary resuscitation

Common root words

-abdomin: abdomen -aden: gland -adren: adrenal gland -angi: vessel -arterio: artery -arthr: joint -broncho: bronchus, bronchi -card, cardi: heart -cephal: head -chondr: cartilage -col: colol -crani: skull -cyan: blue -cyst: bladder, cyst -cyt: cell -derma: skin

Sources of evidence-based/informed practice

-academic journals -massage therapy foundation -research and systemic reviews of research -internet -data from other massage therapist (like case reports) -knowledge gained from experienced massage therapist and other healthcare professionals

Additional terms related to ADA

-accessibility:degree environment allows access -accessibility standards:quality accepted as norm -affirmative action: recruitment of people w/disability -appropriate technology:meets needs of users -augmentative and alternative communication:replace speech and handwriting -assistive device: assistive technology -barriers: factors in environment that limit functioning -capacity: highest level functioning person achieves -communication: various communication formats -condition (primary): main health concern -condition (secondary): additional health concern

Disclosure

-acknowledging any situation that interferes with or affects the professional relationship and informed the client of that situation

Movement methods

-active/passive joint movement -stretching

Regardless of self-employed or employee at entry level

-actual income to therapist's is the same

Hot and cold methods

-adjuncti methods -thermotherapy/cryotherapy, hydrotherapy, hot stones hydrocollator, hot pack, warm pack, cold pack, ice massage, foot bath, ice immersion, paraffin dip

Clients

-all massage recipients

Sexual misconduct

-any type of sexual activity that occurs between the professional and the client -jokes -gray area

Standard of care

-assessment and treatment process that a clinician (like PT) should follow for a certain type of clinical circumstance performed at the level at which similarly qualified practitioners manage the client's care under the same or similar circumstances -best practices guidelines -Massage Therapy Foundation develops process to identify evidence-based/evidence informed practice guidelines

Mechanical approach

-attempts mechanical change in soft tissue

Being laid off

-b/e business was not producing enough income to justify your pay -support employer -letters of recommendations and references -eligible for unemployment benefits -

Abundance, enough, not enough: balance

-balance: as much is need, enough -scarcity: not enough, not without -yin/yang balance -time balance during a massage to reach all body parts -need money reserves (savings) for scarce times -abundance: more than enough -consider future needs and wants and who depends on us (investments grow to produce income)

Adhesions

-bands of scar like tissue that form between 2 surfaces inside the body and cause them to stick together

Client base

-base of clients to support a massage practice requires between 75-100 solid contacts

Needs assessment

-based on client history and a physical assessment is used to devise an initial treatment plan

When communicating feelings

-be specific -define words -open ended questions (when, where, what, how, which) -avoid why questions -use active and reflective listening

Evidence-based practice uses

-best available research -logical, plausibe suppositions (educated guess/hypothesis) -expert opinion consensus (majority experts agree) -practice knowledge based on clinical experience

Anatomic position

-body is erect w/the arms handing at the sides and palms facing forward

Supine position

-body is laying in a horizontal position, facing up

Prone position

-body is lying in a horizontal position, facing down

Skeletal system composed of 3 types of tissue

-bone -cartilage -ligaments

Maintaining the professional environment

-boundaries/space -starts session open/inviting/connecting/moving toward client -end session moves away fm client/pulls in/separates

Career vs job

-career: chosen pursuit, a life's work, evolve -job: regular activity performed for payment

Gratuity record keeping and reporting

-cash/non cash tips are income and subject to federal income taxes -cash tips directly from customers -through electronic settlement/payment -value of non-cash tips like tickets or other items -received from other employees paid out through tip pools or tip splitting arrangements

Clients who arrive on the wrong day

-client mistake: show mistake to them -company mistake: apologize, schedule now if you can or another staff member -need built-in buffer system

Right of refusal

-clients have the right to refuse the massage practitioner's services -at any time -professionals also have the right if justifiable cause exists

Client retention

-clients who receive massages regularly -quality massage, consistent personal attention -exceptional service -affordable fees -word of mouth from happy and educated clients -measurable benefits to goals, understand physiologic reasons for results, safe/professional/ethical environment -common goals: on time, relaxation, pain management, functional mobility, measurable goals, long term plan -proper marketing -scrutinizing ourselves, being honest with skills/appearance/etc

Bursae

-closed sac or saclike structure -close to joint cavities -lining a synovial membrane -lubricate area between skin, tendons, ligaments, or other structures and bones

Basic components of connective tissues and extracellular matrix relative to the understanding of adhesiveness are

-collagens are the most abundant components of extracellular matrix and soft tissues -elastin is another major component of certain soft tissues -fibronectin is a core component of many extracellular matrices (sticky)

Tissues

-collection of specialized cells that perform a special function -histo "tissue" -histology: study of tissue -primary tissues of the body are the epithelial, connective, muscular, and nervous tissues

Organ

-collection of specialized tissues -specific functions, but not act independently of other functions -make up systems (10 systems)

Soft tissues in body are usually

-colloids --solution w/small particles able to remain evenly distributed throughout a fluid

Culture

-combination of a body of knowledge, body of beliefs, body of behavior -personal ID -language -thoughts -communication -actions -customs -beliefs -values -institutions -specific to ethnic, racial, religious, geographic, or social groups

Integrated approaches

-combined methods of various forms of massage

Hallmarks of a successful employee

-commit to career growth; develop excellent employee work ethic, attitude is friendly

Defamation of character

-communication of false information to the 3rd party about a person that results in injury to that person's reputation -verbal or written

Resume

-compilation of professional and personal data about a person -your professional story -cover letter: introduction to the hiring company (who, position, why) -targeted, current

Mandatory ethics

-compliance with the law as the only motivation in ethical behavior

Keeping records

-comprehensive client files, business records, electronic is common, -schedulers, calendars, SOAP note forms, inventory tracking, financial records, etc -money handling with square, google wallet, paypal

Contraindication

-condition or factor that may make an approach harmful -severity: 1) general avoidance of application: do not massage 2) regional/local avoidance of application: perform massage but avoid a particular area 3) application with caution and adaptation, usually requiring supervision from appropriate medical or supervising personnel --perform massage but carefully select the methods to be used, the duration of application, the frequency, and the intensity of the massage

Types of diarthrodial/synovial joints

-condyloid joint-atlantooccipital -ball and socket joint - shoulder/hip -gliding joint - articular processes between vertebrae -saddle joint - carpometacarpal joint of thumb -pivot joint - dens of axis rotation against atlas, head of radius rotating against ulna -hinge joint - elbow

PHI (protected health information)

-confidential, personal, identifiable health information about individuals that is created or received and is transmitted or maintained in any form --name --address --email address --birth date (except the year) --SSN

Informed consent

-consumer protection process -requires clients to be informed of the steps of treatment, that their participation is voluntary, and that the be competent to give consent -an educational process that allows clients to make knowledgable decisions about whether to receive a massage

Body cavities

-contain organs -ventral and dorsal regions -dorsal cavities: cranial cavity, vertebral cavity -ventral cavities: thoracic, abdominal, pelvic cavities -sometimes the abdominal and pelvic cavities are considered as one cavity

Muscular system

-contractile tissue -cardiac, smooth, skeletal muscle -shape/location of muscle, density/pliability of all fluid, fibers and connective tissue of the muscles (muscle tone) -motor tone: nervous system controlling how long or short a muscle is by regulating the degree of muscle fiber contraction

Self-employment status: independent contractor

-contractual form, reviewed by attorney, meets requirements of department of labor -business owner cannot direct work hours, kind of work, what to wear -pd: percentage of every massage (10-50%) (avoid if possible), or practitioner pay monthly rent

The ambiguity of ethics and the concreteness of professionalism and standards of practice

-converge to form a basis for ethical decision making

Therapeutic relationship

-created by the interpersonal structure and professional boundaries between professionals and their clients

Database intake form procedure

-created with info obtained from history-taking interview w/client and other people w/pertinent info, physical assessment, previous records, health care treatment orders -becomes the needs assessment and provides basis for treatment or care plan/contraindications to therapy/assessment or needs for referral

Analysis of data on intake procedure

-critical thinking and clinical reasoning process -same model for decision making

Insurance/3rd party reimbursement

-current insurance payment for massage is uncommon -usually if an employee of a licensed medical professional or of a managed care corporation with access to insurance billing bodes and is working under direct supervision -hourly or salary wage; the physician collects from insurance company -if client collects from insurance company: need prescription for massage, receipt, diagnostic code and description of the procedure: need pre-approval from insurance company -if company bills insurance directly: form 1500 health insurance claim form, uncommon

Market analysis (part of business plan)

-description of industry -survey of competition -description of target market

Qualifiable goals

-determine measures the know a goal has been achieved -like an activity a client can do now but unable to do before

Ida Rolf

-developed Rolfing

Elizabeth Dicke

-developed connective tissue massage

Dr. Milton Trager

-developed the Trager system

Dr. Dolores Kreiger

-developed the therapeutic touch-energetic approach

Effective listening

-development of focusing skills -no response needed

Company overview (part of business plan)

-different parts of business will work together -reasons this is successful

Advantages and disadvantages of employment by others

-disadvantages: adherence to business rules/regulations, less flexibility in scheduling, other employees behavior, share workspace -advantages: not responsible for business concerns, focus on clients, government protections, support/mentoring, paid vacations/benefits, stable income, pay increases

Disability terms

-disfigurement: trauma, disease, congenital conditions -down syndrome: chromosomal disorder -HIV/AIDS:disease of immune system -Intellectual disability: intellectual limitations -learning disability: neurological condition -postpolio syndrome:polio post issues -psychiatric disability: psychological conditions -seizure: involuntary muscle contraction

Dr. James B. Mennell

-divided the effects of massage into 2 categories --mechanical actions --reflex actions

Model Practice Act

-document that can be adopted by states as an example for developing legislation

Voluntary verification

-does not necessarily require a specific education; other forms of verification acceptable -does not provide title protection

Conflict resolution

-does not resolve tensions -align tensions between people to get them back to their goals

Creep

-due to constant stress over an extended period applied to a viscoelastic material

Common root words

-duoden: duodenum -encephal: brain -enter: intestines -fibro: fiber, fibrous -gastr: stomach -gyn, gyne, gyneco: female -hem, hema, hemo, hemat: blood -hepat: liver -hydr: water -hyster: uterus -ile, ili: ileum -laryng: larynx -mamm: breast, mammary gland -my: muscle -myel: spinal cord, bone marrow -nephr: kidney -neur: nerve

Common prefixes

-dys: bad, difficult, abnormal -ecto: inner, inside -en: in, into, within -endo: inner, inside -epi: over, on -eryth: red -ex: out, out of, from, away from -hemi: half -hyper: excessive, too much, high -hypo: under, decreased, less than normal -in: in, into, within, not -inter: between -intra: within

Choosing a business location

-each community has specific zoning regulations -visit local government offices and get this zoning ordinances -show licenses as proof

Managing intimacy issues

-educate clients -evaluate personal feelings -refuse treatment as needed -if client asks for sex-you can call police -pair up if going into homes -do not lock doors-put sign instead -safe touch (not apt to cause danger, harm or hurt; free of risk) -deal w/personal issues b/4 dealing w/client

Physical assessment on intake procedure

-effective and functioning deviations from the norm: visual/functional/palpation/manual testing assessments

Cartilage of skeletal system: white fibrocartilage

-elastic, flexible, tough, interarticular fibrocartilage found in joints (like the knee) -slightly mobile -between vertebrae (disks) -between pubic bones (symphysis pubis)

Fee discounts

-entice new customers, encourage referrals, reward client loyalty, modulate fees based on income or need -package deal, discount booking weekly appt, sliding fee based on client's income, -discounting is a way for low and higher income groups to afford

Use evidence to

-explain and justify your reasons for a decision -help you choose among different approaches -explain what the research says about massage services a client is receiving -raise your awareness about a condition or illness

Cultural competence

-exploring one's own culture and a sincere curiosity about other cultures to develop the ability to interact genuinely and respectfully with others -multicultural to all humans and cultures

Normalizing body systems by

-external manual stimulation of the nervous, circulatory, and respiratory systems, connective tissue, and muscles to achieve --generalized stress reduction --decrease in muscle tension --symptomatic relief of pain related to soft tissue dysfunction -other benefits similar to those of exercise -other relaxation responses produced by therapeutic massage to increase the clients well-being

Massage therapist must be able to

-find, read, analyze research (research literature) -analyze the accuracy of clinically based evidence of massage benefit when research is not able to validate fully the massage result -use clinical reasoning to apply the information to massage practice -apply information derived from clinical reasoning process to develop outcome-based massage sessions -justify decisions related to indications and contraindications to massage applications for individual clients -address each client in a client-centered manner, individualizing the massage for the individual client based on valid evidence

Therapeutic intention

-focus on client and goal centered interactions -centeredness (attentiveness, palpation skills, confidence, continuity in contact)

Internal marketing ideas

-follow-up calls -invite openness -clean/attractive office -discussion of problems -staff identification -staff interrelations -staff enthusiasm -timely correspondence -thorough presentations -bouquets to clients -theme open house -telephone manners -professional appearance/un-rushed competency

Friction

-force that acts in an opposite direction to movement -force that holds back the movement of a sliding object -tissue or push or pulled (using lubricant)

Tissue load

-forces load soft tissues during massage application -creates stress in tissues -strain (change in shape of tissues may not respond as desired): too much = damage, too little=no change

Internal force

-forces that create loads on soft tissue -like misaligned joints or poor body mechanics cause soft tissue to shorten, tighten, lengthen, and/or weaken, which may load surrounding tissues -i.e. tight muscle or tendon compress a nerve or cause pain/disfunction, or overeating

External forces

-forces that create loads on soft tissue by pushing or pulling on the body in a variety of ways -i.e. belt on your waist, gravity, massage

Credentials

-form of official verification, earned by completing an educational or examination process that confirms a certain level of expertise in a given skill -only required is ones specified by government agency -others are voluntary -500-1000 hours for entry level

4 important developments in massage profession since 2010

-formation of the Coalition of National Massage Therapy Organizations -the Coalition of National Massage Therapy Organizations working together to fund and support the Massage Therapy Body of Knowledge (MTBOK) and the Entry-Level Analysis Project (ELAP) -The Federation of State Massage Boards development of a Model Practice Act (MPA and agreement with the National Certification Board for the MBLEX to be the only licensing examination -National Certification Board for Therapeutic Massage and Bodywork validating credentialing of massage practice beyond licensure through Board Certification

ECA (The Bureau of Educational and Cultural Affairs)

-fosters mutual understanding between US and other countries to promote friendly and peaceful relations -academic, cultural, sports and professional exchanges

Wilhelm Reich

-founded psychotherapeutic body techniques

Client autonomy and self-determination

-freedom to decide -the right to sufficient information to make the decision

Types of movement permitted by diarthrodial joints

-freely movable joints -flexion, extension, abduction, adduction, pronation, supination, eversion, inversion, plantar flexion, dorsiflexion, rotation, circumduction, protraction, retraction, elevation, depression, opposition

Home-based business

-investigate local government, neighborhood associations, rental agreements for limitations or code regulations for home offices -some lease to save costs -refer to lawyers, insurance agents, accountants for advisement -other issues: business demand from home space, family needs, management plan for household, integrating family and business space needs

ANS

-involuntary -sympathetic division (feelings): thoracolumbar division -parasympathetic division: craniosacral division -autonomic plexus: intertwined plexus

Reflex

-involuntary body response to stimuli -cross-extension -extensor thrust -flexor withdrawal -gait -intersegmental -monosynaptic -nociceptive -optical righting -ocular pelvic -pilomotor -psychogalvanic -postural -proprioceptive -righting -startle -stretch -tendon -tonic neck -vasomotor -visceromotor reflexes

Supervision

-involves a person who overseas others and their professional behavior -may be from different disciplines or one who has more skill and experience than those supervised -position of authority -actively involved in such areas as --development and approval of treatment plans, review of clarity, scheduling, discipline and teaching

Motivation points

-know thyself (core values) -follow your dream (desire/motivation) -accept that experience is the best teacher (mistakes/successes) -ask "what's in it for me?" (benefits gained from process) -recognize that self-concept matters (self-esteem/who we are not what others want us to be) -believe in your product (understand/explain benefits) -provide a quality product (skilled )

Raises in pay

-know you deserve it first, 2 way discussion, set appointment, rehearse before hand, be aggressive as needed, keep confidential

Seeking help

-know your strengths (use them) -recognize weaknesses (limitations, hire out as needed) -chamber of commerce and small business organization offers free services

Self-employment status: sole proprietor

-least expensive -mobile/one site in private homes, offices -start up costs under $5,000 -table, cards/brochures, electronics, membership with professional organizations, insurance, supplies, bank account, website, advertising, location (place)

Standard of living

-level of wealth, comfort, material goods, and necessities available to a certain socioeconomic class in a certain geographic area -income, quality/availability of employment, class disparity, poverty rate, hours of work required to purchase necessities, gross domestic product, inflation rate

Cultural humility

-lifelong commitment to self-evaluation and self-critique of the power imbalances in the client and massage therapist therapeutic relationship related to diversity -value client's cultural beliefs & recognize complexity in language interpretation

Lawsuits

-litigation -negligence -good samaritan law -malpractice -defamation of character -invasion of privacy -computer security -fraud

Opening business banking accounts

-local bank -DBA is required -business cc -automatic payments for bills

Setting fees

-look at what others are charging for same service; set a mid-range -coupons not always good -$25-$30 for 30 min massage/$40-$70 for 1 hour massage -10 min pre and post massage procedures -$1 per minute for 30 min massage -urban areas are higher than rural areas -calculate average hourly wage of people in target market and multiply it by 3

Massage and body work

-massage therapy is a bodywork system by the MPA -not all bodywork systems are massage --some somatic practices (like shiatsu and structural integration have separately developed systems and philosophies, scopes of practice and educational requirements) -outcomes are similar: relaxation, stress management, pain management, support for mobility and physical performance -

Exemptions

-means that a practitioner is not required to comply with an existing local or state regulation -excuses practitioners who meet specified educational requirements from meeting current regulatory requirements -does not provide title protection

Quantifiable goals

-measurable in terms of objective criteria; such as time, frequency, rating 1-10 scale, measurable increase or decrease in ability to perform an activity, or a measurable increase or decrease in a sensation (like relaxation or pain)

Common suffixes

-megaly: enlargement -oma: tumor -osis: condition -pathy: disease -penia: lack, deficiency -phasia: speaking -phobia: exaggerated fear -plasty: surgical repair or reshaping -plegia: paralysis -rrhage, rrhagia: excessive flow -rrhea: profuse flow, discharge -scope: examination using a scope -scopy: examination using a scope -stasis: maintenance, maintaining a constant level -stomy, ostomy: creation of an opening -tomy, otomy: incision, cutting into -uria: condition of the urine

Membership models

-member fee and non-member fee -common in franchise-based -monthly fee automatically withdrawn on a cc includes 1 hour session then discounts on massage services received that month

Mentor/supervision/peer support

-mentor (concerned with successful career growth) -supervision (periodic review in work setting) -peer support (format for discussion, brainstorming, reflection

Energetic approaches

-methods of bodywork that focus on subtle body responses

Applied kinesiology

-methods of evaluation and adaptation that use an application of muscle testing, along with various forms of massage, for corrective procedures

Structural and postural integration approaches

-methods of massage derived from biomechanics, postural alignment, and the importance of the connective tissue structures

Executive summary (part of business plan)

-most important part -devised last -mission statement, locations, services, market summary, number of employees, etc -focus of proposed massage business/expertise/competitive edge in market

Disability (ADA definition)

-physical or mental impairment that substantially limits one or more major life activities -functional limitation that interferes with a person's ability

Value

-most professionals underestimate value of their service -equity hypothesis: people usually live according to an equal exchange for services rendered or for goods received -do a reality check on income potential and fees -average massage is $50 to $70 a session ($1200-$1680 per year) -value is measured in more than income -satisfaction received from helping someone is also a measure of value

Brochure (primary tool for education)

-nature of services provided -description of services offered (plus draping, touching procedures) -qualifications of practitioner (include license number) -client's financial and time investment (costs, temporary effects, best results consistently, self-help) -clients role in health care (client's responsibility)

Countertransference fed by

-need to fix people -need to remove pain and discomfort -need to be perfect -need to have the answer -need to be loved

Need vs want

-need: necessary for life, food, etc -want: sense of satisfaction, not needed

Needs vs wants

-needs sustain life -wants lead to sense of satisfaction

Ronald Melzack

-neuromatrix theory of pain

Persons unable to provide informed consent

-non-gray area: freshman high school learner, 24 year old developmentally disabled client, an elderly client with dementia, terminally ill hospice client -gray area: elderly client living alone, 30 year old woman (victim of a closed head injury who communicates with a computer), client who does not speak english (no interpreter present), client under the influence of alcohol

Wellness personal service massage

-nonspecific approach to massage that focuses on assessment for the purposes of detecting contraindications to massage or a need for referral to other health care professionals -also for developing a health-enhancing physical state for the client

Sexual harassment

-occurs in the work setting between peers or with supervisors -unwelcome sexual interaction (physical/verbal) in conjunction with employment status or work environment constitutes sexual harassment -by law

Common root words

-ocul: eye -orth: straight, normal, correct -oste: bone -ot: ear -ped: child, foot -pharyng: pharynx -phelb: vein -pnea: breathing, respiration -pneum: lung, air, gas -proct: rectum -psych: mind -pulm: lung -py: pus -rect: rectum

External marketing ideas

-office tours -lectures -directories -building sign -business cards -greeting cards -media advertising -open house -website -newsletter

Social media

-online platforms that sites that provide a way for people to connect and share content with friends and like-minded people -facebook, twitter, link-in, google, -lines are blurred-stay professional

Bone

-os, ossa, oste, osteo=bone -206 bones -dense connective tissue, calcium/phosphate

MTBOK

-our profession is massage therapy; we are massage therapist -massage therapy is a health care and wellness profession -the practice of massage therapy involves a client/patient-centered session intended to fulfill therapeutic goals, with the therapist being free of personal agenda -massage therapy also meets the well-researched need for touch and human connection -massage therapy is about one human touching another with clear intention, focused attention, and the attitudes of compassion and nonjudgement

Common ground

-overlapping interests -interdependence -points of agreement -starting point for conflict resolution

Employed incomes

-owners responsible for paying income taxes -less profit margin; about 5-20% -volume to offset costs -flat fee or percentage fee (commission based): pd each massage and hourly wage for when not massaging

Therapeutic edge

-particular pace and depth and intensity of work for hte specific client that allows for achieving outcomes -place where client feels the good hurt or therapeutic discomfort -technique feels closest to the limit but the client also feels that the tissue is changing in a positive way and the stroke feels appropriate and satisfying

Forms/styles

-particular procedure or cultural approach used to do massage and bodywork -swedish/classical massage, craniosacral therapy, reflexology, manual lymphatic drainage, esalen massage, seated massage, lomi lomi, russian massage, ayurvedic massage, thai massage, tuina

Generating income

-payment received for a service or product -gross income: income generated from the sale of products and services -net income: all bill paid for relating to managing business, remaining amount -self employed: pay income taxes on profit -company: takes out money from wages to pay for taxes -to mx stable business structure, the company needs a profit margin of at least 15% of gross revenue

Patients

-people who receive medical care or treatment

Negligence

-performance of an act that a reasonably careful person under similar circumstances would not do or the failure to perform an act that reasonably careful person would do under similar circumstances -action of omission or commission -breach of duty -injury to client

Boundary

-personal space located within an arm's length perimeter -personal emotional space designated by morals, values, and experience

Transference

-personalization of the professional relationship by the client

Body-Mind-Spirit Connection

-physical body functions: feelings, anatomy, physiology -cognitive process: interprets physical sensations/sets physical responses in motion -emotions: result of interplay between body and mind -behavior: action results from physical-emotional-cognitive combo -spirit: strength/hope/faith/love to create a reason for being -multidisciplinary approach with other professionals

Boundaries

-physical boundary (personal space w/in an arm's length perimeter, by morals/values/experience) -until invited to come closer -personal space (arm in front then in a circle) -setting limits -discussed in initial informed consent procedures and writing policy statement

Defensive climate

-reflects the type of atmosphere characteristic of competition; inhibits mutual trust)

Factors of well-being

-physical well-being -economic well-being -social well-being -emotional well-being -psychological well-being -life satisfaction -engaging activities and work -life satisfaction -engaging activities and work -longevity -healthy behaviors -mental and physical illness -social connectedness -productivity

Joints

-places where bones come together where limbs are attached and where the motion of the skeletal system occurs -rigid, flexible -allow motion of the musculoskeletal system, bear weight, and hold skeleton together

Time management

-planning/scheduling work and avoiding wasting time -waste time by: failing to plan/budget time, giving in to interruptions, failing to follow through and complete a task, slowness in reading and making decisions, performing unnecessary work, and failure to delegate -evaluate: recording the way you spend your time; analyzing how you spend your time; determining which activities can be adjusted to make you more effective -to do: discipline for scheduling your activities, organize individual tasks, mx daily schedules, analyze daily tasks, schedule major projects, establish deadlines, organize workflow

Wellness and personal services

-pleasure/relaxation/general health mx -education/massage methods to encourage normal self-regulating mechanisms of the mind and body -giving recommendations only -key goal is to enhance the client's health or to provide massage for individuals who are currently healthy and want to mx or improve their health -manage stress -scope of practice: nonspecific approach focusing on assessment procedures for detecting contraindications to massage , referral as needed, development of a health-enhancing physical state for client

Force has a vector quality - 3 variables

-point of application (where) -magnitude (intensity) -direction (in relationship to tissues)

Business USA at https://businessusa.gov/

-portal to all the government has to offer for assistance in career and business development and designed by businesses for businesses. -this site has a wizard feature to help with goal setting and business decisions

Common prefixes

-post: after, behind -pre: before, in front of, prior to -pro: before, in front of -re: again -retro: backward -semi: half -sub: under -super: above, over excess -supra: above, over -trans: across -uni: one

Proportionality

-principle that benefit must outweigh the burden of treatment

Justice

-principle that ensures equality among clients

Confidentiality

-principle that the client's information is private and belongs to the client -built on respect and trust -client signs release of info form to exchange info to others

Nonmaleficence

-principle that the profession shall do no harm -prevent harm from happening

Beneficence

-principle that treatment should contribute to the client's well-being

Standards of practice

-principles that serve as a specific guideline for directing professional ethical practice and quality care --including a structure for evaluating the quality of care -an attempt to define the parameters of quality care

Arranging for insurance

-professional liability insurance (malpractice insurance) --reduces risk of a liability claim --accurate/comprehensive records are next best protection --through professional organizations -premise liability insurance (trip/fall insurance) --from professional organizations --from local insurance agent --business rider is needed on insurance -product liability insurance --selling products -independent contractor liability insurance (3rd party claims)

Obtaining licenses

-professional licenses (achieved skills to practice profession) -business licenses (from local government, allows government body to regulate the types and locations of business operations)

Mentoring

-professional relationship in which an individual with experience and skill beyond those of the person being mentored provides support, encouragement, and career expertise

Developing a client-practitioner agreement and policy statement

-professional rules for the client; policies; comprehensive -part of comprehensive than the marketing brochure and informed consent process -clarifies nature of service; help protect against unwarranted and unrealistic client expectation; serve the practitioner as a constant reinforcement of the scope and limits of his or her practice within acceptable legal parameters; serves a a valuable factual tool if required in court action

Adhesiveness

-property of sticking together

Per Henry Ling

-proposed an integrated program of active and passive movements based on Swedish gymnastics

Laws and legislation

-protect the safety and welfare of the public -not to protect small groups

Compression

-pushes or presses soft tissue; shorter/thicker -2 pushing forces opposite of each other that squeeze or press an object and try to squash it -gravity can create compressive stress

People first language

-puts the person first instead of his/her disability -objective description instead of a label

Additional terms related to ADA

-reasonable accommodation: modifications for those with disabilities -rehabilitation: measures to mx optimal functioning -sign language interpreter: interprets info -specific learning disability: impairments info processing -speech and language therapy:restores communication capabilities -universal design: environments usable by all people

Business transactions

-record of gross income -income taxes paid quarterly on net income -avoid using cash for business expenses -business cc -organized monthly

Supportive climate

-reflects collaboration -leads to mutual trust -document as needed

Business name

-reflects intention of business -appeals to you and client focus -comforting/familiar -short, descriptive, concise, easy to pronounce/remember -imagine it on a business card/advertisements -logo -avoid: embarrassing, misspellings, abbreviations, implied associations -secure/protect the name with the law offices in the area

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

-requires that the transactions of all patient health care information be formatted in a standardized electronic style -protects privacy and security of patient information -legislation on the formation of medical savings accounts, authorization of a fraud and abuse control program, the easy transport of health insurance coverage and the simplification of administrative terms and conditions

ELAP

-research project initiated by the Coalition of the National Massage Therapy Organizations in March 2012 -goals: define knowledge and skill components and entry level education and recommend the minimum number of hours schools should teach to prepare graduates for safe and competent practice in the massage profession -completed in December 2013 -published 2 documents: The Core: Entry-level Analysis Project Report (final report) and The Core: Entry-Level Massage Education Blueprint (the Blueprint) -website : elapmessage.org

Immune system

-resist organisms or toxins that can damage tissues and organs -immunity -terms: acquired immunity, acquired immnodeficiency, active immunity, allergy, antigen, suspectible

Ethical principles

-respect -client autonomy and self-determination -veracity -proportionality -nonmaleficence -beneficence -confidentiality -justice -direct development of standards of practice

Ethical principles

-respect for the dignity of people -responsible caring -integrity in relationships -responsibility to society

U.S. Equal Employment Opportunity Commission at http://www.eeoc.gov

-responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee b/c of a person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information

Dual role

-results when scopes of practice overlap --i.e. when professional provides support in more than one area of expertise -or the personal and professional relationships overlap

Lymphatic system

-returns vital substances to bloodstream from tissues of body (help from interstitial fluid) -mx fluid balance by draining fluid from body tissues -aids in body's defense against disease-producing substances -aids in fat absorption from digestive system

Ownership information (part of business plan)

-review subjects -owners names, percentage of ownership, owner influence

Common root words

-rhin: nose -sten: narrow, constriction -stern: sternum -stomat: mouth -therm: heat -thromb: clot, thrombus -thyr: thyroid -toxic: poison, poisonous -trache: trachea -ur: urine, urinary tract, urination -urethr: urthra -urin: urine -uter: uterus -vas: blood vessel, vas deferens -ven: vein -vertebr: spine, vertebrae

Ethical behavior

-right and correct conduct based on moral and cultural standards as defined by the society in which we live

Receprocity

-right of exchange of privileges between governing bodies -accept different state's license -not common practice

Veracity

-right to the objective truth

Quadrants of abdomen

-right upper quadrant -right lower quadrant -left upper quadrant -left lower quadrant

Computer security

-safeguards that are implemented to prevent and detect unauthorized access or deliberate damage to a computer system and data

Scheduling for productivity

-scheduling for productivity (up to 5 sessions per day with good body mechanics; up to 50 business hours for single massage therapist for full time per week allowing for buffer times

Ethics

-science or study of morals, values, and principles, including the ideals of autonomy, beneficence and justice -compares principles of right and good conduct

Therapeutic massage

-scientific art and discipline involving assessment and the systematic, external application of touch to the superficial soft tissue of the skin, muscles, tendons, ligaments, and fascia and to the structures that lie in the superficial tissue -methods of touch including stroking (effleurage), friction, vibration, percussion, kneading (petrissage), stretching, compression, passive and active joint movements within the normal physiologic range of motion and adjunctive applications of water, heat, and cold

Limits of practice

-scope of practice -personal limits -set/mx boundaries

Safe touch

-secure, respectful, considerate, sensitive, responsive, sympathetic, supportive and empathetic contact

Independent contractor

-self employed but working on a contracted basis -only for work performed, less risky to business owner -avoid if possible -business would need to make a profit to work

Palpatory sensations

-sensations that signal soft tissue is changing -knowledge that informs touch, like ability to name body landmarks in a particular region -kinesthetic discrimination skills, or the ability to sense, feel, and interpret normal and altered qualities of the body's tissues (like temp, texture, fiber direction, density, depth, hydration, and tone -communication skills (terminology/name sensations)

Abbreviations

-shortened form of a word or phrase -in writing

The most rapid expansion of employment opportunities is

-spa and franchise settings

Home operations/business

-special restrictions from local governments -service oriented (not retail) -special permit

Professionalism (ELAP) characteristics)

-specialized body of knowledge -extensive training -an orientation toward service -commonly accepted code of ethics -legal recognition through licensure -verification of advance training with Board certification -membership in a professional association

Standards of practice

-specific guidelines and rules that form a concrete professional structure -direct quality care and means of measuring the quality of care -more concrete than ethical principles

Self-employed incomes

-spending 30-50% gross income of business on overhead expenses -setting aside 1/3 of net income to pay income taxes -1 hour massage requires 30-60 minutes of business management time -giving two one-hour massage sessions is at least 40 hrs of work per week: 50% profit gross income

CareerOneStop at http://www.careeronestop.org

-sponsored by the US Department of Labor, Employment and Training Administration, and has detailed information and templates on resumes, cover letters and interviewing skills

Ethics

-standards, ideals, morals, values, and principles of honorable decent, fair, responsible, and proper conduct

Guidelines for setting goals

-state in present tense: I, me, my -realistic and attainable: resources, others help -speak positively: active words -target deadlines -small steps toward ultimate plan

Using clinical reasoning model to set goals

-step 1: gather facts to identify and define the situation (outcome, facts, mission) -step 2: brainstorm possible goals (do, what if's, possibilities, intuition) -step 3: evaluate each possible goals identified in step 2 objectively (pros/cons, what if's, consequences of acting/not acting, what would/could happen) -step 4: evaluate the effect of each possible goal on the people involved (how, effect on others, feelings) -step 5: choose a goals and develop an implementation plan after carefully processing steps 1-4 -step 6: implement the plan and set a date for re-evaluation (set subgoals; SMART identify each one in acronym)

Gliding methods

-stroking -swedish/classical effleurage --a stroke applied in a smooth, continuous motion that does not lose contact with the client's skin

Conflict

-struggle between 2 parties who perceive incompatible goals, scarce resources, and or interference from the other party in achieving their goals

Plastic

-substances soft enough to be molded yet capable of hardening into the desired foxed form

Respiratory system

-supplies O2 to and removes CO2 from cells of the body -external/internal respiration

FSMTB (Federation of State Message Therapy Boards)

-support members to ensure massage therapy is provided to the public in a safe, effective manner -developed examination for state licensing -launched in 2007 -2014-created MBLEx -2014 released the Model Practice Act

Dual or Multiple roles

-supports more than one area of expertise or when personal relationships overlap with professional services

Social Security Administration (SSA) at www.socialsecurity.gov

-supports various funding tools for self-employment, impariment-related work expenses blind work expense, and self-employment subsidy

Massage in the western world

-systems based on lines and points

Percussive methods

-tapping -hacking -cupping -slapping -beating -pounding -clapping

Cover letters

-targeted to a specific employer -investigate company/vision/mission/organization/leadership -use action verbs/skills/abilities -1/2 to 3/4 page -first introduction to employer -true/honest

Business plan

-teaches you about the details required to finance, own, operate, and succeed in business -better employee with understanding of employer -good resource is the SBA (small business association) -SBA (independent of US government; help build small businesses, free advice) -good resource is SCORE (service corps of retired executives): free advice

Jurisprudence examination

-test taken to demonstrate knowledge of a specific piece of legislation --such as massage therapy law

USA.gov at http://www.usa.gov/

-the US governments official web portal makes it easy for the public to get US government information and services on the web

Ethical decision making

-the application of ethical principles and professional skills to determine appropriate behavior and resolve ethical dilemmas

Evidence-based practice

-the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients -documented scientific evidence -allows for innovation while incorporating the lessons learned from the existing research literature

Pressure is determined by

-the contact area -large broad contact, like foramen, will distribute the force and pressure will be more comfortable than pressure applied with a narrow contact (like the tip of finger or elbow) -small contact area force application, more specific and apt to cause injury and pain sensations

Newtons 2nd law of motion

-the effect (acceleration) on the smaller mass will be greater (more noticeable)

Massage (ELAP definition)

-the ethical and professional application of structured, therapeutic touch to benefit soft tissue health, movement, posture, and neurologic patterns

Peer support

-the interaction among those of similar skill and experience to encourage and maintain appropriate professional practice.

Right of refusal

-the right of both client and the professional to stop a session

Scope of practice

-the when, where, and how a professional may provide a service or function as a professional

Title options

-therapist -technician -practitioner

Client communicate perceptions about massage with therapists

-therapist assist the client in describing what is expected during massage

Massage therapy and intimacy

-therapy is sensory stimulation -may be intimate -may be construed as sexual -alter approach/pattern of massage to diffuse sexual energy -keep discussion light, change topic change environment -mx professional space and monitor personal feelings -communicate with client

Description of management and organization of staff (part of business plan)

-who you will hire -who will be in charge of certain duties and why

Decisions

-though-out responses based on principles, information, and the complexities of the situation --define situation/problem --consider facts --generate possible solutions/courses of actions --evaluate logical consequences of cause/effect (pros/cons) and the effect on people of each of the potential solutions or course of action --make a decision

Barriers to effective communication

-time -old patterns -avoidance -language and culture

Soft tissue deformation

-tissue changes shape -internal forces in material oppose the applied force -too much=permanent (break/strain -depends on: stiff/pliable, time/how long applied, temperature, type of load

Orientation of service

-to meet a need

Resignation

-to your advantage; ethically -person who voluntarily leaves suitable work without good cause attributable to the employer is not eligible for unemployment benefits (wages/hrs/working conditions of job) -only if you took reasonable steps to inform employer of your dissatisfaction and sought to remedy the problem before you left can you get benefits -reason, notice, letter plus verbal, confidential, keep negative there, ethical for clients to follow you -non-compete agreement (avoid if possible)

License

-type of credential required by law as a means of regulating the practice of a profession to protect the health, safety, and welfare of the public

NCES education categories

-undergraduate majors: academic or career majors -federal law defines vocational education as instruction for careers below the baccalaureate level -at the baccalaureate level, career majors are considered profession (nonvocational) -at the sub-baccalaureate level, they are considered vocational

Unemployment benefits qualifications

-unemployed at no fault of your own -physically/mentally able to work full time -actively seeking work by making reasonable efforts to find employment each week

ELAP bluprint

-use of interactive lectures, written activities, discussions, peer work, demonstrations, structured hands-on practice time, role-playing, written session planning, and simulations of massage and bodywork sessions as primary methods to move learners from point A (student) to point B (ready to work)

Conflict resolution

-use of mediation, negotiation, and communication skills

Burnout

-use up your energy faster than you can replenish it -motivation is lost -reasons: physical fatigue/injury, financial strain, emotional stress -reduce: take care of yourself, family/friends/continuing education, hobbies, live life with a purpose

Followers of Johann Mezger

-used french terms like effleurage and petrissage

Ambrose Pare

-used massage for joint stiffness and wound healing after surgery

Health care and sports massage services

-verified through the Board Certification by NCBTMB -works with PT, athletic trainers, etc -specific athletic training protocols: --develop, mx, rehabilitate, or augment physical function, relieve or prevent physical dysfunction and pain, and enhance the well-being of the client -methods: --assessment of soft tissue/ joints, treatment by soft tissue manipulation, hydrotherapy, remedial exercise program, client self-care programs -wellness: do not work with sick/injured unless directly supervised by licensed and qualified professions (pt, etc), they prevent more serious illnesses -respect other professional's strengths

Oscillating methods

-vibration -rocking -jostling -shaking

Categories of records

-vital records (can't be replaced, financial, insurance policies, tax stuff, in fireproof box) -important records (valuable to office, invoices, checks inventory, payroll records, tax audit stuff, mx 5-7 years) -useful records (employment applications, expired insurance policies, petty cash vouches, bank reconciliations, etc, kept 1-3 years) -unimportant records (notes, reminders, outdated announcements, pamphlets, discard)

Essential touch

-vital, fundamental, and primary touch that is crucial to well being.

Massage therapy

-vocational level: diploma or certificate an associates degree is available -college credits toward an associates/bachelor's degree -some combine higher degrees with massage therapy to function in the health and athletic worlds

Living wage

-wage needed to cover basic family expenses (basic needs budget) plus all relevant taxes -more than minimum wage -market based approach that draws on geographically specific data related to a family's likely minimum basic necessities costs -decent standard of living -living wage calculator: http://livingwage.mit.edu//

Quality of touch

-warm, soft, dry, open, confident hands/forearms that sink into the tissue at just the right depth; continuity of massage sequence

Approaches

-way of thinking and problem solving during a massage -wellness/relaxation approaches, clinical/treatment-oriented approaches, myofascial approaches, movement approaches, psychological mind-body approaches, energetic approaches, eastern approaches

Without a common language

-we cannot communicate

Internal Revenue Service at http://www.irs.gov/

-website has tax information also much more helpful content

Massage therapy practice settings

-wellness --spa setting --massage franchise/national massage chains --independent massage practice -health care --sports and fitness setting --clinical/medical/rehabilitation setting

Kernels of truth from most motivational sources

-whatever we believe (w/emotion and feeling) becomes our reality -what we do with confidence can become our self-fulfilling prophecy -we attract into ur lives that which harmonize with our dominant thoughts

Unemployment benefits

-when leaving an employment position -laid off, fired, quit -if no fault on your own part

The business career plan

-where are you now, what path were you on, what have you learned from experiences: foundation for future plans -find and fill a need

Database intake procedure basic questions

-will you please explain the situation or tell me what happened -how did/do you feel about the situation -what has been the result of the situation in terms of costs, limitations, and changes in activity or performance -how would you prefer the situation to be or what would you like to occur

Variety in massage/bodywork application

-work in layers -engage the interest of the client -muscles in particular areas respond better to certain methods and techniques -reduces stress on therapists body via overly repetitive motions

Dovetailing

-working a 2nd client into the schedule during another scheduled client's treatment -not for massage therapist

You will achieve confidence with professional decision making when

-you learn to recognize, develop, and trust inspiration, intention, and intuition

Possible sequence for obtaining informed consent

1) general explanation of massage, supported by written information (in form of brochure) about indications, benefits, contraindications, and alternative approaches that provide benefits similar to those of massage 2) informs client about the scope of practice for massage; reporting measures for professional misconduct and recourse policies; the professional's training, experience, and credentials; and any limiting factors that may affect the professional relationship, including lack of training in a particular area and any special circumstances of the massage professional that may need to be considered (covered in a brochure) 3) discusses business and professional policies and procedures, including the logical consequences of noncompliance by the client (including payments, scheduling, sexual impropriety, draping, hygiene, confidentiality) 4) client signs an informed consent form

Healthy people 2020 4 goals

1)attain high-quality, longer lives free of preventable disease, disability, injury, and premature death 2)achieve health equity, eliminate disparities, and improve the health of all groups 3) create social and physical environments that promote good health for all 4) promote quality of life, healthy development, and healthy behaviors across all life stages