EQUINE MASSAGE THERAPY PROFESSIONALISM & ETHICS
Chapters 1-10
PROFESSIONALISM & ETHICS SECTION 1: SELF, OTHERS, AND RELATIONSHIPS
Chapters 1: Participation
Chapter 2: Self-Concept
CHAPTER 1: PARTICIPATION
Learning often takes place in groups. Group learning does not just happen, it is the result of the commitment and involvement of the participants. Here are some hints on how to be a good participant in class discussions:
1. Say it to the group ▪
There should be only one person talking at one time during class discussions
2. Sharing is essential ▪
Your ideas and opinions are needed so that the group can move forward
3. Support each person in the group ▪
The more confidence each feels, the more anxiety diminishes, and the more easily we learn
4. Support needs to be expressed ▪
People will not know you agree with them unless you tell them
5. Putting people down closes them up ▪ This prevents the sharing of ideas
6. Opposing ideas are acceptable and needed ▪
They identify where people stand, and what people consider important
7. Avoid forcing your viewpoint ▪
Trying to take over a discussion prevents participation by other members
8. Avoid becoming defensive ▪
You are among friends.
▪ Opposing views are an invitation to re-examine and test your ideas
9. Be open to change ▪
It makes for meaningful discussion
10. Stick to the point ▪
Keep to the main idea
11. Speak for yourself ▪
Avoid using "we" or "anyone" when you mean "I" ▪ Take responsibility for what you say
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EXERCISE 1: DISCUSSION
1. Do you have any other suggestions or comments about participation?
2. How does participation help people learn?
3. What are the benefits of participating?
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CHAPTER 2: SELF CONCEPT
EXERCISE 2: DISCUSSION
1. What does identity mean to you?
2. Is identity important to you?
3. How does identity impact people, their behaviour, and their attitudes?
SELF-CONCEPT AND IDENTITY
• Self-concept: To be aware of oneself is to have a concept of oneself
• The following self - concept definition is provided by Baumeister, "The individual's belief about himself or herself, including the person's attributes and who and what the self is"
(McLeod, S. A. (2008). Self-concept. Simply psychology: https://www.simplypsychology.org/self-concept.html)
• One's self-concept, also called self-construction, self-identity, self-perspective or self- structure, is a collection of beliefs about oneself that includes elements such as academic performance, gender roles, sexuality, and racial identity • Self-perception: The idea that you have about the kind of person you are. People’s self - perceptions are often very different from the way other people perceive them. Can be positive or negative
• Self- perception is a person’s own appraisal based on his or her own or their significant others’ expectations.
• Identity is the collective aspect of the set of characteristics by which a thing is definitively recognizable or known. The distinct personality of an individual is regarded as a persisting entity; individuality.
• For us to define ourselves, we must first define ourselves within the context of the society in which we interact.
• Socialization can be defined as : The complex set of processes by which infants become distinct and unique individuals as well as members of a society and historical era. Socialization refers to additional factors such as the acquisition and acceptance of the ideas, beliefs, behaviours, roles, motives and thought patterns of a particular culture.
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There are many theories about the development of self- concept. The ability to define “me” and to establish a belief system allows us to function autonomously within society. We begin the process of self-discovery in early childhood, continue to define our identity throughout life, and through our experiences and education.
EXERCISE 3: DISCUSSION
1. Can you think of examples of defining moments from movies, books or other examples?
2. How do these moments impact us, our lives, behaviour, identity?
3. Do you have a defining moment?
4. Is anyone comfortable sharing?
All of us have a sense of "I", "me", and "mine". One factor that brings this about is that your own body is fundamentally different from every other object in the universe. You discover this through vision and touch. The infant explores the world with their mouth and fingers, realizing differences in how things feel. When a baby is touched, they touch back. Other sources of bodily self-concept are the many sensations that come from within, like muscular movement, strain, aches, and pleasures. Eventually all these sensations become linked as part of a general concept: that of one's own body. This, in turn, becomes the foundation upon which our complex self-concept is built.
EXERCISE 4: DISCUSSION
1. Do you believe horses have a sense of self-concept?
2. If yes, what does that look like? How is it different than people? If no, why not?
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It is suggested that positive self-concept skills are essential. Elick suggests that the following skills are needed:
• Ability to perceive of oneself as capable • Ability to make decisions tied to a personal value system • Ability to interact socially • Ability to accept responsibility for one’s own behaviour
EXERCISE 5: DISCUSSION
1. Which of these skills do you feel is most important, if any?
2. Do you feel that these skills will affect your ability to function as an Equine Massage Therapist? How?
OTHERS AND RELATIONSHIPS
There is little doubt that there can be no full-fledged "I" without a "you" or a "they". A crucial component of self-concept is social.
According to many authorities on child development, the child begins to see themself through the eyes of important figures in their world, and so acquires the idea that they are a person, even though they are a little person.
As social interactions become more complex, many more details are added to the self-picture.
In effect, the child sees themself through the mirror of the opinions and expectations of those who matter to them, mother, father, siblings, and friends. Later behaviour is shaped by this.
Our conceptions of self are realized through the attribution process like that which allows us to form conceptions of other people.
Most authorities agree we do not know ourselves directly. In their view, self-knowledge can only be achieved indirectly, through the same attempts to find consistencies, discount irrelevancies, and interpret observations that help us to understand others.
SELF-AWARENESS, SELF-EXPRESSION, AND SELF-EVALUATION
Self-awareness : is having a clear perception of your personality, including strengths, weaknesses, thoughts, beliefs, motivation, and emotions. Self-Awareness allows you to understand other people, how they perceive you, your attitude and your responses to them in the moment. As you develop self-awareness you are able to make changes in the thoughts and interpretations
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you make in your mind. Changing the interpretations in your mind allows you to change your emotions. Self-awareness is one of the attributes of Emotional Intelligence and an important factor in achieving success.
EXERCISE 6: SELF-AWARENESS ACTIVITY
Write your name vertically down a piece of paper. For each letter of your name, write a word that describes you. EXAMPLE:
L – Loyal I – Influential S – Sincere A – Able
If you are willing to share, discuss your choices
Self-expression: Expression of one's own personality, feelings, or ideas, as through speech or art. It is how we interact with others and the world. It can be supremely fulfilling or irritably frustrating. Self-expression takes place through communication, body language, artwork, and even our clothes and hairstyles. It includes how we decorate our homes and the way we drive a car. Sometimes we don't even think about how we express our inner reality to those outside. It just happens naturally. At other times, we may strive to express something and disappointedly fall short of what we meant to get across.
Self-evaluation : Looking at your progress, development and learning to determine what has improved and what areas still need improvement. Usually involves comparing a "before" situation with a current situation.
EXERCISE 7: REFLECTION AND DISCUSSION
1. Do you do any personal reflection related to these three concepts?
2. Do you think it is or would be beneficial? How?
3. If you do not do any reflection about these, would you like to?
4. Does anyone have ideas on how to get started? For example, writing things down or setting specific parameters on what to evaluate or when?
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MASLOW’S HIERARCHY OF NEEDS
• Physical needs – Basics • Safety needs – safety & security • Love needs – relationships • Esteem needs – feeling of accomplishment • Self-actualization needs – self-fulfilment, reaching full potential
EXERCISE 8: DISCUSSION
1. How do you think our needs change throughout life?
2. How have your needs changed since you were a baby, a child, a teen until now?
3. What do you think happens to babies, children and teens whose needs are not met?
4. How do you think they will change when you are a senior?
Confidence
Confidence: Whatever happens in life, you know you will be able to deal with it. Composure: The ability to think clearly, even when there is chaos around you. Competence: You can handle all situations with strength and dignity.
SELF CONFIDENCE OR SELF WORTH
The result of feeling competent, listened to, and appreciated by people who are important in our lives and responsible for our actions.
We are not born with it. It is something we develop as a result of what we have experienced in life and the way we feel about ourselves.
People who feel good about themselves, tend to: • focus on positive traits • keep themselves healthy
• work themselves to achieve goals • respect themselves and others • accept responsibility for their actions Therefore, it is important to LEARN to focus on our strengths and point out the strengths of others, so that we can improve our own and other's self-confidence.
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Self-confidence is: 1. Feeling skilful - able to do things, if only a few things well.
2. Feeling appreciated, feeling loved, accepted, listened to and supported by other people. 3. Feeling responsible - feeling able to make healthy decisions for yourself and take responsibility for your actions and their effect on others. Feeling that you have something to say about what happens in your life and you are not just a victim of forces and pressures beyond your control.
EXERCISE 9: DISCUSSION
1. Write down three ways in which you feel skilful. For example, I can play the piano.
2. Write down three things that other people appreciate about you. For example, People say I am funny.
3. Write down three things for which you are responsible. For example, I am great at keeping the car in good running order.
4.
Is anyone willing to share?
Self-Disclosure: is the ability to be open and honest about oneself with others.
It is important in the process of developing and maintaining effective interpersonal relationships.
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EXERCISE 10: ACTIVITY
Imagine you have some personal thoughts and feelings you want to share with someone. Imagine the type of person with whom you would want to share them. Which of the following characteristics would best describe that person? Put a check mark beside these characteristics. You may wish to add characteristics that are not already listed.
Cheerful.................
Logical..................
Caring...................
Helpful..................
Good Listener............
Non-judgemental..........
Open-minded..............
Sincere..................
Honest...................
Trustworthy..............
Other....................
Circle the three most important characteristics and explain why they are important.
DISCUSSION
1. What are the most/least important characteristics to you? Why?
2. Is anyone comfortable sharing their answers?
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THE LIMITS OF CONFIDENTIALITY
It is important to know that, if we share confidential information with someone, we can trust that person to maintain our confidence. We do not expect to hear our secret spread around the school.
When a person shares information with you, he/she is sharing a responsibility. Sometimes, you may be caught in a conflict between your promise and your responsibility.
However, there are limits to confidentiality. Sometimes, keeping a secret may be life-threatening. In this case, maintaining a life is more important than maintaining a confidence. For example, if someone tells you he has a gun, plans to kill himself, and swears you to secrecy, it is more important to get him help to save his life, than to keep the secret.
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PROFESSIONALISM & ETHICS SECTION 2: WORK LIFE BALANCE
Chapter 3: The Work Addiction Scale
Chapter 4: Professional Visualization
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CHAPTER 3: THE WORK ADDICTION SCALE
EXERCISE 1: DISCUSSION
1. How do you think being self-employed impacts work life balance?
2. What do you think happens when people do not have a good work life balance? Why?
3. How can we work towards maintaining a work life balance?
4. What does a good work life balance look like?
PROGRESSION OF THE DISEASE
Early Stage:
Rushing, busyness, caring, rescuing
• • • •
Inability to say "no"
Constantly thinking of work
Compulsive list making
• Exaggerated belief in one's own abilities • No days off • Hours exceed 40 consistently
Middle Stage:
Increase in other addictions begins
•
• Food, alcohol, relationships, money, etc. • Social life diminished or nonexistent • Begin giving up relationships and relationship obligations • Attempts to change fail • Physically worn out, difficulty sleeping • Periods of comatose staring into space • Blackouts at work, on the road
Last Stage:
• chronic headaches, backaches, high blood pressure, ulcers, depression • stroke, serious illness, hospitalization • emotional deadness • moral and spiritual bankruptcy • death
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The Progression of Recovery:
Joyfully alive, living a day at a time Intimacy with self, others, work Secondary addictions confronted Boundaries set appropriately
• • • •
• Compulsiveness diminishes in all areas • All decisions made with awareness of priority of recovery • Ability to distinguish between being into workaholism and not • Reawakening of feelings • Sense of humility, realistic about abilities • Family obligations met • Relationships re-established • Sleeps regularly, food and exercise integrated in health manner • Gradual recovery of physical health • Limits hours at work, takes time off • Spirituality returns • Develops work plan, uses tools of recovery program • Feels optimistic about possibilities • Feels grief at loss of addiction • Begins attendance at twelve-step program • Seeks treatment • Open to support, input of others • Actively seeks help • Admits having a disease • Understanding disease concept of workaholism • Admission of powerlessness
Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Need to have self-awareness to catch it before it happens. Dealing with Burnout: 3 R approach
• Recognize – Watch for the warning signs of burnout
• Reverse – Undo the damage by managing stress and seeking support
• Resilience – Build your resilience to stress by taking care of your physical and emotional health
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EXERCISE 2: DISCUSSION
1. Has anyone experience burnout?
2. If yes, what were the circumstances? (if you are comfortable sharing)
3. How did you manage burnout?
4. What situations are more likely to be times when burnout is a possibility?
5. How can people prevent burnout?
EXERCISE 3: ACTIVITY RATE YOUR STRESS LEVEL HANDOUT # 1
This test was developed by Dr Thomas H. Holmes, Professor of Psychiatry and Behavioural Sciences at the University of Washington School of Medicine. To take the test, check any of the events that have occurred within your life in the past 12 months. Your total score measures the amount of stress you have been subjected to in the one-year period. Because of the relationship between stress and physical illness, the total score can be used to predict your chances of suffering serious illness within the next two years. For example, a total score of less than 150 means you have only a 37% chance of becoming ill within two years. If your score is between 150 and 300, you have a 51% chance of poor health. If your total score is greater than 300, the odds are 80% that you will become sick and as the score increases, so do the odds that the problem will be a serious one.
A word of caution. The total scores do not guarantee illness in two years. It is saying that there is a chance of becoming ill because of your stress levels.
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CHAPTER 4: PROFESSIONAL VISUALIZATION
THE PSYCHOLOGY OF CREATING VALUE
Self Esteem
-------------------->
Worth =
I like me
Self-Respect
-------------------->
Value =
I value me
Love and Respect for others ---->
Love
=
I like and value others
Contribution
-------------------->
Making a difference
EXERCISE 1: DISCUSSION
1. How does value help shape our identity?
2. How does value help shape self-concept?
PERSONALITY TRAITS AND TYPES
The 5 big personality traits are common in today’s psychological and social research.
Mind: How we interact with our surrounding. Are we introverted, extroverted or somewhere in the middle? Energy: How we see the world. Are we practical and realistic, imaginative and curious or somewhere in the middle? Nature: How we make decisions and cope with emotions. Are we objective and rational, sensitive and emotionally expressive or somewhere in the middle? Tactics: How we approach work, planning, and decision making. Are we organized and decisive, flexible and keeping options open or somewhere in the middle? Identity: The foundation for other traits, confidence in ourselves. Are we self-assured and comfortable with our decisions and paths, self-conscious and sensitive to stress or somewhere in the middle? Understanding personality types and traits allows us to be aware of what we need to succeed both in life and work. Understanding our personality type allows us to work towards personal satisfaction by understanding how we think about ourselves, others, and the world around us.
Follow the link below and complete the personality test. Read your results and be sure to review the strengths and weaknesses, career paths, workplace habits, and conclusion.
https://www.16personalities.com/
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HOW CAN WE RECOVER OUR INTEGRITY?
EXERCISE 2: DISCUSSION Only share what you are comfortable sharing!
1. Do you agree with your results from the personality test? If yes, why? If no, why not?
2. How does your personality type impact your daily life?
3. What did you learn from the strengths and weaknesses and career paths sections
about your personality type?
4. How does this relate to comparing ourselves to others? Does this make working with
others or understanding others seem more likely or successful in the future?
5. How does comparing ourselves to others affect our self-awareness?
Begin by looking at our self-concept. The way we see, think and feel about us shapes our beliefs and our beliefs shape our expectations. Our expectations in turn shape our attitude which produces the results in our lives.
For example:
Belief
- I am a failure
Expectations
- I just know that I am going to fail
Attitude
- It's no good, I always end up failing
Results
- I failed
Here we have the infamous self-fulfilling prophecy. How can we change this negative cycle of events?
All psychological and motivational literature of today tells us the same thing - "change our belief system and adopt a positive mental attitude." A positive mental attitude begins with the belief that we control our lives and consequently that we are responsible for us.
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GUIDELINES FOR CREATING VALUE
EXERCISE 3: DISCUSSION
1. How can people change their belief systems to adopt a more positive attitude about themselves? Be specific
1. Accept yourself unconditionally (reverse process of destructive criticism). Remember, we are all born with value. It is a gift, not something we acquire or earn. 2. Live out who you are and follow your heart! 3. Take good care of your body, mind and soul. Feeding all of you with loving and positive thoughts. 4. Set noble goals and ideals. 5. Accept responsibility for your life. (Be proactive) Life doesn't just happen to us. 6. Be committed! Remember commitment is an action not a word or a feeling. Live by your word. 7. Plan and manage your time wisely. Without planning and goal setting, life is like a lottery and we never have enough time to win. 8. Be determined. Perseverance is the key to success. Remember genius is 5% inspiration and 95% perspiration. 9. Be disciplined. We all need to become our own masters in order to realize our goals and make our dreams come true. 10. Embrace work. Work is not a burden to bear, but rather an opportunity to give what we can and be who we are. 11. Learn to forgive and accept others even if you do not understand them. 12. Make love, relationships, and community a priority. 13. Make a difference. Start with you!
PSYCHOLOGY OF SELF ESTEEM AND CREATING VALUE
All human beings have three life giving instincts:
1. Instinct to be integral, to be whole in all respects of our being and to express this wholeness.
2. Instinct to connect and relate to others. Deep seated need to love and be loved.
3. Instinct to contribute to life. To make a difference and become part of a greater spiritual purpose which provides us with meaning and significance.
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PROFESSIONALISM & ETHICS SECTION 3: COMMUNICATION SKILLS AND STRATEGIES
Chapters 5: Effective Communication
Chapter 6: Preparing a Speech or Presentation
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CHAPTER 5: EFFECTIVE COMMUNICATION
What is communication?
• Active Listening • Body Language • Assertion Skills • "I" Statement
EXERCISE 1: DISCUSSION EFFECTIVE COMMUNICATION, PROBLEM-SOLVING, AND CONFLICT RESOLUTION
1. How do you think these skills help with effective communication?
2. Which skills are your strongest? Weakest? Why?
3. How can we incorporate the 4 points above in problem solving and conflict resolution?
4.
As EMTs, not only are we communicating with owners, trainers, vets, and other equine health care professionals, but also horses.
EXERCISE 2: DISCUSSION
1. How do horses communicate with us?
2. Can you give examples of specific movements horses make and what they mean?
3. How do we reciprocate?
Communicate (verb): To give or pass on feelings, information... etc. To make others understand one's ideas To be in touch by words or signals Communication (noun): Sending, giving or exchanging information Communication gap:
A failure to convey or understand the information, intent or meaning of another, especially between individuals of different perception
(noun)
Communicative (adj.): Communique (noun): Perception (noun):
Informative, willing to talk informatively
An official communication
The ability to perceive (to see), especially to understand
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Four Principles for Effective Communication with Clients
1. Have a direction 2. Pay attention to the pattern of communication 3. Be flexible 4. Commit to a solution
The Three Ingredients of Communication Albert Mehrabian's 7-38-55 Rule of Personal Communication
7% - Actual words 38% - What we hear 55% - What we see, body language, tone, inflection, and meaning
We hear with our ears, but we listen with our eyes.
COUNSELLING TECHNIQUES FOR BETTER CLIENT MANAGEMENT
Massage therapists are not psychologists. However, they should be empathic listeners. Make it a point to know your community resources for referral purposes, for your client's benefit and your own.
LISTENING
EXERCISE 3: DISCUSSION
It is not uncommon for clients to talk to us while we are massaging a horse. This can be extremely distracting and make it more difficult to focus on what you are doing.
1. What ideas and suggestions do you have for dealing with this situation?
Often all a client really needs is a non-judgemental listener. If they are angry, sad, embarrassed, despairing, or frightened, the most useful skill we can develop is to allow them their feelings without judging them or encouraging them to change it (to a more "positive" outlook). When someone tells us their problem, it is useful for them and us, if we can have the attitude that they are the best person to solve their own problem and that the solution resides within themselves (where necessary, assisted by a trained professional). A useful listening skill is to reflect back onto the person what you are seeing and hearing.
EXAMPLE: "You sound very angry about that."
"You seem very sad and hopeless about this problem."
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ACTIVE LISTENING
• Avoid giving advice, lecturing, judging, criticizing, blaming, sympathizing, interrogating, analysing or being sarcastic. • Convey understanding of both the emotion and content of the statement. • To be of any help, the listener cannot make judgements and should not offer suggestions. This is not helpful because you may not have all the information that is needed to solve the problem effectively. • Also, you would be telling the person how to solve the problem as if it were your own. What the other person needs most, is someone to listen.
EXERCISE 4: DISCUSSION
1. What happens when clients are personal friends?
2. What ideas or suggestions do you have to make sure that your professional and personal lives do not clash in this situation?
PITFALLS TO AVOID WITH CLIENTS
1. Being triggered ourselves:
Often, we get upset along with the client because their issue reminds us of an issue of our own. Their grief over their father's death reminds us of our sick father who we are frightened might die. Being triggered is not a pitfall, but what we say or do in this situation could be. It is okay to say nothing and let your concern express itself silently. We could mix our feelings into their situation and bring our judgements to bear on the situation, where it would not be appropriate.
2. Judging or analysing:
Sometimes when a client gives us some problem, we may be tempted to start giving our opinion on the situation and analysing it for them. This approach brings forth our judgements and the client may leave feeling judged or misunderstood. Also, what we think is best, may or may not be what is best for that person.
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3. Giving advice:
Often a client will ask for advice. Often what is really wanted, is our belief in them that they hold the answers within themselves. This is oftenmore helpful than our ideas on what is best for them. If we take this on, we are liable to be blamed when a situation does not go well. Also, if a situation does not go well, they may not be able to let themselves feel thrilled because they did not make the decision.
4. Feeling responsible:
It is difficult to hear of a client's difficulties. Sometimes we feel responsible as if it is up to us to solve their problems or help them in some way (other than massage) because they have confided in us. It is important to remember that they are responsible and to think carefully before we go beyond our therapist-client relationship. Also, if their physical problem does not clear up as fast as the client would like it to, we can also tend to feel responsible. We must remember that we do the best we can and that conditions take time to clear up.
5. Facial expression:
It is useful to show caring, empathy, and non-judgement in our face when working with a client. Even when we are not feeling these things, our face can be showing them to a client. For example, if a client is sad and we think about their grief, and show sadness on our face, it may not be the most supportive thing. A client will not want to depress you with their problem.
TRANSFERENCE
Positive or negative unconscious feelings that the client develops towards the therapist which originate from early emotional relationships with other figures (usually parents) and are transferred or projected towards a therapist.
COUNTER-TRANSFERENCE
When the therapist returns or redirects the feelings back onto the client. A therapist must be aware to regulate feelings.
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EXERCISE 5: DISCUSSION
You are an REMT. You are confident with your abilities and their effectiveness. You have just finished a treatment on a horse which has a very swollen leg due to an injury. During the treatment session the swelling visibly reduced, and the horse is moving its leg much more freely now. As you are leaving the stall, someone approaches you and asks what you are doing. “I have just finished a massage treatment on this horse,” is your reply. “I don’t believe in that stuff,” he/she responds. “I rub my own horses’ legs rather than waste my money”
1. Describe how this interaction makes you feel.
2. Would you feel differently if the person was an older man or a young woman?
3. Describe three different responses which you could make: one which would trigger a confrontation, a second which would be neutral and end the conversation, and a third response which would create a different scenario from the first two . . . use your imagination!
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CHAPTER 6: PREPARING A SPEECH OR PRESENTATION
Why is it important to have good writing skills? •
Record keeping (case history, ongoing clinical) • Correspondence with clients (treatment plans, post-treatment reports, homecare instructions) • Correspondence with equine health care practitioners • Articles/publications
Why is it important to have good presentation skills? • Live demonstrations • Trade shows/equine expos • Information sessions • Guest speaker
LEARN HOW TO PREPARE A PRESENTATION OR SPEECH
You have all been bored at some time or another by a speaker’s grating voice, self -conscious manner, and dull material. If you are called upon to speak in public, you have an obligation to your listeners. Do not waste their time! If you follow carefully eight public-speaking rules, your performance should be good. 1. Select a subject carefully. Keep in mind the occasion and your audience. A valedictory address to classmates will be entirely different from your storytelling to amuse the neighbour’s children. 2. In your mind, clarify your goal. Are you trying to persuade, convince, inform, or entertain your listener? Different purposes require different material and organization. 3. Collect information and material on your subject. Do your research. 4. Outline your speech/presentation in point form. Keep in mind the three divisions of introduction, body and conclusion. It is much better to learn five main points of your speech/presentation than to memorize the whole speech. Memorized speeches sound mechanical and are usually poorly received. 5. Prepare a skilful opening and conclusion to your speech/presentation. Be original and sincere. 6. Make your speech/presentation vivid and interesting. Use concrete examples, clear illustrations, fresh comparisons and contrasts, picturesque details, and noteworthy quotations. 7. Rehearse your speech/presentation several times. Have somebody time your delivery. 8. Deliver your speech/presentation in an alert, sincere manner. Your eye contact, stance, and voice should contribute to the pleasing impression your material makes on your audience.
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AUDIENCE
• Reading level • Language • Beliefs and attitudes • Age and sex
PURPOSE
• Clarify goals • Exemplify • Capture interest (cartoons/graph) • Hold interest • Organization & flow • Help presenter (jog memory) • Act as an analogy/relationship • Motivate
TIPS
• Appropriate visuals • Make sure they fulfil purpose • Keep them simple • Do not show what not to do • Label the visuals
• Position appropriately • Leave out the jargon
• Highlight or indicate key info • Make sure audience can relate • Easily transportable • Keep within time boundaries
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PROFESSIONALISM & ETHICS SECTION 4: PROFESSIONAL BUSINESS SKILLS Chapters 7: Record Keeping
Chapter 8: Ethical Business Practices and Issues
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CHAPTER 7: RECORD KEEPING
The following guidelines are set by the RHPA/MTA (Regulated Health Professions Act/Massage Therapy Association, 1991, Ontario Regulation 544/94). It is recommended that the practice of EquineMassage Therapy follow the same guidelines as defined by the practice of humanmassage therapy and/or veterinary practitioners.
RECORD KEEPING (IFREMT requirements based on RHPA/MTA: Part lll, S. 7-23)
1. Financial Records (must be kept for each client)
All financial records must contain the following: • Massage treatment given • Fee charged/received • Receipt record • Date of treatment • Client name, horse’s name • Who rendered the service
2. Client Health Records (must be kept for each horse)
All horse health records must contain the following: • Client name & contact information • Horse's name (registered and stable name) • Description, age, sex, colour, tattoos, brands, distinguishing marks • Location of where horse is stabled • 2 nd contact name & information • Name, address, and phone number of the client's veterinarian • Any reports received with respect to x-rays, tests, examination, consultations by any other health care professional • Appropriate medical/massage case history information • Assessment/examination findings • Date, time and duration of each treatment • Particulars of any/all advice given by the REMT • Particulars of any referral out to another caregiver (i.e. Farrier, chiropractor) • Particulars of every fee charged (massage treatment, hydrotherapy, any product sold) • A copy of every written consent (informed consent) • A record of every refusal of treatment or procedure and signature of the client confirming the refusal
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A needs assessment A treatment plan
• •
• Ongoing record of each treatment given per appointment including date of treatment, areas treated, findings, who provided treatment • At least a brief version should be sent to the referring veterinarian within a reasonable time following therapy, both as a professional courtesy and to keep the vet informed of the any procedures and progress
3. Identification
Every part of the health/financial records must be identified/referenced to whom it belongs (client #/name).
4. Entries
All entries must be in ink if hand-written, dated and signed by (or name noted) the person who provided treatment. If entries made are digital, a back-up copy must be saved.
5. Record maintenance
All client’s records must be kept for seven years following their last appointment. (If the client is under 18 years of age following their last appointment, records must be kept until the day the individual would have turned eighteen.) Records may be kept by means of an electronic or optical storage system. Records must be kept in a manner which ensures they are secure from loss, tampering, interference or unauthorized use or access.
6. Destruction of Records
Done in a manner which ensures the client's confidentiality (i.e. burning or shredding).
7. Inspection of Records/Premises
• The client has the right to see his or her own records/files
• The client has the right to inspect the R.E.M.T.'s clinic (if applicable) prior to treatment as part of INFORMED CONSENT
• The IFREMT has the right to inspect any/all client records, and R.E.M.T.'s clinic (if applicable) at any time, if there is reasonable cause
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RELEASE OF INFORMATION
Either verbal or written information can be released upon receiving WRITTEN request along with a signed release form from the client, ALL OR PART of the client's records can be released to:
The client
•
The client's personal representative:
•
a) lawyer b) insurance company
c) other health care professional d) others: the IFREMT, CVO, etc. * anything which identifies the client is removed
The exception to this rule is if you are ordered by the law to release client information, such as a court order.
If the client is deceased, a release form can be signed by the client's legal representative.
If the client is incapacitated/unable to give authorization
A release can be signed by: • A committee of the client's appointed under the mental incompetency act • The client's spouse • A person of the opposite or same sex with whom the client is living in a conjugal relationship, if: • They have cohabited for at least a year • They are together the parents of a child • They have entered into a cohabitation agreement under section 53 of the family law act • The client's son/daughter • The client's parent
Reasonable fees for providing client records
It is NOT misconduct to refuse to provide copies of information until the REMT has been paid a reasonable fee: • $ per page for photocopying plus time • $ per page for medicolegal reports
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MISCONDUCT (IFREMT practices based on RHPA/MTA Part VIII S. 26, S.S 2-4, 26-29)
• Failure to keep records as required by the IFREMT • Falsifying records in any way • Failure, without reasonable cause to report, information from a file, Certificate of Registration, in a reasonable amount of time when requested in writing by the client, or a representative who has been authorized (see release of information) • Signing or issuing a document the member (R.E.M.T.) knows contains false or misleading statements • Allowing any person to examine a client's health record or giving any information, copy, thing from a client's record to any person except as required by law, or as allowable as per written release • Failing to provide copies as required by law/written release • Failing to make arrangements with the client for transfer of the client's records when: • The R.E.M.T. retires • The R.E.M.T. changes office location and client requests records to be transferred • When requested to do so by the client
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CHAPTER 8: ETHICAL BUSINESS PRACTICES AND ISSUES
RECEIPTS
Must be issued if requested (to anyone who in whole or part is paying for the treatment). • R.E.M.T. must keep a copy of the receipt • A blank receipt must NEVER be issued • Must be signed by the therapist providing treatment and given to the client
All receipts must contain the following:
• Indication that charges are for Massage Therapy Treatment • Date, duration of treatment given • Fee charged/received • R.E.M.T.'s name, designation and registration number
Billing for a missed appointment is allowable BUT receipt must indicate that charges are for a MISSED appointment.
FAILURE TO DO ANY OF THE ABOVE, IS GROUNDS FOR MISCONDUCT and may result in misconduct charges/hearing.
BARTER/CASH PAYMENT
BARTER is NOT allowable (illegal in Ontario unless you claim it and pay proper taxes). CASH (cash, cheque, credit cards) fee charged must be reasonable, not excessive.
TRUTHFUL REPORTING
All information in records, files, reports must NOT be falsified or misleading in any manner. Do not sign any document that you know contains false or misleading statements/information.
NON-EXPLOITATION
It is considered unethical to treat a client if you feel the client would derive NO benefit from treatment (if treatment is only for the financial/emotional benefit of the R.E.M.T.).
CLAIMS
Do not make any claims, provide service, or behave in a manner which is unsafe, unproven, untested, unfair or untrue.
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ACCURATE REPRESENTATION IN ADVERTISING (IFREMT standards based on RHPA/MTA Part ll, S. 6)
Advertising must not contain: • Anything which is false or misleading • Anything which cannot be verified • Any endorsement other than that by an organization that is known to have expertise relevant to the subject matter being endorsed • Any testimonials by a client, former client, family member or friend (basically no testimonials) • Sexual innuendos • Wording which implies that all persons working within the clinic/business are R.E.M.T.'S (if they are not)
Advertising MUST: • Be comprehensible to the persons to whom it is directed • Identify the registrant who has responsibility for the practice advertised • CONTAIN THE R.E.M.T.'S NAME AND TITLE
Optional: Name of business, address/location/phone number of practice, services provided, specialty, on site or home visit available, accessibility (by appointment only), referrals accepted, hours of business.
EXERCISE 1: ACTIVITY
Look up some business cards of EMTs and REMTs.
1. What do you think? Do they follow the standards?
2. Do you like/dislike them? Why? How would you change them?
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ADVERTISING STANDARDS (IN ACCORDANCE WITH THE IFREMT)
Equine Massage Therapy is not a legally regulated practice, but rather, subject to the rules of a voluntary association and the International Federation of Registered Equine Massage Therapists (IFREMT). As an R.E.M.T. is a practising professional upholding both the Federation’s Code of Ethics and Standards of Practice, he/she must abide by certain standards in their advertising practice as well. There are legal restrictions imposed by Ontario legislation, Section 11 of the Veterinarians Act, 1990.
Therefore, a Registered Equine Massage Therapist must:
NOT state anything in their advertising that might be perceived as practicing Veterinary Medicine. If anything is perceived as such, they will be given a cease and desist order from the CVO (College of Veterinarians of Ontario), and their advertisements will be refused by publications.
It is imperative that all R.E.M.T.s emphasize in their advertisements that they work in conjunction with an attending veterinarian.
It must NOT appear that the R.E.M.T. is practicing veterinary medicine without a license. Any statement or published material which implies that an R.E.M.T. will diagnose, heal, rehabilitate or treat physical abnormalities or injuries will be interpreted by the CVO as a pretension to the practice of veterinary medicine.
The IFREMT currently offers to its members the ability to submit their advertisement to legal counsel for perusal, to ensure the content/wording is legally acceptable.
For the guidance and protection of consumers, R.E.M.T.s are encouraged to refer to the IFREMT and use the crest/logo in all advertising and promotional materials.
MISCONDUCT (IFREMT practices based on RHPA/MTA Part VIII S. 26, S.S 30-40)
1. Submitting a charge or account for services that the REMT knows is false/misleading.
2. Charging/accepting a fee or amount that is excessive or unreasonable in relation to
services provided or to have been provided or ARE to be performed.
3. Failing to inform fees for service (as well inform client of office policies regarding
payment).
4. Charging a fee in excess to the informed fees without prior consent of the client.
5. Charging a fee less than the informed fees without noting the reduction and reason in
the client's financial record.
6. Failing to advise in advance of services rendered, fees proposed for services rendered.
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7. Failing to abide by a written undertaking given by the REMT to the IFREMT or to carry
out an agreement entered into with the IFREMT (resolution of complaint/discipline
hearing carried out).
8. Offering/giving a reduction for prompt payment of an account.
9. Failing to itemize an account for professional services (if requested to do so by the
client, person or agency who is to pay in whole or part for the service).
10. Selling/assigning any debt owed to the REMT for professional services (this does not
include the use of credit cards for payment).
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PROFESSIONALISM & ETHICS SECTION 5: PROFESSIONAL REGULATION & ETHICS
Chapters 9: The Practice of Equine Massage Therapy
Chapter 10: Ethical Practices
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CHAPTER 9: THE PRACTICE OF EQUINE MASSAGE THERAPY
Equine massage therapy should only be done therapeutically with the knowledge and consent of the referring veterinarian, particularly if the horse is already under the medical therapy of this vet. If the client approaches the R.E.M.T. directly, the R.E.M.T. should consult with the veterinarian prior to any services both to inform them that a request has been made by the horse owner, and whether the veterinarian has any objections to the massage treatment proposed. It would be professionally courteous to inform the vet of any relaxational massage performed, at least at the primary occasion, if only as an introduction to the potential R.E.M.T services possible; it would be "advertising" for one’s skills. The vet could be told that if therapeutic massage was indicated they would be consulted. The assessment made by the R.E.M.T should be discussed with the referring veterinarian prior to service. The initial work up and/or diagnostics should be done by the referring veterinarian. If the R.E.M.T.’s assessment should differ from the referring veterinarian’s assessment, a mutual agreement with regards to therapy (that is in the best interest of the horse) should be made. If the veterinarian specifically states that the procedure is contraindicated, or that he/she feels the therapy is wrong, the owner, as with the entire process, should be informed. The R.E.M.T. in this case should NOT perform the procedure until the vet or another licensed veterinarian gives approval. This would involve the owner obtaining a second opinion from another licensed DVM. The R.E.M.T., when performing a therapeutic massage, is a secondary caregiver, working in conjunction with the primary medical caregiver, the licensed veterinarian. It is only with this open- information policy that massage therapy will become recognized as a “professional” treatment. If the R.E.M.T. feels that some inappropriate behaviour has been shown to the horse by the owner or other person (abuse, negligence, etc.), it would be suggested to discuss it with the referring veterinarian first before reporting to the police or other animal protection agency. Safety first: If the horse is not behaving well, the R.E.M.T. should back off to avoid being injured. Therapy should not endanger the health of the R.E.M.T., the owner, handler, or the horse. If any horse appears generally unwell, or if there are obvious skin lesions, the R.E.M.T. should not work on the horse without informing the referring veterinarian about these changes.
If the horse is known to have a disease that spreads from animals to humans, the R.E.M.T. should not provide the therapy.
Client - horse - veterinarian confidentiality goes as per human massage therapy.
As with all animal health care, the horse’s well -being should be the main focus. Humane handling and therapy are essential.
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The R.E.M.T. should NOT have access to use drug therapy.
Bear in mind that the location the therapy is performed may be owned by others than the owner of the horse, so treat the owner and the premises with respect.
If the R.E.M.T. is working on more than one horse in succession, hygiene should be carefully monitored. Washing off of hands and any equipment is mandatory to prevent spread of disease.
Massage has significant physiological effects on the circulatory, muscular, lymphatic and nervous systems in the management of soft tissue problems and pain control, and is acknowledged by practising physicians as a proven, valuable aid in musculo-skeletal disorders. It is gradually being acknowledged in a similar way by practising veterinarians. The practice of Equine Massage Therapy is currently not regulated in Canada. The purpose of the International Federation of Registered Equine Massage Therapists is to provide a self-governing body for Equine Massage Therapists. It is similar in structure to the College of Massage Therapists which, until the Regulated Health Professions Act was passed in 1994, was also a self-governing body.
Equine Massage Therapists are registered initially via an entrance to practice examination administered by the International Federation of Registered Equine Massage Therapists.
All Registered Equine Massage Therapists (Reg. E.M.T. or R.E.M.T.) can be identified by their name listed on the IFREMT current members webpage.
Equine massage therapy is currently not covered by equine insurance companies; however, the equine insurance business is rapidly growing and may, in the future, incorporate some health care and preventive health care coverage to horse owners. Equine Massage Therapists primarily travel out to their equine clients. It is an individual decision as to travel fees charged, although there is a government-set limit to the amount a practitioner can charge per kilometre.
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