Life, Outsourcing, and Massage Therapy – Part 1

Just reading the title, you may be wondering what the heck I’m talking about. Well, you may have noticed that it’s been a while since I’ve posted to this blog. Life happened. Life is still happening. I teach, I have a family, car repairs, sports massage events, I’m in school taking classes, and I’m working on setting up a business. I just got busy.

The thing is, so do our clients. Often, as massage therapists, we wonder where our clients go. The truth is that many times it has nothing to do with the client not wanting to come back. Life just got in the way. Very few people I know have large blocks of time in their schedules to do with what they wish. MTs often fall prey to thinking that they are only competing against other massage therapists. Some who see a little bit more realize that they are also competing against other niche products like chiropractic, pain relief, and stress-reduction activities. But in the broader scheme of things, we are fighting tooth and claw with almost every other business (and even person) out there for one thing. Time.

Time and Our Service Economy

We are competing with sports events, TiVo, concerts, charity events, kids’ recitals, theme parks, you name it. Time is our clients’ most precious commodity. It seems that all too often, even when you want to get together with a friend, they have to check their schedule and pencil you in in three weeks. More and more, people are just so busy they can’t get away for anything.

What does that have to do with the service economy? Few would deny that massage therapy is a profession that rests firmly in the service sector. Whether you look at it as health care or a luxury, it is still a service. In one of my business classes recently, I learned that the rise of the service economy in the U.S. really began after World War II. What ended up happening is that incomes rose so that people had more to spend. At the same time, a counter-trend was occurring in that people had more demands on their time. The result was this, people began to pay others to do time-consuming services that they didn’t wish to do. Things like dry cleaning, painting the house, dining out increased. People began outsourcing more of their needs to others.

Outsourcing

The way I see it is that our clients have outsourced some of their care needs to us. We provide a therapeutic service and can rattle off all kinds of therapeutic benefits for massage therapy. We’ve been contracted to provide something that our clients want or need, but either can’t or don’t want to do themselves.

Think for a minute about the things that you want or need and can’t/won’t do for yourself. A person could get in shape without a personal trainer or a gym membership, but isn’t it easier to pay the membership or have somebody else guide you? Massage is kind of the same. People could reduce their own stress, there are many forms of massage that people really could do for themselves. But that isn’t really the issue. It’s time and focus.

General Busy-ness

A month ago, I wrote about my TFL and my plan for addressing it. I was going to chart the progress and write about it here. I know this stuff. I teach this stuff. I recommend it to my clients. Did I do it? Nope. It wasn’t important enough to me at any given moment to do much. Oh, I worked on it a few times. I got some massages at my school. But did I do the entire protocol that I laid out for myself? Sorry.

The point is that our clients are the same way. It’s not that they’re lazy, or uncommitted, or that they don’t want to be healthy. It’s that they have a gazillion priorities and their health is only one of them. Proper nutrition requires a lifetime commitment while McDonald’s only requires a commitment of $5, right now. When so many people demand so many things, something has to give. Unfortunately for us, for many people that seems to be massage and taking care of themselves.

And Back to Outsourcing

The answer to busy-ness for most people is one of two things. Put it on the back burner to be ignored or forgotten OR… outsource it. Our clients are outsourcing part of the wellbeing to us. We just need to know the best way to go about it for our particular group of customers. So what can we do to fulfill our contract as outsourced wellness providers? I’ll save that for part 2… (nice teaser, eh?)

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Your Perception Is Your Reality

“Your perception is your reality”

I recently heard someone say this and I thought it would make a great critical thinking question, especially when applied in context to massage and our client relationships. This is a pretty deep statement and has implications that affect all aspects of our lives. Many times people perceive what they want to perceive. In class, we identified five areas of impact – personally, professionally, communication, your clients, and your work.

Personal Perceptions

Your personal perceptions dramatically affect your own self-esteem and relationships. In essence, your own self-perception is actually the basis of self-esteem. Relationships also have a large element of perception. I know that I have seen people that when they state “I’m not happy in my relationship” it is less of an observation and more of a decision. They have decided that they are not happy and that nothing about it ever will. Others seem to be able to make it through hard times by having the faith that it is only a temporary struggle and that brighter times are ahead. We call these kinds of perceptions a person’s character and we describe it in terms of being optimistic or pessimistic or cheerful or sarcastic. These personal perceptions can really color a person’s world. Stereotypes are an example of this too.

Professional Perceptions

Let’s talk about ethics first. When it comes to ethics, there are times when perceptions can matter almost more than the substance. Were you to socialize with a client, another client or professional could easily perceive the relationship as being improper. Really any interaction is open to interpretation about motives and you only have any kind of control over the impression that you present (I call it impression management). While you can’t control the thoughts of another person, you want to avoid anything that could give the “appearance of impropriety”.

Professional perceptions are also exemplified in job interviews. Your performance in that interview is dependent on how that interviewer perceives you. In this case the perception can quite literally create the reality in that you will never really be that employee unless they perceive you to be.

Communication

Since communication takes two, and the two can never completely know each other’s mind, there is an aspect of interpretation. How many times have we discovered a miscommunication because one person perceived a meaning the other never intended? Sometimes perceptions can also relate to selectivity – only seeing or hearing what one wants to see or hear. Different perspectives will also place different priorities on different things. You may intend emphasis on one thing, but someone else prioritizes another.

Your Clients

I know I’ve seen many clients who say that they are stressed. Sometimes I have to wonder how much of that is a symptom and how much is a self-fulfilling prophecy. Are they stressed, or does believing that they are stressed just allow them to accept it and not find a way to get rid of it? If a client resigns themself to a life of chronic pain, does the perception create or contribute to that reality? There is a connection.

Another aspect is the “I can’t” mentality. You know what I’m talking about. A child is working on their math homework and is saying “I can’t do it” and then after a lot of frustration and agony they do in 30 seconds what they’ve been “unable” to do for half an hour. They’re just trapped in a mindset and convinced their self that it is too hard. They can’t do it as long as they believe that they can’t. Other examples can be clients stating that they can’t function without a steady stream of caffeine, that they don’t have time to take care of their self, or eating right is impossible.

In Your Work

Perceptions here can create some conflict when you perceive something to be beneficial to a client and others may disagree. A huge example of this is I have heard of some spas prohibiting their MTs from working on clients’ gluteal areas because of the perception that it is sexual. These clients miss out on an important integrative region of their body because of a perception (I’d say misconception, but that is my perception! :D). You may perceive that a client needs more pressure to achieve the results they seek, but they perceive that the pressure is already too hard. You perceive that trigger points are to blame for the agonizing pain they are in, but they perceive that trigger point work is simply increasing the pain they are experiencing.

So What To Do About Perceptions?

The good news is that you do have control over your perceptions and, to a lesser degree, others’ perceptions as well. Even a phrase like “look on the bright side” indicates that there is a choice about how you choose to perceive something. An important thing is to do some periodic self-evaluation and see (pun intended) if there are any perceptions that hold you back. Do you have any self-fulfilling prophecies? “I think, therefore I am” could be changed to “I think ______, therefore I am _______.” To a degree, when you think certain thoughts, you start behaving in a way to start to bring those thoughts into reality. Affirmations work this way. You choose something you want to be (a perception), and through repetition you change your thought processes to make it a reality.

Another simple strategy is to just do it. How many times have you thought something was hard or impossible only to realize it wasn’t all that bad? When an event occurs that dramatically changes our entire world view, we call it a paradigm shift. We can cause these to happen intentionally by opening ourselves up to new experience.

I certainly hope that you’ve perceived this to be helpful!

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Diversity in Your Practice

Jack of all trades, master of none - or so they say.

While there is a lot of merit in specialization and becoming a master of your chosen niche, it is important not to become overly limited and specialized as well. And in that respect, I'll use another old cliche - moderation is key.

Why Diversify?

In investments, you diversify to minimize risk. In the workplace to capitalize on different cultures and viewpoints. In massage, it's both.

Risks?

What risks, you might ask? In massage school, we all should have learned (and hopefully learned well) the risks associated with improper body mechanics and repetitive strain injuries. We learn how to help our clients deal with and prevent these things in their lives. But what about ours? Massage is physical work, and even using the best body mechanics isn't going to eliminate all potential problems. We all come into this work with a different history, a different accumulation of life's wear and tear on our bodies, and different genetic predispositions. Some can certainly last longer than others, and proper body mechanics employed consistently and habitually should allow any therapist to (as I always say in class) "let you work for as long as you choose to, not for as long as your body will let you." So, performing the same movements over and over again in your work can create the potential for RSIs.

Let's not forget that we are holistic beings here, so we can't neglect emotional, mental, and spiritual aspects of specialization as well. Personally, I thrive on novelty. I love new projects, getting things kicked off, establishing procedures and efficiencies, building businesses, and starting careers (that's why I love teaching). Doing the same darn thing day in and day out is torture for me. For me, psychological burnout is a bigger concern than physical problems. There is a real danger to the client-centeredness of your practice when things become so habitual you stop asking questions and start running on autopilot. Work becomes less fulfilling, monotonous, and a chore. I'd venture to suggest that just as many, if not more, MTs leave the profession because of this as for physical reasons. It can also lead down the slippery slope of focusing on what you're getting out of it (aka $). Not a good road to go down.

Specialization has its rewards too, but I don't hear too often any discussion about the downside. A healthy MT/practice/career strikes a balance.

Diversify

OK, so over-concentration in a single area can be risky. What do I do about it? How do I diversify?

Well for starters, it may mean using some different techniques. I'm sure there are a lot of things you learned in massage school that you haven't used in a while. Or you could watch a massage DVD, even search on YouTube so you could see some different techniques. Trade massage with an MT that uses a different style than you do or purchase one. Read a book. Even learn something from a discipline that is similar but different like PT, emotional healing, yoga, breath-work... You could also just make the effort to change up the emphasis in your sessions - do a lot more stretching, try some techniques that require client participation, mix zen shiatsu into your Swedish.

Another way is to provide some complementary services. Body wraps, exfoliations, hot stone, aromatherapy, and others are all great ways to mix things up. They can use your body in a different way or potentially use your body in the same way but with an entirely different thought process. It helps to keep you (and your client) engaged in the process.

It might also mean diversifying your work environment. Getting out of a rut means breaking routine. Try working in different environments - a spa, chiropractice office, a pain clinic, a law firm, a house call, outdoors at the charity 10K... Try working with some different clients that have different challenges for you to work with.

Got some ideas on how to diversify? Let me know!

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Raising Your Rates

A touchy subject for all massage therapists. When do you do it? How? What do you say? This question was recently posted on LinkedIn's Massage Therapists & Bodyworkers group:

I would like to hear what other therapists tell their clients when they ask why you've raised prices. (or if they complain about it). I raised my prices last year from $70 to $80/hour. I was underpriced for my area, now I'm competitive. I own the business so about 30% of my clients tip but I don't count on it and it isn't expected or considered in my financing. We all know why we have to raise our prices: 1) To stay competitive and not under-value our work. 2) To pay for the increases in the cost of doing business so that our profit margin remains the same. People who are employed get annual 'cost of living' raises. we don't unless we raise our prices. I am resentful of people who don't understand this, and have a hard time coming up with a concise, professional way to explain. I certainly think I'm worth the raise, so that is not the issue, and I'm not defending that. Thanks!

Cass Vertefeuille Garrett of Greenleaf Therapies, LLC

First off, Cass has it right. When we're self-employed, we are the ones who have to give ourselves a cost-of-living adjustment. I think that Cass has already presented some good reasons why we need to raise prices, but let's take a look at the thought process behind it and the when and how of increasing rates.

Why Raise Rates?

The thought process here is a simple one. Our prices aren't static, as our clients often seem to think they are, and like we MTs can even fall into the trap of believing. There are lots of factors that drive our pricing, some of the most obvious being: inflation, increased cost-of-living, increased costs of doing business, having increased experience, training, or specialized skills, and so forth.

Because these expenses aren't static, neither can our prices. We need to build that mentality into our business plans and practices. Ideally, we should also build this into our clients' expectations. Think about the example of a client who wasn't informed that they might be sore following a massage who then becomes sore afterwards. The are upset because it was a surprise and worried that something might be wrong. The same can happen with your business practices. Build in the expectation that prices will change periodically to reflect the current economic environment and it won't be such a nasty surprise when it happens. I'd include this expectation in your policies from the very first appointment with your client.

When to Raise Rates?

The knee-jerk response to this question is "when you need to" and that is a valid answer. But it is also an answer that implies a lack of planning or control. While you do need to be responsive to factors such as rent increases and the like, that shouldn't necessarily be the only reason to look at your rates.

My recommendation is to develop a process to systematically examine your pricing structure. Earlier, I used the word "periodically" to describe when rates would change (nice foreshadowing, eh?). That means that there is some kind of established and regular time-frame for when the rate changes occur. I go with a yearly period, but you could go shorter or longer if you'd like.

This evaluation should take into account all of the changes to your personal business climate over the course of that period. Some examples:

1. Taxes - increase or decrease?
2. Expenses - personal and business
3. Inflation - don't overlook this one!
4. Local changes in the market - competition, new regulations...

Inflation alone means a pay-cut every year if you don't adjust your rates. A 3% inflation rate means you essentially earn that much less in spending power that year. Over a couple of years of static pricing, that really adds up!

Generally, I would suggest that you factor all of the cost increases in and figure out the percentage that impacts your real income (not dollar amount, but buying power). If it's not too big, you can hold off tacking on another $5 onto your rates, but then plan on it for the following year. Just make sure that you establish a schedule - a fiscal year, if you will.

How?

This is probably the one most MTs have the problem with. How do I actually break it to my clients? Won't they be resentful? Will I lose clients? These are common fears.

As far as resentment from your clients, nobody likes to have prices go up, but it's a fact of life and if you have prepared they way with client expectations it won't be as big of a deal. And losing clients? Maybe. But if a client leaves because of a small and realistic price increase, they weren't there for you, the health of your business, or the results you deliver; they were there for price alone and you won't miss them. That's a reason why I only use low introductory rates with caution - it fosters an relationship where the most important factor is your low price relative to the competition. If you do have some clients that truly cannot afford your new rates but you want to keep in your practice and they need the work - try including these clients in part of your planned charitable giving. All individuals and businesses should plan on giving some of it all away, either for free or at cost. It's good for everybody. Set aside a certain number of appointments a week (I shoot for 10%) that you can either give away or perform at a reduced price. That way the cost to you is limited, accounted for, and planned on. Everybody wins.

Breaking the news is not the most pleasant of tasks, but like other forms of boundary enforcement, it is necessary. It should be done in the spirit of both acceptance of the fact it must be done and compassion for how it affects your clients. It should be delivered firmly and clearly, with compassion but not regret or apology. Some suggestions that I posted on the LinkedIn forum:

You might try something along the lines of:
"Dear valued client, As I'm sure that you are well aware, the current economic environment has placed additional pressures on all businesses. Unfortunately, my practice has not remained isolated from these pressures and in order to continue to operate soundly I need to increase my rates to (insert your new rate schedule). These new rates are effective on (date). Thank you for your continued support."
Or...
"Periodically, I must adjust my rates to reflect changes in inflation, cost of living, and operational expenses. As a result, I will be increasing my rates to... on (date)."

Promote It

As a teacher, I've had to deal with from time to time is change - curriculum changes, textbook changes, procedural changes - and times of change can be stressful to students (and clients). The important thing when you are implementing a change, even a rate change, is to promote the positives. Sometimes it icludes an explanation about why, sometimes you just emphasize the improvements. With rates, it could be as simple as "to continue to provide the same level of service in the face of rising costs". Your students, and you clients, will pick up on your attitude about it and it does influence how they feel about it. If you are positive, it will move their feelings about it in a more positive direction. If you are negative, they will fight you on it. And if you are wishy washy about it, they will feel they can get you to make exceptions and special allowances.

One thing that can turn the change more positive is to tie in the rate increase with a promotional period. Give a date for when the new pricing takes effect and allow your clients to take advantage of getting in some more appointments at your current rate. Even allow them to buy packages or gift certificates at your current rates up until a certain date. This can have the effect of increasing both the amount of business and having money in your pocket up front. If you worry that things might get tight, you could restrict the discounted certificates to certain times or days so it doesn't interfere with your full-priced business.

So to summarize, make sure you regularly evaluate your pricing and make sure that your pricing is optimal for your business climate and meeting your needs. Be positive, firm, clear, and compassionate about how you communicate a rate increase to your clients. Expect you may lose a few, but most will understand and the ones that leave aren't the healthiest clients for your practice anyway.

Good luck!

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Bad Experiences

Another Critical Thinking Exercise from class...

The Question:

Think of a really bad experience you had with a “professional”, a business, or a service provider.

1. What went wrong – with the circumstance and the resolution process?
2. What happened after? Was it resolved?
3. If you were them, what could you do to have prevented or dealt with this situation?

The Ugly

The students had some fun with this one. I mean, who doesn't like to tell their horror stories about something like this. Statistically, if someone has a bad experience with a business, they will go and tell at least 10 other people about it. Why? Because people love to gossip about this stuff and see people's reactions ("They did what?!"). If only they did the same thing when they have a good experience.

These stories ranged from a hotel room paid for a month in advance with a bug infestation and the fight to get their money back, to a dentist that started drilling without anesthesia or permission, to auto sales, to insurance claims, to omnipresent and dastardly telecom companies, to a doctor that assumed everybody that he saw was filing a fraudulent workman's compensation claim and refusing to actually do his job and diagnose their pain, to a landlord taking a complaint about an authorized cat to the level of screaming that their tenant was a bad mother and a worthless human being. Man! Everybody has one of these stories to tell.

We've all had these ugly experiences. Getting shuffled from department to department and having to explain the same thing over and over to an army of people, none of whom are equipped to help you with your problem. Skepticism or outright disbelief that you, the customer, are actually telling them the truth!

The Bad

In these student stories, we identified a number of common themes that make for a bad experience:

1. Rude, abrasive, aggressive, or insulting: This one was common. Resorting to insults and attacks will never turn the conversation in a positive direction. In fact, it will almost inevitably escalate the hostility in the conflict. If a client does this to you, it still isn't right to return the favor.
2. Assumptions: We all know the old saying here about assume and "u and me". There is a distinction between using experience to make an educated guess in anticipating the needs of another and making an assumption that you already know what they're thinking or want.
3. "Own Agendas": One of the biggest problems I see with unsuccessful MTs/sessions is that the therapist thought they knew better than the client about what was right. That way the needs were ignored. You use your knowledge to inform your work, but we don't dictate to the client what is right for them (and it is unethical to do anything that benefits you at their expense!)
4. Conflicts of Interest: Who are they really working for? You or their shareholders? This goes hand in hand with having your own agenda. Client-centered practices require that you do what is best for your client. It should for all business!
5. Bait & Switch: Of course this is illegal as well as unethical. Misleading clients into getting something other than what they expected won't win any hearts.
6. Lack of Concern: They just don't care about you and your life, only about your customer number, payment history, profitability. Massage is a people business, so caring is our business. Don't make this mistake.
7. Incompetence: There's no excuse for not knowing what you're doing or what you're selling. One student had an experience where the sales clerk didn't even know the most basic things that they sold in their store, before copping an attitude about it!
8. NOT LISTENING: Big one, this, and common. It goes along with agendas, rudeness, and others. When customers get angry, it's most often because they aren't being heard (of course this is set off by something). You can't solve the problem if you don't listen to what it is.

The Good

Whew! A lot went wrong, didn't it? On the other hand, the class identified a number of themes as being essential to the relationship either to begin with... or to repair it when things have gone wrong.

1. Boundaries: Know what you are willing to give and take and stick to it. Communicate it clearly and firmly and keep things "in bounds". Limit discussions to the matter at hand. That landlord was way out of line for calling her a bad mother simply because she had a cat!
2. Respect: We've all heard of the Golden Rule - treat other the way you would want to be treated - but the platinum rule takes it to the next level - treat others the way that they would want to be treated. Not everybody wants to be treated like you would. This automatically rules out aggression, insults, and dismissal.
3. Follow Through: If you say you're going to do something, do it. No excuses. You should always operate this way, but when you are trying to mend a relationship, it is an absolute must. Don't make promises you can't keep.
4. Accomodation: Know what you are willing to part with or what you are willing to do to placate this customer. Figure this out ahead of time so that you don't make a mistake in the moment. It may include bending the rules a little - like coming in on your day off or staying late for them, or comping a service or gift certificate. Remember - a customer who had a problem that was resolved to their satisfaction is more loyal than a customer who never had a problem at all.
5. Communication: Honestly, most conflicts are the result of mis-communication. Don't make it worse by continuing the mistake. Make sure that you take extra efforts to ensure that both parties are clear on the message. Listen. Listen. Listen. Often, when people are angry, it is mostly out of frustration that they are not being heard. Allow them to speak. Make sure you pay close attention not just to the words, but to the meaning behind them.
   
6. Informed Consent: They want to know what their in for and it is your job to let them know. Build realistic expectations with your clients and make sure you give them all of the information they need in order to make an educated decision about what is right for them.
7. Professionalism: Conduct yourself appropriately and diplomatically. Make sure you maintain your client-centered attitude throughout. Professionalism is a skill and a habit. Make sure you think about these kinds of situations ahead of time and figure out how you would like to handle them to create and ideal resolution.
8. Deliver: Make sure they get what they pay for. Don't overstep your bounds (and scope of practice), but make sure you live up to your billing. Make sure you bring your A-game to the table every time, for every client, without fail.

Once again, an excellent discussion. Mind you, I helped to frame some of these terms, but my students came up with all of this on their own, simply by relating their own stories. Kudos!

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Effects and Benefits of Massage Therapy

This is the first in my Critical Thinking Series of questions from class discussions.

Question:

How does understanding the effects and benefits of massage or massage techniques make you a better massage therapist and/or more successful?

As we discussed this topic as a class, several themes emerged:

1. Effectiveness & Outcomes
2. Contraindications
3. Professionalism
4. Marketing
5. Communication & Education

Effectiveness & Outcomes

The very first student comment to this question was in selecting treatment. We examined the adage "If all you have is a hammer, everything looks like a nail" and how it applied to this idea. In understanding how a massage technique will affect the body, we also can determine whether or not it is appropriate or effective for a given problem. Selecting more effective techniques leads to better outcomes.

Contraindications

Naturally, the prior discussion led right into the discussion of what to do when massage is not appropriate. Understanding the effects is a large part of the "do no harm" mantra. It can prevent possible harm, but sometimes it can serve another positive function in practice - positive regard for the client. This overlaps into the next theme, but it demonstrates a positive regard for the client's well-being to help them find the help they need, even if it isn't with you.

Professionalism

As part of this discussion, I asked the students how many of them had had a client who had asked them about a particular massage style or technique and what it did. Of course they all had. The follow up was "what did you say?". It was quickly determined that many hadn't felt they had provided the best answer, or that they had to think about how to condense an entire class down into a simple, understandable statement. The consensus was that you look like an idiot when you are unable to give an answer to those questions. Who should know better what a technique does, you or your client? Understanding these effects makes you appear more professional in the eyes of the client - more competent, more knowledgeable, more credible.

Marketing

Why should they buy what you're selling if you can't even give them a reason? Understanding effects is the foundation of what you need to communicate to your clients. But it doesn't stop there. A discussion of effects seldom means a whole lot to the client. Enter benefits.

Effects vs. Benefits

Effects are what happens in the body - mechanical, physiological, reflex... increased circulation, parasympathetic stimulation, enhanced lymphatic flow, and many, many more. Benefits are what the client experiences because of those effects - they sleep better, experience reduced pain, improved body image... Clients for the most part don't care about the effects (in marketing we call them features) because it doesn't really mean much to them. Benefits, on the other hand, are the things they care about - that register on their consciousness.

Back to Marketing

When a student learns the effects of massage techniques, the next step is to be able to translate those effects into why it is a good thing for the client, aka the benefit. Often this is a very different way to frame it and it is also highly dependent on the audience. It doesn't do a whole lot of good to discuss with an athlete how massage will help them sleep better when they are really concerned with performance improvement. Likewise an insomniac won't care about increased rang of motion and power out of their throwing shoulder. A thorough understanding of effects and benefits allows you to speak in your client's language about their problems. Not grasping this is like trying to speak a foreign language with only half the alphabet.

Communication & Education

Effective marketing is honest education - education about why your service is valuable to your client. Communicating and educating about effects/benefits effectively increases the value that you offer to your clients. You can't teach someone why what you do is important if you don't already know it yourself! To be honest, this category encompasses all of the ones we've talked about so far because education and communication are such an integral part of what we do.

Anything we missed? Please add it to the comments below. Happy massaging!

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Massage Student Motivation - Part 4

Continuing my discussion of International Journal of Therapeutic Massage and Bodywork's article A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education from parts 1, 2, and 3...

So What Does It All Mean?

So far we've established that over the course of a massage program, intrinsic motivation decreases and extrinsic motivation increases in students (see the article above for the study). To summarize:

1. Students become more aware of financial responsibilities (debt load)
2. Students grow to understand the contributions and limitations of their work (effectiveness)
3. Students place more value on their skills as they realize the commitments required in their education
4. Students begin to make associations between professionalism and their career. They identify with being a professional and what that implies.
5. Interaction with seasoned professionals (faculty) moderates students' idealism with "realistic altruism"

How Can Massage Educators Use This Information?

So it is a fact that students experience decreased intrinsic motivation and increased extrinsic motivation over the course of their program. Dr. Finch concludes that this isn't actually a problem, but a natural progression and reflects a healthy change in attitude. They learn a more balanced perspective.

As educators, we need to be conscious of this shift, and address it appropriately as we bring our students along. We need to be cautious about not injecting the realities to quickly, which may disillusion new students at the outset. At the same time, we need to make sure that students recieve the realities "on schedule" to achieve the balance necessary by the end of their training. We must ensure that we include this transformational process as part of the training, not a side-effect. It deserves some focused attention and even to be raised to a conscious level in the students as well.

It requires also a conscious effort to maintain the altruism through the end. Instructors must be careful to moderate the realities so that the ideals of their students aren't shattered. The idealism should be fostered and molded into something tangible that the students can use. In my classes, I teach my students to build their altruism into an intentional plan. It helps to have a target, or quota for their altruism - I teach 10%. It helps the students to have that target - that way they don't feel guilty about not giving anything away, have it as part of their plan to give something away, but don't give away the farm. This principle can also help to stave off the problem of viewing clients as numbers, or as a means to an end - becoming too extrinsically motivated.

As teachers, we have to be conscious of giving our students what they need in its proper time. This study shows that their exposure to us is a part of this process. We have to bring our students along as they are ready and not introduce them to all of our "realities" too soon. We also need to make sure that as we teach professionalism, we cultivate their altruism as part of the process.

Happy teaching!

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Massage Student Motivation - Part 3

Continuing my discussion of International Journal of Therapeutic Massage and Bodywork's article A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education from part 1 and part 2...

The Evolving Self Image As a Health Care Professional

Again, Dr. Finch broke this theme down into parts:

1. Rigor/Intensity of the Educational Program
2. Developing Perspective of Massage Therapy As a Career
3. Interaction with Faculty

Let's discuss these themes individually (summarized from the article).

Rigor/Intensity of the Educational Program

Dr. Finch describes this theme as the students expectation of commitment to the program. Most students "were largely unaware of the commitment it would take to successfully complete the program". This had the effect of increasing extrinsic expectations because of acceptance of implied level of expertise. It kind of makes me wonder if some of the problems we face in our field comes from the fact that many people aren't aware of just how much we massage therapists know! As the student becomes more aware of the level of knowledge required, they also place more value on their skill and with it the expectation of more rewards. It fits well with the risk/reward paradigm, in that the more you risk, the more you typically expect to receive in return. When the student makes those sacrifices, they look for "a return on all that investment".

As much as I try, it is nearly impossible for my incoming students to fully comprehend what they are signing on to. It is invariably more involved, more work, more homework, more reading, more massage, more, more, more, than the students expect. This leads to Dr. Finch's last point on the theme, that the amount of focus on the details of the work can draw focus from the why behind it - that students quickly run out of time for even thinking about the intrinsic rewards to what they do.

Developing Perspective of Massage Therapy As a Career

As a student progresses through the massage program, they increasingly identify with being part of health care. They realize that they can and often are expected to assist with clients' health problems and that accompanies a level of responsibility.

In addition, students learn about what it means to be a professional and the thought processes, behaviors, and "things" that go along with it. Often there is an association between being successful as a professional and the freedom that goes along with having more money. Personally, I include it as part of my program the entire thought process behind making massage therapy work as a career. The students must think about how they are going to support themselves and their business, pay the bills and enjoy life too. I see it as part of my job to help them figure out how to get there.

Interaction with Faculty

Of course, faculty have been through massage school already. They have experience working as a massage therapist. They have been through the struggles and triumphs of being a practicing massage therapist. They've had their naivete stripped away already. While of course many things must really be experienced before they are truly learned, the instructors begin the process of creating more realistic expectations for the students. It's a part of the process. Altruism is taught as well, but from the tempered perspective of the seasoned professional, and as the students look up to their instructors as role models, the attitudes begin to have an impact.

I've met some very jaded massage therapists in my time - the kind that won't lift a finger for anybody else (figuratively!) unless they're paid for it (can you believe I've had MTs ask to be paid for their time when students asked them for a 10-minute interview?! Talk about a learning experience for the students!). Who'd want a person like that as a teacher? So a good teacher will still maintain some of the altruistic, idealistic spirit to impart to their students - albeit with a realistic and experienced frame of reference.

I love the term that Dr. Finch uses for this - "Realistic Altruism". Boy am I going to start using that!

So what does this all mean? On to part 4...

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Massage Student Motivation - Part 2

Continuing my discussion of International Journal of Therapeutic Massage and Bodywork's article A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education from part 1...

The Reality of Life in Practice

This is what Dr. Paul Finch decided to name the first theme that his study identified. I think it is a very appropriate title. He further breaks this theme down into two parts:

1. Debt Load
2. Effectiveness in Achieving Positive Health Outcomes

Let's examine each of these sub-themes and before discussion (I summarize from the article).

Debt Load

This one seems fairly self-explanatory. When the student first begins their studies, their loan repayments are generally a long way off. As they progress through their program, the reality that they will soon begin to have payments due, coupled with a mandated financial aid exit workshop and discussion in class about business, making a living, and other financial education means that the students become more financially savvy. As the end of the program approaches, and students face the prospect of being out on their own, responsible and independent professionals, without the crutch that being a student offers. Looking for a job also heightens awareness of the importance of financial acumen to their future.

Effectiveness in Achieving Positive Health Outcomes

Dr. Finch describes this one as a growing awareness that what the student can do can make a real difference in people's lives. Students become aware of the contribution that they can make to a person's well-being and health. They also obtain an understanding about the knowledge that is behind what they do. That might lead you to think that intrinsic motivation increases with this, but it is tempered by the fact that students also learn that massage isn't the answer to every problem and "you are not going to help everyone with everything". To me that indicates a loss of idealism, which isn't an entirely bad thing if their idealism is now balanced with realistic expectations.

Discussion

The reality of life certainly does have a moderating effect on idealism and naivete. To me, I feel it is an instructor's duty to assist the students' growth through this process into a mature professional. It is a disservice to move students through a program without educating them about these realities. Of course, as Dr. Finch mentions, it is also the instructor's job to balance this fact with maintaining support for the "humanistic mission of the profession". I believe that in essence it is a teacher's job to take a dream and turn it into a reality. Part of that process is to help the student to have more realistic expectations about what those dreams really are.

Both of these are a natural part of the process of education. In school, we discuss the practical realities and real-life situations that our students will face. But still, I believe that for me, the value of this discussion is in raising the awareness of the need to keep the realities from crushing the ideals. It is important to find the healthy balance.

On to part 3...

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Massage Student Motivation - Part 1

The second issue of the International Journal of Therapeutic Massage and Bodywork came out today and there was a very interesting article about the changes that massage students experience in motivation over the course of their program. I found it fascinating and it reflected a phenomenon that I have observed over the years in the classroom and in practice - particularly with the "jaded" massage therapists that are just in it for the money.

Here's the article:
A Qualitative Investigation into Why Massage Therapy Students’ Motivation Changes over the Course of Their Professional Education (and their license)

To summarize, the study is about why massage students' motivation changes from more intrinsic to more extrinsic over the course of their education. It takes place at only one school, with a small sample size, but the author recognizes this weakness, and from my observations in my classes the findings are accurate. Please note that I am commenting on this article and adding my observations - Paul Finch, PhD (the author) deserves all of the credit for the article and the pieces I quote from it.

Intrinsic vs. Extrinsic Motivations

First off, many massage students enter their massage programs with some "naive expectations", as Dr. Finch puts it. These expectations manifest as a desire to help others, an altruistic ideal about the work they are about to learn to do. The naivete isn't so much in the altruism as in that it isn't balanced by the realities of the profession they have yet to learn. Intrinsic motivation also comes from things like the satisfaction in the work being done and the self-esteem derived from being skilled and appreciated. IN-trinsic motivation is IN-ternal and given to yourself.

By extension, EX-trinsic motivation comes from rewards from EX-ternal sources. Of course those include compensation, the praise and recognition they get from happy clients, prestige, and more.

Past studies have shown that as a massage student progresses through their program intrinsic motivation decreases and extrinsic motivation increases. This study looked at why.

So Why?

Dr. Finch identified several themes prevalent in the study participants' responses. He describes them as follows:

Reality of Life in Practice

1. Debt Load
2. Effectiveness in Achieving Positive Health Outcomes

An Evolving Self-Image As a Health Care Professional

1. Rigor/Intensity of the Educational Program
2. Developing Perspective of Massage Therapy as a Career
3. Interaction with Faculty

Don't worry, I'll discuss each one of these in more depth in this series. I'll also introduce my perspective on how we as educators could use this information to foster this development appropriately and help our students leave our programs best prepared for a vibrant, healthy career. So let's get started!

On to part 2...

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5 Quick Tips to Build Clientele

I posted this response to a question on the Associated Bodywork and Massage Professionals group on LinkedIn.com. I thought I'd repost it here since there are some good, quick tips for building your client base.

The Original Question:

Hello, I am a massage therapist in training. I will be completing my studies in
October 2009. Is there any advice that can be given or suggestions as to how to
start building a clientle. -Nicole Morris

My Response:

Nicole, There's a lot of great information here (referring to other posts)! You need to find your balance between different methods of building your business. I'm always for spending as little as possible to the best effect, so let's look at a few to get you started. Others have mentioned networking here. Networking is in my experience by far the most effective, but it takes time to build it up. There are however some things you can do to speed the process.

1. Be ready to talk to everybody about it. And even more importantly, you have to know what you want to say. Make sure you know your market and what it is that they are looking to get out of what you do. Then you can craft what you say to appeal to them. Get your message as clear and concise as possible, then be ready to say it whenever anybody asks what you do.
2. Recruit your network. You're a member of Linked In here, so you know the power of networking. Use the network you already have of friends and family. I have my students write a letter to them explaining what they've been doing and what they do (back to #1). By telling them in your words, they are more likely to use your language in describing your work to their friends and family - which appeals you your target market more. And then be sure to ask them directly for their help - "please help me build my practice by telling all of your friends and family about my work" - or more directly - "invite your friends and family...". That way they know what you'd like them to do.
3. Partner-up. That doesn't necessarily mean a business partner, but build a network of people to refer to you. In my work it used to be networking with concierges in hotels, who in turn referred clients to me. Think about how you can create win-win-win situations for you, your referral network, and your clients.
4. The right kinds of incentives. Don't assume that everybody wants to have a free massage or a discounted rate as a reward or incentive. Sure they can be the cheapest, but they aren't always the most effective. Ask them what they want and give it to them - then they'll give you what you want.
5. Track it. Make sure you keep tabs on where your business is coming from. Track the top 20% of referrers in your network and make sure you keep them happy and referring as they'll probably send 80% of your referrals by themselves. Hope that helps. I write on these and other topics frequently on my blog ( http://www.linkedin.com/redirect?url=http%3A%2F%2Fwww%2Emassage-continuum%2Eblogspot%2Ecom&urlhash=OjAp&_t=tracking_disc ) if you'd like to read more.

Additional Comments:

I can add to this that as she is a student, she should start building her client base now. Word of mouth takes a while to build and the sooner she starts, the better. She should begin letting her potential clients know where she is with her business development and can start working on these clients (maybe with student rates even). Many students who choose not to charge while they are in school still make quite a bit in tips. One word of caution though, make sure you build in the expectation up front that rates go to your normal professional rates after you graduate. If you don't build this in from the get-go you may run into problems later in transitioning these clients to paying (or paying more).

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Constant Vigilance!

Having just gotten off the phone with our friendly neighborhood police department, I thought Mad-Eye Moody had it right in Harry Potter when he said "Constant Vigilance!".

Unfortunately, we live in a world where you have to watch over what is yours and keep it safe and sound. In my case today, somebody got hold of my debit card number and wired themself some money from my account. Luckily I caught it before the charges actually hit my account, but still I spent the last hour on the phone with my bank and the business charging me and with the police department. I certainly can think of better things to do with my time. It is very frustrating to have to spend a lot of time and effort dealing with something that shouldn't have happened in the first place.

It got me thinking about the importance of keeping your eye on things. Complancency can get you into trouble. Many of us have the tendency to assume that things will continue along just as well as always - even if we don't pay attention to them. Generally however, it is the things we don't pay attention to that go awry.

Business Sense

Really it is like driving a car. You wouldn't go out and drive a car by leaving your hands off the wheel and then just before you crash trying to get back on track. It is much more effective to make little corrections, to monitor your travel constantly and avoid trouble before you come to it. That's how we need to run our businesses (and lives?) as well - not taking things for granted, giving everything the proper attention, and dealing with problems before they arrive instead of damage control.

The majority of the students that enter my massage program want to have a private practice or even their own massage business that employs other MTs. Although owning a business does take a certain temperament and willingness to take risks there really isn't anything all that special about it. The most important thing to being successful in running a small business is managing the details - lots of details. Of course managing them the right way is the other half of the equation.

Top dogs don't stay top dogs by accident. Success is a process that doesn't end - it must be maintained.

Confidentiality

My current problems with my bank account really come down to the fact that somebody didn't manage my private information properly. I've purchased things online from unkown vendors without much of a thought about whether they would protect my information/ Part my fault for trusting them, but definitely their fault for negligence.

We can run into the same problems with our massage businesses. We keep private health information, contact information, collect checks and credit cards. As business owners, it is our job to safeguard that information. HIPAA laws detail the protection and obligation to protect health information, but we don't have the same kinds of standards for the other sensitive information that we handle in our work.

Controlling Access

Make sure that only those who need to see the information can access it. That means securing it so that the opportunity isn't even there for unauthorized access. Password protect. Locked and secured storage. Provide physical barriers to the access.

If you work with others and especially if you employ others, you need to establish policies about protecting client information. Your employees need to know what information they need to safeguard and how. Contractors also need to receive this instruction. If you work in a group setting, make sure that you have these policies outlined with your colleagues. If you work in a business where these policies are not in place, initiate it. The last thing that you want to have happen is to get involved at the center of a fraud investigation.

Positive Habits

It is a good habit to get into to keep a close eye on your obligations. Make sure you access your accounts regularly and frequently to make sure all is well. Respond quickly if there is a problem, as these matters often take time to resolve - the sooner you get started the better. It may seem like a hassle to keep an eye on everything, but you will avoid the aggravation of having to prove your innocence of fraudulent charges and the navigation of countless automated phone menus.

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Massage and the Happy Medium

Massage takes place at the hands.

It sounds obvious, right? Maybe. Maybe not.

I've taught massage therapy for almost five years now, I've educated clients for almost 11 years, and before that I taught martial arts. I've observed how people learn and practice their skills for quite a while. In my experience teaching, I've noticed that there is a spectrum that all students fall upon...

Intuition (Client) <---------------> Intelligence (Therapist)

...where the intuition refers to your feelings and sense of the way things should be and the intelligence refers to your knowledge and thoughts. That naturally begs the questions where are you and where do you want to be?

Intuition

I always ask my students when I first meet them about what drew them to massage. A common theme in their responses is often a story about how they have always done massage in some form. People tell them they have a good touch. They have a talent for finding the knots and even though they don't know what they're doing or how to describe it, they are able to melt the knots away.

I place these students high on the intuitive side of this equation. They are sensitive to other people. They are able to work from information that they gather through their hands from the other person's body. They are responsive to the changes they sense in the other's body and adapt to it. When they do massage, they are performing "inside" the other person's body - on the client side.

Intelligence

People high on the intelligence side of the spectrum operate from the confines of their own head. They intellectualize things, do very well with tests and theory and assessments, and are good at putting the pieces of the puzzle together. They can also see how different techniques and styles can be used effectively on various conditions. They perform massage mostly in their head, thinking through the process - they have a plan. They are performing massage "at" the body, almost as an academic exercise.

Intuition vs. Intelligence

As a teacher, I have observed many students who tend to struggle on one side of the spectrum or the other. First, the problems...

Intuition Problems (or the too-touchy-feely sydrome)

When it comes to the intuitive students, they often have issues with timing, assessment, and figuring out the puzzle. Their sessions can become muddled because having a plan comes from within the therapist. The client's body can lead them in different directions or because every area is crying for help they can get caught up in one spot and neglect the other problems. They can also sometimes have difficulty reconciling the difference between what the client's mouth says and what their body asks for. These students also can have problems in finding where the problems really are when the issues require critical thinking to pin down. They can also overlook some problems because others are "talking louder" and drawing their attention.

On the other hand, these students can seem naturally gifted because their bodywork addresses the clients' needs. They often seem to take a new technique and while they might not always do it right, they take it to a point where it feels good to the client quickly. Because that's where their focus is. One thing to watch out for is the potential discouragement these students can experience when they used to get praise for the quality of touch they had when they didn't know what they were doing and then in school they fumble around with some techniques that engage the intelligence side of the spectrum.

Intelligence Problems (or the you're-thinking-too-much sydrome)

Students who are too far over on the intelligence side of the equation over-think most of what they do in class. They're always worried that they are doing it right. They seem to be able to nail the theorey quickly, but then can struggle with the application. Placement of hands, body mechanics, or doing techniques in a way that are both effective and feel good to the client can be challenges. By the self-focus (hence the therapist-oriented approach), they can sometimes neglect the clients' needs, forget simple things like noticing that the client is cold, or miss some observable information from their client because they are focus inwards. Sometimes these students can get discouraged because they don't seem to get the high praises that the intuitive students get for their work. That just fuels the insecurity that it isn't right and spurs more furious thinking.

These are great people to talk to if you need to get your mind around a problem or you need to piece together pieces of information. They can often, even as a student, piece together some great assessments and make connections between disparate symptoms. They can figure out what is going on with the client and are usually quite good at formulating a plan to do it. They can prioritize the problems and design a session for the best results in the time they have.

The best bodyworkers strike a balance between Intuition & Intelligence

So now we get back to it. Massage takes place at the hands. That means that your massage must be a marriage of the knowledge in your head and the wisdom in their body. Your head will come up with brilliant ideas about what is going on and where to look and their body will tell you "over here!". It's all about the balance. Massage doesn't take place "inside" their body or in your head - it takes place where you and your client connect - at your hands. Where the rubber hits the road, so to speak.

If you perform your massage too far onto the intuitive side, it may feel good, but often the client leaves feeling like you didn't get to everything, that you spent too much time on their (insert body part), or that the results were short-lived.

If you perform your massage too far onto the intelligence side, your client may feel disconnected or that you're very smart, but it dodn't feel good, or again that their needs are ignored. Or perhaps that the massage addressed everything but left them feeling like something was missing.

If you are intuitive, take steps to think things through and plan your strategy. If you're intelligent, work on setting yourself free from the shckles of your thoughts and feel what the client's body tells you - put yourself in their skin.

The hands inform the head.
The head guides the hands.
The union of your intuition and intelligence is wisdom

And that's the Happy Medium.

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Massage and Money

Money. It's a word that has a lot of baggage tied up with it. And it's something that I have noticed that many people seem to be uncomfortable with. Especially massage therapists. I have had plenty of students and seen plenty of practicing MTs that have an unhealthy relationship to money. Why? Massage is about relationships, and this post is about a massage therapist's relationship with money.

I've heard many people misquote the Bible as saying that "money is the root of all evil". Actually it says that the "love of money is the root of all evil." A big difference and a lot more true. Money itself is just a tool. A medium of exchange. A knife isn't a good tool or bad tool, it's how you use it.

Another heavily quoted line is "do what you love and the money will come". A lot of people do what they love and money doesn't come, so what gives? This statement has the priorities right, but misses the mark. I choose to interpret it as

"do what you love (follow your passion with a systematic plan) and the money will come (if you respect it for what it is and what it means to you)"

So why do so many people have such an antagonistic relationship with money?

First off, some people hate what money represents. They have seen what some people do to others to get it and don't want to be associated with that. It could be a matter of worth or value - the the therapist doesn't feel that they are worth the money - a self esteem issue. It could be a sense of idealism or a genuine desire to help without need for compensation.

Money can seem hard to come by. It can seem like there is a chronic lack of it. Especially in these economic times. A person can get used to thinking that there is never any money for them, hating it all the while. Some people pursue money as an end to itself, a way to keep score, as if just having money affords the status or life that they want.

The problem with the pursuit of money is that money is a very poor motivator for happiness. People (and studies prove this) don't gain a whole lot of satisfaction or improved quality of life from having more money. Ironically, the reverse is true though, that not enough money is a huge de-motivator and a source of distress and unhappiness. Money can't buy happiness, but not having any leads to sadness.

Putting Health and Money at Odds

Our society often seems to pit health and money against each other. When we hear studies of the impact of some diseases on the poor and the exclusion of 40% of americans from our health care system because they can't afford it, there is an association with money. In fact, the increasing inclusion of massage in health care may make massage more exclusive instead of more accessible.

Many massage therapists have an idealist streak that creates guilt about charging money for what they do. Massage is like a divine gift, something that is present in all of us and can sometimes feel like charging for bottled water when people can get perfectly good water out of their tap.

Unfortunately, this can lead some MTs with a burden of guilt about money and their business. It sets the stage for a struggle with their career. After struggling in their private practice, they may get a job at a massage business and harbor resentment towards the business for collecting the money the therapist feels guilty about charging! Sometimes the MT grows disillusioned, thinking that the bodywork itself was tainted when it was their attitudes and beliefs about money that were the problem. They end up moving into a profession they don't really care about but is more "reconcilable" with their ideas about money.

Cultivating a Healthy Attitude About Money

If you already have a healthy attitude about money, you can skip this next part. This is for any MT who feels at all guilty about collecting money for their services.

Money isn't evil. I'll say it again. Money isn't evil. You say it. Really. That wasn't so bad, was it? The first step to cultivating a healthy attitude about money is to acknowledge that, at the risk of being redundant, money isn't in fact evil. It's your attitude that is.

You have to realize that you need to make a living. If you can't make a living doing massage, you'll need to make a living doing something else to pay the bills - which means that you won't have nearly as much time to give the gift of massage. Massage-wise, everybody loses that way. You aren't doing what you love and your clients won't get to receive the benefits of your work. I suppose your new employer would benefit from your awesome-ness, but that's not quite the point.

A healthy business supports both you and itself. And when I say supports, I don't mean just squeaking by. It should support your lifestyle and help you to achieve your dreams.

Example. I knew a massage therapist a while back who had been working longer than I had. She'd been out of school for maybe four years and still had plenty of clients that were paying her student rate - half her regular rate. I found this out after asked some questions following her wondering why she was having trouble making her car payment. When I asked why a significant number of her clients were still paying such a reduced rate, she told me that she was afraid of losing them if she charged them more. Several weeks after we spoke, she did decide to raise her rates. Not all the way, but much closer to her going rate. She did lose a few clients, but most stayed with her, and a few even told gher straight out that they had wondered why she hadn't raised her rates a long time ago. She ended up making more from the remaining clients than she did with her full load at the prior rate. The clients that left only came to her because she had the cheapest rate around, not out of any loyalty.

There Is Plenty Of Money To Go Around

You may not believe it, but there is. For example, here in the Bay Area we have around 7 million people and a median household income of a little over $70,000 per year. If we estimate an average household as 4 people then we're looking at somewhere around $120 billion every year flowing through this area. That's a plentyhuge pie to capture a very small slice of.

The other thing is that that money is going to be spent anyway. Either they go to buy a car, or they go to the mall, they order an iPod online, or they invest it somewhere - but money is changing hands all the time. All you want to do is have some of it pass through your hands first. There's no need to feel guilty about that. Shed the attitude that just because you make money, somebody else loses it. It's just not true. All you need to do is figure out how to tap into that flow.

Tapping the Flow

Think synergy (boy am I full of cliches in this post!). It's not really a competition. When you do well, your clients do better, you do your part to keep the economy chugging along, et cetera. Synergy is when the sum is greater than the parts. In this case, your massage + your clients' money = better lives for everybody. Really, your work helps to make your clients' lives better, and isn't that what they are out there earning money to do? Gee, I hope your guilt meter is starting to read zero by now!

Think Win-Win-Win

Thinking synergy involves thinking win-win-win. You win, your employer or business partners win, and you client wins. Everybody likes to play when they can't lose. Think of money as the tool that it is - a device to help everybody win.

Another way to look at money to develop a positive attitude about it is to look at it literally - as a means to an end. Money by itself doesn't do much for you. It's what it allows you to do that makes it important. Think about the things that enough money will allow you to do - expand your business, take that vacation you've been longing for, take scuba lessons, whatever. Look at money as a stepping stone to your goals (see my last post for more on defining success).

Parting Thoughts

Think about money differently. It is not a dragon to be slain, a mountain to be conquered. It is a tool of the trade. A necessary tool that will allow you to continue helping people while also experiencing what life has to offer. Now get out there and tap into the flow.

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Defining Success

Me: “So what are your goals as a massage therapist?”
Student: “I want to be a success…”

Every time I teach my business classes the subject of success comes up. So what is it? Students want to be successful… who doesn’t? The problem is that people seldom know what they mean by “success”. It’s made more difficult by the fact that it means something different to everybody. Let’s take a look at this thing called success.

Dictionary.com defines success as:

1. the favorable or prosperous termination of attempts or endeavors
2. the attainment of wealth, position, honors, or the like
3. a successful performance or achievement
4. the achievement of something desired, planned, or attempted

What is Success?

The first three definitions above sound good, but when you get right down to it, do they really mean anything? How do I know if I am successful? I could argue either way about my success to this point and I would be right – if those are the criteria. The fourth definition is a little bit better – it introduces a concept of planning and a desired outcome. It turns out that that is the key to finding success – knowing what you want in the first place.

Intention & Priorities

You have to start by asking yourself what you want to accomplish. Simply saying that you want a successful business isn’t enough. What do you want to get out of it? And who do you want it for? You could say “I want to help people”. OK, a little better. Wait, you want a business that earns money too? Now you’ve got more than one person involved! How much money? “I want to be rich” is often the facetious reply to that question (and I’ll tell you now that there are much easier professions to grow rich in). My reply is usually, “How rich is rich?” In essence, you need to make it definable.

I like to use visualization in this process. How do you picture success? I want you to get that image in your head and then start to think of all of the elements that make your vision so appealing to you.

What gets me is that many people don’t really think about what they want to get out of their “success”. Money is one way to define it, but certainly not the only one. Do you want freedom – financially and with time? Esteem, reputation, honors & accolades, respect, credibility, recognition, gratitude, satisfaction, or any of the other things that can be derived from your work? These can all be measures of success.

There, I said it. Measure. It is one of the key points in attaining success. In order to do this right, you should list out all of the things that you want you or your business to accomplish. Then you should prioritize them in order of importance. Finally, you have to find a way to measure it.

For example, you could define success as:

1. Having work that allows you to earn a full-time income on 30 hours a week
2. Operating a business that earns enough to support you and itself (be sure not to short-change yourself and set this number as the bare minimum to pay the bills – it has to support your lifestyle)
3. Being able to take a 2-week vacation to another country once a year.
4. Owning a home (again, be specific about the type of home and where…)

…or a combination of things. Setting SMART goals is an effective method that helps you to define and attain success for yourself. More on that later. The most important thing for defining success though is being specific.

Stay on Target

Knowing what you want helps you to stay on track and not go astray. I have witnessed massage therapists let their career get away from them – either drawing in clients that weren’t their intended market or growing so dissatisfied with their jobs that they leave the profession. I would say that this is most often an alignment problem – that their internal (and undefined) idea of success and what they were actually doing were worlds apart. Defining your idea of success gives you a gold standard to compare everything to – a set of criteria. If what you’re doing doesn’t fit in with your vision of success, if it doesn’t move you closer to those measurements of success, then it’s not for you.

The best part of setting measurements of success is that you know when you get there. Do you ever wonder why kids always ask “Are we there yet?”? It’s because they don’t have a measure of how far you’ve gone or have to go. As we get older, we do have those tools. We see a sign that says 20 miles and we can instantly figure out that we’ll be there in 20 minutes – counting down the time all the way. It makes the long trips easier (and your career).

Having a specific measure of what success is to you provides motivation as well. You’re on the way. Your path. To a place that you know you want to be. And when things get tough, it’s the light at the end of the tunnel.

What to Measure

That being said, think carefully about what you measure. Make sure it really is what you’re looking for. I get asked all the time by my graduates “They pay this much at this spa. Is that good”. I don’t know, is it? The real question is, does it get you where you want to go? I’ve seen many people, in many different kinds of jobs, lose focus of what they really wanted and leave a better, lower paying job for a higher paying, higher stress job that they hate and tears their family apart. Or they do it for benefits. Or sometimes worse, they settle. Don’t do it just for the money.

If I measured my success based on money, then in my eyes I’m a failure. I won’t tell you what my definition of success money-wise is, but I can tell you that I’m not making it on a teacher’s salary. I did not say that I’m not a success though. I’m esteemed in the eyes of my colleagues (OK, so that is hard to measure). I just finished a degree. And here’s my favorite one. I’ve personally graduated and changed the lives of 120 students who by the averages are out there having made a combined $8 million! If only I got royalties!

That is a serious measure of success in my book.

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Leadership & Massage 3 - Characteristics

Part 1   Part 2

In the last post, we looked at the power that leaders possess. Here, I’ll take a look at what makes a leader a leader. While there are many descriptions and lists of leadership characteristics, there are a few that seem to be universal.

A Compelling Vision

So where are you leading your followers? A leader has a vision of the future. Something that isn’t here yet, and will take work and time to get there, but is possible. An effective leader has a very clear vision, one that is almost tangible. A vision that offers hope of a better future, a place that others want to be. Nobody wants to follow a vision that takes them to a worse place – although they may be willing to suffer hardship to get to a better place.

Having this vision is central to leadership and directly impacts other essential leadership components such as passion and inspiration. It isn’t enough to just have a loose idea of the future, the vision must be clearly defined and articulated. Write it down as best you can. Try to formulate a simple statement that encompasses your vision. It isn’t a good vision or goal until it’s outside of your head. Which leads us to our next vital component of effective leadership…

O Come All Ye Faithful

Sorry, I couldn’t resist the holiday cheer! But it is a very appropriate statement in this case because we’re talking about communication. Not just communication, but creating the faith in others that they want to follow you. This is why it is so important to clearly define and articulate your vision – you have to share it with others. You should be able to describe it easily to other people. And frequently. As a leader, nobody should have to wonder what it is you’re all about. Why? Because you will tell them straight up consistently and often.

You need to tell people where you are going and if your vision is compelling enough they will join you.

Passion, Enthusiasm, and Optimism

These three go hand in hand and all spring from your vision. When the vision is compelling, it is a source of motivation. Most people, even the extremely unmotivated have little trouble getting started when they are working on something inspiring. It becomes a positive circle in which the vision feeds the action, passion, and motivation and they feed back into the vision. It is hard to get motivated and passionate about a ho-hum vision.

Hope springs eternal and it also is the fuel for the journey. A positive outlook is attractive and draws others into following you. People like to be around positive, energetic people. You need to believe that your vision is possible – if you don’t you need to choose something you can believe in. Think Eeyore from Winnie the Pooh, he was always depressing to be around – not exactly an inspiring figure.

A Plan

Finally, a leader must have a plan. You must know how to get there, or at least a pretty good idea. Your followers want to see progress, action, something being done to reach the goal. The vision can be a prize that can get a person through a rough patch along the way, but if no progress can be seen, if the leader seems to be uncertain, then the followers will begin to lose interest. Have a plan. Create milestones. Chart the progress. Take the time to step back and reflect on how far you’ve come from time to time. Leaders hate to be stagnant and are always changing and reworking things to better fit their vision.

Control

Leaders will not hesitate to enforce boundaries or redirect the course of events to stay on track. The first sign that things aren’t quite going right is the feeling that things aren’t quite going right. Evaluate it against the vision and if it doesn’t fit, redirect. Non-followers can damage your following through negativity. Leaders employ a “healthy surveillance” to monitor the goings-on within their sphere of influence and act accordingly.

Leadership in Context

Just to bring things into perspective a little, let’s take a look at the recent presidential election. In my opinion, Barrack Obama won because he demonstrated stronger leadership qualities than his opponent. Obama campaigned on a vision of hope, restoring American status in the world, a new energy future, and better health care. He was able to convey the hope well and I think that this was the primary reason that he one so convincingly.

In order to keep us engaged however, he’ll have to fill in some blanks and operate on more than just hope. We’ll need to see a plan and the milestones along the way. He’ll need to repeat the vision often and clearly.

Other characteristics that I’ve seen described as essential to leadership are:

1. Sacrifice – This one goes with passion. If you’re fired up about your vision, you’ll go to great lengths to see it through and be willing to put up the time, money, and effort to achieve it.
2. Moral Character – People hold their leaders to a different standard. We expect them to be better than us. Make sure you demonstrate the qualities that your followers expect. A part of this is to “practice what you preach”. Related to this are credibility and honesty
3. Self-Confidence – When you have a clear idea where you’re going, there is a degree of certainty about your actions that creates confidence in yourself and your followers.
4. Emotional Intelligence – AKA empathy, it’s the ability to recognize emotions in yourself and others. Great leaders are able to feed off of, address, and even develop desired emotions in their followers.
5. Desire – You have to want it.
6. Comfort Zone – Ironically, although leaders push their followers outside of their comfort zones in the pursuit of a better future, the leaders themselves create a new comfort zone within the vision. They provide a structure or framework from which to operate. The leaders don’t have this safety net however, and must draw on their own drive and passion to persist.
7. Win-Win Thinking – Leaders get the advantages of power, but they have to bear in mind that following is voluntary and that the power is received at the whim of the followers. In other words, the followers must see the advantage of following. For that to happen, the leader must operate from a position of mutual reward.

Leading & Massage Therapy

Your clients come to you to be led. That’s a part of the therapeutic relationship. It’s up to you to exercise that power in the most effective manner for your client. Pay respect to client-therapist boundaries; to the effects your actions, words, and attitudes can have in either a positive or negative way. Understanding leadership is an important part of leadership.

Where are you leading your clients? Are you on the same page? Are the benefits balanced? Do you have clarity about your vision? Do your followers? How can you use your power for the most benefit? These are all questions you should ask yourself in your massage practice so that you can truly own your role as a therapist… and a leader.

So where are you leading your clients?

Compiled from various sources (Human Relations, Dubrin), (Supervision Today!, Robbins & DeCenzo), (Leadership, Chapman & O’Neil)

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Leadership & Massage 2 - Power

<<< Part 1                                                                       Part 3 >>>

I know that you didn’t get into the field of massage therapy because you wanted power over people, so don’t get your bonnet in a twist. You do have power, however. A leader’s power is derived from the followers. In other words, they give it to you! There are three different kinds of power:

Role Power

As I mentioned in the last post, power is inherent in the therapeutic relationship. The client has lost power over their condition somehow and is turning to you for help. This kind of power is called Role Power – or the power of your position. You are the therapist and they the client. They have given you power over their healing. As we facilitate the healing, we gradually give their power back, but there will always be a degree of role power in play.

Other examples of roles that are given power (to a greater or lesser degree) are parents, your boss, teachers, police officers, or the president of the United States. Sometimes these roles have authoritative power attached to them – such as the police officer’s ability to have you do something against your will.

Role Power is effective when you need to “lay down the law” such as with enforcing boundaries when someone in your charge has stepped out of bounds. However it becomes less effective the more you use it. It is best to rely on role power only when necessary.

Personality Power

Charisma. Likability. The power of persuasion. This power comes not out of respect for the role you occupy, but because of respect for who you are. Are you courteous, respectful, trustworthy, optimistic, communicative, amiable, welcoming, helpful, and/or a whole bunch of other good things? Have you ever convinced (I won’t say manipulated) a friend or family member to do something they didn’t really want to do but you could get away with it because of your relationship? Personality power in action!

Knowledge Power

People like to be led by others that have the answers. It is a cliché that knowledge is power, but clichés only become clichés when they are true. The more knowledgeable you are about something, the more power others will give you with regards to it. Never stop learning! The more knowledge power you have, the more credibility you will have when you give you clients helpful information.

Use of Power

Obviously we need to wield our power effectively and appropriately. Our job is to gradually give our clients back much of their power. We use our power in our clients’ best interests. That is part of the essence of being a leader – the proper use of the power that has been given them. The most effective leaders apply these different types of power at different times and in different situations, something called situational leadership. There are times where you need to put our foot down and use your role power to redirect the ship. At other times, you convince. Others you educate. Wise leaders learn when to do which.

Next, we look at the characteristics of leadership…

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Leadership & Massage 1 - Intro

Massage Therapy and leadership? What do those have in common? You might say, “I got into this profession to help people, I don’t want to lead them!” But you do.

Why Leadership?

Leading your clients is an unavoidable circumstance in massage or any other healing profession. It is inherent in the therapeutic relationship. They look to you for guidance. In the therapeutic relationship, one person is always in need. They seek out the therapist to address that need. Your clients will have varying needs, some common themes, but they all are coming to you for help. They look to you for guidance, expertise, assistance, and yes, they want you to lead them to their goal. Sometimes a client won’t even know what they want from you, so again it takes leadership to help them to discover it!

Leaders and healers are both involved in empowering their followers.

You steer the ship. You chart the course. You choose the destination. When you allow your clients to participate in the planning, you are still the one that decides upon how to get there. In some ways it can help to envision your massage practice as a kingdom with you at its heart. Your clients are the people who live in your kingdom (just don’t get too carried away with this image!). People choose to live in your kingdom or not, they must have a reason to stay there. You control that for them. No matter whether it is your private practice or some regular clients at your work, your practice (your little universe) is centered around you (take that Galileo!). If you cease to lead, your universe (or massage practice) ceases to be.

So what makes a leader anyway?

Are they born or made? Most sources will say that although some characteristics of leadership come naturally to some people, most leaders are developed. The good news about that is that it means it is something you can learn to do. If you truly want to be successful in your massage business/career, you need to learn to develop these skills.

Even better news for us all is that there is no standard definition of what it means to be a leader. How is that good, you might ask? Because it means that there is flexibility both in how you choose to emphasize your leadership, and on the leadership characteristics that you choose to develop!

Defining Leadership

In my studies, I have come across numerous definitions of leadership. Here are a few to wet your appetite (not my definitions, although I modified a few slightly):

1. “Leaders have the ability to influence others towards challenging goals.”
2. “Leaders bring about constructive change”
3. “Leaders get people to think, believe, see, and do what they might not have otherwise without your presence”
4. “A person with a compelling vision that he/she can communicate to and inspire others with.”
5. “A leader is a conductor, director, or guide”
6. “One who has influence or power”

In a later segment we’ll take a look at specific leadership characteristics, but first, let’s see where leaders get their power in part 2...

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Creating a Safe Space

I just returned from a trip (not by choice) to Ciudad Juarez, Mexico. Murder rates are sky high, crime is rampant and there is a three-way (at least) drug war going on. And the only place in Mexico to get a US resident visa happens to be there. Go figure.

When we got back onto American soil, I had a vision of how it is in the movies - where the hero returns home and kisses the sand of his homeland - and believe it, I understood exactly how he felt. It was good for my companions to have me there, even though as a gringo I stuck out like a sore thumb. And it was against this backdrop that I began pondering the idea of "creating a safe space" for your clients.

I've taught the concept of creating a safe space to my massage students for years. However, my recent experience very much deepened my understanding of it.

Everyone needs to have a safe place to be - to work, to play, to be. Good old Maslow placed safety in second place on his pyramid of needs - second only to physical existence needs like food and shelter. When we exist in a place in which we don't feel safe, our body's natural defense mechanisms kick in. Stress chemicals flood our bodies - cortisol, epinephrine (aka adrenaline) - as our bodies prepare to either flee from danger or to fight it. (More on stress in a later post) When we are stressed, we seek a safe haven to retreat to - a safe harbor to weather the storm and recuperate.

A Safe Space For Healing

Massage can be a truly therapeutic form of healing if this idea is taken to heart. Most of us therapists understand this on some level - Our clients seek us out to find that safe space for healing. This safe space can be physical - such as our office space, a quiet room, seclusion from the hustle and bustle of life outside, privacy. And it can be conceptual as well, like an invisible bubble that shields your client in the same way a physical space can - a blanket of trust, warm and welcoming energy, moral support, encouragement.

You see, all healing takes place when we are at ease. Relaxed, stress-free and safe. Stage 4 sleep. Massage. Studies have shown that we heal at least 50% faster when we are stress-free and relaxed. Interrupted sleep, high-stress jobs, constant activity all interfere with our bodies' ability to cope and recuperate.

One of the most profound benefits that you can offer to your clients is that safe haven. A place where they can go to get away from it all and focus on what they really need - healing at every level, emotional, spiritual, mental, physical. This safe space is one of the most important, yet most intangible qualities about the work we do. It is vitally important to our clients and our success as massage professionals, and it is one of the hardest things to communicate.

Creating a Safe Place

Trust
We all know that it is difficult to relax with somebody that we do not trust. We keep our guard up and remain wary and suspicious. But we also all know (I hope!) the feeling of ease we get when we are with someone we can trust and let down our guard, take off the mask we show the world and just relax. Trust is something that can be granted in a surprisingly short period of time when the stage is right. It is impossible for our clients to trust us if we don't first start with the wholehearted intention to do well by them (see point #3)

Consistency
Consistency will build trust over time. We humans enjoy the stability that comes with regularity. It is difficult to trust and relax when we are on edge from not knowing what is coming next. When we do know what to expect, we get "in the groove". Consistency is comfortable. Think of all of the little things that you do the same way, just because it feels right. Brushing your teeth, crossing your arms, even the way you walk - it's all habitual. Clients will come to you not just because of the great work you do, but that you have a groove they can relate to, that is comfortable to them. They don't want things shaken up every time (or to come and listen to your drama). They want the stability and strength that rises from the Earth element. We can foster this consistency by creating little rituals - starting and ending your session the same way, greeting our clients the same way, finding out what they like and making sure it is there for them every time. Clients are attracted to the familiarity you create, if they aren't, they go elsewhere to find it.

Intention & Attention
These two go hand in hand. First you must start with the intention to build this safe place, then you must pay attention to the details to make it so. Make sure you ground yourself sufficiently before each and every session - clear your thoughts of your to-do lists and the guys who cut you off on the freeway on the way to the office - those aren't client-centered thoughts. Bring your whole attention to your client, because that is your role to play, the "safe space maker", so that they can heal the way they need to.

Remember the Process
Healing occurs in its own time. Let it take its course. Your job is simply to create a conducive environment. That doesn't mean that healing will take place, only that it can.

Playing It Safe

A key to remember is that healing only occurs when the client is ready. I have known many therapists (massage and otherwise) that have grown frustrated that a client doesn't seem to be making any progress. Well they never will until they're ready and I always say that

"You can't inflict healing, it must occur from within."

Creating a safe place is the first step in the process as the client's mind will never allow the healing to begin in an unsafe environment. Healing requires one to drop their defenses. If you can do this for your clients, you can bring to them the same feeling of overwhelming relief and joy as I felt as I passed into El Paso and touched home again. The funny thing (or not so funny) is that the stress of the trip has lingered and I still haven't been able to fully relax yet.

I think I'll head over to my safest massage therapist to find my peace of soul.

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