Hi everyone,
I'm new on this site, found out about the link last week and have had an (all consuming) last few days intrigued by all the comments, information and support on here... very hard to pull myself away to do some much needing writing up of case studies! What a great place to be...
I'd like to share an experience - hoping to get some guidance and help in understanding something that took place last night with a case study - I'm studying Reflexology by the way and am a qualified massage therapist, and practice reiki.
I was introduced to this case study, lets call her Ms B, by a very dear friend who is also a holistic therapist. Mrs B is one of her clients and had apparently shown an interest in reflexology as a therapy but due to financial constraints could not afford treatments. Mrs B has a number of conditions currently causing her distress, a number of them emotional and psychological, she believed reflexology would help her. She'd expressed an interest and a willingness to be a case study and my friend passed me her details.
I contacted her a couple of days after and she came for the first session two weeks ago. We diarised all five future treatments to take place at the same time on a monday evening and proceeded with the treatment. After the treatment, she said she'd forgotten to mention she was taking the following week off and would be visiting with friends, so could not make the following monday, but would return when she got back.
I completely forgot she'd mentioned this and forgot to update my diary. Last monday when she didn't arrive, I phoned her asking if I'd misunderstood and got my dates muddled and whether or not the session had been cancelled, I said I'm sure it's my mistake, could she get back to me to confirm the next treatment. I did not hear back from her and I assumed she no longer wanted to come as a case study.
Yesterday evening, she arrived for her treatment. I welcomed her and asked if she'd got my message, I said that I'd got myself confused and must have completely forgotten she was going on holiday hence the voicemail, she said she hadn't got my message and I said that's odd, we'll have to check your mumber. I said I was glad to see her and showed her to my treatment room and proceeded with the the pre-treatment consultation (how she'd been, any changes, etc. etc).
She didn't look very comfortable at all and said she'd had quite an adverse reaction to the first treatment, she'd been emotional, teary and felt quite depressed for a few days after. She then very quickly asked me whether I'd written her chart up (?). I didn't know what she meant and asked her to explain, she raised her voice and said, 'I'd like to read what you've written about me'. I felt very uneasy and sensed she was on edge, I was grappling with possible explanations thinking she's put out that we'd had the misunderstanding about her holiday dates, that I'd left her a voicemail asking her to confirm, my mind was reeling for a possible explanation, I was just so unprepared for what was transacting between us.
I tried to explain that the foot chart I was making notes on at the last session and would infact be making notes on again this session was for my reference for what I'd written up our first session. She demanded to know what I'd written about her saying it's about her, she has a right to read what's been written about her, she said I'm disapointed, I thought your tutors would give you comments about me and what's wrong with me. I was quite stymied, I couldn't think of anything to say and could feel myself on the verge of tears, I told her I'd not handed anything in that I'd written up about her as yet because she'd filled in, but not signed the consent form last time and I was a little behind with my case studies in any event (I did not tell her that I thought she wasn't coming back because she'd not responded to my messages and I'd made that assumption and therefore wasn't going to spend three plus hours writing her up if she wasn't coming back).
She sat up, took the consent form I'd given to her to sign at the start of the session, folded it up and said I came here to find out what's wrong with me and I have a right to know what you've written up. I was extremely uncomfortable and wanted her to leave, I tried to stay calm and said, I think we've misunderstood onanother, I'm not qualified to make any diagnosis, you're here to receive a reflexology treatment and I'm doing the treatment on you at no cost to enable me to learn and become proficient in this therapy. I am required to write up my own interpretation and that interpretation is then marked by the school and my tutors, that is targetted at my tutors as the audience, not you.
She was extremely uptight by this stage said what difference does it make, I have a right to see what you've written about me, I don't see why I can't see what you've written up. She stood at the door angry, saying she was wasting her time, she'd never heard of this nonsense before, she'd gone for reflexology many times and the therapist had talked to her at the following session about what she'd found and had shared a charts with her(?). I said I'm sorry you've expected that from me, but I'm not able to provide you with any charts and I'm not able to diagnose you, that's not what I'm here to do, I'm here to give you an hour's reflexology treatment and I'm very sorry you thought differently.
I opened the door and lead her out. She was still ranting and raving about having a right to see what I've written up about her. I closed the door behind her and burst into tears, feeling completely unprepared for the whole experience and never wanting to treat another person in my home again.
The experience has really shaken me up... I've not experienced that kind of hostility in a treatment environment before and I've done many, many hours of case studies as well as treatments for fun and money in the past, I've always felt quite humbled to be in a position of giving a treatment and receiving such gratitude from the person receiving. I felt extremely vulnerable having this woman in my home, and being so confrontational.
The irony is, I work in a fairly hostile 9-5 environment, another irony being that I work in an area that deals, amongst other things with data protection...which got me thinking has she got a right to read my notes and my submissions? An extremely overwhelming experience all round.
I'm not sure if anyone has had any experiences of this sort, and whether you have some guidance or a steer on the matter, as to what I can learn from this and from a practical perspective, how to deal with this kind of behaviour in my practice.
I've had years and years of reflexology from many varied therapists and in all the years, I have never had a 'chart' given to me?? I'm now also extremely concerned about data protection issues, I've had a look at the business curriculum we cover and I'm not sure this is dealt with. Has anyone got any thoughts?
From a personal perspective I'm not letting this deter me from what I'm doing and loving, the experiences I've had so far along this journey have been gratifying and rewarding and I'm still unfalteringly committed to establishing my own clinic and encompassing this path as a career.
Any thoughts and guidance would be appreciated.
x
Hi Robyn
I do hope you're beginning to get to the other side of this disturbing experience and are feeling more positive about it. After all, this kind of thing may happen again, for all you know, and at least if it does, you won't be thinking 'I've never known anything like this before'. Hopefully, of course, you won't have to face this kind of hostility again and I'm glad it hasn't put you off. Just goes to show that it takes all kinds....I should say here that I'm not a therapist but, from my own point of view, it seems clear that this woman was possibly not quite the full ticket. You said that she had emotional issues, poor thing, she sounds completely flakey to me. Also I'm picking up on the fact that you were wide open to her psychic disarray and therefore you picked up on her jangled thoughtwaves and this, as much as her behaviour and attitude, helped to discombobulate you. However, I think you acted absolutely correctly. Absolutely. Your responses sound totally professional to me. Now keep telling yourself that there is nothing wrong with you, 99% of your future clients will be lovely people. And because you have got through this unpleasant occurrence, you will be able to cope perfectly with the odd 1%!
Good for you. Keep on trucking!
Lots of love
Sunanda xxx
As a client, they are, under the Data Protection Act allowed to view any personal data held about them, therefore they do have a right to read any notes you have made about them. In theory, notes should be written up regularly after treatment, so that they are available should a client request them. In practice, we will probably have a schedule for doing this, so it will rarely include every treatment carried out to date unless it's writeup day.
I don't understand why the client became defensive, nor why she was expecting a diagnosis. Did you spend time with the client after her first treatment discussing your findings? You were right in stating that you cannot diagnose, merely treat.
Put it behind you, as a learning experience, I have never heard of a case study client becoming so upset, perhaps the healing crisis shocked her, perhaps she has never experienced this before, or perhaps the personalities just didn't mesh.
Whatever it is, move on, the next experience will be better.
The patient has every right to see what you've written about them, be it in your case notes, a letter to her GP, or your write-up for the tutors. Incidentally, I'd also argue that the treatment notes at least should be written up almost immediately.
You're quite right in that you're not a primary health care provider, so you're not responsible for diagnosis; and I'm not sure why the patient would expect a full write-up (for the tutor) to be done at her convenience.
As for sharing the charts as a matter of course, I'd imagine that's an individual choice thing, dependant on each therapist.
Another thing I'd pick up on (para 9), is that you seem to say that you gave her the consent form to sign on the 2nd treatment; I may be reading this wrong, but it sounds as if you did the 1st treatment on impled consent, rather than signed, which could be potentially dodgy.
Confrontations with patients happen, and are always distressing to a greater or lesser degree; the only thing we can do is to learn from it, see how we can avoid the situation should it happen again, and see how to resolve it, should avoidance not be possible. Certainly don't let it put you off what you're doing
hi robyn,
i agree with gussie's thoughts. what had you written that you didnt want to show? and really, there's nothing wrong with telling our findings to clients, as long as you make clear its not a diagnosis. you are a massage therapist anyway... its not so different with reflexology.
just make sure that the notes you write in future are carefully worded, so that you can show them if requested. after one treatment, you wouldnt have written up the study anyway, just your consult type notes.
but i also think you got a difficult client and they are not usually like that, although you were aware that she had emotional problems, just not aware maybe of how severe.
have you asked your tutor about it and what does she say?