An image of two people speaking to each other, superimposed over a blank progress note, is used to illustrate the concept of using SOAP notes as a form of deep listening to what a client says.

Making your SOAP notes a deep-listening experience for your clients is the first step in addressing what matters to the client.

Deep listening builds trust with your massage clients and allows them to speak with transparency in a safe and confidential manner. Thus, you will gather good and comprehensive information to guide your massage-touch intervention. 

Deep listening also reduces the stress and apprehension the client might be experiencing over the facts, conditions or circumstances that brought them to seek massage care from you in the first place.

Deep listening, according to Buddhist Zen Master Thich Nhat Hanh (1926-2022), is the type of listening that can “relieve the suffering of another.”

When we, as massage therapists, meet a client for the first time and proceed to take a history and perform an assessment using the SOAP notes model, it can be a stressful moment for a person who is experiencing pain—one coupled with their frustrating experiences inside the U.S. medical system, which often values opinions of insurance carriers more than those of clinician or patient.

Promote Trust

Taking your SOAP notes history with a client can be a wonderful therapy experience when done with mindfulness and deep listening. This is the first step of your massage therapy intervention that promotes an atmosphere of trust and confidence that massage therapy will help the person.

Many of my clients have reported to me that their primary care physician or specialist will often impose their own thoughts and feelings when they are listening to the patient or client. This is a sure sign of a poor listener.

An essential skill of the successful massage therapist is to remain silent and allow the client to say more about what matters to them. While taking SOAP notes, do not interrupt the client while they are speaking or try to drive their words in a particular direction because of a recent workshop you attended and new knowledge you have just gained. (As the popular saying goes, if all you have is a hammer, then everything begins to look like a nail.)

Also of great value when taking SOAP notes is to listen to what is not being said, which may require another skill: the ability to translate between the lines. This ability comes with years of experience and giving thousands of massages. (I have personally administered over 70,000 massage therapy sessions of 25 minutes or longer in my 47-years-and-still-going career.)

The ability to reflect on what the client is sharing with you is a vital part of deep listening. This can be done when you draw together all the aspects of the SOAP notes history-taking and assessment time with the client. Include observations of body language, their word selections when describing what matters to them and their facial expressions.

5 Things the Massage Client Seeks

I believe the massage client is seeking five fundamental experiences before the skin-to-skin touch portion of the massage therapy session begins:

1. To be heard

2. That their opinions matter, especially relevant to the SOAP notes gathered by the massage therapist

3. To have our empathy

4. To have our respect and courtesy

5. To be believed

An Artful Technique

One successful technique I have used for over 40 years with my SOAP notes experience that I provide for my clients is this:  I begin with having the client do some coloring on a blank body-outline picture. I create a coloring book experience that draws the client into their right side, feeling, and brain, and gives them a way to express their feelings with a picture of what matters to them.

They color in the areas on the body chart that represent their concerns of pain, discomfort, restrictions and mobility. This coloring book experience now becomes the center of our conversation that allows them to share and allows me to employ mindfulness and deep listening as I gather SOAP notes.

Using their artful expression of where they live in their bodies allows my assessment questions to be without judgement, thus building a therapy relationship of trust and support. Using the visual expression of coloring the body outline allows me to accurately perceive what my client is saying.

It allows me to receive and hear the information, the facts, the conditions and the circumstances that are all part of their history.

It is through mindfulness and deep listening that the massage therapist will express empathy and respect for the client. It will show the client we understand what they are saying and we value and respect them as human beings.

Structured touch–massage therapy—remains the most powerful vehicle for transmuting the emotion of love to a society where many are suffering from touch deprivation, or touch hunger. After all, the skin reflects our nervous system and our primary contact with the world we live in.

The massage therapist is the best-trained skin-to-skin touch professional in the world, and thus can support the human experience through the power of massage therapy.

Benny Vaughn

About the Author

Benny Vaughn LMT, BCTMB, ATC, LAT, is a Master Coach for mindset transformation and mastery.