encountered among therapists who work alongside physical therapists or physicians. A client should be given enough time – five to ten minutes – to accurately fill out an intake form. In order to speed up the process, a therapist should give a client a well-lit, quiet place to
fill out their intake form. The therapist should remain in an area close-by in order to answer any questions regarding the form. Once completed, the therapist should keep the intake form with them during the massage for reference purposes.
THE CLIENT INTERVIEW
The interview might also help the therapist determine what position to start the client in; modifications may be required in cases in which a client has difficulty breathing depending upon which way they lie or if the client is pregnant. In addition, the interview gives the therapist a chance to ask a client exactly what they hope to achieve by receiving a massage and what the client likes and dislikes in a massage. The length of the interview depends on several factors such as how much health history is provided by the client, the need for any clarification, new techniques which might need to be discussed with a client so they can consent to new treatments, how much time has been allotted for the session, and how quickly a therapist can understand and synthesize all of the client’s information. PPALM PPALM is an acronym that stands for Purpose of Session, Pain, Allergies and Sensitivities, Lifestyle and Vocation, and Medical Information. PPALM is a means of organizing the interviews so that the most relevant information can be obtained and a course of treatment planned. The first ‘ P ’ – Purpose of Session – is meant to discover why the client is getting a massage. A common question put to clients is, “What is your goal for today’s session?” This gives the client a chance to state exactly what they would like their therapist to do. If the client is unsure how to answer, a closed-ended question may help guide them; ask the client, “Would you like me to reduce your lower back pain today?” The second ‘ P ’ – Pain – has several domains that should be answered to rule out contraindications. Pain should be discussed in terms of when it started, where exactly is the pain, how severe it is on a scale from 1-10, what makes it worse, what makes it better, whether the pain is acute or chronic, if the pain radiates to another location and how often is the pain present. These questions for the client will be discussed in more detail in the next section. ‘ A ’ is for Allergies and Sensitivities . As alluded to earlier, sometimes clients forget to include allergies on their intake form. However, this information is vital as many clients have peanut or other nut or seed allergies. Many massage oils and lotions are made with nuts and seeds and may cause an allergic reaction during the massage. Other clients may be allergic to latex, meaning that the use of latex gloves during a massage will be ruled out (A therapist might wear a latex glove to protect a scrape or cut). Some clients may be so sensitive to certain products that an allergic reaction can be life threatening, so it is worth double checking before the massage begins. ‘ L ’ is for Lifestyle and Vocation . The way a client uses their body throughout the day, during exercise, or during their job can have a profound impact on their muscles and skeleton. In many cases, long periods of sitting with arms reaching forward in conjunction with computer use may lead to tension in the hamstrings, chest and deep abdominal muscles, strain the lower back, and overstretch the upper back muscles. A client who enjoys cycling may have hypertension and/or soreness in their quadriceps and hamstrings as well as having overstretched upper and lower back muscles from leaning forward towards their handlebars. ‘ M ’ is for Medical Information . This is where your client’s health history is annotated. The most relevant information to collect in this area is twofold; most current or recent illnesses or injuries and medicines the client may be currently taking or have prescribed (Over-the- counter and prescription medicines will be
Once the intake form is given to the therapist it can be reviewed for accuracy. The verbal portion of the intake process follows and gives a therapist the chance to clarify any information that requires a deeper understanding. The conversation helps the therapist do the following: ● Look for local or absolute contraindications (whether a certain condition should be avoided, or massage ruled out altogether. ● Allows the therapist to discuss the massage therapy itself and the techniques that will be used. ● Enables the therapist to double-check for allergies or recent injuries. ● Provides the client with an opportunity to express their own preferences for the massage. Conducting the interview Professional communication with a client can make the interview process move swiftly and reduce errors. A proper interview should begin by greeting the client with a smile and using the client’s name. If you are unsure how to pronounce a client’s name, ask the client; this shows the client that you are invested in who they are. Introduce yourself by name and title. Escort the client to the treatment area and interview them there away from other clients and therapists; remember that a client’s information is confidential. Upon reaching the treatment area, try to remain at eye level with you client to indicate that you are equals who share information. When conversing, first take into consideration the client’s level of education and your own; while you may be in the habit of using terms like ‘scapula’ and ‘clavicle,’ your client may only understand these terms as ‘shoulder blade’ and ‘collar bone,’ respectively. From there, become an active listener. This means engaging the client with eye contact while they speak, making utterances that indicate you are listening such as ‘okay’ and ‘uh-huh’ and paraphrasing their words back to them to show that you understand what the client is saying. Another important aspect of the interview is to ask open- and closed-ended questions. An open-ended question is a question that allows the client to explain their pathology such as when they first noticed a problem, what the pain level is (discussed in more detail later), if there is something they are doing to aggravate their condition, or what helps improve their condition. A closed-ended question seeks a ‘yes’ or ‘no’ answer to a therapist’s question. Examples of this may include “Does it hurt your shoulder when you raise your arm from your side?” or “Do you experience numbness or tingling along with your pain?” Something important to remember is that according to research, most communication between people is non-verbal. For the therapist, this may mean that something like an elevated shoulder on one side of the body may be impacting the client’s condition in some manner. For the client, they may not be as forthcoming with information to a therapist who interviews them with their arms folded across their chest. Finally, in conducting the interview, stay focused on your client’s health and do not let the conversation stray into other topics. This will minimize the time spent conducting the interview and leaves more time for the session. With a client with numerous health issues and with whom an interview may take upwards of ten minutes, it may be practical to leave more time between massages so that a client can receive as much treatment time as possible within a specified time frame.
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Book Code: MTX1324B
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