What makes a good structural integration practitioner?

We are often asked to refer clients to other practitioners in other areas, including in other countries. We let our clients know that we are reluctant to recommend a practitioner unless we have received their work or know of their good work through our professional network.

We DO refer clients to many links located in professional association web sites and web sites for structural integration (see Links to Information). So clients are often left to their own means to locate, interview, and determine whether a structural integration practitioner is right for them. Below is an inventory of what we believe are the attributes of a good practitioner. It takes a special person, with a special combination of skills and attributes, and with advanced training to become a good practitioner.

There are six main attributes to a good practitioner:

• Excellent touch and sensitivity
• Intelligence and analytical skills
• Emotional maturity and experience
• Excellent training
• Ability to listen and provide support
• Professional and ethical conduct

Unfortunately, if a practitioner is lacking in even one area, the effectiveness of treatment or the safety of the client may be at risk.

Touch and Sensitivity:
No matter what other skills or attributes the practitioner has, a sensitive and effective touch is essential. You will know immediately if a practitioner has or does not have this sensitivity when you get on the table (ask others who have experienced their work for their input if that is possible). Some practitioners have it, some don't. A new practitioner will develop a more and more sensitive and effective touch over time. But those who have been doing if for a year or more who do not have the touch, rarely will develop the touch after that, at least not without excellent mentorship. We recommend that you avoid those practitioners. Find another one, one with "the gift of touch"

Note that sensitivity of touch does not mean that the work will not be intense at times. But the good practitioner will not only sense the intensity, but back off to an appropriate level for each client and the conditions of the tissue. Persons with fibromyalgia or polymyalgia will need to be especially careful to select a practitioner with a sensitive and light touch.

There is an "art" to manual therapy. The art is the intuitive felt sense that the manual therapist has after years of experience with clients and their tissues. You will be able to feel that with a good practitioner. I once had a client who said I was a "body whisperer", similar to the character in the horse whisperer movie. I took that as the best compliment a client could give.

It seems needless to explain, but we have found clients who have gone to massage therapists or manual therapists who feel inappropriate pain, ask the therapist to refrain or back off, and the therapist does not comply. We recommend that you stop the therapy session immediately and leave the session. Find another therapist. No therapist should intentionally hurt you. You should always be in control of your session and feel safe.

Intelligence and Analytical Skills:
One of the most important aspects of the practice of structural integration is the ability to evaluate structural compensation patterns and analyze the specific needs of each client. This requires training, knowledge of human anatomy, the ability to systematically catalog and integrate each factor or compensation into a holistic pattern, and the intelligence and experience to put together an effective treatment plan for each client. There is no standard prescription. Every client is unique, as are their needs. Without the analytical skills, the practitioner will not be able to put together an effective treatment plan.

Emotional Maturity and Experience:
The "maturity factor" is the unknown attribute that requires subjective evaluation on your part. Structural integration is a holistic exploration of your body, mind, and soul when you take the therapy to its fullest potential, beyond the initial injuries or dysfunctional compensations. You have the opportunity to move beyond your limitations and open up to new possibilities, reclaim some of your more youthful function and energy. It is an opportunity for major personal transformation. That kind of vulnerability and energetics requires that the therapist has the maturity and experience to support you in that context. Many schools do not allow students under the minimum age of 25 to attend, based on the maturity factor required by this work.

Excellent Training:
Training for myofascial and structural integration varies considerably, from weekend workshops to years of training in the thousands of hours. A practitioner should have at a minimum, 650-1000 hours of training specifically in an full curriculum structural integration program, a licensed school. Advanced on-going training is typical for excellent practitioners.

"Myofascial release" techniques are NOT the same as myofascial structural integration programs. Structural integration is the fully integrated practice of addressing the structural compensations in the body, use of release techniques, ability to analyze and evaluate compensation patterns, detailed knowledge of human anatomy and pathology, and movement reeducation, at a minimum.

Advanced practitioners will have knowledge of many modalities of practice and maintain membership in professional organizations. Check for licensure in your state or country.

Ability to Listen and to Provide Support:
The exploration of symptoms and health history of a client is core to the treatment evaluation, planning, and execution. The practitioner must be able to focus on the clients needs, listen carefully to the stories and clues presented in each session, and be there to validate the client's situation, pain, or emotional needs. For many clients, this is the first time they have really been heard or someone has given them the time to "tell their story" in full. It is not uncommon for clients to discover for the first time themselves, what it is or was that created their problems. The memory of the trauma surfaces slowly with treatment of the tissue.

Professional and Ethical Conduct:
The practitioner must conduct his/herself in a professional and ethical manner at all times. The safety of a client is paramount to the healing and transformation process. The client may experience periods of vulnerability as they open up to new possibilities or go through the healing process. For many clients, it is the first time they have submitted themselves to manual work on a massage table, and they need security and assurance that they are in a safe environment.