Informed Consent: What to Expect from CMIT

tool, a positive response suggests that further assessment is warranted (see Appendix F for the AC- OK). In addition to any clinically relevant information obtained from the comprehensive assessment, the results of the AC-OK and of the trauma checklist are shared with the massage therapist. The referral process highlights relevant traumatic experiences in order to minimize clients having to retell their stories, thereby resulting in integrated care.

2. Informed Consent: What to Expect from CMIT

In accordance with best practice standards, informed consent needs to be obtained prior to initiating CMIT services. First and foremost, the expectation that parents/guardians participate in the treatment by attending every massage therapy session with their child is clearly articulated as part of this process. Further, the guardian and child need to be alerted to all possible risks and benefits of participating in CMIT. Clients are first oriented to the overall benefits of MT and told that the intervention with the massage therapist will involve touch. Clients are told that the massage component of CMIT differs from standard massage in that a number of elements are added to focus on sensory and emotional awareness, with the goal being an integration of body and mind. As a part of obtaining informed consent, the referring clinician explains that massage therapy can help reduce symptoms associated with anxiety and depression in adults and aggression in adolescents. The following list summarizes the salient points for therapists to review with clients to clarify what they can expect from the experience:

1. You are always in control of what part of your body is massaged. The MT will ask you where you want to be touched.

2. You will decide how you want to be dressed for your massage. Some people want all their clothes on to start; others wear a bathing suit and some take shoes off.

3. You will lie on a massage table and will be covered by a sheet when your body is not being massaged.

4. You will have a chance to talk about what the massage was like for you after the treatment is over.

5. Your parent/guardian will always be present during the session.

In addition, as part of explaining the program the diagram in figure 4 is reviewed with the child and guardian. The client is invited to circle on the picture of the human body any area where he/she is uncomfortable being touched (see Appendix x for the complete What to Expect from MT handout).

Figure 4. WHAT TO EXPECT FROM MASSAGE THERAPY

Massage May Help You

_{℘ feel calm/relaxed ℘ behave the way you want}

℘ sleep better

℘ feel less angry, sad or afraid

℘ feel better about yourself ℘ feel safe when you are touched

_{℘ learn ways to help yourself calm down when you “feel uptight”}

Things That Might Happen to Make You Uncomfortable

Circle area where you would not

want to be touched

Sometimes when the massage therapist touches you, you may remember if you have been touched before and the touch hurt you or made you afraid. If you experience these feelings, please share them and talk to your massage therapist and to your psychotherapist. This can help you feel better.

Another important part of obtaining ethical consent for treatment involves a thorough review and explanation of client rights. It is critical to convey to families that the child has the right to feel safe at all times, that they can change their mind at any time and that they have the right to opt out of treatment without other services being impacted. They are encouraged to ask questions. Families shall also be alerted to the possibility that their child may feel uncomfortable while receiving massage therapy. Parents need to be told that although treatment is designed to help youths with emotional and behavioral problems, there is no guarantee that their child will improve and that they have the right to withdraw from treatment at any time. All the above- referenced information also needs be to be communicated with the child, using developmentally appropriate language designed to engage him or her in a meaningful conversation (see Appendix x for Informed Consent and Client Rights Forms).

3. Treatment Readiness Process

Once a thorough assessment is completed and informed consent is carefully obtained, a series of prereferral questionnaires and surveys exist to help guide clinicians, parents/guardians and children in preparing for CMIT (see Appendices G-I for the Prereferral Questionnaires).

The clinician questionnaire is designed for the referring psychotherapist to document what changes (thoughts, feelings or behaviors) they hope to see in their clients upon completion of the program. The psychotherapist is expected to identify how integrating a body-based component to psychological trauma treatment relates to a specific goal in the child’s recovery. The client prereferral questionnaire explores the clients’ expectations and hopes regarding CMIT. This includes an assessment of what the client has historically done to help reduce tension in his or her body and a review of other skills that may have proven to be effective in the past to regulate states