Detroit Massage and Wellness (wiki)

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Contents

Bodywork

This is a tool to get knowledge and ideas from my head to your head
This is a tool to get knowledge and ideas from my head to your head

Session Planning and Time Management

Use the clock as a way to measure time, not as a way to tell the time. Once you re-enter the treatment room to begin your session, check the minute-hand. A 60 minute session should last 60 minutes, and a 90 minute session should last 90 minutes.

60/90 FBM

60 Minute FBM Starting Prone
  1. Apply hot pack and greet the body.
  2. 5-7min post neck, traps, and head
  3. Approx 5 min each arm

(1- 3 should equal 15 minutes)

  1. Move hot pack to hips. 15 minutes on back. (ok to continue work on 2 throughout this time too)
  2. Hot pack back along spine
  3. 7.5 minutes each leg. Posterior and lateral. Also work feet a bit here.
  4. Lower light, remove hot pack and flip ct.
  5. Adjust bolster if needed.
  6. Lower face cradle, and remove the pillow case. Fold case in half or quarters length wise. Steps 7-9 should only take like 30 seconds
  7. 5min Work on head, face, ant neck and chest.
  8. Split 5min between the two anterior legs.
  9. Spend any extra time on feet/ankles
  10. Close session. Compressions, reiki, pick your poison, but it should be a ritual your cts can recognize and understand.
90 Minute FBM Starting Prone
  • You can use the extra time to address any issues your CT talked about during oral intake.
  • Alternatively, you could follow a similar outline to the 60-minute protocol, but add a few minutes to each ‘region’.
  1. add 5 minutes to total time spent on arms
  2. add 5 min to back/neck/traps/shoulders
  3. add 5 to each leg (10 min total)
  4. add 5 minutes to anterior legs, or neck
  5. add 5 to feet

Thermal Compress

To Use On a Client Hot

  1. Preheat hotpack before client arrives if he/she is a RC. If CT is new, heat hot pack while he/she fills out the intake form.
  2. Heat for about 2 minutes at first (a bit more if it’s the first time you’re heating it for the day)
  3. Flip the hot pack. You can move the fill around the inside to get a sense of how warm it is and to help it heat evenly.
  4. Touch the hotpack to the inside of your forearm to get a better sense of how warm it is.
  5. Very important not to burn the hotpack b/c it will make the whole place smell like burnt popcorn (I learned this the hard way)
  6. Always keep a layer (either a sheet, pillow case, or towel) between the hotpack and your clients skin.
  7. You can cover the hot pack while you’re using it (or while you’re not using it) to insulate it and keep it hotter for longer. Ex. when I use the hotpack on a CTs back, I place it on top of the sheet, but under the blanket.
  8. Sometimes it feels good initially, but after a moment, the heat starts to really sink in and it can be several minutes before a CT realizes that the heat is beyond his/her level of tolerance. If the hotpack is too hot for a CT, you can place additional layers between CT’s skin and the hot pack. Ex. if I’m using it on someones back and they say “I think that might be too hot”, I might take it out from under the blanket and put it over the blanket. This gives more protection to the CT’s body and also lets the hot pack cool down faster. If it’s a 90 minute session, I might heat it up extra hot on purpose and wrap it in a towel for the first half of the session. When it starts to feel less hot through the towel, I can remove the towel and the hot pack will still deliver heat for a good while longer.
  9. When CT starts prone, lay the hot pack along the spine (under the blanket, over the sheet). Spread the fill so the pressure and temperature is even. This can be a great way to greet the body. I usually give some compressions through the hot pack and do some gentle rocking. This also helps warm my hands before I begin. When I’m ready to work on the back, I move the hot pack to lay across the hips. This can help keep the drape in place (but it can also work against you, so be careful) and it heats up the region of the body I might be working on next. And when I’m done with the back, the hot pack goes back along the spine. You can align the hotpack so it helps hold the drape in place while you work on the glutes. I do not lay the hot pack across the shoulders because it feels uneven in every way, and it often rolls up by the neck putting an uncomfortable and unhelpful pressure in a place that is already misaligned on most people.
  10. When CT starts supine you can place the hot pack under the neck, across the abdomen or over the face. If you're draping it over the face or on the neck you must wrap it in a towel or a pillow case. If you lay it across the abdomen, you can lay it over the blanket. I prefer lay it over the full drape (as opposed to between the sheet and the blanket) because messing with the drape in that area is risky and can make the ct feel exposed. If you lay the hot pack in the abdomen, make sure to set it down on ct's exhale. It's heavy, and with this I mind the hot pack can aid in deepening the breath as opposed to disrupt it.

To Use on a Client Cold

Store thermal compress in refrigerator or freezer (inside a tupperware or ziplock bag so it does not absorb any unintentional odors. When you use the thermal compress (hot or cold) it's important never to let the fabric come into direct contact with the clients skin. Use a pillow case, towel, or sheet as a barrier.

Some great places to use a cold thermal compress would be...
  • Over the eyes
  1. Make sure the fill does not fall completely off the sides of the face b/c that will weigh down the bag and the fabric will pull against the clients eyelids instead of providing a therapeutic compression.
  2. When you use a larger compress, it will also cover the forehead and sinuses. This is a really good thing! Just make sure it is not blocking the nostrils because we would never want to make it more difficult or unpleasant for our client to take full, cleansing, healing breaths throughout their session.
  • Base of the skull (while supine)
  1. This can be helpful for clients with sinus issues or congestion.
  • Over an acute injury
  1. You would not massage an acute injury, but if you're working on a client who is healing from an injury, placing a cold compress on that area could be incorporated into the session.
  2. The compress also serves as a great reminder for the therapist to steer clear of the injury.

How Your Clients Can Use Their Thermal Compress at Home

Massage therapists can also use Thermal Compresses at home!

How to Care For Your Thermal Compress
  • Store in a cool, dry place.
  • Avoid getting the Thermal Compress wet.
  • Spot clean only.
  • Do not heat in a steamer, toaster, or oven.
  • Do not overheat. Contents may burn and your compress will be ruined.
  • Over time (years) contents will loose the ability to maintain temperatures. When this happens, contents can be composted.
Hot

Heat in a microwave on high for 2-3 minutes. Times may vary based on microwave strength and heat preference/tolerance.

Cold

Chill in a freezer for several hours. To prevent your Thermal Compress from absorbing freezer odors, store in an air tight bag.

Some Suggestions For At-Home Use
  • Drape your warmed Thermal Compress across sore shoulders or around the neck to relieve tension.
  • Lay your warmed Thermal Compress along the spine to promote deep relaxation.
  • Place your chilled Thermal Compress over eyes, sinuses, and forehead to relieve sinus pressure caused by allergies or colds.
  • Use your Thermal Compress to warm up a newborns crib before placing him/her down for the night. Your baby will stay sounds asleep not realizing that he/she is no longer in your arms.
  • Lay your chilled Thermal Compress over swollen, tired eye.

Techniques

Note: Contraindications are not outlined here. Please do not attempt any of these techniques unless you are trained to know who not to do them on.

Prone

Upper Body
  • Neck/Head/Traps
  • Arms/Forearms/Hands
  • Stretches
  • Back/Upper-Glutes
Lower Body
  • Lower-Glutes/Upper-Legs/Lower-Legs/Lateral-Legs
  • Feet (Dorsal/Plantar)

Supine

Upper Body
  • Neck/Head/Face/Traps
  • Chest/Pecs/Sturnum/Anterior Shoulder
  • Arms/Forearms/Hands
  • Stretches
  • Abdomen
Lower Body
  • Upper-Legs/Lateral-Legs/Medial-Legs
  • Lower-Legs
  • Feet (Dorsal/Plantar)

Side-Lying

Transitions

With every transition (as minor as it may seem) there is an opportunity to introduce stress, anxiety, or confusion to the clients experience. With many of these transitions, we're guiding our client away from the normal, harsh, outside world, and into a safe, quiet place where they can quiet their minds and focus inward. Once we've helped them get to that place, we don't want any of the transitions during their visit to disrupt that or move them out of that place. And when it's time for them to prepare for the outside world again, we transition them with awareness and sensitivity.

Pre-Session

Greeting The Client
  • Answer the door when you hear the bell ring. (We listen carefully for it so we can answer the door right away. We don't want our clients waiting out in the heat of summer, the cold of winter, or the pouring rain...!)
  1. "Hi, Aaron? Come on it, I'm Hannah, I'll be working with you today"
  2. For new clients, you'll direct them up the stairs and say "We're going to go all the way up the stairs" so they don't stop at the clinic door.
  3. On your way up, some light conversation is nice. "Did you find it ok?" or "How's your day going so far?" And actually, talking about the weather can be nice too! "Such a nice day out today..."
  4. When you get to the top of the stairs, open the door for them and direct them across the hall to the waiting room "We'll start in this room right across the hall, I just need you to fill out a short intake form". You can say this as you're walking with them into the waiting room.
  • If someone else let your client in, greet him/her in the waiting room.
  1. For clients you’ve never worked with before, introduce yourself to the client with a handshake. Your handshake should be firm and comforting (a preview of what’s to come!)
  2. “Hi, my name is Hannah. I’ll be your therapist today” or, “Hi, I’m Hannah, I’ll be working with you today”
Intake Form
  • Welcome your client into the waiting room, hand him/her the intake form clipboard with a pen and gesture to the chairs se they can have a seat and fill out the intake form.
  • Say
  1. It's front and back sides, but it's just one page, the rest are just copies.
  2. Please sign and date at the bottom on the back.
  3. Would you like some water or tea while you work on that?
  • If they want something to drink, get it for them. If they don't, you can say "ok, just help yourself if you change your mind" and gesture toward the water cooler.
  • Then walk away and leave them to it. Write your notes, use the bathroom, preheat a hot pack, whatever.
  • When you think he/she is finished filling out the form, you can say "all set with that?"
  • This is when you offer the bathroom. "Would you like to use the restroom before we get started?" (there are some detailed suggestions on guiding a client to the bathroom somewhere in here)
  1. If they choose to use the bathroom, this is your chance to look over the intake form carefully and thoroughly. Look for points to talk about during oral intake.
  2. If the client chooses not to use the restroom, tell him/her you're just going to take a minute to look over the form before you begin (everyone stays in the waiting room for this part). Look for KEY points that will have a big effect on your approach to oral intake. Ex, injuries, pregnancy, never had a professional massage before, etc...
  • Then invite him/her to the treatment room. Bring your clients file with you! You can offer to take a coat or a bag or whatever if they're flustered or trying to carry a cup of water or tea with them.
  • I like to gesture and give directions to where we're headed so I can walk behind the client. Notice how they use their body. Hunched to one side carrying a computer case? How do they walk? This is valuable intake.
Oral Intake
  • When you get to the treatment room, walk inside with your client and take the side of the table opposite the chair. Your client should take the side of the table with the chair and face you.
  • Close the door, but not all the way. We want to offer privacy during the oral intake, but we don't want people to feel trapped. So close the door, but not all the way. And don't stand right in front of the door, stand beside the table, out of the way of the door. This will help keep your client from feeling trapped.
  • Oral intake will need to be adjusted based on the individual (obviously) but pay special attention to adjusting your oral intake based on how comfortable the client is with the whole process they're being taken through. If you're working with a new client who has never had a professional massage before, he/she will need extra explanation. It can also be helpful to give them a sense of the more general timeline before you get into their oral intake. "So you made it here, you've filled out the intake form, now we'll talk a little bit about what you want to work on, then I'll leave the room, you can disrobe to your comfort level, and then I'll come back and we'll start your session."
  • "How are you feeling, what would you like to work on today?" Asking this questions in this way with these words will give you the information you need. If you ask “How are you” before you know it, you’ll find yourself listening for 10 minutes about your clients car troubles. Not that it’s totally irrelevant, but there’s information that you need that you won't get unless you ask this way.
  • You can use the file as a prop here. You can open it, glance inside for reminders, close it, and get back to good eye contact. It's good to break up the eye contact with glancing at the folder to keep the experience from getting too intense or awkward for the client.
  • Was there anything on the clients intake form you wanted to ask about? Or anything you read in the noted from sessions he/she has had before?
  • If the client specifies areas or issues he/she wants to address, ask "Do you want to work on just that? Or would you like to do a full body and focus on that?"
  1. if you think you may not be able to fit a full body massage (FBM) in the time you have, ask them if there's something they don't mind if you skip, or is it important to touch on everything?
  • Ask “Is there anything I need to stay away from? Hair, face, anything like that?”
  • When a client asks how you are (or something even more detailed)
  1. You're encouraged to answer if you feel comfortable and it's an appropriate question
  2. If the conversation gets stuck on you for longer than 2 sentences, it's time to actively turn the focus back on the client. (Even if it seems like all he/she wants to do is ask about you, it's our job and sometimes it can be tough, to provide an opportunity for the client to focus inward. And if the client is committed to talking, that’s fine, but it needs to be about them, not about you.) This is an important guideline to follow during the session too.
Instructions onto table
  • “OK, so I’m going to leave the room and you can disrobe to your comfort level. Lots of people ditch everything, but you’re welcome to leave on whatever you’re comfortable with. You’ll be covered everywhere that matters (gesture to torso/pelvis)...”
  • Do you have a preference to start face up or face down? (Do NOT say “prone or supine” no one will know what you’re talking about. Our job isn’t to know fancy words, but our job is to be able to communicate with clients effectively and keep them feeling at ease)
  • Your client might hesitate or say “I don’t know”. That’s when you say “Let’s have you start face down” (or face up). The point it, you don’t allow time to swell around the questions because if they don’t know their preference, they’re probably wondering what the “right” answer is or the “normal” answer... these are the thoughts that lead your client to feeling anxious, so we avoid it by offering direction. You could add “that way, I can have plenty of time to work on your neck, although I’ll probably work on your neck more after we flip you to be face up” or whatever.
  • “So hop on the table UNDER these sheets (lift blanket and flat sheet away from table, maybe even fold it over at an angle, sort of opening the table to them... inviting...) and ON TOP of this sheet (place your palm on the fitted sheet) and FACE DOWN in here (touch the face cradle)”
  • For clients who are new to massage, add “This is the bolster (gesture to the bolster that is under the sheets). It should line up under your ankles while your face down and under your knees while you’re face up. This helps maintain the natural curvature of your body and helps take pressure of your low back. If it’s not lined up, I’ll fix it when I return.”
  • “Do you have any questions for me?”
  • “OK, I’ll be back in a couple minutes, so take your time.”
  • Leave the room, and make sure to turn the door lever as you close the door behind you so it does not make a noise that will disrupt other people in the space, or be jarring for your client.
  • To re-enter room, gently knock on the door and open it slightly and say “All set?”. Be careful to turn the door lever all the way before you start to open the door, and turn it all the way before you close the door behind you.
Begin session
  • While aligning the bolster and straightening out the sheets, say “So let me know at any point if the pressure is too much or not enough,” you can add “if you get too hot or cold, or if there’s anything I’m doing that you just don’t like”
  • Get the thermal compress in place and say “And let me know if this gets too hot”. Sometimes clients say “Oh, that feels wonderful” and you can say “Good, sometimes after it sits for a while it starts to feel too warm, so just let me know and we can put another layer between you and the heat” or whatever...
  • Then greet the body. When the client is starting prone, I like to place my hands on either end of the hotpack and center myself. Then I move my hands to the lower end of the hotpack (by the clients sacrum and posterior superior iliac spine) and firmly rock their lower back and hips back and forth a few times. Aha, this is what it feels like to be relaxed and let someone else touch you and move you around!
  • Then begin your session, yay!

During Session

Closing the Session

When the session is over, do not say "time's up" or "how do you feel?". Instead, say "Thank you for letting me work on you. Take your time getting up from the table and I'll see you outside whenever you feel ready." Practice this out loud right now three times. "Thank you for letting me work on you. Take your time getting up from the table and I'll see you outside whenever you feel ready." Again, "Thank you for letting me work on you. Take your time getting up from the table and I'll see you outside whenever you feel ready."

You can maintain contact with your client while you say this. If your client is supine, you can stand by their feet and do some gentle compressions over the drape while you say it (this gives really clear signals that the session is over, but they don't need to get up or move or anything). And if the client is prone, you could place your hands on the back over the drape (one near the top, one near the bottom) while you say it. This will also send clear signals that the session is over, but they do not need to move or say anything if they're not ready.

Post Session

  • Exit the room and close the door quietly. This is part of the reason I prefer using door levers instead of door knobs.
  • Go straight to the sink so you can wash your hands and arms with soap. Wash all the way up to your elbows if you’ve used your forearms.
  • Fill a glass of water for your client (unless you know he/she brought a water bottle).
  • When your client comes into the reception area, hand him/her the glass of water, or gesture to it if you’ve placed it on the table or desk.
  1. “Here’s some water for you if you’d like.”
  2. For new clients (not just clients who are new to DMW, but especially clients who are new to massage in general), or infrequent clients, give them a short spiel about the importance of drinking water. They may look interested, in which case you can continue to offer information and details. They may even ask you “Why?”. But if they seem disinterested or in a hurry (or totally out of it b/c they just had an incredible massage session) leave it at the short spiel and move on.
  • This is when you can offer information you gathered during your session with them.
  1. How did the muscle tissue feel? Range of motion? Did you notice your client was sensitive in a specific area?
  2. “I was looking for the tightness in your right shoulder, but where I found most of the tension was in the left side of your neck.”
  3. If your client seems interested, you can explain why/how that happens, and offer some exercises or stretches he/she can do at home or at his/her office between massage sessions.

Be careful to stay tuned into your clients signals so you know when to STOP talking or when to KEEP talking.

  • Some clients like lots of details (anatomical terms, how different muscles work, etc)
  • Some clients don’t want to hear a massage therapist go on and on about something they don’t care about, or something that they know more than we do about.
  • Sometimes a client will want the details and other times that same client may not want details.
  • Every client should be given the allowance for any/each of their appointments (even if you work on him/her regularly and it’s usually the same story) to be a completely different story. When a client you work with every week always comes in and says he wants a full body massage with focus on the neck, you still need to ask before each session “How do you feel and what would you like to work on?”. During your session, you still need to recognize that although he asks for the same thing, his body is telling a different story altogether, each session, and it’s your job to maintain open lines of communication with his body. So after his/her session, you might need to switch up the kind of check-out experience you offer.
Analogies

Analogies can be helpful when trying to describe what’s going on in the body and why we suggest the things we suggest.

  • Tight vs Taut

Clients often describe their muscles as being tight. It can be frustrating for a massage therapist who can tell that what the client is calling tight is actually weak and stretched out. A common example is when a clients anterior shoulders are out of balance with their rhomboids. They come in and say they have all sorts of knots and tension between their shoulder blades, which is usually true, but not because those muscles are tight. It’s usually because those muscles are taut. Taut like a tightrope. As massage therapists, it’s part of our job to make our clients feel heard and understood. We never want to make them feel like something they’re complaining about isn’t real because that would be unfair, frustrating for them and kind of cruel in general. We want to support them being aware of what’s going on in their bodies and we want to help them develop a wider language around it so they can more accurately understand and describe it. This is why in a situation like this (when the push and pull of a certain area is out of balance) I like to describe what’s going on in their “upper back” or “between their shoulder blades” or “rhomboids” as their muscles being “pulled taut like a tightrope”, and actually it’s the front of the chest that is tight in this case. This way, they still get to hear you say the word “tight” when you’re describing what’s going on, but also the word “pulled”, which still implies the strain and discomfort they’re trying to describe, but from a different cause. This is how you can lead into a conversation about stretching the pecs or anterior shoulders in a doorway, or strengthening the upper back or rhomboids.

  • Sponge
  1. Muscle tissue is like a sponge. When it’s hydrated, it’s flexible. And when it’s dehydrated, it’s brittle and hard.
  2. Also, when you put a dry sponge under a running tap, the water will run right over it for some time. Eventually the water will start to absorb, making the sponge soft and flexible again. When the sponge is soft and flexible, it’s much easier for it to absorb and retain water. Same goes for your muscle tissue. If you slam a bunch of water all at once, it goes right through you and won't keep you hydrated throughout. So the key is not just to drink a certain amount of water every day, but to take in water regularly. (And avoid salt and sugar)
Rescheduling
  • After talking about the session with your client, ask if he/she would like to reschedule.
  1. "Would you like to reschedule while you're here?"
  • If the client says something like "oh, I'll have to call" or "I don't know when I can come back"...
  1. It's important to be very active and aware of how you deal with this situation b/c we do not want clients to feel awkward or like we're disappointed or like they need to offer any sort of reason or excuse. It's so important that they feel like we feel really good about it.
  2. Just say OK and give them a business card w/ our number and say "sure, no problem, here's our number, we're here for you when you need us" or "Sure, you can just call to set something up whenever you're ready to".
  • If the client says that he/she would like to reschedule before leaving...
  1. Say "Great, when would you like to come back?"
  2. The thing you should NOT say when a client says he/she would like to reschedule is "OK, I'm here every Monday and Friday, and every other Saturday". It implies that the client cannot come in whenever works best for him/her, but only when what works for him/her aligns with what works for you, and that is not the case.
  3. The client might ask "Well, what days do you work?" In which case you can say "I'm here every Monday and Friday, and every other Saturday"
  4. If it's a repeat client who usually comes at a regular interval, you can say "Great, two weeks? I don't have a 5:30 that Tuesday, but I do that Wednesday. Or Halley could see you at 5:30 on Tuesday" (If the client has explicitly told you that he/she prefers to continue working only with you, you should not offer appointments with other therapists unless youre unavailable and they'll be thrown off their normal regiment. But you cannot assume that he/she wants to only work with you until he/she says so specifically.)
  5. If the client indicates that he/she will be rescheduling, but not now, you may say something like "Sure, I'm here every other Saturday, but all the other therapists are really good, so whoever you end up work with should be great." And you can even add "And if you know what kind of work you like, you can talk to the receptionist when you call and she'll help you figure out who to book with based on what you're trying to work on" or something like that.
  • If the client asks how often he/she should be getting massages...
  1. You can suggest a regiment based on what you learned from working with them.
  2. You can also explain the packages so they know they can save money if they're planning to make it a regular or semi-regular thing.
  3. You could suggest they listen to their bodies and come back when it's time. Then you'll have an idea of when to reschedule them after their next appointment. They might come back saying something like "yeah, 3 weeks was just a little too long, can I come back in 2 weeks this time?"
Checkout

When you’re finished rescheduling the client, you collect their payment.

  • If they have a series of 5 sessions...
  1. let them know how many they’ll have left after you redeem one. “So after today, you’ll still have 2 sessions left...”
  2. To redeem one of the coupons, you will take one out of their folder, and write the date on the line that says “Date Rdmd”. Then you can put it in the “bank”.
  • If they’re paying with a credit card...
  1. Swipe their card, hand them the ipod so they can sign it with their finger.
  2. When they hand back the ipod, HAND them their credit card. Do not put their credit card on the desk as a way to give it back to them. Put it into their hand.
  3. You can offer them the option of having a receipt sent to their email, but do not offer them the receipt via text message option b/c it doesn't actually go through.
  4. If the client hit the “Charge” button and you’re not sure if they left a gratuity on the card or not, you can check under “History”.
  5. Write on a slip of paper the clients name, the date, your initials, the amount you charged and the amount they paid (ex: David Tamm, 11/13/12, HL, $60+$10grat=$70) and put the slip into the ‘bank” to represent the payment.
  • If they’re paying with a check...
  1. Checks can be made out to “Detroit Massage and Wellness” or “DMW” for short. We like to make it easy for clients after a session...
  2. Gratuity can be left on a check as well.
  • Cash payments
  1. If the client hands you more cash than you’re charging them, ask if they’d like change. If they say no, the extra is a tip for you! They might say “yes” or “Let me get $15 back” or something like that, you can make the appropriate change from the “bank”. (If the cash we keep in the office is turning into more $20 bills than $5 or $10 bills, leave a note for the receptionist that we need more change.)
  2. Write clients name and date on a scrap of paper and clip it to the cash before putting it into the bank.
  • If a client is paying with a Gift Certificate, just make sure their name is on it before putting it into the bank.

Pressure

Cream/Oil

I realize they warn in school against using too much oil on your client, but I will also warn against using too little.

  • For most people, (especially older people, women, people who’ve recently lost weight, etc) the skin covering the superior, medial extremities is looser. So when you’re working on these areas, or gliding over them, it’s important to use sufficient cream/oil to avoid dragging or pulling the skin in a way that could result in bruising or discomfort for your client.
  • Spread the cream/oil between your palms before you apply it to the client.
  1. This will help you warm the cream/oil before it lands on your client.
  2. It will also help you get a more even application.
  3. This is one of the ways you can avoid lumps of cream and splotches of oil getting on the sheets.

Draping

Bolster / Setting Table / Face Cradle

Bolster

Leave the Bolster on the Table

In school, they teach you to set the table without the bolster, and offer it to your client when you re-enter the room to begin the session. But this is wrong. When a client is waiting on the table for his/her therapist to re-enter, he/she should be able to continue deepening into relaxation. Having a bolster on the table (even if it's an inch or two in the wrong place) will provide substantially more comfort and alignment during that time, allowing them to not be distracted by locked knees, or not knowing which direction to flop their feet. This also sets you up for a calmer and less confusing re-entry.

They also teach you to remove the bolster before you flip your client, and then put it back on the table when they're done flipping. This is also wrong. Our time with our clients should be spent on our clients, not patchkying with the bolster, face cradle, or drape. It's not difficult for people to flip with the bolster on the table, so to take time (and to break your clients focus inward) to move it from under them and then again when you need to put it back is not in support of the ultimate goal and really not necessary.

Over time, you will be able to adjust where the bolster sits on the table during your oral intake just by eye-balling your clients height (and you'll be able to adjust it while paying all of your actual attention to your client and even maintain eye contact). Until then, it's a forgiving thing. When you re-enter the room, the first thing you do is to just slide it to where it belongs without your client needing to move, or lift his/her legs, or open his/her eyes, or anything. And most of the time, you'll find that you don't need to slide it around at all.

When to remove the bolster
  • Prenatal (unless the client will be supine)
  • When you're working with someone who has a hard time flipping or getting on/off the table
  • When removing it will allow you to accomplish the techniques you're trying to accomplish
  • When a client prefers not to have it on the table

Setting the Table

Set the table with a twin size fitted sheet, twin size flat sheet, pillow case, and a blanket. We also use table warmers and an extra layer to protect it (usually a flannel sheet fitted specifically for massage tables - this helps hold everything in place and adds one more layer between our clients and the table heater. So when a client sweats through the sheets, we have another layer we can change and launder.) Please note that instructions for changing the face cradle cover are below in a separate section.

  • Make sure the fitted sheet is on neatly with no folds or wrinkles (tug it taught). We do this so clients know we made the table just for them with fresh sheets. If the sheets aren't pulled taught it kind of looks like someone might have already been in them!
  • Line up your flat sheet so there's enough slack at the bottom of the table so when your client is supine, his/her feet will be covered and not touching the blanket, but not so much that it's hanging to close to the floor. This usually means the flat sheet reaches past where the face cradle attaches and sometimes past the face cradle entirely. This is good.
  • Lay the blanket on top of the fitted sheet so the bottom of it aligns with the bottom of the flat sheet. The blanket can hang a bit beyond the flat sheet at the bottom, so long as you're confident that it will not touch the clients skin at any point during the session, and so long as it's not touching the floor. The blanket will sometimes reach beyond the flat sheet at the head of the table. This is ok.
  • Make sure the blanket and flat sheet are both evenly on the table side-to-side.
  • Make a shallow fold to the get blanket and flat sheet to align, then fold them both over (bigger fold this time).
  • Pull layers taught and straighten out the slack that hangs off either side of your table.
But why do we do it this way?
  • We do this so that when our clients are on the table prone, we can unfold the sheet and blanket and there backs will be covered and warm.
  • We also do this so that while a client is supine, his/her arms can be un-draped, but wont be touching the blanket directly with their armpits.

Setting the Face Cradle

Sheet Burrito

This is the best way we know to gather the used sheets from the table and get them ready to load into our top-loading washer. This technique would probably look a little different if we were using a front-loader. The reason we do it like this is 1) so we can easily assess when it's time to put another load in (3-4 sets of sheets per load), 2) so we can load the washer on our way out without letting our hands touch the side of the sheets that the clients body was touching. This consideration is part of the basic hygiene practices we follow in our office. 3) when we load the washer, the sheets are all separated and not tangled so they all get washed thoroughly.

Loading the Washer

Loading a load of sheets is very different from loading a load of clothes. Sheets are long and broad and love to get tangled. This is the basic consideration that influences how we load the washer.

  • Add the soap or detergent to the water before you start to add the sheets.
  • Grasp one of the "Sheet Burritos" with both hands, and open it over the washer.
  • Let the sheets from the inside fall away from the sheet you are grasping and into the washer.
  • Then add the fitted sheet that is left in your hand.
  • We usually do 3-4 sets of sheets per load. This way when we're ready to move them to the dryer, the whole load can go in at once and dry throughout. This number also helps us stay on top of the laundry without it accumulating too much.

Basically, each therapist puts in one load, takes out one load, and folds one load for each shift he/she does, and that matches up pretty closely to the number of sheet-sets he/she is using per shift.

Loading the Dryer

  • Untangle sheets as you load them into the dryer.
  • Make sure no pillow cases are stuck in the corners of the fitted sheets.
  • Add a dryer sheet if it's winter (dry climate outside will encourage static, and this is how we counter that).
  • Don't fill it too much or some of it wont get dry (this is why we limit how much we load into the washer).
  • Use the hot setting (we've never had a problem with bed bugs, this might be part of the reason why).


Front of House

Communication

Phones

Texts
  • Read texts carefully.
  • Return texts appropriately and clearly.
  • Proofread texts carefully before sending them, especially if they're being composed on a cell phone.
  • Be very clear with days, dates, and times.
  • Archive the conversation after each response you give.
  • Mark a text as unread if the client is still waiting for your response.
  • Archive conversation when it’s completed.
Taking Phone Calls
  • “Detroit Massage, this is Hannah, how can I help you?”
  • “Detroit Massage, how can I help you?”
Schedule Appointments Over The Phone

The goal is to narrow in on an appointment time that works for your client without overwhelming him/her with different appointment-time options. This is part of the clients experience with DMW, and as with all other areas of the clients experience, we strive to extinguish anxiety and confusion every step of the way. It's also our goal that an appointment we schedule over the phone turns into an appointment that actually happens (instead of turning into a no-show or a late cancellation or any other sort of cancellation).

Clients often call and say something like this, "Hi. I'd like to make an appointment" or "Hi, I was wondering if I could make an appointment?" Of course you can! We want you to! Without people like you, making phone calls like this, we can't do what we do!

  1. "Sure, I can help you with that" Yay, I called the right place, for the right thing, and most importantly, I'm talking to the right person!
  2. "Did you have a specific day or time in mind? Or would you like me to check for the next available appointment?"
  3. If the next available appointment is same-day, you can say something like "We have a couple appointments still available this afternoon (or evening, or whatever), would that work for you? Or should I check for another day?"
  4. If they ask for another day, ask if they'd prefer a morning, afternoon, or evening appointment.
  5. Then offer 1-3 days that fit all the criteria you've established with the client. Ex, if the client says "Weekday evenings generally work best for me" And you see on the calendar that we have availability every weeknight except Thursday, you might say "We have availability on Tuesday, Wednesday or Friday. Would any of those days work?"
  6. Then offer them 2-3 time options for whichever day they pick.
  7. If for some reason none of those options will work for them, or if they sound hesitant like they might have a conflict they overlooked initially, you can offer a couple more options (if we have more options) by saying "We also have availability later on that evening as well." or "We take our last appointment at 7pm." Just so they know we're flexible, and they can ask for a specific time.
  8. But what if the client asks for a time that would mess up a massage therapists shift? Ex, Rebecca works from 2:30pm-7pm, and someone asks for a 6:30. Offer the client the options we have that are closest to the time they requested, 5:30 or 7pm. If for whatever reason the client cannot be flexible and they need the 6:30, booking it for them wont be the end of the world, it's just best to keep on schedule whenever possible.

If there are two therapists who could take the appointment, you might try to ask if the client knows what kind of work he/she prefers. This could help you decide who to book him/her with. Otherwise just book the client with the therapist on-shift who has fewer appointments. If a therapist is on-call for that time, he/she only gets booked after all the on-shift therapists are booked, unless the client requests to work with that therapist specifically (or if the client is asking for a type of work that the on-shift therapists are not equipped to offer)

The general idea is to not offer more than three options in any questions you ask.

  1. Mornings, afternoons or evenings
  2. 1-3 days that have availability during those general times
  3. Specific appointments we have available
What To Add When Scheduling a New Client Appointment

Directions to office

Our office is located inside the Cabrini Clinic at 1234 Porter in Corktown. You can park your car/bike behind the building in the private lot. Please come to the back door (on the left side of the building from behind) and ring the bell that says "DMW" on it. When you do, one of us will run down to let you in.

Cancellation Policy

We ask for 24 hours notice of a cancellation, so please let me know if you need to reschedule. And feel free to call/text/email if you have any questions or need better directions.

Intake

"And if you could plan to arrive a few minutes early just to fill out a short intake form, that would be very helpful. Maybe 10-15 minutes early."

Making/Returning Phone Calls
Client Answers
  • “Hi Heath, this is Hannah from Detroit Massage and Wellness, how are you?”
  • “Uh, yeah hi, how are you?”
  • “I got your message, were you still interested in making an appointment?”

--then you have a conversation--

Client Does Not Answer -- leave a voicemail
  • “Hey Heath, this is Hannah from Detroit Massage and Wellness...”
  • “Our number is 313.355.0629, again that’s 313.355.0629”
No-Show/No-Call
  1. Call the client 5 minutes after appointment time (unless you know he/she is usually running late).
  2. “Hi Heath, this is Hannah from Detroit Massage and Wellness. We were wondering if you were still coming to your appointment. We have you in for a 2pm and it’s about 5 after right now.”
  3. You can add (if it’s true) “You’re our last appointment for the day, so if I don’t hear back from you in the next 15 minutes, I’ll probably just close early”
  4. “Please call us back and let us know you’re ok, you’re usually on time.”
  5. Go into the appointment event details and change the color to red. Do not change the calendar, just the color. Also add into the event title some details like “No show, no call” or “No show b/c he was in a car accident” or “No show, he was very sorry, totally forgot, rescheduled for Monday”
Voicemail
Listen to voicemail
  1. If you’re listening to the voicemail while clients are in session, make sure to keep the volume down or use a headset.
  2. If you’re listening to the voicemail while a client is in the waiting room, use a headset or phone instead of computer speakers.
  3. If you listen to a voicemail, but do not return the call, mark the message as “unread.”
Return voicemail
  1. Return all voicemail even if the client was inquiring about an appointment time we don’t have available. (You can offer to put him/her on a cancellation list.)
  2. If we receive a new voicemail during normal business hours, return the call asap - aim for at least within 3 hours.
  3. If we receive a voicemail outside of normal business hours, return the call the next morning (at 9-9:30am if it's a weekday, around 10 or 11 if it's a weekend day).
  4. Archive returned voicemails; mark unreturned voicemails as unread

Never delete voicemails (or texts or emails) from the DMW account. Archive them when you’re done with them.

Confirmation

  • Confirm appointments two days ahead of time. If the client makes the appointment less than two days ahead of time, confirm while they’re on the phone, before you hang up. Include an explanation of our cancellation policy, and directions to the office if it’s his/her first appointment.
  • Indicate on the appointment schedule that the appointment has been confirmed by putting a “+” before the client’s name.
Confirmation text script

“Hey Halley, Just confirming your appointment for Saturday at 2pm w/ Rebecca. Let me know if you need to reschedule, otherwise we’ll see you then. Thanks, Hannah”

  1. If the text you’re composing does not fit into a single message, you can abbreviate the word “appointment” to be “appt”, and/or abbreviate the day (ex, “Tuesday” could be “Tues”).
  2. If it’s a repeat client who usually works with the same person, you can leave out the part where you write which therapist the client is scheduled with.
  3. You can also leave out that bit if you are the therapist the appointment is scheduled with b/c you sign your name at the bottom. If this is in the case, instead of “otherwise we’ll see you then” it would be “otherwise I’ll see you then"
Confirmation voicemail script -- new client:

(Give your name, reason for the call, appointment day, date, time, therapist and session duration. Specify if the client is down for any specialty treatment, such as aromatherapy, hot stone or reflexology. Ask them to come early to fill out the intake form. Remind them of the cancellation policy.)

“Hi Joe, this is Hannah from Detroit Massage and Wellness. I’m just calling to confirm your appointment for this Tuesday, the 10th, at 4,pm for one hour with Cindy. Remember to come to the back door, which is on the left side of the building from behind. Ring the doorbell that says “DMW” on it and one of us will run down to let you in. Please plan to arrive five or 10 minutes early to fill out a short intake form. Let me know if you have any questions; our number is 313-355-0629. And just a reminder, we ask for 24 hours' notice of a cancellation, so please let us know if you need to reschedule. Again, our number is 313-355-0629. Thanks Joe, we'll see you soon.”

Confirmation voicemail script -- returning client

“Hey Maura, it’s Hannah. I’m just calling to confirm your appointment for Tuesday at 5:30 for with Rebecca. Let me know if you need to reschedule, otherwise we’ll see you then. Thanks, bye.”

Confirmation script for new client who answers the phone
  • Give your name, reason for the call, appointment day, date, time, therapist and session duration.
  • Specify if the client is down for any specialty treatment, such as aromatherapy, hot stone or reflexology.
  • Ask the client to come early (5-10 minutes) to fill out the intake form.
  • Remind the client to come to back door on the east side of the building.
  • Remind the client of the cancellation policy.
  • "And don't hesitate to call, text or email if you have any questions or need better directions"
Confirmation of appointments by email

Returning client: confirm appointment date, time and therapist. Confirm session duration if anything other than one hour, or if it’s different than what the client usually books. Confirm any specialty treatments, such as hot stone, aromatherapy, etc. Remind the client of the cancellation policy (“Just a reminder, we ask for 24 hours notice of a cancellation, so please let us know if you need to reschedule. Otherwise, we’ll see you soon!”)

New client: same as above, but also include “Directions to DMW”, and a request that the client plan to arrive five to 10 minutes early to fill out a short intake form.

"Our office is located inside the Cabrini Clinic at 1234 Porter in Corktown. You're welcome to park behind the building in the private lot. Please come to the back door (on the left side of the building from behind) and ring the bell that says "DMW" on it. When you do, one of us will run down to let you in. We ask for 24 hours notice of a cancellation, so please let me know if you need to reschedule. And feel free to call/text/email if you have any questions or need better directions."

General Community Management

Postcards

Choose an expiration date that seems appropriate based on what you know of the client.

  • 2-3 months from date of appointment for most clients
  • 1 year from date of appointment for clients who live out of town but come visit for work or family (b/c chances are they'll be back at some point within the year, or they'll know someone who can use their coupon)
  • "Never" for clients who are from out of town and who have no obvious ties to Detroit.
New Client Postcards

"Hey Maura, Thanks for coming in for a session with me. It was great to meet you and to work with you. Here's a coupon for your next appointment. Till then,Hannah"

"It's Been A While" Postcards

Mailchimp

Facebox

We still have no idea how to make Facebook work for us. For now, we do the following...

  • We "like" the things we like.
  • We post when we have an appointment we're trying to fill (with a special offer like a FREE aromatherapy upgrade)
  • We post things that we find useful, helpful, or interesting (articles about bodywork, wellness, nutrition, events we support in the city, etc...)

In general, I'm not convinced Facebook is a useful tool. Since we started using it, it's become harder and harder to reach people without "promoting" our posts (which we haven't even tried b/c the premise is something I'm not sure we agree with). I suspect Facebook will not continue to be a part of how we try to engage with our community of clients in the future.

Answers to Frequently Asked Questions

About DMW

Rates

We offer an introductory rate of $50 for your first 60-minute massage.

  • We do this because these are the rates most of our clients pay (b/c they purchase packages)
  • When people ask, we also offer the $10 discount to first time clients who are booking a 90-minute session.
Massage Therapy Sessions
  • 30 minutes - $40
  • 60 minutes - $60
  • 90 minutes - $85
Packages of Five
  • 60 minute sessions $250 ($50/session)
  • 90 minute sessions $375 ($75/session)
Aromatherapy

using 100% pure essential oils

  • add $10 to any session
Herbal Upgrade

using herbal tinctures - many of which are made locally

  • add $10 to any session
Hot Stone Massage
  • 60 minutes - $115
  • 90 minutes - $175
Gratuity
  • for a 60-minute session, clients usually tip $10-$20
  • for a 90-minute session, clients usually tip $15-$25
  • Some clients don't tip at all and that's OK too!

We have a little sign on our front desk with envelopes and a pen to encourage our clients to tip. This is how we introduce an aspect of socialism to our business. We offer very low rates so we can make our services accessible to the people who are looking for it. But there are may clients who can afford to pay a higher rate. Instead of having a sliding scale (which is difficult, messy, and puts pressure on clients in a way that is not helpful and does not encourage overall wellness) our clients who can afford to pay more have the option to leave a gratuity.

Cancellation Policy

We ask for 24 hours notice of a cancellation. If a client misses a scheduled appointment or cancels within 24 hours of an appointment, he/she will owe a 60% late-cancellation fee, which must be paid prior to his/her next visit.

Payment Options
  • Cash
  • Credit Cards (all but amex)
  • Checks
  • PayPal (payments must be made prior to appointment time)
Location

The right way to give complicated directions to someone is to make it seem very simple.

  1. Our office is located inside the Cabrini Clinic at 1234 Porter in Corktown. (You can add "right down the street from Mudgie's", or "The building is really easy to find")
  2. You're welcome to park behind the building in the private lot. (You can add "There's a fence back there too for bike parking.")
  3. Please come to the back door (on the left side of the building from behind) and ring the doorbell that says "DMW" on it. When you do, one of us will run down to let you in.
Gift Certificates
  • We sell gift certificates for services or dollar-amounts.
  • Gift certificates can be purchased over the phone, in person, or online through PayPal.
  • We can ship the gift certificate directly to the recipient, or to the purchaser to he/she ca give it to the recipient.
  • Gift certificates expire one year from issue date.
  • Purchaser can include a gratuity in the gift certificate.

How to sell a gift certificate

  • Use one of the Ultra Fine Point permanent markers on these. Pens don't show up clearly, and the pilot pens wont dry on this paper quickly enough.
  • Each certificate is numbered and they're in order, so take the certificate from the front first.
  • Each certificate has a piece of paper with a matching number. This is call the Gift Certificate Receipt (GCR).
  • Have the client fill out the top half of the GCR. Or you can ask the client to dictate the information to you. This includes...
  1. Name of who the gift certificate is going to ("GC recipient")
  2. Recipients phone number or email address (this is so that we can call/email the GC recipient before the certificate expires)
  3. Name of who it's from
  4. Contact info for the purchaser (phone number or email address so we can call/email if we cannot schedule the recipient. At least someone should use the certificate...)
  • Then we fill out the bottom half of the GCR, which includes...
  1. Service or dollar amount (usually a good idea to ask "would you like to include a gratuity on this?")
  2. Date issued
  3. Date expires (one year later)
  4. Paid (dollar amount, specify if gratuity is included)
  5. Authorized (by you, so put your initials on this line)
  • Then use your nicest handwriting, and fill in the actual Gift Certificate. To, From, and what the GC is for. Date issued, date expires, authorized by... If the GC is for a 60-minute massage and the purchaser included a gratuity, you would write "A 60-minute massage, gratuity included" on the line that says "This certificate entitles you to". If the GC is for a dollar amount, you would write "$25 toward your next service"
  • Put the gift certificate in an envelope (do not put the GCR in with it) but don't seal it in case the purchaser wants to write a note to go with it or needs to look inside to make sure he/she is giving the right GC to the right recipient.
  • You could also put an appointment card inside the envelope.
  • Put the GCR in the bank clipped to the payment method (cash, CC slip, check...)
History

Detroit Massage and Wellness has been in Corktown since late 2010.

DMW started as a several-month-trial. Hostel Detroit acquired a building in the neighborhood, but didn't plan to start construction for several months. I offered to rent part of their space in the time between to see if a massage therapy practice could sustain in the city. By the time Hostel Detroit was ready to pick up construction, it was clear that a massage practice could be a success here. So I went hunting for a new space - hoping to find something more permanent this time.

It's easy to think that finding space in Detroit is a simple task. Vacant lots, vacant buildings and so on. But I was committed to only spending money that I could regenerate month-to-month through the practice. I needed a space I could afford while it was just me, and a space that I could grow into as the practice grew.

In early 2011, we moved into the Cabrini Clinic where we've been since.

Culture

The therapists in our practice are not competitive. We refer clients to one another, and we refer clients to therapists outside of our practice.

About Massage Therapy

Modalities
Session Time
Frequency
Preparation
Post Massage Suggestions

About The Massage Therapists

Therapist Shifts

DMW on the World Wide Web





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