Aaaand I'm back! I've got two more videos recorded and another filming session coming up, so I'll be finishing the year strong. Thanks as always to my Patreon supporters! Nothing is behind a pay wall, so it's really neat that some people choose to support me and this weird Sloth stuff I do. If you'd like to see what Patreon's about, go to www.patreon.com/MassageSloth ... and there may be some new shirts(!) at Threadless: massagesloth.threadless.com/
I’m a new massage therapist and this kinda makes me feel better. I just get nervous about what to ask or if I jump ahead and say something wrong because I’m nervous.
Thank you :) It was fun to see how you go about your interview, and I just love reading all the comments people write sharing their wisdom and great questions too. When someone has scheduled a full body massage, I like to ask "is there any area that you would like me to avoid working on?" It's interesting how probably 3 out of 10 people offer up an area like hands or lower legs. I always feel grateful for that information and follow up with "do you have a preferred area you'd like me to put that extra time into?" Sometimes people know exactly, others don't have a preference. It feels good knowing I can give them more of what they want! Also, the way I communicate about pressure is by saying "regarding pressure, every one experiences it differently, and even different parts of the body and from day to day preferences change. So never feel shy about communicating about it. If it feels like to much, please let me know, and likewise if I'm in an area that's warmed up and you'd like more, I'm happy to see what your body will allow. You'll never hurt my feelings ok? I mean it" People smile relief when I say this! If it's a deeper tissue modality, I set the expectation by sharing "in the beginning you can expect it to be more superficial as we get the tissues warmed up" (OMG this helps a LOT so people aren't like "deeper please" in the first 2 minutes) After almost 11 years of giving massage, these conversations feel pretty graceful now ;) Building this rapport right away is so key! Thanks again for all your great videos!
During your intake, ask about the client's occupation, and his/her repetitive motions. Also consider asking a client what they think causes the pain or when he/she notices it most.
I just got started in the field and am working my first job in the industry. This helps me refresh and solidify my skills as I get to know my new clients and to better help their needs! I like the part on introducing your style as a therapist. I get so caught up in them that I forget to really introduce myself! Thanks!
Greetings! As a therapist for about a year now, mostly in the spa setting, I have found the intake interview is a subtle but incredibly powerful art form, especially as a male therapist working with many females it is imperative that you meet the client with a direct, gentle and client-centered approach. Body language, tone of voice, and meeting the client with enthusiasm all make a huge difference. It is all pretty basic psychology 101, and the implication of the "Golden Rule", yet it makes a WORLD of difference when you are hands on with people, especially as said, when there exits an inherent power differential potential.
Thanks for the reminder. After 3 yrs of doing this (massage), I have slipped to some patterns that I need to change. This is one of them. I so often rely on the online intake form and then just quiz them about anything on that. I should take more time to learn about my first time clients. Thanks again, Ian!
Yes! It's so easy to slip into patterns that we don't even notice, and it can be useful to reexamine them every now and then. That's something I need to think on when I'm brainstorming future videos. Thanks Clint!
I loved this video. Very informative. I've been a therapist for about 6 years and still question my ways of dealing with new clients. Thank you for posting this I'll be sure to ask more thorough questions for now on.
I would say.... perfect! Every massage therapist should have this kind of approach to the clients. They allow you to work on their body (and not only) and you need to gain their trust. And this video show one of the most kind and professional model
Thank you so much. Starting my small practice & I graduated awhile ago. I’ve worked in the medical and dental field. So I’m not shy. This was so helpful in refreshing & learning. 🙏🏻💜✨✨✨
100% agree with all that you say here, Ian! I increasingly use a Solution-Focussed approach that primes the client towards a more positive frame of mind. So, as well as asking them about 'what brought them in today', I also aim to ask them more outcome-based questions, like 'what are your best hopes for today's session?' or 'What difference would you want to see by the end of the session?' This starts to get the client thinking about the noticeable difference they're aiming for, and away from just no longer feeling the pain.
OMG I NEED YOU! I've just had my first massage & got NONE of what you have said! I just was told to sit down (as I can't lay down), told to take my shirt off & put a towel over my Chesticles (well it makes sense to call them that as a female, we have 2, men have 2, they both hang & they both float in the bath), then she just started rubbing my back! I was sooo nervous. I tried to talk to her so it wasn't so awkward for me & she said "I don't talk much, I'm very introverted"! Lawd, I wish I had of seen this first!
Gosh I was feeling so self conscious in how I do my intake after 10 years of practice. I thought maybe I wasn't doing it right anymore, but my intake pretty much mirrors yours to a T.
This is a great start to creating a safe non-judgemental space in which to dialogue and explore your clients condition. It covers a lot of the general psycho-therapeutic components that make for a trust based interpersonal therapeutic experience. Where it completely falls down though, is (a) it doesn't draw distinction as to why a client is seeking care - whether it's for general wellness or a health condition and (b) it doesn't explore either of those scenarios to any extent. For instance, if a client was seeking wellness based care, I would inquire as to their wellness based needs - perhaps they want to explore their bodily awareness or optimize their daily yoga practice. Each scenario would call for a unique line of questioning and approach to care based on their answers. If the client as in this case, was complaining of several different concerns, I would do the same as our sloth - isolate which concern is primary, then secondary, etc. and take a methodical framework based line of questioning from there. Our sloth asked about the site but didn't discriminate between local structures or tissue levels, he didn't ask questions about when her condition started (is it acute or chronic - this would greatly influence your treatment planning), was the onset insidious, episodic, or periodic, when it does bother her - how long does it last for, what sort of intensity does she experience (using visual analog charts as an informative aid), how would she characterize the pain (he started moving in this direction but didn't explore it to its end)...I could go on...but i digress. Gathering clear concise subjective info provides the opportunity for you to create an informed clinical impression which then drives your efficiency in collecting your objective info. That way when it comes time to develop your treatment plan (by linking your prioritized impairments too your interventions/modalities) you'll be far more effective in meet your treatment outcomes.
You are remarkably helpful. Thank you. I am a male that is nearly done with massage therapy school. Anyone who sees this please give me advice. I Love and Respect you all ☮️. -Oklahoma M.T.
Client (not yours) feedback: This was great! Yes, I would have loved being met like this. I was not, and it has made for some uncertainties/awkwardness, although the massage therapy has definitely been useful.
I also ask about any bumps, bruises or areas they'd like me to avoid. :) What about maybe an assessment video? I know you said you don't do body reading much but what about assessment findings on the table, etc. or just general tips for that? I feel like that's an area I can struggle with at times. Thanks so much :)
Hmm I might be able to do that, maybe even in the context of my next communication video ("communicating on the table"). I do let communication guide the modifications to my massage for the most part, but I'm certain I make some changes based on observation/palpation :) I'll need to think on it. Thanks Donna!
He needs to make a continued education course. I think there is a lot of money in that. But not a lot of therapist are taking advantage of that. that being said, he probably does well for himself. Wouldn't you agree
This is fantastic. I often spend 20 minutes at least for the first consult, however I am an Ayurvedic practitioner and body therapist so my systems are a bit different to this.
I am about to start massage school and am so happy to have found your channel! So much great information that I will definitely be incorporating when I begin my own practice. I always appreciate this high level of communication as a massage client as well, as there have been many times where I’ve felt confused about the process. Your demeanor is very calming too.
That was perfect. I often loose the way so to speak about how to prompt ppl to tell me exactly how they feel with their pain. I recently found you and glad I did! Your awesome! Benge watching your channel lol
Actually I loved the way u conducted your consultation especially since u are consulting with a female client,its good to let her feel comfortable and get across not getting too much into her private space,I realize u didn't ask if she was pregnant but I guess by filling out the form she would have indicated whether or not she was or she isn't pregnant, which I realised fro previous experiences some females are not being honest and didn't tick that part on the paper and they know they are pregnant, so it's good to always review your form and ask questions more than once,but yes I loved your video ,and again asking the client to touch area of concerns is good,thumbs up,keep me posted
Great video, Ian. I like that you reduce (we hope) the power differential with your positioning. I also like, and will start using, the "... It may not be too much for you, but it's too much for me", regarding teeth-clenching pressure...
When I was a kid,there was a tumor between my hips,and it got on my nerves during the operation, and my legs wouldn’t collapse at all. The spinal balance of the body,such as the spine,pelvis,legs,and soles of feet,has collapsed,and the muscles of the right arm and hip are degraded. The image will always be large. Thank you!!>
Thank you for elaborating massage sloth, I have been a practicing therapist for a little over 2 years now and still find it difficult to run a client down when starting the session. As someone on the autistic spectrum doing massage the communication aspect can be challenging.
This took me years to develop, and I promise it doesn't come out nearly this smooth most of the time :) Just remember that people won't remember exactly what you said, but rather how they felt. If you can find ways to give them permission to tell their story (allowing space after they speak, asking good follow-up questions), they'll do the heavy lifting. Oh, and have a look at this video about communication during a massage: ua-cam.com/video/UC_Vdcsa_Is/v-deo.html Even if you aren't able to spend this much time or mental energy prior to the massage, there's plenty of time to draw out that story during the session. Let me know how it goes!
I have used a couple of these techniques that you offered. What are you like outside of the clinic. Do you put on a "mask" at work or is this how you are all the time?
How can I find a RMT like yourself? Everyone always seems so rushed and unwilling to hear my 'story' - It's great to find your videos and it gives me hope that there are more practitioners such as yourself!
I prefer to get clients to fill out a visual intake form right there and then and then ask about anything I need more information on. Alot of problems become obvious while actually working through my basic routine that covers the essential muscles.
These types of videos are GREAT! Would love to see one of how you explain some at-home care to a client! :) Thanks for everything you do. Looking into your patreon now!
Welcome back! I noticed in other videos you do not rub on the vertebrae, you rub along the sides. I understand. A lot of people, myself included, have pain in the spine area (it feels like the bones themselves are the problem but I doubt it). For me, I feel like I can't stretch my back properly. Can you do a video about this? Thank you.
Thanks T W! And that's a great idea. I find that pain that feels centered on the spine itself is often caused by those nearby spinal muscles; if we can get those to chill out (along with their near neighbors and antagonists), then that central pain can drop.
Thank you for sharing. I'm just starting school for MT, and was wondering where you did your studies? I'm trying to find standards that follow The College of Massage Therapists of Ontario.
Hi, I'm a massage therapist and I've been working 16 hours a week for the last 7 months and I have a question about your consultation. I've been using printed off consultation forms from the FHT and those go into a lot more detail about medical history and contra-indications. I noticed you didn't ask if the client had any health conditions - is there a reason for this? Nice video though, I liked how you asked the client where their pain is, "lower back" can mean a lot of different things! :-)
Aw man, I wish I had addressed that in the video...! I do have a fairly thorough written intake that I have them fill out while they wait. I mostly let them lead the way when it comes to talking about their goals, using the information on the form to prompt them about anything they didn't address. Glad you asked!
This was going to be my question. We have always had to wade through forms to check medical history and contra-indications. It takes time and I often feel bogged down by it in an initial consultation but understand the necessity. Do you have any videos including your forms. I found this video very helpful. Thank you.
Thank you for your videos Ian. They are very helpful, teaching different techniques and reminding me of things I had learned and forgotten. What techniques or tips do you have for clients with very hairy bodies? I use coconut oil and it is still difficult to glide without causing discomfort.
No doubt, that was my experience as well. In those situations, I found that even an extra minute of interview, plus some extra intake on the table, was enough to help me customize treatments better. I talk more about how I dealt with those time constraints here: facebook.com/massagesloth/videos/1834947013392734/
Hi Ian. A lot of my clients are unable to relax even after many massage sessions. They may be asleep and snoring and yet they are very tense. What is your experience in that matter
For clients who seem really nervous about the situation, I do find that sitting and taking my time with the interview helps. It gives me a chance to allay some common fears, explain more about who I am and what I do, and get better information from them (even if they don't feel comfortable doing much explaining). I won't force the issue if they're not forthcoming with much information, and I'll try to get more info on what pressure they prefer, what areas need work, etc, while they're on the table. For some people, being on the table is less stressful than a face-to-face interview, so they might be better able to express themselves. Afterward, I warmly invite them back, and maybe in future sessions some of those walls will start to come down, and they'll feel more comfortable from the outset. For clients who find touch to be aversive or anxiety-provoking, I try to make each session start with a gradual reintroduction. That might mean making broad, static contact to the back, feet, or head, allowing my hands to stay in place for a while as they breathe. I make sure to undrape slowly and confidently, and tuck securely. As I work, I make sure that each contact is applied and withdrawn gradually rather than abruptly, and I return to those broader contacts frequently. Realize that your approach may need to be different for every client, and even from session to session. I just do what I can to empower them to give voice to their needs that week and follow their lead. Great questions!
I've always done what Ian said and do full body, calming compressions. But if I feel like they are nervous before the massage I always remind them gently that they will be fully covered unless I'm working on an area and that they do have the right to end the massage or change the treatment at anytime if they are uncomfortable. People almost always visibly relax at that point because the trust that I will stop if they ask me too is there. (no one has ever terminated a treatment so thats good :P )
Great responses from the others! Additionally, based on a client of mine, I found what helped her was when I somewhat “narrated” the massage process I was doing. It helped her to stay relaxed as she knew what I was going to do next. For example, after massaging and covering her back, I’d calmly say, “Okay, next I’m going to un-drape your left leg, and I’ll securely pull the sheet around it, and hand the end of the sheet to you to hold onto, or if you prefer, I can tuck it in” (she chose to hold it, giving her more control of it being securely snug). Then, I’d say, “okay now that I’ve finished here, I’ll take the sheet back from you as I need to put the draping back in place to keep you covered, and warm, next we’ll do the same with your right leg.” Etc. Over the course of time and appointments, the narration became less as she knew what to expect, and she was also able to relax more. In these situations communication is key to having a good rapport, along with respecting the client, and allowing them to feel comfortable at their own pace.
very helpful, i seem to get a little nervous when interacting with new clients, but with these guides, I'll be a pro at this in no time. As for new clients who have a good first interview, but get on the table and the communication seems to turn off, how would you handle this? Those who just agree with and say everything is ok when you ask. Is this stemming from the pre-massage interview? Thanks!
Hi Jon! I do find that the more thorough intakes tend to garner better communication on the table, but part of it can also be the way that we approach questions during the massage (which I plan to make a video on!). For instance, asking "how's the pressure?" tends to get the answer "fine" from 95% of clients, even if communication had previously been good, and even if the pressure's not fine! Basically, I don't ask any questions that have a pat, polite answer. I'll either invite them to speak using open-ended wording ("tell me about this area. Any pain or tightness?") or forced-choice questions ("would you like more pressure or less?"). They can always still choose to give short answers, but both of these completely rule out "fine." Good questions, and don't pressure yourself to be perfect or to never be nervous! Clients don't remember the parts where we fumble or have to take a second to search for words, so we shouldn't either :)
Massage Sloth Thanks for the thorough response. Looking forward to applying these practices. I'll take more time on intake, because I had this preconceived notion that the client wants the full table time they are paying for, when a good intake helps them know how you said knowing they are the expert of their own body.
Yes! I've been meaning to make that very video. Basically, I'd want to adapt a lot of work from chair massage to use on the table: Rhythmic compression, static compression, deep friction, etc. As for your other question, I wouldn't take shooting pain down the leg to necessarily mean sciatica (I wouldn't be able to say if it meets that definition), but it would make me want to do more extensive work with the posterior pelvis. Good questions!
Do you make your own consultation cards? if yes it would be helpful to me to see what questions you ask on it and how thorough it is. I have been a massage therapist for just 3 years but i am starting up on my own fairly soon and want to make sure i do everything properly/the best i can, thank you :)
You know I’ve literally have always done what you talked about in the beginning. It’s short and gets the gist but I’ve always said it’s not good needed to go in more depth. I always get it’s my upper shoulders lol nothing more always the shoulders. So routine is what I work with. Lol. Would you interview existing clients? And how would you approach that if you’ve been working with them for years to get a better sense of their needs. Or would you just continue on. I have an idea may switch this world up a bit. Thanks
I would say something like, "we've been working together for a while, and I wanted to have a quick chat about how your body's doing. Anything causing you any pain of frustration lately?" If anything come up you can ask about related/nearby areas to see if there's anything else going on that might not have felt worth mentioning. I think it's a good idea to touch base like this every now and then, so good on you!
I'd be interested in seeing a video from you on assessment. Do you do much testing before starting work to determine what muscles to work on specifically?
That's something that I've been doing less and less of over the years. These days I make a mental note of posture, but base my routine more on their subjective report. I also come at areas of interest from lots of angles rather than trying to encourage the tissue to go one way or another, so even if I noted a tilt in the hips, it probably wouldn't change my approach. I talk more about that here: ua-cam.com/video/nOvhjD8t4J8/v-deo.html
Part of the reason why I ask is that I just read an article in the latest ABMP Massage and Bodywork magazine, which seemed to be coming very close to saying that MTs should not work with clients in pain unless they are skilled at doing the tests to determine which exact part is the source of the problem, suggesting that we could do harm if we just work generally without that assessment skill.
I've encountered that sentiment before, but I strongly disagree. There are certain critical symptoms we should be able to identify (stroke, heart attack) so that we can refer people to the emergency room, and others that we should keep in mind when they might be confused with musculoskeletal pain (symptoms of kidney infection, blood clot, shingles, etc). As for figuring out exactly which part is dysfunctional when dealing with musculoskeletal pain? That seems unnecessary to me. That kind of information is important for surgeons, but massage has powerful nonspecific treatment effects that don't rely on targeting any one muscle or ligament. Some of our strongest evidence comes from pain research using good old Swedish massage. But really, what convinces me most is the literature that uses "sham surgery" as a control. Powerful effects on pain and dysfunction are wrought by treating someone with all the trappings of orthopedic surgery without actually doing an operation. And of course, I've seen great results in my practice just from working tangentially with painful areas without necessarily digging in to the area at issue. My motto is "think locally, act globally." Great question!
What about what to tell a client after the massage? One thing I've been told to tell them is to drink plenty of water afterwards, but do they really need to?
I dropped the water recommendation a while back. I still hand clients a cup of water after the massage, because being prone in a face cradle tends to engender stuffy sinuses and a dry mouth, and because it's a nice gesture. There doesn't seem to be evidence for over-hydration being superior to sufficient hydration, so I trust them to drink what they need. As for other stuff to say after the massage, I plan to do another one of these videos on that! For now: I ask how they're doing, check back in on their area(s) of concern, and ask if they'd like to rebook :)
Massage Sloth Thanks. I'm still a student, 2 months into an 8 month program, but I suspect some of the stuff one of of my instructors tells us is just straight up woo BS.
Ian thank you for the video! I too am quite thorough in my initial intake consultation and sometimes find resistance with patient / clients that often times don't see the need for the consultation questions and will give very vague answers and a rather rushed manor. How do you address this issue?
I will ultimately let the client lead the way and set the tone. If they give brief answers and don't indicate any areas of interest, I won't try to force any extra info out of them. In those cases I'll just do my best to determine their preferred pressure and give a standard massage routine. I used to get more clients like that when I was working in a group setting like a spa or franchise; I've found that most clients who come to me personally after seeing my website and blog are more likely to want to engage more deeply.
Stop being mean to yourself you do not teach in a weird, unusual way you teach very methodically very clearly, understandable, Massage sloth you’re the awesomeness. Now you quit with that slightly negative self talk young man
Hey Ian, I suffer from a lot of muscle spasms and a lot of back pain. I’ve been getting treated by a chiropractor for over a year now but the pain just gets back to where I was in the beginning. I have never tried going to a massage therapist. Any suggestions?
Only in very specific cases, or as a follow up to them reporting that they have a ROM problem. For instance, if a client has a current crick in the neck, I'll have them turn toward the restriction and then point to the pain. That lets me know more about their experience, and it gives us something to compare to afterward. I do the same with frozen shoulder clients (demonstrate ROM, point to pain) and try to track this over multiple sessions. Other than these two cases, I don't really track ROM. There are so many variants of pain-free ROM, and I don't feel the need to try to change it if it works for them. For instance, my neck doesn't rotate very far in either direction, but the only time I have pain is when massage therapists try to stretch it :) Good question! (oh, and feel free to join us on the forum! Search for "Massage Sloth Clubhouse" on Facebook)
Hello. Love you. You're great, calm, comforting. Curious as to why no notes were being taking during the consultation? I'm a note, documentation kind of person. CYA cover your assets from my real estate broker experience and life. Thank You
This is a great point, and it's just me being dumb when I make videos. I always take notes AND have these meandering conversations. I'm not a strict SOAP guy, but I do make sure to note pain/dysfunction, pressure preference, and any relevant medical treatments that are in the past or ongoing. Afterwards I'll note down what I noticed, what was well received, and what I'd like to pursue in future sessions. Great question!
When you're interviewing a client do you think it would be appropriate to ask them for their permission to record the conversation so you can go back and make s.o.a.p notes accurately? I understand that some therapists take notes during the intake. I just feel like I would focus more on the client and what their telling me if I wasn't worried about writing down things and could mentally take comfort in listening to the recording later. While knowing I'm giving my full attention to my client.
What does it mean when i move neck i can hear noise as grinding? Sometimes it feels very strange, sometimes i dont feel anything just noise. is it something serious or just something weak (muscles, neck or something else) thank you for you answer.
I don't massage people with their clothes on. I feel that would be taking a risk if they have any skin pathology. I believe it is a good thing to see the skin, particularly the back and the legs. The back can have precancerous sunspots, moles, pustules, abscess etc. I like to inform the client and ask if they are aware of them. Bruises and varicose veins also need to be located and avoided.
Aaaand I'm back! I've got two more videos recorded and another filming session coming up, so I'll be finishing the year strong. Thanks as always to my Patreon supporters! Nothing is behind a pay wall, so it's really neat that some people choose to support me and this weird Sloth stuff I do. If you'd like to see what Patreon's about, go to www.patreon.com/MassageSloth ... and there may be some new shirts(!) at Threadless: massagesloth.threadless.com/
Massage Sloth another wonderful video! Thanks for all you do Ian! Looking forward to your first book? When might we expect that? ;-)
It is so good to see you!!! Been wondering about you!
we love you lazy massage sloth man!
Do you have a post massage interview?
What an amazing channel! In fact, you inspired me to re-train as a massage therapist! Keep up the excellent work, Ian!
I’m a new massage therapist and this kinda makes me feel better. I just get nervous about what to ask or if I jump ahead and say something wrong because I’m nervous.
Thank you :) It was fun to see how you go about your interview, and I just love reading all the comments people write sharing their wisdom and great questions too. When someone has scheduled a full body massage, I like to ask "is there any area that you would like me to avoid working on?" It's interesting how probably 3 out of 10 people offer up an area like hands or lower legs. I always feel grateful for that information and follow up with "do you have a preferred area you'd like me to put that extra time into?" Sometimes people know exactly, others don't have a preference. It feels good knowing I can give them more of what they want! Also, the way I communicate about pressure is by saying "regarding pressure, every one experiences it differently, and even different parts of the body and from day to day preferences change. So never feel shy about communicating about it. If it feels like to much, please let me know, and likewise if I'm in an area that's warmed up and you'd like more, I'm happy to see what your body will allow. You'll never hurt my feelings ok? I mean it" People smile relief when I say this! If it's a deeper tissue modality, I set the expectation by sharing "in the beginning you can expect it to be more superficial as we get the tissues warmed up" (OMG this helps a LOT so people aren't like "deeper please" in the first 2 minutes) After almost 11 years of giving massage, these conversations feel pretty graceful now ;) Building this rapport right away is so key! Thanks again for all your great videos!
During your intake, ask about the client's occupation, and his/her repetitive motions. Also consider asking a client what they think causes the pain or when he/she notices it most.
Awesome. I am a new therapist and this is very helpful.
M how’s it been going?!?
how has the first two years in practice been? What are you doing now with the COVID-19 pandemic ?
I just got started in the field and am working my first job in the industry. This helps me refresh and solidify my skills as I get to know my new clients and to better help their needs!
I like the part on introducing your style as a therapist. I get so caught up in them that I forget to really introduce myself!
Thanks!
Greetings! As a therapist for about a year now, mostly in the spa setting, I have found the intake interview is a subtle but incredibly powerful art form, especially as a male therapist working with many females it is imperative that you meet the client with a direct, gentle and client-centered approach. Body language, tone of voice, and meeting the client with enthusiasm all make a huge difference. It is all pretty basic psychology 101, and the implication of the "Golden Rule", yet it makes a WORLD of difference when you are hands on with people, especially as said, when there exits an inherent power differential potential.
Thanks for the reminder. After 3 yrs of doing this (massage), I have slipped to some patterns that I need to change. This is one of them. I so often rely on the online intake form and then just quiz them about anything on that. I should take more time to learn about my first time clients. Thanks again, Ian!
Yes! It's so easy to slip into patterns that we don't even notice, and it can be useful to reexamine them every now and then. That's something I need to think on when I'm brainstorming future videos. Thanks Clint!
assessments are KEY
I loved this video. Very informative. I've been a therapist for about 6 years and still question my ways of dealing with new clients. Thank you for posting this I'll be sure to ask more thorough questions for now on.
Ian is like the Yoda of the massage world
:D
I second that
I would say.... perfect! Every massage therapist should have this kind of approach to the clients. They allow you to work on their body (and not only) and you need to gain their trust. And this video show one of the most kind and professional model
Thank you so much. Starting my small practice & I graduated awhile ago. I’ve worked in the medical and dental field. So I’m not shy. This was so helpful in refreshing & learning. 🙏🏻💜✨✨✨
100% agree with all that you say here, Ian! I increasingly use a Solution-Focussed approach that primes the client towards a more positive frame of mind. So, as well as asking them about 'what brought them in today', I also aim to ask them more outcome-based questions, like 'what are your best hopes for today's session?' or 'What difference would you want to see by the end of the session?' This starts to get the client thinking about the noticeable difference they're aiming for, and away from just no longer feeling the pain.
Oh wow, those are excellent! Definitely going to think about how I can incorporate that kind of language. Thank you!
the helpful part of mirroring for me is to identify and feel the actual muscles that are the problem and I like to feel the action on myself.
Bookmarking this so I can come back to it. And taking notes. Thank you.
WOW...11 years - I have just started.. 1 month. Thanks for the info
Your absolutely correct good communication is key! Thank you for reminding all of us how to do a client consult well!
OMG I NEED YOU! I've just had my first massage & got NONE of what you have said! I just was told to sit down (as I can't lay down), told to take my shirt off & put a towel over my Chesticles (well it makes sense to call them that as a female, we have 2, men have 2, they both hang & they both float in the bath), then she just started rubbing my back! I was sooo nervous. I tried to talk to her so it wasn't so awkward for me & she said "I don't talk much, I'm very introverted"! Lawd, I wish I had of seen this first!
The first moment you meet the client sets the tone and expectations
Gosh I was feeling so self conscious in how I do my intake after 10 years of practice. I thought maybe I wasn't doing it right anymore, but my intake pretty much mirrors yours to a T.
This is a great start to creating a safe non-judgemental space in which to dialogue and explore your clients condition. It covers a lot of the general psycho-therapeutic components that make for a trust based interpersonal therapeutic experience. Where it completely falls down though, is (a) it doesn't draw distinction as to why a client is seeking care - whether it's for general wellness or a health condition and (b) it doesn't explore either of those scenarios to any extent. For instance, if a client was seeking wellness based care, I would inquire as to their wellness based needs - perhaps they want to explore their bodily awareness or optimize their daily yoga practice. Each scenario would call for a unique line of questioning and approach to care based on their answers. If the client as in this case, was complaining of several different concerns, I would do the same as our sloth - isolate which concern is primary, then secondary, etc. and take a methodical framework based line of questioning from there. Our sloth asked about the site but didn't discriminate between local structures or tissue levels, he didn't ask questions about when her condition started (is it acute or chronic - this would greatly influence your treatment planning), was the onset insidious, episodic, or periodic, when it does bother her - how long does it last for, what sort of intensity does she experience (using visual analog charts as an informative aid), how would she characterize the pain (he started moving in this direction but didn't explore it to its end)...I could go on...but i digress.
Gathering clear concise subjective info provides the opportunity for you to create an informed clinical impression which then drives your efficiency in collecting your objective info. That way when it comes time to develop your treatment plan (by linking your prioritized impairments too your interventions/modalities) you'll be far more effective in meet your treatment outcomes.
Thank you! This was helpful.
You are remarkably helpful. Thank you. I am a male that is nearly done with massage therapy school.
Anyone who sees this please give me advice. I Love and Respect you all ☮️. -Oklahoma M.T.
I always ask what kind of work they do or if they go to school. Also, asking whether they play sports or workout helps.
Client (not yours) feedback: This was great! Yes, I would have loved being met like this. I was not, and it has made for some uncertainties/awkwardness, although the massage therapy has definitely been useful.
I also ask about any bumps, bruises or areas they'd like me to avoid. :) What about maybe an assessment video? I know you said you don't do body reading much but what about assessment findings on the table, etc. or just general tips for that? I feel like that's an area I can struggle with at times. Thanks so much :)
Hmm I might be able to do that, maybe even in the context of my next communication video ("communicating on the table"). I do let communication guide the modifications to my massage for the most part, but I'm certain I make some changes based on observation/palpation :) I'll need to think on it. Thanks Donna!
Sounds great! I love the idea of a "communicating on the table" video. Thanks :)
I'm really interested in how much information you get from direct, hands on assessment as well. Please do a video on that!
I like the suggestion to ask if they have any areas we should stay clear of, maybe a new tattoo or something too. thanks Donna
I would love to see an assessment video, gait, postural scan...
Thank you Ian!
This is in no way strange teaching it’s actually brilliant, I wish I could take a course from you.
KEEP DOING GOOD SIR
He needs to make a continued education course. I think there is a lot of money in that. But not a lot of therapist are taking advantage of that. that being said, he probably does well for himself. Wouldn't you agree
This is fantastic. I often spend 20 minutes at least for the first consult, however I am an Ayurvedic practitioner and body therapist so my systems are a bit different to this.
I am about to start massage school and am so happy to have found your channel! So much great information that I will definitely be incorporating when I begin my own practice.
I always appreciate this high level of communication as a massage client as well, as there have been many times where I’ve felt confused about the process. Your demeanor is very calming too.
I love that last comment especially. Really well done- some things I hadn't thought of before
Everything you said makes so much sense
Thank you for sharing this! it was so helpful!! i got a bad lesson for improper consultation!!!
Thank you for this - incredibly helpful and the only video of this kind I was able to find!
That was perfect. I often loose the way so to speak about how to prompt ppl to tell me exactly how they feel with their pain. I recently found you and glad I did! Your awesome! Benge watching your channel lol
Great video. Interviewing clients before their massage is so important. Keep making great stuff.
Great communication is critical...Excellent video!
Thank you very much for a very detailed video about client assessment. I wrote down quite a few tips. It is a big help❤
Actually I loved the way u conducted your consultation especially since u are consulting with a female client,its good to let her feel comfortable and get across not getting too much into her private space,I realize u didn't ask if she was pregnant but I guess by filling out the form she would have indicated whether or not she was or she isn't pregnant, which I realised fro previous experiences some females are not being honest and didn't tick that part on the paper and they know they are pregnant, so it's good to always review your form and ask questions more than once,but yes I loved your video ,and again asking the client to touch area of concerns is good,thumbs up,keep me posted
Hi there New subscriber here. I have been a professional massage therapist for 13 years. love your info.
Great video, Ian. I like that you reduce (we hope) the power differential with your positioning. I also like, and will start using, the "... It may not be too much for you, but it's too much for me", regarding teeth-clenching pressure...
Much appreciated, Kerry!
Hi, this has been very helpful to me. I agree: establishing a rapport is vital, as is clear communication both ways. Thanks again for your great work.
When I was a kid,there was a tumor between my hips,and it got on my nerves during the operation, and my legs wouldn’t collapse at all. The spinal balance of the body,such as the spine,pelvis,legs,and soles of feet,has collapsed,and the muscles of the right arm and hip are degraded.
The image will always be large. Thank you!!>
Thank you for elaborating massage sloth, I have been a practicing therapist for a little over 2 years now and still find it difficult to run a client down when starting the session. As someone on the autistic spectrum doing massage the communication aspect can be challenging.
This took me years to develop, and I promise it doesn't come out nearly this smooth most of the time :) Just remember that people won't remember exactly what you said, but rather how they felt. If you can find ways to give them permission to tell their story (allowing space after they speak, asking good follow-up questions), they'll do the heavy lifting. Oh, and have a look at this video about communication during a massage: ua-cam.com/video/UC_Vdcsa_Is/v-deo.html Even if you aren't able to spend this much time or mental energy prior to the massage, there's plenty of time to draw out that story during the session. Let me know how it goes!
@@MassageSloth Grand, this helped. Thank u-
I am going to just memorize this! So great! I’d love to have a massage therapist like you.
This is such a great demonstration! I am going through massage school right now, just started, so this was great information!
Thanks so much, great info for this new LMT ❤
Thank you so very much for this video!
I needed this video! Thanks so much!!!!!
I have used a couple of these techniques that you offered. What are you like outside of the clinic. Do you put on a "mask" at work or is this how you are all the time?
If only doctors, dentists, et al were to listen to this and take heed.
Awesome, imma Massage Therapist too.
This is super helpful. Many thanks! 🙏
How can I find a RMT like yourself? Everyone always seems so rushed and unwilling to hear my 'story' - It's great to find your videos and it gives me hope that there are more practitioners such as yourself!
I prefer to get clients to fill out a visual intake form right there and then and then ask about anything I need more information on. Alot of problems become obvious while actually working through my basic routine that covers the essential muscles.
this video was really useful and informative. thank you very much for positing this!
These types of videos are GREAT! Would love to see one of how you explain some at-home care to a client! :) Thanks for everything you do. Looking into your patreon now!
Welcome back! I noticed in other videos you do not rub on the vertebrae, you rub along the sides. I understand.
A lot of people, myself included, have pain in the spine area (it feels like the bones themselves are the problem but I doubt it). For me, I feel like I can't stretch my back properly. Can you do a video about this? Thank you.
Thanks T W! And that's a great idea. I find that pain that feels centered on the spine itself is often caused by those nearby spinal muscles; if we can get those to chill out (along with their near neighbors and antagonists), then that central pain can drop.
This was great!
Great as always!! Thank you so much for this video! Is so useful! And I'm sure I will feel much better at the time to speak with my patients.
Thank you for sharing.
I'm just starting school for MT, and was wondering where you did your studies?
I'm trying to find standards that follow The College of Massage Therapists of Ontario.
Hi, I'm a massage therapist and I've been working 16 hours a week for the last 7 months and I have a question about your consultation. I've been using printed off consultation forms from the FHT and those go into a lot more detail about medical history and contra-indications. I noticed you didn't ask if the client had any health conditions - is there a reason for this?
Nice video though, I liked how you asked the client where their pain is, "lower back" can mean a lot of different things! :-)
Aw man, I wish I had addressed that in the video...! I do have a fairly thorough written intake that I have them fill out while they wait. I mostly let them lead the way when it comes to talking about their goals, using the information on the form to prompt them about anything they didn't address. Glad you asked!
This was going to be my question. We have always had to wade through forms to check medical history and contra-indications. It takes time and I often feel bogged down by it in an initial consultation but understand the necessity. Do you have any videos including your forms. I found this video very helpful. Thank you.
Thank you for your videos Ian. They are very helpful, teaching different techniques and reminding me of things I had learned and forgotten. What techniques or tips do you have for clients with very hairy bodies? I use coconut oil and it is still difficult to glide without causing discomfort.
What I hate about working at a corporate place is I can barely fit in a minute of consultation if I'm trying to stay on schedule with everyone.
No doubt, that was my experience as well. In those situations, I found that even an extra minute of interview, plus some extra intake on the table, was enough to help me customize treatments better. I talk more about how I dealt with those time constraints here: facebook.com/massagesloth/videos/1834947013392734/
LOVE THIS! Thank you :)
Thank You !❤
I also ask about medication for conditions that they suffer from.
Do you have any videos about how to verbally end a massage and client outtake communication?
Also, thank you for your videos. They have been extremely helpful
This is a good idea! I think this would be a good one for a livestream format
colorado rockies!
You are great! Thank you!
Hi Ian. A lot of my clients are unable to relax even after many massage sessions. They may be asleep and snoring and yet they are very tense. What is your experience in that matter
Do you have any tips and tricks about helping clients who are very nervous, or maybe even have some trauma/touch aversion?
For clients who seem really nervous about the situation, I do find that sitting and taking my time with the interview helps. It gives me a chance to allay some common fears, explain more about who I am and what I do, and get better information from them (even if they don't feel comfortable doing much explaining). I won't force the issue if they're not forthcoming with much information, and I'll try to get more info on what pressure they prefer, what areas need work, etc, while they're on the table. For some people, being on the table is less stressful than a face-to-face interview, so they might be better able to express themselves. Afterward, I warmly invite them back, and maybe in future sessions some of those walls will start to come down, and they'll feel more comfortable from the outset.
For clients who find touch to be aversive or anxiety-provoking, I try to make each session start with a gradual reintroduction. That might mean making broad, static contact to the back, feet, or head, allowing my hands to stay in place for a while as they breathe. I make sure to undrape slowly and confidently, and tuck securely. As I work, I make sure that each contact is applied and withdrawn gradually rather than abruptly, and I return to those broader contacts frequently. Realize that your approach may need to be different for every client, and even from session to session. I just do what I can to empower them to give voice to their needs that week and follow their lead. Great questions!
I've always done what Ian said and do full body, calming compressions. But if I feel like they are nervous before the massage I always remind them gently that they will be fully covered unless I'm working on an area and that they do have the right to end the massage or change the treatment at anytime if they are uncomfortable. People almost always visibly relax at that point because the trust that I will stop if they ask me too is there. (no one has ever terminated a treatment so thats good :P )
Great responses from the others!
Additionally, based on a client of mine, I found what helped her was when I somewhat “narrated” the massage process I was doing. It helped her to stay relaxed as she knew what I was going to do next.
For example, after massaging and covering her back, I’d calmly say, “Okay, next I’m going to un-drape your left leg, and I’ll securely pull the sheet around it, and hand the end of the sheet to you to hold onto, or if you prefer, I can tuck it in” (she chose to hold it, giving her more control of it being securely snug).
Then, I’d say, “okay now that I’ve finished here, I’ll take the sheet back from you as I need to put the draping back in place to keep you covered, and warm, next we’ll do the same with your right leg.” Etc.
Over the course of time and appointments, the narration became less as she knew what to expect, and she was also able to relax more.
In these situations communication is key to having a good rapport, along with respecting the client, and allowing them to feel comfortable at their own pace.
yeah brother LMT!!!
very helpful, i seem to get a little nervous when interacting with new clients, but with these guides, I'll be a pro at this in no time.
As for new clients who have a good first interview, but get on the table and the communication seems to turn off, how would you handle this? Those who just agree with and say everything is ok when you ask. Is this stemming from the pre-massage interview? Thanks!
Hi Jon! I do find that the more thorough intakes tend to garner better communication on the table, but part of it can also be the way that we approach questions during the massage (which I plan to make a video on!). For instance, asking "how's the pressure?" tends to get the answer "fine" from 95% of clients, even if communication had previously been good, and even if the pressure's not fine! Basically, I don't ask any questions that have a pat, polite answer. I'll either invite them to speak using open-ended wording ("tell me about this area. Any pain or tightness?") or forced-choice questions ("would you like more pressure or less?"). They can always still choose to give short answers, but both of these completely rule out "fine." Good questions, and don't pressure yourself to be perfect or to never be nervous! Clients don't remember the parts where we fumble or have to take a second to search for words, so we shouldn't either :)
Massage Sloth Thanks for the thorough response. Looking forward to applying these practices. I'll take more time on intake, because I had this preconceived notion that the client wants the full table time they are paying for, when a good intake helps them know how you said knowing they are the expert of their own body.
@@bigomondis104 Hey Jon, So are things going now with the practice? haha I am interested
Hi that is very good video thank you.
Would you possibly show us the massage you would give if they did want one fully clothed. I would be totalloy lost. Sciatica???
Yes! I've been meaning to make that very video. Basically, I'd want to adapt a lot of work from chair massage to use on the table: Rhythmic compression, static compression, deep friction, etc. As for your other question, I wouldn't take shooting pain down the leg to necessarily mean sciatica (I wouldn't be able to say if it meets that definition), but it would make me want to do more extensive work with the posterior pelvis. Good questions!
@@MassageSloth have you ever used shiastu techniques?
I freaking love your videos!!!😍😍😍😍😍thank you!🙏🏻
Thanks this was awesome :)
Do you make your own consultation cards? if yes it would be helpful to me to see what questions you ask on it and how thorough it is. I have been a massage therapist for just 3 years but i am starting up on my own fairly soon and want to make sure i do everything properly/the best i can, thank you :)
What are those parrallel bars on the ceiling for
Nice job Brother!
You know I’ve literally have always done what you talked about in the beginning. It’s short and gets the gist but I’ve always said it’s not good needed to go in more depth. I always get it’s my upper shoulders lol nothing more always the shoulders. So routine is what I work with. Lol. Would you interview existing clients? And how would you approach that if you’ve been working with them for years to get a better sense of their needs. Or would you just continue on. I have an idea may switch this world up a bit. Thanks
I would say something like, "we've been working together for a while, and I wanted to have a quick chat about how your body's doing. Anything causing you any pain of frustration lately?" If anything come up you can ask about related/nearby areas to see if there's anything else going on that might not have felt worth mentioning. I think it's a good idea to touch base like this every now and then, so good on you!
excelentes vídeo, parabens!
I'd be interested in seeing a video from you on assessment. Do you do much testing before starting work to determine what muscles to work on specifically?
That's something that I've been doing less and less of over the years. These days I make a mental note of posture, but base my routine more on their subjective report. I also come at areas of interest from lots of angles rather than trying to encourage the tissue to go one way or another, so even if I noted a tilt in the hips, it probably wouldn't change my approach. I talk more about that here: ua-cam.com/video/nOvhjD8t4J8/v-deo.html
Part of the reason why I ask is that I just read an article in the latest ABMP Massage and Bodywork magazine, which seemed to be coming very close to saying that MTs should not work with clients in pain unless they are skilled at doing the tests to determine which exact part is the source of the problem, suggesting that we could do harm if we just work generally without that assessment skill.
I've encountered that sentiment before, but I strongly disagree. There are certain critical symptoms we should be able to identify (stroke, heart attack) so that we can refer people to the emergency room, and others that we should keep in mind when they might be confused with musculoskeletal pain (symptoms of kidney infection, blood clot, shingles, etc). As for figuring out exactly which part is dysfunctional when dealing with musculoskeletal pain? That seems unnecessary to me. That kind of information is important for surgeons, but massage has powerful nonspecific treatment effects that don't rely on targeting any one muscle or ligament. Some of our strongest evidence comes from pain research using good old Swedish massage. But really, what convinces me most is the literature that uses "sham surgery" as a control. Powerful effects on pain and dysfunction are wrought by treating someone with all the trappings of orthopedic surgery without actually doing an operation. And of course, I've seen great results in my practice just from working tangentially with painful areas without necessarily digging in to the area at issue. My motto is "think locally, act globally." Great question!
Thank you. Time to go look up symptoms of kidney infection.
What about what to tell a client after the massage? One thing I've been told to tell them is to drink plenty of water afterwards, but do they really need to?
I dropped the water recommendation a while back. I still hand clients a cup of water after the massage, because being prone in a face cradle tends to engender stuffy sinuses and a dry mouth, and because it's a nice gesture. There doesn't seem to be evidence for over-hydration being superior to sufficient hydration, so I trust them to drink what they need. As for other stuff to say after the massage, I plan to do another one of these videos on that! For now: I ask how they're doing, check back in on their area(s) of concern, and ask if they'd like to rebook :)
Massage Sloth Thanks. I'm still a student, 2 months into an 8 month program, but I suspect some of the stuff one of of my instructors tells us is just straight up woo BS.
"Don't suffer in silence" the title of my new.... BOOK... lol.. joking, this is good stuff, especially the mirroring thing ;)
Ian thank you for the video! I too am quite thorough in my initial intake consultation and sometimes find resistance with patient / clients that often times don't see the need for the consultation questions and will give very vague answers and a rather rushed manor. How do you address this issue?
I will ultimately let the client lead the way and set the tone. If they give brief answers and don't indicate any areas of interest, I won't try to force any extra info out of them. In those cases I'll just do my best to determine their preferred pressure and give a standard massage routine. I used to get more clients like that when I was working in a group setting like a spa or franchise; I've found that most clients who come to me personally after seeing my website and blog are more likely to want to engage more deeply.
@@MassageSloth I love how you are answering everyone haha. Great answer.
loved it thanks :-)
Stop being mean to yourself you do not teach in a weird, unusual way you teach very methodically very clearly, understandable, Massage sloth you’re the awesomeness. Now you quit with that slightly negative self talk young man
I get told this one a semiannual basis, and it's a useful reminder every time 😁 thanks for that!
Hey Ian, I suffer from a lot of muscle spasms and a lot of back pain. I’ve been getting treated by a chiropractor for over a year now but the pain just gets back to where I was in the beginning. I have never tried going to a massage therapist. Any suggestions?
Do you check their range of motion as well before massaging?
Only in very specific cases, or as a follow up to them reporting that they have a ROM problem. For instance, if a client has a current crick in the neck, I'll have them turn toward the restriction and then point to the pain. That lets me know more about their experience, and it gives us something to compare to afterward. I do the same with frozen shoulder clients (demonstrate ROM, point to pain) and try to track this over multiple sessions. Other than these two cases, I don't really track ROM. There are so many variants of pain-free ROM, and I don't feel the need to try to change it if it works for them. For instance, my neck doesn't rotate very far in either direction, but the only time I have pain is when massage therapists try to stretch it :) Good question! (oh, and feel free to join us on the forum! Search for "Massage Sloth Clubhouse" on Facebook)
Hi Ian. Do you still practice massage? All I can find is a location on google that says is permanently closed. 🙁
Hi Mollie, I'm actually in the process of getting started again, this time in Colorado Springs. I'll publicize it a bit once I'm up and running!
Sounds like she needs a chiropractor too! I used to get headaches constantly and it was my neck being out of alignment.
Hello. Love you. You're great, calm, comforting. Curious as to why no notes were being taking during the consultation? I'm a note, documentation kind of person. CYA cover your assets from my real estate broker experience and life. Thank You
This is a great point, and it's just me being dumb when I make videos. I always take notes AND have these meandering conversations. I'm not a strict SOAP guy, but I do make sure to note pain/dysfunction, pressure preference, and any relevant medical treatments that are in the past or ongoing. Afterwards I'll note down what I noticed, what was well received, and what I'd like to pursue in future sessions. Great question!
When you're interviewing a client do you think it would be appropriate to ask them for their permission to record the conversation so you can go back and make s.o.a.p notes accurately? I understand that some therapists take notes during the intake. I just feel like I would focus more on the client and what their telling me if I wasn't worried about writing down things and could mentally take comfort in listening to the recording later. While knowing I'm giving my full attention to my client.
Great video :)
What does it mean when i move neck i can hear noise as grinding? Sometimes it feels very strange, sometimes i dont feel anything just noise. is it something serious or just something weak (muscles, neck or something else) thank you for you answer.
Often times it can signify osteoarthritis
Where did you go??? We miss you
Can I use your video for my presentation?
Feel free to use my videos for anything class-related!
I don't massage people with their clothes on. I feel that would be taking a risk if they have any skin pathology. I believe it is a good thing to see the skin, particularly the back and the legs. The back can have precancerous sunspots, moles, pustules, abscess etc. I like to inform the client and ask if they are aware of them. Bruises and varicose veins also need to be located and avoided.
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