A MASSAGE PRACTICE TO BOWENWORK
Part 3 of 3
By Alexia Monroe
You may wonder how to price and schedule your new work. It is definitely best to set it up differently than for a massage practice (see Part 1, Dec. 07 issue, for details). Ideally, start to group your interested clients into a half day or full day in which you do only Bowenwork. As your numbers grow, you can add more days devoted to only Bowen. Charge by the session, not by the time. Do your best to set yourself up to work on multiple people. If you do, you can charge a bit less than your local massage prices, and still make more, overall.
The price for a massage here in Northern Arizona is $50-60. I charge $65 for my initial intake visit, and $50 for follow-up visits. That keeps the price reasonable enough so that I have a large number of clients who make appointments every 3-4 weeks like clockwork, just for maintenance of their well being. They are my bread-and-butter, and the core of my referral network.
Focusing on some area of “special pricing” is always a good idea. You can target a group you are particularly interested in. Some practitioners give a senior citizen discount, or one for service personnel in a field of your choice. I choose to work on all children with a paying adult for free, and teenagers with a paying adult for $25. This is very popular! Our work is so applicable to children and teens, who are often living with pain and yet would never get a massage. Kids universally love our non-invasive, staying-out-of-their-space approach. Too, they usually respond so fast that the adults become more aware of their own improvements. By the way, children do not need to lie still during sessions. Let them play quietly with a book or a stuffed animal during the session.
I strongly advise you not to accept tips. Tips put you in the category of hairdressers and waitresses and spas; it is the mark of a "luxury service", not a necessity. People who understand Bowenwork pay for it even when the economy is depressed. It is their "doctoring" for pain, not a luxury they would eliminate. They often offer a tip the first time, but when I insist that I don’t take tips, I can see that they feel relief. It establishes clarity in our relationship.
TIMING THE SCHEDULE
I like to schedule 9-10 people in an afternoon. I have three tables. I begin at 12:30 pm, and stagger clients to start each half hour, which means each table is scheduled for the next client 1 and 1/2 hours later. When two people schedule together, I might schedule one table for 1 and 1/2 hours later, and one 15 minutes before or after that. I leave a time slot free each 3 or 4 people to allow space for the unexpected, such as a client coming in with an injury or one who needs extra time lying down. I leave the office by around 6:30 pm.
The intake conversation with new clients takes extra time. I talk to them in a waiting area outside the treatment room, so as not to disturb the clients in session. I plan for 20-30 minutes of listening and writing down their wordings, asking for more detail than they’ve written on their intake forms. It evens out, as I know that their actual treatment time will be shorter than most. I tell the new client, “I will be going in and out of the room to do moves on the others during our intake, so we will talk in little soundbites, ok? I will hit the “pause button” every few minutes, and then I’ll come back to continue”. I make sure that each segment of our conversation is paused just after they have spoken last, not I. This way they don’t feel blocked just when it is their turn to speak. Then I’ll say, “Ok, let’s pause for a minute, and I will respond to what you just said (or ask more details, or take some ROM’s) right after I come back”. It keeps the intake concise, yet feels ample to the client.
TAKING NOTES AS A SCIENTIST
In this work, it is essential to have detailed objective and subjective descriptions of a client’s state. We need far more information than we usually take for massage, so we have clear bases of comparison week by week.
At the first visit, ask for pain reports (on a pain scale) for each area of complaint. Take range of motion assessments (ROM's) for these areas. Note the ROM of shoulder and neck, even if they are not complaints; these give you extra information. There is often limitation in the shoulder, even though the client describes only a problem in the back.
It is vital to write details of their own words as they describe discomforts or restrictions of activities. Put them in quotation marks. If they say, “I have low back pain”, do not stop there. Ask a series of questions, “Is it both sides or one? Sacrum, lumbar, SI joint, or a band of pain across the whole low back? Continuous or intermittent? Worse in morning or evening? Frequency per week?”
Write down specific descriptions as they respond. There are real differences between “stabbing”, “burning”, “dull ache”, “feels like a knife in the back” and “I’m afraid to bend over”. One might say, “When I walk, it feels like I have shards of glass in my feet”. Their exact words capture their experience in a vital way.
Next week, before the session, take the assessments again. Commonly, both you and the client will see an improvement right away; that’s always delightful! But when a client says, “I don’t think there was any change; my back and feet still hurt”, I respond, “That’s fine – we want to know your specific experience. I’d like to ask for more details, okay?”
I’ll review all the pain levels and ROM’s from the previous week. They often report lower pain numbers or show increased ROM, surprising themselves! I’ll review their phrasings. I’ll ask, “Were you afraid to bend over?”, and might hear, “Not at all, now that you mention it.” When I ask, “So how was the walking – still on shards of glass?”, they might respond, “Well, no, as a matter of fact. While my feet ached, the glass sensation wasn’t there at all! Weird, I hadn’t noticed that!” By the time we finish the intake, we have both become aware that changes DID occur.
If changes truly did not occur, I’ll say, “That’s fine! Now I know that you aren’t easily overloaded, so I can address more in this session. We’ll get more specific with that pain today”.
Remember, Tom Bowen’s most vital principle was to keep it minimal until you know how the body is going to respond. The first session is likely to be Low Back, Upper Back and Neck, or maybe only 2 out of the 3 BRM’s. At the most, I will add one area of specific concern, and only if one condition stands out from the rest. If they are quite ill, or have multiple areas of breakdown in the body, then the MOST I will do are BRM’s. Let the body tell you by its response over the next week what it considers the priority. If an area “kicks up” with increased sensations, and then I might address it specifically on the second session.
Sometimes, after a few sessions of Bowenwork, a client wants to go back to receiving massage or chiropractic. You might say, “OK then, let’s approach this as scientists. Let’s take note of where you are now (in pain scales, ROM's, and wordings in quotes). After a few weeks of receiving the other work alone, let’s assess again. Then we’ll be clear about your body’s response to each modality.”
When you do assess them again after a few weeks, it is not unusual for the client to have lost ground on all levels of assessment, yet not noticed! Their increased pain and decreased range are so familiar, they will be surprised when you recite their exact words and readings from weeks before, which revealed their improvement with Bowen alone. Some will be persuaded by the evidence, and embrace this new approach on the spot.
RELEASING COMPETITION AND EMBRACING A WORLD OF BOWENWORK
Every Bowenworker in the world will be more in demand as awareness of this work increases. Understanding this reality may help you to release any worry about competition. If you are one of only a few who do Bowen in your area, then you must work very hard to find and educate potential clients about Bowenwork. When you are one of hundreds in your area (yes, hundreds), then your practice will attract people easily.
Don’t believe me? Just think of all the massage therapists around you. When I graduated from massage school in 1984, the title of “massage therapist” still raised eyebrows. My business was identified as Therapeutic Massage, but I still got callers asking for the “other kind”. Over the next 10 years, four massage colleges opened in my area, and turned out thousands of LMT’s each year. By that time, everyone’s Aunt Edna had received a gift certificate for massage for Christmas, and massage had become understood and respected. Callers all asked for the real thing, and LMT’s who knew how to run a business had chock-full practices.
This is the way it will be for Bowenwork. When my town of 50,000 people was home to about a dozen people doing Bowen, the word began to spread… By the time we get 50 more, then any one of us will be able to hang out a shingle or buy a paper ad and attract clients. Do you think one practitioner per 1,000 people is going to hurt your business? I hope you realize they can only HELP you promote your work.
Encourage people in your area to take the training. Each one of them will contribute to the buzz of people helped by Bowen. Refer clients to your fellow practitioners when you are unavailable, especially when a client is injured. Encourage your clients to value the work more than the practitioner. People talk to people, and word of the work will travel far from the original practitioner. The work is the value that will build your businesses. And the more people who are out there seeking Bowenwork, the more will find YOU.
Parts 1, 2, and 3 of this article can be found on Alexia’s website, www.bowenworks.com.