DOCUMENTATION FOR CLINICAL PRACTICE AND RESEARCH GUIDE FOR STUDENTS, PRACTITIONERS, AND INSTRUCTORS
PRESENTATION TO THE FACULTY OF THE
ROLF INSTITUTE OF STRUCTURAL INTEGRATION
AUGUST 4, 2006
BOULDER, CO
PEDRO PRADO
Certified Advanced Rolfing Practitioner
Rolfing Movement Practitioner
DOCUMENTATION FOR CLINICAL PRACTICE AND RESEARCH
INTRODUCTION FOR STUDENTS AND PRACTITIONERS
BACKGROUND
Despite its benefits, Rolfing® Structural Integration has not yet received broad
recognition. Over the last 30 years, most of our intellectual product has been published
only in the Rolf Institute’s journal, Structural Integration (formerly Rolf Lines). This
journal is not comprehensively or publicly indexed, and few articles on Rolfing have
been published in recognized scientific periodicals. At this point, research and
communication with the scientific community is essential not only for greater recognition
and affirmation of our profession, but for the continued development of the work itself.
This requires language and protocols that will enable us to communicate with
each other, our clients, the scientific community and society at large. And we, the
practitioners, must create them. In so doing, we will insure coherence in the structure and
content of our teaching, our language and our clinical attitudes. A certain care and level
of awareness must be cultivated in and developed by each member of our community.
The documentation protocols presented here have their roots in traditional Rolfing
instruction, which has been transmitted largely by word of mouth, with few books or
written records. The ABR (Brazilian Rolfing Association) originally developed the
precursors to these forms years ago at the ABR’s NAPER clinic, which is dedicated to
the study, clinical practice and research of Rolfing. As a supervised group clinic,
NAPER was an ideal environment in which to cultivate coherence in documentation and
communication of clients’ processes.1
The forms have been refined and elaborated by
the Brazilian Rolfing School and the school of the Rolf Institute. Now, the forms serve
as teaching tools, clinical documentation protocols, and sources of data for research.2
THE FORMS
The forms register information gathered before and after the process from both
the client and the practitioner. They all include both closed and open questions, which
require different attitudes on the part of the practitioner or researcher. Closed questions,
which are answered according to pre-established classifications or scales, require the
questioner to seek out specific information and grade it. Open questions, which invite
free narrative response, require a receptive attitude.
The open and closed portions compliment each other; they can be used separately
or jointly, as needs and circumstances indicate. For example, if time is limited, the
1
A NAPER client is not necessarily treated by the same practitioner for the entire
duration of the process. Therefore, at NAPER, clear and consistent documentation of
clients’ process that can be readily understood by any NAPER practitioner is essential.
2
In practice, the forms should be used as written and all questions should be answered;
modifications should be made not in individual cases, but only by institutional consensus.
closed questions may be used alone. If both open and closed questions are used, their
order can be adjusted to fit the respondent’s cognitive style. In the forms, open questions
on a given subject are italicized, set forth below the corresponding closed question, and
denominated by the closed question number plus an alphabetic indicator; e.g., an open
question related to Closed Question No. 20 might be 20A or 20B.
The forms presented here are the Initial Interview (to be completed at the start of
the process), and the Rolfing Practitioner’s Report (to be completed partly at the start and
partly at the end of the process) and Client Report (to be completed at the end of the
process).3 Although all forms include both open and closed questions, the information
gathered from the client through the Initial Interview and the Client Report is subjective;
whereas the observations about the client’s process in the Rolfing Practitioner’s Report is
objective.
Initial Interview
This is organized in two parts: one to be completed by the client before the first
meeting with the practitioner; and other to be completed by the practitioner during the
first meeting. It records basic client identifying information and personal data; physical
and emotional status, history and treatment; Quality of Life issues; and process goals.
The Initial Interview has both clinical and institutional objectives. Clinically, it
records essential client information; and indicates points in the process that might require
special care, emphasis or avoidance. What’s more, completion of the form establishes a
first contact between practitioner and client and initiates the therapeutic relationship.
Institutionally, the form collects data on client demographics, which can facilitate future
promotion and delivery of services.
Rolfing Practitioner’s Report
The Rolfing Practitioner’s Report has two parts. Part I — which covers goals,
evaluation of the client, and strategy for the intervention – is to be completed before the
first session. It is absolutely essential to complete Part I in a timely manner. The Part I
material charts a course for the process; completing Part I after the process is underway –
or worse yet, after it is over — would be meaningless.
Part II, to be completed after the process, invites the student or practitioner to
compare the work performed to the work planned, and the results to the goals. It also
addresses the therapeutic relationship and follow-up. Part II is, in a sense, the outline of a
case presentation. To complete it, the student or practitioner must review the Session
3 At NAPER and the Schools, students and practitioners also complete Session Reports that follow the
SOAP model, which is universally applied in manual therapies.
See Thompson, Diana L., Hands Heal:
Documentation for Massage Therapy – A Guide to SOAP Charting, 1993, Diana L Thompson, 916 N.E.
64th, Seattle, Washington, 98115, USA. For a discussion of Session Reports, see Appendix.
Reports and other notes, and engage in the same reflection required to generate the kind
of presentation used for evaluation, class instruction, or even publication. Used to close a
cycle of work, Part II trains the student or practitioner in the practices required to report
cases in a professional manner. And consistent case reports can build the foundation for
the validation and continued development of Rolfing.
This form elicits the student or practitioner’s perspective regarding the client’s
goals, the analysis and evaluation of the client, work strategies, results, the therapeutic
relationship, and follow-up recommendations. It is through this report – which requires
the student or practitioner to apply Rolfing concepts, assess the results (verify the
adequacy of the strategies to achieve the goals), and evaluate the quality of the interaction
with the client (therapeutic relationship) — that we can advance pedagogical and clinical
goals.
Client Report
The client completes this report at the conclusion of the process. It is an
opportunity for client reflection and self-expression about the institutional or private
setting; the practitioner and the therapeutic relationship; and the perceived results
compared to the client’s initial goals. Reviewing the responses with the client will
heighten awareness of the process for both client and student or practitioner.
But the forms are more than data collection devices. They were designed with the
idea that the mental and emotional activity of completing them invites reflection that
brings awareness of the topics surveyed to both client and practitioner. The experience
of completing the forms is thus a purposive component of the structural integration
process itself, in that it facilitates integration of the physical, emotional, spiritual and
cultural layers.
Completion of the Client Report is part of closure. Ideally, it is done at the
closure interview, so that the responses will inform follow-up recommendations. If time
constraints will not allow completion of the Client Report at or prior to the closure
interview, the client can be given the form to complete later. In that case, the client must
also be given the sections of the Initial Interview concerning goals and pains or illnesses.
This facilitate the client’s “before & after” comparison and encourages the client to acknowledge and anchor the changes.
Session Reports
See Appendix.
DEFINITIONS OF TERMS AND CATEGORIES
We are dealing with a holistic system. The philosophical basis of our thinking and
practice is a monist one, which postulates psychophysical integration. Our method is
somatic in that aims for integration of the physical structure within a gravitational field through the manipulation of connective tissue and movement education. However, we believe in the unity of the dimensions of the human phenomenon: any transformation in one dimension implies transformations in others.
Dr. Jeffrey Maitland proposed four levels of reference: Structural/Geometric, Functional, Energetic, and Psychobiological.4
The modification of Maitland’s division set forth below reflects the reality of our work and lets us refine our definitions of each category:5
Physical: Structural
Functional
Psychobiological: Emotional/Psychological/Worldview
Cultural/Environmental
Existential/Spiritual
Energetic
Because Rolfing is a somatic modality, its perspective, techniques and practices are on the physical level; but from that level, we touch the whole being. In a holistic system, we can theoretically make a translation to link one level with another and observe the relationship between the two; e.g., we can describe an emotional complaint in terms of physical structure, or see the spiritual aspect of a transformation manifesting on
an emotional level.
The awareness, concerns and goals of both client and practitioner can operate at multiple levels of being. Recognizing this facilitates better planning, choice of techniques and clinical decisions. Then, if the assessment of outcome in the Rolfing Practitioner’s Report follows the same categories of reading and classification used at the outset (based on the Initial Interview), it allows us to understand better how the work affected the client across various levels.
Our objectives of education, clinical practice, communication and research all require us to be consistent in our definitions. The following are the category definitions to be used in completing of the forms.
4 See Jeffrey Maitland’s and John Cottingham’s article, Integrating Manual and Movement Therapy with
Philosophical Counseling for Treatment of a Patient with Amyotrophic Lateral Sclerosis: A Case Study
that Explores the Principles of Holistic Intervention (Alternative Therapies, March 2000. Vol. 6, No. 2)
which published access categories in holistic therapies for the first time in an indexed
periodical (which serves as a reference for scientific publications).
5 This division simplifies Dr. Maitland’s four categories into two broader ones that, in turn, include the
others. For purposes of research and tabulation, this division is clearer. Also, because the principal two
categories comprise the others, this division normalizes errors of distribution over many categories.
Physical
At the physical level, the practitioner and client express objectives, complaints and observations in words or gestures that reference the body (as one or more parts or as a whole) in its concrete, material aspect. The structural classification is appropriate when the reference is to the body or its parts as entities. The functional classification is appropriate when the reference is to physical or physiological functions or activities of the body or its parts.6
Psychobiological
When objectives, complaints and observations are expressed in words or gestures that refer to psychic, non-physical states, we are in the realm of the psychobiological.7
Psychological/Emotional/Worldview: These factors motivate behavior and set the
human being in motion. They can organize into patterns of feelings or behaviors (e.g.,
stress, anxiety, insecurity, anguish, fear, love, rage, depression, etc.). Here we also find
questions of self-image and self-esteem. Self-esteem means affection for oneself or the
pleasure taken in oneself; self-image means the mental representation or map of the self,
as drawn by life experience. The broad category includes sensory self-perception and
modes of perception. As posture problems are often accompanied by disturbances in
these areas, we must attend to both the words expressing and the body language
accompanying the complaint. The client’s universe of meanings is important here. The
meanings attributed to the body or its parts are directly related to structure and function,
self-esteem, self-perception and worldview. References to trauma and life history can
also present themselves.
Cultural/Environmental: The person’s culture and environment influence body
form and movement. Certain physical or functional patterns are considered typical of
particular cultural groups – e.g., the bowed head of a subservient Japanese woman; the
puffed-out chest of the American super-hero; the trim belly of the Girl from Ipanema; the
straight-on, purposeful walk of the man of business; or the slow side-to-side sway of a
“rapper” from São Paulo or New York). Patterns can also represent historic icons (the
cool hippie guy, the woman in the Victorian-age corset), or phases of psychosocial
development in groups whose members use mutual self-reference to create and maintain
shared postural patterns (e.g., a peer group of teenagers, all of whom have closed
thoraxes). When any such pattern manifests in the individual, it is, of course, imbued
6
According to Maitland, the structural taxonomy concerns biomechanical and geometric
alignment of the body. It can be observed through segmental or geometric positions, or
through computerized topography. Functional taxonomy concerns the quality and
economy of movements, which may be evaluated, for example, with tests of balance.
7 According to Maitland, the psychobiological taxonomy concerns what is traditionally called the ‘mind’
and includes the worldview associated with the client’s perceptions. This taxonomy includes self-sensing,
the client’s emotional and perceptive orientation concerning movement, self-image and place in the world.
The client’s worldview is shown in personal reports and inventorieswith uniquely personal meanings, as well as and cultural ones.
Existential/Spiritual: When the client’s objectives and narratives concern the transformational aspect of Rolfing, this level comes to the fore. Despite having chosen a somatic modality, the client wants to grow in the metaphysical dimension. Clientssometimes state this explicitly — but we may infer it when they say they want to ‘get something out of their systems’; to ‘be more themselves’; to ‘reach a higher state’; or to ‘grow as a person’. These expressions often reveal ontological objectives, which concern the nature of being.
Energetic: This level is perhaps the most difficult to discuss and observe because concepts of energy are haphazard, and a given term is often used to refer to different and even opposing concepts.8
However, the absence of theoretical or didactic consensus about energetic phenomena is no excuse for neglecting the energetic dimension in our thinking and practice. A person’s general energy level can be called vitality or life force.
It is indeed somatic because it is directly related to the activities of the hormonal, immunological and neurological systems, as well as to physical and emotional illnesses (e.g., migraines, bruxism, fibromyalgia, depression, sexual dysfunction).
One of the oldest somatic energy models is the chakra system, which describes seven aligned centers from the root chakra in the pelvis to the crown chakra in the center of the head. Reich considered chakras to be points of character armor formation. In The Endless Web, Louis Schultz and Rosemary Feitis correlated the chakras with distinct connective tissue patterns.
Peter Levine has postulated that complaints and objectives can be interpreted as expressions of the need to rebalance or regulate the activity of the autonomic nervous system (ANS). In Levine’s terms, the energetic level can be observed as patterns of constriction and discharge in the ANS and the over-coupling of neuromuscular structures.
8 According to Maitland, the energetic taxonomy concerns energy fields and fluxes transmitted through
the body. These manifest themselves in many ways, such as micro-currents transmitted in the connective
tissue matrix or variations in autonomic activity (e.g., heartbeat).
READING TOOLS
Indicate tools used
PHYSICAL
Structural:
( ) The “Line” in Gravity
( ) Blocks
( ) G and G’
( ) Cylinders ( ) right ( ) left
( ) Lines and orthogonal planes ( ) front central line ( ) back central line
( ) right lateral line ( ) left lateral line
( ) Palintonic Relationships ( ) front-back ( ) side-side
( ) above-below ( ) inside-outside
( ) Three-dimensional Axes ( ) longitudinal (x) ( ) transversal (y)
( ) latero-lateral (z)
( ) Planes ( ) saggital ( ) horizontal ( ) coronal
( ) Robert Schleip ( ) flexor preference ( ) extensor preference
( ) Hans Flury ( ) internal ( ) lock-kneed internal
( ) external ( ) regular external
( ) Jan Sultan ( ) internal ( ) external ( )incongruent
( ) Pelvic ( ) tilt ( ) shift
( ) anterior ( ) anterior
( ) posterior ( ) posterior
( ) Shoulder Girdle ( ) tilt ( ) shift
( ) anterior ( ) anterior
( ) posterior ( ) posterior
( ) Other ( ) Visceral Space ( ) Axial Complex
( ) Superficial v. Deeper Layers
1 © Pedro Prado 2006. All rights reserved.
Functional:
( ) Breathing Preferences: ( ) inspiration
( ) expiration
( ) pause placement
( ) paradoxal breathing
( ) Walking Analysis: ( ) initiation from G
( ) initiation from G’
( ) Rhythm ( ) fast
( ) slow
( ) coordination among ( ) hinges
( ) limbs
( ) the 5 lordoses
( ) muscle chains
( ) Contra-lateral motion ( ) limbs
( ) axial
( ) Articular Restrictions: ( ) toes
( ) ankles
( ) knees
( ) hip joint
( ) sacro-iliac joint
( ) inter-vertebral ( ) lumbars
( ) thoracics
( ) cervicals
( ) atlanto-occipital
( ) Perceptual Preferences: ( ) visual ( ) focal
( ) peripheral
( ) auditory ( ) internal
( ) external
( ) sense awareness ( ) internal
( ) external
( ) kinesthetic
( ) Orientation: ( ) spatial
( ) ground
3
PSYCHOBIOLOICAL
Emotional/Psychological:
( ) Client’s Body Image: ( ) segmented ( ) global
( ) Client’s feelings about: ( ) body as a whole ( ) particular body areas
( ) Self-Esteem: ( ) positive ( ) negative
( ) Meanings attributed to: ( ) morphological characteristics
( ) functional attributes
( ) existential beliefs
( ) spiritual aspects
( ) Body/postural attitudes
( ) Personal/relational attitudes
( ) Character armor analysis ( ) Lowen ( ) Hakomi
( ) Keleman ( ) Reich
( ) Other _____________
( ) Qualities of contact with the other
Cultural/Environmental/Worldview:
( ) Main beliefs in relation to the environment and social group
Energetic:
( ) ANS Dominance ( ) sympathetic ( ) parasympathetic
( ) under/over neuromuscular ( ) hypertonus ( ) hypotonus
coupling
( ) Chakras (Reichian “rings”) ( ) pelvic/abdominal
( ) diaphragmatic
( ) chest/heart
( ) throat
( ) mouth
( ) eyes
( ) top of head (crown)
ROLFING® PRACTITIONER’S REPORT
Client: _______________________________________________
Practitioner: _______________________________________________
Start Date: _________ End Date: _________ ( ) 1ST Series ( ) Return
Total number of sessions: _____
Structural sessions: _____
Movement sessions: _____
Combined sessions (structural and functional):_____
The following details are essential for (a) return visits in which the client is treated by other practitioners and (b) for orderly collection of data on the client’s process.
Did the client complete the process? ( )Yes ( ) No
If not – with reference to the goals and territory of the 10-session recipe – after which “session” was the series discontinued? ____
Client’s stated reason for interrupting the process:
( ) no perceived improvement ( ) financial problems
( ) health problems ( ) resistance to the process
( ) emotional problems ( ) problems with the practitioner
( ) contact problems with Rolf Institute
( ) other (please specify):________________________________
Practitioner’s perception of reason for interrupting the process:
( ) no perceived improvement ( ) financial problems
( ) health problems ( ) resistance to the process
( ) emotional problems ( ) problems with the practitioner
( ) contact problems with Rolf Institute
( ) other (please specify):________________________________
Comments
PART I
To be completed at the start of the process
1. Client’s Goals:
Physical (01)Structural (02)Functional
Psychobiological (03)Psychological/Emotional (04)Cultural
(05)Spiritual (06)Energetic
Other (07)Interest in the technique
(08) Other (09) Return
1A. Client’s stated goals:
(Take information from question 19 of the Initial Interview form.)
2. Practitioner’s Reading:
(What you have observed about your client)
2.1 Principal tools used for reading (see attached list)
2.2 Analysis
(In terms of the reading tools used, state your observations.)
2.2A Describe your own internal response to the client.
3. Work Plan:
(Based on the client’s goals and your reading, outline your plan here.)
Dimensions most important for this work plan:
Physical ( ) Structural
( ) Functional
Psychobiological ( ) Emotional
( ) Cultural
( ) Spiritual
( ) Energetic
4.1. Strategies and Techniques Planned:
General Format: ( ) Classic recipe
( ) Functional Recipe
( ) Non-formulistic work
Elements: ( ) Manipulation
Touch ( ) direct
( ) indirect
( ) titrated
( ) Movement Education
( ) neuromotor repatterning
( ) enhanced proprioception
( ) improved coordination
( ) enhanced perception
( ) Work on beliefs and meanings
( ) Work on attitudes
4.1A. Comments:
4.1B. Which dimensions beyond those encompassed by the client’s stated goals do you expect to be affected by the process? How do you anticipate that will these be affected?
PART II
To be completed at the end of the process
4-2. Strategies and Techniques Used:
General Format: ( ) Classic recipe
( ) Functional Recipe
( ) Non-formulistic work
Elements: ( ) Manipulation
Touch ( ) direct
( ) indirect
( ) titrated
( ) Movement Education
( ) neuromotor repatterning
( ) enhanced proprioception
( ) improved coordination
( ) enhanced perception
( ) Work on beliefs and meanings
( ) Work on attitudes
4.2A. Comments:
4.2B. Which dimensions beyond those encompassed by the client’s stated goals were affected by the process? How?
5. Results:
Do you believe the client’s goals were achieved?
( ) Yes ( ) No
( )Partially (specify):
5A. Comments:
5B. Which were the most important and most salient changes you observed (at both physical and psychobiological levels)?
6. Therapeutic Relationship:
How did you feel about the process?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
6A. Which aspects of the therapeutic relationship are noteworthy?
7. Recommendations for Follow-up:
Form devised by NAPER (Núcleo de Atendimento, Pesquisa e Ensino em Rolfing®) [A
branch of the Brazilian Rolfing Association based in São Paulo, Brazil]
CLIENT REPORT
Your Name: ___________________________________
Rolfer’s Name: ___________________________________
Date: ___________________________________
1. What were your goals at the start of the process?
2. Have you achieved your goals? ( ) Yes ( ) No ( ) Partially
2A. Comments:
3. How was the process for you?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
3A. Comments (physical, emotional or other aspects):
3B. What changes do you perceive?
4. Did Rolfing help you in ways beyond your original goals? ( ) Yes ( ) No
4A. Comments:
5. How are you emotionally after Rolfing?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
How were you emotionally before Rolfing?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
5A. Comments:
6. If you were or are still suffering physical pain, please describe it. In which you listed the pains in the initial interview. Include all pains listed in the initial interview – even pains that are gone now. If you now have pains that you did not list in the initial interview, please include those pains here. Grade the intensity of each pain on a scale from zero to ten, with zero indicating “no pain” and ten indicating “unbearable pain”.
PAIN A
7. Location:
8. How frequent is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How frequent was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
9. How intense is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How intense was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
PAIN B
7. Location:
8. How frequent is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How frequent was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
9. How intense is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How intense was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
PAIN C
7. Location:
8. How frequent is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How frequent was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
9. How intense is this pain since Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
How intense was this pain before Rolfing?
0 ( ) 1( ) 2( ) 3( ) 4( ) 5( ) 6 ( ) 7 ( ) 8( ) 9( ) 10( )
10. Are there any other comments you would like to make?
10A. How has Rolfing affected you physically and emotionally?
10B. How are you currently addressing any remaining pain?
11. How was it working with your Rolfer?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
11A. Any suggestions?
12. How were you received at the Rolf Institute?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
12A. Do you have suggestions for improvement?
13. What was it like being received in group?
( )1 awful ( )2 bad ( )3 fair ( )4 good ( )5 excellent
13A. Comments:
14. How would you describe Rolfing® to another person?
15. Would you like to make any further comments?
Form devised by NAPER (Núcleo de Atendimento, Pesquisa e Ensino em Rolfing®) [A branch of the Brazilian Rolfing Association based in São Paulo, Brazil]
APPENDIX: SESSION REPORTS1
At NAPER and the Rolf Institute Schools, students and practitioners complete individual Session Reports according to the SOAP model, which is universally applied in manual therapies.2 This model is now the established clinical standard, and its language is accepted by insurance companies and in judicial proceedings.
Under the SOAP model, information is recorded from both the client’s (Subjective) and the practitioner’s (Objective) viewpoints. Then, the process is analyzed by looking backward (Assessment) and forward (Projection) in time.
Subjective
Subjective information comes from the client. It includes the client’s history, current symptoms and issues, and the client’s previous treatment approaches. The more specific the subjective information, the greater the opportunity to perceive the results ofthe process, get the client to own the work and the changes, and involve the client in selfcare. At NAPER and the Schools, much of this information is recorded on the Initial Interview form. Additional information comes from the client interviews that precede each session, and from the Client Report that follows the series.
The activity of gathering the subjective information is as important as the information itself. Many clients are dissociated from their somatic reality. By exploring and describing sensations and feelings, the client connects to the body and develops better perception. This, in turn, allows the client to acknowledge a greater range of needs and identify psychophysical relationships. The client’s original motives for seeking treatment are often revealed to be connected to other life issues or aspects of the client’s experience. When all of this is brought to light, both the client and the practitioner can expand the goals and scope of the process.
Finally, when the practitioner listen carefully to the client, it facilitates the therapeutic relationship, fosters empathy, and enriches the work for them both.
Objective
Objective information comes from the practitioner’s observations. Ideally, the
format of the information should facilitate observation of changes during the process and
at its completion. Examples include:
• Narrative of the body reading
• Visual or tactile impressions
• Results of biomechanical assessments
1 © Pedro Prado, 2006. All rights reserved. 2 See, Thompson, Diana L., Hands Heal: Documentation for Massage Therapy – A Guide to SOAP
Charting, 1993, Diana L Thompson, 916 N.E. 64th, Seattle, Washington, 98115, USA.
• Sketches and diagrams
• Analyses of posture and movement patterns (including photographs or videos)
To master our work, we must be clear and consistent in our terminology and documentation. Therefore, we should specify models and tests used in universal and consistent terms. To facilitate this, the material accompanying the forms includes
definitions of the terms and categories and the Reading Tools list.
Assessment
Here, the practitioner records what was done and what happened in the session,
and describes the immediate results in both qualitative and quantitative terms. This includes “before & after” comparisons. It is also the place to note any changes in objectives and strategies. Remember that because others may read the assessment, use of universally understood and consistent language is essential. When choosing language, it helps to imagine your self in a reader’s place.
Projection
This is forward-looking. First, based on what happened in this session, what is the plan for the next session? Be sure to identify work not completed in this session for lack of time or other reasons. What came to light in this session that should be taken into account in the next and future sessions? Recording the following immediately after the session insures that it will not be forgotten:
• Were certain techniques, positions or maneuvers particularly effective?
• Was certain language particularly suitable or unsuitable?
• What new information did you get about the client or the client’s needs?
• Were particular moments or events of the session especially important or
intriguing?
• What “homework” or recommendations did you give the client?
• How is the client integrating the work and applying it to daily life?
This is also the place to reevaluate your plan for the frequency of future sessions and the pace of the work. In this connection, remember that as the work progresses, the client will be taking greater responsibility for the process.
ACKNOWLEDGEMENTS
I dedicate this piece to those who, like me, believe in Rolfing and will take this research forward.
I would like to thank all those who supported this effort, including:
• The 35 Rolfing Practitioners from NAPER who with their work and curiosity
helped shape these questionnaires.
• The Rolf Institute instructors who participated in this exploration by using the questionnaires in their classes: Monica Caspari, Patrick Ellinwood, Valerie Berg and Sally Klemm; and their assistants, Duffy Allen, Paula Mattoli, and Kevin
McCoy.
• My loyal friend Mhohamed Salim for his constant technical support.
• Heidi Massa for her fine and extensive editorial assistance.
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