Massage Therapy Journal Summer 2025

56 • Massage Therapy Journal

AMTA Continuing Education

• Be aware of non-verbal communication . Body language makes up the largest part of non-verbal communication—eye contact and hand gestures can convey powerful messages. As William Shakespeare said in Troilus and Cressida: “There’s language in her eye, her cheek, her lip.” In most Western countries, eye contact is a sign of welcome and attention. In some Middle Eastern countries, same-gender eye contact is appropriate, but opposite-gender eye contact beyond a brief glance may be inappropriate. In some Asian, African and Latin American countries, avoiding eye contact is a sign of respect. Hand gestures can mean very different things in different cultures. The “okay” sign means you are calling someone a slang word for “anus” for people from Greece, Spain or Brazil. A thumbs up in America and European cultures is an indicator of a job well done, but in Greece or the Middle East, it can mean “up yours.” • Be aware of customs . A right-handed handshake as a greeting is acceptable in most Western countries. People from Central and South America usually add their left hand in to create a two-handed clasped handshake. Men from Islamic countries rarely shake the hands of females outside the family. Females from some Muslim cultures may cover their heads and include a spouse and/or family member when making certain decisions. • Be aware of terminology . America uses the imperial system of inches, feet, yards and miles, as well as the Fahrenheit temperature scale. Most other countries use the metric system and the Celsius temperature scale. Be sure to include appropriate conversions when giving self-care instructions to clients from countries that use the metric system or Celsius scale. Consider using the word “toilet” instead of restroom (public facility) or bathroom (private or residential facility). Restroom and bathroom are acceptable terms in most regions of the world, but the universal term is toilet. In the UK, you may hear loo, which is short for lavatory.

“Happy Holidays” or “Seasons Greetings” are more inclusive greetings than “Merry Christmas” because not everyone celebrates Christmas. Also, saying “Merry Christmas” to someone who celebrates Hanukkah, Kwanzaa or nothing at all might make them feel marginalized. Use language that is immigrant supportive and avoid referring to someone in terms such as “illegal” or “alien.” • Plan for language services proactively. Be sure front desk staff members are multilingual or are familiar with some basic phrases in the spoken languages of the client base. Use “I Speak” flash cards, which can be downloaded from the Limited English Proficiency website. Be sure “All are Welcomed Here” are in languages of the populations that you serve. Next, inquire about language service needs, and inform the client that language services will be made available to facilitate the intake process. Have forms and materials in languages other than English, or use translation software or apps. • Ask for client feedback . Incorporate a client satisfaction survey to gain valuable feedback. This survey should include questions to help you determine whether clients believe that the therapists or the organization relates well to them and gives them an opportunity to identify problem areas. Also find out your sources of referrals. Talk to people from actual or potential referral sources, including primary care physicians, and ask whether they are referring clients, and if not, why. It is important to know who is not walking through your door. Assemble all the information into a report, along with comments and suggestions. Make appropriate changes to your practice. • Recruit staff and therapists that reflect the population(s) served . Be sure to recruit and hire therapists and staff who reflect the clients served at the facility. • Create professional development programs or attend trainings that address cultural competence . These should include the importance of cultural sensitivity in the dialog between staff/therapists and client. During

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