Show Notes:

17: Manual therapy and massage practitioners are voracious consumers of professional continuing education. Who should be deciding what they learn?

In this episode,

  • What implications does the “medically necessary” discussion have on massage and bodywork education, CE, and credentialing?
  • Why don’t Rolfers think they’re doing massage, anyway?
  • What is the post-COVID roadmap for professional continuing education?

In the Thinking Practitioner series, join two of the leading educators in manual therapy, bodywork, and massage therapy, as they delve into the most intriguing issues, questions, research, and client conditions that hands-on practitioners face. Stimulate your thinking with imaginative conversations, tips, and interviews related to the somatic arts and sciences, with Whitney Lowe and Til Luchau

Resources discussed in this episode: 

Sponsor Offers:

Your Hosts:

Til Luchau Advanced-Trainings        whitney lowe
Til Luchau                          Whitney Lowe

Thanks for listening and subscribing to the podcast! Make sure to connect with us on Twitter, Instagram and Facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on Apple Podcasts!

Your Hosts:

Til Luchau Advanced-Trainings
Til Luchau

whitney lowe
Whitney Lowe

Thanks for listening and subscribing to the podcast! Make sure to connect with us on Twitter, Instagram and Facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on Apple Podcasts!

(The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

Full Transcript:

Tip: Use the green printer sharing-icon to save a free PDF!


The Thinking Practitioner Podcast:
Episode 17: Who Charts Our Path?

Broadcast date: 6/24/2020
©Copyright The Thinking Practitioner Podcast, Til Luchau & Whitney Lowe

Whitney Lowe:

Welcome to The Thinking Practitioner Podcast.

Til Luchau:

A podcast where we dig into the fascinating issues, conditions, and quandaries in the massage and manual therapy world today.

Whitney Lowe:

I'm Whitney Lowe.

Til Luchau:

And I'm Til Luchau. Welcome to The Thinking Practitioner.

Whitney Lowe:

Welcome to The Thinking Practitioner.

Til Luchau:

Hey, this is Til Luchau and today's episode is sponsored by Handspring Publishing. When I was looking for a publisher for the books that I wanted to write, the Advanced Myofascial Technique series, I was lucky enough to have had a couple offers. One was from a big company, the other was from a little company in Scotland run by four great people, Handspring Publishing. And in the end I went with them. I went with my gut and chose Handspring because not only did they help me make the books that I wanted to write, but their catalog has emerged as one of the leading collections of professional level books written especially for body workers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness.

Whitney Lowe:

And Handspring does have a new instructional webinar series called Moved To learn. It's a regular series of each 45 minute segments featuring some of their amazing authors and it really is a very impressive group of authors working at Handspring there. So head on over to their website at handspringpublishing.com to check those out and have a look at their excellent catalog while you're at it. And be sure to use the code TTP when you find any of those gems that you need to have at checkout. Again, the code is TTP. And we thank Handspring very much for supporting the podcast.

Til Luchau:

Thank you Whitney. Yeah. That code gives you a discount on your purchases at Handspring. Whitney, how are you doing there?

Whitney Lowe:

I'm doing okay. We are in mid May that we're recording this. I think this will be released sometime around mid June. We are sort of on the brink of that period of everybody trying to figure out how to get back into some sense of normalcy and it's been a very challenging time across the board for the entire field as well as for so many individuals and it's just ... I was talking with somebody the other day. Actually, I was talking with my sister the other day. She is a grant writer for a crafts school in North Carolina. The school has had to of course close all of their summer programs and fall programs and we were just saying ... She was talking to me about my business and said, "You know, I've watched you in your business over these years do all kinds of things and deal with all kinds of troubles and challenges. It's been really great to see how you've done this." I said, "Yeah, well part of that is that all those kinds of challenges and things in the business, there are things that you read about and you figure out alternative plans for how to deal with them. But global pandemic that wiped out the entire economy didn't really make it on to my radar screen of things to prepare for."

Whitney Lowe:

So like everybody else I think we were really caught quite off guard by this situation trying to figure out what we do with it here.

Til Luchau:

Well yeah, you and everybody else and getting back to normal. We don't even know what that means. This new normal, what is that? We'll know more like you said, in a few weeks when this airs. But it's an evolving question. All of us having to adjust and deal with the changes as they come forward.

Whitney Lowe:

Yeah. Yeah. Yeah. And you've got both classes I imagine that were canceled as well as clinical practice things too that all got put on pause for a while.

Til Luchau:

Yeah, that's right. The in person classes are just completely on hold for now. Maybe the fall, we'll see. But the online stuff is interesting. That's really boomed and I know that's been keeping you busy too. We've been having such a strong response to the online offerings that it's faced us with the choice of how do we not overwork in this time which is a worthy inquiry as well.

Whitney Lowe:

Tell me a little bit about what you are doing with your online classes and things because I've seen some stuff across the social media landscape of ... You even seem to get a good bit of engagement with your community and things like that as well.

Til Luchau:

That's the challenge is how do we stay engaged, how do we stay connected and most people are either trickling back in or can't do their work still. So the question we're dealing with is how do you stay engaged as a body worker with your skills and your learning and your own body when our connection is virtual? When our connection is just through Zoom calls or offline study and things like that. So yeah, we've been experimenting with different ways of doing that, a few courses. But the most exciting one is a course where I give the lectures I would give at an in person training about a particular part of the body and then people go off and practice those in terms of movement practices with themselves. Yeah, or watching videos and then we have a small group with an instructor where they meet and discuss those things in a repeating cycle of those elements that turns out to be really gratifying for all of us involved. So we're learning a lot and going forward with that plan.

Whitney Lowe:

Nice. When they go off to do this practice thing they do that just for a certain designated period of time where they come back and a certain time later to meet up with the person who's going over these things with them, is that-

Til Luchau:

Yeah. It's a two week cycle. You listen to the lecture. About 90 minutes. Ask questions and such, it's live. Then you go watch a video of me doing a demonstration. Then you take some of those techniques you saw and turn them into self care for yourself or movement. For the people that are practicing they can go ahead and practice that. But otherwise you're mocking them up on yourself so you get an embodied sense of that. And then the other element is you meet in a small group with an instructor on Zoom to debrief and discuss and share your learning. And then that cycle repeats every two weeks.

Whitney Lowe:

These are wonderful examples of some things that personally for me as a person who's obsessed with education and looking at educational strategies and methods, it's been fascinating to watch this process of educators becoming incredibly innovative in very short periods of time with having to do things because there is a significant difference between designated and well planned out and well developed online education curriculum as opposed to emergency remote teaching, which is really a lot more of what's having to happen right now. And it's been really fascinating to watch what a lot of the educators and teachers have done coming up with creative ideas for how to do some things like this. And I think it's been very impressive.

Til Luchau:

Tell me about what you're up to or what are the highlights there on your side?

Whitney Lowe:

Well, for us it's been a little bit different because we were in the midst before this hit of a major course overhaul on all of our online programs and what this has really done is just sort of accelerated the need to get that done and it really hasn't impacted or changed a lot of what goes on with our students in our online programs because they're already all asynchronous. Meaning they weren't necessarily doing anything at one particular time. There's been a great influx of people moving back into their courses to do things now that they're out of practice and they've got some time to work on it. So that's been very significant. But I haven't ventured back out into any sort of synchronous delivery things like what you're doing there. Because we're really trying to actually use this time as much as we can for getting all these program revisions done.

Til Luchau:

And that's probably plenty. That's probably keeping you busy.

Whitney Lowe:

Yeah. It's been very, very busy and we're still a long way from getting everything done because the iterations of this. You see things that you want to have done differently and then you do a little tweak on this and like no, I don't like that, I want to do this differently, I want to change that thing, I want to change this activity this way. It's a whole lot of activities across seven different courses involving hundreds of video clips and interactive exercises and every little piece of technology. One little blip on there and some button's not working and somebody goes launched off into another place. It's a lot of moving parts to get it working correctly.

Til Luchau:

You've been renovating your whole school and cleaning out the closets and fluffing up the pillows and all that kind of stuff at the same time it sounds like.

Whitney Lowe:

That's right. Yeah. Yeah. All that project was planned before all this calamity of collapse happened of everything. So it's all being done on top of that as well. It is challenging. But it's fascinating at the same time.

Til Luchau:

And so what do you want to talk about today?

Whitney Lowe:

Well, I've been thinking about this a little bit with some of the things that had come up during the Covid-19 situation. And it made me think about this. It was interesting. It made me think about this topic and this issue in a light that I hadn't really given a lot of thought to before. And so wanted to kind of ... I wanted to bounce some things off of you and just sort of chat about this a little bit. There's been a big question mark that's come up for a lot of people when they were making decisions with their state legislators, et cetera about who would close, who would stay open, about whether or not massage therapy was medically necessarily. Or was it really a practice that was critically important for people to stay in practice. And there is a lot of debate on both sides of that question about whether or not it is or not. I have opinions about that but that's not really where I wanted to go with this. What really came to mind for me in looking at this is, we don't have any guidelines or definitions about this at all within our field of-

Til Luchau:

About what's necessary?

Whitney Lowe:

Yeah. What the topic of medically necessary means or how do we define that? And it got me thinking about well, we do have this issue we've talked about before here on the podcast of at least the massage therapy world being sort of a split personality between whether or not we are a personal care service trying to just work on general overall wellness with people or if we are a healthcare profession. And that question mark still exists out there about how we actually define what we are and we're clearly some of both in a lot of different situations. The thing that made me begin thinking about this some more is that in many of our other sister and brother allied health professions, occupational therapy, physical therapy, chiropractic, whatever those other fields are, there are designated curricula that identify the things that you really need to know to be working as a healthcare professional. And in massage therapy, in body work for example, we have basic entry level training requirements that establish a base level of training that an individual needs to get in order to be considered a safe practitioner and get their license.

Whitney Lowe:

But that really doesn't get into the level of determining or developing skills for them for the more challenging things that they would do with advanced practice. And that's why they go to all these CE courses and do all these kinds of things. But there really isn't a designated curriculum of advanced training. So what you choose to do with your advanced practice and your advanced training, which direction you go in is completely up to you. And it's an interesting model because it certainly gives people a lot of individual flexibility and individuality with creating their education which I'm all for that. I think that's a great model. But at the same time, there are some really important things that people really should be paying greater attention to and should be part of, let's say, a more formalized curriculum that doesn't happen when that is the situation. So it poses an interesting questions so we sort of talked about this topic of, who charts our path? It is mainly something that we do ourselves but should there be some other kinds of guidelines about the kinds of things that are necessary? Skills, knowledge, abilities for working in some of these other different challenging environments.

Til Luchau:

Okay. So that's the question then. How do we chart the path? Who charts it? It isn't so much what makes something medically necessarily if I get your drift. It's more like, how do we decide what to study and who's deciding what that as we go into the advanced levels of this work? Is that right?

Whitney Lowe:

Yeah. Right. Yeah. For sure.

Til Luchau:

All right.

Whitney Lowe:

There's a whole passel of people out there doing some phenomenal work in the education world of teaching soft tissue manual therapists all kinds of really great stuff. But again, there is no sort of guidance, guidelines, or standardization on what we need to know to work in some of these more challenging environments. That poses some challenging questions for us in terms of looking at ourselves from a regulatory standpoint and having to make some decisions in a time like this. In like the Covid-19 situation of when should we go back to work based on how necessary and important this is and what kind of things do we need to be knowing to do that?

Til Luchau:

Yeah. Okay so there's so many places I could go with this. I mean, what is the necessary piece? But it sounds like we're steering more toward the standards piece or to the how do we chart our path? Who's charting our path? So if I put the blinders on for a second, because the medically necessary one is kind of pulling at me a little bit. I got to say, your focus on charting the path and what are the standards is interesting. You say you're all for flexibility and creativity. Are you saying that you think it would be helpful if there were more standards in place coming from either government entities, professional entities, that would help us in our advanced level trainings?

Whitney Lowe:

I think this gets back to some fundamental questions that many of us in the profession have been trying to grapple with for years about what is this sort of distinction? I mean there is this sort of distinction between these two pathways of ... I don't have a great way to call this, so we end up calling it like personal care service stuff. And again, acknowledging that there are health benefits to what everybody does, so please don't assume that I'm saying just because something's not called healthcare massage, there's not health benefits. We all know there's great health benefits with general relaxation, massage, et cetera. But the individuals who practice in that model don't necessarily see themselves as working on some type of compromised heath condition let's say. So they're saying, I'm just mainly working for people to reduce stress, help them feel better, enhance their wellbeing, that kind of thing.

Til Luchau:

I got the just in there. I'm just working on that. I heard the just by the way.

Whitney Lowe:

Ah yeah. Shouldn't of said just. That's a good point. I am focusing on this but I am not necessarily seeing myself as a healthcare provider who has to learn all of this other stuff about HIPPA and contrary indications related to complex medical conditions. Making clinical decisions about should I do this refer or that kind of thing. Again, there's gray area obviously, because there's a blend over. It's not a clear black and white distinction. So yeah, that sort of separation exists there but we never have really established ... This is something I think I said in the podcast earlier in one of the earlier episodes that I think we do a good job of training requirements for the sort of focus on soft tissue manual therapy in the personal care service realm. At whatever is that training level. The 500 hours. Sort of the average timeframe. I think we do a pretty good job of-

Til Luchau:

For a massage therapist in the US, yeah. I think you're right.

Whitney Lowe:

Yeah. And I agree with a lot of the people who like to practice in that environment saying like, I don't want to have to go to a 3,000 hour program to do this particular type of work that I want to do which is just mainly around stress reduction, wellness enhancement, and all that kind of thing. I think there's a valid point to that. But then, for those individuals that do want to work with people who have compromised health problems and conditions and things like that, we are way, way under educated for grappling with those kinds of things. The question comes up, who sets those standards? Who develops those kinds of bars that we have to jump over? And credentialing issues. That's the sticky wicket.

Til Luchau:

That is sticky. I'm following your lead here. I'm deferring to your overview here because this is something you've been working with for quite a while and puzzling out and working with different collaborations and alliances around this question. How do we actually set standards and what needs to happen both at the entry level but perhaps at the advanced level? I know for myself I think of myself as focusing on wellness rather than disease. In other words, I wouldn't make the case that my own work as valuable as it is, would be medically necessary. Because just by the nature of what I do, I'm not dealing with issues of survival. Surviving a life threatening illness say. I'm interested and I'm better at helping people go beyond the absence of disease into a level of wellness that's an enhancement factor.

Whitney Lowe:

Yeah. And this kind of gets into my personal opinion. I don't think we really can say any aspect of what we do is medically necessary from the standpoint of life threatening treatments that somebody needs to have. I think we fall in that can, all of us do, of not being medically necessary. But I would also call what you do and the students who come to your work to come to training for your work, as mainly focusing on the individuals who are working with people who have more compromised health issues that they may be grappling with. Because you do some pretty advanced level training work with people on both the advanced level of what they're doing with their hands, the palpatory specificity with what you're doing as well as the things that you're teaching them about the way that they're working with people. It's definitely at that level.

Til Luchau:

So you're saying hey, Til, you're doing advanced work, you're putting it out there as that even, and so the patients or clients, that are going to be coming in to your practitioner's practices are dealing with some serious issues. And maybe there's some things that they need to know about that. Is that what you're saying?

Whitney Lowe:

Yeah. Absolutely.

Til Luchau:

I'm with you. I'm with you.

Whitney Lowe:

And so the problem is this is part of our whole guru education model that has been in sort of our practice field for so many years. These methods started mainly because there were some dynamic charismatic individuals who started doing some type of thing and they taught a group of people and those people taught a group of people and those people taught a group of people and that sort of was the way a lot of the education got passed down. As opposed to curriculum being identified by some external body of subject matter specialists that all got together and said, these things are important for us to know and so we're going to designate this as the curriculum for whatever it is. Whatever that field is. Manual therapy, massage, structural integration, whatever your field of choice is. Those kind of things don't exist.

Til Luchau:

That's right. And there's probably even diversity of opinion about what the unified field is and whether there is a unified field. I know that that's a big issue within the structural integration community that we are massage we say. And we want to distinguish ourselves from massage therapy. And I know there's those kind of distinctions that are important to different sub groups with our larger field of hands on work as well. So that probably inhibits our ability to talk about what are the standardized things that should be there to keep people safe. Because I think that's what you're talking about. You're talking about what keeps the recipients of our work safe. Especially if they're dealing with serious medical or musculoskeletal issues.

Whitney Lowe:

Yeah. If I can I would like to pick your brain a moment to tell me a little bit about that from ... Because I have heard this a number of times and this would be great to have somebody knowledgeable in this particular area from the perspective of structural integration saying that they're not massage.

Til Luchau:

Okay. How did I get to be elected to the spokesman for that? But I'll go there. I'm with you.

Whitney Lowe:

Because you said it.

Til Luchau:

I did. I brought it in. So you are saying, so what's that about? Why do people say that or what's the rationale?

Whitney Lowe:

What's the argument of saying that they're not massage? And I've heard that lots of times over the years. Many times. So what is essentially the argument?

Til Luchau:

Wow. Okay. Let me see if I can go there-

Whitney Lowe:

If you can kind of give me a-

Til Luchau:

No. Honestly, I can't say it's my position. Having taught at the Rolf Institute for 20 years and trained Rolfers and I chose that path rather than massage for myself for various reasons. I also want to be really clear and careful that for my own values and my own perspective, it's not about positioning ourselves in relationship to each other. So that's why I'm probably hesitating or reluctant to even dive into it. And it's not like structural integration is good and massage is bad. But let me just take the point of view of the people that are saying the ones doing structural integration are not massage. Maybe the argument is when I'm doing structure integration my goals are different perhaps. Ida Rolf was very clear that we are not fixing symptoms. We are raising the functioning of the organism, the individual to a higher level in an integrated fashion. And that by getting caught up in specific say musculoskeletal issues or any kind of other issues, we're actually missing the whole.

Til Luchau:

By stepping back and keeping in her mind, the functioning of the organism within the field of gravity as our goal, we're going to probably benefit those symptoms but we're not even going to try to address those in a direct or linear or reductionist fashion. We're going to keep our sights on the big picture. And that means the big picture of the way the body is connected in a structural whole, in her model, in a factual viewpoint and as a integrated feeling, living, breathing, energetic entity within a larger field of gravity which she saw as the connecting matrix around us.

Whitney Lowe:

Yeah.

Til Luchau:

So I hope I did that okay. I mean that's maybe the philosophical background. I think for sure ... Now we're getting into Til's opinion here. For sure there's an interest in distinguishing ourselves from each other professionally. And she was dedicated to exceptionalism. Let's just put it that way. She was from an exceptionally motivated family background. She as a woman in the 1920s who went and earned her doctorate at Columbia was exceptionally driven and interested in being exceptional and she was. And she wanted to start a work that was exceptional. And when you do that you by definition exclude. In order to be exceptional you exclude other things and so she was saying no, we are not all these other things, we are going to do this and we're going to do it really well. So I think there's some of that heritage there too of being exceptional in some ways.

Whitney Lowe:

Yeah. Right. And again, I think we find ourselves even with those sort of coming at this thing from various different perspectives we find ourselves looking through a similar lens at this particular situation now. Again, my limited perception and understanding of the structural integration is that the training program is pretty lengthy and pretty significant compared to many massage therapy training programs. So there is-

Til Luchau:

Objectively-

Whitney Lowe:

Is that true? Yes? No?

Til Luchau:

I think there's that ... No. I think that I believed that when I had only been in that world. Sorry. And then when I broadened my horizons a little bit I realized ... Especially when I got involved in the curriculum design and the accreditation and then this was during the time the NCB was forming and those kinds of things. Because the Rolf Institute was in those discussions and I was very active in those discussions within the organization. Realizing that hey, actually the number of hours that we train people in that model wasn't significantly different. Maybe even less than some thorough massage schools. Something less than a thousand hours. And so from an objective standpoint the number of hours involved isn't more.

Whitney Lowe:

Yeah.

Til Luchau:

And yet, I got to say, this is where my loyalty comes into my heritage and my tribe and my buddies there to say, there is some exceptional level work going on. Exceptionally good teachers, exceptionally good practitioners, and an exceptionally effective narrative that has done a good job I'd say of evolving over time too.

Whitney Lowe:

Sure. That gets us off into a whole different soap box thing about hours and time versus competencies in what you're actually accomplishing in that period of time and those things are not necessarily correlated. Number of hours does not necessarily mean better. Longer programs are not necessarily better. What makes it better is really the outcomes and the instructional processes, designs, the educators and all the other educational elements in there.

Til Luchau:

Yep. Yep. I mean there's two jokes ... Just to go back to the Rolfing thing. Two jokes. One is like how many Rolfers does it take to change a light bulb? Just one but it's 10 sessions.

Whitney Lowe:

Mm-hmm (affirmative). I've heard that one before.

Til Luchau:

And the other one was, how many Rolfers does it take to change a light bulb? One to do it and another one to say, I could do that better. Because there is this kind of ... The shallow side of exceptionalism could be perceived from the outside as a kind of arrogance or superiority and I'll raise my hand yeah, I have been there and maybe I'm a hopefully recovering person with a superiority complex.

Whitney Lowe:

Right. It doesn't show through so you must be fully recovered-

Til Luchau:

Maybe I'm overly compensated. Who knows? But any case, yeah, I think that's some of the things in the background of us coming together to shared visions or shared standards as you said or even to talk about what are the things that we need to be aware of as educators in this field? So that's one of the barriers for sure is these divisions within our field.

Whitney Lowe:

Yeah.

Til Luchau:

I think maybe this one you talked about too about is it are we medically oriented or are we ... You said personal services. I said wellness. Are we oriented toward disease care? Are we oriented toward health enhancement? Are we fixing symptoms and helping people with musculoskeletal issues or are we in Ida Rolf's view, elevating ourselves above that to a bigger broader picture that includes those things but actually is interested in taking people to the next level of functioning?

Whitney Lowe:

Yeah. And again like I said earlier, these lines are so blurry because you could take individuals who might be working let's say, in a work environment that would appear to be one basically focused on wellness enhancement pretty exclusively like let's say a spa or a franchise operation for massage therapy. And I asked this question a number of years ago. I was in an event with one of the large franchise organizations and some of the top massage therapists in each one of their states had come to this event. And I asked them, what do you see the most of? Who's coming to see you? And they said like 75 to 80% of the people who come to see them are coming to see them for some type of pain complaint. So there goes our bias and perception about people who work in franchises aren't doing healthcare oriented massage. It just isn't true.

Til Luchau:

Pain specific work or symptom specific work.

Whitney Lowe:

Just not true.

Til Luchau:

No. I think it's huge. I think honestly I see this in my own practice. I see it in the people that come to our trainings. They want to know how to help. I see it in the Rolfers honestly. In the structural integration people. They want to know how to help people with problems, specific problems because that's what motivating the clients and patients to come to us. And so then yeah, you're right. We got to think not only ... Which has been my inquiry. Is like how can we be really effective at helping people and creating the right expectations around that so that we can have these miracles that happen where people feel amazingly better? And when that doesn't happen, how we can still be useful and realistic with people and help people feel empowered by what we provide. So how can we do that? But at the same time, be clear about our scope of training and the scope of ability and not overreach or over promise or supplant other things that people might need to do to take care of themselves. All those questions too.

Whitney Lowe:

Yeah. Yeah. So I've got a couple of other things that I wanted to look at along these lines here and we'll come back and circle back around to a couple of those things after we hear from our halftime sponsor today.

Til Luchau:

Wow. That's great. Ready for them already?

Whitney Lowe:

I think we are here. We're at about that place here. So today's halftime sponsor is ABMP. And we want to thank them very much for their support of The Thinking Practitioner Podcast and ABMP membership does include over 50 plus member discounts on everything from massage tables and supplies to cellphone service and all members can access over 200 continuing education courses with free CE hours. You can read ABMPs award winning member magazine, Massage and Body Work at massageandbodyworkdigital.com. Both Til and I are frequent contributors on that magazine and it is an award winning publication there. And listeners who join ABMP as new members can save $24 at abmp.com/thinking. So with ABMP you can expect more. And we again appreciate their support of the podcast here.

Til Luchau:

Yeah. And the support they're peddling hard, working hard to offer to the field. I know some of the people there, they're working so hard to try to get out accurate useful clear information in this time so many people are looking for guidance.

Whitney Lowe:

Absolutely. A quick little plug. They just launched a new podcast too with some really good interviews of things going on currently with the Covid-19 situation so check that out as well. The ABMP podcast. There's some good stuff coming on there as well.

Til Luchau:

It takes some courage to stand up and say things that are definite because we don't know and yet you see you become a target of so much ... Well, appreciation on the good side but certainly frustration of wanting to know more. They're not the only ones, but they're one standing up that says okay, we're going to say some things.

Whitney Lowe:

Yeah. Yeah. And that is so needed because people feel ... I think part of what's going on is just a great deal of fear around uncertainty and lack of knowledge around things. It's clear that nobody has a monopoly on the answers right now, but certainly any good strong guidance with evidence informed things is certainly helpful and we can use more of that for sure.

Til Luchau:

There you go. What else do you want to make sure we have time for?

Whitney Lowe:

Well, I wanted to circle back around to one of the other things about this. Kind of getting back to this issue of looking at how we chart our past and the fact that this sort of advanced training component that we talked about is really up to everybody else to choose what they're doing.

Til Luchau:

Up to the individual, you're saying. Yeah.

Whitney Lowe:

Yeah. Up to the individual. I was thinking back and reflecting about this a little bit with myself and my sort of educational path which has been sort of a checkered combination of traditional education and school and radical independent pushing away of traditional education methods as well. And I remembered there was a time, and you may be familiar with this with your background in psychology as well, there was a book I read when I was an undergraduate in college. It was by the psychologist Carl Rogers and the book was called Freedom to Learn. I don't know that it's still in press any longer, but it was really a wonderful ... It was one of those things that was life changing for me because it was the first time I had read something that really said to me, you are in charge of your own education. And I realized and recognized that a lot of things were up to me in terms of what I was really choosing to do with that. I did take some of the messages out of that book and distorted them to my benefit the way a 19 year old college student will do by saying things like, "Hey, I don't really care if I study before this test or after this test as long as I learn this stuff. That's what's really important." Arguing that that was a reason not to have to study a whole lot immediately.

Whitney Lowe:

So anyway, that didn't have great results but it was an interesting idea-

Til Luchau:

I'm sorry. How old were you?

Whitney Lowe:

Let me think. I probably was 19. Probably 20. Probably 20, 21. Something like that.

Til Luchau:

I'm laughing as a former 19, 20 year old myself and as the father of one now. So yeah, go right ahead.

Whitney Lowe:

That you're watching, that's right. Doing those things again. But anyway, back to this whole thing, this whole idea of us charting our own education and saying, how do we determine what are the things that we want to learn and what do we want to focus on? I'm thinking about what I see in our field with people making these choices about what to take for CE course offerings and they ask other people for example, on social media, "Hey, what class should I take? What's a good thing for me to do?" The course of your education, if you want to think about it this way, is often charted by where you live geographically and who comes around your neighborhood on the CE circuit. So that ends up being a big factor to determine those kinds of things. But a lot of times it's also stuff like, well, who do people talk about a lot as being a good class to take and what does that really mean? Because sometimes a good class is one that you enjoyed because it was really entertaining or some kind of fascinating sort of mind blowing things were presented but was this really a good educational experience that you can say met particular criteria that gave you established skills and abilities that you can walk away with?

Whitney Lowe:

And those are some interesting questions that I think are important for us all to look at when we're trying to evaluate what makes a good course offering, a good thing that you should invest your time and money and effort into.

Til Luchau:

The division there ... I'm almost reluctant to bring it up because it's so big. The division there you're talking about or the paradox or the distinction there is, should we be free to follow our freedom to learn in that Rogerian sense of whatever's unfolding and the learner is the most important, most vital and most motivating thing? Or, are there things that if we step back with some perspective that we should be regulating or standardizing to make sure that everybody knows? Like it or not.

Whitney Lowe:

Yeah. And I think what we see as ... At least I'll speak for myself. What I see now as a more seasoned educator is that there is you kind of temper those perspectives and saying, as a young student who doesn't know a lot about the field, if you leave it 100% up to that person to designate their own path, they'll choose the things that seem either most interesting or easiest to go through. And that's not necessarily the things they need to really focus their attention on because sometimes you need to study the stuff that's hard. Like nobody would probably say, "Oh, I can't wait to start memorizing 200 muscles in the body because this is just going to be fun." But it is important that they know where these things are. That's just a natural part of that training program that they have to do. So, that's the challenge with the self selected, self identified training path is that you might miss some really important things that are crucial somewhere down the line. Like just as an example, the vast majority of people I think who find themselves working in more challenging healthcare environments, let's say in a clinic situation or a hospital or places like that, will probably admit that they're training on HIPPA guidelines and healthcare communications and working within healthcare teams was either grossly inefficient or nonexistent in their entry level training.

Whitney Lowe:

And these are skillsets or knowledge about many of these things that ... Now of course, this may differ nowadays since people are trying to pay more attention to some of these things. Some of these curriculums are doing a much better job of it. But there's a lot of training programs out there that just don't go into that kind of stuff and I know of a lot of massage schools that teach massage therapists for example and do a really good job of training massage therapists but they haven't learned some of the complexities of how health care teams work and how to communicate appropriately inside those environments.

Til Luchau:

All right. So do you see that as an important thing to include in entry level education? How to interface with the medical world. Or do you see that as a specialty that someone would focus on after entry level?

Whitney Lowe:

Well ideally, I really think it should be taught at our entry level training programs because as we said before, you can't always assume that you're not going to see people who have some of these challenges and you'll find yourself in situations where you need to communicate with other health professionals more thoroughly or in the ways in which they're used to dealing with health records and things like that just because that's the nature of what we're doing sometimes.

Til Luchau:

All right. So you're saying that me, whether I'm working in a franchise where you said the stereotype is we assume people are coming for a spa experience and relaxation, or I'm working as a structural integration person where I'm interested let's say in an Ida Rolf's vision of integration and wholism more than symptom fixing. You're saying that maybe I do need to know about HIPPA and interfacing with medical people?

Whitney Lowe:

Yeah. I'm saying that those are skills that I think would be beneficial for everybody to be learning just because it has to do with record keeping. It has to with methods of communication and appropriate communication with other health professionals we might be referring to and that sort of thing. So yeah, I do think that's important at that level.

Til Luchau:

Okay. Well, do you have more specifics? What's most important to talk about? These specific things, like is HIPPA high on your list or is it medium? Are the other things higher on the list?

Whitney Lowe:

I think there's probably other things that are higher on the list in terms of good decision making about what I shouldn't be doing. Who should I be referring certain types of things to? I think that kind of thing is important. But you know, people may have a good understanding of those kinds of things. Sometimes it really is more of I think a gradient scale of how well we know some of these kinds of things as opposed to just a black and white, we know this or we don't know this kind of thing. It kind of gets into where we draw that dividing line between our entry level training and what happens on some of those advanced training levels.

Til Luchau:

Yeah. I'm just thinking ... You're making me reflect and I think I do it instinctually is ... In my trainings I'm constantly thinking about where is the limit that I want to go with this client or patient? At what point do I need to pull somebody else in, give a referral? And what is right both in expectations to create a new client but then also what are the red flags I need to be watching out for?

Whitney Lowe:

Yeah. And it's a particularly challenging thing for us I think in this field because we do have many students who come into this work with ... They don't have undergraduate degrees when they come to their training programs and they sometimes don't have ... If you look at the overall skillsets of many of the young people entering the workforce these days, lots of people, and I'm not just talking about in our field, I'm talking about in every field, complain about people's ability to write well, to communicate well, to interact appropriately with other professionals and things like that. There's some basic skillsets that we think ideally would be covered in let's say, a basic undergraduate level education program. But there's even now I think a lot of questions about do people really learn how to do that stuff that well in many of those kinds of environments? So that makes it even more important that we focus on how do we train some of those things if people aren't coming into these programs and even because there are no degree requirements. When you think about it, we are the only field where somebody can come in without an advanced degree of any kind or without a undergraduate degree from a university or college institution and be a direct access healthcare provider.

Whitney Lowe:

And that's kind of scary to me. It's quite scary in fact that we have that kind of flexibility. If you want to take it to the extreme of looking at it as like a 18 or 19 year old kid. The one that I'm talking about in college was making these poor decisions earlier. That individual can be a direct access healthcare provider and choose to treat anybody who walks in off the street with any type of complex medical condition if they want to.

Til Luchau:

I find myself wanting to take the other side, so let me go for it. What about the commonly repeated point of view that says well, actually for instance our liability insurance rates are particularly low because there isn't a whole lot of actual harm that comes from the normal practice of hands on body work? So is there evidence of this being a harmful or dangerous profession that we're engaged in?

Whitney Lowe:

Yeah. And that argument has come up a number of times and I think there's some valid points to look at with that such as, yeah, I think overall massage therapy is not very dangerous in a broad scale. So that's one reason we don't see a lot of those kinds of complaints. But we also do know that there are certain situations where it could have very adverse consequences in certain types of unusual circumstances. The other thing is, and this is just completely anecdotal and I'll just say this is not a data driven statement, but it's something I recognized a lot of times when I was in clinical practice. We'd have people come to me as clients saying, "Yeah, I went to see a massage therapist for this and they hurt me." And I said, "Well, did you do anything about that?" Say, "What do you mean? No, I didn't do anything about it." So one of the reasons that I think a lot of injuries and adverse effects from massage are under reported is there's no place to go to tell anybody about it.

Til Luchau:

Yeah. For a long time I taught ethics at the Rolf Institute and one of my experiences I guess from stories I heard, also my own experience was that there probably wasn't a lot of physical injury, but there's all sorts of potential psychological level kind of injury or harm as subtle as body image or the way we think about ourselves, or the narratives we tell ourselves about our symptoms. And then beyond that of course the more egregious kind of violations of our ethics involve sexual boundaries and things like that that go on.

Whitney Lowe:

Yeah. And all of those are very important key factors of making sure that we practice safely with individuals. And I think medical journals in general do not want to publish articles about adverse effects of massage therapy so you don't see those kinds of things making it to medical journals and that's one of the reasons that there's not a lot of stuff reported there. So I don't think we have accurate data about how frequent some of those kind of adverse events occur. And like you mentioned here, the instances of people feeling like they were inappropriately communicated with or inappropriately touched or something like that during those kinds of environments, that kind of stuff is just not well reported at all.

Til Luchau:

Okay, but those are soft skills aren't they? Aren't those more in the realm of say human interaction and understanding more about the therapeutic alliance more than say a medical type of model?

Whitney Lowe:

I think it crosses both lanes because there's many other instances where like a person would come into me and say, "Yeah, I had this really bad neck injury and this person worked so deeply on me it just was killing me after they were done." So I mean that's clearly an inappropriately applied manual therapy approach. But that doesn't get reported anywhere. What the person does is they say, "I'm not going back to them anymore."

Til Luchau:

Okay, so what would you like to see happen?

Whitney Lowe:

What would I like to see happen?

Til Luchau:

Yes. Where do we go from here?

Whitney Lowe:

I'd like to see it all be fixed.

Til Luchau:

Yeah. Well, you got a roadmap for us?

Whitney Lowe:

I got to admit I'm getting tired. I'm 30 years into this battle of trying to find some way ... Here's the thing. If this was an easy answer, we'd have done it a long time ago. Really what I endeavored to do to day or wanted to do today was to shine sort of a different light on this issue of us thinking about the fact that we do self select our educational paths along these ways. And there's a lot of challenges and problems that come along with that. I think the answers to that are far more complex and they are things that we've attempted to grapple with various forms of credentialing through certificate and certification programs and licensing issues, all these types of things. And most of them are inadequate and in many instances inelegant solutions to these challenges and they are fraught with lots of problems. But it always felt-

Til Luchau:

No. I get you. I just underlining the tired you mentioned, but I was all ready for you to propose a solution and then I was ready to pick it apart too because I don't think there are really good models we have out there.

Whitney Lowe:

No. I would agree. And that's why I was saying if it was easy and there was a really good solution I think we would have done that a long time ago. I've been involved with a number of failed adventures and a number of adventures that I thought were steps in the direction but flawed models of doing things that I think are at least attempts to look at some of these things and attempts to find solutions. But it's challenging. It's big and challenging. But I would advocate I think what I would leave us with today is really saying how important it is that I think we start to at least come together on establishing what we feel like are maybe some core sets of competencies and skills that we should strive for. And most of our people who are working like you and I are with education levels at the CE level and at advanced training level, really try to tackle making sure that we fold as many of these things into our training programs as we can so that we can help people have access to getting those solutions available to them.

Til Luchau:

Yeah. That's right. That's right. Let's go ahead and just brainstorm together to acknowledge at least a couple more of the bright spots out there. Because it's a difficult situation and a lot of people, yourself included, put a lot of years into trying to say raise the standard or get some agreement on these standards and institutionalize those. And me teaching in different places, I see a variance across, for sure states, but even countries in terms of the amount of work that's been done on trying to get an agreed upon level of training. And I have reluctantly, I don't think it's in my nature, but I've reluctantly got behind that saying yeah, actually I do see for sure clear differences in the quality of work being done in places where there has been some regulatory involvement say in our field.

Til Luchau:

I'll think about it too, but can you think of bright spots where there seems to have been progress or something that you can stand behind and say this is good?

Whitney Lowe:

Well yeah, I would say some bright spots that I see are, again, the evolution of the internet and the global communication and social media has allowed the rapid dissemination of a lot of models, of a lot of information. Current research and things like that gets out faster that way. It also allows for, at least in the constructive times, it does allow for academic debate about things that help us move ourselves forward in some of these directions. So I think there's certainly some benefit in that direction of doing some of those kinds of things. I do think there's also some benefit in us looking at issues around competencies of what do we want people to be able to do once they get out of these training programs and encouraging some of the educators who are out there doing some of this kind of stuff to focus a little bit more on educational quality in some of these kinds of programs. Which I think has happened. I do see that as also a bright spot that in former years it was pretty easy for a lot of people to go out and sort of become gurus on a particular topic area and just really get out there and promulgate their own pet ideas and theories and models and things like that.

Whitney Lowe:

And now there's a lot more sort of critical analysis of these kinds of programs and content.

Til Luchau:

Yes. There is.

Whitney Lowe:

In ways that I think helps us all get better. I see those as steps in the right direction and steps toward improvement out there. And you look at the people who are doing really good stuff out there, really good educators doing really good stuff, and people aspire to meet that standard and go farther and go past that, which is good.

Til Luchau:

Yeah. I know it keeps me on my toes looking around at what my colleagues are doing. And I'm with you on the tired and I'm with you on the limits of what we've tried. I'm also with you on the bright spots because there's something really dynamic about our profession's hunger to learn. The amount of dedication, time, and money that people just throw into their personal improvement, but their professional improvement, their learning. And it's enormously gratifying to be a part of that.

Whitney Lowe:

It is. And it is inspiring. And I think for me, that's one of the things that has kept me going all this time is seeing some really good things out there and like you said looking around at some of my colleagues like oh man, this is really good stuff. Try to take this another step forward or something like that.

Til Luchau:

Yeah. We used to have this kind of virtual actual division. It's getting very blurred here in the post-COVID world where it's not a clear ... Someone said to me the other day, "We're having this nice in person conversation, you and me." And we were on Zoom and I go, "Okay, so this is the new in person?" Really. That's getting deeply integrated as well as what we used to call social media, which is now just another way that we're connected. It's another social dimension. And some of the very creative and interesting uses of that for better or worse. I mean, there's certainly downsides to the addictive nature or the fragmented nature of that kind of awareness, but there's also really creative and engaging things that are coming out of say Instagram and specialized groups within the different platforms that allow a focused conversation. It's just a fascinating landscape with a lot of dynamic movement in it.

Whitney Lowe:

And I heard you say something the other day and I can't remember where this was. If this was on a presentation that you were doing online somewhere or some discussion. You were saying that really in many instances we haven't decreased social distancing, we've decreased physical distancing with each other. Because there has been a whole lot of emphasis toward increased communication and interaction to some respect with a lot of things that we've been doing. So that was an interesting way to look at it I thought.

Til Luchau:

And there's a lot of cost in doing more through this medium, through this virtual medium. A lot of cost. It's not the same as touching. Never will be. No way. It's hard to include the body. Always will be. And yet, I just realized yesterday I'm actually getting better at reading subtle cues. I'm getting better and more intentional as listener. And I'm actually getting better too at thinking about how learning impacts the body because I can't get away with as much. I can't just sit there and talk to people for an hour and a half and not have them squirm. I have to think as an educator and as a practitioner too, I have to think about how do I really engage people's interests on all levels and keep their body engaged and keep their emotions engaged and all those kind of things too?

Whitney Lowe:

Yeah. So despite our best efforts I don't know that we've solved that major world problem today in this short segment of time, but hopefully at least maybe we shined a light on it and let some people have some different things to think about and reflect on.

Til Luchau:

No, thanks for bringing it forward and proposing it. Should we do our wrap up?

Whitney Lowe:

Yeah. I think we'll call that a wrap for today. You wanted to mention something too for our ending I think today too, an organization that you've come across here. I wanted to have you share that.

Til Luchau:

Well, it's my featured cause of the month and who knows, maybe longer. Kiva.org. K-I-V-A.O-R-G. It's a microfinance organization. They help match lenders with borrowers on a very small scale. They started in the developing world helping somebody be able to afford a cellphone so they could provide cellphone service for their entire village. And then it's moved on to anybody can apply for a loan throughout the world. And there's people in the developed world. There's quite a strong US contingent coming forward asking for loans. And then you can loan money directly to people who need it. The repayment rate is remarkably high and you can actually apply risk filters and other kinds of filters for the type of loan people want. There's a lot of people borrowing money for healthcare expenses to get a surgery that they need or to buy inventory for a store they want to launch. What I haven't seen a lot of, and I'm just starting to trickle in, is hands on therapists taking advantage of all of the lenders out there wanting to help someone through these interest free loans. And by the way Kiva's loans are interest free. By making a simple proposal, putting it out there, and seeing what you get.

Til Luchau:

It's kind of a GoFundMe kind of platform for loans as opposed to donations.

Whitney Lowe:

Interesting.

Til Luchau:

Yeah. They're interest free and they don't count against your credit rating. So as a lender, I know I've loaned a bunch of money there over the years. I know that I may or may not get paid back, but I consider that an acceptable risk. It's a gift I'm giving in any case. Like an interest free loan is a kind of gift. So anyway, check it out. Kiva.org. I'm want to see if this actually catches on. Right now there's only one body worker, or one say massage clinic in the US right now that's listed on Kiva that's helping themselves through the Covid time. I know there've been a couple more. But if you're interested in getting some assistance or if you have even as little as 25 bucks to lend, just go check it out. Kiva.org.

Whitney Lowe:

Great. Thanks so much for sharing that. I think that's a good thing we like to help people have some other input of things that may help them through this difficult time here so that's great for sharing that with everybody.

Whitney Lowe:

And we would like to say again, thank you to our sponsors for the show and to thank you all for listening, those of you who are listeners out there. We appreciate you listening. You can stop by our site, thethinkingpractitioner.com for show notes, transcripts, and other additional information there. And Til, where can people find you on the interwebs?

Til Luchau:

Advanced-trainings.com where we also have the full transcripts, show notes, and a bunch of other stuff about what I'm up to. How about you Whitney, where do people find you?

Whitney Lowe:

Absolutely. People can find us over at theacademyofclinicalmassage.com as well. And reminder, we've had some nice comments come in from listeners out there. You can always email us at info@thethinkingpractitioner.com as well as finding us out there on social media.

Til Luchau:

That's right. Please do let us know your thoughts, your questions, your suggestions and how we can best be supporting you during this time. Follow us on social media or find us on Spotify, Apple Podcasts, wherever you listen to podcasts. Rate us, tell your friends, listen, and take care everybody.

Whitney Lowe:

That sounds good. We'll see you again in two weeks.

Til Luchau:

Thanks Whitney.

Whitney Lowe:

Okay, take care.

 

Huge thanks to our founding sponsors:

           ABMP massage therapy            Handspring Publishing

 

Live Workshop Schedule

This Month's
Free Online Course

Our gift to you.
Includes CE, Certificate, and Extras.

Follow Us

Join us on FaceBook, Instagram, and Twitter for information, resources, and upcoming classes!

0 Comments

Submit a Comment

English简体中文繁體中文ItalianoDeutsch日本語한국어PolskiPortuguêsEspañol

Pin It on Pinterest

Share This