Managing Client Expectations
My treatments always offer an element of relaxation but more often than not, my clients come to me wanting to be ‘fixed’ as well as relaxed. This then raises the question as to what ‘fixed’ actually means? In many cases it means solving an immediate physical problem. A good example might be a client who presents with chronic lower back problems due to spending most of their day sedentary in a less than ideal position. Of course, they want their discomfort to stop, and they believe I can do it immediately. But realistically, all I can offer is some symptom relief in the short term. In the long term there are greater problems to solve, a single session is not going to resolve a lifetime of bad habits. So how do I deal with the expectations of my clients?
Understanding The Client
I will start all my sessions with a discussion and acknowledgement of where the client is currently. How they are feeling and moving generally, while also addressing the bigger issues of ‘how and why’ we both think they’ve reached this place that has brought them to me.
Sometimes clients don’t want to know why they have a problem, they just want it to go away, and they consider it my responsibility to make that happen. This attitude can often be a challenge to overcome. However, there are ways that as therapists, we can help manage our client’s expectations and guide them to an understanding of what we’re able to do for them, and what they’re also able to do for themselves.
I would like to think that my hands-on skills, my experience with reading and understanding tissue, are what makes the biggest difference to my clients, but the truth is that the most important factor that increases my success rate is an ability to communicate well. Communication is a two-way thing. We need to be able to listen, understand, read between the lines, while also speaking in a clear and relatable way.
As a therapist we may have to ‘coax the client to communicate not only factual information about their health history and background, but less clear-cut information about the client’s assumptions and expectations regarding the massage and its outcome.’ (1) The more information we are able to get from the client, the more we are able to manage their expectations and also understand what it is that they really require from us.
My clients often refer to me as a physio, which brings about another problem, their understanding of what I provide. In my world physiotherapists use to do hands on work, massage, but for many reasons most no longer do, but because I ‘fix’ people my clients they attach the title physiotherapy with what I provide. There are so many different modalities offering different forms of soft tissue work, it can be confusing to a client as to what to expect from a session. We should use basic language when explaining what kind of massage we intend use. Remember that we are the ones with expert knowledge and understanding, most clients wouldn’t know what effleurage or Transverse STR is, or why it might help them. We need to be clear about what will happen during the session, and also our own expectations of the outcome of the massage, as well as our client’s participation in the session and beyond.
As massage therapists it’s really important that we understand our limitations. When our clients are in pain and desperate for us to ‘fix’ them, we want nothing more than to be able to do just that. However, I cannot provide more than what my training and experience has given me, so while I want to instill confidence in my client, I have to be realistic about the changes that can be achieved based on my skills. For that reason, I am not shy about referring, especially if we aren’t achieving the expected outcomes. In fact, I’ve often found that, rather than losing a client when I refer them on, I gain more, because they feel they can trust me to be honest with them and they recognize I am looking out for them, it is about their success and not me holding on to their custom.
My client’s wellbeing is my priority. That’s why my sessions are always about what is best for them. Not what they think is best for them, but what my training and experience tells me is best for their recovery. As I mentioned in the last point, I will always refer on if needs be, and always suggest further investigation when I don’t have all the answers. I also often suggest they might want to try something that would complement our sessions, for example if I think my client would benefit from seeing a pilates instructor to help with better engagement and movement capabilities, I will tell them just that, and explain how the two therapies can complement each other. As with everything communication is key. How you explain things to your client will make the difference between them listening to you and taking your advice, or not.
The cold, hard truth is that a client’s outcomes are based on so many varying elements, some of which are totally out of your control; such as how switched on they are. However there are other things that will impact their outcome that don’t seem to be directly in your control, such as whether or not they do their homecare and how regularly they come for sessions. But these things are indirectly in your control. If you foster a sense of confidence and trust with your client, they will listen to your advice and they will come back regularly if you suggest it. They will also work on their own recovery if that’s what you’ve told them to do, because they trust that you know what is good for them and have their best interests at heart. All of this is down the way you communicate with them. If you are able to express yourself well and demonstrate that you understand your client and their needs, you will find that their expectations are realistic and manageable because they too have understood you and your capabilities.
 French, RM. The Complete Guide to Lymph Drainage Massage, Cengage Learning, 2011