The client’s goal should always be in the front of mind for the PNMT therapist. This sounds an obvious statement, but knowing accurately the client’s goal is often easier said than done. Understanding the client’s goal and doing everything we can to attain it is the job of a good clinician. Yet it is equally important to ensure that the client’s goal is realistic and attainable.
I had a client with ankle pain a while back who had worked hard to recover from the persistent pain with massage and lots of self-care and had made immense progress. She had gone from constant, daily ankle pain to none at all and she was thrilled. She had stopped coming to see me as she wasn’t feeling the pain anymore and then 8 months after the last time I saw her I got a call from her and she was in a panic. Her knee was hurting and she was calling me to find out how quickly she could get in to fix it. I asked her a few questions, including how long it had been hurting. “A couple hours,” she said. I asked how severe the pain was and she said “It is about a 2 when it’s really bad.” Now, I knew why she was panicking, given her previous experience with her ankle, but I also knew that a couple hours of mild knee pain probably didn’t warrant that panic. I came to a realization that I needed to talk to this client about the goal of our work. I took the appointment worked on her knee (I didn’t want to make the mistake of invalidating the pain she was feeling) and we discussed the idea of normal pain versus chronic or persistent pain. Pain is a part of life, it’s actually a good thing that helps our body in a number of ways. Importantly it’s good not to worry about soft tissue pain and often the mild short term knee pain will go away on its own.
I have since started telling clients that the goal is not to never feel pain again. It’s a tough thing to say to those in chronic pain and nuance and delivery are important, but it’s important to make sure that the client and I have realistic goals of the work. I quickly go on to tell them that the goal is to stop the persistent pain, make sure the pain isn’t interfering with the quality of their life, and to help them understand the pain so when (not if) they have pain again they can try to manage it on their own. Although I was nervous at first to make this statement it’s been my experience that not only do clients appreciate it, but it also helps the results with the client and puts us on the same page to healing.
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