A Safe Container

By Darren Buford
[Editor's Note]

I recently attended the San Diego Pain Summit and was struck by a presentation from Maxi Miciak, PT, PhD, titled “Establishing Conditions for Cultivating Therapeutic Relationships.” Though Miciak’s background lies in physical therapy, her presentation shined a light on how to improve therapeutic relationships between clinicians and their patients/clients—massage being no exception. 

Here at Massage & Bodywork magazine, we work many months in advance before the launch of a publication, and we were already busy with Lauren Cates’s wonderful article for this issue (“Tell Me More,” page 56) when I heard Miciak’s presentation. (Cates’s article focuses on bringing curiosity and engaged listening into your practice, and checking your “expertise” and preconceived answers to bodywork conundrums at the proverbial door; therein, practitioners will discover deeper connections with their clients.)

Even though I don’t believe they know one another, Miciak and Cates are kindred spirits when it comes to reframing the practitioner-client interaction, and Miciak’s presentation read like a Part 2 to Cates’s “Tell Me More” feature in this issue. Where Cates sets the foundation for therapeutic exploration by quelling practitioners’ temptations to know all the answers and never “get it wrong” when it comes to diagnosis, Miciak explores how practitioners can set the stage for better clinical outcomes by providing a “safe container” for clients. Through better listening and empathy, practitioners can inspire conversations and build trust with clients, thus leading to better satisfaction and better results.

Following are Miciak’s four conditions for creating that safe container.

Be committed. Maintain an ethic of care, a desire to be of service. Resist being satisfied with the generic. Make all efforts to honor the best interests of the client. And go that extra mile.

Be genuine. Be yourself; be honest. Convey a sincerity of being in the moment in a therapeutic relationship. Invest in the personal. Be transparent, providing the necessary information. Establish clear expectations of roles and responsibilities, limitations, and a plan. Be direct, but also calm and forthright with compassion. Resist any facades.

Be receptive. Remain attentive in order to become aware of salient states, issues, needs, and wants of the client or situation. Have an open attitude and suspend judgment. Be willing to listen. Give space; don’t fill space. Collaborate and negotiate: be open to their reports and behaviors, and willing to adjust the plan. Continually engage their contribution.

Be present. Stay in the moment in the therapeutic interaction. Be immersed, but with a sense of calm. Be curious: observe and respond.


Miciak closed her presentation by suggesting clinicians ask themselves the following questions after each session in order to reinforce the above principles:

1. Was I committed? 

2. Was I genuine?

3. Was I receptive? 

4. Was I present? 

These suggestions aren’t only good food for thought for clinicians of all stripes, but for everyone, everywhere in their daily lives. We hope you enjoy this issue and find value for your practice in these pages.


Darren Buford