Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to administer client remedial massage treatment according to the philosophy and practices of a remedial massage framework

Application 

This unit may apply to work in massage in a range of settings and contexts

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Manage treatment

1.1 Explain factors which may interfere with the effectiveness of the treatment

1.2 Explain mode of administration and management of the treatment to the client

1.3 Request client to monitor reactions and contact practitioner as required

1.4 Ensure consent for treatment 

1.5 Drape client to expose only the part of the body being worked on

1.6 Provide massage according to the treatment plan

1.7 Recognise reactions to treatment and promptly respond  if necessary

1.8 Explain time, location and content of future sessions clearly to the client

1.9 Document recommendations

2. Apply remedial massage techniques

2.1 Apply massage techniques 

2.2 Apply remedial massage techniques to achieve specific therapeutic outcomes

3. Advise and resource the client 

3.1 Educate the client in relevant and practical techniques  for promotion and maintenance of optimum health

3.2 Answer client queries with clarity, using the appropriate language

3.3 Use honesty and integrity when explaining treatment plans and recommendations to the client

3.4 Use appropriate interpersonal skills when explaining treatment plans and recommendations to the client

3.5 Promote client independence and responsibility in treatment wherever possible

4. Review treatment

4.1 Evaluate progress with the client

4.2 Identify and record effects of previous treatment

4.3 Review previous treatment plan

4.4 Evaluate need for ongoing and/or additional treatment

4.5 Negotiate changes to the plan with the client to ensure optimal outcomes

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Advanced assessment procedures and options allowing complex regional assessments
• Best practice massage therapy principles
• Classification of joints and types and ranges of motion
• Ethical, legal and regulatory implications of treatment
• History, philosophy and beliefs of massage therapy within a health framework
• Indications and contra-indications for massage
• Pain and chronic pain syndromes
• Pathology and symptomology
• Regional anatomy
• Structure and function of anatomical systems appropriate to massage therapy and scope of practice, such as:

• articular system
• cardiovascular system
• endocrine system
• immune system
• lymphatic system
• nervous system
• reproductive system
• respiratory system

• Technical and practical knowledge of treatment
• The organisation of the body
• The processes of ageing and biological maturation
• The role of massage in:

• alleviating depression and anxiety
• auto-immune disorders
• enhancing attentiveness
• enhancing growth
• immune disorders

• The situation and referral patterns of trigger points
• Understanding of physiology and anatomy according to massage therapy
• Understanding of the fundamental principles of biomechanics and functional anatomy

Essential skills :

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Communicate effectively with client/other health practitioner
• Complete documentation of all recommendations and client responses
• Comprehend common medical terminology
• Demonstrate skills in applying advanced assessment techniques
• Develop and implement treatment plans to achieve optimal health, rehabilitation, or to improve quality of life which involve:

• treatment of a range of conditions/disease states
• compressive techniques including digital ischemic pressure
• deep tissue massage techniques
• demonstration of the application of all of the techniques listed under the range of variables:
• effleurage including cross over stroke, longitudinal stroking, gliding techniques
• friction techniques
• manual lymphatic drainage
• mobilising techniques
• myofascial tension technique
• passive joint movement techniques
• passive soft tissue movement
• percussion techniques
• petrissage/kneading
• proprioceptive neuromuscular facilitation
• stretching techniques
• temperature therapy
• trigger point release techniques
• vibration

• Ensure all treatment or care delivered is consistent with legislative and regulatory requirements
• Gather and interpret information through the tactile senses
• Handle a case requiring referral to another health care professional
• Identify and describe a treatment outcome using accepted medical terminology
• Identify bone landmarks, structures and individual muscles through palpation
• Identify prominent bones/structure and phasic and postural muscles
• Manage time throughout consultation and treatment
• Palpate prominent bones/structure and phasic and postural muscles
• Prepare the client for treatment according to massage principles

continued  ...

Essential skills  (contd ):

• Provide treatment according to the individual, the condition and the presence of complicating factors. It must be the safest, most efficacious method that is also cost effective to the client
• Review treatment plan
• Transcribe assessment findings and treatment in a client history using accepted medical terminology
• Use equipment and resources competently and safely
• Write referrals, appraisal letters for insurance companies and other documentation

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of performance in the workplace or a simulated workplace (defined as a supervised clinic)
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
• Assessment may contain both theoretical and practical components and examples covering a range of clinical situations
• Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender
• Assessment of sole practitioners must consider their unique workplace context, including:

• interaction with others in the broader professional community as part of the sole practitioner's workplace
• scope of practice as detailed in the qualification and component competency units
• holistic/integrated assessment including:
• working within the practice framework
• performing a health assessment
• assessing the client
• planning treatment
• providing treatment

Context of and specific resources for assessment :

• An appropriately stocked and equipped clinic or simulated clinic environment
• Relevant texts or medical manuals
• Relevant paper-based/video assessment instruments
• Appropriate assessment environment
• Demonstration model/client

Method of assessment 

• Observation in the workplace
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice
• Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting
  If successful, a second assessment is to be conducted during workplace application under direct supervision
• Explanations of technique
• Oral questioning and discussion

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Related units :

This unit should be assessed after or in conjunction with the following related units:

• HLTCOM404C Communicate effectively with clients
• HLTFA301C Apply first aid
• HLTHIR301B Communicate and work effectively in health
• HLTIN301C Comply with infection control policies and procedures

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Consent for treatment refers to :

• Informed consent according to the local and national regulations and legal guidelines
• In the case of a minor or a ward of the state that an appropriate adult be present during any examination

Respond may include :

• Adjusting treatment accordingly
• Seeking appropriate expertise or referral
• Discussing reaction with the client
• Adhering to clinic guidelines for response to accidents and emergencies
• Using first aid procedures according to St Johns, Australian Red Cross or other appropriate first aid training
• Maintaining a senior first aid certificate which is renewed at least every three years
• Accessing local, emergency services

Massage techniques :

To be performed in a variety of positions, ie, standing, seated, prone, supine and side recumbent lying, and through clothing as well as conventional table massage. These include but are not limited to:

• Passive joint movement techniques

• joints are moved through their range of movement, ie to the point of mild tissue resistance

• Passive soft tissue movement

• technique is applied with palmer surfaces of the hand, heel of hand and/or fingers
• jostling:
• shaking of the muscle from origin to insertion

• Gliding techniques

• effleurage:
• broad superficial strokes using the entire palm surface of the hands to cover large surface areas of the body

• Longitudinal stroking:

• deep gliding movement is applied in the direction of the muscle fibres through focal pressure using any of the following; fingers, palm, heel of hands, forearm and/or knuckles
• transverse gliding
• cross over stroke:
• pulling and pushing of the tissue using the hands in a criss-cross manner

• Kneading/petrissage

• technique is applied with palm surface of the hand, heel of hand and/or fingers
• soft tissue is mobilised with rhythmical circular rolling, squeezing or pulling movements

• Friction techniques

• superficial tissue is moved over an underlying structure in circular, longitudinal or transverse directions
• deep repetitive movements of short amplitude are applied usually with thumbs, fingers and knuckles or massage tool
• friction techniques are believed to be beneficial in releasing adherent/scar tissue

continued  ...

Massage techniques  (cont ):

• Compressive techniques

• digital pressure
• compression: successive and rapid pressure,
  i.e. a series of short duration compressions, is applied to soft tissue between two structures,
  i.e. underlying bone structures and therapist's hand, or hand to hand

• Percussion: cupping, tapping, hacking, pummelling and flicking are applied rhythmically using the hands
• Temperature therapy

• conduction, eg heat packs and immersion baths
• radiation, eg ray lamps
• friction

• Topical applications
• Deep tissue massage techniques
• Myofascial tension technique: techniques conducted on superficial and/or deep tissues to:

• lengthen tissue
• reduce adhesions
• increase range of movement
• decrease compartment pressure
• restore elasticity

• Manual lymphatic drainage
• Trigger point release techniques: apply digital ischemic pressure and/or apply stretching after treatment. It incorporates:

• ischemic pressure
• stretching

• Stretching techniques:

• static stretching
• dynamic stretching
• contract-relax and hold-relax

Advise and resource the client refers to :

• Providing relevant literature or information materials
• Referring client to other information sources
• Providing advice regarding self-care
• Advising client of suggested resources
• Providing of details which help to fully inform client of relevant information
• Providing referrals to other health professionals
• Availability of products required or suggested for treatment
• Postural correction advice

Practical techniques that promote and maintain optimal health may include :

• Postural improvement strategies eg ideal posture for activities
• Discussion of causes of poor posture
• Simple follow-up activities and/or strategies to work on between sessions
• Activities and/or tasks to avoid
• Self-massage techniques