Key Point

• While treatment planning still involves asking your client about their needs, it calls for establishing long-term goals that can potentially create a dramatic change in their quality of life.

Many massage therapists run their practices on a session-by-session schedule. After a client receives their massage session, the practitioner rebooks for the next session only. While this might be sufficient, it’s worth asking yourself, “Is this approach in the best interest of both my client and my practice?” 

A good way to determine the answer is to consider goals. What are the reasons this client has come to you; what are their goals? And what are your goals as a practitioner? Is your aim to offer clients one special experience of relaxation? Or is it to be a guide along a personalized path of long-term wellness? If you’re in for the long haul, treatment planning creates the map. 

Session Planning vs. Treatment Planning

It’s possible that when you were in school, the focus was primarily on session planning. This involves asking your client what their needs and session goals are, then breaking down how you will spend the time addressing those needs during that session.

Treatment planning entails much more. While it still involves asking your client about their needs, it calls for establishing long-term goals (with short-term goals along the way) that can potentially create a dramatic change in their quality of life. It requires an investment from both parties. The practitioner must invest extra time and research into determining potential root causes of the client’s experience, then design a path that progressively molds the body into the desired new state. The client must invest time and money into the process, then commit to taking part in the journey through in-session feedback and consistent at-home self-care.

This isn’t to say that a single session can’t create change or that a practitioner won’t attempt to determine root causes and educate a client on how they can help themselves between sessions. But, as with any substantial goal, a long-term, dedicated commitment is imperative. And so is a plan!

Charting the Path

To prepare for a journey, first determine your destination. Then, look at where you are so you can find the most efficient path. In the case of treatment planning, find out where the client wants to go (i.e., how they want to feel and what they want to be capable of doing), then look at where they are (i.e., how they feel and what they are capable of doing). During the client interview, write down the answers to these questions to assist you in providing a written treatment plan. 

From there, make a list of necessities for the journey. This will vary depending on the extent of the trip. A person who wants to hike a 10,000-foot peak along an eight-mile trail would certainly need more time, food, water, and gear than someone who wants to hike three miles to an overlook. As you work with your client to chart their path, be realistic about the distance between their goal and their starting point. Consider their age, physical constitution, level of investment financially and logistically (how much time they can dedicate to sessions and self-care), and genuine mental and emotional willingness to take part in the therapeutic process.

There’s no exact formula for developing a personalized treatment plan; each client is unique. It’s important to be honest with them and ask them to be honest with you. For example, if they don’t think they will commit to multiple self-care recommendations, provide one that will make the greatest impact. Or, if they don’t have the financial means to pay for two 60-minute sessions per week, try two 30-minute sessions per week. Additionally, if their goal over one month is to be able to walk three miles without stopping but they currently can’t walk a half mile, recommend a more realistic time frame. Gathering as much information and being as clear and straightforward with each other as possible will result in an effective planning process as a therapeutic team.

Developing a Personalized Road map

A personalized road map plots out the precise route to the end goal. While there are fine details I won’t cover here, following is a basic overview of this process.

Identify the Client’s Goals

Start with the health history form. Be sure there is a line item that asks what their goals are for your work together. Then, in the client interview, obtain as many details as possible. 

For example, if they say they want relief from neck pain, ask how it affects their daily life and what activities this concern hinders. When do they most notice the concern, and what exacerbates it? Perhaps they experience the most pain while driving when they turn their head to see in their periphery. So, the goal could be to increase cervical range of motion while reducing pain so they feel safer engaging in this activity.  

Assess

Next, assess where they are so you have a sense of the distance between their present state and the goal. This is done subjectively and objectively.

• Subjective—this is what the client tells you they are experiencing. It includes physical sensations as well as mental and emotional states of being. Ask the client how they feel about what they are experiencing. These are all parts of the whole and will affect the pace and type of approach you use.

• Objective—this is a measurable observation and is done through multiple assessment methods: palpation, posture, range of motion, pain, and functional limitations. Also observe how their nervous system responds to their thoughts and feelings about their condition by noting their demeanor, such as facial expressions and body language.

Set Specific Goals

Even though you determined what their goals are, your job as the educated professional is to set more specific goals at short intervals to get them there. Use the SMART goal model—in other words, each goal should be specific, measurable, attainable/achievable, realistic/relevant, and time-bound.¹ Goals are best set and reviewed for progress in 3–4 session intervals. Then, depending on whether the treatment approach is working, you will keep doing what you are doing or pivot to a different approach.

Determine the Approach

This will vary depending on the type of work you perform and your client’s needs. Options to consider are:

• Tissue manipulation—gliding, torsion, shearing, elongating, oscillating, and/or percussive forces
• Joint movement—passive, active, resistive
• Static methods—static compression, myofascial release, energy work, etc.
• Hot/cold therapy
• Variations of application—pace, depth, rhythm, etc.
• Record and track—every session must be documented and tracked for progress.  

Guiding the Path

When you take the time to guide a client’s path by recommending and developing an individualized treatment plan, you show investment in them and their well-being. This goes a long way in gaining their trust, respect, and willingness to engage in their health. It also encourages your client to be invested, which increases the chances of creating change.

A perk of incorporating treatment planning into your practice is more consistency of client booking, which guarantees a fuller schedule and better financial outlook. Most importantly, you make a significant difference in your clients’ journeys. 

Note

1. George Doran, Arthur Miller, and James Cunningham, “There’s a S.M.A.R.T. Way to Write Management Goals and Objectives,” Journal of Management Review 70, (1981): 35–6, https://community.mis.temple.edu/mis0855002fall2015/files/2015/10/S.M.A.R.T-Way-Management-Review.pdf.