Client Centered Philosophy

My Practice Approach

I feel it is important for you to understand the Client Centered Philosophy from which I approach my massage therapy practice. While the following is a bit long, I recommend you read it in full. Not only will it provide some information about the way I would treat you if you do come in for therapy, this page will also make you think about how you have been treated in the past by other healthcare providers.

I conduct my massage practice with a Client Centered Philosophy (sometimes called a person centered philosophy). This may sound like a foreign term when compared to your previous experiences in therapy, so I will give you a good working definition, then go on to explain.

shadoW0W

The Client Centered Philosophy proposes four concepts:

• The client wants the services of a clinician.
• The clinician is seen as a facilitator.
• There is an environment of trust & acceptance.
• There is a joint pursuit, by both the therapist and the client, of a change in function or health.

Client: You. In an economic sense, it means consumer. However, in the sense of the Client Centered Philosophy, it means as a Client that I (the therapist) work as an agent for YOU. My goal is to "treat you like a person". The term also has other certain connotations which associate with the terms: free-will, choice, empowerment, wants or desires, and humanity or dignity.

Patient: Still You. Typically used in the traditional medical model. While there is great debate in the exact meanings of this word, the word’s origin indicates both a feeling of suffering and forbearance (such as having to restrain oneself even in the eye of provocation). Some have used the term to describe a “submissive sufferer”. While most who use this term will confess they want to treat you like a person, in reality, you are often thought of as more of a disease or condition. While the term is not used in the Client Centered Philosophy, keep the term in mind while reading the rest of this page.

In my massage practice, I will always refer to you as a “client”, and never “my patient”. While you may be the patient of the physician that referred you to me, I am ultimately accountable to YOU first and foremost. Also note that I will never think of you as “my client” as I have no ownership over you. You have the free-will choice to leave my services at anytime, and I respect that fact that you may want to try the services of other massage therapists, even if your physician referred you specifically to me.

The Client Centered Philosophy is based on four assumptions:

• Clients know what(outcome) they want from therapy.
• The only relative perspective is that of the client.
• Professional dominance is counter-therapeutic.
• Therapists can not cause change; clients cause change (or healing). Therapists can only create an environment in which change can be facilitated.

Advantages:

• Clients generally experience increased self-esteem, self-satisfaction, satisfaction in the therapy service, and a feeling of mastery and independence (notice how these last two terms relate back to dignity and free-will).
• Therapy conducted under a Client Centered Philosophy gives a truly individualized perspective.
• The Client Centered Philosophy gives the unique benefit of the opportunity for personal and professional growth of the therapist, perhaps even making them a bit more human.

• There is a perception that a therapist who uses the Client Centered Philosophy is somehow less skilled (viewed predominately by the medical model).
• There is some ambiguity about roles in the client/therapist relationship.
• Some clients feel anxiety and discomfort when being a part of the Client Centered Philosophy. This is to be expected, though, as few of them have ever been allowed to be a part on their own healthcare recovery.
• The Client Centered Philosophy is not accepted by all parties. While it has already been stated that the medical model conflicts with Client Centered Philosophy, medical insurance companies are also reluctant to reimburse for services in which a client has so much control. (refer back to term “patient”)

Now that you understand a little about the Client Centered Philosophy, let me explain why I would choose such a philosophy from which to approach my massage practice.

It took me a little while to understand, but I am neither in the “people business”, nor the “body business”. I am in the “person business”. Once I finally figured this out, I realized why so many people were unhappy with the body business. Yes, they were grateful after being patched up after a nasty accident by the body business, but most were still left unhappy because they realized “Hey, I’m not who am because of my body; I’m who I am because of my ‘Living’ “.

Fortunately, or unfortunately, there seems to be an intimate connection with humanity/dignity and with free-will and choice. Along with that, our humanity and dignity is a function of how we occupy our time (“Living”). Take away someone’s free-will choice, and their humanity/dignity level goes down. When humanity/dignity goes down, “Living” goes down.

Perhaps now you may understand why our healthcare system often misses the mark. Yes, we are great at patching bodies up and solving medical problems, however, our system is not so good in making us feel human again. Please, do not misunderstand me. There are some very caring individuals out there in our current medical system. They are very competent and committed to their field of healthcare.

What our healthcare system fails in is usually empathy, not caring.

(Reiser & Schroder, 1980) wrote: “In order to help people who are sick, we must know what it is like to be in their shoes, but at the same time, also know very well that we are not in their shoes”.

Most of us in the healthcare industry have already learned and know this. What we have never been taught is how to implement it. While I can say the Client Centered Philosophy approach is one way to get to validation, I can think of a few ways that do not.

Depersonalizing a client’s therapy is a sure firing way to avoid validation. Looking from the client’s perspective, many clients who feel depersonalized during treatment often state that their healthcare provider:

• Failed to see the personal consequences of their illness and disability.
• Denied the client of a feeling of caring.
• Dismissed the clients totally or their concerns.
• Failed to show that they, themselves, feel or can appreciate a client’s pain.
• Engaged in distracting behavior while giving treatment.
• Withheld vital information.
• Were silent or acted aloof during the treatment session.
• Acted brusquely.
• Mis-used their power.

Clients generally view their illness as the experiences of that illness, the feelings of unease that it causes and the meaning those experiences have on the client’s “Living”.

Healthcare practitioners often fall into a line of thinking based on the perception that the client’s illness is just a disease or medical condition in the mechanism of the body of their client.

The consequence of this strong adherence to rational fixing of disease or the body is further experienced by the client as invalidation, and who then ends up resenting the practitioner because of this narrow “disease” view.

The litigious times of our society have caused our healthcare system to produce a service model which centers on highly defined techniques, protocols and procedures. Unfortunately, these things, too, have the unintended effect of making the client feel invalidated.

Remember the perceptions I wrote about above? Our clients are viewing their illnesses as an experience; they want solutions to their problems of “Living”. We healthcare providers, are always afraid of being sued, so we stick to rigid protocols and use the mainstream techniques and FDA-approved technology because we know it treats disease. This may actually be good for our own protection, but from the perspective of the client, it appears we are walking around with blinders, unable to see their experience of illness.

Perhaps my examples have made you look back at your own previous experiences with healthcare and illness. If you can identify with any of these, you can see now why I have chosen to approach my massage practice based on the Client Centered Philosophy.

When you come to me for therapy, I do not view you as a disease. I view you as a partner-in-health. After all, you are a "person"!

What are your own experiences of the approach your past healthcare providers have used to treat you? Did they treat you like a person or treat you like a disease?

Is the Client Centered Approach right for you?

Return from Client Centered Philosophy back to Home Page