Session planning is the process of using information gathered during an assessment to set goals and choose appropriate techniques in collaboration with the client. Session planning helps ensure client safety, establish realistic client expectations, and guarantee an effective session that meets the client’s needs.
Clients visiting a spa on vacation or taking a cruise vacation are more likely to accept and enjoy a standardized wellness session. Clients who experience sore muscles from playing basketball over the weekend, have low-back pain from cleaning house, or for any other reason feel soreness, pain, or high levels of stress are more likely to need focused work in particular areas.
After ruling out contraindications, session planning focuses on using data gathered before, during, and after the session to meet the client’s unique wellness goals.
Before the Session
The information the client tells you before the session is very important. You want to understand clients’ expectations for sessions, what they hope to feel like at the end, and the body areas where they want massage.
Clients with a lot of experience receiving massage may have clear expectations and give you specific directions. Alternately, the client may have no experience with massage and need guidance. It can be helpful to ask, “What do you know about massage and what do you think massage will be like?” This can clue you in to clients’ expectations, even when they say they have none.
During the health-intake interview, make general observations about the client’s freedom of movement, symmetry, breathing patterns, stress level, and body language. These observations often bring to light a client’s massage needs. If you notice a client turning his head cautiously, ask about any neck pain. If a client explains that she slept strangely and woke up with a stiff neck, focus a good deal of massage time in this area. If you notice a client taking shallow, rapid breaths, suggest starting with a deep-breathing exercise. A client demonstrating high levels of sympathetic dominance is likely to benefit from slow, calming strokes during the opening sections of the massage, while a client with an open body position in good physical health may be ready for strokes that are firm right from the start.
Clients usually want something specific from a session, and their goals may be realistic or unrealistic. A client who worked all day in the garden and tells you, “I’m sore in every single muscle of my body and I don’t want any soreness” has unrealistic expectations. Explain that you expect that the soreness will be reduced by massage but that there will likely still be some soreness after the session.
It is important to identify the body regions the client wants or does not want massaged. If a client mentions that her neck and shoulders need lots of work, plan to get to the neck and shoulders early in the massage and make sure to work those areas well. When you feel you understand the client’s expectations, summarize the plan for the session and ask the client if the plan sounds right. Once you and the client agree, the session can begin.
During the Session
As the massage progresses, it is likely that the plan you established with the client will evolve or adapt. This might happen because the client’s wishes change, or because of something you palpate in the tissue.
A client may insist he wants deep work, but you may feel that his tissue is resistant and that the client is guarding by tensing his muscles as the stroke begins. You need to find a balance between honoring the client’s request and honoring what you feel through palpation.
A dilemma might also arise if a client wants prolonged work in one area. If you are providing deep work on one area of the body for an extended period of time, you may begin to feel that the tissue is overworked, and you might become concerned that the client will be sore from the massage later. The best advice is to share your concerns with the client.
After the Session
At the end of the session, after the client has dressed, conduct a brief postsession interview. Ask how she feels, and note any changes that have occurred, such as better breathing or more relaxed body language. Point out your observations to your client. You can say, “When you arrived for your session, your arms were clasped across your chest, and you looked pale and tired. Now, your shoulders are relaxed and your color has come back into your cheeks.” By alerting clients to these visual changes, you help them identify some of the subtler positive effects of massage, which encourages them to return.
Sometimes when the session ends, you find you did not achieve all of the client’s goals. The client can now turn his head without pain but still feels tension in his shoulders, or you massaged his back for an extended period of time but the rhomboids still feel tense. Acknowledge that progress has been made, and add that more sessions make lasting change.
If the client wants to schedule another appointment, use the information gained from this session to help you plan the next. Any plans for future sessions should be noted in your documentation of the session. Clients appreciate therapists who support their goals and think ahead to how those goals might be achieved.
Anne Williams is the director of education for Associated Bodywork & Massage Professionals and author of Massage Mastery: From Student to Professional (Lippincott Williams & Wilkins, 2012), from which this article was adapted, and Spa Bodywork: A Guide to Massage Therapists (Lippincott Williams & Wilkins, 2006). She can be reached at anne@abmp.com.
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