International Therapist Winter 2019 by Redactive Media Group

International

Therapist fht.org.uk

FHT

Training Congress special see page 33

TRIGGER

WARNING

Deactivating trigger points with soft tissue release

Facing ﬁbromyalgia

Peel power

Positive measures

Advanced massage techniques for ﬁbromyalgia

The beneﬁts of skin peels and importance of best practice

Two ways to evaluate client outcomes

PUBLISHED BY THE FHT ISSUE 127 (WINTER 2019) THE LEADING MAGAZINE FOR PROFESSIONAL THERAPISTS 01 cover_IT WINTER 2019_International Therapist 1

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CONTENTS

International

Therapist fht.org.uk

ISSUE 127 (WINTER 2019)

ON THE COVER

FEATURES 12

Trigger warning Jane Johnson talks about trigger points and how soft tissue release can deactivate them

Taking charge of health Professor Sarah Stewart-Brown talks to the FHT about therapies, wellbeing and research

NHS role model Gwyn Featonby talks about developing the first NHSapproved complementary therapy school

30 08

Your views

Ask an expert

2018 FHT Conference and Excellence Award winners

Music licences and environmental issues

2019 FHT Training Congress

News update

Research

Essential oil profile

Medical A-Z

Cypress

Local support group news

Industry news

CPD questions and diary dates New in the reading room and spiral quiz

On the couch…

FHT learning

with Angie Buxton-King, award-winning healer

FHT accredited courses

03 CONTENTS_IT WINTER 2019_International Therapist 3

Facing fibromyalgia Jing’s Rachel Fairweather discusses how massage techniques can help clients with fibromyalgia

Weak at the knees

Positive measures Nicola Brough and Professor Sarah Stewart-Brown talk about two patient-reported outcome measures relevant to therapy interventions

MEMBERS’ PAGES 50

A day in the life of… Sheree Phelps, MFHT, sports massage therapist and 2017 FHT Excellence Award winner

Migraine

FHT.ORG.U FHT.ORG.UK UK

Dawn Morse provides an introduction to runner’s knee and offers techniques to address the condition

LEARNING ZONE

What’s new at FHT

Dermalogica’s Candice Gardner talks about skin peels and the importance of best practice

REGULARS

Peel power

Members’ news… Maureen Bonner reflects on a meeting with Tracy Walton, US-based oncology massage expert

Reviews, competition and new products

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:13

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11/01/2019 09:46

EDITOR’S WELCOME

WELCOME Federation of Holistic Therapists 18 Shakespeare Business Centre Hathaway Close, Eastleigh Hants SO50 4SR Contact T. 023 8062 4350 E. info@fht.org.uk W. fht.org.uk Editor Karen Young Deputy Editor Daniel Ralls Sub-editor James Hundleby Art Editor Sarah Auld Picture Editor Charlie Hedges Advertising Annabel Boorman-Shiffer T. 020 7880 6230 fht@redactive.co.uk Deadlines – Spring 2019 (Issue 128) Editorial – 5 Feb Classiﬁed adverts – 28 March Display adverts – 5 April Published – 25 April Senior management team Beverly Bartlett; Jade Dannheimer; Julie McFadden; John Parsons; Annie Walling; Karen Young Governing Council President – Christopher Byrne Vice Presidents – Gerri Moore; Mary Dalgleish; Herman Fenton; Judith Hadley; Maria Mason Lay member – Helen Chambers FHT Expert Advisers Julian Baker, MFHT; Lynne Booth, MFHT; Amanda Brooks, MFHT; Lorraine Davis, FFHT; Christine Fisk; Sally Kay, FFHT; Cameron Reid, MFHT; Tina Reid; Neil Sheehan, MFHT; Denise Tiran Recycle your magazine’s plastic wrap – check your local LDPE facilities to find out how.

n behalf of everyone at the FHT, I’d like to say thank you to everyone who joined us at our integrated healthcare conference in November. It was such a pleasure to hear members chatting excitedly during the breaks about how motivated and optimistic they felt about the future – sentiments repeated time and again in the feedback forms completed. However, it’s also clear that to support the move towards a more integrated approach, being able to demonstrate the health benefits of therapy interventions through research remains a priority. Thankfully, it would seem some significant nods are being given in the direction of patient-reported outcome measures, or PROMs. The Charity Commission announced in December 2018 that it would be updating the way it assesses CAM organisations applying for charitable status.* It will now be accepting a wider range of evidence including ‘outcome reports by patients or observational studies based on patient responses’ (see fht.org.uk/cc-outcome for more information). Why the change? Because it now appreciates that ‘this type of evidence may, for example, be the best available source to evidence a patient’s level of pain, functional limitations or other symptoms’. In addition, the Commission feels as if this change in approach will ensure CAM organisations ‘that are capable of proving public benefit can demonstrate this without being hampered or restricted by requirements for inappropriate types of

USEFUL FHT CONTACTS

evidence’. Hooray! Some acknowledgement at last that, as Sir Sam Everington told us, ‘it’s not just what’s the matter with the patient, but what matters to the patient’. And what evidences this better than PROMs? Ending on that note, I hope you enjoy Nicola Brough and Sarah StewartBrown’s article (page 46), which introduces two PROMs: WEMWBS and WHHQ. And stay tuned. The conversation about PROMs does not end here…

Karen Young, Editor

*Charity Commission for England and Wales. (December 2018) Outcome report. The use and promotion of complementary and alternative medicine: making decisions about charitable status.

International Therapist (IT) is printed on FSC® responsibly sourced paper. If you can bear to part with your copy of IT, please pass it on to a friend to read or recycle.

ACCREDITATION Annie Walling E. accreditation@fht.org.uk W. fht.org.uk/accreditation

INTERNATIONAL THERAPIST Daniel Ralls E. dralls@fht.org.uk W. fht.org.uk/IT

CPD REQUIREMENTS

MEMBERSHIP AND INSURANCE Beverly Bartlett E. bbartlett@fht.org.uk W. fht.org.uk

Heidi Hinton E. cpd@fht.org.uk W. fht.org.uk/cpd

PRESS AND MEDIA Karen Young E. kyoung@fht.org.uk W. fht.org.uk/press-and-media FOLLOW FHT ON FACEBOOK, TWITTER, LINKEDIN & INSTAGRAM

FHT is a trading name of the Federation of Holistic Therapists, which is authorised and regulated by the Financial Conduct Authority (FCA) under ﬁrm reference number 502095. You may check this on the Financial Services Register by visiting the FCA’s website, register.fca.org.uk or by contacting the FCA on T. 0800 111 6768. Registered in England and Wales, No. 02864349. Registered ofﬁce: Chilworth Point, 1 Chilworth Road, Southampton SO16 7JQ. This issue of International Therapist has been published on behalf of the Federation of Holistic Therapists by Redactive Media Group, 78 Chamber Street, London E1 8BL. The Federation has taken all reasonable steps to ensure the accuracy of the information contained in the magazine. Except in respect of death or personal injury caused by the Federation’s negligence, the Federation shall not be liable, by reason of any error in or omission from the information contained in this or any previous editions of the magazine, for loss or damage whatsoever arising therefrom. Neither FHT, Redactive Media Group nor the authors can accept liability for errors or ommisions. Neither the Federation nor Redactive Media Group necessarily associates itself with any views that may be expressed in this magazine, to which readers are invited to submit articles of general interest for publication. Responsibility cannot be accepted for unsolicited manuscripts or transparencies. No part of this magazine may be reproduced in any form or by any means, whether electronic, mechanical or optical without written permission from the Federation.

FHT.ORG.UK

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PRESIDENT’S WELCOME

WELCOME

he New Year is a time to reflect on what has been achieved the year before and a number of things come to mind, not least the FHT Conference on 29 November, which was a resounding success. It was a real privilege to listen to some of the most respected and forward-thinking academics and integrated health professionals of our time, and also to learn about the great work being carried out by our 2018 Excellence Award winners (see page 24 for more information). November also saw the 100th anniversary of Armistice Day, with some very thoughtprovoking scenes and activities taking place up and down the UK. It was a time to give thanks and remember not only those whose lives have been lost in times of conflict, but also those who are still with us, and who continue to bear the physical, mental and emotional scars of war. I know that many of our members play a vital role in supporting these individuals, and their families, for which I would personally like to say thank you. As we now enter a brand-new year, I’m delighted to welcome to the FHT’s Governing Council Judith Hadley, who was officially co-opted on to the board by her peers in October. Judith brings more than 30 years of knowledge and experience to the table, having worked as a hair, beauty and complementary therapy practitioner, training provider (in further

education, higher education and privately) and external verifier for a major awarding organisation. In particular, she will be representing the interests of our therapy lecturer FHT members. I’d also like to take this opportunity to thank our existing Governing Council and board members – Gerri Moore, Herman Fenton, Mary Dalgleish and Helen Chambers – for their continued support and unquenched enthusiasm for the organisation. And it’s with great pleasure that we also welcome back Maria Mason to the fold after a short break. Collectively, all of us – bar Helen, who is a lay member – are here to represent and safeguard your interests. As such, it’s important for you to know that we are here to answer any queries or concerns you may have – simply send your email to info@fht.org.uk and it will be directed to me. Or if you would prefer to give more general or anonymous feedback, please complete our 2019 FHT Member Survey (fht.org.uk/2019-survey). Whichever way you get in touch, we look forward to hearing from you.

Christopher Byrne, President

FHT GOVERNING COUNCIL

PRESIDENT Christopher Byrne ICAT (International Council of Acupuncture Therapists) and PACT (Professional Association of Clinical Therapists) FHT EXPERT ADVISERS Julian Baker, MFHT; Lynne Booth, MFHT; Amanda Brooks, MFHT; Lorraine Davis, FFHT; Christine Fisk; Sally Kay, FFHT; Maria Mason, MFHT; Cameron Reid, MFHT; Tina Reid; Neil Sheehan, MFHT; Denise Tiran

VICE PRESIDENTS Gerri Moore IFHB (International Federation of Health and Beauty Therapists)

Herman Fenton HFST (International Council of Health, Fitness and Sports Therapists)

Mary Dalgleish ICHT (International Council of Holistic Therapists)

LAY MEMBER Judith Hadley

Maria Mason

ATL (Association of Therapy Lecturers)

HBEF (Health and Beauty Employers Federation)

Helen Chambers (representing the interests of the public)

For biographies, please visit fht.org.uk/about-us 6

INTERNATIONAL THERAPIST WINTER 2019

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FHT.ORG.UK

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WINTER 2019 INTERNATIONAL THERAPIST

14/01/2019 10:32

HAVE YOUR SAY

Your views STAR COMMUNICATION

In defence of beauty therapists After reading the ‘Editor’s welcome’ in the Summer issue of International Therapist, I wanted to add my comments, with reference to the Training Congress delegate who said she was tired of doctors and consultants mistaking her for a beauty therapist. I was pleased to see that you had highlighted this derogatory remark, which sadly is not new. I have on countless occasions attended meetings and had to emphasise the many professional skills of a beauty therapist. Indeed, our professional organisation, the FHT, would not be where it is today without the beauty therapy industry, which is where it all began. A beauty therapist can offer enormous benefits to their clients. As Gill Morris explains in her ‘On the couch’ interview in the same issue, she discovered electrolysis during her beauty therapy training and was able to really help clients with hirsutism, hormonal issues and polycystic ovary syndrome. This specialist intricate treatment is performed by a beauty therapist. Another condition which can also cause embarrassment and emotional stress is acne vulgaris. Again, the beauty therapist can use their expert skills and knowledge to try and keep the condition under control and prevent any scarring. These treatments will require liaising with the client’s GP. I have met some amazing beauty therapists throughout my career, whose aim is to make their clients feel good – whether that be physically, emotionally or cosmetically. All therapists have a part to play in the health and wellbeing of the public, whether it is a facial performed by a beauty therapist, reflexology from a complementary therapist or sports massage from a sports therapist. Wendy Arnold, SFFHT

Foot-reading showcased at conference

PLEASE KEEP IN TOUCH WITH US... Email dralls@fht.org.uk Facebook facebook.com/fht.org.uk Instagram fht_org FHT website fht.org.uk Twitter @FHT_Org Write to 18 Shakespeare Business Centre, Hathaway Close, Eastleigh, Hants S050 4SR

Nicolle Mitchell, MFHT @Massage4Dmentia WOW! What an emotional inspiring day! I got a special mention in my category for seeing the person behind the disease. Congratulations to all ﬁnalists/winners of the 1st #ComplementaryTherapy Awards where integration is being pioneered at an accelerating rate. #CompTherapyStars

STAR COMMUNICATION

Sheldon Mindfulness: Anxiety and Depression In the next issue of International Therapist, the lucky member who wins our star communication prize will receive a copy of Sheldon Mindfulness: Anxiety and Depression, by Dr Cheryl Rezek. Get in contact for a chance to win (see details at top of page).

Five foot-readers from around the world recently came together to deliver a conference that has been described by delegates as ‘an incredible day’. Foot-reading has risen in popularity, with therapists and practitioners realising and recognising the superb benefits it offers clients. FHT accredited course provider Jane Sheehan, Sam Belyea, Christine Stormer Fryer, Mauricio (Moshe) Kruchik and myself all got together for a one-day event, highlighting our different techniques, experiences and artistry in foot- and hand-reading. The day was attended by 150 eager delegates, who had a great time. Highlights included Jane giving us a light-hearted guide to foot-reading by analysing some royal feet, and Sam giving an informative presentation on how to use social media to market your business using foot-reading. For my part, I took a fresh look at the basics of foot-reading and how it benefits babies and children, their parents and practitioners. The conference delegates were enthralled, there was lots of laughter and amazing feedback – and I am thrilled to have been involved in such a successful event. Sue Ricks, MFHT

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Ask an expert | BUSINESS

THE FHT ADVISES ON MUSIC LICENCES AND ENVIRONMENTAL CONCERNS Q. DO I NEED TO PAY FOR A LICENCE TO PLAY MUSIC DURING MY TREATMENTS? The FHT says: If you wish to play music at your business premises – on a radio, TV, mobile or other device – then it is more than likely that you will need TheMusicLicence. This might even apply if you are selfemployed and work from home, if you have registered your therapy business to your home address. Previously, businesses playing music had to pay for separate licences, from both PRS for Music and PPL, which would then pay royalties to all those involved in creating the music. The two organisations have now come together to form PPL PRS Ltd and launch TheMusicLicence, in order to streamline the process and create just one licence. The cost of the licence will depend on a number of factors, such as the size of the business, the number of employees, and the different types of devices the music is played on.

While some therapists may prefer the freedom offered by TheMusicLicence, it is possible to purchase licence-free music that is appropriate for therapy treatments. This type of music would not require you to obtain TheMusicLicence, providing you only play licence-free music for your business. For instance, iChill (ichillmusic. com) and DavGar (davgarmusic. com) offer a wide range of ambient, licence-free music, and you can listen to samples on their websites before purchasing. These are by no means the only companies offering licencefree music – a browse online will bring up numerous options, but before purchasing, be sure to check that the music you are interested in buying does not require TheMusicLicence or any other licence. More information about TheMusicLicence is available at pplprs.co.uk/themusiclicence or call 0800 0720 808.

Q. WHAT KIND OF PAPER IS USED FOR INTERNATIONAL THERAPIST? The FHT says: International Therapist is printed on responsibly sourced wood-free paper certified by the FSC® (Forest Stewardship Council). The paper is made up of a mixture of virgin wood fibre from an FSC®-certified forest, reclaimed or recycled, or from controlled sources (controlled wood). Controlled wood fibres must come from sources that are not: Illegally logged Harvested from areas where there is violation of traditional or civil rights Harvested from forests in which high conservation values are threatened by management activities Harvested from areas being converted from forests and other wooded ecosystems to plantations or non-forest uses Harvested from forests in which genetically modified trees are planted. The pulp is bleached using an elementary chlorine-free (ECF) process, preventing the release of pollutants.

Q. IS THE WRAPPER FOR INTERNATIONAL THERAPIST BIODEGRADABLE? The FHT says: The polywrap we currently use is not biodegradable, but it can be recycled along with other low-density polyethylene (LDPE) items such as carrier bags, bread bags and toilet roll wrapping at recycling centres found in the UK’s larger supermarkets. LDPE plastic collection points can be found at larger stores of the Co-op, Sainsbury’s, Waitrose, Morrisons, Tesco and Asda. Although it’s not generally collected from the kerbside, some local councils are beginning to include items like this as part of household recycling schemes. The FHT has looked into a number of biodegradable alternatives, but has been advised that unless these are composted effectively – that is, placed in a compost that is regularly turned and aerated – the wrapper will not be exposed to sunlight and oxygen, which are both required for it to break down properly. Please note that we do periodically review the products we use to print and distribute International Therapist, and there are some promising environmentally friendly wrappers coming to the fore, which we are keeping a close eye on for the future. For more information about the materials used to print and distribute International Therapist, please visit fht.org.uk/IT

PICTURE: ISTOCK

Ask an expert

Environmental queries

WINTER 2019 INTERNATIONAL THERAPIST

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NEWS

Reﬂexology may help with surgery anxiety Reflexology may benefit heart patients who are experiencing surgery anxiety, according to a study published in the Journal of Advanced Nursing. A team of researchers conducted a systematic review and meta-analysis of randomised controlled trials involving reflexology as a complementary therapy for cardiovascular patients undergoing procedures to establish its effect on anxiety. Using leading medical databases, the team found 10 studies that met their criteria, representing 760 patients with an average age of 59. Their findings showed that reflexology significantly decreased the anxiety of patients when compared with the control group. The team is calling for further research in this area to ‘create reliable evidence’. Read an abstract of the study at fht.org.uk/IT-127-reflexology-surgery

UK doctors at greater risk of anxiety than the public A growing body of evidence indicates that GPs need more support from the wider workforce because of the increasing demands of their job and the toll it takes on their health and wellbeing. The latest report by the Society of Occupational Medicine and the Louise Tebboth Foundation found evidence to suggest that UK doctors are at greater risk of work-related stress, burnout, depression and anxiety than the general public. The risk of suicide is also high compared with the general population. Mental health problems among doctors are on the rise, alongside increasing demands, lack off supp ssupport, u ort, a faster pace of work, loss of autonomy and dim diminishing resources. GPs and junior doctors are said to o be b the worst affected, often experiencing burnoutt early on in their career. The report also suggests that these working conditions ng conditi tions ons could have major implications for patient health. Access the full report at fht.org.uk/IT-127-doctors-anxiety ety

PICTURES: ISTOCK; SHUTTERSTOCK

Predicting osteoarthritis based on previous injuries

Doctors of the future may be able to predict knee joint conditions, such as osteoarthritis, based on previously sustained injuries. Knee joint injuries usually occur due to participation in sport, but people often don’t realise that such injuries can lead to joint inflammation and post-traumatic osteoarthritis. In advanced post-traumatic osteoarthritis, joint cartilage breaks down completely, causing severe joint pain and lack of mobility. The mechanisms leading to osteoarthritis are not yet known and it isn’t possible for a doctor

INTERNATIONAL THERAPIST WINTER 2019

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examining a patient to predict future uture joint conditions and development of osteoarthritis. However, this may soon change, according to a new study from the University off Eastern Finland and Massachusetts Institute of Technology. echnology. The study presents a new model del for cartilage degeneration that could identify y lesions in the cartilage for osteoarthritis development, opment, predict osteoarthritis, suggest optimal rehabilitation ehabilitation protocols, and improve quality of life. Access the full study at fht.org.uk/ t.org.uk/ IT-127-knee-osteoarthritis ritis

Welsh Young Ambassadors improve wellbeing A new report by Sport Wales suggests that its Young Ambassador Programme has boosted the wellbeing of young people across the country. Founded in 2009, the Young Ambassador programme was set up to empower and inspire young people in schools, colleges and universities across Wales to become leaders through sport and to encourage others to take up physical activity throughout their lives. Of the young people who participate in the programme, 96% say their confidence has improved since taking part, and 91% believe they have helped improve the health and wellbeing of other young people. Read the report at fht.org.uk/ IT-127-young-ambassadors

Acne vaccine could be on its way Scientists could be close to developing an acne vaccine, according to a new study published in the Journal of Investigative Dermatology. The study demonstrates that antibodies to a toxin secreted from bacteria in acne vulgaris can reduce inflammation in human acne lesions. The vaccine would be the first to target bacteria already in human skin, instead of invading pathogens, and could help millions of people worldwide. While acne isn’t lifethreatening, it can have a detrimental effect on wellbeing, lowering self-esteem and contributing to mental health

FHT.ORG.UK

14/01/2019 10:48

Body hair removal on the rise for young men Young British men are seeking hair removal treatments almost as much as women, a new Mintel report suggests. The data shows that 29% of men aged between 16 and 24 use hair removal treatments, compared with 34% of women the same age. The popularity of body hair removal for men of all ages has grown by almost a third in two years – from 36% in 2016 to 46% in 2018. The demand for chest hair removal has doubled from 15% to 30%. Nearly half (45%) of adults agreed that it was unfair that women’s bodies are expected to be hair-free, while 19% agreed that men should remove hair from their bodies. Find out more at fht.org.uk/IT-127-hair-removal

problems. Current medications are said to be insufficient, and can cause side effects such as irritation, dry skin and depression. The new vaccine would potentially carry far less risk of side effects. Scientists have called for a largescale clinical trial to be conducted to validate the findings and lead to the release of a new, safe and efficient vaccine. Read the study at fht.org.uk/ IT-127-acne-vaccine

FHT.ORG.UK

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Prime minister backs social prescription Prime minister Theresa May has pledged to increase social prescription as part of the first government loneliness strategy. Set to be implemented by 2023, the strategy will see £1.8m allocated to communitybased projects. The decision to make loneliness a health priority follows research in 2017 by the Jo Cox Commission on Loneliness, the legacy of the late Labour MP, who was committed to addressing the growing health problem, as well as initiatives by councils, charities and health experts. According to the Campaign to End Loneliness, 75% of GPs see between one and five patients every day who come in mainly because they are lonely. Under the new government plans, social prescription will allow GPs to refer patients to non-clinical services, including community cafés, gardening, creative activities, cooking and healthy eating, counselling, mindfulness and complementary therapies. Theresa May says that social prescription will improve quality of life and take pressure off the NHS. Read more about social prescription on the FHT blog at blog.fht.org.uk

NATIONAL CYCLE NETWORK IMPROVEMENTS NEEDED Around 46% of the National Cycle Network is said to be either poor or very poor, according to a report by Sustrans. Sustrans, a charity that manages the network, aims to make all paths safe, accessible and trafﬁc-free and calls for more funding from the government to achieve this. Read the Sustrans report at fht.org.uk/IT-127-cycle-network

COSMETIC TREATMENTS BOOST CONFIDENCE The top motivation for having cosmetic treatments in the UK is to improve self-esteem or conﬁdence, according to a survey by RealSelf. That was the reason given by 43% of respondents, who all had cosmetic treatments or were considering having them over the next year. Read the report at fht.org.uk/ IT-127-cosmetic-treatments

GLOBAL FERTILITY RATES ALMOST HALVED SINCE 1950 Women around the world now have an average of 2.4 children over their lifetime, a dramatic reduction from the 1950 global average of 4.7. Researchers were surprised by these results, which should eventually lead to shrinking populations in many countries, including the UK, where women currently have an average of 1.7 children. Access the full study at fht.org.uk/IT-127-fertility-rates

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MASSAGE | Trigger point release

TRIGGER WARNING IN THIS EXCERPT FROM THE SECOND EDITION OF SOFT TISSUE AND TRIGGER POINT RELEASE, JANE JOHNSON TALKS ABOUT TRIGGER POINTS AND HOW SOFT TISSUE RELEASE CAN DEACTIVATE THEM

PICTURE: SHUTTERSTOCK

any of you are likely to have come across trigger points, whether you know what they are or not. If you are a massage therapist, you will almost certainly have discovered specific points in the muscles of a client that are tender when pressed, or even sore. Despite this, the client finds massage to these points soothing because it provides relief from pain and a reduction in feelings of tension. You may even have discovered trigger points in your own body, or have seen the pain referral charts associated with these points. Although debate continues within the scientific community as to the presence of trigger points, they are widely acknowledged by manual therapists, who report being able to identify them with palpation. In this article, you will learn how to identify a trigger point, why they should be treated, and some of the methods used to treat them. You will also learn how soft tissue release (STR) can be used to deactivate trigger points, using the examples of triggers found in levator scapulae, hamstrings and infraspinatus.

HOW TO IDENTIFY A TRIGGER POINT Trigger points were described by Simons et al (1999) as a ‘hyperirritable spot in

skeletal muscle that is associated with a hypersensitive palpable nodule in a taught band’ and by Leon Chaitow (2000) as ‘localised areas of deep tenderness and increased resistance, and digital pressure on such a trigger will often produce twitching and fasciculation’. In simple terms, myofascial trigger points are specific spots within skeletal muscle that are palpably tensioned and uncomfortable or painful when pressed firmly. They also refer pain in a predictable pattern. If you run your finger or thumb firmly over a muscle containing a trigger point, it can be felt as a pea-shaped area of increased tension. The muscle here is firm to touch, resistant to pressure and may feel warm. Trigger points can be identified using equipment too, because they emit electrical signals that are measurable. If you regularly use your hands to provide treatment, it is likely that you have trigger points in the muscles of your forearm, including the wrist extensor muscles where, instead of a specific, single point, they may also be felt as a twangy band that is tender or even painful when pressed, where more than one trigger point is located in the same band of muscle. Latent trigger points, which have been described as ‘clinically quiescent with respect to spontaneous pain’ (Simons et al, 1999), are only painful when pressed.

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Trigger point release | MASSAGE

LEARN MORE AT THE 2019 FHT TRAINING CONGRESS Jane will be giving a seminar at the 2019 FHT Training Congress at Holistic Health on Monday 20 May, called ‘Trigger Points for Beginners’. For more information, visit fht.org.uk/congress Jane is also teaching a two-day FHThosted workshop on Trigger Points for Beginners from 29 to 30 June in Birmingham. To register your interest, please email education@fht.org.uk

By comparison, an active trigger point ‘is always tender’ and produces referred pain and tenderness. Both forms of trigger points have a taught band within them that restricts range of motion.

WHY SHOULD TRIGGER POINTS BE TREATED? Trigger points are associated with a variety of problems, such as: Tight and weak muscles Decreased muscular strength Stiff joints Joint pain Muscle pain. They have also been associated with headaches, blurred vision, dizziness and sinus problems (Davies, 2004).

HOW ARE TRIGGER POINTS TREATED?

MEMBER OFFER FHT members can receive 20% off Soft Tissue and Trigger Point Release (RRP £32.99) when buying from humankinetics.com by entering the code FHT20 at the checkout. Offer ends 24 April 2019.

Massage and other modalities such as dry needling, anaesthetic injection and cryostretching are reported to reduce the sensitivity of trigger points and thus reduce the pain associated with these. In addition, STR can be used for reducing the pain of trigger points. STR is a form of stretching that can be incorporated into massage or used as a stand-alone technique. A specific point on the muscle is ‘locked’ by pressing into it, and then, while this pressure is maintained, the muscle is stretched. STR should not be used if clients bruise easily, have fragile skin or osteoporosis. It needs to be used with caution on clients who have a known hypermobility syndrome or a condition affecting the nervous system as the effects of STR can be unpredictable in these clients.

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MASSAGE | Trigger point release

TREATING TRIGGER POINTS IN... LEVATOR SCAPULAE Trigger points in levator Trigger point at scapulae produce pain inferior angle of locally as well as to the scapula medial border of the scapula and the back of the shoulder. When 1 active, these trigger points can limit rotation of the neck and cause feelings of neck stiffness. Many factors perpetuate these points, including carrying a bag on the shoulder of that side, retaining a static posture with the head turned to one side, using a walking stick that is too long (which causes the shoulder on that side to be elevated), as well as repetitive overhead actions of the arm. The easiest trigger point to identify is the one that lies close to the insertion of the muscle at the inferior angle of the scapula (Figure 1). To make palpation of this trigger point easier, position your client so that the trapezius is passively shortened by sitting them at a right angle to a table, with their arm resting on the table with a cushion beneath. Then palpate through the trapezius to locate the superior angle of the scapula and the trigger point in levator scapulae. The active-assisted type of STR is an ideal way to deactivate trigger points in levator scapulae. This is because the client performs active neck movements during the stretch, within their comfort level, making it unlikely that the neck tissues would be overstretched. Levator scapulae is often lengthened anyway, so STR is a useful way of deactivating a trigger point and reducing tension in the muscle, without further lengthening the tissues. Deactivation of triggers in scalenes and posterior cervical tissues is also very useful in this example, as these too restrict movement in the neck and can inhibit release of levator scapulae. Although STR can be used ‘dry’, it is more effective to gently soothe the area first using massage. In this case, massage the side of the neck and shoulder as you would normally, and then place a small cloth over the area before continuing with STR. The purpose of the cloth is to prevent your ‘lock’ from slipping. STR to levator scapulae is contraindicated in pregnancy. STEP ONE: Locate the trigger point in levator scapulae, perhaps by palpating up the medial border of the scapula until you reach the superior angle (Figure 2). In our example, the client is seated with their arms resting by their sides, but could just as well have their arm resting on a table, passively elevating the shoulder.

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After the stretch, soothe the area using massage. Palpate for the trigger point again and ask your client whether there has been any change in discomfort when it is pressed. If the STR has been effective, you should find that you need to press more firmly to elicit the same degree of discomfort as prior to the stretch.

STEP TWO: Lock the muscle by gently but firmly using your thumb or elbow (Figure 3). Notice that it can be helpful to direct your pressure ever so slightly downwards. This is because when the stretch occurs, your thumb or elbow will be drawn upwards, away from the trigger point so very slight downward pressure will help you remain fixed on the point.

A client can attempt deactivation of this trigger point by using the hooked end of an umbrella (Figure 5) or a self-massage tool, such as a Backnobber. Another option for self-treatment is to use a tennis ball. This is great for self-treatment of rhomboids but it can be difficult to get the ball in the correct place on the levator scapulae muscle. 3

CASE STUDY STEP THREE: Maintaining gentle pressure over the trigger point, ask your client to slowly turn their head away from you about 45 degrees, and then look to the floor (Figure 4). Maintaining this stretch position for around 30 seconds is beneficial, but many clients may not be able to tolerate this, so encourage the client to return to the start position sooner if they need to.

In a randomised clinical trial, De Meulemeester et al (2017) compared trigger point dry needling with manual pressure for the deactivation of trigger points in 42 female office workers who each did a minimum of 20 hours of computer work per week and had myofascial neck or shoulder pain. Baseline measurements were taken using a numerical rating scale, the Neck Disability Index, pressure pain thresholds and muscle characteristics. Six trigger points were identifi ed for treatment, including levator scapulae, and participants were treated once a week for four weeks. At the end of the study, no significant differences existed between the dry needling and manual pressure groups; both resulted in a significant improvement in NDI scores. Significant improvements also occurred in the other outcomes of pain, muscle elasticity and stiffness.

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Trigger point release | MASSAGE

STEP ONE: The application of heat can be HAMSTRINGS helpful in reducing Trigger points are found tension in tissue throughout the middle Semimembranosus prior to STR. Ask and lower portions of Se Semitendinosus your client to try all hamstring muscles Biceps femoris (long head) and identify trigger – semimembranosus, points in their semitendinosus and hamstrings either by biceps femoris. Triggers 6 7 palpation or by using here may refer pain to the a small ball positioned back of the knee and to the proximal part of the between their thigh and a chair (Figure 7). STR posterior thigh and are perpetuated by activities of any kind is contraindicated for clients with such as sitting for prolonged periods of time varicose veins in this area. with the knees flexed, as when driving or seated at a desk, or when immobilised in bed or a wheelchair following injury or illness. Prolonged STEP TWO: Once the trigger is identified, pressure to the back of the thigh is another the client simply straightens their leg perpetuating factor. You can palpate trigger (Figure 8) and holds this for 30 seconds points in this muscle group with your client in if possible. The advantage of this is that the prone, side-lying or even supine position, in activation of the quadriceps, which is each case with the knee flexed. required for knee Pain radiating down the back of extension, helps reduce the leg can be an indication of tone in hamstrings and trigger points in hamstrings. can aid deactivation of the Advising a client how to trigger point. Soothing the deactivate triggers in their area with massage afterwards hamstrings is a useful adjunct to is useful in reducing any the treatment you might provide soreness and reducing the 8 as a therapist. likelihood of bruising.

Infraspinatus

INFRASPINATUS

Trigger points are found throughout this Teres minor muscle (Figure 9) and usually develop from sudden overload rather than overuse. They refer pain to the front of the shoulder and to the medial border of the scapula, which can radiate 9 down the anterolateral aspect of the arm. To deactivate trigger points in infraspinatus, use active-assisted STR. STEP ONE: Begin with your client resting prone, with their arms resting by the sides of the body, externally rotated at the shoulder (palms of the hands against the couch). Warm the area with massage. Palpate for trigger points and when you find one, depress it gently using your thumb (Figure 10). STEP TWO: Maintaining this pressure, ask your client to slowly turn their hands so that the back of the hand now rests on the couch. It can be difficult to maintain your lock on the trigger point as the client rotates their arms internally. In this example, using less pressure, rather than more, to fix the lock can help you stay over the trigger point. Hold the end position (arms internally rotated, back of the hands on the couch) for 30 seconds if possible. Soothe the area with massage and assess the trigger point again.

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CASE STUDY Using a group of 30 physically active males with tight hamstrings and at least one trigger point, Trampas et al (2010) compared the effects of trigger point release with stretching alone and a control group. They measured knee range of movement, stretch perception, pressure pain threshold and pain subjectivity (using a Visual Analogue Scale) pre- and postintervention. Non-painful crossﬁbre friction massage was used over the trigger points in the trigger point plus stretch group. Both groups showed improvements in post-treatment measures compared with the control group; and the group that received trigger point massage as well as stretching showed a signiﬁcant improvement in outcomes compared with the group who only received stretching.

CASE STUDY Hidalgo-Lozano et al (2010) explored the relationship between trigger points and pressure-pain hyperalgesia in 12 patients with unilateral shoulder impingement, 42% of whom had trigger points in infraspinatus. Participants were also asked to rate their pain on a rating scale and to draw the location of their pain on a body map diagram. The pressure pain threshold over different trigger points was measured and compared with that of a control group of patients who did not have shoulder impingement. Signiﬁcant differences were found between the two groups. For example, the patients had a variety of active and latent trigger points, whereas the control group only had latent trigger points and the patient group had a signiﬁcantly lower pressure pain threshold. In the patient group, the intensity of pain correlated to the number of trigger points; the greater the number of trigger points, the greater the level of reported pain.

Jane Johnson is a sports massage therapist, chartered physiotherapist and author. Jane has updated her Soft Tissue Release book, and the second edition includes information about how to use STR to treat trigger points. jane@janejohnson.co.uk

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ESSENTIAL OIL PROFILE | Cypress

CYPRESS

(Cupressus sempervirens) The cypress is a tall, narrow evergreen tree that grows up to 15 metres in height, with aromatic, scale-like leaves and small spherical cones. Synonymous with the Mediterranean countryside – and Tuscany in particular, where it can be found majestically lining roads, driveways and gardens – the tree’s essential oils are chiefly produced in France and Spain. Steam-distilled from the leaves and twigs, the oil is colourless to very pale yellow, and has a woody, spicy aroma and base to middle note. Often found growing in cemeteries, Davis (2005) notes that the ancient Egyptians and Romans dedicated the tree to their gods of death and the underworld, with its evergreen leaves perhaps symbolising life after death. Hippocrates is said to have recommended cypress for severe cases of haemorrhoids with bleeding (Battaglia, 2002), a use it is still indicated for today because of its reputation as a venous decongestant/phlebotonic. Some of its chief uses the female ses in aromatherapy h py are to help regulate reg reproductive system, reduce duce excessive fluid in the body, and calm the nervous system. A powerful astringent, ent, it can be used to address a number of skin concerns, and its deodorising effectt makes it a useful addition to footbaths for sweaty feet.

is non-phototoxic and the ‘low reproductive toxicity of α-pinene, β-myrcene and [+]-limonene […] suggests that the cypress oil is not hazardous in pregnancy’.

RESEARCH Antimicrobial activity An Iranian study published in 2013 that tested the antimicrobial activity of methanol-extracted taxons from 11 different Iranian conifers found that those taken from Cupressus sempervirens demonstrated antimicrobial activity against Pseudomonas aeruginosa and Staphylococcus aureus . The authors concluded that ‘these results indicate that the essential oils derived from coniferous trees [including Cupressus sempervirens], which have mild antimicrobial properties, can inhibit the antimi antimicro growth of gram-positive and gram-negative gram-ne bacteria and fungi’. Respiratory complaints Interestingly, while cypress essential oil is indicated for respiratory complaints, including asthma, a recent study in adolescents living in southern Italy (Liccardi et al, 2018) indicated that Cupressus sempervirenss pollen was a sensitising agent for 4.9% of 443 subjects with asthma.

Botanical family Cupressaceae

Chemical composition Hydrocarbons – Monoterpenes: α-pinene (up to 53%), δ-3-carene, terpinolene, ene, [+]-limonene, β-pinene, sabinene, e, β-myrcene. Sesquiterpenes: δ-cadinene. adinene. Alcohols – Sesquiterpenols: cedrol. rol. Monoterpenols: α-terpineol, terpinen-4-ol, borneol. Esters – α-terpinyl acetate, terpineninen4-yl-acetate. The chemical composition of any essential oil can vary greatly according cording to the plant species, the climate, altitude titude and soil where the plant is grown, and d when it is harvested. Refer to the manufacturer’s acturer’s safety data sheet for a breakdown wn of an oil’s chemical proﬁle.

PICTURE: ISTOCK

Therapeutic properties

Antibacterial, antiseptic, antispasmodic, smodic, antisudoriﬁc, antitussive, astringent, gent, calming, decongestant, deodorant, nt, diuretic, insecticide, phlebotonic. c.

berry, lavender, marjoram, myrrh, h, patchouli, rosemary, sandalwood..

Indications

Safety data

Asthma, broken capillaries, bronchitis, chitis, cellulite, circulation (poor), cough, h, cramp, dysmenorrhoea, haemorrhoids, rhoids, incontinence, irritability, menorrhoea, rhoea, night sweats (menopause), oedema, ma, perspiration (excessive), rheumatic atic swelling, skin (oily, over-hydrated), varicose se veins, whooping cough.

In Essential Oil Safety, Tisserand and Young (2014) stress that the oil can cause skin sensitisation if oxidised. They go on to state that ‘because of its high α-pinene [up to 53%] and δ-3-carene [up to 22%] content we recommend that oxidation of cypress oil is avoided by storage in a dark, airtight container in a refrigerator. The addition of an antioxidant ant to preparations containing it is recommended.’ They also highlight that cypress essential oil

Blends with Bergamot, frankincense, ginger, lime, juniper

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REFERENCES S For references and further reading, visit fht org uk/IT r fht.org.uk/IT-references

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Peace of mind for you with our

tailor-made insurance Now with personal accident cover as standard At the FHT, we’re extremely proud to support members with our robust package of membership EHQH¿WV. And thanks to our insurance partners Hiscox, we’re also able to ensure that you’re covered with an insurance policy that keeps you and your clients safe. Our medical malpractice, public and products liability insurance policy covers more than 360 therapies, with lots of added extras included too: • Up to £5,000 to cover expenses that arise from identity fraud • Up to 30 days cover to work abroad • 5HSODFHPHQW RI¿FLDO GRFXPHQWV LI ORVW RU irrevocably damaged

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14/01/2019 10:34

Taking charge of

HEALTH

DR SARAH STEWART-BROWN, PROFESSOR OF PUBLIC HEALTH AT WARWICK MEDICAL SCHOOL, TALKS TO THE FHT ABOUT COMPLEMENTARY THERAPIES, MENTAL WELLBEING AND HER CURRENT RESEARCH INTERESTS

PICTURE: ISTOCK

WHEN AND HOW DID YOU DEVELOP AN INTEREST IN COMPLEMENTARY THERAPIES?

I developed a curiosity about Chinese medicine in the late 1990s, during a very stressful period in my life. I started to practice qi gong and tried acupuncture. I became more and more intrigued the more I experienced. Then I got breast cancer, and it became clear that radiotherapy, chemotherapy and Herceptin were not going to be good for me overall, even though the trial statistics said that they benefited the average woman with the sort of cancer I had. So, having had a wide local excision and hormone treatment, I set about investigating the benefits of different complementary, alternative and integrative approaches (CAIA) the best way I knew how – by experiencing them for myself. A friend

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introduced me to the body work called zero balancing, and I was so taken with the fact that this apparently simple therapy could induce a relaxation response in me like no other that I decided to train to become a practitioner. I went on to become a teacher in zero balancing, and trained in emotional freedom technique and deep massage.

WHAT DO YOU SEE AS THE BIGGEST CHALLENGES FACING PUBLIC HEALTH? The importance of mental health – not just mental illness, but the ordinary everyday mental health challenges we all face. Mental health underpins everything, including physical health and relationships, but quite a lot of the medical profession and the public really don’t want to see this. Another challenge is to legitimise a greater focus on

the positive, on strengths and solutions rather than on what is wrong. We need to understand more about ourselves and our interaction with others and to take charge of our own health to a greater extent.

WHAT WOULD YOU SAY ARE THE KEY DETERMINANTS OF MENTAL WELLBEING? There are external and internal determinants. The most important of the external are relationships with other people. It is the very earliest relationships – those we form in infancy – that have such a profound influence on the wiring of the emotional and social brain. They set the thermostat on our stress response and determine the extent of resilience we experience as adults. Things such as food, physical activity, the workplace environment, adult relationships and green spaces are among the many other influences. Classic risk factors such as income and education play a role, but the relationship is complex because mental health problems influence our capacity to learn and to earn, so the relationship is bi-directional.

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Interview | COMPLEMENTARY

DO YOU THINK MINDFULNESS COULD BE USED ON A WIDER SCALE TO IMPROVE MENTAL HEALTH? Mindfulness is one very valuable tool for increasing mental wellbeing, and more and more people are finding it helpful. But some people find that they get on better with meditative movement such as yoga or tai chi. Physical activity, making music and creating beautiful things are all tried and tested methods. It is important people experiment and find what works for them.

TELL US A BIT ABOUT YOUR CURRENT RESEARCH INTERESTS…

It is possible to influence the wiring of the emotional and social brain in adulthood, and so what happens in infancy does not need to dictate how we feel and relate throughout life. One of the main ways this is done is by developing greater self-awareness and increasing our capacity for self-regulation.

TELL US A BIT ABOUT THE UNIVERSAL WELLBEING AND MINDFULNESS PROGRAMME AT WARWICK MEDICAL SCHOOL… The wellbeing and mindfulness programme offered as part of the personal and professional development teaching at Warwick aims to introduce students to the idea that their personal wellbeing matters for their learning and memory, their performance as the doctors they will become, and their own health and happiness. They consider the ways that they already combat stress and enhance their resilience, and we introduce them to mindfulness as one evidence-based way of developing selfawareness and self-regulation.

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Recently, I have focused on the development and validation of outcome measures. Quantitative (number-based) evaluation is favoured in healthcare, and outcome measures can transform client or patient experiences into numbers. So they can help bridge the gap between conventional biomedical approaches and holistic approaches. I started with the WarwickEdinburgh mental wellbeing scale (WEMWBS). This is a very simple 14-item scale that has proved enormously popular for several reasons. It is simple to use and makes concrete what had previously been thought of as a bit of an ‘airy-fairy’ idea, allowing both clinicians and patients to focus on the positive. Because CAIA affect mental wellbeing, WEMWBS is very good at quantifying health improvement in this context. One of the great strengths of WEMWBS is that it can compare the effectiveness of interventions and approaches across sectors. There are many things that CAIA offer that aren’t explicitly covered by WEMWBS, and recently I have had the opportunity of working with Nicola Brough to develop an outcome measure called the Warwick Holistic Health Questionnaire (WHHQ) that picks up on this. Key among these are increases in self-awareness and empowering clients to take control of their own health (see page 46).

DO YOU THINK COMPLEMENTARY THERAPIES CAN PLAY A BIGGER ROLE IN IMPROVING PUBLIC HEALTH? In order to impact the ubiquitous high levels of stress in today’s society, people need to take charge of their own health and to practise activities that support selfregulation and self-awareness. We need to move from a health service that aims to look after people to one that helps people look after themselves better. CAIA often have a better grasp of how to do this than conventional approaches. There is such a high level of suspicion

and fear among many of the medical profession. Methods of evaluation favoured in traditional medicine are very ill-suited to CAIA. Most of the doctors I meet who appreciate CAIA do so because they have experienced the effects. So one approach is to introduce wellbeing services that offer CAIA for health professionals. Another barrier I am trying to tackle is the lack of understanding among traditional healthcare professionals that the state of our minds – the negativity/positivity, the extent of stress, the feeling of being overwhelmed – all have a profound influence on the functioning of the body and so play a big role in determining future health and longevity.

WHAT CAN THERAPISTS DO TO PROVE THAT THEIR THERAPIES ARE EFFECTIVE? Setting up a simple audit process and using a patient-reported outcome measure is a good start – asking clients to complete, for example, the WHHQ before sessions so it is possible to monitor improvements in wellbeing (or lack of them) over time. Clients also value seeing that they are getting better in this way. Qualitative research is also of great value in bringing to attention the value of these therapies in a systematic way.

HOW DO YOU TAKE CARE OF YOUR OWN HEALTH AND WELLBEING? An important mainstay for me at present is belonging to the Ridhwan School, which addresses personal development in many ways, including spiritual teachings, meditation, embodiment and inquiry – a process where students support each other’s personal inquiries with presence and compassion. I also have a daily qi gong and meditation practice. I visit a splendid massage therapist, and for the last two years I have been having trauma therapy.

TELL US A BIT ABOUT SARAH… I have two children and four grandchildren who I like to see a lot of. I see friends, sing with community choirs, walk, garden and go to the cinema.

Dr Sarah StewartBrown began her career as a paediatrician in hospitals, before switching to public health; she has been working in higher education since 1994. She is committed to bridging the gap between CAIA and conventional medicine.

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COMPLEMENTARY | Integrated health

NHS

role model GWYN FEATONBY, 2018 FHT TUTOR OF THE YEAR AND EDUCATION LEAD AT THE NHS NATURAL HEALTH SCHOOL, TALKS ABOUT DEVELOPING THE FIRST NHS-APPROVED COMPLEMENTARY THERAPY SCHOOL

omplementary therapies (CTs) are more widely known and accepted throughout the UK than ever before, with many hospitals, hospices and GP practices now offering patients access to services. Added to this, a wealth of online and media resources means there has been a shift in the way the public chooses its healthcare options and practitioners.

This is good news for complementary therapists with a drive and passion to provide quality-assured, evidence-based treatments for their clients, but the increase in demand for therapies throughout the NHS has created a number of concerns and problems for patients, practitioners, service managers and commissioners. The NHS Natural Health School, located in Harrogate District Hospital, is the first NHS-approved and -owned CT school,

developed and run by NHS employees and built upon the ethos of taking the core values of patient care and applying these to our learners.

CURRENT HEALTHCARE CLIMATE The sole purpose of the NHS is to provide free healthcare at the point of need. As we regularly hear in the news, NHS resources struggle to meet the ever-increasing demands of more patients requiring more care than ever before. Coupled with this, the healthcare needs of the population are increasingly complex. Improvements and innovation in both medicine and social standards mean that people live longer; consequently, we have seen a huge increase in people living with long-term conditions such as diabetes and heart disease, and in survivors of diseases such as cancer that may have been fatal just a decade ago. Looking at cancer statistics alone, we know that someone is diagnosed with cancer every two minutes and it is estimated that, by 2030, around 50% of the UK population will be diagnosed with cancer at some point in their lifetime. The good news is that more than half of cancer patients are living 10 or more years, but clearly there are vast numbers of people who need support. The cost of managing such a complex population with limited resources means it is unlikely that CT will ever be a priority

The Sir Robert Ogden Macmillan Centre in Harrogate

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Integrated health | COMPLEMENTARY

for the NHS. Simply put, if the money is available for one treatment, should it be chemotherapy for a child with leukaemia, or CT to help relieve their symptoms? The money is just not available through central NHS funding to provide CT as a treatment option for all patients. This lack of equity, and the ability to provide it free to all, means that it is unlikely to find its way into mainstream healthcare without a self-funding model that will secure sustainability – one of the key requirements of ethical healthcare. Added to this, NHS managers have a duty to ensure that the services they commission for their patients are effective, qualityassured and safe. This can be problematic because many foundation-level courses in CT actively teach that treatment of patients with complex needs is contraindicated. Consequently, many practitioners qualify without any exposure to patients with complex healthcare needs and therefore may lack the necessary skills, experience or knowledge to treat such patients once they have completed their initial training. NHS managers and commissioners often have no benchmark when it comes to retaining the services of complementary therapists. Practitioners have to negotiate a sea of often unregulated, unaccredited and expensive postgraduate training in the hope that the CPD course they choose will offer the correct level of information required to be accepted by their preferred NHS department. Put the two issues together and we find that therapists could potentially be paying for training that will not improve their chances of paid work within the NHS, firstly because the funding isn’t there, and secondly because service commissioners do not feel confident that safeguarding and the quality agenda can be met.

“By welcoming learners into the multidisciplinary care team, we believe that we will help create confident, competent practitioners ready to meet the needs of a demanding industry” multidisciplinary care team, we believe that we will help create confident, competent practitioners ready to meet the needs of a demanding industry who are able to support the provision of specialist care for a wide range of patients and clients. Our courses, however, are not purely for those looking for an NHS post. We can all benefit from evidence-based clinical training. If we go back to the statistics referred to earlier, 50% of the population may be affected by cancer during their lifetime by 2030. Without the correct training and understanding to treat such patients, CT practitioners may be reducing their target market by 50%. Regardless of the therapy or area we choose to work in, we will all be exposed to more and more clients with complex health needs. Some of the courses we offer include foundation-level training in a range of therapies – aromatherapy, reflexology and massage – and we also work in collaboration with other training providers to offer

Bowen therapy, the Emmett technique and emotionally focused therapy, and a host of CPD and advanced courses enabling complementary therapists to specialise in many areas of complex patient management. One of our most innovative developments to date is the NHS certificate programme for complementary therapists. This programme, the first of its kind, focuses largely on the supervised clinical experiences we offer qualified practitioners within the hospital and allied health provider premises. An individual learning portfolio allows negotiation of personal learning objectives under the supervision of an approved mentor. Working directly with our patients allows the learner to gain a deeper understanding and hands-on experience of treating patients with complex illnesses. Added to the work placement, learners undertake competency-based learning programmes that meet the essential standards as directed by the Care Quality Commission (CQC), national occupational standards and agreed competencies for the specialist pathway as set by the clinicians working within each department. As our courses are NHS products, we comply with CQC standards. As such, our learners must have DBS clearance and complete other employment checks prior to exposure to our patients. Pathways are available for cancer and palliative care, occupational health and maternity, with further specialities being developed over the next 18 months. The programme is

PICTURES: INFINITE 3D; ISTOCK; CHRIS NORTH

PROVIDING SUSTAINABILITY AND QUALITY The NHS Natural Health School has evolved as an innovative way to address the two main concerns of sustainability and quality, and our mission is to provide CT diplomas and CPD courses that will uniquely include practical placements and clinical supervision within the NHS. We know from experience that when CTs are integrated into patient care, we are able to deliver safe, high-quality care that fulfils the needs of even the most complex of patients. By welcoming learners into the

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COMPLEMENTARY | Integrated health

A royal hospital visit, with an NHS patient receiving care from Julie Crossman

being licensed through NHS Innovations and, although currently available only within Harrogate, there are plans to potentially license out to other trusts in the future.

GETTING OFF THE GROUND Developing the school has been no easy task. Before Harrogate and District Foundation Trust (HDFT) would even consider such an undertaking, a great deal of work had to be done. Firstly, evidence that the therapies to be included were of benefit to our patients had to be demonstrated, a task which fell largely to Julie Crossman, MFHT, CT lead at the Sir Robert Ogden Macmillan Centre within HDFT. Julie used Measure Yourself Concerns and Wellbeing – or MYCAW – to evaluate every patient treated over a four-year period. The data provided rich evidence to show that a CT service was safe, cost-efficient and effective in the reduction of many symptoms experienced by patients undergoing cancer treatments. A further project demonstrated that offering staff CT made a significant impact in reducing short-term sickness absence, and this was used as a driver to promote a specialised occupational health pathway for practitioners undertaking the NHS certificate training. Once the benefit to our patients was evidenced, a great deal of work was required to put together a business plan that included risk assessments, financial projections, policies and sustainability. Although the business is part of the HDFT portfolio, almost £90,000 had to be raised to ensure that staffing and set-up costs would be met. This is standard practice within many NHS departments, with staff fund-raising for new equipment and services all the time, but it has to be done on top of the day job, and is no easy task in today’s financial climate. We have been very lucky to have a strong manager, fully committed to the development of the business. Sarah Grant, health and wellbeing manager, has led the project from the outset, pulling together and driving forward the business plan, and attending countless meetings to provide assurances for HDFT that the business would be both sustainable and quality-assured, and ensuring robust financial governance.

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“We strive hard to ensure that we see a huge quantity of patients without losing our ethos for holism, compassion and drive” The amount of work and expertise in driving innovation within the NHS cannot be underestimated. It is important to stress that the school did not just pop up out of nowhere – it has taken four years of tough challenges to get to this stage. Sarah does not have a therapy background, but she is very dedicated to improving patient wellbeing and has a great deal of knowledge and understanding around business development within the NHS. The school would not exist today without her leadership.

patients, students and staff. In the case of patients, being told this makes them feel in safe hands; learners know that their unique needs and learning objectives will be respected; and for staff, it tells us that if we don’t look after number one, we can’t look after anyone else. Self-care is vital and we invite practitioners to attend specialised CPD workshops we have developed that cover all aspects of self-care planning – from clinical supervision and mentorship right through to the science behind why the ‘bubble of light’ does actually work to protect us. So, given the time and effort required to set up an NHS school, is it worth it? Current activity suggests that we will have a selfsustaining CT model within a year. Student recruitment is going well and our first diplomas are underway; many CPD courses are well subscribed, and the NHS certificate is attracting a great deal of interest. Of course that does not mean we can rest on our laurels. Business remains tough and uncertain throughout all UK industries and we will need to continue to develop, but yes, the benefits are absolutely worth it. To be able to use this model to fund CT free at the point of delivery for our cancer patients who would otherwise miss out on beneficial treatments is a very significant start. But we also recognise that there are many patients treated within other specialities who would benefit from our services and so integration throughout the whole trust is where we have set our sights.

SUPPORTING OUR STUDENTS Resilience is a key skill required to succeed within the NHS. Practitioners are exposed to levels of distress they are unlikely to see in everyday practice. Coupled with this, we strive hard to ensure that we see a huge quantity of patients without losing our ethos for holism, compassion and drive. We recognise the challenges for caregivers within high-stress industries, and it seems somewhat paradoxical to train expert therapists at high risk of burnout. Consequently, self-care forms a core part of every course we deliver. Resilience comes from recognising how you feel will affect both the longevity of your career and the quality of care you are able to provide. Our strapline, ‘You matter most’, applies to our

Gwyn Featonby is a qualiﬁed nurse and complementary therapist with more than 35 years’ experience. She is education lead at the NHS Natural Health School in Harrogate. Along with her colleagues, she won a 2018 Complementary Therapy Award for furthering integrated healthcare and is 2018 FHT Tutor of the Year. nhsnaturalhealthschool.co.uk

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FHT CONFERENCE AND AWARDS | Winners

THE FHT SUPPORTS THE INTEGRATED HEALTHCARE AGENDA AND CELEBRATES EXCELLENCE AT ITS ANNUAL CONFERENCE

Onwards and

UPWARDS T

he 2018 FHT Conference brought together leading experts in research, education, and health and social care to discuss some of the many ways professional therapists can help to support the public and health professionals, and share successful models of integrated healthcare. Held at The King’s Fund, London, on 29 November, the conference got under way with two research-focused presentations. Professor Nicola Robinson discussed some key issues surrounding the collection and use of evidence base for therapies, while Dr Julie McCullough highlighted the positive findings of a trial that looked at antenatal reflexology for women with pregnancyrelated low back and/or pelvic girdle pain.

“It’s not what’s the matter with the patient, it’s what matters to the patient” Sir Sam Everington

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Winners | FHT CONFERENCE AND AWARDS

PICTURES: ISTOCK

MEET THE WINNERS OF THE 2018 FHT EXCELLENCE AWARDS

Delegates also enjoyed listening to presentations from two of the most influential GPs in healthcare – Sir Sam Everington and Dr Michael Dixon. Sir Sam left delegates captivated with an insight into the Bromley by Bow Centre, a practice that has transformed healthcare in one of the most diverse and economically deprived areas in London through community-based integrated services and referrals. Dr Michael Dixon then looked at the potential of social prescribing and personal health budgets, giving delegates an overview of the Culm Valley Integrated Centre For Health in Devon. Like Bromley by Bow, Dr Dixon’s practice champions social prescribing and community health through integrated care, but serves a very different local community. He highlighted that if patient-centred community care can work in Bromley and Culm Valley, it can be implemented anywhere in the UK. Discussions then centred around how therapists could convince the NHS to work with them in their local communities. Both GPs said it is important to ‘win over the hearts’ of medical professionals – and although this can take time, it is important to persist. Talks by Anita Mehrez, MFHT, a member of the complementary health and wellbeing team at The Christie NHS Foundation Trust, and Jennifer Young, MFHT, founder of Beauty Despite Cancer, offered delegates an insight into how therapies have been successfully integrated into the NHS, working alongside conventional medical care to support those impacted by cancer. The day’s programme was then rounded off by conference host Janey Lee Grace – a regular presenter on BBC Radio 2 and UK Health Radio – announcing the winners of the 2018 FHT Excellence Awards, which serve to recognise those raising the bar in therapy training and practice.

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COMPLEMENTARY THERAPIST OF THE YEAR Winner: Jane Sheehan Jane’s ambition had always been to successfully integrate complementary therapies into mainstream care. It was an ambition she went on to realise in 2009, when she took on the role of complementary therapy coordinator at an NHS specialist palliative care hospice in Norwich. Drawing on 36 years of experience as a qualified nurse and 29 years as a complementary therapist, Jane developed the existing complementary therapy service to create a safe delivery model to benefit patients, therapists and healthcare professionals alike. Among other achievements, she was responsible for: Bringing the therapy service in line with clinical governance Developing a robust complementary therapy policy Creating a sustainable delivery model with therapists employed by the NHS, providing security for them and the patients receiving their care Designing a bespoke model of care for patients wanting care at home Developing protocols for using aromatherapy for malodorous wound care Introducing MYCAW to measure patient-related outcomes Providing experiential learning for healthcare staff to promote therapy awareness. Jane’s nomination was supported by dozens of testimonials and letters of support from clients, colleagues and

industry experts, including Dr Jane Buckle. Read about Jane’s work in palliative care at fht.org.uk/Sheehan-palliative Highly Commended: Kelly De Souza Kelly works in a specialist palliative care setting where she provides much-needed complementary therapies to patients. She has also been instrumental in developing a number of key projects, including a staff welfare programme for those working in end-oflife care, a self-management education programme for patients, and integrating therapies into a bereavement service for children and local nursing homes. Highly Commended: Marc Johnson Marc retrained as a therapist after being critically injured while serving as a medic in Iraq. Now a qualified hypnotherapist, psychotherapist and acupuncturist, he runs a busy clinic and is an administrator of the Post Major Incident Therapist Network on Facebook, which provides free therapeutic support to victims of major incidents. This volunteer role has seen him working with survivors of the Manchester Arena bombing and the Las Vegas mass shooting. Highly Commended: Julie McCullough The research Julie carried out for her PhD at Ulster University has significantly contributed to the evidence base for complementary therapies. The results of The CAM in Pregnancy Trial indicate that reflexology in the third trimester is safe, reduces the duration of the second stage of labour, and reduces low back and/or pelvic girdle pain and associated stress in women pregnant for the first time. To read more about Julie’s work, visit fht.org.uk/reflexology-pregnancy Finalists: Robert Sylvester Coleman, Julie Crossman, Jackie Grimley, Nicolle Mitchell.

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FHT CONFERENCE AND AWARDS | Winners

SPORTS THERAPIST OF THE YEAR

Like all FHT coordinators, Alison goes to a great deal of effort to support local therapists and organise a varied calendar of events for them each year. However, what made her entry stand out from the rest was that she was nominated by an FHT member who doesn’t live in her area and hasn’t physically attended any of her meetings. For personal reasons, the member who nominated her is unable to travel to the group meetings near her home, but she has been able to enjoy the content of Alison’s meetings through Skype, webinars and other online platforms. In her own words: ‘In many industries, the way in which Alison works is commonplace, indeed essential to business performance, yet online communication for some reason is behind in the complementary healthcare world. ‘Through her knowledge of social media, she has been able to share information with those who are unable to attend their local FHT meetings. Alison has far exceeded the requirements set out by the FHT to provide a local support group.’

Winner: Nefeli Tsiouti Nefeli is a sports massage therapist with a background in dance and dance science. She has chosen to focus her work and research efforts on improving health and reducing injury in dancers, performing artists and other movers in general. From first-hand experience she knows how prone this group is to injury and that some performers, such as breakdancers, are not invested in properly when it comes to injury prevention education. To address this, she collaborated with other dance and medical experts to offer conditioning, strengthening and injury prevention workshops and lectures to dancers in several countries. She is also currently conducting research into dancers’ injuries, physiology and biomechanics, as an associate researcher at Cyprus Musculoskeletal and Sports Trauma Research Centre. Nefeli also recently received first prize, along with a prize for Most Innovative Idea, at a competition for entrepreneurial business start-ups, where she pitched her idea to investors regarding a Performing Arts Medicine and Science Institute that she will be launching in 2020 in Cyprus.

STUDENT OF THE YEAR

Finalists: Sheree Phelps, Sophie Vowden. Category sponsor: Physique.

Winner: Brian Jauncey Brian entered the field of complementary therapy as a mature student at the age of 42.

LOCAL SUPPORT GROUP COORDINATOR OF THE YEAR

The simple act of twisting to get out of a car one day resulted in two prolapsed discs which meant he couldn’t work for 16 weeks, leaving his manual career in jeopardy. Spinal surgery was recommended, which was promptly refused, and it was when trying different therapies to help with his back problem that Brian discovered the benefits of massage and acupuncture. In his own words: ‘Through these modalities, I was able to manage my pain, mobility and quality of life to a degree that I never thought possible.’ With the support of his family, he decided to enrol on a Complementary Therapy in Healthcare degree at Wrexham Glyndŵr University so that he could help others in a similar situation. Brian quickly developed a passion for learning and as the nominated representative for his course, helped to promote the university at open days, performing demonstrations and talking to prospective students. Having just gained a first for his degree, he is already looking at other ways to expand his skills and knowledge. Finalist: Teresa Elliott.

TUTOR OF THE YEAR Winner: Gwyn Featonby A qualified nurse, Gwyn has been practising complementary therapies for more than 30 years. Much of her work has been within

WITH THANKS TO OUR CONFERENCE AND AWARDS SPONSORS, SUPPORTERS AND ATTENDEES

Winner: Alison Brown

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Winners | FHT CONFERENCE AND AWARDS

hospitals and hospices, where she used therapies to help adults and children manage symptoms related to cancer and other long-term or lifethreatening conditions. Today, Gwyn is education lead at an NHS-approved school, which she helped to develop as part of a dedicated team. The NHS Natural Health School is dedicated to training the next generation of expert therapists, and is part of a self-sustaining model that provides free treatments to patients at a Macmillan cancer centre based in the same hospital. It’s at this school that Gwyn delivers a unique NHS Certificate in Complementary Therapies, a competency-based programme that provides Level 3 students with the skills and experience necessary to practise in an NHS setting and ensure they meet the needs of patients with complex health needs. In the words of someone who has known Gwyn for 15 years: ‘She is very modest in her achievements but I, and a lot of others in the complementary therapy field, know that she is an amazing practitioner, an informative, knowledgeable and approachable teacher and a pioneer in the complementary therapy field.’ Read an article about the NHS Natural Health School on page 20. Highly Commended: Dawn Morse Dawn offers private training in a range of sports therapy techniques. She has also lectured for the University of Bath and the Open University. As well as her excellent classroom delivery, she also supports learners remotely, offering advice via text and a dedicated Facebook group. In addition, Dawn teaches people ‘on location’, including physios at the Welsh Rugby Union; she also runs yoga classes and retreats, and shares her expertise in trade and consumer publications.

Rachel Clark, lead complementary therapist, palliative care, Walsall Healthcare NHS Trust

The FHT Award for Complementary Therapy Research

CONGRATULATIONS TO WINNERS OF THE COMPLEMENTARY THERAPY AWARDS 2018 The FHT was proud to be involved in the presentation of the inaugural Complementary Therapy Awards, which took place on 18 October 2018 at a special celebratory lunch held in London. Organised by Chamberlain Dunn, these independent awards celebrated practitioners, teams and advocates enhancing the health and wellbeing of others through a variety of initiatives that focus on an integrated approach to patientcentred care. As platinum sponsor, FHT’s Governing Council and staff enjoyed working closely with Chamberlain Dunn throughout the development and promotion of these new awards, from offering guidance on the different awards categories, through to supporting the shortlisting and judging process, and presenting the FHT Award for Complementary Therapy Research on the day. The winners of the Complementary Therapy Awards 2018 are:

Overall Winner and The Award for Cancer Care Angie Buxton-King, director, Sam Buxton Sunflower Healing Trust Read an article about Angie on page 66.

The Award for Prevention and Self-Care Roberta Meldrum, director, The Letchworth Centre for Healthy Living

The Award for Palliative Care Elaine Cooper, clinical lead specialist, complementary therapies, and

Nicola Brough, clinic director, Torus Wellbeing Clinic, and Sarah StewartBrown, professor of public health, Warwick Medical School Read an article by Nicola and Sarah on page 18.

The Award for Mental Health and Wellbeing Naji Malak, co-founder and CEO, Stand Easy Military Support Special mention: Nicolle Mitchell, MFHT.

The Award for Pain Management, Injury Prevention and Rehabilitation Gina Reinge, sports therapist, The Reinge Clinic

The Award for Furthering Integrated Healthcare Gwyn Featonby, education lead and FHT accredited course provider, and Julie Crossman, MFHT, complementary therapy lead, NHS Natural Health School Read an article by Gwyn on page 20. Christopher Byrne, President of the FHT, said: ‘The FHT has been at the forefront of promoting high standards in therapy training and practice for more than 50 years, which is why we were extremely proud to support these new awards. In addition to our own FHT Excellence Awards, these will help to bring further recognition to the important role professional therapists have to play in not just supporting the public, but also the integrated healthcare agenda as a whole, one of the FHT’s key objectives.’

MORE ONLINE For more information and to read Chamberlain Dunn’s Complementary Therapy Awards 2018 Winners Guide, visit fht.org.uk/IT-127-CTA

Finalists: Maureen Bonner, Sharon Mountford, Jane Sheehan.

MORE ONLINE Visit fht.org.uk/blog and enter ‘awards’ in the search box to see a short highlights video of the conference and awards presentation.

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WHAT’S NEW

FHT in the press We are delighted to have contributed to a number of publications in recent months, helping to promote both the FHT and you, our members. Recent highlights include the following: g Natural Health magazine – FHT President Christopher Byrne talked about the energy-boosting benefits of acupuncture, amno fu massage, Chinese herbs, acupressure massage, qi gong and essential oils in the October issue, while FHT Vice President Mary Dalgleish highlighted the role of reflexology, aromatherapy and massage therapy in reducing stress and anxiety in its November edition.

In the Moment – In the October issue (#17) we turned our attention towards baby massage, looking at what a treatment typically involves, as well as five key benefits of the therapy. Following this, we asked readers of the November issue (#18) if they had tried cupping therapy. Both of these are part of a series in the magazine, which puts a spotlight on different therapies practised by FHT members.

Your Healthy Living – We shared an article on natural ways to boost fertility and support a natural pregnancy in the October edition.

Look out for more updates on the FHT blog and our social media channels, or see our advertising schedule at fht.org.uk/consumer-campaigns

FHT partners with Jing for free webinar The FHT is delighted to be partnering with Jing Advanced Massage Training for a free webinar on myofascial release for fibromyalgia and other chronic pain conditions. Taking place on Wednesday 27 March from 11.00 to 11.45am, this dynamic webinar will be hosted by Jing director Rachel Fairweather, who will talk about her upcoming myofascial release for fibromyalgia and other chronic pain conditions workshop at the 2019 FHT Training Congress at the Holistic Health Show. Chronic pain conditions such as fibromyalgia, chronic fatigue, irritable bowel syndrome, rheumatoid arthritis and ongoing pain from accident, injury or emotional trauma can be frustrating for the massage therapist to treat. Adding myofascial release techniques to your skill set can be highly beneficial in the treatment of these complex and chronic pain conditions. These versatile skills can be used as a stand-alone technique or incorporated into your existing bodywork practice. By registering for this webinar you will automatically be sent the recording, so if you can’t make it on 27 March – don’t panic. Last September, the FHT was pleased to partner with Human Kinetics for a free webinar with Jane Johnson on low back pain. This was very popular, and we hope the webinar with Jing will be just as successful.

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FHT members can gain one CPD point from watching the webinar and completing a reflective practice. Register your place at fht.org.uk/Jing-webinar

Read an article by Jing on page 36

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Top blog The FHT blog brings you the latest therapy news, health information and business resources. Here are some top posts that readers have enjoyed in recent months:

CRISIS AT CHRISTMAS APPEALS FOR VOLUNTEERS

SUPPORTING YOU TO SUPPORT OTHERS As Self Care Week approaches (12 to 18 November), we share some articles that will help to give you a little boost.

TURMERIC EXTRACT COULD BE USED TO HELP TREAT GLAUCOMA

Eye drops containing curcumin, an extract from turmeric, could be used to treat the early stages of glaucoma, according to a new study from University College London and Imperial College London.

HIGH-PROTEIN DIET SLIGHTLY INCREASES HEART FAILURE RISK IN MIDDLE-AGED MEN Crisis UK appeals for qualiﬁ ed complementary therapists to help its homeless guests relax and unwind at Christmas.

NEW UK HEALTH SECRETARY SUPPORTS PLANS TO INCREASE SOCIAL PRESCRIPTION Secretary of state for health and social care Matt Hancock addressed an audience in Manchester at NHS Expo, supporting plans to dramatically increase social prescription as ‘growing evidence’ suggests that encouraging patients to lead sociable, healthier lives could relieve pressure on the NHS.

MINDFULNESS IMPROVES SLEEP IN FIBROMYALGIA PATIENTS Researchers at the University of Derby have conducted the ﬁ rst-ever study focusing on exploring the effects of mindfulness for improving sleep in individuals with ﬁ bromyalgia.

For middle-aged men, eating higher amounts of protein can lead to a slightly more elevated risk for heart failure than those who eat it in moderation, according to new research from the University of Eastern Finland.

NEW LEAFLET HIGHLIGHTS POTENTIAL OF ACCREDITED REGISTERS WORKFORCE FHT members can download a leaﬂ et that outlines the key ﬁ ndings of a special report published by the Professional Standards Authority and Royal Society for Public Health in November 2017, entitled Untapped Resources: Accredited Registers in the Wider Workforce.

To read more, visit fht.org.uk/blog and enter a title in the search box.

Reﬂexology on the radio Dr Julie McCullough, MFHT, was recently interviewed for UK Health Radio, speaking to Nana Akua (aka LadyXsize) about the benefits of reflexology, with a particular focus on antenatal care. Julie’s interview formed part of a series on UK Health Radio, featuring interviews with industry experts put forward by the FHT. Other interviews featured Jennifer Young, MFHT; Dr Michael Dixon; Nicolle Mitchell, MFHT; and Carol Samuel, FFHT. As part of Julie’s PhD at Ulster University,

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she joined a team investigating the impact of antenatal reflexology on women experiencing stress caused by pregnancyrelated low back and/or pelvic girdle pain. Julie shared the positive findings of the trial in an article in International Therapist and at our FHT Conference in November. To listen to the interviews mentioned above, go to fht.org.uk/blog and enter ‘UK Health Radio’ in the search box.

FHT member wins ﬁrst National Massage Championship Congratulations to Mario De Sousa, MFHT, who has won the first ever National Massage Championship. Mario competed over two days against more than 70 massage therapists representing a wide range of disciplines, including Thai, Swedish, remedial, freestyle and chair massage. In the final, Mario competed against five expert massage therapists, including Tamer Morsy, MFHT, and was victorious after impressing judges with a 60-minute chair massage. Also finishing first in the chair massage category, Mario said: ‘Winning the competition was a tremendous honour for me, and a pleasure to be surrounded by amazing people. My congratulations to the organisers, judges and therapists.’ Congratulations also to Tamer Morsy, who achieved second place in the SPA wellness category and third in advanced massage. The judging panel was made up of nine industry experts, including FHT Vice President Mary Dalgleish. Mary said: ‘It was an honour to be invited to represent the FHT as a judge at the very first UK National Massage Championship. As well as having the opportunity to observe some of the best bodyworkers in action, it was great to connect in person with the other judges, who are all respected names in the CAM industry. ‘City Lux director Kate Tora and Carl Newbury from Massage World did a wonderful job of organising the event and have plans to make it even bigger and better next year.’

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BEAUTY | Skincare

PEEL POWER CANDICE GARDNER FROM DERMALOGICA TALKS ABOUT THE BENEFITS OF SKIN PEELS AND THE IMPORTANCE OF BEST PRACTICE

hemical peel services are in growing demand, largely because the results speak for themselves. I know first-hand the difference a skin service that gets results can have – not just on the skin, but on an individual’s self-confidence. I started working with peels more than 20 years ago; one of my early experiences was doing a series of glycolic acid peels for my best friend. She had quite severe acne scarring and oily, open-pored skin, and the treatments made a profound difference. She had struggled with her skin all the way through school and was extremely self-conscious. Without doubt, the peels were a turning point for her.

PEELS IN PRACTICE Chemical peels work by removing layers of the skin, stimulating cell renewal and turnover, improving the skin’s texture and appearance, and promoting more evenly distributed melanin. This makes them a popular, relatively inexpensive treatment choice for a wide range of skin concerns, from acne and hyperpigmentation to advanced signs of ageing. Peel formulas have become more sophisticated over the last 20 to 25 years, and we have moved beyond grading the effectiveness of a peel purely on acid selection and concentration. Today, we have advanced our understanding of the skin’s physiological changes, refined our technique and boosted formulations with additional agents that

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Skincare | BEAUTY

Skin peels are a relatively inexpensive treatment for a wide range of skin concerns, including acne

“The high success rate with peels, on a broad range of skins, makes these treatments very rewarding to deliver”

enhance or complement the lead acid for faster results in fewer peel treatments. We have also transformed the client experience as formula advancements have made peels better tolerated with less downtime. While there are risks attached to chemical peels, the vast majority of these can be mitigated by maintaining high standards of practice and prioritising client safety, both of which are reliant on effective training. In this article, I’ll be exploring some areas of best practice, so if you are already offering peels, you can compare your existing procedures and protocols. If you are new to peels, this may assist you in developing your service procedures.

PICTURES: DERMALOGICA; ISTOCK

THE CONSULTATION Determining whether a peel, and perhaps which peel, might be appropriate for a client starts with an in-depth consultation. Thorough discussion with the client will rule out contraindications – such as use of isotretinoin in the last six months, skin infection, contagious disease or pregnancy – and identify the desired outcomes, but the consultation process must do more than this. It should help the practitioner to identify client skincare behaviours and lifestyle choices that could influence the peel results. As an example, it is recommended that a client reduce direct UV exposure – both natural and artificial – and apply daily SPF sunscreen in the two weeks leading up to a peel to ensure melanin production is at baseline according to their skin type. This helps reduce the risk of hyperpigmentation developing post-peel. Clear advice and modifications can be presented on everything from retinoid use to scheduling correctly around other cosmetic procedures and treatments. The practitioner has a responsibility to brief the client on what to expect during the peel procedure, the skin changes that occur

after treatment, the implications of not following the skin management directives, and how long recovery should take. This is followed by coaching clients effectively on how to modify their skincare regimen in preparation for the peel. Having skin in the best possible condition can improve tolerance to the peel and facilitate recovery. Priming the skin prepares it for application of the highly active chemical agents. This is particularly beneficial if a client is new to peels. At-home exfoliants containing retinol or hydroxy acids can acclimate the skin and improve the tolerance of professional-grade peeling agents. Any treatment product that reduces build-up of the stratum corneum increases the permeability of the epidermis and thus the penetration of hydroxy acids. Be sure that the clients observe the rules in relation to exfoliant-free days pre-peel so that the skin tolerates well. This varies according to the type of exfoliant and product. Generally speaking, healthy skin is less likely to experience adverse reactions to a chemical peel. Cracked or dehydrated skin allows chemical peel agents to penetrate quicker and further. This can intensify stinging and burning sensations during the procedure, which necessitates reducing the length of application or number of peel layers and potentially compromises the result due to client discomfort. Rapid penetration also increases the risk of irritant responses and over-peeling vulnerable areas. Prescribing the relevant products to repair barrier function and increase hydration in advance of having a peel will contribute to the right skin outcome. Covering all this essential information ensures that the client can make an informed decision about whether to proceed with the service, so scheduling enough time for this consultation appointment is vital. As chemical peels could present a problem in some skins, it is important to carry out a patch test. This is a simple strategy that reassures both you and the client that it is safe to proceed. A minimum of a 24hour patch test protocol is recommended. However, you could patch-test several weeks in advance of the peel as it is preferable that you have at least two weeks to prime the skin to maximise the peel outcome. As an aside, if you have not read the small print on your liability insurance, make this a priority. Insurers are usually very clear about the procedures that should be followed for your cover to be valid, and patch testing generally features. If the policy stipulates that you should follow manufacturer’s protocols, then be aware that reputable peel companies will have patch testing as part of the standard procedure.

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BEAUTY | Skincare

THE PROCEDURE

LEARN MORE AT THE 2019 FHT TRAINING CONGRESS

Actively address safety for the client – and for yourself, as practitioner – in every service. Never become complacent. Gloves and safety glasses should be worn when performing peels, as set out in the national occupational standard. Of key importance is protecting the client’s eyes. If not using a treatment chair, the head of the treatment couch or plinth should be elevated rather than flat during the procedure, to avoid peel solutions running into the eyes. Protect the eyes with eye pads and make sure there is an eye wash station on standby for emergencies. Practitioners must be trained to perform an eye flush to ensure they can confidently handle the situation if the need arises. Keep the lights up so you can observe skin changes effectively and use a sensation scale to monitor the client’s discomfort level while the chemical agent is in contact with the skin. By getting the customer to actively grade their discomfort the practitioner can maintain conscious engagement in the client experience, and can take action to allay concerns or stop the peel if necessary. This information can also be recorded and agreed with the client post-service for accurate record-keeping in the event of liability claims. The depth of peeling should be controlled by neutralising at the appropriate point. This will be determined by both the manufacturer’s protocols and the skin response. Close monitoring will ensure that you don’t push the skin beyond your remit, or compromise the outcome by over-peeling and causing long-term damage. Skin may feel as if it is sunburned. This can range in terms of severity of erythema and sensation. If done correctly, however, the depth of a superficial peel would not usually cause undue swelling or blistering. Some spot blanching on small areas that have been overprocessed should be an exception rather than an expectation in the case of hydroxy acid peels. Of course, this will be different in the case of trichloroacetic acid, which is a keratocoagulant. Keratocoagulant agents contribute to exfoliation by coagulating the skin’s proteins, contributing to stimulation of cell renewal rates and cell turnover. In this reaction, the protein is denatured, similar to an egg white turning white as it cooks. This can produce the skin-whitening effect known as ‘blanching’, particularly in areas of breakout or dehydration. Practitioners should be very conscious of the increased sensitivity when removing neutralisers or applying moisturisers. Lightening the application or working pressure to minimise friction and

Candice will be giving a seminar – ‘Achieving results with peels’ – at the 2019 FHT Training Congress at Holistic Health on Monday 20 May. For more information, visit fht.org.uk/congress

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increasing irritation or inflammation could lead to scarring. Clients should focus on hydrating the skin as much as possible. For superficial peels, this process is usually completed in five to 10 days, at which time you will see the result. Series applications usually schedule subsequent peels at two- to four-weekly intervals to compound the result. Provide clients with clear guidance on how to manage their skin after the peel. A written reference piece provided in print or digitally will ensure there is no confusion or misunderstanding of how they should take care of their skin.

ESSENTIAL POST-CARE ADVICE

manipulation of the skin is recommended. Never massage these peeled areas. Experienced therapists can be habitual and don’t always consider how much effleurage they use or what the pressure of the strokes may be. Techniques can easily be adapted to lessen the aggravation.

THE RECOVERY Observation of the post-care instructions prevents delay in recovery and reduces the risk of undesirable side effects. The initial priority after a peel is to protect the vulnerable skin. Having removed a large proportion of the protective epidermis, the skin requires a moisturising barrier product and daylight protection with a minimum of SPF 30. You may wish to select a physical sunscreen agent as the sensitivity potential is lowered and will feel more comfortable for the client. The peeling process usually begins one to five days after treatment and the skin may appear darker, dry and flaky. The acids dehydrate the keratinocytes, which contributes to the pigmentation looking darker. This is not a pigmentary change due to increased melanin production. It is the result of the lost reflective moisture in the epidermal cells and subsequent compounding of pigmented cells as cell turnover accelerates. Skin will feel tight due to this dehydration and will start to peel. It is essential that the client does not scratch loose skin or scabs, as

1 Apply sunscreen protection (minimum SPF 30) daily following treatment. 2 Avoid direct sunlight and sunbeds for two to three weeks. 3 Do not wax or use any type of exfoliating product for 72 hours, or until the skin shows no signs of sensitivity on the treated area. 4 Do not peel loose skin or pick at scabs or blisters, as scarring may occur. 5 Avoid excessive heat sources, such as sun exposure or dry saunas and steam rooms. 6 Avoid strenuous exercise or any activity that could lead to increased blood circulation to the face for 24 hours following treatment. This can cause an increased warming effect, which could result in discomfort, redness, inflammation, swelling or other side effects.

GETTING RESULTS The high success rate with peels, on a broad range of skins, makes these treatments very rewarding to deliver. Set up for results by putting the right procedures in place and you will reap the benefits, not only in results but in a loyal client following that bolsters service profitability.

Candice Gardner has been a professional skin therapist for more than 25 years and regularly contributes to trade and consumer press. She is education manager – content for Dermalogica and the International Dermal Institute (UK and Ireland) and a member of the City & Guilds Industry Advisory Board for Beauty. dermalogica.com

FHT.ORG.UK

11/01/2019 14:25

Key facts | FHT TRAINING CONGRESS

2019 JOIN US ON SUNDAY 19 & MONDAY 20 MAY AT THE HOLISTIC HEALTH SHOW, NEC BIRMINGHAM

e are delighted to announce our annual Training Congress – with 30 sessions led by experts in the therapy industry, it’s the perfect opportunity to learn new skills, refine your practices and broaden your horizons, all while obtaining CPD points. All sessions are an hour long and hosted in a suite of private training rooms, outside the main Holistic Health Show hall, providing the ideal learning environment. You’ll also have ample time to enjoy some shopping in the main exhibition and a bite to eat. Be sure to come and see the FHT on our stand, where you can chat with the team and enjoy discounts in your members’ shop.

HOW DO I GET THERE?

FHT Training Congress WHAT TIME SHOULD I ARRIVE FOR MY TALK? Please arrive 10 minutes before the start time to be seated for the talk. This also allows you time to look through any handouts that your speaker may have prepared for you. Be sure to leave enough time to get to the talk, as the surrounding areas of the show are expected to be very busy. Please be aware that talks cannot be delayed for delegates GAIN CPD who are running late. POINTS

DO I NEED A SEPARATE TICKET FOR THE HOLISTIC HEALTH SHOW?

Earn 10 CPD points for attending two days of seminars

Yes, you are required to book entry tickets for the Holistic Health Show through the show organisers. Visit holistichealthshow.co.uk to claim free pre-booked tickets or see the insert. Please note that Holistic Health Show tickets will not be free on the day.

The NEC is served by Birmingham International railway station, via a covered bridge link. If you are travelling by car, enter HOW MANY CPD POINTS B40 1NT into your satnav. The NEC WILL I GET? has 16,500 parking spaces Each seminar is worth one CPD point, (chargeable by the venue) but you must attend the full seminar. and provides a free shuttle DAY PASSES Certificates will be sent out after the bus service running event via email; please keep these in AVAILABLE to the exhibition your CPD portfolio. By attending a £10 off a halls. Birmingham full day of seminars you can gain five full day International Airport is CPD points, a total of 10 CPD points of seminars just a few minutes from if you attend both days. the NEC.

WHERE IS THE FHT TRAINING CONGRESS LOCATED? The FHT Training Congress will be located outside of the Holistic Health Show hall, in hospitality suites 28, 29 and 30. Please visit our website at fht.org.uk/congress for a downloadable map.

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CAN I BUY FHT TRAINING CONGRESS TICKETS ON THE DAY? Yes. Please make your way straight to the Training Congress, situated outside the main Holistic Health Show hall (tickets will NOT be available at the FHT stand in the main exhibition area). Spaces sell fast and will only be available on a ‘first come, first

served’ basis on the day, so book in advance to avoid disappointment. Please bring your FHT membership card with you if buying tickets on the day.

CAN MY FRIEND ATTEND THE TRAINING CONGRESS? Tickets are available to non-FHT members, but please note the show organisers have a strict policy that babies and children under the age of 14 years will be refused admission.

WHAT DO I NEED TO BRING? Please bring your email confirmation or invoice (if booking by telephone), which you will need to enter the seminar rooms. We would also recommend bringing a pen, notepad and water.

HOW MUCH ARE THE TRAINING CONGRESS TICKETS? You can purchase Training Congress day passes to take advantage of a full day of seminars at a discounted price. Day passes are £50 for FHT members and £65 for non-members. Individual seminar tickets cost £12 for FHT members and £15 for non-members.

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:26

FHT TRAINING CONGRESS | Learning

4.00 – 5.00 2.30 – 3.30 1.00 – 2.00 11.00 – 12.00 9.30 – 10.30

DAY 1: SUNDAY 19 MAY

ROOM 1

ROOM 2

ROOM 3

DR DEEPA APTE

ANNA VENABLES

DR TOH WONG

Diagnostic techniques in Ayurveda to help support your practice

Informing treatment: auricular reading and response

Five main reasons why therapists don’t get referrals from the medical profession

Techniques that will help you understand what is happening in the body and mind.

An integrative approach to understanding and treating the health status of the client.

Discover the insider secrets to getting your foot through the GP door and consistent referrals.

DR CAROL SAMUEL

ROCKTAPE’S MIKE GRICE

JOHN BRAM LEVINE

Pain in cancer survivors

Ankle ligament rehab journey

Boost your therapy with brainwave music

Discover how reﬂexology can support cancer survivors who have long-term pain.

Learn how Rocktape and Rockblade techniques can rehabilitate an acute ankle injury.

Learn about the correlation between the brain and the inﬂ uence of music.

TANIA PLAHAY

ROCKTAPE’S MIKE GRICE

CHRIS AND KARENE LAMBERTGORWYN

Five key tips for working with those living with dementia

Instrument-assisted massage for low back pain

Get more clients now!

Learn how to allow those living with dementia to feel well, relaxed and practise self-care.

How to incorporate instrument-assisted massage into the rehabilitation plan for your client.

Know how to get more of your ideal clients through the door – double your income in just two weeks!

JULIE CROSSMAN

MONICA HALPER

EMMA HOLLY

The role of the complementary therapist within the NHS

MELTing connective tissue: a missing link in resolving chronic pain?

Why should therapists learn about scars?

The many ways that complementary therapists can help support the NHS.

Discover for yourself the effects of using specialised balls to feel vibrant and pain-free.

Emma will discuss the potential impact of scar tissue and approaches to treatment.

NIC WOOD

JING’S RACHEL FAIRWEATHER AND MEGHAN MARI

JILL WOODS

How the mind works with the Hudson Mind Theory – Body Mind Workers

Sacroiliac joint dysfunction – assessment and treatment for massage therapists

Marketing your business ofﬂine

Gain more insight into how the mind works and what keeps people stuck in their problems.

Gain a greater understanding of this complex joint.

Join Jill, marketing expert, as she helps you grow your ofﬂine marketing conﬁdence and develop your practice.

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FHT.ORG.UK

11/01/2019 14:26

Learning | HOLISTIC HEALTH SHOW MORE INFORMATION

4.00 – 5.00 2.30 – 3.30 1.00 – 2.00 11.00 – 12.00 9.30 – 10.30

DAY 2: MONDAY 20 MAY

For more details about the talks and to book, visit fht.org.uk/congress

ROOM 1

ROOM 2

ROOM 3

LORRAINE SENIOR

ANNA-LOUISE HAIGH

LISA SLATER

Reﬂexology and the Functional Reﬂex Therapy Framework

Guided meditation – experience the Blogging for business power to transform

Supporting children and adults with high levels of anxiety and additional needs.

Experience how positive guided meditation can enhance the therapeutic value of your sessions.

An insight into how to use a blog as an effective sales and marketing tool.

TEACH THERAPY’S KATE MULLISS

JANE JOHNSON

DERMALOGICA’S CANDICE GARDNER

Aromatherapy for arthritis and rheumatism

Posture: does it matter and can it be corrected?

Achieving results with peels

Learn how appropriate blending can assist with pain relief.

Explore some of the controversies surrounding posture and postural correction.

Discuss how to elevate the client experience, maximise skin recovery and ensure treatment success.

KATHRYN ELLIS

JANE JOHNSON

CHRIS AND KARENE LAMBERTGORWYN

Thai yoga massage: how to provide a deeper massage with less effort

Trigger points for beginners

Making more money – the heart-centred way

Learn how the techniques will allow you to provide an even more effective massage with ease.

Learn what a trigger point is as well as the causes, identiﬁcation and how to treat these.

Recode your perception of money so you can build a business which makes a difference.

MAUREEN BONNER

DAWN MORSE

VALERIE DELFORGE

Adapting massage for clients at risk of lymphoedema, DVT and bone metastases

Integration of dry cupping within sports and massage therapy

Producing a winning brand

Understanding when your clients are at risk of the silent effects of cancer.

How dry cupping can provide synergistic treatment effects within sports and massage therapy.

Learn how your marketing and branding can enhance your business.

SHIRLEY O’DONOGHUE

JING’S RACHEL FAIRWEATHER AND MEGHAN MARI

VALERIE DELFORGE

Social enterprise – improving community wellbeing

Myofascial release for ﬁbromyalgia and other chronic pain conditions

Attract new customers with your digital communication strategy

Find out about this business model that Learn how MFR techniques can be helps to give back to the local community. the missing link in the treatment of complex conditions.

FHT.ORG.UK

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Learn how your communication can increase customer loyalty and attract new customers.

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:27

MASSAGE | Fibromyalgia

ibromyalgia syndrome (FMS) can be one of the most challenging conditions for a therapist to work with. Seemingly random and unrelated symptoms such as dizziness, aches, pains, sleep disturbance, brain fog, sore throat, heightened sensitivity and exhaustion are typical of the pathology, and that’s just for starters. When you add into the mix the commonly co-related stress and mental health issues such as anxiety, depression and post-traumatic stress disorder, you can see why some therapists’ hearts might sink a little at the prospect of successful treatment. To make things even more complex, the delicate balance of fibromyalgia means that it is not unusual for ‘normal’ massage

treatment to result in increased pain and symptoms for the client. Yet, with a little knowledge and time, a well-trained massage therapist can provide great relief for clients affected by this complex condition. The use of appropriate soft tissue techniques twinned with an understanding of the underlying psychological and physiological processes can bring about radical and long-lasting change.

SYMPTOMS OF FMS The list of common symptoms associated with FMS can seem long, and often appear unrelated (see figure, right). The typical FMS client is likely to experience a combination of symptoms including widespread constant pain in muscles, soft tissue and joints; painful and tender skin; shooting pains; restless legs; numbness and fogginess; aching; stiffness; muscle weakness; nausea; giddiness; visual disturbances; irritable bowel syndrome; allergies; heightened sensitivity to light, sound, smell or touch; sore throat; increased sensitivity to pain; chronic fatigue; flu-like symptoms; mental health issues; sleep disturbances; poor concentration and memory loss, and more.

Facing ﬁbromyalgia JING’S RACHEL FAIRWEATHER DISCUSSES HOW ADVANCED MASSAGE TECHNIQUES CAN HELP CLIENTS WITH FIBROMYALGIA

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FHT.ORG.UK

14/01/2019 10:51

Fibromyalgia | MASSAGE

CENTRAL SENSITISATION IN FMS AND CHRONIC PAIN FMS can be difficult to understand because although clients can be in terrible pain, there is no actual damage to any tissues or organs of the body. The system that has gone awry in FMS is actually the central nervous system – the brain and spinal cord – which has gone into overdrive, often because of stress or trauma. A key factor in FMS (and other chronic pain conditions) is a phenomenon known as central sensitisation. In central sensitisation, the sympathetic nervous system is in a persistent state of high sensitivity (known as ‘wind-up’). This results in the spinal cord and brain acting like a faulty amplifier that turns up the volume of any pain signals. Central sensitisation has two main features: allodynia and hyperalgesia. ⦁ Allodynia – when an neutral stimulus is interpreted by the brain as painful ⦁ Hyperalgesia – a normally painful stimulus is interpreted as being much more painful. This explains why a client with fibromyalgia might be jumping off the treatment table when you are barely touching them. In addition, central sensitisation can lead to heightened sensitivities across all senses and is associated with the cognitive deficits common to FMS, such as poor concentration and short-term memory. Central sensitisation is also correlated with increased levels of emotional distress, especially anxiety. It is vitally important when treating clients with fibromyalgia to understand that a main part of our job is to address this oversensitised alarm system.

FIBROMYALGIA AND FASCIA: THE MISSING LINK I always joke with my students that if they fall asleep in class and I ask them a question, the answer is most likely to be fascia (or the psoas). This is definitely the case with FMS as although no definitive evidence of muscle pathology has been found, there

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Problems with vision Jaw pain

Pain in muscles

Paired tender joints

Nausea

Urinary problems; dysmenorrhea (in women) Skin problems Joint pain and morning stiffness Restless leg syndrome

FIBROMYALGIA SYMPTOMS

is some evidence for dysfunction of the intramuscular connective tissue, or fascia. Research by Liptan (2010) proposes that inflammation of the fascia is the source of peripheral nociceptive input that leads to central sensitisation in fibromyalgia. Interestingly, the inflammation of the fascia is similar to that described in conditions such as plantar fasciitis and lateral epicondylitis, which also respond well to myofascial techniques.

MASSAGE TREATMENT FOR FMS Treating clients with FMS can be challenging because of the extreme sensitivity of their systems. Every detail of the treatment process must be thought through – from the smells in the room, to the client’s positioning on the table, to the techniques and quality of your touch. Here are some top tips for working with FMS clients: ⦁ Allow a good half hour for your initial consultation assessment and interview. FMS clients often have complex histories, and it is vitally important that they feel truly heard. ⦁ Share your treatment plan: tell them what you are doing and why, and expect their input.

⦁ Be extra careful with basic client care.

For example, have plenty of blankets and pillows ready, as basic positioning might be uncomfortable. Check the temperature as your room might need to be warmer than usual. ⦁ Allow clients to change position often if they want to; staying in one position can be painful. ⦁ Expect the smallest amount of treatment to have a disproportionately large effect; don’t think you have to pack very much into one treatment. ⦁ Remember the main issue in FMS is central sensitisation. Treatment that is too intense may trigger the warning system and make things worse. ⦁ Listen to your client – take their word for everything they say. They know best. If they say ‘Don’t touch my stomach’, don’t. ⦁ Keep treatments short if necessary: 20to 30-minute pain release at the most, followed with relaxation massage. ⦁ Be very gentle – light rather than deep. What for us is felt as discomfort can be extremely painful to an FMS client. ⦁ With FMS, progress can be very slow, over several treatments, and often it may not seem as if there has been much progress.

WINTER 2019 INTERNATIONAL THERAPIST

PICTURES: ISTOCK; SCIENCE PHOTO LIBRARY

The symptoms of FMS are so diverse it is common for sufferers to have spent months or years undergoing medical tests in an attempt to find a cause. This process in itself brings intense frustration for clients who may have been told that the symptoms are psychological or exaggerated. There is often an intense feeling of not being believed that clients carry around with them.

Fatigue, sleep disturbance, cognitive problems, memory problems, headaches, dizziness

11/01/2019 14:28

MASSAGE | Fibromyalgia

TREATMENT TECHNIQUES AND TIPS My own approach to treating chronic pain conditions has been developed through clinical practice with thousands of clients. For most chronic pain conditions, including FMS, I recommend a multi-modal approach incorporating several elements, including the use of fascial techniques, heat, acupressure, stretching, and self-care suggestions. A sample treatment for FMS could include the following: 1 MFR cross-hand stretches. Myofascial release is the go-to technique for fibromyalgia. Place your crossed hands adjacent to one another in the area to be released – they should be a few inches apart at this point. Sink down until you have a sense of being on the deep fascial

PICTURES: JING ADVANCED MASSAGE TRAINING

LEARN MORE Jing will be holding a seminar on myofascial release for ﬁbromyalgia and other chronic pain conditions at the 2019 FHT Training Congress on Monday 20 May, as well as a talk on sacroiliac joint dysfunction on Sunday 19 May. See page 33 for more details. We are also delighted to partner with Jing in a forthcoming webinar on myofascial release for ﬁbromyalgia and other chronic pain conditions on Wednesday 27 March. Register for your place at the webinar at fht.org.uk/Jing-webinar

layer that runs around and through the muscles. Then put a stretch on this tissue so you have a sense of tension between your two hands, like a piece of material being stretched to a barrier. After a while you will start to feel the sensation of the tissue starting to move beneath your hands. Make sure you maintain the stretch and follow the tissues until you feel the tissue release. This whole process takes around three to five minutes, so you will need to be patient. Repeat cross-hand stretches on anywhere that is needed. 2 Power effleurage with hot stones. Heat is fantastic for many chronic conditions, including fibromyalgia. If you are trained in hot stone work, this is a great time to introduce some dynamic stone strokes. Stand at the head of the table in forward tai chi stance with a hot stone in each hand. Ask the client to take a breath in and let them know there will be heat coming – they should be sure to tell you if it is too much. Apply the stones with a few quick strokes to the top of the client’s upper arms first, as this is a less heat sensitive area. Then glide down either side of the spine using your body weight to work into the erector spinae muscles with the stones. Work down to the lower back with the stroke, working slowly and deeply, then come back up with a light return stroke and repeat. Breathe out as you work down the body and imagine energy or qi flowing down your arms. 3 Acupressure. Acupressure points that address the emotional component of FMS can be very helpful. Conception vessel 17 (chest centre) is a wonderful point for helping to calm and release emotional energy. Its location is on the sternum, level with the fourth intercostal space. Use the third finger to hold the point for three to five breaths. It feels nice to have the other hand under the head as you do this. 4 Stretching. Gentle static stretching can be very helpful in areas of pain. The stretch shown is helpful for low back pain.

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5 Self-care suggestions. Fibromyalgia clients often feel they lack control over their health, so self-help techniques that allow them some sense of empowerment are vital. Teach your clients gentle stretches and meditation/breathing exercises for home care. Fibromyalgia is such a complex condition that a multidisciplinary approach works best for treatment. Referring your client to resources that can offer talk therapy, such as cognitive behavioural therapy, gentle yoga, strength training or meditation, will be extremely helpful in their recovery.

Most of all, help your client to feel that there is hope. Recovery is certainly not quick but it is possible and, as an understanding and well-trained massage therapist, you can be a key piece in this process. Rachel Fairweather is the co-founder and director of Jing Advanced Massage Training. She is an author and international lecturer with more than 25 years’ experience in the industry. Rachel also holds a degree in psychology and a postgraduate diploma in social work. jingmassage.com

FHT.ORG.UK

14/01/2019 10:51

C I T S I L O H H H E A LT

BRITAIN’S PREMIER

COMPLEMENTARY THERAPY EXHIBITION 19th & 20th MAY 2019 NEC, BIRMINGHAM GROW YOUR COMPLEMENTARY THERAPY BUSINESS AT HOLISTIC HEALTH • THE LATEST TRENDS, LAUNCHES AND INNOVATIONS • INSPIRING EDUCATION PROGRAMMES • £1,000S OF SHOW OFFERS AND DISCOUNTS • TREATMENT TASTER OPPORTUNITIES

Join the FHT on stand U20

HolisticHealthShow.co.uk TICKET HOTLINE: 01332 227 698

HHShowUK

INT.Winter2019.039.indd 2

HolisticHealthShow

GuildNewsMag

10/01/2019 17:30

REGIONAL UPDATES

Local support groups Lavender farm fun for Chester LSG In July, the Chester LSG enjoyed a visit to a lavender farm in Rainford, near St Helens, writes group coordinator Dee Kelsall. We had a great turnout, with a group of 15, and the weather was glorious. Attending a lecture, we learned about the growing of the plants, as well as the quality-control methods used at the farm. And we heard the interesting background story of the frankincense that is also distilled on the farm. After going into the fields and picking lavender, we had the opportunity to take the lavender into the laboratory and watch it being distilled into oil. In addition, we visited the rescued animals at the farm, had a farmhouse buffet lunch and visited the shop. We look forward to returning to the farm next year and welcoming new members.

Mindful eating and body positivity in Hereford Twenty people attended a fantastic talk by Lisa Beasley on mindful eating, writes Hereford LSG coordinator Carina Jones. Lisaâ&#x20AC;&#x2122;s Bristol-based company, My Body Positive, runs talks and workshops to help women step out of the diet culture and embrace a person-centred, empowering model of food awareness. By placing physical health and self-esteem rather than weight loss at the heart of the process, she helps to build a sustainable and guilt-free relationship with the food

women eat and helps them to understand their personal cycles with food behaviour. Clearly, a 90-minute talk didnâ&#x20AC;&#x2122;t give us all the answers, but it certainly raised a lot of questions; everyone had such a lot to think about as we unpicked the messages that we give and receive constantly about food, weight and body image. When the question of weight, health or body image arises in our treatments it can be difficult to know how to respond. I am

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often taken aback by the bodyshaming language that clients use about their own bodies, and wish I could do more to reframe the conversation. We need to shift the focus from weight to health and replace shame with support. There is much work needed to counteract the insidious and persistent fat-fearing and fat-shaming language that exists not just in the media but in the medical profession too. Of course, it would be wrong to suggest that some diseases

and conditions are not caused or worsened by poor lifestyle choices and excessive weight. However, there are more pertinent truths that this kind of one-dimensional coverage neglects that weight alone is a poor indicator of overall health, that fat-shaming and fat-fearing does a lot of damage and does not inspire positive lifestyle choices, and that shame does not help people lose weight or become healthier. Treating people as individuals, compassionately listening and

FHT.ORG.UK

11/01/2019 14:29

REGIONAL UPDATES

FIND YOUR LOCAL SUPPORT GROUP Local groups are a valuable hub for all those with a passion for therapies. Hear from excellent speakers about the latest therapies and business ideas, take part in outings and social events, enjoy treatment swaps and share best practice.

North Birmingham LSG gets to grips with grief The North Birmingham LSG was recently treated to a talk on grief, loss and recovery by Victoria Moore, writes group coordinator Alison Clamp. Victoria has many years’ experience in this fi eld, and she has great compassion and empathy for those suffering loss. She identified that there are many types of loss, including loss of health, bereavement, not being where we thought we might be, abuse and childhood trauma. Loss can cause deep-rooted emotions that we can bury and carry around with us for many years. Victoria identified these emotions as a possible cause of depression, stress, illness and frustration. We often suppress feelings that we don’t know how to process, which can lead to great unhappiness in the future. Victoria went on to list a number of myths surrounding grief, including ‘Time heals’, ‘Keep busy’ and ‘Grieve alone’. As therapists it can be all too easy to talk to clients in this way, and it was really useful to know what is helpful to say and what isn’t. Encouraging clients to talk about their loss or grief is a huge step forward in their recovery. In our previous meeting, speaker Dr Singh also stressed the importance of listening to clients with an open, loving heart. Identifying the grief and pain can really help others – and ourselves – on the path to recovery.

helping to build self-esteem and self-worth provides a much better foundation from which to empower people to make sustainable and lifelong positive lifestyle decisions. From here it is left for us to consider how we can build into our practice and conversations with clients, messages that contribute to a more positive dialogue about larger bodies. To read more articles about body image, log in at fht.org.uk/ members-area and type ‘body image’ in the search bar on the top left-hand side.

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EAST MIDLANDS Alfreton Leicester Lincoln Northampton Nottingham EAST OF ENGLAND Colchester Ely Essex Hertfordshire Luton Newmarket Norwich IRELAND Donegal NORTH EAST Durham Newcastle NORTH WEST Blackpool Chester Lancaster Liverpool and Rainhill Manchester (North) Manchester (South) Wigan and Leigh NORTHERN IRELAND Belfast Coleraine Lisburn Lisnaskea Newtownabbey South Tyrone SCOTLAND Ayrshire SOUTH EAST Basingstoke

Chichester Dartford, Gravesham and Medway Eastbourne and South Downs Hastings High Wycombe Horsham and Crawley Kent (North) London (North) Oxfordshire (South) Waterlooville Worthing SOUTH WEST Bath Bournemouth Gloucester Ipplepen Mendip Salisbury Taunton WALES Llanelli Swansea Wrexham WEST MIDLANDS Birmingham (North) Birmingham (South) Coventry Hereford Redditch Staffordshire (North) Stourbridge and Dudley Wolverhampton YORKSHIRE AND THE HUMBER Harrogate Kirklees and Calderdale Leeds Shefﬁeld

MORE INFO For group contact details and information about forthcoming meetings, go to fht.org.uk/lsgs

CAN’T FIND A GROUP IN YOUR AREA?

Lisa Beasley

Why not become a local support group coordinator? It is a very rewarding role, and there is a range of additional beneﬁts available exclusively to coordinators. Go to fht.org.uk/become-a-coordinator for your information pack.

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:29

SPORT | Runner’s knee

Weak at the knees

n the New Year, many people are encouraged to take up sports like running and cycling for the first time, to get fit or lead a more healthy lifestyle. Recreational athletes are often motivated to start training for a challenge, such as their first 10km road run, half marathon or triathlon. This increase in exercise frequently goes hand-in-hand with an increase in sports-related injuries, and a common injury seen during this time is runner’s knee. Runner’s knee is a term used to describe iliotibial band syndrome, a common condition among triathletes, runners and cyclists.

for longer after the activity and, in some instances, pain can present as far up as the hip or downward towards the fibula or lateral shin region. Pain and its location is the key symptom of this injury, but in some cases visible swelling may be present, the area may be tender to touch and the client may find it painful when walking down stairs. There can be significant tenderness on palpation of the lateral epicondyle of the femur, as this condition is caused by excessive friction between the iliotibial band and the lateral Tensor fasciae latae Iliotibial tract

SYMPTOMS AND CAUSES This condition usually presents as localised lateral knee pain, which is aggravated by activity such as cycling and running downhill. The pain associated with iliotibial band syndrome often starts in the same position on the lateral side of the knee. As the condition worsens through continued training, pain can start earlier and continue

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Gluteus maximus

epicondyle when the knee is flexed at around 30 degrees. Swelling in the area may be linked to friction, or injury to the bursa, a fluid-filled sac located between the iliotibial band and the lateral epicondyle. The bursa is designed to prevent friction, but in the case of this injury it can become impinged or inflamed due to repetitive motion, leading to additional pain. Although iliotibial band syndrome is caused through friction, it is linked to overtraining or excessive overload of training, including sudden increases in running or cycling distance or an increase in the number of training sessions within a weekly period. This condition can also be linked to exaggerated foot pronation, tibial rotation at the joint and excessive tightness within the iliotibial band.

INJURY ASSESSMENT Vastus lateralis Lateral condyle of tibia

Palpation, pain questioning, observation and running gait are all useful for identifying this condition, along with the Ober’s test. This is a special test used within examination and assessment of injury, to

PICTURES: SARAH AULD; AKIN FALOPE; ISTOCK; SHUTTERSTOCK

DAWN MORSE, MSc, PROVIDES AN INTRODUCTION TO RUNNER’S KNEE AND SOME TECHNIQUES TO HELP ADDRESS THE CONDITION

FHT.ORG.UK

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Runner’s knee | SPORT

TREATING ILIOTIBIAL BAND SYNDROME Massage techniques Sports or deep tissue massage can be used to reduce tension in the associated muscles of the iliotibial band. Massage application and deep tissue techniques such as soft tissue release, active movement and manual compressions should focus on treating the associated muscle and surrounding area, including the TFL and gluteus maximus, paying particular attention to the origin and points of interaction with the iliotibial band. Treatment should also cover the quadriceps, adductors and hamstring muscle groups, along with the gluteus medius and minimus. If treatment time and pain levels allow, massage should also cover the iliotibial band itself, with focus on the insertion point to reduce the level of friction being produced around the lateral aspect of the knee. It’s also useful to close the treatment with passive or proprioceptive neuromuscular facilitation (PNF) stretching, to help address muscle memory and function, while improving range of motion at the hip joint.

Rest and active rest

evaluate a tight, contracted or inflamed tensor fasciae latae (TFL) which runs into the iliotibial band. Instead of having its own tendon for muscle attachment, the TFL (along with the gluteus maximus) runs into the iliotibial band for insertion to the skeleton. There are two methods used to conduct the Ober’s test. In the first method, the client is side-lying, close to the edge of the treatment couch, with hip and knee flexed in a 90-degree angle. The therapist stands behind the client and stabilises the client’s pelvis with one hand. The other hand holds the medial aspect of the client’s affected knee and places the affected knee in a five-degree flexion angle, then fully abducts the leg to be tested. Gravity is then

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used to adduct the affected leg (without rotating) until the hip cannot adduct any further. If there is tension within the TFL and associated iliotibial band, the affected leg will stay in an abducted position and will not lower.

Advising rest from sport or exercise programmes while symptoms cause pain will allow the condition time to heal. However, active clients often find rest difficult, therefore active rest can also be advised. This would involve reducing activities that are hip-focused, such as running and cycling, and switching to upper body exercise, such as swimming with a float between the legs, using an arm bike or using a rowing machine, but only completing upper body movement.

Self-treatment

In the second method, the client is positioned on the side of the unaffected leg, with the unaffected hip in neutral position and the knee in full extension. The same procedure is then followed. Once iliotibial band syndrome has been identified or suspected, treatment should focus on reducing symptoms, such as pain, along with the cause, which may be linked to muscle imbalance.

To maximise therapy benefits between treatments, the client can use a myofascial release ball to help reduce tension in the muscles around the hip. Using the palm, the client can roll the ball with firm pressure over the muscles at the front of the hip, such as the TFL and quadriceps, to the side of the hip, down the iliotibial band, and over the gluteal muscles.

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SPORT | Runner’s knee

Stretching The stretches in Table 1 below will help to maintain muscle function and length and reduce muscle tension. While symptoms are present, ideally these stretchess should be done two to three times daily, to aid muscl muscle memory and movement. Each stretch should be held for 30 to 60 seconds.

TABLE 1: STRETCH ETCH OBJECTIVES STRETCH

OBJECTIV OBJECTIVE

Low lunge with the chest st lifted d

stretch To help st out the rectus re femoris, iliopsoas and the TFL

STRENGTHENING EXERCISES Due to the demands of sport and exercise, it’s important to stretch and strengthen the associated muscles linked to iliotibial band syndrome. The following exercises can help to address muscle imbalances that may have led to the development of the condition or those that have resulted from the condition itself. Start with completing each exercise once and gradually build up to three sets of each exercise with 15 to 25 repetitions. Exercises and stretches should be performed on both sides of the body.

The clam help Lying ng glute glute To hel he p reduce re stretch tension in the stre gluteus maximus

Seated adductor stretch

To help lengthen leng the adductor adduct group muscle gro

and Piriformis an lateral glute stretch stretc

Keep the feet together and use the glutes to slowly open and close the legs like a clamshell. Use a smooth controlled motion and avoid rocking the pelvis during the movement.

Side leg raise Using a slow and controlled motion slowly raise the the left le leg le aboutt 45 degrees, then lower.

To help stretch out the external hip rotators

Bridge/hip thrust Press the heels into the ground and use the glutes to raise the pelvis up until the body forms a straight line from knees to shoulders. Hamstring mstring stretch tch

To help lengthen and reduce tension in the hamstrings muscle group

Side shufﬂe shufﬂ e Stand with the legs about hip-width apart, with an exercise band around the ankles or knees. Take 10 steps to the right and 10 steps back to the left to complete one set.

Standing iliotibial To stretch out Sta band stretch the TFL

LEARN MORE

Dawn Morse, MSc, is the founder of Core Elements Training and is the 2018 FHT Highly Commended Tutor of the Year. Dawn offers a range of FHT accredited courses, including sports and remedial massage, dry needling, myofascial dry cupping, manual therapy and rehabilitation. coreelements.uk.com

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Dawn Morse will be holding a talk on the integration of dry cupping within sports and massage therapy at the 2019 FHT Training Congress on Monday 20 May. See page 33 for more details.

Pistol squat Stand on the right leg with the left knee raised out in front, and slowly lower the body while balancing on the other leg. Lower as far as possible until gradually reaching parallel or 90 degrees at the knee.

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RESEARCH

Massage and cold water immersion help fatigue SPORT-RELATED FATIGUE CAN BE DEFINED AS A DECLINE OF MUSCLE FORCE OR AN EXERCISE-INDUCED IMPAIRMENT OF PERFORMANCE (KNICKER, 2011)

Sports massage (SM) and cold water immersion (CWI) are more effective at reducing fatigue after a marathon than active rest (AR) and passive rest (PR), according to a study published in PLOS One (Wiewelhove et al, 2018). Scientists recruited 46 healthy male recreational runners taking part in the same half marathon event and assigned

them to four groups of equal ability, which had either SM, CWI, AR or PR within 15 minutes after the event. The SM group received effleurage, petrissage and friction techniques for 20 minutes, focusing on each leg for five minutes in prone and supine positions. CWI involved participants sitting in cold baths, maintaining a temperature of 15°C ± 1°C, while participants of the PR group sat at rest on a bench, and those in the AR group jogged at 60% of their anaerobic threshold, all for 15 minutes. Jump height, muscle soreness and perceived recovery and stress were measured

Thai massage can help with Parkinson’s symptoms

Reﬂexology may reduce intensity of migraine

PICTURES: ALAMY; ISTOCK

MIGRAINES AFFECT TWICE AS MANY WOMEN AS MEN AND ARE EXPERIENCED BY ONE IN SEVEN PEOPLE IN THE UK (MIGRAINE ACTION, 2018)

Reflexology could be a beneficial treatment for people who are experiencing migraines, a recent study suggests (Imani et al, 2018). A randomised controlled trial was conducted, with 75 male subjects divided into three equal groups, receiving reflexology (intervention), a placebo or no intervention (control) to evaluate the effects of the therapy on nitroglycerininduced migraine-type headaches. Researchers collected data using a patient information form created for the study and a numeric rating scale to measure pain intensity. Subjects in the intervention group

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24 hours before the half marathon, immediately after intervention, and 24 hours after the race. The results showed that SM and CWI had no effect on objective markers of fatigue, such as changes in muscle and the blood, but they did have a significant effect on subjective fatigue measures, including perceived recovery and muscle soreness. These interventions were more effective than PR, while AR had no physical advantage and a negative effect on perceived recovery. For the full study, go to fht.org.uk/ 127-research-Wiewelhove

PARKINSON’S DISEASE AFFECTS ONE IN EVERY 350 PEOPLE IN THE UK (PARKINSON’S UK, 2018)

received foot reflexology, focusing on the points corresponding to the brain, for 10 minutes on each foot. For the placebo group, subjects received an ineffective foot massage, focusing on unspecified points on the heel that didn’t relate to the head. Both treatments were repeated three hours later, with data collected at the start of the study and after interventions. The results showed a statistically significant reduction of headache intensity in the reflexology group when compared with both other groups after treatments. Read the full study at fht.org.uk/ 127-research-Imani

A study suggests that Thai massage could help improve arm muscle strength in people with Parkinson’s (Miyahara et al, 2018). A randomised controlled trial allocated 30 patients with Parkinson’s and muscle weakness to receive either six Thai massage treatments in three weeks alongside standard medical care or standard medical care alone. Patients in the Thai massage group showed significant improvements in their peak flexion torque, peak extension torque and time to maximal flexion speed. Access the research at fht.org.uk/ 127-research-Miyahara

REFERENCES For full references, go to fht.org.uk/IT-references

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XXX | xxxxx

Positive MEASURES NICOLA BROUGH AND SARAH STEWART-BROWN PROVIDE AN INTRODUCTION TO WEMWBS AND WHHQ, TWO PATIENT-REPORTED OUTCOME MEASURES RELEVANT TO THERAPY INTERVENTIONS

valuation of healthcare is increasingly based on patient-reported outcome measures, or PROMs. These measures aim to capture how patients or clients feel in response to therapies or treatments, and to take this into account alongside physiological changes in the client’s condition or disease, or ‘pathophysiology’. This development is very pertinent for complementary, alternative and integrative approaches (CAIA) to healthcare, which often have a profound effect on the client’s sense of wellbeing in a way that has been difficult to capture using just biomarkers and other objective measures. PROMs are by definition selfreported measures. Guidelines for their development require interviews with clients to create questions that

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capture the health and wellbeing changes they attribute to therapeutic intervention and consider important. PROMs also require a conceptual framework that outlines how the scale developers think the therapy influences health and wellbeing. Finally, they require the psychometric testing of the measures, which shows they are sound from a statistical point of view. Practitioners who are thinking of evaluating their CAIA services may be interested in two recently developed PROMs. Both of these ask questions about positive experiences (Huppert and Ruggeri, 2017) and therefore break away from the traditional disease-based models of health, where the focus of evaluation lies in measuring reductions of disease markers and symptoms.

MEASURING MENTAL WELLBEING WITH WEMWBS The first was developed by Sarah StewartBrown, professor of public health at Warwick Medical School, and is called the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) (Stewart-Brown, 2015; Tennant et al, 2007). It was developed to evaluate approaches that aimed to improve mental wellbeing in general populations and not CAIA specifically. However, the scale has proved very popular with many different sectors and has been used to successfully evaluate CAIA (Maheswaran et al, 2012). Using WEMWBS, it is possible to investigate whether CAIAs are more or less effective in improving wellbeing than traditional healthcare or other wellbeing approaches. In the Maheswaran study, CAM resulted in much greater improvement in mental wellbeing than other well-valued public health interventions and traditional medical approaches. Advantages of the scale used in WEMWBS is that it’s now well respected and very popular in conventional healthcare. There

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Patient outcomes | WELLBEING

public (Stewart-Brown et al, 2015). It has been successfully used to measure, for example, the impact of mindfulness in schools (Huppert and Ruggeri, 2017) and nature walks as an intervention for depression (Korpela, 2016). A seven-item version of the scale, known as SWEMWBS, is also available. Both versions are free to use, but practitioners are required to register. For more information, visit warwick.ac.uk/fac/sci/med/ research/platform/wemwbs

MEASURING HEALTH AND WELLBEING WITH WHHQ

“The questionnaire incorporates holistic statements and represents new concepts in evaluation, covering self-agency and self-care”

PICTURE: ISTOCK

are national norms in UK countries and the PROM has been translated into around 30 different languages. The disadvantage of using WEMWBS in the CAIA setting is that CAIA can bring about changes to a client’s health and wellbeing that are not captured with this measure, such as in social and spiritual aspects. About the WEMWBS questionnaire The WEMWBS comprises 14 positively worded statements that measure mental wellbeing, such as ‘I have been feeling useful’ and ‘I have been feeling relaxed’. The scores range from 1 to 5 on a scale, (Likert, 1952) with response categories ranging from ‘none of the time’ to ‘all of the time’. The minimum score is 14 and the maximum score is 70, with higher scores representing higher levels of mental wellbeing. The recall period is two weeks. The WEMWBS is part of the government’s health and social care frameworks, has been used extensively in different health settings, is well validated, sensitive to changes happening in integrated healthcare settings, and is well liked by practitioners, patients and the

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Under the supervision of Sarah Stewart-Brown and Helen Parsons, Nicola Brough developed the second PROM of interest – the Warwick Holistic Health Questionnaire (WHHQ) – as her PhD study at University of Warwick. As a craniosacral therapy (CST) practitioner, Nicola’s primary focus was to develop a tool that could evaluate the changes in health and wellbeing of people using this intervention. CST clients often note improvement in areas of mental wellbeing, physical wellbeing, social wellbeing and spiritual wellbeing. In particular, they report a heightened state of self-awareness, including psychoemotional aspects of self and mind-bodyspirit links, and greater engagement with self-care, including the ability to manage health problems and adopt better coping strategies. Spiritual changes, including a sense of connectedness with self, others and the wider universe, and a general sense of enhanced wellbeing, are also reported (Brough et al, 2015). The WHHQ was developed to capture all these outcomes. The 25-item questionnaire incorporates holistic statements and represents new concepts in evaluation, covering self-agency (‘I’ve felt in control of my health and wellbeing’) and self-care (‘My awareness about my health has helped me manage my life’). The advantage of the WHHQ is that it therefore covers changes in health and wellbeing that are not captured by existing PROMs. Because it is based on detailed qualitative examination of outcomes important to clients, it can capture the full range of experiences, enabling individuals to reflect on change in aspects of their health and wellbeing that they might not have thought would change. The disadvantages are that, because the measure is new, there are few comparative studies and no population norms. The WHHQ is currently being evaluated as a tool to audit practice and enable more robust studies of the effectiveness of CST and other CAIA.

About the WHHQ questionnaire The WHHQ is available in paper format and on an electronic platform called Pragmatic Tracker. Its 25 statements, mostly positive, are linked to health and wellbeing. The response options are on a five-point scale (0 – little or none of the time; 1 – rarely; 2 – sometimes; 3 – often; 4 – most or all the time) and a total score of between 0 to 100 is achieved by adding up all responses (0 to 4). Measurement properties show the WHHQ is psychometrically sound, with good internal consistency and convergent validity with the WEMWBS. Tests of repeatability and responsiveness are currently underway, and questionnaire development is an ongoing process. The WHHQ will continue to evolve as it is used more widely. Currently, Nicola is in conversation with membership organisations, including the FHT, to be early adopters and implement WHHQ on an evaluative licence. This would enable practitioners to evaluate the extent to which the WHHQ can enhance the therapeutic encounter, which in turn would help improve communication, prompt discussion and monitor changes. Anyone wishing to use the WHHQ would need to register their interest and contact Nicola direct (address below). NB: Both the WEMWBS and WHHQ are subject to copyright. All rights are reserved. Any unauthorised copying, changing of wording, layout or content of the questionnaire will constitute an infringement of copyright.

REFERENCES For full references, go to fht.org.uk/IT-references

Nicola Brough is a craniosacral therapist who runs a private practice in Stoke-on-Trent and teaches the beneﬁts of using PROMs to enhance practice. She won the FHT Award for Complementary Therapy Research (Complementary Therapy Awards 2018) n.brough@warwick.ac.uk Sarah Stewart-Brown, professor of public health at Warwick Medical School, is a medical doctor and practitioner and teacher of zero balancing. For more information about Sarah, see page 18.

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LEARNING

Medical A-Z MIGRAINE A migraine is a moderate to severe headache, characterised by throbbing pain on one side of the head, which can be accompanied by nausea, vomiting or light and noise sensitivity (NHS Choices, 2018; Peters, 2008).

CAUSES The exact cause is not yet known, but it is thought to relate to abnormal brain activity affecting chemicals, blood vessels and nerve signals. This could be genetic or triggered by emotional, physical, dietary, hormonal, medicinal and/or environmental factors.

SYMPTOMS The main symptom is a headache on one side of the head that gets progressively worse, particularly when moving, and can last between four and 72 hours. Other symptoms can include increased sensitivity to light and sound, nausea, vomiting, sweating, poor concentration, feeling very hot or cold, abdominal pain and diarrhoea. One in three people with migraines experience ‘aura’, sensory warning signs before a migraine. These include seeing blind spots, zigzag patterns or flashing lights; numbness or a tingling sensation moving up the arm before reaching the face; feeling dizzy; difficulty speaking; and, in rare cases, losing consciousness.

PICTURES: GETTY; ISTOCK

ORTHODOX TREATMENT

Although there is no cure for migraines, treatments are available to ease symptoms. Many people find sleeping or lying in a dark room helpful when having a migraine. Others may find symptoms ease after eating or vomiting. Over-the-counter medications such as paracetamol, aspirin and ibuprofen can help if taken at the first signs of a migraine. If these don’t work, a GP may prescribe something stronger or refer patients to a specialist. Anti-sickness medications can be beneficial to patients experiencing nausea and vomiting. These are usually prescribed by a GP

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and can be taken alongside painkillers. Pharmacies may also stock combination medicines that contain both painkillers and anti-sickness medicines.

COMPLEMENTARY AND SPORTS THERAPY Traditional Chinese acupuncture could help clients manage migraines, according to a number of clinical studies. A team of scientists reviewed studies published on acupuncture for chronic migraines between 1981 to 2017 and found data to suggest that the therapy could help treat and prevent chronic migraine through the mechanism of neuroplasticity, the brain’s ability to restructure itself following learning, experience or injury (English Oxford Living Dictionaries, 2018; Xu et al, 2017). Exercise may also be beneficial. A recent randomised controlled trial looked at the effects of different endurance exercise modalities on migraines in 45 patients, with scientists comparing high-intensity interval training (HIIT) with moderate continuous training and a control group (Hanssen et al, 2018). The two intervention groups trained twice a week for 12 weeks. Overall, moderate migraine reductions were observed. The results indicated that HIIT was more effective than the other two methods for migraine reduction and improvement of cerebrovascular health. Therapies have the potential to address certain symptoms of migraine. Acupressure, for example, may alleviate nausea in clients who experience migraines when used alongside sodium

valproate medication. One study randomly divided 98 patients with chronic migraine into an intervention group, receiving acupressure alongside sodium valproate, and a control group receiving medication alone (Xu et al, 2017). Using a numeric rating scale and recording migraine frequency over eight weeks and at a fourweek follow-up, the researchers found that the acupressure group had significantly reduced nausea when compared with the control group. However, the results also suggested that acupressure did not relieve pain or improve quality of life in patients with chronic migraine. Inhalation of lavender oil could help reduce migraine headache severity. A study from 2012 assigned 40 patients to two groups, either inhaling lavender oil or a placebo for 15 minutes, and recording their headache severity and associated symptoms at 30-minute intervals for two hours (Sasannejad et al, 2012). The results showed significant improvements in the lavender group when compared with the placebo group.

NB: The information provided in this article is not all-encompassing, and intended as an overview only. It should not be used for the purposes of ‘diagnosis’. Members or clients presenting with any symptoms should always consult a GP or other relevant health practitioner. The advice of a doctor, pharmacist or other suitably qualiﬁed person should be sought before taking any form of medication or treatment.

REFERENCES For full references, go to fht.org.uk/IT-references

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How are things?

Please let us know in our 2019 Member Survey Your feedback is really important as it helps us to make sure we are providing you with the support and services you need as a valued member of the FHT. Weâ&#x20AC;&#x2122;d be really grateful if you could complete our 2019 FHT Member Survey when you have a tea break, so that we can learn about whatâ&#x20AC;&#x2122;s important to you and how you think weâ&#x20AC;&#x2122;re doing as your preferred professional association. As a thank you, weâ&#x20AC;&#x2122;ll enter you into a free prize draw. One lucky winner will receive a ÂŁ100 John Lewis & Partners gift card and a yearâ&#x20AC;&#x2122;s free membership to the )+7 DQG ÂżYH UXQQHUV XS ZLOO UHFHLYH D ÂŁ20 John Lewis & Partners gift card.*

Visit fht.org.uk/FHT-survey

Visit fh fht.org.uk/FHT-survey h t .org.uk/FHT T-s s urvey

*Entries to be received by no later than 19 February, 2019. A prize of equivalent value to the John Lewis & Partners gift card will be provided if the winning member lives outside of the UK. Standard FHT competition terms and conditions apply â&#x20AC;&#x201C; please see fht.org.uk/competitions. If you would like a printed copy of the survey, please contact the FHT by post, telephone or email (see contact details on page 5).

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A DAY IN THE LIFE | Sheree Phelps

A DAY IN THE LIFE OF… SHEREE PHELPS, MFHT, SPORTS MASSAGE THERAPIST AND 2017 FHT EXCELLENCE AWARD WINNER

12PM

I see my first client of the day for dry needling. My client has had a tremor in his left arm for more than three years. He’s had every test, prod and poke a doctor can give and they have shrugged their shoulders at what to do. After treating his family, they asked me if I could help. The results so far have been outstanding. After one session of dry needling his flexor and extensor forearm muscles, he had 10 hours without the tremor. The second appointment gave him two days’ relief, and the third, a whole weekend. We are continuing with one appointment a week and monitoring the progress. I may never know what started it, but if I can help slow or stop it, then it will be my greatest achievement.

1PM

My next client is a 78-year-old golfer who’s lost range of movement in his swing. A few simple sports massage treatments on his hips and glutes and he’s back on the course. He is my oldest client and even brought his wife along to meet me, so she could thank me.

2PM I have a mountain biker who

8AM

I normally wake up, have a quick read of the paper and go through my social media while lying in bed.

10AM After pottering around the house, doing laundry and having breakfast, I head down to the gym (three out of five days a week) and have a swim, then a body balance or aquafit class. I’m not always this disciplined – having such a physical job, I take each week as it comes.

11.30AM I set my room up, pop the heated bed on and send out messages to any new clients who came the day before to see how they have been since their treatment.

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always presents with new injuries, niggles, twisted kneecaps or delayed onset muscle soreness from his last ride. A regular in the clinic, he has referred many clients from the biking world to me.

3PM

that day for me to have on the way home. I do love my clients, but not just for the free cakes.

5PM

The first of the evening clients come in. This one is off to New Zealand, cycling the length of the two main islands for a charity, the Pilgrim Bandits, and raising money for ex-service personnel and wounded soldiers. I give him sports massage before and after his training.

6PM

I often have a relaxation or pregnancy massage client in, and they feel ready to sleep when they go home. Some of them even bring their pyjamas to go home in. I don’t blame them, with the candles burning and dimmed lights, my treatment room is rather cosy.

7PM I tidy up, clean the room and pop a towel load in the wash, then head home.

8.30PM I’m grabbing some dinner, not always the healthiest, but I try my best. I round up my day, replying to any messages and returning phone calls.

10.30PM

I collapse into bed, grateful for the clients I have and the help I’ve been able to give. I smile, knowing that in the morning I’ll be waking up to a job I love.

I’m jumping in my car, driving to a client’s home, while eating half a sandwich and drinking Pepsi Max (which keeps me going on long days).

3.30PM

I reach my client’s home and offer treatments, mainly for relaxation and lymphatic drainage. Her dog, Lulu, sits in with us and watches my every move. Lulu is happy to see me because I bring her a carrot each week as a treat.

4.30PM The other half of my sandwich is downed and often my client gives me a slice of whatever she has baked

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MEMBERS’ NEWS

Across the pond MAUREEN BONNER, MFHT, REFLECTS ON A RECENT MEETING WITH US-BASED ONCOLOGY MASSAGE EXPERT TRACY WALTON

hat better way to update my CPD and discover what’s new in the world of oncology massage than to learn from Tracy Walton, a world leader and award-winning educator on the subject. Attending Tracy’s four-day course in Boston, Massachusetts, I had the pleasure to conduct an interview with her and discuss developments in oncology massage.

WHY ONCOLOGY MASSAGE? I asked Tracy why she was drawn to this area of work. She said: ‘I’ve always loved massage therapy, but there’s something about oncology massage therapy that speaks to me. By providing skilled touch with possible symptom relief and companionship, we can ease the way for people. I feel grateful and honoured to participate at that time in someone’s life.’ As Tracy spoke those words, I was happy to hear that we share some of the same motivations for working in this field. I have been working with clients who have cancer since 2003 and, like many complementary therapists, I was drawn to the industry to make a difference to people’s lives.

GROWING DEMAND We still have a long way to go but it’s pretty exciting. The demand for skilled oncology massage therapy is consumerdriven – patients are demanding it, and they are often our biggest advocates. Tracy told me that oncology massage therapy can often be a client’s first experience of massage and from this they discover the value of treatments, realising they are more than a luxury. They usually request further treatments, and the demand for oncology massage often exceeds its supply.

UNPAID WORK For hospices in the US to receive funding, they are required to provide volunteer hours, and this is often where massage therapists come in. Tracy regularly receives phone calls from hospices about volunteer opportunities. Tracy said: ‘Massage therapists are generous and compassionate people, but there is a built-in expectation that we are joyful altruists at every moment – that would be great, but it doesn’t pay the bills. The expectation is that we need to provide the care for free

ONCOLOGY MASSAGE DEVELOPMENT Tracy and many other therapists have been part of a massage revolution over the last two decades, including developments in oncology massage. Speaking of these developments, Tracy said: ‘We’ve had 10 years of standards and education in oncology massage therapy, with research dating as far back as the 1990s. That was an enormous achievement – but now we can refine things rather than creating them from scratch.’

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and that it has no other value, which is unfortunate.’ I agree with Tracy when she says it would be much more sustainable to pay a massage therapist for retention. In the UK, we have a growing number of paid therapists in hospices, hospitals and charity projects, and I am happy to have seen this develop over the years. On the flipside, the US joint commission in hospitals has recently enacted a policy that requires hospitals to provide non-pharmacological approaches to pain management, which specifically lists therapies like acupuncture and massage.

THE FUTURE Tracy identified oncology massage research as a key area of future development she would like to see in the US, which she believes will be possible if programmes are properly funded. In addition, Tracy indicates that hospices and hospitals still develop training from scratch, lacking access to a single body of knowledge that can be drawn on for programme development. Looking at wider healthcare inequalities in the US, Tracy said: ‘Healthcare policy doesn’t work for the entire population, we’ve made it work for some of the population but it’s incredibly inequitable. ‘To ask complementary therapists to solve these problems is a big ask. As complementary therapists, we have to be realistic about what we can accomplish and hopeful of what we can achieve.’

MORE INFORMATION Read more about Tracy at tracywalton.com

2019 FHT TRAINING CONGRESS Maureen will be giving a seminar at the 2019 FHT Training Congress on Monday 20 May, called ‘Adapting massage for clients at risk of lymphoedema, DVT and bone metastases’. For more information, visit fht.org.uk/congress Maureen Bonner (right) meets Tracy Walton

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MEMBERS’ REVIEWS

WELEDA ALMOND SOOTHING FACIAL OIL L Weleda’s Almond Soothing Facial Oil is orning formulated for dry skin to use morning nt or and evening for extra nourishment to protect against the elements.

JOANNE MASON, MFHT I would highly recommend this 10/10 fragrance-free oil that is very light and gentle on the skin. It hass sed as a facial oil endless uses: not only can it be used that deeply nourishes sensitive, dry skin, but it’s ke-up. It soaks also perfect for removing eye make-up. ily into the skin easily, doesn’t feel oily sturised. and has left my skin soft and moisturised. A little really does go a long way.

ANNE ROSSI-TALL, MFHT

8/10

It didn’t leave my skin feeling greasy, asy, ape just lovely and soft. I loved the shape and colour of the bottle; it looked like a luxury product. It is a great all-rounder as it removes turiser for dry make-up and is also a great moisturiser mell, but overall skin. There is a slight marzipan smell, it is a lovely product.

BEST BUY RRP £18.95, available from weleda.co.uk

MOVEMENT MATTERS, BY KATHY BOWMAN In Movement Matters: Essays on Movement Science, Movement Ecology, and the Nature of Movement, Katy Bowman explains the mechanics of a sedentary culture and the deep complexity of the phenomenon we call movement.

BEVERLY CHILSON, MFHT 8/10 This extraordinary book makes you think about movement in many different ways and will challenge your beliefs and behaviours from the start. A recommended read for anyone working with or studying the mind and body on any level. Easyto-read short essays link together well, showing how movement matters for yourself and the compassionate community. VICKY GREATOREX, MFHT

8/10

The book is a real eye-opener. I would normally be put off with the ‘essays’ subtitle, but this was an easy read. There are

lots of useful tips about lifestyle, and nuggets of information you would have to do quite in-depth research to ﬁnd, such as exploring how our eyes are underutilised in the contemporary world, which is fascinating. I’ve recommended it to friends and clients and will continue to do so.

MEMBER OFFER FHT members can receive a 20% discount on Movement Matters (RRP £12.99), when purchasing from Combined Book Services. Call 01892 837171 and quote FHT20 when ordering. Offer ends: 31 March 2019.

NEW PRODUCTS BABYOPATHY AROMATHERAPY OILS The new Babyopathy range has been developed by aromatherapist Angela Spencer. Expertly blended with Base Formula’s essential oils and carrier oils, the range is designed to nurture mums throughout pregnancy and beyond. Oils include a pre-conception oil to prepare mind and body for pregnancy, and speciﬁc oils for each trimester and the birth itself. A luxury Bump & Bits Massage Oil can be used by mum-to-be to help prevent stretch marks and for perineal massage.

ESSENTIAL OILS FOR MINDFULNESS AND MEDITATION, BY HEATHER DAWN GODFREY Outlining the practice and beneﬁts of meditation and mindfulness in combination with the use of essential oils, Heather Dawn Godfrey, MFHT, explains how these practices hone and sustain a conscious awareness of being in the present moment, focusing attention on what you are sensually experiencing and leaving no space for fears or anxiety. Heather introduces readers to a group of oils speciﬁcally selected for attaining and maintaining a state of mindfulness.

PRICE: from £6.95, (discount available for registered FHT members), available at baseformula.com

PRICE: £12.99, available at simonandschuster.co.uk

INTERNATIONAL THERAPIST WINTER 2019

52-53 REVIEWS_IT WINTER 2019_International Therapist 52

BULLETPROOF BODIES, BY ROSS CLIFFORD AND ASHLEY KALYM YM

PILATES FOR REHABILITATION, BY SAMANTHA WOOD

From tennis elbow to low back pain, Bulletproof Bodies aims to demonstrate how targeted body-weight exercise can be ange of injuries used to tackle a range and improve joint range-of-motion, muscle strength and endurance, and ligament and tendon health. As an added bonus, by using the suggested exercises you will also gain strength and physical ﬁtness. The exercises in Bulletproof Bodies offer a challenging, stimulating and accessible means of dealing with those niggling injuries.

With Pilates for Rehabilitation, you can learn how to apply proven pilates methods to address dysfunction and help clients f achieve optimal performance. Renowned instructor Samantha Wood provides detailed descriptions of the most effective exercises for rehabilitating and healing injuries, improving functional strength, promoting efﬁcient movement, and managing pain. Contains step-by-step instructions for pilates apparatus and mat work.

PRICE: £14.99, available at amazon.co.uk

PRICE: £37.99, available at humankinetics.com

FHT.ORG.UK

11/01/2019 14:34

THE CRYSTAL HEALER: VOLUME 2, BY PHILLIP PERMUTT Author Philip Permutt explores diverse ways of working with crystals. In his second volume, he introduces 250 new crystals, including some only recently discovered.

SARAH HARDY, MFHT A well-laid-out, informative and 10/10 resourceful aid to working with the gem world. This second volume gives us a better understanding, using an easyreference colour-coded ﬁnder. I love the clear photos and descriptions. It explores ways of working with crystals to soothe emotional problems, alleviate physical symptoms and for spiritual and lifestyle enhancement. Philip shares his passion, knowledge and experience, taking you further on your crystal journey.

EVE SCHNEIDER, MFHT The book is a sound guide for the 8/10 beginner, as well as the advanced crystal healer, with the description of new crystals and their properties, as well as more established ones. It’s nicely illustrated with examples of crystal grid laying and descriptions needed to perform a healing session from beginning to end. In the last chapter, the author includes a useful glossary for everyday ailments and the corresponding crystals.

BEST BUY RRP £12.99, available from rylandpeters.com

Competition Four lucky members will win an Absolute Aromas Aroma-Mist Diffuser and Breatheasy Essential Blend worth more than £35. With subtle mood lighting , the Aroma-Mist is the perfect companion whether you wish to create a calming mood, benefit from the healing qualities of certain oils or bring a touch of luxury to your home or workplace. Simply add a couple of drops of your chosen essential oil to the diffuser to enjoy your favourite scents, while benefiting from their therapeutic properties. Absolute Aromas’ range of essential oil blends have been formulated using 100% pure and natural essential oils, designed to assist, support and offer relief from all of life’s eventualities. The Breatheasy Essential Blend is perfect for this time of year, as it’s formulated to offer a fresh and clearing aroma to help soothe stuffy noses and heavy heads. Breatheasy includes eucalyptus, tea tree and peppermint essential oils. All chosen for their natural properties, these oils also help offer protection against colds and flu. Simply add a couple of drops of Breatheasy Essential Blend to the water within the AromaMist Diffuser, and sit back and breathe as the room is filled with this soothing and clearing blend to soothe your winter chills. absolute-aromas.com

PRIZE WORT OVER H £35

TO ENTER, PLEASE ANSWER THE FOLLOWING QUESTION: How many drops of Breatheasy Essential Blend should be added to the Aroma-Mist Diffuser? 2 4 6 Simply email your name, address, membership number and answer to dralls@fht.org.uk, typing ‘Absolute Aromas competition’ in the subject box. Alternatively, send your answer and details on a postcard to: Absolute Aromas Competition FHT 18 Shakespeare Business Centre Hathaway Close Eastleigh Hampshire SO50 4SR The closing date is 14 February 2019. For full competition terms and conditions, visit fht.org.uk/competitions

Please note that product descriptions featured on these pages are provided by the supplier/manufacturer.

CUBAN BLEND HAIR TONIC The Bluebeards Revenge Cuban Blend Hair Tonic is inspired by the rich aromas of exotic Caribbean oils and has been carefully formulated to provide vigour and freshness to the scalps of men, while promoting a natural shine and a light hold. When massaged intensely into the scalp, the tonic helps to condition and moisturise a man’s hair while stimulating circulation. The light hold created by the tonic also makes hair easier to work with for professionals and can create the vital foundation needed to build extravagant hairstyles.

PRICE: £9.99, available at bluebeards-revenge.co.uk

FHT.ORG.UK

52-53 REVIEWS_IT WINTER 2019_International Therapist 53

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:35

LEARNING

CPD questions

FO R M O R E IN F O R M AT IO ABO UT H OW N G A IN C P D P T O O IN T S BY R E F L E C T IN G O N YO U R FAVO U R IT E A R T IC L E S , V F H T.O R G .U IS IT K /C P D

BELOW ARE QUESTIONS RELATING TO ARTICLES IN THIS ISSUE OF INTERNATIONAL THERAPIST. TO GAIN THREE CPD POINTS (UNLESS OTHERWISE STATED), ANSWER ONE OR MORE QUESTIONS RELATING TO THE SAME ARTICLE, USING A MINIMUM OF 300 WORDS IN TOTAL. IF YOU DON’T THINK THE QUESTIONS ARE HELPFUL, YOU CAN POSE YOUR OWN TO ANY OF THE ARTICLES FEATURED IN THE MAGAZINE. TRIGGER WARNING (P12-15)

Jane Johnson talks about how soft tissue release (STR) can deactivate trigger points in the infraspinatus. Write about how a client might use active STR to deactivate a trigger point in infraspinatus – what position might they need to be in and what tool could they use?

Using Jane Johnson’s article as inspiration, write about how you would treat a specific muscle with a therapy you practise. How would you identify potential problems and what techniques would you use to address these?

another beauty therapy treatment which is either new or gaining in popularity. Discuss its benefits.

FACING FIBROMYALGIA (P36-38)

Jing’s Rachel Fairweather discusses how advanced massage techniques can help clients with fibromyalgia. Identify a different health condition that may benefit from advanced massage techniques and explain how you would adapt treatments for this.

2019 Diary Dates 15-17 February University of Westminster, London Yoga in Healthcare Conference yogainhealthcarealliance.com 24-25 February ExCeL London Professional Beauty London professionalbeauty.co.uk 8-9 May ExCeL London COPA Series copashow.co.uk 18-19 May Park Avenue Hotel, Belfast Belfast’s 1st Mind & Sole Interchange facebook.com/ events/478507806005622 19-20 May NEC Birmingham FHT STAND & 2019 Training Congress at TRAINING the Holistic Health Show fht.org.uk/congress 1-2 July University of Worcester CAMSTRAND rccm.org.uk

TOP 10

Reflecting on your own work, write a short case study on how you have helped a particular client with fibromyalgia or another health condition of your choice.

POSITIVE MEASURES (P46-47)

PEEL POWER (P30-32)

In her article, Candice Gardner from Dermalogica talks about the benefits of skin peels and the importance of best practice. She says that chemical peel services are in growing demand. Write about

Nicola Brough and Professor Sarah Stewart-Brown provide an introduction to WEMWBS and WHHQ, two patient-reported outcome measures. Consider tracking the progress of a regular client using WEMWBS or another patient reported outcome measure (such as MYCAW or MYMOP) and write about the results.

2019 ANNUAL MEMBERSHIP FEES* FHT Member: £62.99 FHT Associate: £68.24 Student Member**: £24.99 FHT Affiliate: £36.74 Overseas Member: from £44.09 Qualified Combined Medical Malpractice, Public and Products insurance: from £46.81

INTERNATIONAL THERAPIST WINTER 2019

54 CPD_IT WINTER 2019_International Therapist 54

reasons for being an FHT member 1

Professional status and recognition.

Campaigning, promoting and protecting your interests as a professional therapist.

Professional representation.

The industry’s leading professional therapist magazine.

Tailor-made comprehensive therapist, salon and clinic insurance policies.

Discounted continued professional learning.

*Ask our membership team about paying by Direct Debit – it could save you 5% on membership fees. **Includes case study insurance cover. £24.99 deducted from full membership fee on qualifying and upgrading. Terms and conditions apply.

The UK’s largest local support group network.

FHT-branded products and member discounts on therapy supplies.

For membership and insurance information or an application pack, visit fht.org.uk or call 023 8062 4350.

Members’ helpline.

FHT is authorised and regulated by the Financial Conduct Authority, Ref: No. 502095.

FHT is a not-for-proﬁt organisation run by therapists, for therapists.

FHT.ORG.UK

11/01/2019 14:35

LEARNING

In the reading room

FHT spiral no. 29

Indications Aches and pains, acne, allergic asthma,

SAGE CLARYsclarea) (Salvia

drugs that are metabolised by CYP2D6 is provided by the authors (Appendix B: page 660), and include

Lamiaceae

oil can vary according to the plant species; the

2017 and soil where the plant is climate, altitude AUTUMN grown; and when it is harvested. Refer to the

in (1.5% dilution) Cedrus atlantica atlanticca as an o oilil that should shou uld not be used experienced the aroma group showed that score and during pregn pregnancy. gnan ncy y. changes in pain signiﬁcant positive group. In Esse Essential ential Oil Oill Safety, Sa Safe ety, however, how wever, Tisserand with the control depression compared Young (2014) state that and Youn ng (2 2014) st tate e th hat tthere here ar are no known

“The essential oil,il, steam-distilled from m the wood, is yellow in colour and has a warm, woodyy fragrance and base note”

manufacturer’s safety data sheet for a breakdown of an oil’s chemical proﬁle.

REFERENCE

go to For full references, -references fht.org.uk/IT

contraindications contraind dicattions for for C Cedrus ed druss atlantica atlanticca, and do not an should list it as a n oil that sh hou uld be avoided d or restricted pregnancy and lactation. during pre regna anccy a nd lact tatio on. Therapists err Therap pists wishing wisshiing g to o er rr on the side siide of caution can choose choosse alternative alttern nattiv ve essential esse sentiial oils.

RESEARCH RESEAR RCH H

Body systems Digestive, endocrine, immune, nervous,

L THERAPIST

national Therapist

Body systems Digestive, immune, musculoskele reproductive tal, nerv nervous, , skin, urinary.

animal can affect human and anim nimal health. In this in vitro o study, the effects of seven

a – were essential oils – including Cedrus atlantica

A number of years ago, we featured a letter and photograph from a member who had framed the essential oil profiles featured in International Therapist and hung these on the walls in her therapy practice. As well as being decorative, she felt the profiles were nice for her clients to look at or be referred to when visiting for a treatment. We thought this was a very original use of the oil profiles, and as these are written and owned by the FHT, we welcome other

tested on engorged ticks (30 per essential oil) at concentrations of 1%, 5% and 10%. Treatment

cystitis, dandruff, dermatitis,

effectiveness was measured by tick oviposition (laying of eggs), the egg’s weight and hatchability.

problems, nervous tension, neuralgia, sebum (excessive),

pos sitiiion on Esters (up to 80%) Oxides – 1.8-cineole – angelates, buty butyrates Hydrocarbon s – ɲ-pinene, sabinene, caryophyllen e, chamazulene

s-pinocarveol NB: The chemical composition oil can vary of any e essential greatly, according species; climate, to the pl plant altitude and is grown; soil where and when the plant it is harvested. manufacture Refer Refe to the r’s safety data sheet of an oil’s for a breakdown chemical b profi profile. file.

treatments anti-parasitic tre eatm ments ts can ca prove pro extremely xtreme as problematic, expensive as well a pro roblem ematicc, because of

Acne, bronchitis, catarrh, cellulite,

12:25 08/10/2018Alcohols – trans

According to the authors, autho orss, the the cattle cattle tick I t pest for cattle’’ in Brazil, Brazil,, causing ca aus using g animal al stress, stress

eczema, lymph circulation

tested. In addition, juniper, ginger, geranium and bergamot showed efﬁcacy ranging from 73% to

urinary tract infections, wounds.

95%. The authors called for more tests as ‘the use

Blends with

great potential for the future as an alternative

Chamomile (German),

method besides chemical products’.

Wound healing

of essential oils in the control of R. microplus shows

cypress, eucalyptus, grapefruit, juniper berry,

REFERENCES For full references, go to fht.org.uk/IT-references

REFEREN

INTERNATIONAL THERAPIST WINTER 2018

A study (Cho et al, 2013) showed that of an aromatherap the inhalation y Roman chamomile blend containing lavender, and neroli was more (with a 6:2:0.5 effective ratio) than conventional helping to care alone reduce anxiety at levels and quality in improve sleep percutaneou s coronary patients in intervention an intensive care unit.

Muscle relaxant Frontiers in Pharmacolo gy recently paper entitled published ‘Evidence a supports in vitro effects tradition: of Roman The chamomile muscle’, outlining on smooth how a study various extracts identiﬁ from Chamaemelu ed that a positive m nobile impact on had smooth muscle, the essential including oil, which ‘had a remarkable muscle relaxant smooth effect in this setting’ al, 2018). (Sándor et

A study published in Targets (Kazemian Infectious Disorders Drug et al, 2018) an ointment indicated containing that Roman chamomile superior wound-heali had ng activities a topical compared antibiotic. with The authors the ‘results concluded indicated that that extract effective of C. nobile antibacteria had l activity the progression and accelerated of wound healing’ and the value of plant extracts ‘revealed to control resistant bacteria in antibioticwound infections’.

Cedarwood, along with palmarosa and lemongrass, showed efﬁcacy of 99% at all concentrations

pruritus, rheumatism, scalp problems, stress-related conditions,

RESEARC H Anxiety and sleep

Asteraceae

Chem Chemical mica al com co composit m

INTERNATIONA AUTUMN 2018

Journal off Ad Advanced University’s J ourrna al o dva anced ed Research, supports the e essential esse sentia al oil’s oil’ss role role in in combating comb bating

insecticides restrictions on the use us of certain cer ti id that

cicatrisant, decongestant, diuretic,

chamomile

otan nica call fa family fam milly

visit further reading, -references fht.org.uk/IT

cedarwood in in peer-reviewed pe peerr-re eview wed d journals that that focus on complementary therapy complement tary y12:50 the herrap py and d healthcare. healthcarre. However, 06/10/2017

Aphrodisiac, antibacterial, antifungal,

mucolytic, sedative, stimulant, tonic.

PROFIL PRO OFILE LE E | Ro Roman oman

)

one recent study study y from frrom m Brazil, Bra aziil, published pu ublished d in Cairo

antiseptic, astringent, balancing,

Indications

carpal tunnel syndrome.

ROMAN AN CHA CHAMOM MOM (Cham (Cha ama a aemel em melu elu um m nobile ILE

lower growth and poor po r performance. pe erfo forma mance. e In addition, addition

Therapeutic properties

A study published in Complementary Therapies in Clinical Practice (Hashempur et al, 2017) showed that the topical application of German chamomile oil could beneﬁt patients with mild to moderate

Eighty-six patients were enrolled in the oil sage essential stress that clary randomised double-blind placebo-controlled Numerous texts Tiran (2018) used during pregnancy. clinical trial and received wrist splint plus topical should not be for midwives it may be useful chamomile oil or placebo for four weeks. They writes that while pregnancy’ it into a ‘post-dates were evaluated at baseline and the end of the weeks to incorporate used before 37 should not be study. Dynamometry (power output), functionality treatment, it labour. Tiran during established and symptom severity scores of the patients were and of labour, or both obstetric a table outlining significantly improved in the splint plus chamomile also provides to the use /precautions oil group compared with the placebo group. medical contraindications caesarean section, including previous Compound latency of the median nerve in the of clary sage, of oestrogenconceive, history chamomile oil group also significantly decreased. attempting to influence of being under the Under dependent tumours, prolonged exposure. Chronic leg ulcer alcohol and avoiding Essential in for clary sage In Aromatherapy o at e apy in C Clinical ca Practice, act ce, Buckle uc e the ‘Safety summary’ state and Young (2014) describes the work of Ames (2006), a nurse and Oil Safety, Tisserand hazards or oil has no known aromatherapist, who used essential oils on a that the essential the plant non-phototoxic. according to , and that it is Stage 2 chronic leg ulcer of a 70-year-old diabetic can vary greatly, on the contraindications soil where the may be dependent altitude and woman (Buckle, 2015). The ulcer measured 4cm by but species; climate, NB: Safety concerns harvested. Refer essential oil, profile of an and when it is side 4cm m and had not responded to medical treatment. for a plant is grown; specific chemical to err on the safety data sheet would be urged Ames applied German chamomile mile (10%) in to the manufacturer’s aromatherapists is a lack of profile. where there an oil’s chemical grapeseed oil twice a day. The wound is reported breakdown of of caution, particularly into its effects. to have completely healed in 13 days. evidence base/research Body systems endocrine, musculoskeletal, Digestive, circulation, skin. respiratory, RESEARCH nervous, reproductive, Diabetes mellitusand Habib, 2018) REFERENCES (Raafat properties A recent study composition For full references, go to Therapeutic the phytochemical two in antifungal, antispasmodic, investigated collected fht.org.uk/IT-references Therapeu Anti-infectious, essential oils deodorant, emmenagogic, tic propertie of Salvia sclarea explored their Anti-inflammatory, calming, decongestant, s in Lebanon and different regions antispasmod carminative, sedative, tonic. antidiabetic potentials. ic, calming, emmenagog oils have acute and subchronic essential There ic, sedative, are three ‘ Salvia sclarea aromathera different vulnerary. and […] They concluded: types of chamomile py – German Indication Indications FHT.ORG.UK SPRING 2018 INTERNATIONAL THERAPIST 21 antidiabetic activities, circulatory ((Matricaria s that are u and Roman shown potential anxiety, asthma, used in as a complementary recutita), recutita), Maroc Amenorrhea Amenorrhoea, (Chamaeme haemorrhoids in the future of Commonly , anxiety, varicose veins, lum nobile), (Ormenis might be used managementknown appetite (stimulant), multicaulis) which is featured burns, depression, problems (including medicine in the digestive as English boils, convalescence, is a native or an alternative or garden dysmenorrh in thi this profile. flatulence, of Western colic-like and cholesterol), chamomile oea, eczema, related complications.’ headaches, Europe and stomach cramps, , Roman cchamomile Hungary, diabetes and gout, indigestion, is widely France and colic, irritability, problems (especially production, cultivated Belgium. intestinal grows life excessive sebum menopause, in En A mat-formin England, neuralgia, pains, flatulence), nervous asthma, and quality of up to 25cm in height, g perennial, psoriasis, Sleep quality with rheumatic effectiveness the plant th problems, pain, shock, compared the that produce feathery leaves and skin (inflamed, The massage sleep A study in Taiwan daisy-like daisy-lik essential oil a irritated, stress, wounds. flowers is steam distilledsweet, apple aroma. and acupressure sensitive), yellow of aromatherapy colour, with from the the sleepinquality flower heads, strategies on for being a fruity, intervention typically typica a gentle, soothing tea-leaf aroma 132 career women. Blends with pale and middle life (QOL) in choice when essential and quality of essential of note. blend treating children oil, Roman Renowned Re Bergamot, found that a clary sage, and and is frequently chamomile is a The researchers lavender, Salvia sclarea antispasmo sandalwood, popular neroli, rose, angustifolia , called upon dic and anti-inflam sweet orange, oils (Lavandula Caddy dual anti-infl for its sedative, ylang ylang. flammatory ) ‘exhibited greater(1997) and Rhind matory properties. chamomile quality Origanum majorana (2016) both QOL and sleep Safety ’s both horticultur make data reference to its traditional al nickname benefits on improving to Roman of lavender Roma No known use as a companion of ‘plant’s physician’, the interventions hazards or compared with contraindica massage in owing ow ‘on the basis plant to help tions and and acupressure in neighbouri of current stave off infect essential oil knowledge, infection ng plants. present any unlikely to hazard in career women’. aromatherap and Young, y’ (Tisserand 2014). Holmes (2016) very rarely, Roman chamomile indicates that, allergic rash may cause in individuals S an REFERENCE who are hypersensiti to plants in the daisy and ve family. For references Botanical Bot

farming Cattle fa arm min ng FHT.ORG.UK Sadly, there e is a lack k of of published pub blish hed research rese earch on

Rhipicephaluss mic microplus cro oplu us is ‘t ‘the e most mos ost harmful

RESEARCH Carpal tunnel syndrome

hormone-like, tonic, vermifuge, vulnerary.

Safety data

harmful insects inseccts (Pazinato (Pazin (P nat to et et al, 2016). 2016). FHT.ORG.UK

respiratory, skin, urinary.

these drugs are indicated. For more information, see

Therapeutic Th herrap peutic c properties pro operties Analgesic, antiallergenic, anti-infl anti-inflammatory, flammatory, antispasmodic, bactericidal, balancing, calming, carminative, cicatrisant, cholagogue, emmenagogue, emmenagog

FHT.ORG.UK

16_Essential

INTERNATI

oil__Internation

ONAL THERAPIST

al Therapist

CES

For references and further reading, visit fht.org.uk /IT-refere

ISTOCK

stress-related), )– problems (particularly oily skin, psoriasis, Coumarins (furocoumarins) loss of appetite, tract flatulence, flu, oil thrush, urinary bergapten, bergamottin (emotional), on of any essential composition shingles, stress climate, NB: The chemical ant sspecies; to the plant infections, wounds. and can vary according plant is grown, Botanical family soil where the altitude and the manufacturer’s Pinaceae Blends with Refer to th chamomile, clary oil’s when it is harvested. black pepper, akdow of an for a breakdown Basil, benzoin, grapefruit, jasmine, safety data sheet Chemical composition eucalyptus, geranium, sage, le. lemon, mandarin, chemical profi lavender, Sesquiterpenes cedrene, ɴ-himachalene, juniper– berry, patchouli, petitgrain, neroli, orange, ɲ-himachalene, cadinene marjoram, ylang. Body systems tangerine, ylang re us, respiratory, Alcohols – atlantol, cedrol nervous, rose, sandalwood, Digestive, immune, Ketones – ɲ-atlantone, ɶ-atlantone skin, urinary. NB: The chemical composition of any essential

Essential Oil Safety (Tisserand and Young, 2014).

Digestive, endocrine, immune, musculoskeletal, nervous, reproductive, respiratory, skin, urinary. urinary

cedarwood, Basil, bergamot, berry, jasmine, juniper geranium, grapefruit, patchouli, rose, mandarin, orange, lavender, lime, ylang ylang. tangerine, sandalwood,

amphetamine, donezipel and tamoxifen, among others. Caution should therefore be exercised where

Body B od dy systems sy yste ems

ESSENTIAL OIL

Botanical family

CEDARWOOD (Cedrus atlantica) ca)

Alcohols –

and drugs metabolised by this enzyme’. A list of

breakdown of an oil’s chemical profi profile. file.

nces

SUMMER

PICTURE:

(Ni et xperimental A study in Taiwan an experimental patients to either preopera 109 preoperative ential oil, essential esse ng diffused bergamot receivin group, receiving our only. vapo i ing water vapour receiving were or a control group, and vital signs anxiety levels All The patients’ intervention. and after the measured before a greater

a) OIL PROFILE | Cedarwood (Citrus bergami AM TESSENTIAL BERGAMO

cultivated sage is now widely up to a France, clary the plant grows Syria and southern biennial herb, A native to Italy, white-to-pink and the US. A of two-lipped, Russia, Morocco spikes. leaves and whorls across Europe, on single or branched with heart-shaped bracts and grow or very pale metre in height, distinctive mauve tops, is colourless flowers that have from the flowering and top note. oil is steam-distilled nutty aroma often The essential a herbaceous, clary sage is yellow, and has highlights that (Salvia officinalis) A-Z, Davis (2005) to common sage not In Aromatherapy in preference of sage, it does in used in aromatherapy of the same properties level of thujone clary shares many with the high ‘because while of toxicity associated of some sage oils)’. present the risks (up to 45% which means common sage Latin word clarus, from the come from the is believed to (sticky substance) was mucilage The name clary the sage Clary reported that from the eyes. ‘clear’, as Culpeper to clear mucus tuberculosis traditionally used sweats when plant’s seeds was remedy for night be used in to be a popular more likely to also believed essential oil is properties. Today, the plant’s and relaxing was widespread. for its antispasmodic aromatherapy

group showed citrus fruit called those in the bergamot of a small green anxiety. northern from the rind Chemical composition obta reduction in preoperative in Lombardy, 74%), geranyl oil is obtained in acetate (up to city of Bergamo Bergamot essential Esters – linalyl widely cultivated amed after the Named bergamot is now acetate a bergamot orange. Morocco, acetate, neryl originally produced, Workplace stress (2011), 54 elementary Guinea, Argentina, oil was origin ɲ-terpineol, sclareol light as Ivory Coast, Italy, where the Shen’s study Alcohols – linalool, and is typically caryophyllene, In Chang and of Italy, as well to evaluate the – sesquiterpenes: by cold expression were recruited the Calabria region Hydrocarbons to top note. on stress he oil is obtained school teachers The myrcene, pinene bergamot spray aroma and middle Monoterpenes: of years Turkey, and Brazil. oil germacrene. with a citrusy ur, w effects of a 10-minute of any essential used for hundreds there were green in colour, composition fruit has been showed that valuable’ NB: The chemical and 2005 bergamot reduction. Results oil is ‘uniquely Davis (2005), a the essential in blood pressure According to The oil is also with and even today ne, a significant decreases and skincare. medicine, and that subjects and anxiety, tea. in Italian folk lavender, lave ende er, lemon, lem mon,, patchouli, pa atcho ouli, peppermint, pe eppermint, rosemary, (among others), ratefeatured Lady Grey ions depression There areand different varieties of cedarwood, butheart the one in this profi le is benefited infections, Grey of anxiety and Earl for urinary tract sandalwood, sand dalw woo od,, tea te ea tree. tre ee. and high degrees moderate used in perfumery Cedrus atlantica, commonly known as Atlas cedar or cedarwood. Native to the Atlas anxiety. key ingredient those with light than mountains of Morocco, this large evergreen treemore grows up to 35 metres tall and has Safety Saf fety yd data ata a A numbe number er of of aromatherapy aro oma ath hera apy titles title es and essential oil needle-like leaves and ovoid cones. The essential oil, which is steam-distilled from om in and anxiety properties Depression state that suppliers s sta tate e th t Cedrus C edru u s atlantica atlan antica a should not the wood, is yellow in colour and has a warm, woody fragrance and base note. . antiTherapeutic patients antidepressant, hospice antibacterial, during pregnancy. be used d urring gp reg gna ancy y. This includes Clinical Cedar was used by many ancient civilisations in medicine, cosmetics andexamined 2008) Analgesic, antispasmodic, study (Chang, Botanical family A Korean antifungal, Aromatherapy for Pregnancy Aroma mathe erapy y fo or P re egna ancy and an nd Childbirth, in perfumery, and inantiseptic, the Egyptian embalming process (Davis, 2005).hand The massage highly y on pain, infectious, digestive, of aroma Rutaceae deodorant, the effects cicatrisant, Tiran writes an ((2000) 20 000)) wr rites that a few sedative oils, aromatic wood was also used tovulnerary. make storage chests, as its odour is said to repel el patients which Tira hospice 58 in antiviral, tonic, uplifting, anxiety and depression to the including ccedarwood, ed darrwo ood, ‘are ‘are not suitable suiitable for use in sedative, stomachic, termites, moths and other harmful insects.cancer. Those assigned Chemical composition with terminal ve-minute maternity and state that matern nity care’. carre’. Price Pricce a nd Price Price (1999) (1 Still used in traditional Tibetan medicine and incense, cedarwood has beena used fised acetate group received Esters – linalyl experimental pinen days, with a cedarw cedarwood ‘considered wood d iss ‘co ons nsid dere ed in n France Francce to be neurotoxic throughout bronchial and urinary infections. It is alsoforindicated ated colds, tract seven Indicationshistory forburns, – limonene, ß-pinene, chicken pox, on each hand Monoterpenes anxiety, massagearoma abortive, and not normally used ortiv ve, a nd n ot norm mally use sed there for for skin problems, including acne, and its ‘masculine’ makes it a more refrankincense and abo and agitation, Acne, lavender depression, digestive Ѕ-terpinene of bergamot, cystitis, colic, for oil. The resultspregnan pregnant women nt wo omen n and and d infants’. inffants’. Davis Daviis (2005) also lists popular choice male toiletries and clients thanblend sweeter-smelling alternatives. ves. eczema, cold sores, linalool, geraniol sweet almond

Th rapist 16

and Young (2014) highlight that chamazulene, farnesene and ɲ-bisabolol inhibit enzyme CYP2D6 between all blue chamomile oil CTs [chemotypes]

NB: The chemical composition of German

with can vary greatly,frankincense, according to the Blends chamomile cypress,

PICTURE: ISTOCK

RESEARCH anxiety ly assigned Preoperative al, 2011) randomly

ESSENTIAL OIL PROFILES – AS PRETTY AS A PICTURE

German chamomile is reported to be non-phototoxic and contains no known carcinogens. In the proﬁle for German chamomile in Essential Oil Safety, Tisserand

whe plant species, the climate, altitude and soil where the plant is grown, and when it is harvested. Refer Re

Chemical composition Ch hair tension, poor muscular Sesquiterpenes – chamazulene, trans-ɴ-farnesene excessive sweating, premenstrual Oxides –depression, ɲ-bisabolol oxide A, ɲ-bisabolol oxide B, growth, postnatal stress. problems, Alcohols – ɲ-bisabolol tension, sexual

off products.’ to state that Young go on of Tisserand and bergapten content ‘assuming a maximum should not be bergamot oil es with 0.33% [...] expressed which correlates than 0.45%, off 0.4%’. used at more maximum level e n-free the IFRA recommended to purchase furocoumarin-fre It is possible ‘bergamott (FCF)’. referred to as bergamot, often

TH L THERAPIST

Clary sage, geranium, lavender, mandarin, sandalwood, rose, tea tree, ylang ylang.

Safety data

Botanical family Asteraceae

to the manufacturer’s safety data sheet for a

and such as the bergapten uted reputed Furocoumarins, bergamia, are present in Citrus 5; bergamottin (Buckle, 2015; ammatory potential ts to have anti-inﬂ these constituents 2007). However, tially Borgatti et al, and potentially essential oil phototoxic ), also make the Young, 2014), c (Tisserand and with photocarcinogeni said to correlate of phototoxicity n In with the level (Tiran, 2000). of bergapten 4) the concentration Young (2014) Tisserand and on] Essential Oil Safety, Fragrance Association] write: ‘IFRA [International to areas of skin that, for application recommends be limited to bergamot oil pt exposed to sunshine, nal product, except 0.4% in the ﬁ a maximum of washsoaps and other for bath preparations,

INTERNATIONA

teething and toothache, ulcers, urticaria, wounds.

Blends with

L OIL PROFILE Clary sage | ESSENTIA Safety data

eczema, fever, hay fever, headaches, indigestion, insect bites, morning sickness, nausea, premenstrual syndrome, psoriasis, rashes, rheumatism, skin (dry, sensitive or itchy), stress, tendons (inﬂamed),

and, as such, ‘there is a theoretical risk of interaction

| Bergamot OIL PROFILE ESSENTIAL

In the reading room section of the FHT website, you will find 450+ therapy and business-related articles and research summaries, with more added regularly. Visit fht.org.uk/readingroom, log in and have a browse.

amenorrhoea, appetite (poor), boils, burns, bursitis, colic, cystitis and other UTIs, dysmenorrhoea,

(Matricaria recutita)

Three varieties of chamomile are used in aromatherapy: Roman (Chamaemelum nobile), Maroc (Ormenis multicaulis) and German (Matricaria recutita), which is featured in this profile. A native of Europe, German chamomile is a fragrant, low-growing annual herb, with feathery leaves and daisy-like flowers that grow on a single stem. The essential oil is steam-distilled from the dried flower heads and has a fruity, herby aroma and middle note. The essential oil is blue and the intensity of the colour correlates with its chamazulene content. An anti-inflammatory, chamazulene is not present in the plant itself but is produced during the distillation process. Chamomile has been used throughout history to soothe digestive disorders and skin complaints. As well as being recognised in folk medicine, German chamomile has been listed in the offi official ficial pharmacopoeia of 26 different di countries (Salamon, 1992). Herbal tea made from the plant’s fl ower heads still flower remains popular today and is often taken to calm the mind, body and emotions.

PICTURE: SHUTTERSTOCK

In the membership and insurance team, we’re often the first point of contact for members, and it’s nice to direct them to articles in the reading room that might be useful. One I often mention is ‘Saying “yes” to massage’, which covers some of the myths surrounding massage and cancer, written by the therapy team at The Christie NHS Foundation Trust. Find this article in the Complementary Therapy section of the reading room (fht.org.uk/readingroom) under ‘Massage: cancer cer care’. care .

German chamomile | ESSENTIAL OIL PROFILE

GERMAN CHAMOMILE

PICTURE: BOB GIBBONS/ALAMY

FHT MEMBERSHIP AND INSURANCE TEAM MEMBER SARAH ADAMS’ PICK

2018

FHT.ORG.UK

members to frame and display b f dd play these in the same way. Currently, there are seven profiles available in the Complementary Therapy section of the reading room: basil, benzoin, bergamot, chamomile (German and Roman), clary sage and cypress. More will be uploaded once these have been published in International Therapist. Visit fht.org.uk/readingroom

TEST YOUR A&P KNOWLEDG E AND

WIN A £20 JOHN LEWIS GIF FT CARD

5 10 13

The winner will also receive a copy off Living Pain Free – Healing Chronic Pain with h Myofascial Release, by Amanda Oswald (lotuspublishing.co.uk).

Write your answers in a spiral from the start, working in an anticlockwise direction, towards the centre of the grid. The last letter of each answer is the first letter of the next. The shaded diagonal line will spell out a type of bone.

12 2

TO ENTER Simply email the word that appears in the diagonal shaded boxes to dralls@fht.org.uk (writing ‘Winter spiral’ in the subject box) or send your answer on a postcard to the usual FHT address. Please include your name, address and membership number. Standard competition terms and conditions apply (visit fht.org.uk/competitions). Entries to be received no later than 14 February 2019.

8 3

CROSSWORD CLUES 1 2 3 4 5

Glands found on top of the kidneys (7) Digestive enzyme produced by the pancreas that breaks down fats (6) Lymph leaves a node via this type of lymphatic vessel (8) - - - - - - - - - - - abdominis, abdominal muscle (11) First pressure read in a blood pressure reading (8)

Abbreviation for body system where you’d find the cerebrum (1,1,1) 7 Corneum and granulosum, for example (7) 8 Atlas master (anag.) foot bones (11) 9 Section of colon that connects the descending colon to the rectum (7) 10 Condition linked to high blood sugar levels (8)

11 Allows movement between the radius and ulna and skull and lower jaw (6,5) 12 Section of the spine with 12 vertebrae (8) 13 - - - - - - tunnel syndrome (6) 14 Lower body exercises that strengthen the legs, buttocks and core (6) 15 Health practitioner who performs operations (7)

Where’s the solution for spiral no. 28? We do not publish the spiral solutions in International Therapist, as completing spirals from the magazine can count towards your CPD (one CPD point per spiral quiz, a maximum of ﬁve points per year). Turn to page 65 for the name of the member who sent in the ﬁrst correct spiral solution to be independently drawn from all eligible entries sent in by the allocated closing date for spiral no. 28 featured in issue 126 (Autumn 2018).

FHT.ORG.UK

55 WNinRR_IT WINTER 2019_International Therapist 55

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:36

Expand your skill set and grow as a therapist with an FHT Hosted Course

CPD is a requirement for all FHT Members and Fellows, refreshing and developing your therapy skills and knowledge. CPD points can be gained through a variety of activities, including courses, and a full guide can be found at fht.org.uk/CPD

INT.Winter2019.056-057.indd 2

10/01/2019 17:32

The FHT is committed to supporting every member with continuing professional GHYHORSPHQW &3' ZKDWHYHU \RXU ÂżHOG Following popular demand, the FHT is hosting a range of courses in the coming months that you can be sure meet the highest standards. Plus, FHT members get a discount of at least ÂŁ10 on each course!

Forthcoming courses include: 10 Feb

Adapting massage for clients at risk of lymphoedema, DVT and bone metastases, Glasgow A one-day workshop on how to safely adapt your massage for clients at risk of lymphoedema, DVT and bone metastases - three of the silent effects of cancer.

23 Feb

EMM-tech short course, Londonderry Created by Ross Emmett, this short course teaches eleven moves specially selected from the EMMETT Technique Practitioner Course.

23 Feb

Postural assessment, Manchester On this practical workshop, you will learn how to carry out a standing postural assessment in a step-by-step fashion and how to document your observations.

24 Feb

Postural correction, Manchester This workshop teaches practical skills to change pelvic, thoracic and neck posture, and covers the rationale behind the exercises provided.

2 Mar

EMM-tech short course, Coventry Created by Ross Emmett, this short course teaches eleven moves specially selected from the EMMETT Technique Practitioner Course.

10 Mar

Cancer awareness for holistic and beauty therapists, Stoke-on-Trent This is a CPD introduction to working with those affected by cancer and covers the condition, the treatment, side effects and the ways therapists can help.

23 Mar

Adapting massage for clients at risk of lymphoedema, DVT and bone metastases, London A one-day workshop on how to safely adapt your massage for clients at risk of lymphoedema, DVT and bone metastases - three of the silent effects of cancer.

30-31 Mar

Assessing and treating neck pain, London On this workshop, you will learn safe and simple techniques to assess a client with neck pain, and gain an understanding of some of its causes.

6 Apr

EMM-tech short course, Maidstone Created by Ross Emmett, this short course teaches eleven moves specially selected from the EMMETT Technique Practitioner Course.

Visit fht.org.uk/courses

for our full list of courses and to book your place

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INT.Winter2019.056-057.indd 3

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LEARNING

FHT accredited course provider news S SUNITA PASSI NOMINATED AS N IINSPIRATIONAL WOMAN OF W THE YEAR T Sunita Passi, FHT accredited course provider and founder of UK Tri-Dosha Academy, has been nominated for an Inspirational Woman of the Year Award by the Nottingham Post newspaper. The Inspirational Woman of the Year Award is one of 13 accolades recognising the work and contribution of businesswomen across Nottinghamshire. Sunita also recently gave her first TEDx talk in Telford, where she asked ‘How might we be healed in the future?’ Sunita turned to alternative health in a bid to combat stress, established the

UK Tri-Dosha Academy after responding positively to ayurvedic treatment in India, and has been on a mission for more than a decade to educate people in one of the oldest known forms of healthcare. The Tri-Dosha Academy certifies therapists in ayurvedic bodywork and instructors in mindfulness and meditation. Tri-Dosha has taught around 800 people since running its first event in 2005, while also having its products sold in hotels and spas across the country. You can watch Sunita’s TEDx talk at fht.org.uk/Sunita-TEDx

LAVA SHELLS HAS THE X FACTOR FHT accredited course provider Shared Beauty Secrets and their Lava Angels

therapists recently returned to the X Factor house for the second consecutive year with their famous Lava Shells heated massage. They treated musical talent such as United Vibe (pictured below) as they competed in the programme’s live shows. Boosted by the Lava Shells treatments, the contestants enjoyed the experience so much they requested weekly visits. The treatments were also a hit with celebrities in 2017, having been offered to last year’s X Factor contestants, including winners RakSu, and the likes of Sean Paul, Amanda Holden, Sarah Harding and Little Mix.

FHT accredited course providers IRELAND Churchtown Institute of Beauty & Holistic Training cibht.ie Q Deirdre Murray Holistic Training deirdremurray2@gmail.com SC Golden Egg Holistic goldeneggholistic.com Q Irish Institute of Nutrition & Health Ltd iinh.net Q Kerry School of Reflexology kerryreflexology.com Q Saint Martin’s College of Physical Therapy stmartinscollegecork.com SC

SCOTLAND Q Myofascial Release UK – MFR UK myofascialrelease.co.uk SC Rosslyn Alternatives rosslynalternatives.co.uk SC Start with Touch Ltd startwithtouch.co.uk SC The Glasgow School of Massage theglasgowschoolofmassage.com Q Therapia School of Reflexology therapiagourock.com

NORTHERN IRELAND NEW Q Angel Haven angelhaven.co.uk Q SC Body and Sole School of Complementary Therapies bodyandsoleschool.co.uk SC Calm Confident Kids calmconfidentkids.co.uk SC Logan Fertility Centre loganfertility.com Q New Beginnings School of Natural Therapies angelsanctuary.co.uk

Q SC Sheila Nugent School of Reflexology sheilanugentschoolofreflexology.co.uk

NORTH WEST Acupuncture Training for Therapists Ltd acupuncturetrainingproviders.co.uk SC Alternatively Better alternativelybetter.co.uk SC Ashwood Beauty & Holistic Academy ashwoodacademy.co.uk Q Breathworks breathworks-mindfulness.co.uk Q SC British Academy of Crystal Healing britishacademyofcrystalhealing.co.uk SC Dawn Alderson & Co Training Academy dawnalderson.co.uk Q SC Dorn Method Academy UK (Jacqui Hamer) dornmethod.org SC Dorn Method Lake District dornmethodlakedistrict.co.uk Q SC Elaine Ellis Courses elaineelliscourses.co.uk SC Energy for Life energyforlife.today NEW Q Gaia School of Natural Health gaiaschool.org.uk Q SC KORE Academy Ltd koretherapy.com Q Reiki Tradition reikitradition.me.uk SC The Master Academy/Urban Body Balance urbanbalance.co.uk SC

NORTH EAST Anna-Louise Haigh anna-louisehaigh.com SC Aries Academy of Holistic Therapies ariesacademy.co.uk SC

INTERNATIONAL THERAPIST WINTER 2019

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SC Butterfly Touch Therapies butterflytouchtherapies.com Q Eve’s Garden (Alison Valerie Peart) alipeart@hotmail.co.uk SC Jong Baik Education jongbaik.co.uk SC Kinesio UK kinesiotaping.co.uk Q Leeds Holistic Training & Therapy Centre (LHTTC) lhttc.co.uk SC NHS Natural Health School nhsnaturalhealthschool.co.uk

EAST MIDLANDS Blossom & Berry Baby Massage & Yoga Training blossomandberry.com Q SC Cameron Reid Training cameronreidtraining.co.uk SC Extraordinary Kinesiology extraordinarychannels.com SC Fertility Massage fertilitymassage.co.uk SC Helen Mary Perkins helenperkins.com SC Infinity Training Academy infinitytrainingacademy.co.uk Q Penny Price Aromatherapy Ltd penny-price.com SC Progressive Kinesiology Academy UK progressive-kinesiology.co.uk SC Routes to Healing sarahling1@googlemail.com Q

Q Shirley Price International College of Aromatherapy shirleyprice.co.uk SC The Active School of Complementary Therapy ukmassagecourses.com NEW SC Total Body Therapy total-body-therapy.co.uk Q Tri-Dosha tri-dosha.co.uk SC Vitali-Chi Headquarters v-chi.com

WEST MIDLANDS Beyond the Limits beyondthelimits.co.uk SC Central School of Massage centralschoolmassage.com NEW SC Chakrascension™ Centre chakrascension.org.uk SC Just BE (Butterfly Experience) with Jacqui Mexson jacqui.mexson@virginmedia.com Q Lorraine Davis Holistic Healthcare and Education Centre lorrainedavistraining.com SC Lymphoedema Training Academy Ltd lymph.org.uk Q Meridian School of Massage & Bodywork jlmeridian.co.uk SC Microsystems Therapies and Training annavenables.com Q Paadena School of Yoga & Thai Yoga Massage Therapy paadena.co.uk SC

FHT.ORG.UK

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FHT accredited qualification(s)

SC The UK Dorn Method Centre dornmethod.co.uk SC Time and Fitness for You timeandfitnessforyou.com/ bt-workshop SC Timeless Partnership Ltd timelesspartnership.co.uk SC Tranquil Heart Training Academy tranquilheart.co.uk

WALES Coleman’s Complementary Therapies holisticsforautism.wordpress.com SC de Prez Training challengeconquered.com SC Dynamic Massage dynamicmassage.co.uk Q Gaia Education gaiaeducation.com Q Glyndŵr University glyndwr.ac.uk Q SC Gower College Swansea gowercollegeswansea.ac.uk SC HB Training Wales Ltd hbtraining.org SC In The Pink! Therapies and Training inthepinktherapiesandtraining.co.uk SC Keep in Touch Training keepintouchtraining.co.uk Q SC Physiotherapy and Complementary Therapies Ltd batts81@aol.com SC Sally Kay reflexologylymphdrainage.co.uk SC Seren Natural Fertility serennaturalfertility.co.uk Q SC TEACH Therapy teachtherapy.co.uk Q The School of Naturopathic Nutrition lovenaturopathy.co.uk SC

SOUTH WEST Advanced Massage School handsonclinic.co.uk SC Amethyst Trust amethysttrust.co.uk Q Barnes School of Sports Therapy barnesclinic-school.com Q SC Cheltenham School of Complementary Therapy & Beauty thetherapyschool.co.uk SC Complementary Therapy College complementarytherapycollege.co.uk Q SC Core Elements coreelements.uk.com/courses SC Cornish Wellessence Training – CWT cornishwellessence.co.uk SC Cotswold Academy of Health and Beauty cotswoldacademy.co.uk SC Devon Academy of Complementary Therapies devonacademy.co.uk Q Devon School of Massage and Bodywork lhbodywork.co.uk SC II Intuitive Ltd 2intuitive.co.uk SC JemmaCo Limited jemmaco.com/training SC LMC Training massagefordementia.co.uk NEW SC Lovegrove Essentials Ltd lovegroveessentials.com SC

LEARNING FHT accredited short course(s)

SC Paula Ryland: School of Holistic Therapies paularyland.co.uk SC SpaNu Massage spanumassage.com SC Sue Chinn Holistic Training Academy suechinn@btinternet.com Q Sunshine Hair & Beauty Training Academy sunshinehairandbeauty.co.uk SC Susan Quayle Complementary Healthcare kidsreflex.co.uk SC The Good Hand Holistic Therapy Instruction thegoodhand.co.uk SC The Seed Institute theseedinstitute.co.uk SC Touchline Training Ltd touchlinetraining.co.uk SC Tranquillity Zone Training tranquillityzonetraining.co.uk Q University of St Mark & St John marjon.ac.uk SC Weston Hospicecare westonhospicecare.org.uk SC With Intention Healing withintention.co.uk

SOUTH EAST Academy of Advanced Beauty academyofadvancedbeauty.com SC Accredited Massage Courses Ltd accreditedmassagecourses.co.uk SC Aneid UK Ltd aneid.com NEW SC Aquamassage Ltd aquamassagetherapycushion. co.uk SC Ayurveda Institute of Europe ayurvedainstitute.org Q SC Ayurveda Pura Academy ayurvedapura.com Q SC Brighton Holistics brightonholistics.co.uk SC Brighton School of Massage brightonschoolofmassage.co.uk SC Calming Influences Ltd calminginfluences.com Q Centre for Nutrition Education and Lifestyle Management cnelm.co.uk Q Cherubs Training Academy – Hampshire cherubsbabyhealth.com SC College of Classical Massage Ltd collegeofclassicalmassage.com SC Corpus et Animus Holistic Therapies corpustherapies.co.uk Q Crimson Catz crimsoncatz.com Q SC Elemi Training elemitraining.co.uk SC Freedom Therapies Training freedomtherapies.co.uk SC Functional Reflex Therapy functionalreflextherapy.co.uk SC Hatton Kalinowska jointpractice.co.uk SC Hawaiian Massage UK Training Centre huna-massage.com SC

FHT.ORG.UK

58-59 FHT ACCRED_IT WINTER 2019_International Therapist 59

Q HypnoTC: The Hypnotherapy Training Company hypnotc.com SC Innamincka Training Services itsperou@depinaperou.plus.com SC Jane Sheehan footreading.com Q Jivita Ayurveda Ltd jivitaayurveda.com Q JB Training Academy – Bedford jbtrainingacademy.co.uk SC Key Workshops keyworkshops.co.uk SC Kneads Must/Kneader Massage (KOM) kneadsmust.com SC London College of Massage/Massageworks londoncollegeofmassage.co.uk Q London Institute of Thai Yoga Massage learntomassage.co.uk SC London School of Complementary Health Ltd lsch.co.uk Q Lucis College Ltd lucisgroup.com Q SC Mary Atkinson Holistic Therapy Courses maryatkinson.org.uk SC Neal’s Yard Remedies School of Natural Medicine nealsyardremedies.com Q Peter Symonds Adult and Higher Education College psc.ac.uk SC Purple Turtle Academy ptmassagetherapycourses.com SC Reflexmaster reflexmaster.co.uk Reflexology UK Ltd reflexologyuk.org SC RJ Buckle Associates rjbuckle.com SC School of Natural Therapies schoolofnaturaltherapies.co.uk Q SC Shared Beauty Secrets sharedbeautysecrets.com Q Shen Mantra shenmantra.com NEW SC SKN-RG Academy skn-rg.com SC St Mary’s University College smuc.ac.uk/shortcourses SC Story Massage storymassage.co.uk SC The Holistic Academy holistic-academy.co.uk SC The School of Abdominal Sacral Massage abdominal-sacralmassage.com SC Total Release Experience (TRE UK®) treuk.com SC TouchPro UK touchpro.co.uk SC Training4Healthcare training4healthcare.co.uk SC Vulsini Ltd vulsini.com SC Wavestone Therapies Ltd thewavestone.co.uk

SC Ziggie Bergman with the London School of Reflexology zonefacelift.com

NATIONAL SC Essential Training Solutions Ltd essential-training.co.uk SC Fertility Massage fertilitymassage.co.uk Q SC Gateway Workshops gatewayworkshops.com Q Health Kinesiology UK hk-uk.co.uk SC Jennifer Young and Beauty Despite Cancer beautydespitecancer.co.uk SC Jenny Cox thebalanceprocedure.com Q SC London School of Massage londonschoolofmassage.co.uk Q Mind International Training Associates bodymindworkers.com NEW SC Online Anatomy and Physiology brightonholistics.co.uk Q Stonebridge Associated Colleges stonebridge.uk.com Q The College of Bowen Studies thebowentechnique.com SC The Chrysalis Effect thechrysaliseffect.com Q

INTERNATIONAL Akademi Ayu Jelita SDN BHD joanphang@yahoo.com Q Cosmo Kemp School of Thai Yoga Massage cosmothaiyoga.com Q Health Coach Institute, LLC healthcoachinstitute.com SC Holistic Therapy Practice holistictherapypractice.com Q SC Jari Jari Spa jarijari.com.my SC Liddle Kidz Foundation liddlekidz.com SC PureAroma Healing Academy purearoma.com.tw SC RAPID Adhesion Release Technique rapidadhesionrelease.com Q Rinalda Therapeutic Kneads wix.com/rinalda/rinalda SC Rustic Nirvana PTE Ltd rusticnirvana.com NEW SC Shiny Forest Ltd shinyforest.com SC The Arvigo® Institute LLC arvigotherapy.com Q SC The Institute of Aromatherapy aromashoppe.com Q Wellness Cosmetology SDN BHD beaubelle.com SC

MORE INFO Please visit fht.org.uk/accreditation for more information about FHT accredited qualiﬁcations and short courses.

WINTER 2019 INTERNATIONAL THERAPIST

11/01/2019 14:36

INDUSTRY NEWS

Miiskin, an app to help keep track of skin and mole changes, has become the first app to receive independent dermatological accreditation from the Skin Health Alliance. Skin cancer is the most common form of cancer in the UK, and early detection is the best defence. The Miiskin app helps users to track skin and moles for changes over time by using photos to create a snapshot of the skin’s appearance. It provides reminders to routinely check for changes and information about the types of things to look for. miiskin.com

Jing supports children’s charity through massage Jing Advanced Massage Training used its passion for massage to raise money for a local children’s charity. It supported Brighton’s Dolphin House during its advanced clinical massage training (ACMT) intensive retreat last summer. Running a magical massage marathon and yoga day festival in the heart of

Brighton’s beautiful Lanes district, Jing’s fabulous BTEC and ACMT students raised a substantial amount for an amazing cause. This is an annual event, so save the date for this year and join Jing to raise money for the domestic violence charity Rise, on Friday 19 July. jingmassage.com

New training from Dr Katerina Steventon Dr Katerina Steventon provides new training in advanced facial techniques and has developed two unique anti-ageing serums. For salons and retail, the serums were Pure Beauty Awards finalists in 2017 and 2018, and formulated for targeted massage techniques. Dr Steventon is an internationally renowned facialist, scientist and writer, specialising in holistic anti-ageing skincare and acne. She combines hands-on clinical expertise and skin science, runs a private therapy practice in Yorkshire and consults for the skincare industry worldwide. katerinasteventon.com

LTA celebrates a 2018 to remember The Lymphoedema Training Academy (LTA) had a fantastic year in 2018, training more than 280 people across the globe. Lymphoedema is a swelling, usually of the limbs; it has many causes but is often due to cancer treatment. LTA trains therapists to improve the lives of those living with lymphoedema. Those who train with LTA can help support patients who have difficulty finding excellent therapists outside the NHS. LTA’s manual lymphatic drainage training is based around lymphofluoroscopy, which visualises lymphatics in real time. Seeing lymph moving and where it is blocked allows therapists to move fluid better. lymph.org.uk PICTURES: JING ADVANCED MASSAGE TRAINING; LYMPHOEDEMA TRAINING ACADEMY; MIISKIN; SHARED BEAUTY SECRETS; KATERINA STEVENTON

Skin-checking app gets a ﬁrst in industry recognition

Shared Beauty Secrets launches handmade vegan candle Made in the UK, the hand-crafted vegan-friendly kokolokahi Sensory Retreat Candle combines 100% natural vegetable wax with coconut oil, grapefruit, geranium and lavender, which allows the user to surrender their senses to the enchanting scent. The pure essential oils work to provide a holistic approach to health and wellbeing. Containing no artificial fragrance or synthetics, the slow and balanced burn of the candle is a testament to the purity and quality of its ingredients. sharedbeautysecrets.com

NB: The information featured on the industry news page is based on information supplied by the training providers and product manufacturers featured. Please always check with the FHT that courses will be covered for membership and insurance purposes before booking.

INTERNATIONAL THERAPIST WINTER 2019

60 INDUSTRY NEWS_IT WINTER 2019_International Therapist 60

FHT.ORG.UK

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WINTER 2019 INTERNATIONAL THERAPIST

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CLASSIFIED

GENERAL CLASSIFIED USED THERAPY ITEMS FOR SALE Hot stone heater. 18 litre capacity. Not been used. £60. Buyer collects. Pimlico, London. T. 07867 319795 Massage couch cotton face ring covers. 95. Washable. Cost £18. Selling at £8 for the lot. T. 07713 733422

JOBS WANTED Massage therapist available for work in Devon. Swedish, deep tissue and on-site massage available. E. Info@ phoenixmassages.co.uk T. 07415 456211

SITUATIONS VACANT Volunteer therapists needed for busy clinical renal units around the North West. Salford, Wigan, Bolton, Oldham and Rochdale. E. janet.cairnie@ srft.nhs.uk T. 0161 206 4812 Part-time sports/remedial massage therapist required. Busy high street clinic. Birmingham area. Contact Annette Ashby. T. 07810 552937

FHT, its Directors and staff accept no responsibility for the accuracy of any description within the classified section and members should ensure they are satisfied with goods and services offered/advertised before accepting/purchasing.

INTERNATIONAL THERAPIST, ISSUE 126

In The Moment competition (p53) Nicola Magner, MFHT Ann Wyatt, MFHT Spiral £20 Amazon Gift Card and Words that Touch (p55) Ian White, MFHT

Apologies and corrections Laws of motion (issue 126, p8) On our Your views communications page, the picture caption reads ‘Lucy Donleavy’, but it should read ‘Lucy Dunleavy’.

FHT DISCLAIMER: Please note that the inclusion of a product or training advert in International Therapist does not mean the FHT endorses that product or training, or that it will be automatically recognised for membership and/or insurance purposes by the FHT.

COMPETITION, SPIRAL AND PRIZE DRAW WINNERS

Members’ reviews (issue 126, p52) On page 52, in our Members’ reviews section we stated that the Base Formula Joint & Muscle Massage Gel is blended with aloe vera, seaweed and black pepper, however it should have said ‘with aloe vera, seaweed and pure essential oils of black pepper, lavender and plai’. Our sincere apologies to Lucy, Base Formula and our readers for these errors and any disappointment or inconvenience caused.

MEMBERS CAN ADVERTISE IN INTERNATIONAL THERAPIST FOR FREE !

BEFORE EMBARKING ON ANY PAID OR VOLUNTARY WORK OPPORTUNITY, WE STRONGLY ADVISE MEMBERS TO ENSURE THEY HAVE APPROPRIATE TRAINING, PREREQUISITES AND INSURANCE COVER (WITH THE FHT OR AN ALTERNATIVE PROVIDER) TO CARRY OUT THIS WORK.

Write your advert here:

Name: .......................................................... Membership no:........................................... Tel no: ..........................................................

Classification (please tick): Situations Vacant Job Wanted Used Therapy Items for Sale Treatment Rooms Available Treatment Rooms Wanted Therapy Items Wanted

Deadine date for Spring issue: 28 March 2019 Please post to: IT Free Ads, FHT, 18 Shakespeare Busines Centre, Hathway Close, Eastleigh, Hampshire SO50 4SR Alternatively email full details to classified@fht.org.uk or see online at fht.org.uk/classifieds

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Please note that members are entitled to one free lineage ad, per issue. We regret that FHT/International Therapist no longer publish lineage ads of a commercial nature free of charge. All adverts that do not meet the free ad classifications criteria and/or word count are charged at 90p per word (nonmembers £1.50) plus VAT.

Please use capital letters and one word per box only, including a contact number

Please contact Annabel Boorman-Shiffer on 020 7880 6230 or email: annabel.boorman-shiffer@redactive.co.uk

WINTER 2019 INTERNATIONAL THERAPIST

07/01/2019 13:50

ON THE COUCH

Healing hands WE CAUGHT UP WITH ANGIE BUXTON-KING, HEALER AND FOUNDER OF THE SAM BUXTON SUNFLOWER HEALING TRUST

TELL US A BIT ABOUT YOUR BACKGROUND…

I’ve had a varied background. One of the main jobs I did was work at London Luton Airport as an airport duty officer, controlling flight plans. Then I got married and started a family. When the children were old enough I went back into work, caring for people in nursing homes. I then went on to work for Age Concern as a carer advocate – speaking up for other people – and that’s when Sam, my youngest son, was diagnosed with leukaemia.

WHEN DID YOU DEVELOP AN INTEREST IN HEALING?

In 1988. My mother had ovarian cancer and was supported by a healer. After she died, I read everything I could about healing and later trained in spiritual healing. By 1995,

when Sam was diagnosed, I was working in a very casual way, as many healers are. The beauty of healing is that it is userfriendly – you can use it any time, any place, anywhere. It’s very flexible and you can integrate it into conventional medicine easily. Your hands are all the tools you need.

TELL US ABOUT THE SAM BUXTON SUNFLOWER HEALING TRUST…

After Sam passed away in 1998, I worked for a while with animals to get my balance back. With restored confidence, I decided to approach hospitals to promote healing as a great tool that could be used to support patients. In 1999, I was taken on by University College Hospital (UCH), working as a healer on the haematology and oncology wards. We were doing good work, but I began to think of succession. We had to create a charity to fund healers’ work in this setting and to encourage the NHS trusts to take it on. That’s how our model was born in 2006. My passion was to take the healer to the hospital bedside.

TELL US ABOUT YOUR PUBLISHED BOOKS…

The first book came out in 2004, and it’s called The NHS Healer. It’s about

Sam’s journey and how we used many complementary therapies to help him be well enough to take conventional medicine. As my then manager said, we need to try to cure patients with medicine but we need to support them while we are curing them. My second book, The NHS Healer: Onwards and Upwards, shares the knowledge of the charity and how we spread it from UCH into 16 other NHS trusts. It can be used as a template for others to pick up and implement themselves. The onwards and upwards part of the title is because I am relentless in moving forward!

YOU RECENTLY PICKED UP TWO AWARDS AT THE COMPLEMENTARY THERAPY AWARDS. PLEASE TELL US MORE…

It meant a great deal to me. I didn’t expect to get the award for cancer care and certainly wasn’t expecting to receive the overall winner award. I was delighted on behalf of our charity and trustees. It helps to raise awareness and spread the word about what we’re doing. I’ve already seen an increase in interest in our courses, because one of the things we do is train healers to work within these special settings.

WHAT ARE YOUR PLANS FOR THE FUTURE?

Our stated aim as a charity is to place a healer in every cancer centre, and that is what we work towards. In the meantime, I’m very aware that we need help and support from other people, so collaboration with others is a big part of my future plans.

HOW DO YOU TAKE CARE OF YOUR OWN HEALTH AND WELLBEING?

We live in a beautiful county, so nature is a great rejuvenating tool for me. We have two dogs and I love being with them. As far as my mental wellbeing goes, we have a healing room at home and I sit in meditation most evenings and send healing out to other people.

WHAT IS THE BEST ADVICE YOU HAVE BEEN GIVEN?

Don’t sit on your hands, use them to help others.

Angie Buxton-King is a healer and the founder of the Sam Buxton Sunﬂ ower Healing Trust, a charity dedicated to supporting cancer patients and their families by providing funds to employ healers in the NHS and hospices. Angie also trains healers and has published two books. cancertherapies.org.uk

INTERNATIONAL THERAPIST WINTER 2019

66 ON THE COUCH_IT WINTER 2019_International Therapist 66

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