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Continuing Professional Development - for better or for worse?

Do you study because you have to or want to? Are you passionate and inquisitive about your therapy and learning about the human body, or is it just how you earn your living? What motivates you to do a CPD course? Your professional association requires it. Your CNHC registration requires it. Your employer requires it. What effect does it have on your treatments and more importantly clients? In this week’s blog Julia Oyeleye, CHP Training Director talks about her views on Continuing Professional Development – for better or for worse?

A step too far..

I like to receive a massage on average a few times a year – I never seem to get time to have a regular monthly treatment and being a reflexologist as well I tend to intersperse it with that too (sound familiar?). So it really matters to me that when I do have a massage, my therapist listens to what I need, spends time finding the areas of tension that I might be unaware of and most of all gives me a complete treatment. Far too often over the last three years I have found myself at the hands of an experienced therapist whose technique leaves me feeling, well, dissatisfied. Why? Because their initial training and basic techniques have been all but replaced with trigger point work and other deep tissue methods that don’t leave the nervous system calmed and soothed but battered and bruised…. In fact, the last time I had a treatment I literally ended up bruised of all places on my hand, not what you want to do to a fellow therapist!

What has happened to make these therapists abandon their key tools and throw out the old in favour of the new? Certainly they will have learned how to perform petrissage, friction and tapotement otherwise they wouldn’t have qualified. Why then do they discontinue these techniques as the years pass? Many articles in professional journals would have you believe it is because of the fear or onset of RSIs. True, it is hard work to deliver six or more hour long treatments a day. But do we ever follow our own advice to clients who do a lot of physical activity? I wonder for example, how many massage therapists stretch before and after each treatment and stay well hydrated throughout every clinic day. One ritual I always follow after a long clinic is hot and cold treatment for my hands and forearms and a warm bath with Epsom salts before bed. It works wonders and is no more than I would advise my sports clients to do after a long training session or workout. How many times have you advised a client to take up yoga or Pilates in order to strengthen and lengthen muscles? Do you follow your own advice?

However, I don’t think injury or fear of it is the only reason the basics are being ignored. I think the main reason is continuing professional development. There are so many courses focussing on advanced techniques that it is difficult to choose what to do next. We are literally spoiled for choice. I am not suggesting that it is this wonderful array of techniques and tools that are the root cause of the problem. It is the fact that we are pressurised into completing a certain number of these workshops every year, whether or not we actually need to develop a new technique.

Are we under too much pressure as therapists?

As a therapist who qualified in the late 1990’s I’ve certainly gone through a lot of additional training but none more so than in the last 5 years as the pressure to prove that I am constantly developing my skills has increased. Thankfully, I have yet to go a year without genuinely wanting to discover more ways to help my clients. This is not driven by their dissatisfaction nor my lack of successes. I am eternally grateful to my teachers who taught me to combine applied anatomy, physiology and pathology with massage theory and therapeutic communication to work out the best and most effective treatment for a client - to be what we call at CHP a “thinking therapist”. It is perhaps because I did have the very best teachers that I have the desire to learn more. Sometimes I need to do this by attending a course or a workshop; sometimes I can get the knowledge I need through reading or even studying online, but like all of you, in order to maintain my professional association membership and CNHC registration a certain portion of it needs to be learned face to face and be therapy specific. For some multi-disciplinary therapists this can amount to over a week’s worth of training every year. This is not only expensive; it isn’t necessarily what they need.

Psychologists have long debated and researched the benefits of extrinsic rewards on intrinsic motivation. The suggestion is that if you reward someone for studying e.g. give a child a prize for doing well in reading, this does not encourage their desire to read for the reward of reading but because of the anticipated prize. What’s wrong with that I hear you ask, so long as they are reading? Well, from an educational standpoint it doesn’t develop natural students and therefore as an adult they are far less likely to engage in lifelong learning unless coerced to do so. In adults, it means that we are less likely to assimilate what has been learned with existing knowledge unless it is taught in that way. It is this that I think is doing the most damage to the quality of massage in the UK.

Adding and integrating to existing skills

My Grandad was a gardener and at the end of every week he would spend a few hours in his tool shed lovingly looking after and repairing his favourite spade, fork and trowel. From time to time he was given new tools to supplement these, but he never threw away the old ones and if anything, lavished even more attention on them as they got older and more worn. Grandad often favoured old methods over new and whereas new ideas were always welcomed, he never abandoned what he knew worked, living by that old adage “if it ‘ain’t broke don’t fix it”. Playing in his garden remains one of the most beautiful memories of my childhood. It was full of thriving plants, flowers, vegetables and fruit trees. So, by all means learn new techniques BUT these should be regarded as additional tools in your toolbox not replacements.

So what do I want included in my massage treatment? I want effleurage, but not too much. Petrissage with rhythm and intent; there is never enough if any petrissage since the CPD revolution and it absolutely cannot be replaced with deep effleurage – that’s just lazy and does not have the same effect. I also want some friction with hands first not a tool that cannot give any feedback on how my soft tissue is reacting. Then and only then you can try a few tricks. However, it shouldn’t end there. The soothing and smoothing out afterwards is just as important as the warm up in the beginning, just like warm up and cool down in sports and exercise. In conclusion, I believe that CPD is valuable as is all learning but not at the expense of utilising all of your skills equally and really tailoring your treatment for the benefit of each client's individual needs. Give them the treatment you would like to receive yourself.

My pet hate though has to be someone following a “routine” regardless of what they feel as they pass over areas of tension and knots…… signature spa treatments are bound to be a subject of a future blog!

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