by Frank Merillat
I was thinking about what are the really important elements in having therapy be effective. Usually folks think about things such as technique and knowledge of anatomy. As I reflect back on my experience over the years, I keep coming back to the piece of how do I get my clients to engage in their own therapy. I think this is probably the most important element in getting positive results.
If I am a great technical therapist, if I am very knowledgeable about the workings of the body, even if folks really like my touch, it is still necessary to get my client involved and participating to get the best results. Think about this. If I see a client once a week for one hour for the rest of our lives together, I see this client for less than one half of one percent of their time. This means that if change is needed and desired by the client, then they must participate when they are moving in their life activities for meaningful change to occur.
How do you engage your clients in their own therapy? What do you do to get your clients to become aware of their experience and participate while they are experiencing their daily life? Do you engage your clients and help them become aware that they are the ones who actually bring about change?
I notice that clients often give me credit for what happens. They say, “Oh you changed that spot,” or something like this. The truth is that I helped them become aware of their own experience and gave them the possibility of another feeling through the use of touch, movement and education. It is the client who makes the change in the feeling in their body.
There are different ways to do this. One of the simplest is to communicate with your client. As you work with an area, invite the client to describe what they feel. Invite them to help you get the feeling of what you are doing “just right”. Invite them to notice the change that occurs and remind them that they are the ones making the change. Communication is key. I remind my clients that yes I am helping by giving them useful information and that allows them to feel something more functional.
It is also possible to have the client participate by offering the possibility of movement in conjunction with the touch. The movement can be passive, initiated by the therapist, or actively initiated by the client. This provides even more information to the client’s nervous system and adds feeling to the client’s experience of the touch.
It can even be more informative if resistance is added to the active movement. Resistance can give information about location of injury, and specific soft-tissue involvement. It can also be used to assess motor signal delivery or strength balance/imbalance. I often use this technique to assess and then treat problem areas. I really like this as it is very educational for the client and they can feel the problem and positive change when it occurs.
Homework is also an effective way to involve the client. The homework is often thought of as exercise or stretching. It can also be simple awareness activities that focus on feeling during activities or posture for example. It might be just taking a break during work activities to prevent repetitive motion or position dysfunction.
All of these things I have covered are ways to involve the client in their own therapy. When a client is educated, helped to become aware of their own body and activities, they are actively engaged and participating in their experience. This is what leads to meaningful change.
How do you engage your clients in their therapeutic experience?
If you are interested in learning more about the use of movement and resistance as an addition to your skills, check out the workshop being offered by Deane Juhan Friday through Sunday, December 5-7. This is work that I use regularly in my own practice. I find it effective and informative for my clients. To get more information check out the FSM website under weekend workshops or contact me directly at fmerillat@mac.com or call (352) 371-0743.
