Episode 171

Jul 24, 2018

Allissa talks to Tracy Walton about her path in massage and the versatility and application of oncology massage therapy training and what’s in it for the massage therapist, too. Spoiler alert: it’s not just about oncology.

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Allissa talks to Tracy Walton about her path in massage and the versatility and application of oncology massage therapy training and what’s in it for the massage therapist, too. Spoiler alert: it’s not just about oncology.

You can learn more about Tracy Walton and her courses at tracywalton.com.

This episode is sponsored by: PurePro Massage Products. Go to PurePro.com and use coupon code PUREPRO25 to get 25% off any size Pure Pro Hypoallergenic Massage Lotion.


Sponsor message This episode is sponsored by Pure Pro massage products. For over 24 years, Pure Pro has distinguished itself by adhering to the values of quality, purity, efficacy, and education. Most massage lotions start out too greasy and end up feeling sticky. With pure organic aloe and golden jojoba oil, Pure Pro’s hypoallergenic massage lotion keeps your client’s skin feeling silky soft and workable. There’s no greasy residue, so your clients leave feeling fresh and clean. Completely unscented and pH balanced, Pure Pro lotion is the perfect choice for elder, hospice, oncology massage, or for anyone with super sensitive skin, and especially if you, as a massage therapist, have super sensitive skin. Pure Pro hypoallergenic massage lotion is the number one choice of oncology massage professionals coast to coast. It’s ideal for elderly and pediatric clients with fragile skin. This lotion is versatile and safe. All Pure Pro products are vegan, cruelty free, and nut free, making your job as a safe, mindful practitioner that much easier. You can trust Pure Pro because it’s made by massage therapists for massage therapists. For 25% off any size Pure Pro hypoallergenic massage lotion, you can go to purepro.com and use coupon code PUREPRO25 at checkout. This offer is good through August 30, 2018. Go to purepro.com to check out the Pure Pro hypoallergenic massage lotion.

Allissa Haines Hello, everyone. Welcome to the Massage Business Blueprint podcast, where we discuss the business side of massage therapy. We have one of our interview episodes today, and I am super pleased to welcome guest Tracy Walton. Tracy, hello.

Tracy Walton Hi there, Allissa. Thank you so much for having me.

AH Yay. I am so excited we finally got you on. So a super brief background — but we’re going to let Tracy talk about her own self and career — but Tracy is a researcher, writer, award-winning educator, and specialist in massage therapy and cancer care. I like to say that she is THE specialist in cancer care. She is the author of the pathology textbook Medial Conditions and Massage Therapy: A Decision Tree Approach, which is my hand guide — yeah, hand guide. Did I say that? Handbook is the word I’m looking for — and Bible here at my office. She has been part of the Touch, Caring and Cancer film to inspire home instruction programs for people with cancer and their care partners, and she’s done a whole bunch more. I’ve known Tracy for years and years, and I’m super fortunate to have her local to me in Boston.

You describe your career better than I do. So we’re going to launch into our series of questions that I like to get background about our guests because I found I’m so curious about what people’s lives were like before they got into massage and what they did. What were you doing before you got into massage and what made you get into massage?

TW Well, I was in graduate school in biochemistry, cell physiology, anything smaller than a cell nucleus, basically, looking down microscope barrels at cells. And I was having some struggles with my own body, and I kind of fell into massage therapy when I landed on Ben Benjamin’s table to get some help. He was really a mentor to me, a lovely practitioner, so helpful at the time, gave me some excellent referrals. I began to be really drawn to this work and landed in his school, oh, I don’t know, about a year later. I started massage therapy school at what was then called the Muscular Therapy Institute in Cambridge, Mass in 1988, and I finished in 1990.

AH Wow. So you’ve been doing this for quite a while.

TW Yeah, for quite a while. I worked first — upon graduation — well, before graduation because we didn’t need a license at that time. There was no state license at the time, to practice. So I was able to work while I was in school, and I worked in a spa — a really great spa affiliated with the Charles Hotel, and I began my private practice simultaneously in Cambridge, Mass. Then I worked at the spa for a few years — it was a great starter job. I got my hands on so many people and met so many wonderful clients there that they found for me. And I also simultaneously began my private practice. So I guess I’ve been at it in earnest since 1990.

AH What was your private practice like at the beginning? What kinds of clients did you see?

TW I saw everybody, and I really, after a few years, started to focus on pregnant women, postpartum women, I taught infant massage for a while. I loved that work. Because a number of people found their way to my practice who were in cancer treatment, I began to see people who were in cancer treatment and beyond, post treatment. Not by design, not because that’s what I planned because I had learned in massage therapy school — at the time, massage therapy would be contraindicated for cancer. I wasn’t clear after treatment when you could begin again, so it wasn’t by design, but just because people find their way to my practice and I had to figure out a way to work with them. I taught myself, I took some great lengths to teach myself how to work with them safely. Then it became reasonable at some point, having taught myself, to share that information and those skills with other people.

AH So I’m going to go totally off track because this is a child- and pet-friendly podcast, we’re going to need to know about the dog that was barking in the background. So tell us about your dog.

TW Wow. So you can hear her? I closed the door, I turned on the air conditioner, and she’s one floor away.

AH Very quietly. I figured there was something being delivered to your home —

TW Yeah.

AH — we knew this was going to happen at some point, so tell us about the dog.

TW Well, I’ll tell you about the dog. The dog feels strongly that anyone walking anywhere near the front of our house, which is on a city street, that we need to be alerted to that fact, and so Lulu, she barks. And she stops barking pretty quickly when you tell her she should. But she does feel strongly about the need to know about someone parking a car half a block away. And that’s probably what you heard, [indiscernible] delivery.

AH And what was the — she’s the neighbor on Bewitched. Remember the neighbor who was always in the thick of it and had to make sure everybody knew what was going on all the time. That’s your dog.

TW Yeah, she’s like the village gossip, really.

AH [laughs] That’s awesome.

TW And she takes her job very seriously, and she’s adorable.

AH Tell me about what your career and practice and stuff like now? What’s an average day or week like for you?

TW Well, I see clients only one day every couple of weeks. It’s nearly exclusively focused on oncology massage therapy. The rest of the time I am at my computer — a little more than I’d like to be at my computer — developing curriculum, building new course, refining what we have, organizing our teaching schedule to teach oncology massage therapy around the country. When I’m not at the computer writing, blogging, tweaking curriculum, working with teaching staff, working with administrative staff, I’m in the classroom teaching our four-day intensive, which is called Oncology Massage Therapy: Caring for Clients with Cancer, or one of our advanced courses. So my days are very screen-focused, and I enjoy it when we actually have a scheduled course, which we work months in advance to bring about, when I can be in the classroom with actual people, not just people who write emails to me and I write them back.

AH Full disclosure, everybody. I took Tracy’s four-day course a couple of days ago — couple of days ago, hello? A couple of years ago and it has been — what I got from that course is part of why I wanted to have Tracy on the podcast, but it was — I haven’t taken a lot of longer courses, which is to say courses more than two days in my career, because it’s a lot to take — it’s a lot to take away from your family and away from your practice and especially if you have to travel to take it or whatever. But why — tell me more about your foundational four-day course and why it’s four days.

TW Well, I’m glad that you think you took it days ago because it means that it’s still fresh in your mind and that makes me extremely happy.

AH I utilize — I pull out the workbook probably weekly to answer one question or another and even things that aren’t related to oncology. But, yeah, it does feel kind of fresh because I do utilize it a lot. But, please — I’ll be quiet now so you can tell us about why it’s four days.

TW Well, the standard set by the Society for Oncology Massage is that a foundational course in this area should be three. And in about 2011 — up to 2011, we could accomplish it in three days, but we really grew to four days because we were trying to get a lot done. My experience in teaching — and I’ve taught for a long time, since I was a teenager I’ve been teaching something or another — and my experience is that people need — massage therapists need, not just information to work with people with cancer and with cancer ministry as well, but they need skills.

Along with the hands-on skills, which are extensive, there are also the outside-of-the-table skills, and that includes interviewing, knowing which questions to ask clients and why you’re asking them, and then what the heck you’re supposed to do with the answers to those questions. How do you use those client answers in planning the massage therapy session? That is really key. You don’t want to overwhelm people with a bunch of questions about their cancer treatment that you don’t need, but you do want to ask the ones that you do need. And so picking and choosing and then how to run an interview in terms of what are the follow up questions if someone says Yes, I’ve had these diagnostics in the last week and a half, then what are my follow up questions about that and how does that play into the sessions. Or if someone says I’m taking this medication, what do I ask about that medication and how do I use the answers in planning the session? If someone had radiation therapy 19 years ago, what are the follow up questions I need to ask because there are some precautions we follow that are lifelong; they’re not just during treatment, and they’re lifelong. It’s that kind of — those levels of information and processing that are really important.

So, yeah, the interview skills, then what do you do with the answers is their reasoning skills, and finally the communication skills, too, to be able to communicate well with the client about what precautions you might need to follow 19 years later, 25 years later, during treatment, at end of life, early in the diagnostic process. Wherever they are, what are the precautions you need to follow and why and how do you describe those precautions in terms of, well, specific pressures. And I developed a 5-level pressure scale with some help from others in the field, Gail McDonald and Don Nelson. And let’s be really clear about the pressure and what does that mean and then explaining that to the client in a way — sometimes you get pushback and being able to be really firm about that, but also really compassionate.

So I don’t know. Those are kind of nuanced skills that it takes some finesse there, and so we teach those skills throughout the four days, and then there’s a chance to practice them in a clinic on the last day. We work with actual client scenarios that are fully fleshed out of different forms of cancer and different kinds of treatment where student’s get to carry out an interview — for half of the time during clinic, they get to play the role of a client with a script — answers to those questions that their therapist will then ask them. And half the time they get to play the therapist and both give and receive a full oncology massage therapy session. So they get exposed to two different common clinical scenarios. And then they get to apply the principles of oncology massage therapy. I think it’s so much easier to memorize a few principles rather than, I don’t know, learning a bunch of facts about cancer and cancer treatment and having them memorize those. That is incredibly tedious and intimidating, but if you can learn a few principles about how to work like well, what if a vital organ is affected by cancer or cancer treatment? What questions do I ask and how do I treat this person? As opposed to these are the five vital organs, these are the 50 or 100 cancers that affect those organs, or even more, this is how they’re treated, and I need to memorize all that.

Learning principles makes the work easier in the long run, but it takes longer in the short run. It takes us four days to really present that whole system and have people practice it. Not just inhale it or swallow it, but really practice it and process it and turn it around so that they, by the end of the course, they can really turn around and use it on Monday morning with a client. And people write to us and say that: I used it Monday morning. Thank you.

AH I totally did.

TW You did?

AH I totally used it immediately upon finishing the course, like that week. That week I was able to ask better questions on some complicated clients and get better answers and adjust my work accordingly, which dramatically increased my — I call it my “therapeutic confidence,” the how I feel, my confidence level, when any particular client walks in the door or especially when a new client walks in the door.

I used to have a lot of confidence issues and a lot of fear about a new client walking in and me not knowing if I would be able to handle what they brought me. I gained confidence over the years seeing a variety of different kinds of clients with various continuing education and knowing that my communication skills improved. But the difference between when I took — after I took that course, it just doubled and tripled to the point where it is really rare that I have any anxiety about a new client coming in or about an existing client coming in with a new or different problem. I feel very confident that whatever walks in the door, I can handle it, and I can handle it safely, and I can handle it so the client is happy with the treatment they received. The deep thinking that happened in your course was instrumental in that.

It really reminded me, I had a French teacher — I took a couple years of French in junior high and then in high school, and I was never very good at it. And I remember the French teacher said You know, you know how to ask “where’s the bathroom”. You go to Paris, you can ask where the bathroom is. But you’re probably not going to understand the answer for a while, and that’s what we need to get you to that point of speaking this language. I felt very much that way with intake questions. I could ask them the intake question, I could get the answer, but in most cases, I didn’t know what to o with the answer. I was lucky in that I have career in retail pharmacy. Pharmacology questions, pharmaceutical drug interactions, precautions related to medications I was all over that —

TW Yeah, I bet you were.

AH — but other kinds of health stuff, I was not. Positioning, I was so weak on positioning until I took your four-day course and learned your extreme bolstering, and I still utilize that in a lot of clients, not just oncology related. But my therapeutic confidence dramatically increased after that introductory course. And I don’t mean for this to sound like a commercial for your course, but that was a huge, huge thing for me exactly because you taught the principles, which I needed to digest for a little while and now I can get them to happen in my head much quicker.

TW Right, I’m totally stealing that term, “therapeutic confidence.” Thank you, Allissa.

AH Yay, we have the next episode of our podcast. [laughs]

TW We can just stop this one right here. I’m done, this is awesome. Thank you.

AH No, we’re sucking more out of you. So tell me, the last of our canned questions is what’s your fantasy job, location or whatever or does it not involve your career at all — what’s your “if I win the lottery” plan for your life and your career?

TW You know, if I won the lottery, there’s so many things begging for attention. And one thing I really have always wanted to do is to be able to provide massage therapy as palliative care and/or end of life support for people who are homeless or people without access for some reason, impoverishment. I think that would be really going to that — meeting that need is really appealing to me, exploring that and finding out what I have to learn about that in order to do that work. That would be good.

I would love to also work on healthcare inclusivity so that everybody gets covered. I’ve seen firsthand in my clients the terror of being denied health insurance because of pre-existing conditions — and in this country that’s actually a real thing, not just for people on Medicaid or working Medicaid or any of that, but also for people with employer-sponsored insurance — that premiums could spike because someone has had acne or cancer or whatever. I’ve witnessed firsthand the effects of a broken system, and also the ways the system has been healed as well, on my clientele. And I would love to work for healthcare or any number of needs or causes that could speak to me or speak to any of us. That’s what I’m thinking about today.

AH I’m with you on that. I would support that cause.

TW Okay. Well, I may come knocking, so thank you.

AH Before we jump into the meaty stuff of how oncology massage therapy can help build your practice, we’re going to take a pause for our halftime sponsor.

Sponsor message We are so fortunate that this episode is sponsored by Pure Pro massage products, and specifically, Pure Pro’s hypoallergenic massage lotion with pure organic aloe and golden jojoba oil. Pure Pro’s hypoallergenic massage lotion keeps your client’s skin silky and soft. It’s completely unscented and pH balanced making it ideal for elderly, pediatric clients with fragile skin, oncology massage therapy clients. It is versatile and safe. All of Pure Pro products are vegan, cruelty-free, nut free, making our jobs as safe, mindful practitioners so much easier. We are incredibly lucky because Pure Pro has a special offer right now for 25% off any size Pure Pro hypoallergenic massage lotion. You can go to purepro.com and use coupon code PUREPRO 25 at checkout. This offer is good through August 30, 2018.

AH Tracy, I know that you use this hypoallergenic lotion, so tell us what you love about Pure Pro’s stuff.

TW I like it — it’s so interesting because people ask me a lot about lotions and topicals, and I have to say that I just don’t want to think about it. So I don’t — I just don’t want to have to think through Is this okay? Is this not? What about this person? What about this person? And I think the reason I use it is I don’t have to think about it. Many hospitals use Pure Pro lotions with their medically frail clients, with their inpatients, with their outpatients. Lots and lots of Pure Pro is used in cancer care facilities. I really like it because I don’t have to think about it. I just know it’s safe, and I can be done with my research. I use the lotion, I use the therapeutic blend oil as well and I’m leaning towards a little more lotion in my practice these days. When you do home visits, I think the lotion is better. Any lotion is better than oil sometimes because you’re leaving, sometimes, people in their beds or they’re not able to wash afterward.

AH For 25% off any size, Pure Pro hypoallergenic massage lotion, you can go to purepro.com and use coupon code PUREPRO25 at checkout. This offer is good through August 30, 2018.

AH So now we can jump into the meat here of how oncology massage therapy can help build your practice because it is not surprisingly, but surprisingly to some, not just about oncology massage therapy. So, Tracy, tell us where we’re going with this.

TW I think a lot about this question of how it can help because we — just a little bit of background because we get this question — we get a lot of questions through our website. And one question we get frequently is If I take your course or any oncology massage therapy course — and we do recommend a whole — there are whole racks of courses out there that are awesome, and so we sometimes refer people to other course, but we get this question a lot — Will I be able to find a job in oncology massage therapy?

I’m always a little thrown by that question because yes, jobs specifically in cancer care are growing, but we don’t have a lot of data on that because we don’t have a lot of data about the massage profession in general. We have some. I’m thrown by it because the job is really right in front of us. Not that it’s a stupid question; it’s a very good question. Before I invest in a course, I want to know that it can pay off. But if you’re a massage therapist being able to work with people with cancer and post treatment, those skills are really important for a lot of reasons. The big reason is your clients. If you haven’t seen someone with cancer yet, you probably will. If you haven’t seen someone post treatment, you probably will. It’s just way better to have the feeling that you feel when someone new comes into your practice — what is it you called it? therapeutic confidence —

AH Yep.

TW — and know you can work safely and well with them and really help them, than the alternative which is uncertain. Am I going to spread it? Am I going to do this? Am I going to hurt them? I don’t know what to ask. I don’t know what to do. I’ll just work lightly and try to get through the hour. I mean, that’s a terrible feeling. I have about 30 reasons that doing oncology massage can help your practice. But I did boil it down — for the purpose of this conversation, Allissa, I boiled it down to a handful.

AH I’m so proud of you.

TW Yeah, it’s really tough for me. The first one is that — if you do Swedish or relaxation massage therapy or maybe more client therapeutic massage — the language is notoriously unclear about this, but if you do Swedish types of techniques, that’s great; you can help a lot of people. But if you can do Swedish relaxation massage therapy thoughtfully and safely for people with cancer, you can help a lot more people. It’s kind of great to be able to help more people and build a practice without learning new techniques. New techniques or modalities are great, but we don’t have to — you can make an even greater impact with your practice and build your practice with the same techniques if they’re modified for these different populations and these different presentations.

And we can really help them. We can help them notably — the research is still developing on this point. But notably, the research is showing us strong support for being able to help people with anxiety and depression that can accompany cancer and cancer treatment and definitely post treatment, and pain, and even there’s some suggestion that massage can help with fatigue and nausea. That data’s still developing, but it’s in a promising direction. I wouldn’t say that research proves this yet, but I would say that the research is growing in support of this. Being able to help people with significant, what I call “the Big 5 symptoms and side effects of cancer treatment,” is huge. Without having to learn new ways of seeing the same people, it’s learning modifications of what we already know to help these people and more people. That would be benefit 1 of how it can help a practice. No new techniques or modalities are required. You can just make a greater impact with the same ones, just modifying them and knowing how to bracket them with other skills like interviewing and reasoning.

The second reason is I really — the second way to help is that oncology massage therapy really can set you apart in your community because so far massage therapy basic education as a whole is behind on preparing massage therapist to work with this population. We’re still getting over this myth that we’ve been getting over for 25 years about massage spreading cancer. Whereas skilled massage, when correctly applied, is not going to spread cancer. We need to ask the right interview questions about it so you don’t work directly on tumor sites, and there’s a surprising amount of clinical thinking that goes into that. But schools are still teaching some of them that you can’t work with people with cancer so people graduate with a deficit and if you are able to — with therapeutic confidence, as you said — work with this population post treatment, during treatment, end of life, if you choose during diagnosis, you can really set yourself apart in your community. I think it’s a curiosity. People love to ask questions about it and I wonder — after you returned from the course and started working with people if you found that, too, that people were kind of struck by it or curious about your work seeing people with cancer. Like, Oh, I didn’t know that was a thing. Did you find that? Because I found that.

AH Yes, very much so and specifically people asked really smart questions about Well, what’s different? What’s different about the massage? It took me a while to be able to answer that well, to be able to say Well, it depends on the situation. There’s nothing specifically different, but I know the questions to ask to adjust the massage so it’s more safe and comfortable. It was — yes, people are really — when they hear that — and there’s always — the path of it is so much mimicking the work that I’ve done with the autistic community where everyone, when they hear you do that, says Oh, I know three people with cancer right now; could you work with them? They want to tell you they have this and this and this is going on. I know that they have pain from this; is that something massage could help with. So, yeah, it is a thing that everyone can talk about because everyone is experiencing — is having some experience with cancer in one way or another. So yes, it’s a huge curiosity factor, and it’s a conversation starter.

TW I think you’re right about that. And one of the exercises — I teach an advanced mentorship, an oncology massage therapy mentorship program, it’s online, and it’s for anybody who’s take a foundation course either from us or one of the other recognized providers. One of the exercises we go through is how do you answer that question in an elevator speech kind of way and a more in-depth way? How is it different? And we really need to emphasize what you said about well, the strokes might seem similar, but I might ask you some different questions beforehand, and I would ask that — we aim to help with symptoms and side effects. That’s what we’re all about is the Big 5 in cancer care: pain, nausea, anxiety, fatigue, depression. We want to help people with that. We also want to help people sleep. Even though, oddly enough, the research on massage therapy and sleep is pretty weak — I haven’t seen a lot of compelling research on this; the numbers aren’t there yet — we hear from our clients that it helps them sleep. We hear from their families that it helps them sleep. When you can sleep better, you can heal better. When you sleep, it helps your anxiety. When you sleep better, it helps your pain. We add the benefits of oncology massage therapy, the potential benefits. We’re very careful and thoughtful about how we quote research. We quote it well; we don’t overstate it, but we really are all about helping with specific side effects and symptoms. And that’s really compelling. That really speaks to people. It is a curiosity factor. I feel like that — if you’re the only therapist, or if you’re one of four therapists in a county or a town who can work with — safely and well and effectively — with people with cancer, then the word gets out. Massage therapists start referring their clients to you.

AH Absolutely. I referred out — I felt like I referred out often, a lot before I took your course and felt more competent to handle stuff. People are looking, and other therapists refer to me. I’m the only person in my office with the training, so I get referrals from my colleagues here in my officer with openings on their schedule who send clients to me because they don’t have the skill set yet.

TW Yep.

AH It’s huge.

TW And I think the funneling is really important. It doesn’t mean you can hang out this credential on a shingle and get clients. It’s not that simple. But it means that you put out a clear call and people can find you.

I think the third way it helps your build your practice is related to the second way, which is that you really can build more solid relationships with healthcare professionals because we can achieve concrete outcomes with their patients and there’s only so much anti-anxiety drug, analgesic medication, fill in the blank, that can be prescribed. You hit a limit of pharmacological solutions to side effects and symptoms. I mean, pharmacologic solutions are highly, highly effective and way more effective than even 10 years and 20 years ago. But we can help with the edge of that, certainly. Helping, we can really create a name for ourselves if we’re seeing a certain subset of people in town because the word gets out that Oh, this person has actually, specifically helped with these symptoms and side effects. That wave of support for providers in cancer care that we can provide [indiscernible] and massage therapy is significant and it’s starting to be noticed that we’re part of the circle of care for people during a really tough time. You can build solid relationships with healthcare professionals.

I’m thinking about another reason, too, which you mentioned earlier is that you use to have to refer out and you don’t feel like you have to refer out so much that people funnel people towards you. That is that we’re able to see people through the life cycle. If you can work safely and well with people with cancer and cancer histories. Remember, I keep inserting that. It’s not just about cancer treatment; it’s post treatment, it’s 30 years post treatment or 2 years post treatment, it’s everyone. There are still considerations and we still got to know them. If you can see people through the life cycle, if you can see cancer is associated with aging, the incidence of cancer increases with age, so if you can better able — if you’re better able to see our aging population through their aging, then you don’t have to turn away or refer out clients that you already have as they develop cancer.

AH And that is so painful to be treating someone for years as their massage therapist and to have them become ill with probably the scariest illness they’re going to have in their lifetime, hopefully, and then to say I’m sorry, I can’t care for you. I have to send you to a stranger with a better skill set. It’s brutal. We have these relationships with people, so to not be able to help them when they can most use our help, from us, because we have that relationship, it is really, really hard. And that’s probably what drives a lot of massage therapists to take these kinds of courses when we realize we want to better help the clients we already have. That is a gift to already have a skill set to help someone who trusts you with their body already and is undergoing some really scary and making themselves vulnerable to new practitioners to get their illness treated. Ooh. That’s a huge thing.

TW Yeah, you have an established relationship, you have rapport, and if you can continue that seamlessly, it’s just so much better for everyone. And I know massage therapists — and I don’t make this stuff up. We don’t try to do a hard sell for our courses. I repeat what therapists tell me, and massage therapists have told me I’m embarrassed that I have to send people out, that I have to refer them out for prenatal massage therapy, that I have to refer them out for oncology massage therapy. I think that’s what’s beneficial about being able to work with populations, not just with modalities. But anytime you can increase the number of populations — the number of people you can work with, the diversity and the inclusiveness in your practice, really serves you. It serves you, it serves you and me if we have needs of a massage therapist ourselves. We want to go to someone we know. I appreciate that you had that direct experience.

I think also — I’m forgetting exactly what you said that made me think of this, but earlier, there’s something about marketing more easily, promoting a practice more easily if you’re specializing with people —

AH It’s so easy. It’s so much easier. When you’re coming up with a description for your particular massage therapy treatment. So offering a 60-minute treatment at $90 and then describing that treatment becomes so much easier when you know who you’re talking to. It used to be — I used to have this generic treatment information like a massage incorporating relaxation and deep tissue techniques to tailor a massage perfect for you. That doesn’t mean anything. But when I know I am serving, let’s say oncology clients, then I know I’m saying — and I’m not going to come up with a service description off the top of my head, but I know when I’m talking to them I want to say to help relieve pain, improve sleep, and it gets so much easier —

TW It’s results oriented, right? It’s outcome oriented.

AH It is and you choose the words that fit that very small group. Once you know the lingo, all of it is so much easier. It takes a lot of the decision fatigue away from running your business and away from those scary parts of getting your foundation built because so many decisions get made for you once you choose that specific audience.

TW You know when you said “decision fatigue,” I was thinking about maybe it’s the client’s decision fatigue too. Clients, instead of looking at a confusing array on a spa menu of all these different kinds of massage treatments, they actually are looking at hey, is this speaking to you? Do you have this history? Are you going through treatment now? Have you been through treatment in the past? Would you like help with this? Then this is the massage therapy session that’s tailored to you and with a few extra questions on our part is aimed at helping you with these issues and these outcomes. I will add, it not only helps our language about our work, and language about massage therapy is hard to come by — but also it helps — people with cancer and cancer histories, this is going to sound a little bit crass, but people are easy to find. It’s easy to find people, it’s easy to find a support group and go make a presentation, make the relationship with the facilitator, start a relationship with a patient navigator, a nurse navigator helping people through cancer treatment and forging those rewarding relationships, professional relationships with her or him or anyone doing that kind of work. It’s easier to locate — people congregate at cancer care facilities, at support groups, in community service organizations, it’s just easier to find people and speak to them about your work and let them know you are available to try to help them. That’s more focused, I think.

We work on marketing, too. Not in our foundational course; there’s not time. We’re too busy dealing with the precautions, the techniques and such. But in my advanced course — I actually have a course I’m launching in the fall on setting fees and discounts for people with cancer and people in hospice care. And I’m excited to teach that because things arrived there, too, about if cancer treatment creates a health crisis, it can also create a financial crisis, and how do I see people within that context and make massage therapy accessible to them and also earn a living for myself.

I’m also thinking that since we’re looking at the practical or logistical considerations, I’m thinking that massage therapy for people with cancer — if someone chooses to specialize in that, it can be a real practice builder, but possibly even a career extender because working with people during active treatment, and sometimes even post treatment, but during active treatment, often requires that we work more gently. I introduce a 5-level pressure scale and we stick to the 1s, 2s, and 3s, the bottom three pressures, the lighter pressures, and it can require gentler work and possibly — I’m not going to make any wild claims here — but possibly help people extend their career through more years of doing this work because they’re able to work more gently in a greater portion of the time spent table side. I wonder about that. I don’t have any statistics, but often people who reach out to us about our course or about oncology massage in general are asking Hey, I’m getting older or I’ve gotten hurt or whatever, and I just want to be able to do this work. I love it so much, but I want to be able to do it in a way that is easier on my body.

AH So while we’re there, say someone like me who has taken your foundational course for oncology massage therapy, what are the next classes I could take? What else do you offer, since we’re talking to you, and what else is out there that you would suggest people consider if they want to dive deeper into oncology massage therapy or specialize in it, or if they feel like, even after a four-day course and practicing for a little bit, they’re not quite ready to say this is all that I do and this is what I am really, really good at, what are the next couple of courses or what are the other options for more CE on this?

TW I teach an advanced mentorship course in oncology massage therapy. I teach it online and that includes three — sort of the three — it’s online so it’s not about the hands-on work, it’s 3 pillars of a strong practice. The first is we do a lot more in the case study/clinical thinking area. We get stronger in that way. The second, which is the lion’s share of the course, is on promotion and marketing, outreach, we call it outreach. Both online marking and offline. How to make a presentation, people receive a handout, who take this course, they can use in support groups. How to identify a target market, how to speak to them, what are the outcomes, what are the problems we solve, all sorts of things like that. We use email marketing or social media to spread the word about massage and cancer care. And then the third thing, which is really the emotional terrain, the inner landscape of working with people with cancer, and what that’s like and what it brings up and how we manage that, how we reflect and how we grow in that way. So there’s that mentorship program. It’s really been popular. I’ve been operating it twice a year since 2014. Whatever the deficiencies are in marketing, we come out with those points in place. There’s a ton of one-on-one help, I read every assignment, respond with written feedback. It’s a small group, and I do a one-on-one coaching session with everyone, so it’s really aimed at practice building. So there’s that. That’s the principle one that you have.

And then I have smaller courses like I teach a course from time to time on research on massage therapy and cancer and that course satisfies the NCB research requirement, 3 hours of that. So it’s kind of fun to be able to learn about some research skills and enhance your skills, but have it be in the area you’re interested in. It’s all focused on that. There’s a course I teach on ethics in oncology massage therapy and hospice care. Once again, it’s really fun to get your ethics requirements done, but have it be in your area of interest. We have this course on setting fees and discounts that I talked about earlier. And we have a selection of webinars, online courses, all about hospital-based massage therapy where I interviewed a bunch of therapists and one physician and hospital-based massage therapy programs around the country in the US and what makes the program work and program development and implementation and funding and that’s all available and that’s on our website.

But, more generally, in oncology massage therapy, people go on and do hands-on internships in hospital-based massage therapy. Those are listed at the Society for Oncology Massage website, the supplemental courses. I feel like there’s three major branches, maybe four. One is that hospital work, the skills for that setting. Another is lymphedema care involving manual lymph drainage work. Another is work with scars, post radiation, post-surgical scars. And another is pediatric oncology massage therapy. There are lots of ways that people can go on. We don’t teach those courses, but we refer people to those courses through our website by sending them to the Society for Oncology Massage for other areas to get more study and to really focus and hunker down.

AH My final bit — I guess my final question is can people make money doing this, Tracy?

TW I think there’s a market that’s crying out to be addressed. And I do think it can be a really lucrative area. But I also think that massage therapy is what you put into it, and it can be more lucrative depending on what you put into it and the combination of luck and skill. Oncology massage therapy is the same way.

But I also feel that there’s an immense satisfaction in serving the people who do the work. Doing the work because it needs to be done. If you can help with these major symptoms and help people — someone told me this story about their work in a hospital — she worked in palliative care and she said when they notice that a patient’s pain had crossed over into something called suffering — and we won’t go into [indiscernible], but there are decided differences between pain and suffering — and there’s not really any medication for the isolation and terror of suffering. And they noticed that when a patient’s pain had crossed over into suffering that that’s when they would call the massage therapy unit, department, and have them come over to that unit. I was reading a quotation recently by Anne Lamott who said something like “I’ve helped carry scared people the best I could. You have too.” And this is one way that we can really help people when they’re frightened and along the way, you can deepen your own self-reflection. And my own experience of my own humanity has grown and changed over the decades that I’ve been doing this. But it’s really in the service of others in this way that really makes your heart sing. And I have a theory that the human body is — on the topic of being really scared and alone and isolated — the experience of cancer is really scary and lonely and isolating, and I kind of have a theory that the human body is one of the most frightening places to be in. It certainly is during cancer treatment and even beyond. People are even more scared sometimes afterwards. [indiscernible] push through and they’re sort of left to their own devices. People are very much at risk of anxiety and depression after treatment, and they need good massage care and they need a massage therapist who can ask them what kind of treatment they had and knows what to do about that to adapt the pressure and the stroke direction and adapt to missing lymph nodes and all sorts of things. They need someone who’s competent on that level so that they can really sit with someone who can help carry them when they’re scared and that’s a — massage therapy is a real force for good in the world. And oncology massage therapy is really one version of that.

So yes, if you want to be a successful practitioner, I think I just listed a few ways, but working in this way can build a practice. In service of the higher good, it’s a really great way to sleep at night knowing that you’ve done your part to help make it a little bit easier for someone else. And a real experience for me — if I need that kind of care, I hope I don’t, but if I need that kind of care at some point that I really know what it looks like and know what I might need from a massage therapist from a person that’s really skilled at touching other people in ways that are both helpful and profound and deep. There’s that element of it, too, and that’s the most compelling, I think, for me, for sure. And I imagine all of us.

AH I think so. I think the comfort of knowing I’m going to be able to serve my clients that I have developed these long-term relationships with and I’m going to be able to serve them, most likely, no matter what comes their way, is really — that makes for a very happy and peaceful practice, I think. And it makes it easy to be of service, which is why we’re showing up every day, I think.

TW Sure.

AH Is there anything that we didn’t touch upon that you wish we had, Tracy, before I wrap it up and tell people where to find you?

TW I get asked the question How do you do this work — how do you cope emotionally? What about compassion fatigue, and what if I cry? What if it’s too hard? What if I burn out? I try to answer that in a sound bite, for sure, but I do think this level of working with people asks us to be present in a way that is beyond superficial. It asks us to be present in a way that — with another person — that certainly can provoke feelings and inspires us to ask the deeper questions, to reflect on our shared humanity. I think Irene Smith really said it best — she teaches about massage therapy and hospice care, and she was one of my early teachers 25 years or so ago. She said if you choose this kind of work, it’ll be the best work you do on yourself. I really — not like oh, it’s all about me, but I really appreciate that we can work with other people and help them at the same time that we work with ourselves and help ourselves at the same time. That’s brought a great deal of meaning to my work for me, and it sounds like from my conversations with other oncology massage therapists and those in hospice care, it sounds like it’s brought a lot of meaning to them as well. Thank you for giving me a chance to make that observation because it’s a common concern and we don’t address it lightly. We pay real close and thoughtful and affectionate attention to it. But we certainly can’t ignore it in the work that we do.

AH We have given people so much to think about and hopefully talk to their colleagues about this work. Everyone, I’m going to leave it there. Where can you find out more about Tracy Walton and her courses and the work she does? You can go to tracywalton.com. It’s T-R-A-C-Y, Walton is easy to spell, dot com. We’ll have the links to all of her information as well as the links to Pure Pro and their generous offer in the podcast notes. Thank you, Tracy Walton, for joining us today.

TW Thank you so much for having me. I’d pretty much do anything to be able to talk with you for an hour, Allissa, so I’m glad I got the chance to today.

AH If you have any questions for us, you can shoot them to us at podcast@massagebusinessblueprint.com, but otherwise, have a lovely day and a wonderful practice.

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