Our stories matter
I am fortunate that teaching continuing education unit (CEU) courses gives me the opportunity to travel throughout Ontario and the rest of Canada during the year.
By David Zulak
I am fortunate that teaching continuing education unit (CEU) courses gives me the opportunity to travel throughout Ontario and the rest of Canada during the year. Meeting with massage therapists from around the country and talking about clinical practice has always inspired me to read up on the various modalities and techniques they use. I know that without these conversations I would not be treating clients with all the tools I now have at my disposal.
Learning about how other therapists practice in their clinical settings is without a doubt one of the most potent ways of motivating me to explore new approaches to treatment and to seek out new information. This helps me evaluate, adapt and utilize the practices and techniques that I feel will benefit my clients. I am fortunate to have this opportunity for collegial interaction and ongoing learning.
When speaking with other presenters that I meet on the road, they too express much the same sentiment. It is one of the perks that we get from travelling. However, most massage therapists do not get such a wide and diverse sampling of what other therapists are up to. Many therapists may interact on occasion with those near to them and/or get to meet others when taking various CEU courses, attending annual general meetings or going to conferences when possible. Many more find that outside of fulfilling the requisite number of CEU hours they have little contact with the diverse number of those in our profession and therefore miss the wide range of national knowledge. Even when taking CEU courses they are often seeing many of the same MTs, who already share their interests. Yet, most will tell you that this collegial exchange is one of the benefits, often hidden or surprising, about such interactions. Unfortunately, I have had many of the therapists tell me that those interactions seem few and far between.
I have been wondering how we could expand our contact with each other with respect to what we do day-to-day in our clinical practices. Certainly, reading journals and professional publications like Massage Therapy Canada is central and helpful. This need for learning about what it is that others are doing in our profession is what sustains professional journals like this publication.
Online searches can lead us to research articles, case studies and the like. These provide us with valuable information with which we can re-evaluate certain aspects of how we choose and perform an assessment, a technique, a treatment plan and the like.
The formality inherent in research studies and case reports can present varying degrees of evidence concerning causative certainty within very circumscribed explorations of technique, theory and modalities. This careful collection of evidence brings about the science of massage therapy. We can add this data to the mix of our current theories about how massage works, to our assessments of clients and, hence, to the treatment plans we negotiate. But from research and its evidence we cannot get what we need most to be therapists.
We need to learn from the experiences of other therapists, along with our own clinical experience of trial and error. We need not just data; we need to learn to recognize the patterns that clients present with, learn to recognize common patterns of compensations or adaptations that occur with various impairments we see. Most importantly, learn the art of modifying these commonalities (or to know when to abandon them, in certain circumstances) so we can still see the unique inter-relationships of adaptations of each individual client.
Case studies might come to mind as possible sources. However, case studies are quite formal in nature, lengthy (20 to 40+ typed pages), and require a good deal of time to put together. (For examples visit the Student Case Study Award page on the website of the Registered Massage Therapists Association of B.C.) They do take place in a clinical situation, but they are required to articulate a specific thesis, explore it and report the results. They remain constructed scenarios that try to limit variables. They can be great sources of ideas for potential research projects. While I believe it would be good for all massage therapy students to be required to do such a project as part of their training, it is a lot to expect from most practicing therapists. Yet, it is from those with experience in the field that we would hope to hear.
I believe that what we also need is something a little more grass roots, a little more accessible, and something in which any MT could contribute to in order to share the stories of what it is we do, what it is that many of us are up to, across the country. Something that speaks to the art of massage therapy. That is, how we put it all together in the moment.
All of us need to hear how others make their treatment choices. What theories or models do they draw on to supply the context for assessing and treating; do they use one model, or several, and when? Do others also use, for example, Strain Counterstrain followed by stretching (employing contract-relax, on occasion) to treat trigger points? What are the innovative and creative approaches that others have found to work in specific situations?
What I have in mind is a database that contains what would technically be called “field notes.”
Field notes are defined in The Case Study of a Research Method, 1997, by Susan Soy. “Field notes record feelings and intuitive hunches, pose questions, and document the work in progress. They record testimonies, stories, and illustrations which can be used in later reports. They may warn of impending bias because of the detailed exposure of the client to special attention, or give an early signal that a pattern is emerging. They assist in determining whether or not the inquiry needs to be reformulated or redefined based on what is being observed.”
So many massage therapists work on their own and do not often have opportunities to consult with peers. Others may have small informal groups they can consult with but may be insulated by distance from more diverse contact.
Having a place online where other therapist can send informal reports or field notes could possibly help provide a reservoir of stories, experiences, questions, and suggestions that therapists across the country and abroad could contribute to and access.
A submission could include a few sketches of the client (especially what is pertinent to the story), the brief S.O.A.P notes of a treatment, or summary of several – all to sketch out the context – and then a short write-up of an “experiment,” a novel approach, a lesson learned, an observation that changes one’s perspective or a persistent problem or question that keeps popping up but for which one seeks an answer.
Posts in this online community could also include a collection of those interesting events that happen in the clinical setting – humorous, frustrating, amazing, mind-boggling or inspiring stories about our work occurrences that we just would like to tell someone about, stories put out there without judgement.
These stories will require no review, no critique, and no comment on another field report. The only restriction is that they not be of professional misconduct, either in the content or in the telling. If a therapist wants feedback or a debate, leave an email address. If not, that’s ok.
Such a site could be a place to hear what others are up to, that may show trends in our profession, and suggest topics of research for those so inclined. Or, it could be a place to just find out that there are others who have experienced the same thing – a place for stories that we can share with fellow massage therapists.
David Zulak is a RMT, author and educator. The majority of his teachings focus on clinical assessment, treatment and advanced techniques. He is the author of the textbook Comprehensive Assessment for Massage Therapists. He works in a busy group clinic in Brantford, Ont.