Massage Therapy Journal Fall 2024

Fall 2024 • 79

or alternative care approaches. Because such clinicians rely solely on care recipients to self report PTSD and those with PTSD have low disclosure rates, clinicians in complementary medicine fields, such as massage therapy, will likely treat many with PTSD without knowing it.” The case report reviewed a therapeutic encounter between a massage practitioner and a veteran seeking massage therapy for a combat injury. The veteran did not disclose their PTSD diagnosis until two years after initially receiving massage. Disclosure of PTSD was made during follow up communication around missed massage appointments, where researchers noted the participant stated the following when asked about the reason for nondisclosure: “It isn’t something you just tell people. For the most part, you just live with it. Most people don’t understand.” According to researchers, the client’s stated goals of increased range of motion, reduced chronic pain of the injured limb and increased activity in previously enjoyed physical activities were achieved with massage. Additionally, insights around PTSD and clients who might not disclose a mental health condition were also discussed. “Awareness of these issues is particularly needed among those who work with veterans because core symptoms of PTSD can exacerbate typical responses, increase nondisclosure likelihood, and create barriers to treatment commitment or response less recognized in civilian care settings,” researchers noted. “Inconsistent foundation massage education in the United States limits the systematic inclusion of such essential topics in clinicians’ early training, potentially leaving massage professionals ill prepared to meet the growing needs of consumers regarding trauma and/or PTSD.” A word of caution, however. Although understanding, awareness and education around the symptoms and behaviors associated with trauma are key to success, massage therapists should not attempt to pry information out of clients, especially veterans who might be particularly uncomfortable talking about their experiences. “We do not need the client to tell their story to help

them,” says Howe. “They are welcome to share, but discussing details of their trauma may not bring benefit to our treatment process.” Howe says that when working with clients with PTSD, for both those who have disclosed a diagnosis and those who haven’t, intense emotional responses can happen. When they do happen, Howe suggests staying present with the client as they process what they are feeling. “Our hands remain engaged,” he explains. “As long as the client is comfortable, we let them know we are right there with them and they are safe at that moment.” Regardless if a veteran (or any other client) has PTSD, whether they disclose it or not, massage can provide both physical and emotional benefits. Yes, knowing about a client’s PTSD may help to better plan and guide a massage session, but the environment should be one of safety and comfort in all cases. “Working with trauma survivors can be complex and challenging, but it can also be simple,” says Howe. “We aim to help humans human better through healthy touch in a safe, supportive environment where they are empowered to take their next steps in healing.” Hawrilenko MJ, McGinty NK, Resnick A, Tomlanovich NC, Toyama J, Whitehead AM, Kligler B, Zeliadt SB. “We Built it, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches.” J Gen Intern Med . 2023 Mar;38(4):905-912. active duty soldiers with chronic post-traumatic stress disorder and injury to the head.” J Bodyw Mov Ther . 2016 Jan:42-50. 3. Collinge W, Wentworth R, Sabo S. “ Integrating complementary therapies into community mental health practice: an exploration.” J Altern Complement Med . 2005 Jun;11(3):569-74. 4. Rosenow M, Munk N. “Massage for Combat Injuries in Veteran with Undisclosed PTSD: a Retrospective Case Report.” Int J Ther Massage Bodywork . 2021 Mar 1:4-11. 2. Davis L, Hanson B, Gilliam S. “Pilot study of the effects of mixed light touch manual therapies on References 1. Taylor SL, Gelman HM, DeFaccio R, Douglas J,

Working as part of a larger integrative health care team does require massage therapists communicate well with both the client and other health care professionals, while also remaining HIPAA compliant.

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