Working on trauma clients
Hi Jennifer!
I would say that probably 90% or more of my clients are trauma patients. I work with patients on life-support in a sub-acute unit in a local hospital. I also work with amputees, and alzheimer's patients. I massage geriatric clients in nursing homes also. You live long enough you generally experience some kind of trauma. I have developed relationships with some liscenced therapists who send me referrals. I also have worked on clients who have experienced sexual abuse, physical abuse, or have experienced trauma from some type of accident. Quite a few of my clients are on life support.
Training in this area is very useful and I would love to see it provided in schools more. This area is a wide-open field. In a city of about 1/2 a million people and more than 600 massage therapists, I am aware of only one other therapist working on patients in our local hospitals.
I found one book in particular very helpful in my training. I can't seem to put my hands on it at the moment, but it was called something like massaging the medically frail in a hospital setting or something like that. I know that it can be ordered from Amazon.com, so if you did a search on Amazon, and put in hospital massage or medically frail massage, it would probably pull it up for you. If I can locate my book, I will post it, but for now I would try the search on Amazon. It would be a good text for a class. Includes questions after each section. This book is focused more on physical trauma; however and does not deal with the sexual abuse issues.
I worked in the mental health field for about 13 years in both hospital and outpatient settings. This was my major in college and how I started out, but if you don't have training and are not a licensed therapist, it is important to have boundaries and keep the pschotherapy to the liscenced professionals.
One thing I can say as both a survivor of sexual abuse myself, and having been on the receiving end of massage and therapy for this, boundaries, boundaries, boundaries. If someone doesn't want to be touched somewhere, don't go there. Don't push the sexually abused patient to remember trauma prematurely. Let things come up naturally for them and in their own time. If they are receiving bodywork, it would be helpful for them to be in individual therapy or a survivor's group for support. Pay attention to your client's bodylanguage. Many people who have experienced abuse, shut down and disassociate. They may not reveal to you what they are feeling. Get feedback while you are working. Proceed slowly.
Sexual abuse victims or adults who have been traumatized in their youth can be sexualized. This can cause them to have seductive behavior, act out, or be sexually addicted, if not treated by a qualified therapist. If you do not have appropriate attire, and good personal boundaries, this could lead to an uncomfortable situation or liabilous situation for the therapist.
You know the cliche ... "When in doubt, refer out." All pschotherapists are not trained well in this area. This is a specialized field. It is important to have a pschotherapist who is experienced in dealing with the sexually or physically traumatized patient. Many therapists have unwittingly further traumatized a patient without meaning to because they push to fast. This is just an area where you proceed slowly at the patient's own speed ... NO PUSHING! Get a signed medical release so you can talk and share with the therapist and get input on your bodywork and feedback from your client's therapist ... Don't try to do therapy if you aren't trained.
CONFIDENTIALITY is crucial! When client's release emotionally, listen, be supportive, but don't exceed your training and don't talk about anything in your session that you don't have a signed release for. Have emergency contact numbers with medical release forms already signed and call these resources if you get in over your head. Comfort the person. Ask if it is alright to touch them (such as hold them while crying) Let them lead and tell you what they need or want.
Massage is soooooooooo beneficial for these situations, but it is soooooooo important to not proceed faster or further than you client is physically or emotionally ready for.
As far as massage techiniques, just depends on the person and their needs. Looks like you have had some good input in this area.
Glad that someone out there is teaching this. I think it would be helpful to have a sexual abuse therapist share at your upcoming class if you or the other teachers do not have first hand experience with this.
Well that's my two cents. Hope it was helpful. I tend to be a little long winded.
Blessings,
Ann (harmony401)