PD 200 - Review

Scope of Practice:

"A registrant may practice massage therapy" "massage therapy" means the health profession in which a person provides, for the purposes of developing, maintaining, rehabilitating or augmenting physical function, or relieving pain or promoting health, the services of: (a) Assessment of soft tissue and joints of the body, and (b) Treatment and prevention of physical dysfunction, injury, pain and disorders of soft tissue and joints of the body by manipulation, mobilization and other manual methods.

what is the GST threshold amount?

$30,000 per year

What is the cost for a medico-legal: Fact-Only report?

$410

What is the cost for a medico-legal: Fact and Opinion report?

$750

A Corporation can claim capital gains once in a lifetime for how much?

$750,000

What is the cost for a medico-legal: *Progress* report?

$80 non-ICBC $46 (ICBC)

The Ethical Code of Conduct states: "A registrant shall not refuse to treat a patient unless the patient's condition renders the treatment":

(UUN) *1. Unsafe* *2. Unnecessary* *3. Not Beneficial*

*What is the most important question you can ask a client?*

*"Have you ever had a massage before?"* Pt will be basing their opinion of you on the 1st Tx. Framework must be perfect.

What are the 5 conflict styles?

*(CAACC)* -Competing/directing -Avoiding -Accomodating/harmonizing -Compromising -Collaborating/cooperation

which provinces is RMT regulated in Canada?

*1. BC* *2. Ontario* *3. New Brunswick* *4. Newfoundland/Labrador* Applied for regulation: Manitoba

-Logistics which help define our work as a professional -Describes the way therapists organize their practices -Creates trust -Sets boundaries -Creates stability

*Framework* (Office setup, Fee schedule, Cancellation policies, Music, Environment, Professionalism, Length of a session, Website, etc...)

Can an RMT advertise "specialization" in a certain treatment?

*NO* But they can say "preferred area of practice" if there is a certain technique or condition they have advanced training in. 78.9 (2): http://www.cmtbc.ca/legislation-bylaws/cmtbc-bylaws

Does a therapist have to get permission from an infants parents/guardian instead of an infant?

*NO* infant can give their own consent as long as the therapist determines they are capable of understanding the risks and benefits

If an infant makes their own decisions and the therapist has determined they are capable of understanding the risks and benefits, can the therapist give access to the infant's records, to the parents/guardian?

*NO* infant is protected under the same privacy regulations as an adult. Infant would have to give permission (should be written/signed permission at that point)

When in conflict with a client what 3 things must be done?

-*Identify* the conflict to the client -*Resolve* (to the best of your abiity) the conflict -*Document* the conflict

Elements of the Therapeutic Relationship:

-Addressing a client professionally (Mr. Mrs. Dr.) -Active listening/ non-judgemental -Client centred approach to Tx goals -Aware of anything inappropriate in a therapeutic relationship -Obtaining informed consent to Tx -Adhering to privacy regulation -Reflecting on your own client interactions

Conflict communication skills:

-Clarifying & Questioning -Paraphrasing -Acknowledging feelings -Empathizing -Summarizing Use: -I Language -Descriptive language

the act of undermining a person's free will through the control of behaviour, information, thoughts, and emotions.

Mind control (Psychological) abuse

How does the CMT feel about discount coupons?

-It is allowed -Must comply with By-Laws regarding advertising -Can only give a receipt to a person who pays *and receives* Tx. If coupon was a gift, cannot address receipt in patients name -Overall, they don't recommend using discount sites

How does the RMTBC feel about discount coupons?

-It is allowed -They don't like them and think they do not make good business sense. -Undervalues our expert knowledge and role

What are the 6 pillars of self esteem?

-Living consciously -Living purposefully -Self acceptance -Self responsibility -Self assertion -Personal integrity

What are the ethical principles of massage?

-Nonmaleficence -Beneficence -Justice -Autonomy

What are the 4 reserved titles for a registrant?

-Registered Massage Therapist -Registered Massage Practitioner -Massage Therapist -Massage Practitioner *(Massage Therapists Regulation)*

Which type of business has unlimited liability?

-Sole Proprietorship -Partnership

What are the four bodies of legislation for RMTs in BC?

1. Health Professions Act: 2. Health Professions General Regulations 3. Massage Therapists Regulations 4. The bylaws of the CMTBC

8 tips for dealing with people with disabilities

1. Speak directly to the person rather than through a companion or interpreter. 2.Offering to shake hands with people who have limited hand use or who wear an artificial limb is appropriate. (The left handshake is acceptable). 3. Identify yourself and others who may be with you when meeting a person who is sight impaired. 4. When offering assistance, wait until the offer is accepted. Listen to or ask for instructions. 5. Listen attentively when you're talking with a person who has difficulty speaking. Be patient and wait for the person to finish. Ask short questions that require short answers, a nod or shake of the head. 6. Place yourself at eye level by squatting down, leaning against a counter or taking a seat when speaking with a person who uses a wheelchair. 7. To get the attention of a person who is deaf or hard of hearing, tap the person on the shoulder or wave your hand. Look directly at the person and speak clearly and expressively to determine if the person can read your lips. 8. Relax. Don't be embarrassed if you happen to use accepted, common expressions such as "See you later, " or "Did you hear about that?" Ask questions when you're unsure of what to do.

Informed consent mnemonic:

A reas being massaged B enefits/effects C autions/concerns D raping/duration E mpowerment - Pt can ask questions and/or stop Tx at any time

PTSD symptom; term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response. May be referred to as labile mood (marked fluctuation of mood) or mood swings.

Affect or Emotional Dysregulation

expressing ones own needs while denying the needs and rights of others

Agressiveness

What age is a person considered an infant?

Any person *under age 19* (18 years and younger)

An attitude of mind and a way of relating to others. Values themselves and others, seeks respectful communication with others, yet at the same time is able to set boundaries and protect themselves from exploitation, attack and hostility:

Assertiveness

Rational individuals should be permitted to be self-determining:

Autonomy Principle

An approach to care that ensures clients understand a therapeutic approach fully before they give their consent for Tx to begin:

Informed Consent

Sole Proprietorship or Partnership; which must pay capital gains and how much?

BOTH 15-29%

individual attributes that hinder communication

Barriers

Act in ways that promote the welfare of others:

Beneficence Principle ("To Benefit")

An enduring statement of purpose that distinguishes one organization from other similar organizations. What is our business? Describes an organization's purpose, clientele, services, markets, philosophy and basic technology.

Mission Statement

Which type of business can choose how much to pay yourself and report?

Corporation

Which type of business has full legal name protection?

Corporation

Which type of business has limited liability?

Corporation

a business arrangement with one or more owners who remain separate from the business.

Corporation

A commitment to keep private information from being shared w/ unauthorized individuals:

Confidentiality

Respect for privacy of information:

Confidentiality

What do you say if a client is questionable or steps over the line?

Stop the massage and define your boundaries by saying: "I want to be sure that you know that this is a nonsexual massage. I will end the session if you are looking for something else."

What is the first thing you do if a client starts making inappropriate comments?

Stop the treatment

The right to the objective truth:

Veracity

provides many of the benefits of self-employment, without the large responsibility of running a business.

Independent Contractor

An image of the future we seek to create - describes in graphic terms where the goal setters see themselves in the future.

Vision Statement

-Unconscious processes -How a therapist manages their feelings -Feelings from a therapist directed to their patient

Counter-Transference

A factual summary of a patient's history; does not include an opinion on the patient's condition:

Medical Legal Report

PTSD symptom; Emotional Absence, unresponsiveness, avoiding or distancing

Dissociation

Having more than one kind of relationship w/ a Pt:

Dual-Relationship

the infliction of harm by verbal intimidation which intimidates, demeans, or hurts another person.

Emotional abuse

The act of recognising, resonating with, and responding to the experience of another person:

Empathy

Arises when we have a conflict of values, loyalties, obligations in which a choice has both good and bad elements; there is no clear "win-win" option as both options have a "down-side" -Doing what is morally right results in a bad outcome or bad effects -Doing what is morally wrong results in good or at least better effects or outcome:

Ethical Dilemma

A situation which raises a value or moral question about what is the right/good or wrong/bad course of action.

Ethical Issue

A system of public, general rules for guiding human conduct:

Ethics

What happens when 5 provinces get regulated?

GST exemption/ National recognition

How can you avoid a Pt from directing the session (controlling)?

Give control of some things that don't matter (lighting, music, room temp, etc)

PTSD symptom; a state of increased psychological tension marked by reduced pain tolerance, anxiety, exaggerated startle responses, insomnia, fatigue and accentuation of personality traits.

Hypervigilance or Hyperarousal

is fraud an issue or delemma

Issue

The legislation, policies, and procedures that apply to the practice of massage therapy in a jurisdiction including the governing statute college/board rules or bylaws, code of ethics and practice standards:

Jurisprudence

Treat equals equally, and unequals unequally:

Justice Principle

What are the the limits on services able to be provided by RMTs?

No registrant may: -Prescribe or administer drugs or anaesthetics -Treat a recent fracture of a bone -Apply any form of medical electricity -Move a joint of the spine beyond the limits the body can voluntarily achieve using a high velocity, low amplitude thrust (no grade 5 joint mob's)

-Client does not feel comfortable sharing information -Client takes over the Tx -Client forgets to share something

Non-disclosure

Do not act in ways that cause needless injury or harm to others. "First, do no harm":

Nonmaleficence Principle (Maleficent = "To do evil")

Which type of business must submit a financial statement of entire profit and is then taxed based on their percentage of ownership?

Partnership

two or more persons share ownership and all of the income, but also assume unlimited liability for the business.

Partnership

Avoids dealing directly with conflict and tries to meet own needs indirectly (forgetting, arriving late, withdrawing) Holds back direct expression of feelings and instead expresses them indirectly (sarcasm, unkind joking) Operates from beliefs that direct expressions is threatening and fears conflict Meets own needs at expense of others

Passive Agressiveness

used to describe someone who avoids conflict, allows things to happen or who accepts what other people do or decide without trying to change anything

Passiveness

the use of force to cause pain and/or bodily harm which is used as an instrument of intimidation, coercion or control.

Physical abuse

Policies & procedure to protect the safety of the client & therapist are called:

Professional Boundaries

What takes precedence: personal or professional commitment?

Professional Comittment

Benefit must outweigh the burdens of treatment:

Proportionality

what is the true intent of self-regulation: professional benefit or public protection?

Public Protection

What is the most important thing when doing out calls?

Safety

To maintain esteem and positive unconditional regard for guests, other professionals, and one's self:

Respect

-A unique combination of knowledge and skills -A commitment to duty above self interest or personal gain -Independence from external interference in the affairs of the profession -A privilege delegated to a professional or occupational group by the legislature only when it is clear that the public can best be served by regulation of the profession or occupation

Self-Governing Profession

unwanted or inappropriate sexual contact. It is an act of control, power, rage, violence and intimidation with sex as a weapon. ranges from inappropriate seductive behaviour and sexual touching to sexual intercourse. Rarely occurs as an isolated event.

Sexual Abuse

-An agreement among members of an organized society or between the governed and the government defining and limiting the rights and duties of each *or* -An actual or hypothetical agreement among the members of an organized society or between a community and its ruler that defines and limits the rights and duties of others:

Social Contract

What is the simplest and cheapest type of business?

Sole Proprietorship

Which type of business must report all income on personal tax return?

Sole Proprietorship

a business owned by one person who is personally liable for all of the business transactions.

Sole Proprietorship

Feelings of pity and sorrow for someone else's misfortune

Sympathy

Do you need to pay for music you play in the waiting area? Do you need to pay for music you play in the treatment room?

Waiting area: Yes (public space) Tx room: No (private space)

What is the CMT stance on Grat's?

They are allowed but the CMT suggests setting clear boundaries and caution as it creates an ethical conflict of interest

-Unconscious processes -How a client relates to a power imbalance -Feelings from a client directed to their therapist

Transference

Registrants can only issue receipts with their registration number to patients who pay for and receive their treatment. T/F

True

When do you talk to a client about an erection?

Whenever the client or therapist is uncomfortable 1. client does not appear uncomfortable, makes no unprofessional gestures: do not need to address 2. client appears embarrassed, uncomfortable: politely address 3. client makes inappropriate comments: therapist is obligated to address

Can we treat an intoxicated Pt?

Yes

Does a therapist have to get permission from a client before beginning treatment?

Yes

If a registrant is aware of another registrant that has engaged in any unsafe, unethical, or illegal activity are they required to report the behaviour to the CMT?

Yes

Can self regulation be taken away?

Yes!

Code of Ethical Conduct:

http://www.cmtbc.ca/legislation-bylaws/code-ethics

Anxiety disorder associated with serious traumatic events and characterized by such symptoms as survivor guilt, reliving the trauma in dreams, numbness and lack of involvement with reality, or recurrent thoughts and images

post traumatic stress disorder (PTSD)