PERSON OF THE MONTH

Our Person of the Month for this issue of JMS is Dr. Grant J. Rich, PhD, BCTMB, LMT. We think that Dr. Rich’s work is very important for the entire Massage Therapy profession because he dedicated his scientific efforts on the psychological effects of massage therapy.

Therapists widely embrace the concept that massage helps clients to normalize different levels of stress but there is much more to that very basic concept. By working on the cusp between psychology and massage therapy Dr. Rich fills this gap with data which therapists can use to build up their business as well as to help their clients more efficiently.

Dr. Ross Turchaninov, Editor in Chief

Here is our interview with

MASSAGE THERAPY SCIENTIST

Dr. Grant J. Rich, PhD, BCTMB, LMT

JMS: How did you become interested in Massage Therapy?

 

Dr. Rich: I had been immersed in a life of the mind, as I was pursuing a PhD in psychology at the University of Chicago. The university has rigorous and respected programs, but during that era, the average time to PhD in psychology there was 9.9 years, and that was stressing me out a bit… well, a lot actually!

I found massage therapy was beneficial for my stress reduction and general well-being, and I soon became so fascinated I decided to pursue certification in massage therapy as well. I learned from Eisenberg’s Harvard survey that though about 1 in 3 Americans utilized CAM, we really knew very little about its efficacy and effectiveness, and, though I was a fan of the effects I seemed to be receiving from massage therapy, I was skeptical at times about the evidence base on which the profession at the time was founded.

At any rate, I had my first book of quantitative massage therapy research in proofs with my publisher Elsevier (Massage therapy: The evidence for practice) by the time I had my psychology dissertation final oral defense at the University of Chicago. My dissertation committee was surprised but intrigued by the significant psychological effects documented by the massage therapy research, especially regarding depressed mood and anxiety. 

JMS: Your field of expertise is the effect of MT on patients with anxiety, chronic stress, depression and PTSD. From your perspective, what role does MT play in rehabilitation of these patients?

Dr. Rich: Massage therapy can play a critical role on alleviating or reducing anxiety, depressed mood, and many effects of PTSD/trauma. In some cases the effect size can be as large as with psychotherapy or medications. That said, massage therapy is not a panacea, and is not appropriate for all persons with depression, anxiety, PTSD/trauma.

Bodywork Practitioners should be prepared to work closely with psychotherapists and psychiatrists as appropriate and within ethical and legal guidelines to determine what massage therapy treatments may be right for an individual condition and a particular time. Remember, massage therapists are not psychologists or psychiatrists, even if massage therapy may carry significant effects on mood and emotional states and conditions.

Another important point, is that in some societies and places there may not be credentialed psychotherapists or psychiatrists, and thus massage therapy may be the only available treatment- or one of a few available treatments- that may be associated with documented effects on reducing anxiety and depressed mood.

In brief, some of the most clear and robust documented effects of massage therapy are on reduced anxiety and depressed mood, and data include both self-reports (which are common research tools in social science), and physiological correlates, as well as some studies that utilize behavioral observations (e.g., by parents, teachers, others of the client).

JMS: Where can our readers access data which supports the value of the clinical impact of MT on patients with psychological disorders?

Dr. Rich: I have written several peer reviewed journal articles and chapters on the value of MT for clients with psychological conditions or who have anxiety, depressed mood, or effects of PTSD/trauma.

For instance, see my 2010 article in APA’s Professional Psychology: Research  and Practice Journal, my 2013 article on MT for PTSD/trauma/anxiety in the Bulletin of Peoples’ Friendship University of Russia: Series of Psychology and Pedagogy, and my 2012 book chapter in Research studies, literature reviews and perspectives in psychological science. 

I currently have a book chapter on massage therapy effects in a new book in production that promises to make a significant contribution to CAM more broadly called A mental health practitioner’s guide to holistic treatments. The book is being edited by some leading psychologists, including Cheryl Fracasso, Stanley Krippner and Harris L. Friedman.

I’d also suggest several book length reviews of the literature by psychology Dr. Tiffany Field (e.g., 2006, 2009, 2014) as well as a chapter in a recent 2014 APA book Complementary and alternative medicine for psychologists. My 2002 book also contains ample evidence concerning psychological effects of massage therapy. 

As I travel internationally presenting on the psychological effects of massage therapy, I find audiences of mental health professionals are deeply intrigued by the evidence presented, and often a presentation in one nation leads to a presentation in another. For instance, I have presented on the psychological effects of massage therapy in nations including Haiti, Jordan, Japan, The Bahamas, Belize, and South Africa, among others.

Massage therapy can provide tremendous relief to survivors of traumatic events, including refugee populations and rescue support personnel. Incidentally, I’d also encourage massage therapists to pursue a credential in Psychological First Aid, which is somewhat analogous to First Aid training.

In his book on post-trauma interventions, respected Harvard researcher Bessel van der Kolk (2014) reported on survey of several hundred people who had escaped the Twin Towers on 9/11/2001. Responding to being asked what had been most helpful in overcoming the effects of the experience, survivors mentioned, in order, acupuncture, massage, and yoga; massage was especially popular with rescue workers. 

JMS: What is the best way for therapists to build professional relations with psychologists and psychiatrists for the benefit of patients? 

Dr. Rich: There are numerous techniques, though participating in multidisciplinary health conferences is one way to meet practitioners and researchers from associated disciplines and professions. Also, calling therapists to request a meeting can be helpful- be prepared to explain your work and credentials. Read up in advance on some of the research on psychological effects of massage therapy- perhaps be prepared to bring a copy of the article to a meeting or offer to send the psychologist or psychiatrist the references or links.

Many PhDs and MDs may only have a foggy idea of what massage therapy can or cannot do. Another idea is to offer a free or reduced cost massage therapy session or chair massage to the psychologist/psychiatrist so they get to know your work.

Again, many such health care professionals may not have experienced massage therapy and thus in my experience are reluctant to make referrals since they are not aware of the documented health (including psychological) benefits.

Mental health professionals will also want to understand the certification and education required to practice massage therapy locally/nationally and so you’ll want to be prepared to explain that as well as be able to explain the ethical codes and scope of practice by which massage therapists must abide.

Be prepared to describe draping procedures, potential responses if a client has an emotional reaction while on the table, and other pertinent issues regarding client confidentiality and privacy.

JMS: You used term health psychology. Could you elaborate more on this important subject?

Dr. Rich: Health psychology is a cross-disciplinary area that focuses on the development, prevention and treatment of illness/disease, and it emphasizes topics such as stress and coping, the relationship between psychological factors and physical health, and promotion of health behaviors, such as how best to get clients to adhere to an exercise regimen, or to comply with prescribed medications, or to maintain a healthy diet.

Much illness and disease today in chronic in nature and reflects poor lifestyle choices- science may tell us what such unhealthy behaviors are causing/exacerbating these conditions, but psychology may be the discipline that can best educate and nudge humans to actually follow healthy behaviors and make smart health decisions.

In some respects, health psychology is psychology’s answer to what physicians often term behavioral medicine. Dr. Glenn Hymel and I in fact recently coauthored an article entitled “Health psychology as a context for massage therapy” on just this issue for Dr. Leon Chaitow’s Journal of Bodywork and Movement Therapies.

Among the conditions for which health psychology can play an important role are pain, insomnia, headaches, diabetes, obesity, hypertension, various musculoskeletal conditions, and so on. Many health psychologists are deeply immersed in body-mind connections as in the work on psychoneuroimmunology (PNI).

JMS: What is your favorite type of bodywork

Dr. Rich: As for my favorite type of bodywork… that’s a great question, but tough. There are so many styles and techniques- hundreds if not thousands- and they vary by individual practitioner- we are not a one size fits all profession, and we as humans change in needs on a continuing basis.

What works best one day for one person and one condition may not be what works best on another day for another person or another condition. This discipline is not a cookie cutter one!

I encourage practitioners- and researchers- to gain experience with many of the healing modalities in bodywork, from those that are more gentle and light to those that are deeper. Whole encyclopedias have been written on various bodywork styles (see for instance, books by Thomas Claire and by Elaine Stillerman), so enjoy!

I do believe Swedish massage therapy is an industry standard for a reason, and much research has utilized this technique. Depending on the situation I am also a fan of Trager style work and deep tissue approaches.

JMS: What is your advice for JMS readers?

Dr. Rich: We need more massage therapists who are interested in, and motivated to participate in research. One great way to do this is to reach out to PhDs at your local university, often in clinical, developmental or health psychology, or allied health professions, among others. PhD researchers need the insights of bodyworkers so that they know what questions are important to investigate and so that they can construct research designs that are appropriate, and carry validity for the real world, not just the laboratory.

Practitioners can serve as massage therapists for researchers’ studies of course, and perhaps may become involved in assisting with design and write-up. I suggest interested massage therapists also begin to take a sequence of courses in research methods and in statistics at their local universities, often through the psychology or sociology departments (in addition to math departments) – some such courses are now available online as well, and recently several professional organizations have begun to require massage therapists earn several CEUs in research each renewal period.

I also encourage interested practitioners to read a book such as Dr. Glenn Hymel’s Research Methods for Massage and Holistic Therapies. I am honored that Glenn, who is a massage therapist as well as a psychologist, has invited me to co-author a revised edition of his important book, which was first published by Elsevier in 2005. In sum, it is a terrific time for massage therapy and research. There are many opportunities- go for it!

Here is list of References suggested by Dr. Rich:

Barnett, J. E., Shale, A. J., Elkins, G., & Fisher, W. (2014). Complementary and alternative   medicine for psychologists. Washington, D.C.: American Psychological Association. Claire, T. (1995). Bodywork. NY: William Morrow.

Eisenberg, D. M., Kessler, R. C., Foster, C., et al. (1993). Unconventional medicine in the   United States: Prevalence, costs, and patterns of use. New England Journal of Medicine, 328 (4): 246-52.

Field, T. (2006). Massage therapy research. NY, New York: Elsevier.

Field, T. (2009). Complementary and alternative therapies research. Washington, D. C.: APA.

Field, T. (2014). Touch (2nd ed.). Cambridge, MA: MIT. Hymel, G., & Rich, G. (2014).  Health psychology as a context for massage therapy. Journal of   Bodywork & Movement Therapies, 18, 174-182.

Hymel, G., & Rich, G. (in prep.). Research methods (Revised Edition).

Hymel, G. (2005). Research methods for massage and holistic therapies. NY: Elsevier.

Rich, G. (Ed.). (2002). Massage therapy: The evidence for practice. NY:  Mosby/Elsevier. 

Rich, G. (2010). Massage therapy: Significance and relevance to professional practice.  Professional Psychology: Research and Practice, 41(4), 325-332.

Rich, G. (2012). Massage therapy: Research and data relevant to practicing psychologists. In T. 

Patelis (Ed.), Research studies, literature reviews and perspectives in psychological science  (pp. 233-248). Athens, Greece: Athens Institute for Education and Research 

Rich, G. (2013). Massage therapy for PTSD, trauma, and anxiety. Bulletin of Peoples’   Friendship University of Russia: Series of Psychology and Pedagogy 3, 60-66.  https://elibrary.ru/contents.asp?issueid=1142500

Stillerman, E. (1996). The encyclopedia of bodywork. NY: Facts on File.

Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of  trauma. NY: Viking.


Category: Person of the Month

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