FHT and treating pregnant clients
I am a member of the FHT, and treatment of pregnant clients seems to be a very grey area with them. There are a few statements in the FHT code of ethics as follows:
"The following are examples of where care must be taken and where GP input may be necessary, but when in doubt, do not treat before prior consultation with a medical professional.
"You should exercise the greatest caution in treating a pregnant client particularly during the first trimester and if there is any history of miscarriage or medical complications during pregnancy. FHT require therapists to have received specialist training in this field before they become involved in an area in which they are not competent, as the repercussions could be very serious."
Firstly it is not completely clear to me if you have to have specialist training to treat pregnant clients if part of the FHT. I have sent several emails to the FHT on this subject and this was the advice:
"If you do not have the relevant training it is not advisable to treat in the first and last trimesters whether you have consent from the midwife. For insurance purposes, without this additional training, if anything happened, it would be taken into account."
Secondly they say they are unable to recommend a specific course, so it's hard to know if the course you choose to go on will satisfy the FHT and allow you to call yourself a maternity reflexologist.
I wonder what others have understood on this issue, and how you approach treating pregnant clients under the FHT guidelines.
Thanks!
Answers:
Moshe Kruchik Dear Sarah,
The FHT advice is the best guideline I've ever read concerning Maternity Reflexology.
First, it is a message of caution.
Second, they invite everybody who wants to pursue this kind of knowldege to think about his/her client's health and his/her career.
Let me ask you a couple of questions:
What is exactly a Maternity Reflexologist?
Would you be able to say that came across Gastroenterologic Reflexologists, or Orthopaedic Reflexologists, for example?
A Reflexologist who has attended a responsible course in Maternity Reflexology has made a first step to pursue the right type of knowledge and practice. He/she can call him/herself a Maternity Reflexologist in order to focus on a specific area of clients, but he/she will be far from being a specialist.
Many people are temptated to call themselves specialists in Reflexology fields. I really think it is a bit dangerous to do such a thing. At some extent, it would be contrary to the character and definitions of Reflexology as a therapy, Reflexology invites you to observe the person and not the condition. Even if the lady is pregnant, doing a course of one or two weekends will never give you the legitimation to call that a specialisation.
People who are more experienced in a certain field, in this case Maternity, will be able to deliver guidelines for your further practice with this specific kind of clients. My experience with Maternity Reflexology (or even as a Doula or a Childbirth Educator) is that there are not two similar pregnancies, there are not two similar labours, not two similar babies in the belly, not even two similar circumstances during the whole process.
The fantastic thing with pregnancy and chilbirth is that it is a unique experience for the mother and for the baby, and as a therapist, the experience you have with them is also unique.
From the practical side of this discussion, Reflexology is not a science. We Reflexologists defend a theory and try to demonstrate it (successfully most of the times) with a responsible practice. But still, we are unfortunately far from the situation in which we can feel protected by the law for everything we do. It is impossible to prove that Reflexology can cause miscarriage, actually I would say that I don't believe that it can happen. The problem is if it happens.....and you have given a Reflexology session a few hours before it happened. Who will protect you? Who will defend you? How would you feel about that?
I think that every message of caution is not a message of fear, but a call for responsibility. It's always better to know what your limitations are before you take the decision to accept a certain type of client. When you have gained enough self confidence, go ahead, but still, go slowly and observe every step you walk.
If the FHT recommended certain courses upon others, they would be committing a mistake, so they refrain from doing that.
The AOR, for example, counts at least 2 different courses on Maternity Reflexology, accredited as CPD courses, but still they don't recommend one upon others.
Before the AOR accredited the courses, they checked programs, curriculum of the tutor and outcomes of the course. Then, if you attended one of their courses, you would be covered by insurance because this specific course has been already approved by them.
To the best of my knowledge, the FHT has a policy of recognition of other organizations' CPD courses, so you'd better check this point too.
I hope I helped somehow.
Best regards,
Moshe Kruchik
Answers:
sparkie Thanks for your reply Moshe. I have read several of your posts and you always respond with sensible, balanced advice.
I am only recently qualified, and in my reflexology training we were only advised not to treat pregnant clients in the first trimester, and that after this time it was fine so long as there were no complications.
We were not advised of any adaptations to our normal full routine and were not given any precautions.
It is only now, reading some of the recent posts, and checking the FHT code of ethics, that I realise that perhaps I should not accept pregnant clients as firstly, different techniques may be needed, and secondly, I may not be covered by insurance.
I already realise that my new career is going to be one of constant learning, and I think that rather than being able to call myself a maternity reflexologist, or whatever specialist, I need to know that I am able to offer a safe and effective treatment to all, and pregnant ladies being just one group.
The FHT don't seem to be saying you should NOT treat pregnant clients, but also advise that you may find you are not supported by your insurance company. I am certainly going to go on a course so that I can increase my confidence and experience, and also to ensure that I have the backing of my insurers (!)
Best wishes
Answers:
Moshe Kruchik Dear Sarah,
I think this is a good opportunity to start breaking some myths about Maternity Reflexology.
When I started my career as a Reflexologist, I was informed about 17 different types of clients to whom Reflexology would be severely contraindicated, including patients with cancer, ostheoporosis, infants, recently operated,........., and pregnant women (it can cause miscarriage, treat only symptomatically, not more than 20 minutes, etc., etc.).
These limitations sound arcaic to me now.
I have treated several patients with cancer, thanks God they are all alive.
Infants? I treated my daughter when she was only 5 hours old and then everyday until the age of 6 months. She is almost 8 years old now, a healthy (touch wood) and gorgeous girl.
Pregnants? You name it.....Not only symptomatically, full treatment 1+ hour.
Constipation, anemia, hemorroids, oedema, preparing for labour, anxiety (indeed a big issue), diarrhea, headaches, gestational diabetes.....there is so much to do in order to help her keep balance....!
First rule? Never go to the symptom itself, always try to understand what is it causing it, remember what stage of the pregnancy it is, think how can you prevent further developments and always try to avoid further triggers.
Second rule? Be patient and try to study as much as you can. Yes, you are completely right: Reflexology is a neverending story of learning.
Concerning insurance matters: fortunately, Reflexology has made great steps during the last years. Not only Reflexologists but also organisations as insurance companies are today keener to insure a Reflexologist with a recognised background, practice and knowledge about Maternity.
So far, I know about many of my own students who were able to be insured properly, without inconvenients. You'd probably have to check if the organisation you belong to has good insurance agreements. And if not, you'd perhaps have to consider the possibility of joining another organisation with those agreements that fit your practice better. It can sound heavy and not practical, but sometimes you need this to feel calm and silent.
Best wishes,
Moshe Kruchik
Answers:
chickenlicken Hi Sparkie
I had all this trouble with the FHT you know. I did the Suzanne Enzer course Part 1 and got all keyed up to go forth and they said that it was not advisable to work on 1st and 3rd Trimester clients. What? This could be when you are most needed. They really did not commit but just said that i will be fine as long as i work within the training guidlines that i was given. So thats what i do.
The FHT also didn'y even recognise Maternity Reflexology as a separate thing so if someone was looking on their website, they didn't know that the therapist was trained in this. Thank god they have changed this now.
Regards
C.L x
Answers:
sparkie Thanks Chicken Licken!
That's useful to know.
Just found you on the FHT therapists register and see that you are listed for "Reflexology and Pregnancy".
So if I understand you correctly, despite the FHT initially telling you to avoid 1st and 3rd Trimester, you now work within the guidelines of your maternity reflexology training, and presumably do treat throughout pregnancy and consider yourself to be practising within their requirements. (Although still a slightly grey area..........)
Answers:
Moshe Kruchik Hi Sparkie, Chickenlicken
Can't understand either why shouldn't you treat a pregnant woman in the third trimester. I agree with you, this is generally the period in which she is most needed.
It looks like it is much darker than a slightly grey area. As far as you let me understand they say "work within your training guidelines" even when those guidelines include giving Reflexology sessions in the third trimester, but recommending not to do it?
Sorry, it is my curiosity that moves me to ask you this question. It sounds like a contradiction, doesn't it?
If this is right, how can you exactly be insured?
Thank you in advance for your answers
Best regards,
Moshe
Answers:
sparkie Hi again Moshe
I have received further info from the FHT. Whilst they cannot recommend a specific course, I asked if certain course were acceptable to them, and I listed the following:
Best wishes
Answers:
Moshe Kruchik Hi Sarah,
Thank you for clarifying this, now it sounds fine and more logical. Something was missing.
Only for your information, the name of the course I deliver is Maternity Reflexology (Reflexology in Pregnancy and Childbirth) and runs over 20 academic hours (2 days).
Best wishes
Moshe Kruchik
Answers:
chickenlicken Hi sparkie & Moshe
Yes that is what i meant. But when i originally phoned up to see if i was covered i was told that it was not advisable to work on women in these trimesters. Then i asked the FHT if i would be covered they said that i would be covered as long as worked within the training i was and adhered to the contra-indications. I'm sorry if it didn't come across right, but there would be way that i would work on pregnant women unless i was insured, or anyone else come to that!!
I did have to phone up a few times to clarify this.
Regards
C.L x
Answers:
Moshe Kruchik Dear Chickenlicken,
Have you heard an argument or a reason why should you avoid treating women in the third trimester?
Thanks,
Moshe
Answers:
chickenlicken Hi Moshe
I certainly have not heard or read anything which was why i thought it ridiculous when the girl at the FHT said so.
"The following are examples of where care must be taken and where GP input may be necessary, but when in doubt, do not treat before prior consultation with a medical professional.
- The first trimester of pregnancy or not at all where there is a history of miscarriage. (If choosing to practice Reflexology on the pregnant women, it is advised that you take special training in this area)."
"You should exercise the greatest caution in treating a pregnant client particularly during the first trimester and if there is any history of miscarriage or medical complications during pregnancy. FHT require therapists to have received specialist training in this field before they become involved in an area in which they are not competent, as the repercussions could be very serious."
Firstly it is not completely clear to me if you have to have specialist training to treat pregnant clients if part of the FHT. I have sent several emails to the FHT on this subject and this was the advice:
"If you do not have the relevant training it is not advisable to treat in the first and last trimesters whether you have consent from the midwife. For insurance purposes, without this additional training, if anything happened, it would be taken into account."
Secondly they say they are unable to recommend a specific course, so it's hard to know if the course you choose to go on will satisfy the FHT and allow you to call yourself a maternity reflexologist.
I wonder what others have understood on this issue, and how you approach treating pregnant clients under the FHT guidelines.
Thanks!
Answers:
Moshe Kruchik Dear Sarah,
The FHT advice is the best guideline I've ever read concerning Maternity Reflexology.
First, it is a message of caution.
Second, they invite everybody who wants to pursue this kind of knowldege to think about his/her client's health and his/her career.
Let me ask you a couple of questions:
What is exactly a Maternity Reflexologist?
Would you be able to say that came across Gastroenterologic Reflexologists, or Orthopaedic Reflexologists, for example?
A Reflexologist who has attended a responsible course in Maternity Reflexology has made a first step to pursue the right type of knowledge and practice. He/she can call him/herself a Maternity Reflexologist in order to focus on a specific area of clients, but he/she will be far from being a specialist.
Many people are temptated to call themselves specialists in Reflexology fields. I really think it is a bit dangerous to do such a thing. At some extent, it would be contrary to the character and definitions of Reflexology as a therapy, Reflexology invites you to observe the person and not the condition. Even if the lady is pregnant, doing a course of one or two weekends will never give you the legitimation to call that a specialisation.
People who are more experienced in a certain field, in this case Maternity, will be able to deliver guidelines for your further practice with this specific kind of clients. My experience with Maternity Reflexology (or even as a Doula or a Childbirth Educator) is that there are not two similar pregnancies, there are not two similar labours, not two similar babies in the belly, not even two similar circumstances during the whole process.
The fantastic thing with pregnancy and chilbirth is that it is a unique experience for the mother and for the baby, and as a therapist, the experience you have with them is also unique.
From the practical side of this discussion, Reflexology is not a science. We Reflexologists defend a theory and try to demonstrate it (successfully most of the times) with a responsible practice. But still, we are unfortunately far from the situation in which we can feel protected by the law for everything we do. It is impossible to prove that Reflexology can cause miscarriage, actually I would say that I don't believe that it can happen. The problem is if it happens.....and you have given a Reflexology session a few hours before it happened. Who will protect you? Who will defend you? How would you feel about that?
I think that every message of caution is not a message of fear, but a call for responsibility. It's always better to know what your limitations are before you take the decision to accept a certain type of client. When you have gained enough self confidence, go ahead, but still, go slowly and observe every step you walk.
If the FHT recommended certain courses upon others, they would be committing a mistake, so they refrain from doing that.
The AOR, for example, counts at least 2 different courses on Maternity Reflexology, accredited as CPD courses, but still they don't recommend one upon others.
Before the AOR accredited the courses, they checked programs, curriculum of the tutor and outcomes of the course. Then, if you attended one of their courses, you would be covered by insurance because this specific course has been already approved by them.
To the best of my knowledge, the FHT has a policy of recognition of other organizations' CPD courses, so you'd better check this point too.
I hope I helped somehow.
Best regards,
Moshe Kruchik
Answers:
sparkie Thanks for your reply Moshe. I have read several of your posts and you always respond with sensible, balanced advice.
I am only recently qualified, and in my reflexology training we were only advised not to treat pregnant clients in the first trimester, and that after this time it was fine so long as there were no complications.
We were not advised of any adaptations to our normal full routine and were not given any precautions.
It is only now, reading some of the recent posts, and checking the FHT code of ethics, that I realise that perhaps I should not accept pregnant clients as firstly, different techniques may be needed, and secondly, I may not be covered by insurance.
I already realise that my new career is going to be one of constant learning, and I think that rather than being able to call myself a maternity reflexologist, or whatever specialist, I need to know that I am able to offer a safe and effective treatment to all, and pregnant ladies being just one group.
The FHT don't seem to be saying you should NOT treat pregnant clients, but also advise that you may find you are not supported by your insurance company. I am certainly going to go on a course so that I can increase my confidence and experience, and also to ensure that I have the backing of my insurers (!)
Best wishes
Answers:
Moshe Kruchik Dear Sarah,
I think this is a good opportunity to start breaking some myths about Maternity Reflexology.
When I started my career as a Reflexologist, I was informed about 17 different types of clients to whom Reflexology would be severely contraindicated, including patients with cancer, ostheoporosis, infants, recently operated,........., and pregnant women (it can cause miscarriage, treat only symptomatically, not more than 20 minutes, etc., etc.).
These limitations sound arcaic to me now.
I have treated several patients with cancer, thanks God they are all alive.
Infants? I treated my daughter when she was only 5 hours old and then everyday until the age of 6 months. She is almost 8 years old now, a healthy (touch wood) and gorgeous girl.
Pregnants? You name it.....Not only symptomatically, full treatment 1+ hour.
Constipation, anemia, hemorroids, oedema, preparing for labour, anxiety (indeed a big issue), diarrhea, headaches, gestational diabetes.....there is so much to do in order to help her keep balance....!
First rule? Never go to the symptom itself, always try to understand what is it causing it, remember what stage of the pregnancy it is, think how can you prevent further developments and always try to avoid further triggers.
Second rule? Be patient and try to study as much as you can. Yes, you are completely right: Reflexology is a neverending story of learning.
Concerning insurance matters: fortunately, Reflexology has made great steps during the last years. Not only Reflexologists but also organisations as insurance companies are today keener to insure a Reflexologist with a recognised background, practice and knowledge about Maternity.
So far, I know about many of my own students who were able to be insured properly, without inconvenients. You'd probably have to check if the organisation you belong to has good insurance agreements. And if not, you'd perhaps have to consider the possibility of joining another organisation with those agreements that fit your practice better. It can sound heavy and not practical, but sometimes you need this to feel calm and silent.
Best wishes,
Moshe Kruchik
Answers:
chickenlicken Hi Sparkie
I had all this trouble with the FHT you know. I did the Suzanne Enzer course Part 1 and got all keyed up to go forth and they said that it was not advisable to work on 1st and 3rd Trimester clients. What? This could be when you are most needed. They really did not commit but just said that i will be fine as long as i work within the training guidlines that i was given. So thats what i do.
The FHT also didn'y even recognise Maternity Reflexology as a separate thing so if someone was looking on their website, they didn't know that the therapist was trained in this. Thank god they have changed this now.
Regards
C.L x
Answers:
sparkie Thanks Chicken Licken!
That's useful to know.
Just found you on the FHT therapists register and see that you are listed for "Reflexology and Pregnancy".
So if I understand you correctly, despite the FHT initially telling you to avoid 1st and 3rd Trimester, you now work within the guidelines of your maternity reflexology training, and presumably do treat throughout pregnancy and consider yourself to be practising within their requirements. (Although still a slightly grey area..........)
Answers:
Moshe Kruchik Hi Sparkie, Chickenlicken
Can't understand either why shouldn't you treat a pregnant woman in the third trimester. I agree with you, this is generally the period in which she is most needed.
It looks like it is much darker than a slightly grey area. As far as you let me understand they say "work within your training guidelines" even when those guidelines include giving Reflexology sessions in the third trimester, but recommending not to do it?
Sorry, it is my curiosity that moves me to ask you this question. It sounds like a contradiction, doesn't it?
If this is right, how can you exactly be insured?
Thank you in advance for your answers
Best regards,
Moshe
Answers:
sparkie Hi again Moshe
I have received further info from the FHT. Whilst they cannot recommend a specific course, I asked if certain course were acceptable to them, and I listed the following:
- Susanne Enzers, maternity reflexology - 2 weekend courses, case studies, assignments, etc
- Denise Tiran, Caring for Pregnant Clients -2 day course, but not specific to reflexology
- Ann Gillanders, Reflexology for Women - 2 days
- Moshe Kruchik, weekend course
Best wishes
Answers:
Moshe Kruchik Hi Sarah,
Thank you for clarifying this, now it sounds fine and more logical. Something was missing.
Only for your information, the name of the course I deliver is Maternity Reflexology (Reflexology in Pregnancy and Childbirth) and runs over 20 academic hours (2 days).
Best wishes
Moshe Kruchik
Answers:
chickenlicken Hi sparkie & Moshe
Yes that is what i meant. But when i originally phoned up to see if i was covered i was told that it was not advisable to work on women in these trimesters. Then i asked the FHT if i would be covered they said that i would be covered as long as worked within the training i was and adhered to the contra-indications. I'm sorry if it didn't come across right, but there would be way that i would work on pregnant women unless i was insured, or anyone else come to that!!
I did have to phone up a few times to clarify this.
Regards
C.L x
Answers:
Moshe Kruchik Dear Chickenlicken,
Have you heard an argument or a reason why should you avoid treating women in the third trimester?
Thanks,
Moshe
Answers:
chickenlicken Hi Moshe
I certainly have not heard or read anything which was why i thought it ridiculous when the girl at the FHT said so.