Ep 57 – No Wishy-Washy Answers: Professional Ethics with Laura Allen

0:00:00.0 Kristin Coverly: Anatomy Trains is excited to announce a new on-demand video course with Tom Myers coming soon, Deeper Ground: Restoration and Vitality for the Female Pelvis. Reach your deeper ground of embodied awareness and strategic confidence with this four-hour tour of the female pelvis including its key points and unique challenges. Course highlights include hands-on, palpation certainty and technique review for the major muscle groups, assessments and techniques for posterior and anterior pelvic floor, psoas complex and diaphragm, common perinatal biomechanical issues explained, and much more. Sign up for the Anatomy Trains newsletter at anatomytrains.com to be notified when the course is available.

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0:01:00.4 Darren Buford: Welcome to The ABMP podcast. My name is Darren Buford. I'm the editor-in-chief of Massage and Bodywork Magazine and Senior Director of Communications for ABMP. I'm joined by my co-host, Kristin Coverly, licensed massage therapist and Director of Professional Education for ABMP. Our goal is to connect with luminaries and experts in and around the massage, bodywork and wellness profession in order to talk about the topics, trends and techniques that affect our listeners practices. Our guest day is Laura Allen. Laura Allen has been a licensed massage therapist since 1999, and a provider of continuing education since 2000. She is the author of numerous books and articles, including the fifth edition of "The Educated Heart" and "One Year to a Successful Massage Therapy Practice." Laura is a 2011 inductee into the Massage Therapy Hall of Fame, and was named American Massage Therapist Of The Year at the 2011 American Massage Conference. Laura is currently the President of Sales and Marketing at CryoDerm, a family-owned company that makes plant-based pain relief and therapeutic massage products. Found out more about Laura at lauraallenmt.com. Hello, Laura. Hello, Kristin.

0:02:07.2 Laura Allen: Good morning.

0:02:08.5 KC: Hi, Laura. We're so excited to have you here with us today.

0:02:11.7 LA: I'm happy to be here with you.

0:02:13.0 KC: Yeah, and for the first of what I'm hoping and I'm sure it will be many podcast visits with us. So listeners, know that we'll get a lot more of Laura in the future. What we always like to do the first time you're guest with us is start with your origin story, or what we like to call your superhero origin story. And tell us a little bit about how you came to massage therapy. How did this all start for you?

0:02:34.9 LA: Well, in my former life, I was a chef and restaurant owner. I was in the restaurant business for more than 20 years. And in 1993, when I opened my last restaurant, I had previously had three others, when I opened that last one, I told my business partner that she better be prepared to buy me out in five years because I was done. And she said, "What are you gonna do?" I said, "I don't know, but it will not involve standing on my feet for 100 hours a week anymore." So the owner of the massage school that I ended up attending used to eat in my restaurant all the time, and she happened to be in there the day that I sold out. And her school was only two miles away from my house, and if I won the lottery tomorrow, I would still work. So I walked out there and told her that I had sold the restaurant and I said, "How about giving me a job?" I really didn't care if it was a minimum wage, mindless job. I just wanted something to do. And I said, "I can type, I can file, I can sweep the floor."

0:03:44.4 LA: And she said, "Are you serious?" She said, "I'm actually looking for an administrator for my school." So I went to work there a couple of weeks later, and the second day I was there, I took a wild notion that I would sign up for the school [chuckle] as she had a weekend program for people who worked, so I signed up for that. And so I worked for her in the daytime, went to the massage school on the weekends. And in a moment of insanity, I decided to go back to college and finish my psychology degree, so I was doing all of those simultaneously. I had actually taken a class in healing touch about five years before that because a friend of mine said she wanted to go to this class and she had to take a partner. I had no idea of what that even was, and she said, "But I'll pay if you'll go." So I had dabbled for a few years before I entered school. It was life-changing experience to go to massage school.

0:04:55.7 KC: It always is everyone, whether people end up actually practicing massage or not, the experience in massage school is life-changing. Well said.

0:05:05.7 DB: Laura, so now we're in massage school, and now we're starting our career, what specifically because you've made it a priority and one of the things you focus on in your life to focus on business and ethics with regards to massage therapy, where did that passion begin?

0:05:26.0 LA: Well, right after I went to work out there, the owner said, "Oh yeah, you can teach." And she specifically mentioned me teaching business and marketing, and I looked at her and I said, "I've never taken a marketing class in my life." And she said, "No, but you've had over 20 years running a successful service-based business," and she said, "This is all about good service." The ethics part of it... Let me back up. When I was younger, I taught in public school for three years before I decided that wasn't for me. And so I did have some teaching experience, but the ethics part of it, whenever I was in college, I took so many classes in world religions, I actually got excused from taking ethics, which back then was a required course in my program to graduate, so I've just always been very interested in that. So I ended up teaching business and marketing and ethics to my own class when I was in massage school, and that wouldn't be allowed nowadays, but the massage board did exist back when I started. They have rules now governing... Excuse me. They have rules now t the board governing how much experience you have to have and all that, but I did teach those two topics to my own class. And I stayed there teaching for five years, and I've been teaching it as continuing education for a long, long time now for about 20 years.

0:07:00.8 DB: Let's take a short break to hear a word from our sponsors.

0:07:04.3 KC: Oakworks is proud supporter of ABMP and the massage therapy profession, and is happy to extend a special offer to ABMP podcast listeners. For a limited time, all ABMP podcast listeners receive 25% off Oakworks items with the code ABMP Summit 25. Go to massagetables.com and use the code ABMP Summit 25 at check out to receive 25% off your Oakworks purchase.

0:07:36.0 DB: Now, let's get back to the podcast.

0:07:38.8 KC: Laura, I'd love to talk with you about Nina McIntosh. The two of you were friends. I believe you've called her your mentor, and she entrusted you to carry on the legacy of her book "The Educated Heart" which I think we have all read in our massage core programs, and her Massage and Bodywork Magazine column, "Heart of Bodywork." Please tell us more about your friendship, what led you to take on her passion project, and if you will share your favorite Nina story.

0:08:05.6 LA: Well, I met Nina at an author's dinner. Lippincott was both of our publisher, and I don't remember what year that was. It was probably five, six, seven years before Nina passed, which was in 2010. And I was sitting next to her at the dinner and we started talking, and we found out that we only lived about 45 minutes away from each other. So we struck up friendship and attended some of Nina's ethics classes, might as well learn from the master. And so she was teaching up in Ashville frequently, and I would go up there and attend her classes. And I also had a classroom facility here in my town, so I got her to come down here and teach continuing ed, "The Educated Heart" to the folks who'd signed up down here. So she asked me, after she got sick... Nina actually finished the third edition of "The Educated Heart" practically while she was on her death bed. [chuckle] I understand she was the videos that go along with the book, the ancillaries, she was directing those on the telephone from bed, literally. And she asked me before she... While she was sick, she asked me if I would be able to be willing to author the future editions of the book, so I have authored the fourth and fifth editions.

0:09:41.6 LA: I left a lot of it alone because Nina was the master of ethics and one of the... Not the first, one of the very first that focused on the boundaries of the therapist. We all know we have to honor client boundaries, but Nina was a big believer in that the therapist needed to have boundaries too. So I was very, very flattered that she asked me to take over that, and she made Lippincott, draw up a contract that after her death, that I would get to author the future editions. So a couple of years ago, Lippincott discontinued their massage line of books. They're just selling out of what they have, and they had given the copyrights to Nina's family, and Nina's family gave them to me because that was her wish. So the Ethics column, which appears in your lovely magazine, I really don't remember how that came about. I don't know if Darren asked me or Leslie Young or who asked me about taking that over, I don't remember, but it is based on "The Educated Heart." I use a lot of lessons from that when I'm writing and sometimes throw in a few other things, but I'm very honored. I will never take her place, but I'm very honored to be sitting in for her.

0:11:05.5 LA: As far as Nina's stories, Nina was such a character. Anybody that knew her personally, knew that she had a very dry sense of humor, and she could give you a look that would just stop you in your tracks. [laughter] She had the "bless your heart" look. You know I'm famous for saying, "Bless your heart," which in the south, you can say anything you want to about anybody, as long as you follow that up with, "Bless their heart." Nina had the "bless your heart" look. She could just give you that look, but she was also a very... In fact, she won... She was given a humanitarian award at the World massage festival, and she was not able to attend to get that, so I accepted it on her behalf. And when I took that to her, she was in the nursing home, and she said, "Well, I don't think I'm any kind of humanitarian." But she truly was. She did a lot of good works that she never publicized. People had no idea, but one thing that I loved, she... After she got ill with Lou Gehrig's disease, she started nagging her church to install an elevator. Now they did have handicapped access going in the front door, but there was no elevator in the church. And she just thought that was awful, so she nagged the devil out of them until they put one in and she got to take the first ride. [laughter]

[laughter]

0:12:32.9 LA: So she was proud of that, that she got the church to put in elevator. And one of my favorite stories about her, though, pertains to the practice of massage. Nina was a [0:12:44.1] ____ rower for 30-something years, and she had moved to Asheville from Colorado. And so she said one day, it happened to be her birthday after she moved to Ashville, and she had never been to the Biltmore House, which is America's castle up here in Asheville, North Carolina, a very beautiful property. She was gonna take herself to the Biltmore House for her birthday. So she said that she realized on the way there that she didn't have any cash, and she stopped by her office to pick some up. And the phone rang and she said, "I shouldn't have answered it," but the phone rang, she answered it and it was a sometime client, not even a regular client, telling Nina what severe pain she was in and everything and just begging Nina to work on her.

0:13:37.9 LA: So Nina said, "I looked at the clock," and she said, "I thought, well, okay, I can give her a session and still go to the Biltmore House." So the lady came on over. It was a very disappointing session. Nina said, "I even gave her extra time, and at the end of it when she came out I said, How are you feeling now?" And she said, "Well, I feel awful and I forgot my purse. I'll have to pay you the next time." [laughter] And so Nina said, "The lesson there was I got screwed on my birthday." She never heard from the woman again, and she said that was just a big lesson for me not to let myself get talked into doing something." [laughter]

0:14:20.1 KC: Which is so hard for all of us. When people ask, it's hard to say no. It's really tough.

0:14:25.4 LA: It is, and it's a lesson that we all need to learn not to let people guilt us into taking appointments that we don't wanna take, whether it's on our day off or at a time when we've committed to be at home with our families at 6:00 PM or whatever it is. We don't need to allow people to guilt us into doing that, and that's one of Nina's big lesson is about honoring your own boundaries as the therapist, of not letting people take advantage of you.

0:14:54.8 DB: Massage therapists and body workers out there, if you have not read "The Educated Heart," we are talking about one of the most seminal books in the profession. So if you haven't, take some time out, read this publication. It is absolutely a must. So Laura, we started down the path of the ethical dilemmas here, and this is something that comes up all the time as practitioners, whether it's the practitioner situation or brought on by the client. When should the practitioner... When that radar goes up that something is not right about a particular situation, how do they recognize that? How do massage therapists recognize that? And what can they do about that when that moment comes up?

0:15:37.1 LA: Well, I think we all have that gut feeling for a reason. [chuckle] Nina was a huge believer in having policies and procedures. She always thought that the best way to deal with ethical dilemmas was to be prepared for them in advance so that when something arose that you wouldn't be standing there going, "Oh my God, what am I gonna do now?" She thought that and explained very well in the book, and I expanded some of that, that there is a standard way to handle everything. You don't want to sound judgmental or like you're trying to be somebody's parent with a client who's doing something unethical or hinting about something unethical or whatever. You don't need to sound like their parent. You don't need to take everything personally because the fact of the matter is if they're saying or doing something inappropriate or a boundary valuation with you, they would do it to the next therapist as well, so don't take that personally.

0:16:44.1 LA: There is a professional way to handle things. The other thing was not being wishy-washy about it, and Nina's true about that. A lot of times, we don't want to be confrontational with a client, so if they whittle you into something of going outside your normal schedule or wanting to pay you later or saying or doing something inappropriate, and you give a wishy-washy response, you have just given that person permission to carry on with whatever they were... In whatever way they were intending to take advantage of you. And along with "The Educated Heart," we have about 25 or so videos. Nina had directed most of these, added some in after I took over the book. As a matter of course, Nina hated the Internet. She had a love-hate relationship with the Internet, which is the ethical disaster of the planet. [chuckle] So there wasn't hardly anything in her edition of the... Her previous editions of the book about the Internet and social media and confidentiality pertaining to that and all of that. So I beefed that up a lot in there, but these videos that go along with the book, they show ethical dilemmas.

0:18:06.3 LA: And it's an open-ended, there's no correct answer there on the ending. You're supposed to figure out what your professional response would be, and so we have scripts for the videos. I have given wishy-washy responses and judgmental responses, and then a possible professional response to that situation. So I suggest that people to sit down and write policies for themselves of, "What are you gonna do about clients who are late? What are you gonna do about no-shows? What are you gonna do about people that wanna pay later?" And all that kind of thing. There are so many things that we get confronted with, and prevention is always the best policy.

0:18:50.0 KC: Absolutely. So we've got a therapist. They've done their prep work. They're ready. They think they're ready in advance for something that might come up in the moment. As you said earlier, it's often a gut instinct, and then followed immediately by that stress response, full body stress response, a little bit of a panic moment. A lot of people say, fight or flight. I like to say, fight, flight, freeze or fumble. Right? So.

[laughter]

0:19:14.7 LA: That's really good. That's really good.

0:19:17.9 KC: So oftentimes, we freeze like, "This is happening, this is happening, this is happening." And then... And I am guilty of this myself in trying to patch it up because we don't like confrontation or I wanna move through it so quickly, I kinda just do something, a quick response versus tap into my prepared responses, which of course then two minutes later, I'm like, "Ugh, darn it. I could have handled that differently." What do we say to the therapist who's in that moment. They're feeling the discomfort. What can we say to them to coach them through to handle it in a successful manner?

0:19:52.4 LA: Take a deep breath. [laughter] Take a deep breath, and let it go. The owner of the massage school I attended, she always said that. "Take a deep breath, and let it go." We are humans, and we get uncomfortable. But I do think that when we have those prepared responses to these issues, we can draw on those, and I think it's just important to take a deep breath and review and think, "Okay, what's my policy on this and what's the professional way that I'm supposed to handle this instead of just having some kind of reaction?" Because action is always a good thing. Reaction is very rarely a good thing. So we just have to prepare ourselves be... I think a lot of times, if we make our policies clear to the client when they initially become a client, we'll hit a lot of these things off at the pass. And during my years in practice of owning my own business, which I had stayed at the massage school working for five years, then I opened a... Ran a business here for 13 years with a lot of other practitioners in it.

0:21:10.0 LA: I realized the first year that at the end of the first year, I didn't have a cancellation policy. And at the end of the year, I sat down and added up the amount of money that we had lost by people doing no-shows and people cancelling at the last minute when there was not enough time to fill that appointment, and it amounted to over $8000. And I went, "Oh my God, that's a month in Europe." [laughter] That's exactly what popped into my head, and I thought, "Okay, it's time to take Nina's advice and write some policies here." So I think if you do that, those will always be there in the back of your mind, and if you take that deep breath, that's enough time for you to decide what the professional response is to just something. It not only protects your mental health, it also protects your income. [laughter]

0:22:16.6 DB: Speaking of those wishy-washing answers, in our office around here we're big fans of Brené Brown saying, "Clear is kind." And it is so important that I know the tendency is to be wishy-washy because you don't wanna hurt anybody's feelings or come off as judgmental, but it's so important to be clear. Would you agree, Kristin? I just think it's so important.

0:22:37.8 KC: It is. It's a tough lesson, especially for those of us who might gravitate to the massage world because our heart is about helping and creating this beautiful relationship. And sometimes we feel like we're upsetting the apple cart or it's gonna create this huge rift, an unmendable rift, if we say something that might be construed as confrontational. But in the long run, it is always, always better to be clear. I've also heard the term "sword of compassion," and I really like that one a lot where it's like you might have to do something that's hard, but you do it because it's ultimately the most compassionate way to handle the situation.

0:23:18.6 LA: Well, Nina's philosophy throughout "The Educated Heart" was that educating your clients to your policies is actually doing them a kindness. So when I wrote out my policies in regards to my cancellation policy, my late-arrival policy, payment policy and all the other policies, when I wrote those out, policies are not any good unless you inform clients of what they are. So when I wrote those out, I just had a little paper that I would give the client that said, "Office policies." I had signs hanging in the lobby and in the restroom and whatever about late arrivals and the cancellation policy. Those were the two biggies and other things, and then also if you have a website, have them on your website. If you have a Facebook page for your business, then put them on your Facebook page. I also would have clients sign on the intake form that said, "I acknowledge that I have been informed of office policies."

0:24:30.1 LA: So that's protection for you, like I said, for your mental health and for your income. You know something, I had... The huge problem that I had that first year with the cancellations or the last-minute no-shows and that kind of thing, I found that when I framed that policy in human terms, people really got it. Now, I used to... All the years I was in business, I sent out a newsletter. When I first started the first year or two, it was actually a printed newsletter. Later on the client list got so out of hand, I just started emailing that to everyone. But I put a letter in there that said, "Dear Clients, we truly appreciate each and every one of you, and we need your help in taking care of a problem that has gone totally out of control. You might not think it's a big deal to blow off an appointment with your massage therapist, but if several people do that to one therapist in a week's time, there goes their rent or their grocery money or their childcare money or their medicine or whatever it is they need."

0:25:40.0 LA: And when I sent that out, I want you to know the instance of that happening went down to nothing. I mean, it was just such a drastic change, and I felt like it was a better approach than just saying, "You'll be charged for missed appointments," which makes a lot of people mad if they're charged for missed appointments. But when I put that in those human terms of... I'm just the business owner here, and I've never had that many private clients to begin with. I was running the office. I did see a few people, but when I put that into human terms of, "Your massage therapist is a working person who has financial obligations," they got it immediately. And so the instance of that went way, way, down when I wanna handled it that way.

0:26:28.4 KC: That's a great lesson, great story, great lesson. Yeah.

0:26:31.5 DB: Laura, when it comes to business, we're starting to talk about your business now because we know you were in that successful practice for more than 10 years. When it comes to business and you've written on this, you've got books on this, what's the number one thing you see that MTs get wrong?

0:26:45.8 LA: I would say the cancellation policy is a great, big one, not having one of those in place, but I think that they need to be clear on what it is they provide. One big mistake that I see people make is with the name of their business. Now, this is from a business standpoint, not necessarily from an ethics standpoint, but I'm also the author of business books and have written a few columns in years gone by for Massage and Bodywork on business topics. I've seeing people give their business a name because it has sentimental value, something that has sentimental value to them, but it does not convey what they do. And so you look at the name of the business. And I had a friend who was a great massage therapist, and he gave his business the name of Kokopelli Kare. Now for the unknowing, Kokopelli is a little Native-American, Southwestern Native-American symbol, and it's spelled with a K. And he spelled the care with a K, Kokopelli Kare. Nobody knew what that was. I said, "It could be a rehabilitation farm for Australian birds for all we know." [laughter] I was thinking of the Kookaburra.

0:28:10.5 LA: I said, "You have got to make it clear what it is your business does." There's nothing wrong with the Swedish Massage Center or Laura's Massage Therapy or whatever it is, but you have to make it clear what it is that you do. And I saw someone advertising a C class that was called Thunder Massage, and I thought, "Okay, are we massaging outside during a storm or what?" [laughter] There was not a clear explanation of exactly what that was, so I think that's a big thing to be clear about what it is you do and what it is you provide because the name of your business can make or break your business? It really can.

0:29:01.2 DB: I wanna thank our guest today, Laura Allen for joining us. Laura, where can listeners find out more information about you and all of your offerings?

0:29:09.1 LA: Lauraallenmt.com. Now, I'm also very active on social media, mainly on Facebook. I'm still old-fashioned. I know people are jumping off Facebook, but I have hundreds of therapists on my personal page. And when anybody friends me on my personal page, which is just Laura Allen Clayton, actually now that I got a new husband last year, very wonderful man, and I legally did change my name to Clayton. But in the massage land, I'm still known in as Laura Allen. I always send people a message saying, "This is my personal page. You're welcome to be here, but you'll be seeing pictures of my dog, hearing my music, [chuckle] and that kind of thing." So I have another page that's called Laura Allen MT on Facebook where I only post massage-related posts. So I have a lot of online continuing education classes. My books are all listed on my website. I failed to mention, I actually wrote a book about Nina McIntosh, and I lifted with her family's permission, I lifted the journal that she had done. There's a wonderful website called CaringBridge, that is for the purpose of people who are terminally ill or catastrophically ill to update people.

0:30:26.0 LA: And Nina maintained her wicked sense of humor right up until the moment she could no longer communicate, and I think that's when she decided to leave us, when she could no longer write on her little board or speak or anything. She left pretty soon. So the book is called "The Days Still Left," and it's a wonderful book for people who are going through something like that and their caregivers. So all of my books, my classes, and all about me is on lauraallenmt.com, and thank you so much for having me here today.

0:31:02.1 DB: Thank you, Laura.

0:31:03.1 KC: That was wonderful. Thanks through being with us, Laura.

0:31:05.7 LA: Look forward to seeing y'all soon.

0:31:10.5 DB: This has been a production of Associated Bodywork and Massage Professionals. ABMP is the leading association for massage therapists and bodywork professionals in the United States and beyond. From liability insurance to professional advocacy, award-winning publications to the world's largest continuing education library for massage to this podcast, no organization provides more for its members and the profession than ABMP. ABMP works for you.