Archive for Peer Supervision

Massage Business -Creating Policies and Procedures

March 10, 2008 Julie Onofrio Ethics, Peer Supervision, Start Your Massage Business, The Wealthy Massage Therapist

As a massage therapist, creating a solid framework for you business is like creating a solid foundation for a building. The clearer and deeper you go, the taller and larger the building you can build.

So many massage therapists avoid creating policies like cancellation policies, late fees, no show policies and when they do they have a difficult time enforcing them.

By creating these policies it will let your client become more informed about who you are and what you do. They can then decide if you are a good match for them to work with. It also gives you the opportunity to choose who you want to work with and create your ideal massage practice. I struggled with these things too for years as a massage therapist thinking it was what I needed to do to get and keep clients. I thought that by not charging for missed appointments or working longer on people when they are late for an appointment that I was making an extra effort for them to like me and keep coming as a client. I thought I needed to take everyone as a client regardless of whether or not they fit in with my ideal client. In doing that for more than 15 years, I can now see that it was part of the causes for my burnout in the mid 90′s. Giving away your time, money and energy is just downright draining. Period. You may think it is doing the client a favor and helping them more.

I wrote about this previously and mentioned a readers poll done by Massage Magazine last year about their cancellation policies and the ways they enforce their cancellation policies. There is of course such a wide variety of ways and answers.

The thing is to find out what works best for you in supporting you as a business owner and as a person. On one hand you need to make money to pay the bills. Since the number of clients that you can see in one day is limited and having just one client not show up or cancel at the last minute can effect your income significantly. Enforcing the policy sometimes and not on others can be confusing to the clients. As Dr Phil says – “We teach people how to treat us.

While things do happen to people – getting stuck in traffic, sick kids, sick themselves, issues at work – who is responsible for the clients actions? Them or you?

Setting strict cancellation policies may end the relationship. The question is do you really want someone as a client who does not respect you or your time?

Creating well thought out policies can help you create a stronger massage practice.

-What is your policy for when someone cancels with less than 24 or even 48 hours?

- What is your policy for working on someone who arrives late to their appointment? Do you work longer if you have the time? Or do you stay to the alloted time frame?

-What do you do when someone just does not show up period. They just forgot for whatever reason. Then when you call them, they are not apologetic but blame you for not calling to remind them or say they don’t want to pay for something that they aren’t receiving?

- Do you have a cancellation policy that is clearly written and placed on your website and intake form? Do you verbally state your cancellation policy?

There are a variety of ways to handle these situations:

  • Charge a minimum fee like $35 or half your session fee for a no show.
  • Charge your whole session fee for a missed appointment.
  • Choose to work on someone who is late for the full appointment time if you have the time.
  • Give people one session to forget and then remind them of the policy and charge them for any further missed appointments.
  • Don’t charge anything or say anything and you just eat the cost for the lost time and energy.  (How does that one feel?!)
  • Allow for extra-ordinary circumstances such as sickness, deaths in the family, real emergencies.

I also just did a quick search for ‘massage cancellation policies and found a variety of ways that people are communicating their policies some of which are very interesting with one person even apologizing for having to enforce the policy.

Here are some examples that I just copied off some websites ( I know- don’t get upset.)

Everyone’s time is valuable, that’s why we have to follow a few simple rules.

In today’s hectic world unplanned issues come up for all of us. We recognize this fact, but we respectfully request that you cancel your scheduled appointment by phone or e-mail a minimum of 24 hours in advance. That way the open slot can be filled with someone needing an appointment.

Failing two scheduled appointments in a row or three appointments within six months will result in a scheduling hold for Massage Appointments being placed on your account. This means you will not be able to schedule appointments with the Massage Therapy department.

You can also just do a search yourself and use some of the examples you find to create your own policy.  The most important thing to think about is what you need to create a solid massage business.
I guess I am always amazed when people think they won’t have to pay for a missed appointment or have any obligation what so ever for their commitment (which just happened to me only for the second time in 20 years which is why I am writing about this again!) I think that people do feel bad for missing appointments but it may just be too hard to admit that they do. The feeling will overwhelm them and move them into a defense mode – blaming you, blaming traffic, blaming their boss rather than accepting responsibility. Most doctors have cancellation policies. If you book a flight and miss the flight you have to pay a large fee usually. If you get tickets to a symphony and miss it or are late, you don’t get reimbursed.

While creating these polices will be a very personal thing and enforcing them another just keep in mind that what you do is also affecting the massage profession as a whole.  Letting people get away with no shows, late cancellations and late arrivals is teaching people how to treat us (massage therapists) as a whole.  What policy do you need in place to create a successful and rewarding massage practice and profession?

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A New Earth for massage therapists

February 28, 2008 Julie Onofrio Peer Supervision, The Wealthy Massage Therapist

“A New Earth” is Eckhart Tolle’s book that is now being promoted by Oprah. They are teamed up and offering a free online class that starts on Monday, March 3rd.

When I read “A New Earth” a few years ago when it first came out, I couldn’t put the book down and it became an inspiration for me to continue writing about such things despite many massage therapists not quite getting it that they can build a massage practice using similar principles of becoming more authentic by being present.

So many massage therapists are caught up in knowing more, learning more and doing more and the client usually gets caught in the middle. Part of the problem is how we are trained to ‘fix’ in massage school and our new role with the medical profession requires us to do it even more by reporting on improvements and having treatment stopped when function returns rather than when pain is resolved.

I was at a spa a few weeks ago and overheard a massage therapist in the hallway talking to someone who had just come out of the massage room and telling her how stressed the client was and how much more work the person needed. I could feel the tension in the air. The person who had just gotten a massage was being berated for how much stress they had rather than being honored for who they are. Now I am sure I am reading into things because I don’t know the whole story but it is examples like these or other stories of massage therapists saying things like “I just need to fix their pain” or ‘it is my duty to tell people about mercury poisoning and other possibilities that could be causing their health issues or I don’t feel like I am doing my job.

What “A New Earth” talks about is our roles that we take on to protect ourselves and our egos from suffering and how that creates more. But it is suffering that can free us from our pain and unhappy lives.

The ego is not something that is bad or that we need to get rid of. He says “It isn’t wrong, it is just unconscious” We are alive today because our egos are invested in ourselves. Tolle says that ‘Our egos are just are false self. It is the unconscious part of ourself.” The way to become more conscious is to become more present and aware of our egos.

But awakening from being unconscious is a little like thawing out from having frost bite – it is painful as we start to regain feeling.

A common thing that I often hear from massage therapist that I work with is about how they don’t feel like they know enough to help people. Tolle says this is actually the best place to be. When you can admit you don’t know enough you can realize that you are enough just as you are.

Another way to become aware of your ego is to become aware of what you are feeling in your body. As massage therapists we have the unique opportunity to help people feel their bodies more. ( I actually think this is more important than any specific massage technique or method.) Tolle says “Body awareness not only anchors you in the present moment, it is a doorway out of the prison that is the ego. It also strengthens the immune system and the body’s ability to heal.”

I also so often see massage therapists who become their role thinking that they are the only ones that can help someone and that massage is the end all answer to the worlds problems. I used to think like that when I first started out saying things like ‘if everyone got a massage once a week there would be world peace” (well there might be!) I also hear them complaining about things like working for chiropractors who take advantage of them or not having enough clients because of the economy or whatever the complaint is at the moment. Tolle says that “Complaining is one of the ego’s favorite ways of strengthening itself”. It makes us feel better to complain. And clients come into us complaining about this or that, this work situation or family situation and they come in with their pain and their attachment to their pain.

He talks about roles and how we take on roles to get the needs of the ego met.
How can we as massage therapists learn to become aware of our roles and learn to just be as a massage therapist?

How can we learn to serve and become more present with ourselves and with our clients to help make “A New Earth?”

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Forms of Peer Supervision

February 19, 2008 Julie Onofrio Ethics, Peer Supervision

Since many have not been exposed much to peer supervision or peer supervision groups, I am going to be writing as much as I can about them. There are many forms of peer supervision. You can work one on one with an experienced therapist who is trained in peer supervision or you can work in a group setting with the peer supervisor as the facilitator. This type of sessions that meet with a individual peer supervisor includes a fee for service.
Once you understand the concepts of peer supervision and how to work in a peer supervision group, you can start your own group by inviting your fellow massage therapists in your neighborhood or just others that you know. You don’t have to pay for this kind of regular meeting unless there is a fee for the meeting room. You can hire a peer supervisor to come in for specific things like learning to bill for insurance or to look more deeply at your helping issues or whatever is needed by the group.

The basic things to understand are things like this isn’t therapy. It isn’t one person telling another what to do. It is learning to listen and provide empathy in order for others to grow on their own in a supportive group. It is basically what happens on your massage table with clients when you remain present with them and learn to become aware of when you are fixing others on a grander scale. I have written a few pages on my website www.massagepracticebuilder.com, about how to set up and participate in a peer supervision group that you can read yourself, but to really learn how to work in a peer group it is necessary to work with an experienced massage peer supervisor who has at least 5 years experience in doing massage and preferably the same amount of time participating in peer supervision themselves.

One of my basic rules which I have actually adopted from Parker Palmer’s groups which he calls ‘circles of trust’ is “No fixing, no saving, no setting each other straight.” When I inform a new group member of this they often are left wondering what they are going to say or do in a peer supervision group.

A peer supervision group topics is really determined by the participants and their needs. The first few minutes of the group are spent checking in with each person to see how much time they would like to have to speak in that session. While there may not be enough time for everyone to speak, the others often learn just as much if not more from the person sharing their issue or story. ( an in person peer group size is usually from 3-8 people.)

After starting and running my own unofficial and free of charge online peer supervision group (massage_practice_builder at Yahoo Groups ) in the form of an online discussion group (which I started in about 2000 and used for sending out my newsletter and now is open discussions ), I have realized that there are so many lurkers and the group is dominated by a few people who like to speak out that so many are missing out that I have decided to start a private online peer supervision group where participation will be mandatory (well to a certain extent.) The other thing I am seeing from getting regular requests for email consultations is that there are many massage therapists out there who are in rural areas and don’t have a network of support so again the online peer supervision group will fill that need. Having a smaller group will allow participants to get to know each other better and be able to talk about the deeper issues that surround their practice. I will be facilitating the group and also writing a regular newsletter to stimulate conversation. I will be charging a small fee for my time and 20 years experience as a massage therapist and 5 years in peer supervision. To find out more and apply to join please see my website www.massagepracticebuilder.com .

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Peer Supervision – Who needs it?

February 18, 2008 Julie Onofrio Peer Supervision

Peer Supervision is really a confusing term to understand. For the longest time I fought using the words and tried to call it everything but peer supervision – mastermind groups, mentoring, support groups.

The thing is that the best way to really understand what peer supervision is about is to experience it first hand. Once I participated and understood then I said – yes it is peer supervision.

Of course in my opinion every massage therapist needs to participate in peer supervision groups and I have been thinking about what needs to be done to get it included in legal requirements of becoming a massage therapist – it is that important.

A massage therapist needs peer supervision if they want to become the best massage therapist that they can be. I wrote up some information on my website about who needs peer supervision.

While I think that people who have survived the 5 years in business mark as a massage therapist are drawn to peer supervision more, it can be really helpful for a massage therapist who is still in school or just starting out to get the assistance that they need in setting up and learning to run a massage business. Most people starting out are too focused on things like money and getting clients and think that they don’t need peer supervision. They also don’t really understand articles like “In the Service of Life” or books like “how can I help by Ram Dass. I know I didn’t when I was first starting out and there was no way that anyone could tell me that that was me in the article and book. It isn’t until one has struggled long enough or starts to feel burned out that the seek out peer supervision when it is the exact thing that can help prevent it and help a massage practice flourish.

So I am starting an online peer supervision group that you can read more about at my website – www.massagepracticebuilder.com. It won’t be quite the same as meeting in person because you get so much from hearing people’s voices and seeing people’s physical reaction, but it will be a way that we can start learning and sharing from each other in a much deeper way to help protect the future of the massage profession.

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The Drama Triangle- The rescuer massage therapist

February 17, 2008 Julie Onofrio Peer Supervision

The therapeutic relationship is a very complex relationship that requires that we become more aware of the dynamics of relating to each other. One of the ways is by studying and learning about the Drama Triangle. I wrote about it initially on my website www.thebodyworker.com

It is really the underlying dynamic in most relationships but because of the power differential that occurs in the therapeutic relationship, the drama triangle can be more evident in a client/massage therapist relationship. There are three positions of the drama triangle -the rescuer, the victim and the persecutor. There is usually a combination of them at work in a therapeutic relationship or any relationship for that matter. One position leads to the next. The rescuer can become the persecutor or victim and any combination of roles.

As massage therapists we are often taught to ‘fix’ a clients pain and injuries. Many massage therapists come to the profession wanting to ‘help’ others. Clients come to us looking to be fixed and taken care of. One of the roles on the drams triangle is the rescuer. We think we need to get the client out of pain.

People who are in pain or sick or injured quickly take on the role of the victim -wanting someone to fix the condition for them. This is the basis for modern medicine. Needing to be fixed they will find a rescuer to help them. As massage therapists we often take on the role of rescuer but we can also move into any of the other roles with clients and also within ourselves. Becoming aware of how we rescue (help, fix) is not an easy process. It doesn’t just stop overnight. When the process occurs internally taking on various roles at different times, it is usually can lead to feeling stuck in building a practice or finding a massage job. We blame the economy or bad spa owners for our lack of success.

Rescuers need to rescue to feel good about themselves. They need victims to be successful. A rescuer thinks everyone needs their help even those who are not directly asking for it. Rescuers don’t know how to take care of themselves so they focus on others. Rescuers usually have deep unconscious beliefs about themselves that they are not good enough so they rescue to feel good about themselves. Rescuers see others pain so clearly because they are filled with pain of their own. It easier to help others with their pain instead of addressing their own pain. Rescuers are not usually aware of their own pain or even think that they have any issues to work through. They are so busy helping they can’t see their own pain. They say things like “I just want to fix this psoas” or “if only I knew more anatomy, I could fix this”. It is a very unconscious process meaning that most are not even aware of the dynamics and their own part in each interaction. Rescuing others tells the other person that they are not good enough or smart enough to help themselves. Rescuers often end up underming others and reinforcing the victim stance. It is hurting more than helping. Rachel Remen MD explains this beautifully in her article “In the Service of Life”.

The early child/parent relationship sets us up for the drama triangle with parents often taking on the role of rescuer. The child isn’t old enough, smart enough and needs to be protected from the world. When are early childhood needs aren’t met ( which they rarely are ever totally met even with the best of parenting) we often are left waiting to be rescued. We fear asking for help because we may be further abandoned and hurt. We begin helping others so that they will become dependent on us and not leave us.

The thing is that every person has within themselves the power to find the answers to their health problems, business building problems or whatever they are faced with. You and you alone are your best source of advice if you can only begin to access your true self and listen to yourself. As a massage therapist our role is to be present for others as they uncover their own answers and true self. The thing is that you have to know your own self first before you can do this with a client.

People don’t even become aware of their rescuing habits until it becomes too painful to bear anymore. This is usually when a career in massage comes to an end but it doesn’t have to end if one can find the courage to begin to get off of the triangle.

The way off of the triangle is to start learning to feel the pain of abandonment and/or the pain of not getting one’s early needs met. It means learning to take care of yourself in every aspect of your life from being financially sound, healthy, eating the right things, exercising and taking car of your internal needs for acceptance, love, appreciation and recognition. It is about becoming more aware of what you are feeling when a client arrives at your door wanting to be fixed. Staying present with the feeling means that you can have the feeling and not act on it but use it to become aware of what you are thinking or what belief you have about yourself that is creating this need to rescue.

Changing doesn’t happen overnight. It is a process and it can be supported by getting regular peer supervision sessions with an experience peer.

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