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Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
July, 2011, Vol. 11, Issue 07
The Inside-Out Paradigm: The Intake Interview
By Dale G. Alexander, LMT, MA, PhD
"The appointment begins when the client makes the call."1 This phrase, spoken by Dr. Richard MacDonald, DO, 25 years ago, was a turning point in my comprehension of just how important the initial interview with a client is both over the phone and in the office.It is the beginning of a healing contract that might last for a few appointments or for many years. This article will detail the basics of what has served me to assist my clients.
Over the 31 years of my clinical massage therapy practice specializing in chronic ailments, the problems that clients present are increasingly complex, layered and continue to inspire me to explore the "many dimensions of healing." To date, I still do all of my telephone interviews with prospective clients.
Initially, I seek to gather information about how committed they are to their healing, whether we are beginning with a third person trust based on a personal or professional referral or not. In addition, whether they have ever felt injured or misunderstood by other health related practitioners.
The emotionality conveyed by the tone of their voice generally is my best guide. When their voice tone is loud, demanding or commanding, I often ask whether they are scared, hearing impaired, or have been mistreated by other health related practitioners. I give them a chance to start over. I endeavor to keep this initial call to 10 -20 minutes. I give myself permission to encourage that they see a physician before seeing me, if they haven't already. I often refer prospective clients to other alternative health practitioners.
People committed to their healing consistently inquire first about your confidence to assist them and will add additional special circumstances and needs second, once they have established whether or not they sense you have the competence and experience to help them.
When prospective clients place their initial emphasis on money or time convenience for them, this is a flag to me that they are wanting professional care, but only if it meets their conditions. When someone calls to make an appointment for someone else, another flag goes up. Yes, there truly are people that busy, including me at times, but it stills says something about how they run their life including how they drive themselves. I typically book the appointment with the caveat that the named client will call me before the appointment so I may personally interview them.
When a client is looking for a named style of massage or bodywork, I ask them to describe their ongoing difficulties. The nature of what I do along the continuum of bodywork skills has become rather broad such that it no longer fits a specific label. When they ask me whether I have ever worked with their polysyllabic medical difficulty, I am specifically honest as to whether I have or not. And, if not, I request that they educate me. This might seem paradoxical yet it demonstrates from the beginning that I am willing to learn from them. I want to create healing partnerships where they are the star character of their own movie. I'm the hired help.
The Key To The Interview
The key intention of the initial "office interview" is for me to engage the person fully as a human being as well as a practitioner. I endeavor to gather a gestalt of how they see their problem and to assist their perception to include the internal functioning of their bodies and the potential influence of their mental habits and emotional fluctuations. This means I rarely listen to long stories anymore and correspondingly infer that I do not endeavor to convince them of anything. They have the choice to move forward, as do I.
When presented with a vague description of what is bothering them such as, "I have so little energy" or a more psychological inference such as anxiety or depression, I ask them an existential question, "what do you sense is your life purpose?" The turbulence related to identity consolidation in the midst of exquisite life transitions has an enormous influence on our human physiology. Examples of such transitions include the death of a loved one, a job loss, a relational break-up or a financial crisis, among many others.
When presented with a series of physical complaints, I often ask a layered question first. What have you been told about your problems, what do you believe is the root cause, and do you feel as though your mortality is threatened by it? This latter phrase is crucial to include because it flushes out people who really are scared that something has been missed in their medical care and that they might indeed be in serious trouble.
I ask questions to fit the person as I experience them. That is why I don't use standard written questionnaires. However, there is a philosophy and a method to how I ask questions. At the physical level, I seek to discover the earliest sign or symptom that has the longest history as this has assisted me most often to unravel what is happening within their physiology, accreted trauma or might be an indicator of a genetic link or deficit/defect. At the cognitive level, my job is to assist them to connect the dots between the events of their lives and to unhook from the ones that are acting as a drag on their healing. Assisting clients to find their way toward acceptance and/or forgiveness is still a higher octave of our work. We are all challenged to reconcile the difficult transitions of our lives. And, by assisting clients to connect the dots within their lives empowers their capacity to prevent future difficulties.
The following 10 questions and their time line will often trigger a light bulb for them, as well as myself:
Just yesterday, a prospective client with an identified aortic valve regurgitation responded to the flu question by saying that when he does have the flu it was most often of a respiratory variety and that it would last a week to ten days. He had not made the connection between his valvular regurgitation and how this might have extended his illnesses in the past. Such subtle yet revealing information allowed me to orient my skills to relieve the pressure within his chest to allow his heart more ease to do its crucial job.
Interspersed with, or following these questions, I go through the history of their organ systems quickly to ascertain any dysfunction or repetition of illnesses in their lives. I also will ask the same question in a different way if I instinctively am drawn to it. With a recent client who came to me with a rare form of cancer, we had identified that notwithstanding the official diagnosis, she had the beginnings of diabetes that once confirmed by her internist, has begun to radically change her life for the better. Improving a client's quality of life is perhaps our profession's highest service.
Another key to an effective interview is to personalize it. Be more vulnerable than your client.3 Invite a healing contract and define what this means to you while altering your language to include their sense of such a contract. Accept that they will not be able to give you a complete physical history because much of it has been compartmentalized or repressed. During your first appointment, the real opportunity is for both you and your client to decide whether you wish to move forward working together.
People have a tendency to get sick or to injure themselves as a way for their physiology to discharge its excess tension and thereby to rebalance itself. When a client reports a pristine medical history without either, I become quite curious. Typically, there is something they have forgotten or repressed which eventually comes to light over a series of sessions. And occasionally, what emerges is that they have had severe allergic reactions to one thing or another. Again, this is when I refer clients back to their physicians.
Part of our role as massage therapists is to be part of our clients' early detection team. The mathematical normal curve does allow for exceptional individuals to experience amazing health yet, as we age, the probabilities increasingly point to cardiopulmonary, cancer or orthopedic difficulties. In having followed my local newspaper for 15 years, the age of death so often occurs between 50 and 65, which is within the 40 - 70 demographic of those people who most often seek our care. We have a responsibility to assist them to discern those personal events which often signal something is amiss from the "inside-out."
Chronic ailments often have an accreted history involving multiple minor and major traumas underlying a recent physical event or might be the "canary in the coal mine" of the organ systems endeavoring to signal that something deep inside is in need of attention and care. Those chronic problems that seem to have no related physical event associated to their onset are the ones we need to be especially encouraging to our clients to seek consultation with their physicians.
The purpose of this column currently continues to be oriented toward assisting you to understand the "Waves of Aging," their most common origins, and their progressions that fly under the radar of typical medical detection, especially when clients present with chronic somatic ailments.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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