Giving client homework/referrals

[Zerexiam]

I'd like to hear from people who give their clients any kind of homework or referrals to other types of practitioners... it seems like I can *feel* some clients "blanking out" when I make any kind of suggestion.

What I imagine is going on in their heads: "Yeah yeah, I *should* do that--I *should* do ANYTHING else. But I'm not, so there's no point in listening to yet one more thing."

I could be way off base. So I'm curious. I'm not sure I have a specific question so much as a constellation of curiosities, such as: How does this match up or contrast with your experiences? What else could be going on? What ways have you worked successfully (or even not so successfully) with people on taking more responsibility for--and more action toward--their well being?

 

[Pompal 09.]

Some folks are totally into getting suggestions for health. Others do like you said....

I think it is important that we offer something so even those that fade out, I still suggest. But if they aren't receptive, I won't continue doing it.

 

[runners.wife]

I have several clients who have listened and have changed their lifestyle or incorporated stretching and some easy exercises to their routine. And have thanked me for helping them help themselves.
Has it been a large amount of my clients? No, not really.
In fact I have one client who wants me to literally be her form of exercise(keeps asking for more stretches but still wants her full massage) I finally, out of exasperation, told her that she really needs more than a weekly 10-15 minute session of stretches on the table. :roll:
I, too, give up after a few tries. When I see them blanking out or ignoring what I am recommending I simply note it on their SOAP notes what I recommended and back off.
I have found that they end up asking me (later on) to please repeat my suggestions, usually after something cathartic happens to make them want to take better care of themselves.

 

[maurice]

I also have noticed that I seem to be able to get them motivated by being an example myself.

 

[Niofania F]

I suppose it depends on the primary kind of work you're doing, but as I do lots of relaxation work, my take is that some people are just looking for an hour..........to relax.
Even when they hurt somewhere, and ask questions about, "Why does............." I still see their eyes glaze over when I answer and make general recommendations. So I just throw out the suggestions and figure that some people really don't want to, or can't do anything extra, and let it go. I'm not offended.
I've spent so much of my own life disorganized and chaotic I can sort of transport my own head to that place and recognize that sometimes I just wanted to be met where I was at that point in time. And for me most of that time I couldn't get it together to do anything more than what I was doing at that moment - getting a massage, being present with it, and then popping back up and going back into the chaotic black hole.
But I sure would enjoy that hour........and homework definitely wasn't part of the equation.
It's sort of like the time I got a facial while on a cruise ship. I just wanted a facial. I wanted to sink back and disappear into the sensation. Unfortunately the clinician apparently worked on commission, and put a whole lot of energy and umph into trying to get me to buy product.
It made me so uncomfortable it sort of ruined the experience for me. I wasn't looking for her to fix my complexion, I just wanted the soothing experience of a facial (which by the way, it wasn't.........I thought she was going to break my nose off! Yikes!)
I guess if someone is coming to you for specific work and indicating they want to "do" something other than lie there and receive, I would feel differently about it. To do more than make general recommendations would make me feel like I was being "mother/teacher" and either of those roles makes me squirm..........and I have noticed that there are some people that will come to me over and over and ask the same questions about the same issues and listen to the same recommendations.
I can't figure out if they forget, if they really zone out so thouroghly they don't hear, or their "work" is to just go through the motions of asking even though they know they probably won't follow through. But who knows, maybe five years down the road some piece of it will kick in.

 

[Starjumper the R&S Cow]

I've sometimes recommended self-care measures. And the way I phrase it is stolen from "Mission Impossible"...

"Jane, I think there are a couple things that would benefit you. And make your next session even more effective. Your homework, should you decide to accept it, is..."

I think most people are there to relax, as Savannah Bloom suggested. But, there are a few rare clients who realize that most of the best therapeutic work is when both[/ib] massage therapist and client are involved in the work. That the client and the massage therapist are working together as a team, to achieve resolution to their issue.

So, I recommend self-care measures sometimes, but, I know there is a good chance that the client will not follow them. But doing the "Mission Impossible" thing, puts it back in their hands!

 

[Left-T]

If there is some stretching or other little exercise I can recommend to the client to help, I will say something like: If you are interested in them, I can give you a stretch/exercise/advice handout. It can really help (fill in blank).

Letting the client decide if they want to accept seems to help because I rarely get the glazed over look. If they aren't interested, they will say so and I don't have to waste my time. Even though, there are a few of my clients who still don't do the work but it doesn't bother me and I don't nag them about it.

I also spend extra time explaining my work and helping them understand why they may be having that pain (If I am able and well within my bounds). Usually by the end of the discussion, most clients want to become more pro-active in their health.

Ultimately though, this is their session and I am careful not to impose my thoughts on their healthcare unless asked or necessary--such as pointing out a mole that has changed shape and/or color.

 

[Suburbia]

Giving client homework/referrals

What ways have you worked successfully (or even not so successfully) with people on taking more responsibility for--and more action toward--their well being?

I've decided it's their body, their life, their "thing". I can lead a horse to water, but I can't make it drink.

Don't forget to document, document, document!





04/09/08: Edited for really poor spelling!

 

[Violet]

Hehehe... I love the mission impossible bit ;-) Thanks for that.

Just for the record, I'm mainly talking about the kind of client who comes in and wants an hour spent on their left shoulder, or low back, etc.

 

[Muse to my Ears]

I have had great results with some clients doing the stretches/exercises I have given them, and had others completely blow me off. I've had some who came because of MVA's who just won't do a THING to help themselves. Those are the only insurance-pay clients I've had, and I think a good part of that is the fact that there is no personal investment going on at all. It doesn't cost them a dime, and they get "free" massage as long as they don't get better. Others with the exact same injuries (but from a non-MVA incident, thus no insurance coverage) that pay up front for their massage are much more invested in their recovery. I'm sure that wouldn't hold true across the board, and I am basing this on a VERY small sampling, but that is my theory. But I DO also have paying clients who have blown off the homework/self care, too.

ETA: I've had 100% compliance on home care when working with children! That is also a small sampling, but about a dozen kids, and every one of them was given something to do to help themselves, and every one of them was thrilled to know how to stop their own pain. They prefer to have massage because it feels good, rather than needing to have pain before they can ask for a massage. They also haven't been "programmed" to think medicine is always necessary. They tend to hate meds because of the side effects - and connect the side effects to the meds without any information. They listen to their bodies better. When I show them a TP and show them how to stretch it out, they are thrilled. They can learn very quickly how to stop a migraine that is TP induced, and just naturally do that, then go on with their day. So I think the programming our society has received that says we need MEDICINE anytime our body asks for some attention is a lot of the problem, too. We want someone else to fix whatever is wrong, even if better posture would fix it faster, more safely and much more effectively.

 

[BigBangFTW]

Some of my clients want to work to help themselves, some just want me to "fix" them. I haven't found anything to help motivate the unmotivated. After a couple of times, I just stop "annoying" them.

 

[Mrs.Ploughe]

Based on a tip I read on this website, I downloaded VHI software for free. This lets me create customized stretch routines to email my clients after their session. I just do it for first time clients. They seem to really like the idea. I joke with them that while the exercises are fun to look at, you actually have to DO them to do any good. It's understood that some people just blow it off, but at least I don't get that glazed look from them when I let them know to expect an email. It's a nice touch. Here's the link:

http://www.vhikits.com/freeproducts/stretching/FreeStretching.aspx

It comes with 74 stretches to choose from, and you can add your own, and even create customized routines to use over and over. The graphics can be set to male or female and the instructions can be in English, Spanish or French. I've added a ton of additional stretches and created many standard routines. Many of my clients get the "Neck/Upper Back/Lower Back" routine, but I can pick and choose what I want for each client and then save it in their history.

VHI requires that you register once a year but they don't send you anything and it doesn't cost anything. It works well for me! Just two "cons" in case anyone from VHI reads this... I'd like to add graphics or photos to my custom cards and it doesn't look like I can back it up, so if my computer crashes or if I get a new one, it looks like I'll have to recreate all my customized work. I guess you have to pay for more options. Oh well.

 

[heppeee]

Thank you, Sally!!

 

[Hooch Monster (suspended)]

Based on a tip I read on this website, I downloaded VHI software for free. This lets me create customized stretch routines to email my clients after their session. I just do it for first time clients. They seem to really like the idea. I joke with them that while the exercises are fun to look at, you actually have to DO them to do any good. It's understood that some people just blow it off, but at least I don't get that glazed look from them when I let them know to expect an email. It's a nice touch. Here's the link:

http://www.vhikits.com/freeproducts/stretching/FreeStretching.aspx

It comes with 74 stretches to choose from, and you can add your own, and even create customized routines to use over and over. The graphics can be set to male or female and the instructions can be in English, Spanish or French. I've added a ton of additional stretches and created many standard routines. Many of my clients get the "Neck/Upper Back/Lower Back" routine, but I can pick and choose what I want for each client and then save it in their history.

VHI requires that you register once a year but they don't send you anything and it doesn't cost anything. It works well for me! Just two "cons" in case anyone from VHI reads this... I'd like to add graphics or photos to my custom cards and it doesn't look like I can back it up, so if my computer crashes or if I get a new one, it looks like I'll have to recreate all my customized work. I guess you have to pay for more options. Oh well.

Very interesting... I often give stretching homework too. What stretching method(s) does the VHI program utilize? Is it Static, PNF, AIS, MET, CRAC, or some other type of stretching?

Thanks!

 

[airforcewife64]

This is an important part in working with clients - to get them to participate in their healing. Many just come to us seeking to be rescued and want someone to do it all for them.

A great book on this is "Interviewing for Solutions" ( I have forgotten the author but can look it up. It is about finding out what the clients think they need to do to heal and supporting them in the process. It is learning to create a plan that they want to and can do and not what we think they should be doing.

I don't give people any stretches or things to do because it is always more about me than them really - any advice giving is that way. If anything I usually ask them if they want things to do at home or otherwise.

If they ask for something and are interested in doing something that is different.

Julie