by Cassie Sampson

Recently, at a chair-massage event, a gentleman who never received massage therapy approached me for a session. I greeted him, collected standard intake information and instructed him on how to sit in the chair. I adjusted the chair to a position that appeared appropriate and checked in with him before and during the session to make sure the headrest and pressure were comfortable. I also asked him to let me know if he needed me to make changes at any time.

After his massage, I was hoping he’d sit up looking relaxed and refreshed, with the new-client grin that seems to say, “So this is what I’ve been missing!” Instead he grumbled, “I didn’t like it. The face rest was too high.” Though frustrated, I politely responded, “I’m sorry about that. The chairs are easy to adjust, so if you get a massage in the future, please make sure you tell your therapist if you aren’t comfortable.”

Based on my experiences and discussions with colleagues, many clients—like the man at the chair-massage event—clam up about their needs during sessions, rather than express themselves and gain more from their session.
Massage therapists need to ensure clients understand the value of voicing preferences and needs—and that they are comfortable doing so. I have found the following three strategies to be successful in my practice; not only are my clients’ sessions more beneficial, but they have also fostered repeat business.

1. Rethink the intake form
In order to support fellow massage therapists, I often visit their offices and clinics for treatment. Regardless of the quality of the therapist or treatment, one thing has struck me: Most often a therapist’s intake form covers only medical history and doesn’t include questions about a client’s massage-therapy history. Customizing the intake form has helped me gain better understanding of a client’s preferences.

I ask such questions as, “What did you like or dislike about previous massages?” and “Are you comfortable letting your therapist know if you have concerns about pressure, temperature or anything else during your session?” Although many clients state they’ve loved everything about previous massage experiences, some clients cite concerns, the most common of which are the therapist used too much or not enough pressure and their previous therapist talked too much. These comments help me open the lines of communication with a client before treatment even begins, and I also have mental notes to rely on during sessions.

For example, if a client mentions she didn’t like the amount of pressure in a previous massage, I might say, “I noticed in past massages you felt the therapist didn’t use enough pressure. I’ll check in with you to make sure you think my touch is firm enough or if you need more.” Similarly, if a client mentions her last therapist talked too much, I’ll say, “I’m so happy to see you’ve noted you will let me know about any concerns you have during your massage. I’ll check in once or twice to make sure you are comfortable, but I’m glad I can trust you to tell me if you need changes, so I can let you rest quietly.”

More often than not, opening the lines of communication through the intake form and reassuring a client she can feel free to voice concerns with me empowers the client and makes me confident I am providing better treatment.

2. Ask good questions
Sometimes “closed” questions—those that can be answered with a “yes” or “no”—are helpful; for example, asking a new client whether or not she has ever received massage therapy. However, I have found rephrasing questions—even if the response will be one word—allows the client to direct me during treatment.

For instance, when I check in with clients during a session, I never ask, “How’s the pressure?” The reason is because the most common response is, “Um … fine,” which isn’t very helpful. Instead I ask, “Would you like more or less pressure than I’m using now?” This requires brief thought, but it results in more meaningful, direct feedback.
To reinforce this type of exchange, I offer a sincere, “Thank you, I appreciate the feedback,” and then follow up to be sure I understood correctly.

3. Educate clients
In addition to encouraging feedback during sessions, I believe educating massage consumers about the benefits of being assertive in expressing their needs opens lines of communication.

I noticed some employees at a company I visit regularly with my massage chair stopped getting sessions. I wondered if they were just busy or if there was something about my massage they didn’t like. I received permission from the manager to write a short article for the company’s newsletter, which outlined the importance of massage. Additionally, in the article I encouraged employees to tell me about health changes before their sessions and any concerns about pressure and positioning on the chair, so they could receive maximum benefits from their treatments.

Shortly after the article ran, I saw some of the employees I hadn’t worked with in awhile, and some employees decided to book an appointment for the first time. In both cases, the employees were more assertive about their pressure and comfort needs, taking the guesswork and anxiety out of my job. This educational strategy could easily be used to equal success on a Web site, in a blog or in client newsletters.

I often wonder if new clients who noted their last therapist talked too much on their intake form found it easier to visit another therapist than ask their current therapist for quieter treatments. Although it is difficult to say why clients choose not to return to a massage therapist, I’d hate to have someone swear off massage because her therapist wasn’t a mind reader.

Making small changes in how I communicate has helped clients understand I value their feedback and can use it to enhance their sessions—and I am confident other therapists will reap the benefits of more satisfied clients if they do the same.

Cassie Sampson owns The Loft Massage and Body Wellness in Des Moines, Iowa, and is a business and chair-massage instructor at Body Wisdom Massage Therapy School in Urbandale, Iowa. She maintains a blog through The Des Moines Register, in which she educates people about massage and wellness topics. She is currently pursuing her master’s degree in public health, and, in her spare time, she and her husband, Matt, volunteer for basset-hound rescues.