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CONNECTIONS

Fall 2011 Issue ISSN 1916-1042


The Magazine for Natural Health Practitioners
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Fall 2011 Issue
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CONTENTS
Board Highlights
My Lymphatic Journey
NATURAL HEALTH CARE a Right in Switzerland
NHPC Complaints Resolution Process
Summary of Arbitrators Decision and Sanction Committee Decision
Generating Clients on a Tight Budget
Bonnie Prudden: Inspiring Health at Every Age
Perspectives for the Professions
The Efect of Refexology on the Autonomic Nervous System in
Healthy Adults: A Feasability Study
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electronic, or other forms.
Editorial Policy
The magazine welcomes
articles on any topic related
to health and wellness. All
submitted articles must
include the authors name.
The editors reserve the right
to edit articles for clarity,
length, and to correct factual
inaccuracies. The opinions
expressed by the authors of
published articles or adver-
tisements are not necessarily
those of the NHPC, and do
not imply endorsement by
the NHPC Board.
Return Undeliverable Canadian Addresses to:
Natural Health Practitioners
6th Floor, 10339- 124 Street
Edmonton, AB T5N 3W1
www.nhpcanada.org
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Board of Directors
President
Don Himmelman
Vice-President
Michelle Huszar
Secretary
Michelle Blanchard
Treasurer
Kim MacEachran
Directors
Michelle Blanchard
Jef Lazo
Paul Bufel
Stephanie Nunez - Braatz
Administration
Executive
Colleen MacDougall, CAE
Executive Director & Registrar
Doug Baker
Assistant Executive Director

Henriette Douziech
Executive Assistant

Complaints & Privacy
Cathy Sveen
Complaints Director & Privacy Ofcer

Jan Bagot
Complaints Administrator
Communications, Marketing & Public
Relations
Claire Ashton
Communications Director

Nadine Noseworthy
Senior Coordinator : eMedia and Advertising

Jasmine Bischof
Marketing Communications Coordinator
Membership, Credentialing & Research
Roberta Palynchuk
Manager

Lucy Lavine
Membership Coordinator

Lynda Acker
Membership Coordinator (Renewing
Members)

Noelle Gof-Kurlander
Quality Assurance Coordinator

Sarah Kay
Membership Coordinator (New Members)

Jenn Vasquez
Continued Competency
Program Coordinator

Education
Erica Jones
Senior Coordinator

Jamal Gabriel
Education & Events Assistant
Finance & Administration
Suzanne Olson
Manager Finance & Administration

Mora Moore
Assistant Manager Finance & Administration
CONTACT INFORMATI ON
To send us your article or for more
information about the magazine,
please contact us at:
Natural Health Practitioners
of Canada (NHPC)
Sixth Floor, 10339 - 124 Street
Edmonton, Alberta T5N 3W1
Toll free 1 888 711 7701
Tel. 780 484 2010
Fax. 780 484 3605
e-mail growingtogether@nhpcanada.org
website www.nhpcanada.org
5 Summer 2011
A
s summer moves towards
fall, there is much in
transition, in accordance
to this age old cycle. What is true
of the environment around us and
within our lives is also mirrored,
to a degree, within the NHPC. At
the NHPC office new staff have
been hired and trained, serving the
needs of our growing organization.
Meanwhile your volunteer Board
of Directors are transitioning
into their various roles, including
myself. While admittedly more
comfortable contributing in a
background capacity, in this
final year of being on the Board
I accepted the challenge to step
up to be President. As someone
used to living in a quiet hemlock
forest in Nova Scotia, far from the
centre of anything, this feels like
a bit of a leap. So far, though, the
demands have been minimal. The
pace definitely will pick up once
fall indeed arrives.
Connection Cafes
Speaking of the fall, the next
round of in person Connection
Cafes will be launched in October,
beginning in the Maritimes. These
Cafes are excellent opportunities
to meet with your Board members
and ask questions up close and personal, while networking with
members from your region. We, the Board, really value your input
and take what we have learned back to our meetings. Dates and
registration for the Connections Cafe nearest you can be found
online through the members section of the NHPC website.
Insurance Advocacy
The first portion of the two-part National Health Knowledge Dialogue
(NHKD) survey was run successfully and the data is being collected.
This first survey focused on Practitioners while the second, to be
launched very soon, focuses on Patients. The analyzed data from
these surveys will be used in the NHPCs advocacy work with the
government and the health insurance industry. Thank you to those
practitioners who took the trouble to participate.
Sister organizations in countries around the world will also be
running this survey, creating a global picture of the value of
natural health practices. It
is exciting to note that this
initiative, which has never
been done before in such
a coordinated fashion, was
initiated by your NHPC.
MTAA Lawsuit
On a more serious note, by
now many of you are aware
that your NHPC Board of
Directors has initiated a legal
suit against the Massage
Therapy Association of
Alberta (MTAA). This
unprecedented decision
arose when it came to our
attention that for a number of
months the MTAA had been
communicating very serious
allegations about your NHPC.
These allegations were
presented within their own
organization and publicly on
the MTAA website, they were
communicated to government
and insurance agencies in a
number of different provincial
jurisdictions. As a result, the
reputation of the NHPC and
that of our fellow NHPC
members has been harmed.
This legal action seeks a full
and complete retraction and
apology by the MTAA and a distribution of that retraction and
apology to all individuals and parties that were exposed to the false
and malicious statements. We, your Board and the NHPC office,
are working hard to rectify this situation. Feel free to contact the
NHPC office or myself should you have any questions or concerns
about this matter.
While transitions can be challenging at times, in unexpected
ways, they are workable and they carry the potential to be some
of our most rewarding experiences. Im often reminded of this as
my fellow Board members and I work to advocate on your behalf
locally, provincially, nationally and internationally so that all may
benefit from the advancement of natural health.
Board Highlights
Don Himmelman, President
6 Summer 2011
I
t has been my joy to be working with NHPC since the beginning
of July. I have been overwhelmed by the warm welcome
and tremendous support from staff and members since my
arrival. I look forward to supporting NHPC members by working
collaboratively with the amazing NHPC team in Edmonton.
I am also looking forward to being at the Connections Cafes this
fall. Come out and join us for some networking and learning. I
am especially excited to be meeting with, and learning from, our
credentialed schools in conjunction with these events.
There is always plenty going on and I would love to have your
contribution on anything we are doing. Feel free to stop in the
office and join me for a chat and a cup of tea or, if you are in the
far reaches of the country, dont hesitate to give me a call on the
NHPC toll free line or send me an email. Id love to hear from you.
Take Care and Be Well!
Bobbi
Membership & Credentialling Manager
Member Services News
Renewal Season
If you did not renew your membership in May of 2011, chances
are you are due to renew this fall. Watch your mailbox (and
inbox) for notification that your membership is due for renewal.
Renewals will be accepted online, by fax, by mail and in the
office beginning September 12.
If you are due to renew this fall, your membership, including your
NHPC membership number and all insurance policies included
with your membership, will expire on October 31. Please ensure
your renewal form and payment are at the NHPC office before
that date!
Massage Therapy Competency Assessment Process
MTCAP
NHPC developed MTCAP last year to address the need to
recognize the training, knowledge and skills of massage therapists
through review and evaluation of competencies gained through
prior learning, clinical experience and continued education. It is
designed to determine if a massage therapist has developed the
competency equivalency of 2200 hours of training through the
course of their career.
Programs, such as MTCAP, are consistently used in the health
professions in a variety of grandfathering, Prior Learning
and Assessment and Recognition (PLAR) programs and/or
equivalency processes to evaluate the skills and knowledge of
practitioners and professionals. Some of these initiatives include
the Massage Therapy Association of Albertas 2200-Hour
Education Equivalency Process, the College of Midwives of
British Columbias PLAR for internationally educated applicants
and the Canadian Society of Medical Laboratory Sciences PLAR.
NHPC is proud to continue to provide opportunities for success
and excellence of practice for our members by offering our
MTCAP program for Canadian massage therapists.
Continued Competency Program
As Natural Health Practitioners, it is important that we all
continue to grow and learn within our profession. The more we
know, the better care we can give our clients.
NHPC requires that all members meet a standard of continued
competency through seeking to grow and learn. As was outlined
in the last issue of Connections, we are moving to an audit system
for our Continued Competency Program, so please ensure that
you keep copies of all certificates and document all learning
activities that you participate in for at least five years. You will be
asked to submit documentation when your number comes up.
From taking a course, to attending a Connections Caf, to reading
this issue of Connections; every opportunity to learn and grow
counts! For information on how to fulfill your CCP requirements,
please visit the NHPC website and check out the CCP Video Tutorial.
Program Credentialing
There is another cycle of program credentialing starting this fall.
If you have a program that you would like to have recognized by
NHPC, please submit it by the end of September for consideration
at the December board meeting. Contact me (Bobbi/Roberta)
directly for assistance with your application.
Toronto Police Service
Those of you in Toronto will be happy to hear that NHPC is
being registered with the Toronto Police Service Police Reference
Check Program. Once we have been registered with this program,
applying for a criminal record check with a vulnerable sector search
will be much easier on all practitioners applying for membership
with NHPC. Our registration should be complete shortly.
A big thank you going out to the members who brought this issue
to my attention!
Contact Member Services Staff
memberservices@nhpcanada.org
Jenn Vasquez CCP and MTCAP Coordinator
Lynda Acker Membership Renewals Coordinator
Roberta Palynchuk Membership and Credentials Manager
Sarah Kay New Membership Coordinator
Membership News and Updates
7 Summer 2011
M
anual lymphatic drainage
(MLD) was not a subject
that I knew anything about
when I attended the first class as part
of my remedial massage diploma
in 2002. Little did I know where it
would lead me.
After the first class I was not
convinced this particular subject
had anything to offer me but at the
behest of the teacher, with whom I
had an affinity, I returned to finish
the classes. By the end of the sixteen-
week course I had learned enough to
understand that although this therapy
is extremely light to the touch and
delivered in a slow manner, the effects are profound. I also saw
that there was very few therapists performing lymph drainage
as part of the modalities they offered and so I felt that it was
something that would make me stand out in the massage crowd.
Upon entering my into my own practice I started to offer MLD to
my clients, many of whom were prime candidates for this type of
treatment. The results were amazing so I started to document the
effects over the course of many months. Around the same time I
was asked to teach MLD at Victoria University and because I was
enjoying delivering the treatment and seeing the results I took
up the position. As my confidence grew through the application
of this treatment I began to see more and more clients that just
wanted to receive MLD treatment in my clinic. I also noticed that
my teaching style was changing in direct reference to the results
that I was able to see before my eyes.
As I was delivering this treatment daily I began noticing the
effects it was having on my body. There were many times when
I felt that the way I was taught the technique was not in the
biomechanical best interests of my body. Often my posture was
compromised and hands were placed in awkward positions to
deliver the treatment.
Gradually I started to change my stances around the table and to
understand that delivering an effective and complete experience
for my client meant that I must be completely comfortable in the
delivery. As a result of this my technique changed and I started
to move my whole body with each movement. I called this
performing MLD from the ground up, being at home in my
body so that my fluidity and ease of technique not only meant a
better treatment for my client but also a more comfortable work
environment for me. The way that I was doing MLD meant that
what was happening with my hands on the clients body was
the combined result of full body movement and rhythm, the
hands being the END result of the movements of my body. This
idea became the cornerstone of my
teaching, based on the ideals of self-
care and excellent technique. It was
not only enjoyable it also worked.
This was seen time and time again
in my classes where there would be
a student with a particular pathology
who would volunteer to be my
model for a particular sequence.
Many students were breast cancer
survivors, had knee or ankle trauma
or other soft tissue issues such as
primary or secondary lymphoedema.
Almost every time I worked on
them there was both a subjective
and objective improvement in their
condition, often to the amazement
of not only them but other members of the class as well. It was
these instant results, which enabled students to understand that
even though this touch is superficial in comparison to what they
are used to delivering in their remedial treatments, it is elegant,
efficient, and profound when used to treat indicated pathologies.
MLD massage goes where remedial cannot, swollen areas, both
acute and chronic, and the paradox of this treatment is that such
a superficial technique has such a deep and lasting impact upon
the client. Over the years I have had many emails and calls
form students thrilled with the results they were getting for their
clients, and also very happy with the relaxing effects it had on
their own bodies.
Within my own practice there have been numerous stand out
occasions where using MLD has changed the nature of my clients
understanding of massage for the better. Three different ones
come to mind.
The first one is the case of a thirty-five year old woman who
had been suffering from Chronic Fatigue Syndrome (Myalgic
Encephalomyelitis) for ten years. She had been confined to bed
for the previous five years. At her worst she was hooked up to both
a cathode and drip to feed her. She was on copious amounts of
medications, which kept changing as she was experimenting with
all different combinations of drugs to assist her to get through her
days. The most she was ever able to stay awake was three hours
at a time. When we first started to work together I would visit
her in her home twice a week. I started with very short relaxation
massages coupled with small sequences of MLD to assist her to
move fluid through her body, which due to immobility had built
up, in some areas dramatically. The most marked effect of the
early MLD sessions was her increased ability to deal with the
constant pain she was suffering, the parasympathetic nervous
systems response was immediate and her relaxation greatly
improved. She looked forward to our sessions simply from the
My Lymphatic Journey...
Michelle Yafe-Vassallo
8 Summer 2011
point of easing her pain with a drug free alternative. Another
side effect/benefit was an increased removal of toxins from her
system, in her words After an MLD I feel like crap, but the next
day I feel amazing. Further to this her sleeping improved, her
sinuses cleared and over the course of four years her immune
system became stronger so that each winter the numerous ills and
chills of the season became fewer. I still treat her on a weekly
basis and even though her CFS/ME situation is slow to improve
she says she could not do without her weekly MLD sessions.
The second client underwent mastectomies, bilaterally, at
different times. I did not meet her until she had had the first breast
removed due to breast cancer. She had heard about MLD through
a friend and as she was having some post-surgical oedema she
decided to give it a try. She brought her husband along to the
session so that he could learn about the therapy and deliver some
of the more simple strokes to ease her pain between treatments.
It was a revelation to her. Immediately post session she reported
that there was an overall feeling of lightness in her arm that had
been absent since the operation. Also her pain was eased and
she noticed that she had increased range of motion and pain free
movement in both the arm and hand. Within four years breast
cancer had developed in her other breast, which also had to be
removed. Her husband called me and asked if I would go and visit
her in the hospital to perform some MLD on the post-operative
area. I went and did a simplified version of MLD the day after
the operation while the translucent bandaging and drainage tube
were still in place. Many things came of that session, not only
was I was able to ease my clients pain and discomfort but I was
also, through my touch able to help ease her mental anguish in
regards to loosing her other breast. Although it was confronting
as a therapist to be invited into treatment so soon after surgery, it
was rewarding and empowering in that once again I was humbled
and delighted to see that this seemingly superficial technique
could have such life changing effects for people.
The third occurred on route to teach MLD in Canada in 2009. On
that particular night there were many returning Canadians who
had been competing in the masters games in Sydney. One lady
who had been playing soccer had severely injured her knee and
done extensive soft tissue damage by falling directly onto it. At
the time she had kept playing but when the game ended her knee
had started to resemble a soccer ball. On the flight home it had
stared to ache and swell considerably more and things were not
looking good with pain and discomfort increasing by the hour.
Another member of her team and I were talking at the back of the
plane and we got around to discussing the reason for my trip to
Canada. He explained her situation and asked if I would consider
treating her. After we had torn her track pants to get them above
her knee I proceeded to perform the MLD leg and groin sequence
hourly throughout the remaining fourteen hours of the flight and
the reduction in fluid volume and pain was remarkable. She even
offered to come and be my MLD model when I was teaching in
Calgary!
I have also been asked to teach in prestigious Australian Rules
football clubs, the latest being Carlton. To me this suggests
that the benefits of MLD have become more recognised in the
mainstream community through more practicing therapists,
better public education and favourable media coverage. My job
at this elite club was to instruct the on field runners, trainers
and massage therapist in MLD techniques. The value of these for
sports is that often when a player has sustained an injury on the
field or court regular massage is contraindicated, normally RICE
protocol is followed. The beauty of MLD is that along with RICE
it can be applied immediately upon the player being removed
from danger. Not only does it assist in keeping the swelling
at a manageable level it also clears the injured tissue of debris,
enhancing the tissue regeneration process by helping keep the
injured area as healthy as possible hastening the healing time and
allowing players to return to he game much sooner.
9 Summer 2011
Manual Lymph Drainage
Manual Lymphatic Drainage (MLD) is a highly specialized technique
that can be used to treat many injuries and pathologies. It can be
performed as a preventative technique that bolsters our bodies ability
to rejuvenate and resist all types of stress.
MLD not only stimulates the vital functions of the skin, tissues and
internal organs, but also serves to eliminate cellular waste and
stimulate the parasympathetic relaxation response inhibiting muscle
tonus and pain.
By the end of this two-day course, youll possess the ability to
understand and perform a full lymphatic drainage with confidence
and skill.
Where: Winnipeg, MB Where: Edmonton, AB
When: September 17 & 18, 2011 When: September 20 & 21, 2011
Cost: $480 + tax Cost: $480 + tax
Seated Massage
Introduction to seated massage is a 1-day course that will introduce
you to and instruct you in performing a fifteen minute seated massage
over clothes. It will also act as an introduction to the remedial
massage diplomas corporate massage elective.
You will be taught to perform a seated massage with a view to
efficient and safe body use including a range of dynamic exercises
and stretches to help you prepare to deliver the massage. Possible
pitfalls of performing seated massage will be examined, as will
relevant workplace pathologies, and how to treat them in the
corporate environment. We will also look at how to safely manage the
workspace that you will be in and various elements that will make it
easier to do your job.
Where: Calgary, AB
When: September 23, 2011
Cost: $300 + tax
$480 + tax when BUNDLED with Self Care for Massage Therapist
Visit the Centre for Learning at www.nhpcanada.org for more info.
Self care for Massage Therapists
Performing massage can be draining. As therapists, weve all been
there. Ever wanted to learn ways to protect yourself and maintain your
practice for the long haul? Recent research suggests that the working
lifespan of massage therapists in the industry is around two years.
Another survey states that 80% of people who start in bodywork drop
out after two years. Two of the main reasons cited for this are that
hands (particularly thumbs) give out and many therapists belatedly
realize they dont have the physical stamina to do the work.
Where: Calgary, AB
When: September 24, 2011
Cost: $300 + tax
$480 + tax when BUNDLED with Self Care for Massage Therapist
Visit the Centre for Learning at www.nhpcanada.org for more info.
Centre for Learning
WORKSHOPS
with Michelle Yaffe-Vassallo
REGISTER ONLINE in
the Centre for Learning at
www.nhpcanada.org
www.nhpcanada.org
There have been many such experiences in the course of my
practice and this in turn has made me a better teacher of this
therapy. Students attend my classes because they have some
curiosity or interest in this modality, and as far as I am concerned
it is my job to nurture that interest and create a fun, dynamic and
engaging learning experience. Through the provision of theory
and technique I provide the key for students to walk through the
door and follow their own journey with this wonderful therapy.
I am able to share real life practice stories, which adds validity
to the teaching. We discuss situations in their practice and clinics
and how MLD may be able to help their clients. And at the end
of the day as manual body workers and therapists we do what
we do because of a desire to help our clients to achieve their
fullest potential and that is what makes our careers as massage
therapists so rewarding and fulfilling.
Michelle Yaffe-Vassallo is the Director of Rhythm Massage
Development, Michelle, studied her Diploma of Remedial
Massage at Victoria University, graduating valedictorian
of her year. She came to massage as a career change and
quickly found her place, not only treating clients in her own
clinic, but also as an educator of various remedial subjects
at Victoria University. She specializes in Manual Lymphatic
Drainage(MLD); self care for massage therapists and research
literacy.
Space is limited. Reserve today at 1-888-300-7685
The
practice-building
roadmap
8 week webinar series
presents
Patrick Hercus, spiritual
coach, business intuitive
and founder of the
Spiritual Healing Centre
in Richmond, BC.
Goachieve.com Unlocking power. PatrickHercus.com (blog)
Success. Dissolve the fear and uncertainty that is holding
you back from success.
Passion & Purpose. Have fun connecting with your passion
in a way that allows your purpose to unfold automatically.
Vibrancy. Learn how to always be vibrantand never
get burned out.
Abundance. Gain the skills to increase the amount of
clients that come to you.
Do nothing and
attract everything
Teaching success consciousness for practitioners
coaches sales people business owners
Fall Season webinar start dates:
October 10th and November 18th
BONUS: Receive a one-on-one fre starter session with
Patrick (must be registered before September 30th)
Eligible for NHPC Continued Credits
10 Summer 2011
I
n June of this year I had the privilege of extending the
friendship of our association to Switzerland. Switzerland is the
first county in the western world to recognize Complementary
and Alternative Medicine (CAM) as part of their constitution. It
is inspiring to see that others have gone on to be successful in
just what we are trying to achieve, greater recognition for Natural
Health Practitioners.
In 2009, 67% of the Swiss electorate voted, through referendum,
for five CAM therapies to be covered by that countries health
insurance. The government will recognize these five CAM
therapies until 2017, at which time each therapy will be examined
for efficacy, cost-effectiveness, and suitability.
The referendum that brought on this phenomenal change to the
Swiss constitution is largely thanks to Walter Studeli, and the
referendum was just the beginning of the advocacy work for
CAM that he continues with on a daily basis. He says that To
have the constitution is only the first step, now we have to adapt
the legislation. But quite often the problem we have now is not
the laws; its the execution of the laws done by civil servants. So,
you really have to be present to find out whats going on. You must
have influence, talk with the people, have a broad network We
will continue to work, as this is an ongoing process.
When I was in Switzerland, I first met with Dr. Yvonne Gilli,
who is a member of the Swiss National Party and M.P. for the
Swiss Government.. Dr. Gilli gave me a tour of her practice,
which is in an integrated clinic. It was interesting to see that even
though there is now integration between allopathic medicine and
Natural Health Care, allopathic healthcare is still the primary
form of healthcare in Switzerland. This is surprising, especially
considering that most Swiss citizens are raised in a culture where
Natural Health Care is placed first, as there is great respect for
traditional forms of healthcare that have been passed down from
generation to generation. For the most part, Natural Health Care
is understood culturally within Swiss citizens.
Cecile Cassini represents a foundation of associations, which
in many ways mirrors our own association. It represents 28
Natural Health modalities like Massage Therapy, Polarity
Therapy, Rebalancing, Rolfing, and Shiatsu. Right now, Cecile
is advocating for all 28 modalities to be regulated on a standards
basis by the Swiss government.
The majority of the people practicing in these 28 modalities
receive insurance coverage from their insurance company
programs. Similarly to our own healthcare system, in Switzerland,
there are two insurance platforms: there is primary healthcare that
the Swiss government pays for, and there is secondary healthcare.
However, in Switzerland all 28 modalities are recognized, whereas
in Canada insurance companies only recognize predominantly
massage therapy.
When I went into pharmacies in Switzerland, I cheerfully noticed
that the shelves were predominately lined with complementary
medicines, with a visibly limited inventory of allopathic
medicine. When I spoke with the druggists in these stores, they
were proponents of CAM as a first intervention, and recommend
trying CAM first before trying pharmaceutical drugs for many
conditions. That probably has much to do with the fact that Swiss
people grow up knowing the importance of CAM. I couldnt
help but think forward to the day when Canadas pharmacies will
follow suit, even though I know we have a long way to go before
we can realize that dream.
Perhaps the most uplifting thing to see on my trip was my visit
to an integrative hospital just outside of Zurich. In this hospital,
Natural Health Care is a primary focus used to treat patients.
Allopathic medicine is still available, but it is part of the Natural
Health Care methods system of healthcare. I met with several
doctors there who have chosen to work in this hospital because
of its approach to whole body healing and providing patients the
opportunity to really heal themselves with a strong natural health
approach to healing.
Lukas Rist, the CEO of the hospital, tells me that they are constantly
working with the doctors in the hospital on research papers and
projects to continue to show the outcomes and efficacy of a Natural
Health hospital. This is really important because this kind of
research will serve to support natural health in Canada. I look
forward to collaborating with Rist and reading his research papers.
NATURAL HEALTH CARE a Right in Switzerland
Colleen MacDougall, NHPC Executive Director
*CAM and Natural Health Care are used interchangeably in this article
Left to right: Christian Vogel, Colleen MacDougall, Cecile Cassini
11 Summer 2011
Looking to the Swiss people, I know we can learn from them that
CAM is not something Canada should be afraid of. If we can show
the Canadian people, government, and insurance industry the
efficacy of CAM and point to Switzerland as a reference point, we
can convince them of the importance of natural health practices
being integrated into our current healthcare system. Those I met in
Switzerland were warm and eager to share their success with our
association. I cant wait to see our collaborative work.
One of many pharmacy shelves stocked with natural health products
The integrative hospital
12 Summer 2011
NHPC Complaints Resolution Process
Summary of Arbitrators Decision and Sanction Committee Decision
Cathy Sveen, NHPC Complaints Director
A
complaint by a client
regarding an Alberta
Natural Health Practitioner
related to crossing of boundaries
of a sexual nature and practicing
beyond their scope of practice
was reviewed through the NHPCA
COMPLAINTS RESOLUTION
process. Following an investigation
into the complaint, a decision was
made by the Executive Director to
refer the complaint to arbitration.
The Arbitrator found that the allegations that the Natural Health
Practitioner performed Thai massage without having the appropriate
competency set to perform the treatment; and inappropriately
touched or massaged a clients breast and/or nipples in a sexual
manner and without informed consent were proven.
The arbitrator found that these actions were contrary to #6, #15
and #22 of the NHPCA Code of Ethics, was detrimental to the
best interests of the public, harmed the standing of the profession
generally, and displayed a lack of knowledge, skill, and judgment
in the practice of massage therapy, attempts at sexual exploitation
of a patient is a serious breach of professional conduct and shows
failure in judgment and skill as a practitioner.
The arbitrator held that multiple sections of the NHPCA Code of
Ethics were violated: Competency, Integrity, and Responsibility
to prevent Harm to our Clients. The decision of the arbitrator
was then referred onto to the Sanction Committee of the NHPCA
Board of Directors.
The Sanction Committee of the NHPCA Board of Directors
determined at a Sanction Hearing that the appropriate sanction
in this instance is:
Aten(10)monthsuspensionofthepractitionersmembership
from the date of the Committee decision;
At the end of the suspension period, the practitioner can
apply for reinstatement as an Associate or Regular Member
provided the following conditions are meet:
The practitioner provides an undertaking
to the NHPCA that they will only
provide services within the scope of
their competencies, as recognized by the
NHPCA;
The practitioner will demonstrate that
they have successfully completed course
work in the following subject areas. The
course(s) to be approved by the Executive
Director and at the practitioners expense;
- Professionalism
- Informed consent
- Boundaries
- Ethics
The practitioner shall provide a written
report to the Executive Director within
30 days following the completion of the
required course(s) indicating how their
conduct, as disclosed in the arbitration,
falls short of the standards set out in the
NHPCA Code of Ethics, specifically Codes
#6, #15, #22 and what they have learned.
The provisions regarding eligibility for
membership as an Associate or Regular
Member, as set out in the Bylaws, shall
also otherwise apply to the practitioners
application for reinstatement.
Intheeventthatthepractitionerappliesforandisapproved
for registration as a Regular Member, their practice shall be
subject to the following conditions:
o The practitioner shall be prohibited from
providing breast massage.



Classified
Listings

To advertise, contact Nadine:
888-711-7701 or nnoseworthy@nhpcanada.org
For additional listings, please visit www.nhpcanada.org







Part Time Massage Therapist
Edmonton, AB


Location: Wellness Within Health & Learning Centre
West Edmonton, Alberta, Canada

Contact: info@wellness-within.ca

Online Info: http://www.wellness-within.ca/careers.htm

Description:

Get rid of your overhead costs and join our multidisciplinary
community!

Beautifully decorated rooms in newly renovated Centre
Benefits include:
o Reception & on-site Management
o Laundering & linen use
o Cleaning & maintenance
o Online appointment system
o 50% off Massage continuing education and Yoga
Training
o Free Yoga classes and more!


Are you looking for more than just a space to rent?
Edmonton, AB



Our family of practitioners integrates science based
education with heart-full compassion, warmth and humor.


If you feel that you would be a compliment to our team of
alternative health practitioners, please contact:


Sheryl Watson:

(780) 488-3482 or
info@sacreddiva.ca
Sacred Diva Healing Centre,
10830 124 street,
Edmonton, AB T5M 0H3.
www.sacreddiva.ca
13 Summer 2011
Generating Clients on a Tight Budget
Jackie McKay
I
f you are looking to fill your holistic practice you are going
to have to increase your number of clients, and to do that,
you need more leads or prospects. For many business owners,
generating leads feels like a painful struggle, but it doesnt have
to be. In fact, it can be easy and fun. Following are five painless
ways to generate leads.
1 Ask for a referral
This is the easiest way to get new clients and it wont cost you
a penny. Yet so many therapists just dont think of asking their
clients for referrals. If your clients love you, know you and
trust you its more than likely they would be happy to refer to
you and they more than likely know others who need your help
especially if they have friends who are just like them (sports
enthusiasts, moms, stressed out executives, etc.)
After youve finished treating your client, let them know that you
are building your practice and ask them if they can think of someone
they know who might be able to use your services. Ask them to
keep you in mind when they speak to them next. Let them know
you offer referral incentives. Make sure to follow up with a gift!
2 Attend a weekly networking event
You never know who you will meet at a networking event, or what kinds
of connections you might make. When you meet people be the person
who asks the questions. Listen well. Be curious. They will eventually
come around to asking about you. Remember that even if your ideal
clients arent swarming the room, the guy whos dressed casually and
talks too much, just may be the doorway to your ideal clients.
3 Book speaking engagements or hold an information
workshop or teleseminar.
Where do your ideal clients hang out? Get in front of them and speak
to them or volunteer quick tasters of your services. If your ideal
clients are sports enthusiasts, offer to speak to sports organizations
in your city or surrounding areas. Go fish where the fish are!
4 Send a warm letter
Contact previous clients and send an email or snail mail letter thanking
them for their business. Let them know what is new and inform them
of who you treat exactly and that you are expanding your practice and
you are ready to accept new clients. Ask them to keep you in mind if
they can think of someone who is your ideal client.
5 Approach a JV for an opportunity
Joint ventures are a wonderful opportunity to create a win-win
situation for everyone, but often take a dash of creativity to find
and execute. Theyre fun and can be very, very profitable. This is
why you need to keep your ears and mind open whenever you go
to networking events and meetings.
Think of ways you can bring value to possible JV partners and how
they help your clients. For example, if youre a massage therapist
you might approach your local gym and offer to give a talk on the
benefits of using massage while on an exercise program. You could
send your own clients to the fitness facility whenever you hear of
someone who is looking to get back into shape. Essentially, you swap
leads. In turn, they might promote you in their facility or on their
website and receive your services free in return for a specific number
of referrals or sales.
6 Publish a newsletter and commit to doing it regularly
People love to forward emails they think the recipient would like.
A weekly newsletter with timely, high content and personable
information is an ideal way to keep in touch with current clients and
attract new ones. The newsletter doesnt have to be long, but it does
need to contain information that is relevant to your ideal client.
As youre writing your newsletter, remember to write about
topics that speak to your clients struggles make sure to give
them lots of value and offer a solution. Gear your newsletter to
alleviating their pain and enhancing their pleasure. Encourage
them to forward it to their friends and family.
Your Assignment:
Set up a system to generate leads so that your ideal client will find
you. As you continue, your leads will increase, and youll be able
to pick and choose your clients. The key is focus, consistency and
incorporating marketing into your daily routine.
If you would like some 1:1 support developing your own marketing
system that attracts lots of yummy clients, check out the Soul-Inspired
Coaching programs. The Soul-Inspired Prosperous Practice Coaching
programs can show you exactly how you can fill your practice and
attract new clients to your business each month. And, you could do
this in a step-by- step format, without being selly or icky, but just by
being you. How would that make a difference in your life? I created this
one-of-a-kind program to personally walk you through the same secrets
I used (and continue to use daily) to attract my own ideal clients to my
current coaching practice each month. Wanna learn more? Get in touch
with me for a free exploratory session to see if I can help. Contact me
at info@healerswhoprosper.com and go to www.HealersWhoProsper.
com to get your Free Checklist 141 To Fill Your Practice.
Until then, go heal your peeps!
Jackie McKay teaches natural health practitioners the heart-
centered HOW TO of busting through entrepreneurial fears
and making a name for themselves in their healing business.
14 Summer 2011
NHPCs Centre for Learning
Improve your Practice & Collect Continued
Competency Credits with DVDs, Ethics
Modules, & Educational Resources
Creating space for you and your practice to thrive
order online at nhpcanada.org
ON SALE: Master Classes with Stuart Hinds
$40 each (save $25.75) or purchase all four for $160 (save $65)
* plus tax & shipping, ofer expires October 28th, 2011
Stuart Hinds is a lecturer in remedial soft tissue techniques at Victoria University in Melbourne
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2004 Athens and 2008 Beijing Olympics, and will continue at the 2012 London games.
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15 Summer 2011
I
t seems Bonnie
Prudden, age 97,
holds the key to
perfect health at any age.
Her secret, a combination
of physical fitness
and Bonnie Prudden
Myotherapy

, has kept
her healthy and active
over the span of her own
lifetime, proving that if
you take time to care for
yourself, you can age
gracefully, never losing
your vitality or spirit. In
2006, she was the first
person to ever be inducted
into the Massage Hall of
Fame, and also holds a Lifetime Achievement award from the
Presidents Council on Physical Fitness.
If you remember the 1950s, Bonnie Prudden was a household
name to you. You may have read one of her books, watched
her syndicated television show, sported her exercise fashion
line, read one of her many articles in Sports Illustrated, and at
the very least you heard about her conversations with American
President Eisenhower which lead to The Report That Shocked the
President, which showed that American children were alarmingly
out of shape, the least fit children in the world.
If you were born later, much of what you remember about physical
fitness in grade-school is thanks to her. Because of Prudden, many
people from all walks of life began finding time for exercise
in their schedule. Born into an era that didnt understand the
importance of physical fitness, Prudden taught people how to
take care of themselves through exercise. Even now, at the age of
97, she continues to inspire people to make time for exercise in
their day. How could you not be inspired, when Prudden herself is
still active, healthy, and full of energy at the age of 97?
If you work in natural health, you may have heard of myotherapy.
Bonnie Prudden Myotherapy

is one of the 66 modalities


recognized by the Natural Health Practitioners of Canada, and
boasts a 95% success rate in curing muscular pain. Learning
from Dr. Janet Travells method of trigger point injection therapy,
Prudden developed her own method of trigger point therapy
that is non-invasive and can even be practiced at home without
doctor supervision. This method relies on the power of your
hands and elbows to relive pain and discomfort from your life.
Certified Bonnie Prudden Myotherapists receive 1,300 hours of
schooling and are required to report back every two years for an
additional thirty-five hours of continuing education hours. There
are a few Canadians recognized as practicing Bonnie Prudden
Myotherapy

, but most of Pruddens students are practicing in


the United States, coming from her own myotherpy school in
Tuscan, Arizona.
All her life, Prudden has been full of energy, ready to take on her
next adventure.
She tells us that her energetic spark was ignited as early as
when she was an infant, and that as young as two years old,
she was climbing out [her] window into the night, searching
for adventure. Her mother didnt know what to do with her
overactive daughter, and enrolled her in ballet the same year in an
attempt to exhaust her. This might have exhausted her enough to
stop sneaking out of her window in the middle of the night, but
Prudden began to blaze trails in the fitness world as she grew up.
As a young women she danced on Broadway and became one of
the top female mountain climbers in the world.
When Prudden was 23 she was in a bad skiing accident and
fractured her pelvis in four places. To make matters worse, her
doctor told her that she would never dance, climb, or ski again,
and would never be able to have children. To most this would be
considered a major setback, but it seems Prudden took it on as a
challenge. When asked what she was thinking after her doctor
gave her such a negative diagnosis, she said what I was really
thinking was up yours. She did go on to prove her doctor wrong,
continuing to be active all her life and giving birth to two children.
She now serves as an inspiration for anyone living with pain and
physical injury. With the right care, you can and will achieve pain
free existence again.
Pruddens method to pain free existence is a combination of
physical fitness and Bonnie Prudden Myotherapy

. She believes
that you cannot have one without the other, and has even included
an exercise regimen with her myotherapy training. She believes
that stress is a major precurser for chronic pain, telling us you
have to know that if you have any injury, real injury in your life,
that it stays there and can come back again when you have stress
in your life. Suddenly, you have a backache, or shoulder pain,
or something else... then you cant understand why you have a
backache, youve never had a backache before. [But] youve
never done any exercise before [either]. Pruddens method
seems simple enough, maintain an active lifestyle to keep your
Bonnie Prudden:
Inspiring Health at Every Age
NHPC Staf
16 Summer 2011
body strong, and when do you encounter
unavoidable pain from injury, treat yourself
with Bonnie Prudden Myotherapy

to
release pressure from those trigger points
that are causing the pain to surface.
If youre interested in trying Bonnie Prudden
Myotherapy

on yourself or loved ones, you


can start by picking up a copy of Pruddens
book, Pain Erasure the Bonnie Prudden Way,
which was first published in 1980 and is on
the New York Times Bestseller list. This book
walks you through Pruddens techniques
in simple terms using charts, pictures, and
diagrams, that are easy to understand. Plus,
because Prudden believes her therapy cannot
be complete without physical fitness, she
dedicates the later part of the book to showing
people how to begin an exercise regime. If
youve never exercised before, or if you are
recovering from physical injury that makes
exercise difficult, this section will help you on
your way to becoming physically fit.
Every year, Bonnie Prudden celebrates her
birthday by doing a somersault into her
backyard pool, and her 97
th
birthday was no
exception. If that isnt proof enough that her
methods to pain free existence work, I can only
encourage you to try them out for yourself.
With a little determination and self care, it
seems that anyone can recover from injury and
live a long and healthy life.
More information about Bonnie
Prudden Myotherapy

can be found at
www.bonnieprudden.com
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for personal growth opportunities.
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Resource Center.
17 Summer 2011
1
PersPectives
Professions
for the
By field laws Professional regulatory grouP
Issue 10, summer 2011
JOINT SUBMISSIONS ON SANCTION: THE
HEARING TRIBUNALS ROLE
AYLA AKGUNGOR
Once a hearing tribunal has made a fnding of
unprofessional conduct, it is common practice
in many professions for the hearing tribunal
to be presented with a joint submission on
sanction. A joint submission on sanction sets
out a penalty (or penalties), which both the
investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unft, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome
of an extended period of negotiations and
discussions where the parties have addressed
their minds to the issue of appropriate penalties.
In doing so, the parties have streamlined the
hearing process and saved time and resources.
Accordingly, the parties efforts in arriving at
a joint submission on sanction should not be
disregarded unless there are good and cogent
reasons for doing so. Recent decisions of the
courts have emphasized the importance of this
approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for fve years. The Court of Appeal
reversed the sanction decision fnding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate;
not within the range of appropriate sanctions;
unft or unreasonable; or contrary to the public
interest.
similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unft,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unft, unreasonable or not in the public interest,
they should make their specifc concerns
known to the parties and provide them with an
opportunity to make further submissions, either
Continued on Page 4...
1
PersPectives
Professions
for the
By field laws Professional regulatory grouP
Issue 10, summer 2011
JOINT SUBMISSIONS ON SANCTION: THE
HEARING TRIBUNALS ROLE
AYLA AKGUNGOR
Once a hearing tribunal has made a fnding of
unprofessional conduct, it is common practice
in many professions for the hearing tribunal
to be presented with a joint submission on
sanction. A joint submission on sanction sets
out a penalty (or penalties), which both the
investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unft, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome
of an extended period of negotiations and
discussions where the parties have addressed
their minds to the issue of appropriate penalties.
In doing so, the parties have streamlined the
hearing process and saved time and resources.
Accordingly, the parties efforts in arriving at
a joint submission on sanction should not be
disregarded unless there are good and cogent
reasons for doing so. Recent decisions of the
courts have emphasized the importance of this
approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for fve years. The Court of Appeal
reversed the sanction decision fnding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate;
not within the range of appropriate sanctions;
unft or unreasonable; or contrary to the public
interest.
similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unft,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unft, unreasonable or not in the public interest,
they should make their specifc concerns
known to the parties and provide them with an
opportunity to make further submissions, either
Continued on Page 4...
O
nce a hearing tribunal has made a finding
of unprofessional conduct, it is common
practice in many professions for the
hearing tribunal to be presented with a joint
submission on sanction. A joint submission on
sanction sets out a penalty (or penalties), which
both the investigated member and the College have
agreed constitutes a reasonable and appropriate
response to the unprofessional conduct.
A hearing tribunal always retains the discretion
to accept or reject a joint submission on sanction.
Generally speaking, the principle of deference
will apply and the hearing tribunal should accept
the joint submission on sanction unless it is of
the view that the penalty is unfit, unreasonable
or is contrary to the public interest.
The principle of deference recognizes that joint
submissions on sanction are often the outcome of
an extended period of negotiations and discussions
where the parties have addressed their minds to
the issue of appropriate penalties. In doing so,
the parties have streamlined the hearing process
and saved time and resources. Accordingly, the
parties efforts in arriving at a joint submission
on sanction should not be disregarded unless
there are good and cogent reasons for doing so.
Recent decisions of the courts have emphasized
the importance of this approach.
In Rault v. Law Society (Saskatchewan), 2009
SKCA 81, the College and the investigated
member made a joint submission that a lawyer
be permitted to resign in the face of discipline.
The hearing tribunal instead ordered that the
lawyer be disbarred and be ineligible to apply for
reinstatement for five years. The Court of Appeal
reversed the sanction decision finding that the
principles applied in criminal law with respect
to joint submissions on sentencing should also
be applied to professional disciplinary matters.
The Court noted that there are good public
policy reasons for the principle of deference
to joint submissions and concluded that if the
hearing tribunal was of the view that the joint
submission sanction was inappropriate, it had
a duty to give good or cogent reasons on why
the proposed sanctions were inappropriate; not
within the range of appropriate sanctions; unfit or
unreasonable; or contrary to the public interest.
Similarly, in Pankiw v. Chiropractors
Association (Saskatchewan), 2009 SKQB 268,
the hearing tribunal rejected a joint submission
on sanction and imposed different penalties on
the investigated member. The court overturned
the sanctions imposed by the hearing tribunal
on the basis that it had not put its mind to or
concluded that the joint submission was unfit,
unreasonable or not in the public interest. The
court then imposed the penalties set out in
the original joint submission on sanction. The
court noted that joint submissions are to be
encouraged not ignored. If they are ignored,
lengthy discipline hearings and increased
costs to be borne initially by members of the
profession and perhaps ultimately by the public
they serve will result.
In practice, if members of a hearing tribunal are
concerned that a joint submission on sanction is
unfit, unreasonable or not in the public interest,
they should make their specific concerns
known to the parties and provide them with an
opportunity to make further submissions, either
orally before the hearing tribunal or by way of
written submissions. Only after the instigated
JOINT SUBMISSIONS ON SANCTION:
THE HEARING TRIBUNALS ROLE
18 Summer 2011
RECENT CASES OF INTEREST TO REGULATORS
member and the College have provided their
comments on the hearing tribunals concerns
with the joint submission should the hearing
tribunal proceed with making its ultimate
decision on sanction.
Indeed, as the case of Visconti v. College
of Physicians & Surgeons (Alberta), 2009
ABQB 742 demonstrates, this practice
should be followed at any point where the
hearing tribunal is considering varying from
the penalties proposed by the parties whether
or not the penalties were proposed by joint
sanction. In Visconti, the legislation provided
for an Investigating Committee to make
recommendations to the Council of the College
with respect to sanctions. Council imposed
sanctions over and above those recommended
by the Investigating Committee. Even though
there was no joint submission on sanction in
this case, the Court held that the investigated
member should have been advised that Council
was considering a higher penalty and been given
the opportunity to make submissions.
While it remains up to hearing tribunals to
determine whether they will accept joint
admissions on sanction, they must be mindful
of the public policy reasons for encouraging
joint submissions on sanction. In cases where
hearing tribunals choose to deviate from
joint submissions, they must be prepared to
set out in their written decisions cogent and
well-developed reasons for why the sanction
proposed by the parties was unfit, unreasonable,
not in the public interest or not within the range
of appropriate penalties for the unprofessional
conduct in question. s
Reasonable Apprehension of Bias
Lim v. Association of Professional Engineers of
Ontario, 2011 ONSC 106
A complaint against an engineer was referred to
a discipline hearing. The Manager of Legal and
Regulatory Affairs, who was the support staff
who assisted the discipline tribunal in its duties,
engaged in correspondence with the parties to
try to set a date for the hearing. Counsel for
the member indicated he had not received full
disclosure and therefore the proposed dates
would not work, but proposed some alternative
dates. The Manager sent a response by e-mail
indicating that the Chair of the Tribunal had an
obligation to the public to proceed expeditiously,
and that if assertions were made regarding the
lack of availability for a hearing, evidence would
have to be provided to support the assertions.
Further correspondence was exchanged between
the Manager and both counsel, in which the
Manager warned that threats and intimidation
would not be tolerated. The Manager threatened
to report members counsel to the Law Society,
and demanded an apology from counsel.
Counsel for the Association wrote stating that
she also thought the Managers communication
was inappropriate. The member then made
an application for further disclosure and also
argued that there was a reasonable apprehension
of bias. The Manager sought to be added as a
party to the application. The member hearing the
application refused to grant the Manager party
status. The Chair of the Tribunal subsequently
overturned the decision, and decided to add
the Manager of the Tribunal as a party, without
granting the parties an opportunity to make
submissions. The member sought a stay of the
hearing on the basis of reasonable apprehension
of bias. The Court granted the stay and
permanently quashed the proceedings.
Commentary: Tribunal staff, such as the
Hearings Director or persons acting in an
administrative capacity to assist discipline
tribunals in carrying out their functions must
not usurp the function of the discipline tribunal.
Tribunal staff can act as a conduit between the
parties and the discipline committee, but should
refrain from making any decisions on behalf
of the discipline committee, or appearing as if
they are controlling the process. Staff members
acting in this capacity should ensure that (a)
they do not communicate with the parties unless
they have directions to do so from the tribunal
or the Chair (b) they clearly indicate to the
parties that the correspondence is being sent
on behalf of the tribunal and (c) the tone and
content of the communications does not give
rise to a reasonable apprehension of bias.
2
RECENT CASES OF INTEREST TO REGULATORS
KATRINA HAYMOND
reasonable apprehension of bias
Lim v. Association of Professional Engineers of
Ontario, 2011 ONsC 106
A complaint against an engineer was referred to
a discipline hearing. The Manager of Legal and
Regulatory Affairs, who was the support staff
who assisted the discipline tribunal in its duties,
engaged in correspondence with the parties to
try to set a date for the hearing. Counsel for
the member indicated he had not received full
disclosure and therefore the proposed dates
would not work, but proposed some alternative
dates. The Manager sent a response by e-mail
indicating that the Chair of the Tribunal had an
obligation to the public to proceed expeditiously,
and that if assertions were made regarding the
lack of availability for a hearing, evidence would
have to be provided to support the assertions.
Further correspondence was exchanged
between the Manager and both counsel, in
which the Manager warned that threats and
intimidation would not be tolerated. The Manager
threatened to report members counsel to the
Law Society, and demanded an apology from
counsel. Counsel for the Association wrote
stating that she also thought the Managers
communication was inappropriate. The member
then made an application for further disclosure
and also argued that there was a reasonable
apprehension of bias. The Manager sought to
be added as a party to the application. The
member hearing the application refused to
grant the Manager party status. The Chair
of the Tribunal subsequently overturned the
decision, and decided to add the Manager of
the Tribunal as a party, without granting the
parties an opportunity to make submissions.
The member sought a stay of the hearing on
the basis of reasonable apprehension of bias.
The Court granted the stay and permanently
quashed the proceedings.
Commentary: Tribunal staff, such as the
Hearings Director or persons acting in an
administrative capacity to assist discipline
tribunals in carrying out their functions must
not usurp the function of the discipline tribunal.
Tribunal staff can act as a conduit between the
parties and the discipline committee, but should
refrain from making any decisions on behalf of
the discipline committee, or appearing as if they
are controlling the process. Staff members
acting in this capacity should ensure that
(a) they do not communicate with the parties
unless they have directions to do so from the
tribunal or the Chair (b) they clearly indicate to
the parties that the correspondence is being
sent on behalf of the tribunal and (c) the tone
and content of the communications does not
give rise to a reasonable apprehension of bias.
overlapping Jurisdiction
Nowoselsky v. College of Social Workers
Appeal Panel (Alberta), 2011 ABCA 58
A social worker was found guilty of a number
of allegations, including several boundary
violations with clients. The social worker
appealed to Council, which upheld the fndings,
and then to the Court of Appeal. The social
worker raised a number of grounds of appeal,
including that the same conduct was being dealt
with by the employer and was the subject of a
grievance pursuant to the governing collective
agreement. The social worker argued that he
was facing double jeopardy and the Hearing
Tribunal should not have proceeded in these
circumstances. The Court of Appeal rejected
this argument, confrming that in matters of
this nature, the employer could address the
conduct via the mechanisms in the collective
agreement, and the College could address the
conduct under the HPA.
Commentary: The fact that the employer is
addressing the subject matter of a complaint in
the employment context does not deprive the
regulatory body of jurisdiction to process the
complaint under its own governing jurisdiction.
Both the employer and the regulatory may have
a legitimate interest in addressing the conduct.
new evidence
Barrington v. Institute of Chartered Accountants
(Ontario), 2011 CarswellOnt 3623
Four accountants who worked at Deloitte were
involved in conducting an audit approving
the fnancial statements of a large company.
19 Summer 2011
Overlapping Juristiction
Nowoselsky v. College of Social Workers Appeal Panel (Alberta),
2011 ABCA 58
A social worker was found guilty of a number of allegations,
including several boundary violations with clients. The social
worker appealed to Council, which upheld the findings, and
then to the Court of Appeal. The social worker raised a number
of grounds of appeal, including that the same conduct was being
dealt with by the employer and was the subject of a grievance
pursuant to the governing collective agreement. The social worker
argued that he was facing double jeopardy and the Hearing
Tribunal should not have proceeded in these circumstances. The
Court of Appeal rejected this argument, confirming that in matters
of this nature, the employer could address the conduct via the
mechanisms in the collective agreement, and the College could
address the conduct under the HPA.
Commentary: The fact that the employer is addressing the
subject matter of a complaint in the employment context does
not deprive the regulatory body of jurisdiction to process
the complaint under its own governing jurisdiction. Both the
employer and the regulatory may have a legitimate interest in
addressing the conduct.
New Evidence
Barrington v. Institute of Chartered Accountants (Ontario), 2011
Carswell Ont 3623
Four accountants who worked at Deloitte were involved in
conducting an audit approving the financial statements of a
large company. Under new management, serious financial
irregularities were discovered in the companys books.
Complaints were made against the four senior accountants who
were involved in the audit. The complaints alleged that they failed
to adhere to accounting and auditing standards. After a lengthy
discipline hearing, the accountants were found guilty of several
allegations. The Notice of Hearing alleged that the accountants
failed to comply with generally accepted accounting standards
(GAAP) and generally accepted auditing standards (GAAS)
and gave multiple particulars relating to those charges. During
the course of the hearing, evidence came to light that had not
been disclosed to the Institute during its investigation relating to
a dispute that the four accountants had with the company. The
dispute related to an inappropriate agreement that the company
had entered into that was affecting the validity of their financial
statements. Although the company advised the accountants that
it would cancel the agreement, the company failed to do so. The
Discipline Committee found three of the accountants guilty of the
specific allegations in the Notice of Hearing, concluding in part
that their failure to follow up regarding the cancellation of the
side agreement was a breach of the GAAP. They were ordered to
pay a large fine and the costs of the hearing.
The members appealed to the appeal tribunal, which upheld the
decision of the Discipline Committee. The accountants sought
judicial review, on the basis that there was a breach of fairness.
The court granted the application for judicial review in part,
quashing some of the findings, and overturning the costs order.
The members appealed the findings to the Court of Appeal, and
the Institute cross-appealed. The members raised several grounds
of appeal, including that they had inadequate notice of the
allegations and that the Discipline Committee failed to provide
adequate reasons. The Court of Appeal considered whether there
was a breach of fairness, given that the Notice of Hearing and
the particulars referenced therein did not specifically refer to the
side agreement that was referenced and material to the Discipline
Committees decision.
The Court of Appeal held that there was no breach of fairness to
the members, given that the side agreement was evidence that
had not specifically been disclosed to the investigators prior to
the hearing. It was raised by the accountants themselves during
the hearing, and should have been anticipated by them given that
they knew at least one witness would be testifying on the issue.
Moreover, it did not change the essential elements of the charges,
which were whether or not there was a breach of GAAP and
GAAS. Just because the prosecutor had a different theory of the
case did not prohibit the Discipline Committee from considering
the new evidence, since there are potentially different routes to
liability.
Commentary: Where new evidence arises during the course of
a hearing that is relevant to the charges, consideration of that
evidence will not always result in a breach of fairness. If the
member knew of the evidence, and the evidence is relevant to
the allegations in issue, the discipline tribunal may be able to
rely upon it notwithstanding the lack of specific notice. However,
the specific statutory provisions need to be considered. Many
statutes have a specific provision that allows a discipline tribunal
to consider new evidence that arises in the course of a hearing,
provided that notice is given and/or an adjournment is granted. If
new evidence does arise, in order to avoid allegations of a breach
of fairness, the hearing can be adjourned so that the member can
respond to the new evidence. Each situation should be carefully
assessed to determine the best course of action. s
4
These articles should not be interpreted as providing legal advice. Consult your legal
adviser before acting on any of the information contained in them. Questions, comments,
suggestions and address updates are most appreciated and should be directed to:
Katrina Haymond in Edmonton 780-423-9584
Lisa Gaunt in Calgary 403-260-8525
rePrintS
Professional organizations may reprint articles in their own newsletters provided credit
is given for the articles to Field Laws Professional Regulatory Group and the individual
author. Please send us a copy of the newsletter with the article.
disclaimer
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PersPectives for
the Professions
orally before the hearing tribunal or by way of written
submissions. Only after the investigated member and
the College have provided their comments on the hearing
tribunals concerns with the joint submission should the
hearing tribunal proceed with making its ultimate decision
on sanction.
Indeed, as the case of Visconti v. College of Physicians &
Surgeons (Alberta), 2009 ABQB 742 demonstrates, this
practice should be followed at any point where the hearing
tribunal is considering varying from the penalties proposed
by the parties whether or not the penalties were proposed
by joint sanction. In Visconti, the legislation provided for an
Investigating Committee to make recommendations to the
Council of the College with respect to sanctions. Council
imposed sanctions over and above those recommended by
the Investigating Committee. Even though there was no
joint submission on sanction in this case, the Court held that
the investigated member should have been advised that
Council was considering a higher penalty and been given
the opportunity to make submissions.
While it remains up to hearing tribunals to determine whether
they will accept joint submissions on sanction, they must be
mindful of the public policy reasons for encouraging joint
submissions on sanction. In cases where hearing tribunals
choose to deviate from joint submissions, they must be
prepared to set out in their written decisions cogent and
well-developed reasons for why the sanction proposed
by the parties was unft, unreasonable, not in the public
interest or not within the range of appropriate penalties for
the unprofessional conduct in question.
training dVd for hearing
tribunals is now available!
Over the past year, the lawyers at Field LLP had the
opportunity to work on an important and groundbreaking
project with the Alberta Federation of Regulated Health
Professions (AFRHP). The project resulted in the production
of a training DVD that will provide members of Hearing
Tribunals under the HPA with an overview of the discipline
process under the HPA and an introduction to some key
concepts that members need to be aware of. The DVD,
called Hearing Tribunal Essentials provides an overview
of basic administrative law principles, the professional
conduct process, contested and uncontested hearings,
key evidentiary rules, assessing credibility of witnesses,
imposing sanctions, and preparing reasons. The DVD also
includes a number of interesting demonstrations designed
to give new members a realistic snapshot of the hearing
process.
We appreciated the opportunity to collaborate on this
exciting project with the Steering Committee of the AFRHPs
Complaints Process Working Group, which included Kathy
Hilsenteger (ACDMTT), Sharlene Standing (CLPNA) and
Dr. Richard Spelliscy (CAP). If you want to obtain a copy of
the DVD, you can order it online at www.afrhp.org.
While the DVD provides general training, we anticipate that
many Colleges will still want individualized training for their
tribunals. Our Professional Regulatory Group will continue
to provide individualized and advanced training upon
request. Please contact Katrina Haymond at 423-9584 for
more information.
Joint Submissions
Continued from Page 1...
20 Summer 2011
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ASSociAtion, SASKAtoon SHiAtSu centre, SAult college of Applied ArtS & tecHnology, ScHool of HeAltH ScienceS, ScentS of comfort, ScHool for pHySicAl tHerApy At tHe BAltic SeA clinic, ScHool of effective reflexology, ScHool of
HeAling ArtS, ScHool of mASSAge tHerApy And AdvAnced trigger point, ScHool of SpA tHerApieS, ScottiSH ScHool of profeSSionAl mASSAge, ScuolA di eSteticA modernA, SeAted AcupreSSure tHerApy trAining, SHAndong univerSity of
tcm, SHAngHAi univerSity of tcm, SHAnxi trAditionAl cHineSe medicine college, SHeridAn college inStitute of tecHnology & AdvAnced leArning, SHiAtSu AcAdemy of toKyo, SHiAtSu ScHool freiBurg, SHiAtSu ScHool of cAnAdA, Sir
SAnford fleming college, SmitH mountAin lAKe inStitute of HigHer HeAling,SnoWlion center ScHool, SomAticS inStitute ScHool of mASSAge, SoutH AuStrAliAn HeAltH educAtion centre, SoutHern AlBertA inStitute of mASSAge,
SoutHern cAliforniA univerSity of HeAltH ScienceS, SoutHWind jAde, SpA lunA, Spectrum centre ScHool of mASSAge, Sprott-SHAW community college, St. joHn neuromuSculAr pAin relief inStitute, StAte vocAtionAl ScHool for
pHySiotHerApy At WurzBurg univerSity, Still point yogA ScHool, Stone tHerApy ScHool, Stott internAtionAl certificAtion centre, Stott'S pilAteS, SunriSe trAditionAl tHAi mASSAge, SunSHine mASSAge ScHool, SutHerlAnd-cHAn
ScHool, SWediSH inStitute - college of HeAltH ScienceS, tAoye trAditionAl cHineSe medicine And mASSAge inStitute, tHAi mASSAge ScHool of tHAilAnd, tHAi mASSAge toronto ScHool And mASSAge centre, tHAi mASSAge trAining centre,
tHAi trAditionAl medicine development centre, tiAnjin mASSAge tHerApiSt ScHool, tiltAn college, toKyo HeAltH inStitute, toronto ScHool of BuSineSS, toronto ScHool of tHAi mASSAge, toucH of grAy, toucHpoint inStitute of reflex-
ology And KineStHeticS, trAger cAnAdA, trAining in poWer, trAnSformAtionAl ArtS college, tri-StAr pAcific internAtionAl leArning And development centre, ulmKolleg - germAny, uncommon ScentS, univerSAl college of leArning,
univerSAl college of reflexology, univerSity of WeSt BoHemiA - pilSen college, upledger inStitute, uS cAreer inStitute, utAH college of mASSAge tHerApy, utopiA AcAdemy, vAncouver reflexology centre, vAncouver ScHool of
BodyWorK And mASSAge, volgogrAdSKiy medicAl univerSity, WAt pHo trAditionAl medicAl ScHool, Wellington college of remediAl mASSAge tHerApy, WellpArK college of nAturAl tHerApieS, WellSpringS college of mASSAge tHer-
Apy And eStHeticS, WeSt coASt college of mASSAge tHerApy, WeSt coASt college of mASSAge tHerApy (neW WeStminSter cAmpuS), WeSt coASt inStitute of AromAtHerApy inc., WeSt coASt KineSiologyinStitute,WeSt SicHuAn vocA-
tionAl ScHool, WeStern college of remediAl mASSAge,WeStern inStitute of AromAtHerApy, WeStervelt college, WHiStler ScHool of mASSAge And SpA ServiceS, WHiStler tHerApeutic centre, WHite river ScHool of mASSAge, Wild roSe
college of nAturAl HeAling, WindSong ScHool of HeAling, World of AromAtHerApy, WuHAn inStitute of pHySicAl educAtion, yogA AlliAnce (uS), yogA ASSociAtion of AlBertA, yogA in tHe rocKieS, yogA Studio college of cAnAdA,
yogAdotcAlm, zcd - odenSe/odenSe zonecollege, zeemAnS, zen SHiAtSu clinic And ScHool, zenergy BodyWorK And WellneSS, zHAn jiAng SHen mei occupAtion And tecH. ScHool.
NHPC RECOGNIZES MORE THAN
500 PROGRAMS INTERNATIONALLY
and the list keeps growing.
21 Summer 2011
Subhead Makami College:
One of Over 500 School Programs Recognized by the NHPC
W
hen the Pavkovic family opened Makami College in
Edmonton, Alberta, in 2001, they were united by their
simple desire to help people achieve their dreams.
When asked how Makami got off the ground, Marija Pavkovic-
Tovossi, Managing Director of Makami says, It just fit. We had
a lot of professionals that we networked with like chiropractors,
physiotherapists, and massage therapists that had been working in
the industry for over 20 years. We just went to all of them, and it
just happened. We were able to work together, doors opened, and
we were able to create something that is really changing peoples
lives. We like to see people get educated in order to change the
lives of their families.
All four members of the Packovic family are heavily involved
with the day-to-day operations at Makami College. Ljubica is the
Director of Operations and Department Head for the Massage
Therapy program, her husband Dragan is the Finance Director
and Construction Manager, their daughter Marija is the Managing
Director, and their son Vladimir is the Marketing Director.
Ljubica Pavkovic has a nursing background in Yugoslavia. She
is also a Massage Therapist, Holistic Practitioner, and holds
certification in numerous specializations in energy work and
massage therapy. Speaking with her daughter Marija, it is clear
that Ljubicas thirst
for knowledge
combined with her
love of teaching
and strong belief in
inclusivity has led
to her being a big
inspiration to the
students, because
they see where
shes come from
and what shes
achieved.
The Pavkovic family had overcome their own challenges before
realizing their dreams and starting their family business. When
they first moved to Canada from former Yugoslavia in 1987
none of them spoke any English, and because of that they faced
immense difficulty in getting settled here. Makami College,
which started as a small school with only 12 students in their
first year, has grown to having 30 employees and more than 350
students enrolled last year. Against all odds, the Pavkovic family
was able to overcome language and cultural barriers to create a
successful business in Canada.
They now encourage others to do the same by training them to
be Massage Therapists with solid business skills. Because they
know first-hand how difficult it can be to solidify a new career,
the Pavkovic family has designed the Makami program to be as
inclusive as possible regardless of a students limitations. One of our
part time students one time was a blind man, and he is an amazing
Massage Therapist, but hes blind. So no other school would even
take him in, but we had a special instructor work with him through
the whole process. And now he is an amazing therapist. I think we
try to give everybody a chance and an opportunity, because if this is
their dream then we want to help them achieve it.
Makami College is on NHPCs list of over 500 recognized
school programs. For more information about this school, visit
www.makamicollege.com
Are you an NHPC Recognized Program? Want to see your
school program featured in the next issue of Connections?
Contact Jasmine by email; Jbischoff@nhpcanada.org or by
phoning 1-888-711-7701 ext. 230
left to right: Vladimir Pavkovic, Marija Pavkovic-Tovissi,
Dragan Pavkovic, Ljubica Pavkovic
201-611 9th St. East
off Broadway, Saskatoon
Local, Convenient
Affordable
Oils, Linens, Tables,
Accessories... and More
382-4673 or 1-866-478-4998
Contact: Pam Fichtner RMT or Dale Jack
Tues. & Thurs. 1pm to 5pm or by appointment
www.saskmassage.ca
22 Summer 2011
CONTINUING EDUCATION
http://conted.mtroyal.ca/healthhumanservice
Information: 403.440.6867 or cehealth@mtroyal.ca
Reveal a
new you
Addiction Studies
Body Talk Access
Bowen Therapy
Energy Therapy
Feng Shui
Healing Touch
Massage Therapy
Medical Terminology
Mindfulness-Based Stress
Reduction
Personal Fitness Trainer
Reiki
Shiatsu Therapy
Spa Therapy
Yoga Therapy
23 Summer 2011
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4

Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al

found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13

and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4

Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al

found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13

and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
32 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3
Refexology and the Autonomic Nervous System
C. M. hughes, phD,isalecturerintheSchoolofHealth
Sciences,UniversityofUlster,NorthernIreland,United
Kingdom.s. Krirsnakriengkrai, phD,isalecturerinthe
DepartmentofPhysiotherapy,FacultyofHealthScience,
SrinakharinwirotUniversity,Bangkok,Thailand.s. Kumar, MD,
Mphil,isalecturerintheDepartmentofCommunityMedicine,
TeerthankarMahaveerMedicalCollege&ResearchCentre,
Moradabad,UttarPradesh,India.s. M. McDonough, phD,isa
professorattheHealthandRehabilitationSciencesResearch
Institute,SchoolofHealthSciences,UniversityofUlster.
Correspondingauthor:C.M.Hughes,PhD
E-mailaddress:CM.Hughes@ulster.ac.uk
R
efexology is an ancient treatment based on the the-
ory that all the body structures are interlinked with
specifc refex points on the hands and feet.
1,2
The
purpose of treatment is to normalize the bodys
function, break down tension, alleviate stress, and
improve nerve function and blood supply throughout the body.
3,4

Evidence suggests that refexology has an effect on physio-
logical outcomes. Frankel found that refexology increased sinus
arrhythmia, indicating a higher synchronization between heart
rate (HR) and respiration, and reduced baroreceptor refex sensi-
tivity
5
; therefore, refexology helps patients maintain blood pres-
sure (BP) homeostasis by creating changes in autonomic outfow.
zhen et al

found that refexology stimulation could increase the
complexity of HR variability signal, indicating an increase the
vagal activity.
6
When people are under stress, autonomic nervous system
(ANS) disturbances are induced, which consist of suppressed
vagal and/or enhanced sympathetic functions. The observed
effects of refexology on the ANS therefore may help explain why
refexology has been shown to reduce anxiety and stress in cancer
patients,
7
women with depression,
8
dementia patients,
9
and in
the working population.
10
Mental stress may be induced under experimental condi-
tions, provoking sympathoexcitatory responses following emo-
tional or behavioral challenges.
11
The Stroop color word test
12,13

and a mental arithmetic test
14,15
have been widely used as tools for
TheEffectofRefexologyontheAutonomicNervous
SysteminHealthyAdults:AFeasibilityStudy
C. M. Hughes, PhD; S. krirsnakriengkrai, PhD; S. kumar, MD, MPhil; S. M. McDonough, PhD
original research
Background Refexology has been shown to reduce anxiety and
stress in various populations. The mechanism by which this
occurs may be in modulating autonomic nervous system (ANS)
function; however; there is limited evidence available in the area.
PrimaryStudyObjective The aim of the study was to inves-
tigate the feasibility of using an experimental model to deter-
mine the physiological effect of refexology on stress.
Methods/Design A feasibility study to assess an experimen-
tal study design to compare the effect of refexology and control
interventions on heart rate (HR) and blood pressure (BP) fol-
lowing mental stress tests.
Setting The Health and Rehabilitation Science Research Institute
at the University of Ulster, Northern Ireland, United kingdom.
Participants Twenty-six healthy volunteers.
Intervention Mental stress was induced before and after inter-
vention. Participants in the refexology group received 20 min-
utes of refexology, and the control group received 20 minutes of
relaxation with a therapist holding each participants feet.
Primary Outcome Measures The outcome measures, HR
and BP, were measured throughout mental stress testing,
intervention, and a second period of mental stress testing fol-
lowing intervention.
Results The study design was considered feasible. There were
signifcant reductions in systolic blood pressure (SBP) (22%; P=
.03) and in diastolic blood pressure (DBP) (26%; P= .01) during
mental stress following refexology compared to the stress
period prior to intervention. In contrast, there was a 10% reduc-
tion in SBP (P =.03) but a 5% increase in DBP (P =.67) during
the period of mental stress following the control intervention
compared to results obtained during mental stress prior to this
intervention. However, there were no signifcant differences
between refexology and control groups.
Conclusion This study has demonstrated the feasibility of
conducting an experimental study on the effect of refexology in
stress using BP as the primary outcome measure. Results from
such a study would address the lack of high-quality evidence for
the physiological effects of refexology. (AlternTherHealthMed.
2011;17(3):32-37.)
24 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 33
inducing these ANS responses. These studies have shown that
HR and BP increase using experimental mental stress models to
levels similar to those observed during a moderate walking
task
16,17
but below those associated with hypertensive risk. These
experimental models therefore may be used to simulate patho-
logical stress.
The aim of the current study was to investigate the feasibility
of using an experimental model to determine the physiological
effect of refexology on stress using mental stress tests in healthy
adults to induce ANS function. The feasibility of patient recruit-
ment and retention, logistics of intervention, outcome measure
sensitivity, and appropriateness of the control intervention for such
a study design was carried out. These data also will provide the
basis of a power analysis to determine numbers for a future trial.
MATERIALSANDMETHODS
Participants
This study was approved by the Research Ethics Committee
of the University of Ulster. Healthy adults aged between 18 and
45 years were recruited from within the university through e-mail
announcements and advertisements. Participants were excluded
if they had previously received refexology or had any condition
that might interfere with the outcome measurements such as
vascular, lymphatic, or skin conditions; diabetes; pregnancy; use
of a cardiac pacemaker; or current drug therapy to treat hyper-
tension. Potential participants were informed about the experi-
mental procedure and asked to give written informed consent.
The number of participants required for this study was calculat-
ed using power analysis from a similar study of acupuncture,
18
as
there were no similar studies on refexology in the literature. The
sample size from power analysis was 10 per group. The current
study recruited 25 participants who were randomly allocated
into either the refexology group or control group using comput-
er-generated numbers and sealed opaque envelopes. An indepen-
dent researcher who was otherwise uninvolved in the trial
performed randomization. Participants were asked to abstain
from smoking and drinking caffeine or alcohol for at least 6
hours prior to testing and to refrain from eating or performing
strenuous exercise during the preceding 2 hours.
Interventions
The refexology group received stimulation to refex points
associated with the organs that would be expected to induce a
physiological response in the ANS. These points included the
refex area for the peripheral nervous system, including the ANS,
which is responsible for the regulation of HR and BP; the central
nervous system, the brain and spinal cord, as these areas regulate
ANS function; the solar plexus, which within the theory of refex-
ology will calm and relax the entire nervous system; the heart, as
direct refexology stimulation to this point may affect the organ
(left foot only); the kidney, due to its role in the control of BP;
and the endocrine refex points such as the pituitary, thyroid,
and adrenal gland points, as the hormones released from these
glands aid in the regulation of HR and BP. These points were
selected using appropriate published charts and textbooks.
2,19

Pressure was applied to each of these points for 30 seconds at a
time on each of the feet for a total of 20 minutes. The refexology
intervention using grape-seed base oil was performed by one of
two qualifed refexologists with more than 10 years experience.
The control group did not receive refexology stimulation;
the refexologists simply rested each participants heels in the
palms of their hands for 20 minutes. The purpose of this inter-
vention was to control for the effects of relaxation, touch, and
patient-therapist interaction. All interventions were carried out
in the same room.
MentalStressProcedure
Two mental stress tests were employed to induce ANS
parameters within the participants; these were the Stroop color
word test and a mental arithmetic test. A pilot study carried out
prior to this experimental study indicated that both of these tests
increased HR and BP to a similar degree and could therefore be
used interchangeably. The experimental procedure required two
periods of induced stress to the ANS and therefore two separate
stress tests were used to reduce the possibility of accommodation.
The participant determined the order in which the stress tests
were applied by randomly selecting one of two envelopes that
contained the names of the two tests. The test that the participant
selected was used as the frst stress test during the experiment.
The Stroop color word test consisted of presenting color-
naming words, with each word printed in a color different from
its meaning; for example, the word red was printed in blue ink.
To perform the task, the participant had to say the names of the
color of the ink, not the color designated by the word.
20
The men-
tal arithmetic test was a verbal serial subtraction. The partici-
pants were instructed to verbally subtract 13 serially from 1079
for 4 minutes.
15
During the mental stress, the sound from a met-
ronome beating at 2 Hz (120 bpm) was used as a distraction
15

and to increase stress.
21
As sympathetic responses to mental
stress testing are strongly influenced by perception of task
diffculty,
22
each volunteer was asked to assess each mental stress
test, using a standard 5-point scale: not stressful, somewhat
stressful, stressful, very stressful, or very very stressful.
OutcomeMeasurements
HR, systolic blood pressure (SBP), and diastolic blood pres-
sure (DBP) were measured noninvasively using an automatic upper
arm blood pressure monitor (Omron M5-I, Gaiam Ltd, Louisville,
Colorado). All outcomes were measured every minute at baseline
and during interventions and mental stress tests (Figure 1).
ExperimentalProcedures
Participants were asked to lie in the supine position. The
blood pressure cuff was applied to the upper arm, and HR and
BP were recorded every minute throughout the experimental
period. After 5 minutes of baseline measurement, the participant
took part in a mental stress test (color word test or mental arith-
metic) for 4 minutes, followed by a 10-minute recovery period.
Refexology and the Autonomic Nervous System
25 Summer 2011
34 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
The intervention was then carried out for 20 minutes according
to group allocation. A second baseline was measured for 5 min-
utes after the intervention period, followed by a different mental
stress test (color word test or mental arithmetic) for 4 minutes
and another 5-minute recovery period (Figure 1).
18
The investiga-
tors who carried out the mental stress testing and who measured
the outcomes were blinded to treatment allocation.
BlindingStatus
For blinding purposes, all participants were informed that
they would receive one of two different forms of complementary
intervention. After completion of the experiment, all partici-
pants were asked to guess which interventions they received to
check for blinding status. The blinding index for each group was
calculated using the method demonstrated by Bang et al.
23

Confdence interval (CI) of a proportion was calculated accord-
ing to the method described by Newcombe,
24
which was available
online at http://faculty.vassar.edu/lowry/prop1.html.
DataAnalysis
Each outcome measurement was analyzed using Statistical
Package for Social Sciences (SPSS) version 11.5 for Windows
(SPSS, Chicago, Illinois). Data were checked for a normal distri-
bution using kolmogorov-Smirnov test. Baseline values were
averaged from the values of minute 4 and minute 5 at resting
baseline. Data were analyzed for differences from preceding
baseline, during intervention, and during the two periods of
mental stress testing. Analyses of variance with repeated mea-
sures were used to compare treatment effects and time and post
hoc comparisons, using Tukeys Honestly Signifcant Difference
test, were used for signifcant between-group and within-group
comparisons. The level of signifcance was set at 0.05.
RESULTS
CharacteristicsofSubjects
Twenty-six healthy volunteers responded to the advertise-
ments and e-mail recruitment. One of them was excluded due to
previous exposure to refexology. Twenty-fve participants were
randomly allocated into two groups. Seven males and six females
with a mean age of 27.08 6.32 years were allocated to the refex-
ology group. Six males and six females with a mean age of 26.76
5.53 years were allocated to the control group. There was no
signifcant difference in demographics between the groups (P >
.05). There were no dropouts during the study, and no adverse
effects were reported.
ExperimentalProflesofAllOutcomes
During the 4-minute periods of mental stress, HR, SBP, and
DBP were signifcantly increased (P<.05) relative to the baseline
(average of baseline minute 4 and minute 5). This increase was
greater during the frst phase of mental stress testing than the
second phase of mental stress testing that occurred after the
intervention. The profile for DBP obtained at each minute
throughout the experiment is shown in Figure 2. Profles for HR
and SBP were similar.
ComparisonoftheEffectsofRefexologyandControlon
ResponsestoMentalStress
The second baseline period was lower than the frst base-
line; therefore, comparison of the effects of refexology and con-
trol on responses to mental stress was analyzed using the change
in HR and BP from the preceding baseline (average values at
minute 4 and minute 5 baseline). The average changes in HR
and BP over the 4 minutes of induced stress from preceding
baseline are shown in Table 1. There were signifcant reductions
in SBP (22%; P = .03) and in DBP (26%; P = .01) during mental
stress following refexology compared to the stress period prior
to intervention. In contrast, there was a 10% reduction in SBP (P
= .03) but a 5% increase in DBP (P = .67) during the period of
mental stress following the control intervention compared to
results obtained during mental stress prior to this intervention.
However, there were no signifcant differences between refexol-
ogy and control groups.
ParticipantsPerceptionofTaskDiffcultyofMentalStress
There were no signifcant differences in perceived diffculty
between the two mental stress tasks or between the refexology
and control groups as to the perceived difficulty within each
stress task. The perceived diffculty values (meanSD) were 1.23
0.6 (refexology group) and 1.25 0.97 (control group) for the
color word test and 1.92 1.19 (refexology group) and 1.25
0.97 (control group) for the mental arithmetic test.
Mental Mental
Baseline Stress Recovery Intervention Baseline Stress Recovery
5 min 4 min 10 min 20 min 5 min 4 min 5 min

Color word test or
mental arithmetic
Color word test or
mental arithmetic
1. Reflexology to the
ANS-related points
2. Control-touch
HR and BP continuously recorded every minute
FIGURE 1 Experimental Protocol
Abbreviations: ANS, autonomic nervous system; HR, heart rate; BP, blood pressure.
26 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 35 Refexology and the Autonomic Nervous System
BlindingEffciency
Most of the participants allocated to receive reflexology
treatment (53.8%) said dont know when asked which experi-
mental group they were in, while most of the participants in the
control group (66.7%) guessed control (Table 2). The blinding
index was 0.15 (95% CI, 0.03-0.46) for the refexology group and
0.5 (95% CI, 0.22-0.78) for the control group.
PowerAnalysis
The current data were used to calculate the numbers required
to detect signifcant differences for DBP between groups. Using a
within-group standard deviation of 7.1, a minimum difference
between groups of 2.6, alpha of 0.05, and power at 90%, a total of
180 participants per group would be required to detect signifcant
changes between groups.
TABLE 1 Average Increase in Heart Rate and Blood Pressure During 4-minute Stress Test
Intervention Outcomes
AverageIncrease
FromBaseline
%ChangePreintervention
toPostintervention 95%CI
Refexology HR (BPM) Preintervention 10.79
Postintervention 8.54 20.8% decrease 1.2%-42.9%
SBP (mmHg) Preintervention 9.81
Postintervention 7.62 22.3% decrease 0.3%-45%
DBP (mmHg) Preintervention 8.31
Postintervention 6.16 25.9% decrease 2.1%-49.7%
Control HR (BPM) Preintervention 11.40
Postintervention 9.15 19.9% decrease 2.8%-42.3%
SBP (mmHg) Preintervention 8.58
Postintervention 7.75 9.7% decrease 7.1%-26.4%
DBP (mmHg) Preintervention 8.96
Postintervention 9.44 5.4% increase 7.4%-18.1%
The % change in HR and BP during the stress test following intervention as compared to the stress test prior to intervention is shown along with confdence intervals.
Abbreviations: CI, confdence interval; HR, heart rate; BPM, beats per minute; SBP, systolic blood pressure; DBP, diastolic blood pressure.
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Stress
Control
Stress
Reflexology DBP
90
85
80
75
70
65
60
Reflexology
r
e
s
t
3
r
e
s
t
1
r
e
s
t
5
s
t
r
e
s
s
2
s
t
r
e
s
s
4
r
e
c
o
v
2
r
e
c
o
v
4
r
e
c
o
v
6
r
e
c
o
v
8
r
e
c
o
v
1
0
c
a
m
2
c
a
m
4
c
a
m
6
c
a
m
8
c
a
m
1
0
c
a
m
1
2
c
a
m
1
4
c
a
m
1
6
c
a
m
1
8
c
a
m
2
0
r
e
s
t
2
r
e
s
t
4
s
t
r
e
s
s
1
s
t
r
e
s
s
3
r
e
c
o
v
1
r
e
c
o
v
3
r
e
c
o
v
5
Time (min)
FIGURE 2 Profles of Diastolic Blood Pressure Responses to Mental Stress and Refexology or Control Intervention
*Signifcant difference from baseline (average of min 4 and 5) at P < .05
27 Summer 2011
36 ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 Refexology and the Autonomic Nervous System
DISCUSSION
Results from this study indicate that a larger trial would
require 180 participants in each arm in order to have the required
power to demonstrate signifcant changes in DBP in participants
under stress following refexology. This study also demonstrated
the feasibility of conducting a methodologically rigorous control-
led study under experimental conditions using healthy volun-
teers. Recruitment was successful as the required numbers were
randomized into the study. HR, SBP, and DBP increased signif-
cantly from baseline during both of the mental stress indicating
that these tests are appropriate to use under experimental condi-
tions. In addition, all participants self-reported the level of per-
ceived task diffculty using the standard 5-point scale. There was
no difference between refexology and control group, which con-
frmed that the perceived task diffculty did not infuence the
results between groups.
The blinding index was calculated from the method demon-
strated by Bang et al,
23
which was scaled to an interval of 1 to 1, 1
being complete lack of blinding, 0 being consistent with perfect
blinding, and 1 indicating opposite guessing which may be relat-
ed to unblinding. From the results, the blinding index of the refex-
ology group was 0.15 (95% CI, 0.03-0.46) and the control was 0.5
(95% CI, 0.22-0.78), indicating that the blinding may not have been
completely successful for the control intervention. It is diffcult to
defne what an appropriate comparable intervention for refexolo-
gy studies would be. Many studies have demonstrated that sham
interventions produced some effect. Frankel used foot massage for
a comparable intervention to reflexology and found that there
were no signifcant differences between refexology and foot mas-
sage because the foot massage also induced some therapeutic
effects.
5
Hughes et al in a trial comparing refexology and foot mas-
sage on pain in people with multiple sclerosis also found signif-
cant pain reduction in both group.
25
It was suggested by this group
that sham foot massage might also stimulate the refex points asso-
ciated with refexology and therefore have some therapeutic effect.
In a review of studies published on reflexology, kunz and
kunz discuss the problem of fnding an appropriate control for
refexology trials.
26
The authors report 14 studies comparing refex-
ology to a sham refexology treatment (use of nonrelated points)
and 11 studies comparing refexology and foot massage for various
conditions. The results of these trials were mixed, leading to the
general conclusion that foot massage is not a reliable control pro-
cedure for refexology. Therefore for the present study, the control
intervention used a simple touch on the participants heels, which
did not stimulate and refex points. This form of control was suc-
cessful, because although there was some unblinding in this group,
the intervention did not attenuate HR and DBP responses during
mental stress. The study therefore effectively controlled for thera-
pist interaction and touch without the stimulation of refex points.
Refexology moderated BP as the increase in BP observed dur-
ing the frst period of stress testing was signifcantly reduced by
22% to 25% in this group, whereas a small reduction in SBP (10%)
and an increase of 5% in DBP were observed in the control group.
Similar results were reported by McVicar et al, who with a sample
size of 52 demonstrated reductions in SBP and pulse rate following
refexology.
27
However, as with the present study, McVicar et al did
not fnd any differences between intervention and control groups.
In McVicars study, participants received refexology for 60 min-
utes. In the current experimental study, the effect of 20 minutes of
refexology intervention was investigated. This methodology was
based on a previously published study by Middlekauff et al, who
demonstrated reduced BP following 20 minutes of acupuncture.
18

It may be that a longer treatment period in our experimental
design would produce stronger results and should therefore be
considered in any future investigation. Indeed, refexologists stress
the importance of treating a patient holistically with a full treat-
ment rather than limiting an intervention to specifc points for a
specifc condition.
28
kunz and kunz suggest that frequency and
duration of treatment may vary from condition to condition.
26

They reference multiple studies that demonstrate a reduction in
pain or anxiety following one short refexology session; however,
evidence suggests that other refexology treatments (such as for
asthma control or cholesterol reduction) require daily sessions of
40 to 50 minutes over several days to demonstrate any effect. In
addition, the pressure or intensity of the treatment may be a fac-
tor.
26
The McVicar study researchers applied only a light pressure,
27

as this group had previously demonstrated effectiveness of a light
pressure within a cancer patient population. It may be that a mod-
erate pressure is required for optimal stimulation of refex points,
although there is no robust evidence to support this.
26

Refexology has been shown to reduce anxiety and stress in
various populations.
7-10
The mechanism by which this occurs may
be in modulating ANS function.
5,6,27
The current study demon-
strates the feasibility of conducting experimental studies in the
area and indicates that BP may be modulated by refexology; how-
ever, further fully powered trials using suggested modifcations to
the protocol such as longer treatment time are required to confrm
these fndings.
TABLE 2 Blinding Index of Refexology and Control Group
Assignment
Response
Total BI 95%CI Complementarymedicine Control Dontknow
Refexology 4 (30.8%) 2 (15.4%) 7 (53.8%) 13 (100%) 0.15 0.03-0.46
Control 2 (16.7%) 8 (66.7%) 2 (16.7%) 12 (100%) 0.5 0.22-0.78
Total 6 10 9 25
Abbreviations: BI, blinding index; CI, confdence interval.
28 Summer 2011
ALTERNATIVE THERAPIES, may/jun 2011, VOL. 17, NO. 3 37 Refexology and the Autonomic Nervous System
CONCLUSION
This study has demonstrated the feasibility of conducting
an experimental study on the effect of refexology in stress using
BP as the primary outcome measure. Results from such a study
would address the lack of high-quality evidence for the physio-
logical effects of refexology.
Acknowledgments
We gratefully acknowledge Dr Jongbae Park for his guidance on the protocol for this study.
REFERENCES
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diagnostic tool. ComplementTherClinPract. 2005;11(1):58-64.
2. Mackereth PA, Tiran D. ClinicalRefexology:AGuideforHealthProfessionals. Edinburgh,
Scotland: Churchill Livingstone; 2002.
3. Ernst E, Pittler MH, Wider B. The Desktop Guide to Complementary and Alternative
Medicine:AnEvidence-BasedApproach. 2nd ed. Philadelphia, PA: Mosby; 2006.
4. Dougans I. Reflexology: The 5 Elements and Their 12 Meridians. London, England:
Thorsons; 2005.
5. Frankel BS. The effect of refexology on baroreceptor refex sensitivity, blood pressure
and sinus arrhythmia. ComplTherMed. 1997;5(2):80-84.
6. zhen LP, Fatimah SN, Acharya R, Tam kD, Joseph kP. Study of heart rate variability
due to refexological stimulation. ClinAcupunctOrientMed. 2003;4(4):173-178.
7. Stephenson NL, Weinrich SP, Tavakoli AS. The effects of foot refexology on anxiety
and pain in patients with breast and lung cancer. OncolNursForum. 2000;27(1):67-72.
8. Lee YM. Effect of self-foot refexology massage on depression, stress responses and
immune functions of middle aged women [article in korean]. Taehan Kanho Hakhoe
Chi. 2006;36(1):179-188.
9. Hodgson NA, Andersen S. The clinical effcacy of refexology in nursing home resi-
dents with dementia. JAlternComplementMed. 2008;14(3):269-275.
10. Atkins RC, Harris P. Using refexology to manage stress in the workplace: a preliminary
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11. Steptoe A, Vgele C. Methodology of mental stress testing in cardiovascular research.
Circulation. 1991;83(4 Suppl):II14-II24.
12. Teixeira-Silva F, Prado GB, Ribeiro LC, Leite JR. The anxiogenic video-recorded Stroop
Color-Word Test: psychological and physiological alterations and effects of diazepam.
PhysiolBehav. 2004;82(2-3):215-230.
13. Waters AJ, Sayette MA, Franken IHA, Schwartz JE. Generalizability of carry-over
effects in the emotional Stroop task. BehavResTher.2005;43(6):715-732.
14. Aboussafy D, Campbell TS, Lavoie k, Aboud FE, Ditto B. Airflow and autonomic
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Psychophysiol. 2005;57(3):195-201.
15. Reims HM, Sevre k, Fossum E, Mellem H, Eide Ik, kjeldsen SE. Adrenaline during
mental stress in relations to ftness, metabolic risk factors and cardiovascular respons-
es in young men. BloodPress. 2005;14(4):217-226.
16. Graham RC, Smith NM, White CM. The reliability and validity of the physiological
cost index in healthy subjects while walking on 2 different tracks. Arch Phys Med
Rehabil. 2005;86(10):2041-2046.
17. Bhambhani Y, Maikala R. Gender differences during treadmill walking with graded loads:
biomechanical and physiological comparisons. EurJApplPhysiol. 2000;81(1-2):75-83.
18. Middlekauff HR, Yu JL, Hui k. Acupuncture effects on refex responses to mental stress
in humans. AmJPhysiolRegulIntegrCompPhysiol. 2001;280(5):R1462-R1468.
19. Norman L, Cowan T. TheRefexologyHandbook:ACompleteGuide. Bath, England: Bath
CPI; 1988.
20. Stroop JR. Studies of interference in serial verbal reactions. JExpPsychol. 1935;18:643-662.
21. Ross AE, Flaa A, Hieggen A, Reims H, Eide Ik, kjeldsen SE. Gender specifc sympa-
thetic and hemorrheological responses to mental stress in healthy young subjects.
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22. Callister R, Suwarno NO, Seals DR. Sympathetic activity is infuenced by task diffculty
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24. Newcombe RG. Two-sided confdence intervals for the single proportion: comparison
of seven methods. StatMed. 1998;17(8):857-872.
25. Hughes CM, Smyth S, Lowe-Strong AS. Refexology for the treatment of pain in people
with multiple sclerosis: a double-blind randomised sham-controlled clinical trial. Mult
Scler. 2009;15(11):1329-1338.
26. kunz B, kunz k. Evidence-Based Refexology for Health Professionals and Researchers
[e-book]. London, Uk: Dorling kindersley; 2009. Available from: kindle books.
Accessed August 21, 2009.
27. McVicar AJ, Greenwood CR, Fewell F, DArcy V, Chandrasekharan S, Alldridge LC.
Evaluation of anxiety, salivary cortisol and melatonin secretion following refexology
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29 Summer 2011
What is self-care?
Part 2 of 2
(continued from Summer 2011 issue)
Julie Barlow
Professor of Health Psychology, Coventry University
Effectiveness of the CDSMC
In the US, randomised controlled trials (RCT) have found the
CDSMC to be effective in improving self-efficacy, use of self-
management techniques, improving physical and psychological
health status, and reducing health care utilisation among
participants with arthritis, lung disease, heart disease and stroke
(Lorig et al. 1999). Griffiths, Foster, Ramsay et al. (2007)
reviewed four UK randomised controlled trials (RCTs) examining
the effectiveness of the CDSMC (Kennedy, Reeves, Bower
et al. 2007; Griffiths, Motlib, Azad et al. 2005) and the related
Arthritis Self-management Programme (ASMP) (Buszewicz,
Rait, Griffin et al. 2006; Barlow, Turner, & Wright 2000). The
ASMP is very similar to the CDSMC but has a focus on arthritis.
Griffiths et al. found that self-efficacy improved in all studies,
psychological distress improved in three studies (Kennedy et al.
2007; Buszewicz et al. 2006; Barlow et al. 2000) and generic
quality of life improved in one study (Kennedy et al. 2007) based
on intent-to-treat analysis. However, effect sizes were small to
moderate and healthcare utilisation remained unchanged. The
review focused on a limited range of outcomes and thus did
not report effectiveness for outcomes such as positive affect
(Barlow et al. 2000), energy (Kennedy et al. 2007), exercise and
relaxation (Kennedy et al. 2007, Barlow et al. 2000), cognitive
symptom management (Barlow et al. 2000; Kennedy et al. 2007)
and communication skills (Barlow et al. 2000). The study by
Kennedy, Reeves, Bower et al., (2007) was a national evaluation
of the CDSMC which also assessed cost-effectiveness showing
that the intervention produced a small reduction in costs. The
authors report that valuing a quality adjusted life year at 20,000
results in a 70% probability of the CDSMC being effective
leading to the conclusions that the CDSMC may be a cost-
effective alternative to usual care (Richardson, Kennedy, Reeves
et al., 2007). A related paper by Reeves, Kennedy, Fullwood et al.,
(2008) focused on predicting who benefited from the CDSMC,
and showed that participants with lower self-efficacy and health-
related quality of life at baseline had more positive outcomes as
did younger participants who benefited much more than their
older counterparts. The authors conclude that the CDSMC will
have positive outcomes in a wide variety of people although
it may be particularly beneficial for younger people and those
lacking in confidence or not coping well with their LTHC.
Two RCTs examined the effectiveness of the CDSMC focusing
on specific target groups (i.e. Myocardial Infarction (MI) patients
and people with multiple sclerosis). A RCT of the CDSMC
(Barlow, Turner, Edwards & Gilchrist, 2009), focused on people
with Multiple Sclerosis (MS) and recruited nationally. The
CDSMC was open to anyone with a LTHC, thus, participants
with MS learned alongside participants with conditions such
as asthma, diabetes or heart disease. Results showed that at
4-months, the CDSMC was effective in terms of self-efficacy
and depression and although effect sizes were small, these
improvements were maintained at 12-months. The study was
designed to examine the characteristics of people with MS who
had expressed an interest in the Course and received information
about it but then decided not to attend. This group of informed
non-attenders were invited to take part in the study and formed
a Comparison Group. Compared to the Intervention Group, the
informed non-attenders had longer disease duration, were less
anxious, experienced less psychological impact, and fatigue at
baseline. A nested qualitative study based on interviews (Barlow,
Turner & Edwards, 2009) revealed that MS participants compared
themselves to other CDSMC attendees with similar symptoms
(but not necessarily the same diagnosis) and drew inspiration
and hope from those perceived to be coping well. Thus, the use
of social comparisons across and within diagnostic groupings
can be beneficial, suggesting that generic self-management
interventions do not compromise the opportunity for making
relevant informative comparisons. Participants learned new
self-care techniques, such as goal setting, that were catalysts for
mastering new skills. Achieving small, realistic goals enhanced
self-efficacy and led to feelings of empowerment and positive
outlook. As in earlier studies, the self-care competencies gained
by participants were generalised to other situations not directly
connected to MS, such as parenting, social activities and work.
Equally, although participants felt more in control of their MS,
many reported that they had not learned any new information or
skills; rather the benefits of the CDSMC were viewed in terms of
reinforcing and honing existing competencies to further improve
quality of life. Importantly, participants had learned to manage
illness around their lives as opposed to managing their lives
around their illness.
The effectiveness of the CDSMC for MI patients was examined
in a RCT (n = 192, mean age 65.9 years and a median duration of
one year since the first MI) (Barlow, Turner & Gilchrist, 2009).
This study may be of particular interest to readers of this chapter
given that all participants had completed Cardiac Rehabilitation
within the previous two years. The CDSMC was run specifically
for the MI patients and was delivered by two lay tutors who
themselves had experienced an MI. Analysis revealed no
statistically significant differences between the groups although
a pattern of small improvements among the Intervention Group
on self-efficacy, anxiety, depression and cognitive symptom
management was observed. It should be noted that this sample
30 Summer 2011
comprised mainly men (72%) and duration since the first MI
was relatively short (i.e. median of one year), which contrasts
with most other studies of lay led self-management where the
majority of participants are women and mean disease duration
tends to be ten years or more. In addition, participants in this
study were relatively high in self-efficacy and self-management
competencies at the start of the study as may be expected among
MI patients who have recently completed cardiac rehabilitation.
Interviews with a sub-sample of intervention group participants
showed that they perceived an overlap between the CDSMC
and cardiac rehabilitation particularly around diet and exercise.
However, they viewed cardiac rehabilitation as being more about
instruction whereas the CDSMC was more about discussion,
mutual support, and goal setting.
Well, the rehab is different really because the rehab is
mainly exercising. The self-management course is the fact
that, basically youre coming back to setting yourself a goal
to do and get on with it.
The self-management course was better because you got to
talk to people about their problems. At the cardiac rehab, it
was nurses standing in front talking about things.

The action planning [on the CDSMC] made me get up and
do some exercise. I was going to ride my exercise bike which
Ive never got round to using. And I set myself a plan to do
5 minutes a day on that. And now I go out and for a walk ...
and I have joined an exercise class.
Participants positively reappraised their situation as being more
manageable and believed that there is life after a heart attack.
Some were coping better after the CDSMC as they now realised
that they were not on their own. A few participants felt that that
had not improved or got worse in terms of MI-related problems
but nonetheless they felt a bit more positive. It appears that there
are few additional benefits from CDSMC attendance for this
target group who had recently completed cardiac rehabilitation
and had comparatively short disease duration. Interestingly, the
proportion of women (28%) in this study was greater than the
proportion of women attending cardiac rehabilitation, which is
reported to be 11-20% of those eligible (Barber, Stommel, Kroll et
al., 2001). This suggests that shifting the focus from rehabilitation
to self-care may be more attractive to women.
Further examples of self-care approaches with a community
perspective
This section provides some examples of other approaches to
community self-care remaining with the topic of heart disease
as an exemplar. The Heart Manual is a facilitated, home-based,
6-week programme for post-MI patients and is set in a cognitive-
behavioural framework. The programme comprises written
materials, a workbook to record progress and 2 audio tapes. Topics
covered include simple exercises, pacing activities, advice about
risk factors and lifestyle change, relaxation, stress management
and vignettes of patients experiences. Trained healthcare
professionals work with patients and their carers over the course
of the programme. A RCT showed that the incidence of clinical
anxiety was reduced by 50% in the Heart Manual group compared
to a control group who received standard care, information about
MI and lifestyle change, and informal counselling (Lewin,
Robertson, Cay et al. 1992). Patients who were clinically anxious
or depressed at discharge from hospital showed the greatest
improvement. In addition, there was a reduction in GP visits in
the following 12 months and a reduction in admission to hospital
in the first 6 months following discharge. A later study by Linden,
(1995) reported similar findings although sample size was small.
A comparison between the Heart Manual and hospital-based CR
showed no clinically or statistically significant differences (Jolly,
Taylor, Lip et al. 2007). However, Heart Manual participants who
failed to adhere to exercise attributed their lack of motivation to
difficulties in exercising on their own at home suggesting that
some form of group support may have been beneficial. Further



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education with heart-full compassion, warmth and humor.


If you feel that you would be a compliment to our team of
alternative health practitioners, please contact:


Sheryl Watson:

(780) 488-3482 or
info@sacreddiva.ca
Sacred Diva Healing Centre,
10830 124 street,
Edmonton, AB T5M 0H3.
www.sacreddiva.ca
31 Summer 2011
manuals have been developed for Coronary Artery Disease
and Revascularisation (see The Heart Manual, http://www.
theheartmanual.com).
Increasing and maintaining physical activity levels is one
important aspect of self-care included in Cardiac Rehabilitation
(CR). Following CR, maintenance of physical activity over time,
can be difficult. A range of interventions have been designed
and tested to help participants maintain physical activity over
time. Cognitive interventions are based on techniques such as
self-efficacy enhancement, management of barriers to physical
activity and problem solving. Behavioural interventions are
based on self-monitoring, prompting, goal setting and feedback
and some interventions use a combination of cognitive and
behavioural techniques. A systematic review of such interventions
following CR found that whereas cognitive interventions showed
inconsistent findings, behavioural and combination interventions
had consistent outcomes and positive findings.
Increasingly, electronic technology is being incorporated in to
self-care interventions. Such technology enables virtual on-line
communities to be formed with the aim of providing group support
in a similar manner to the face-to-face, group-based approach
discussed above (i.e. the CDSMC). The impact of adding on-line
community features to an internet -mediated walking program was
examined among people who were overweight or had coronary
artery disease or type II diabetes (Richardson , Buis, Janney et
al. 2010). An RCT showed that although there was no difference
in terms of increased daily step count, participant attrition was
reduced among the on-line group. In addition, participants with
low baseline social support made greater use of the on-line features
than those with high baseline social support. An alternative use of
technology is where data is transmitted via telephone lines thus
enabling electronic communication between individuals in their
own homes and their clinical team (i.e. telehealth). The influence
of telehealth on self-management was examined among patients
with heart failure (Dansky, Vasey & Bowles 2008). An RCT found
that self-management behaviours were predicted by confidence
and that participants using video-based telehealth demonstrated
greater gains in confidence compared with control participants
who received routine home visits only.
Further examples of self-care in rehabilitation can be found in
other chapters of this Encyclopedia covering conditions such as
asthma, chronic obstructive pulmonary disease, fibromyalgia,
and myalgic encephalomyelitis/chronic fatigue syndrome.
Conclusions
The terms self-care and self-management tend to be used
interchangeably. Self-care has been used to refer to specific
rehabilitation strategies such as a particular exercise regime for
a specific condition. However, broader definitions of self-care
include not only management of symptoms and treatment but
also management of psychosocial consequences and lifestyle
changes. There is an increasing range of interventions being
developed to enhance self-care using cognitive, behavioural,
or cognitive-behavioural frameworks. Given the importance of
social support for encouraging and maintaining behaviour change,
many interventions involve group support either in face-to-face
group settings or via on-line communities. The advent of generic
courses, such as the CDSMC, provides an additional resource for
those people who require additional support or further guidance in
techniques such as goal setting, communication with family and
healthcare professionals or managing psychosocial consequences
of their conditions.
References
The following References are from the What is Self Care article found on
pages 13, 14, 15:
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Barber K, Stommel M, Kroll J, et al. 2001. Cardiac rehabilitation for community-
based patients with myocardial infarction: Factors predicting discharge
recommendations and participation. Journal of Clinical Epidemiology 54:1025-
30.
Barlow J. 2001. How to use education as an intervention in osteoarthritis. Best
Practice & Research Clinical Rheumatology 15(4):545-58.
Barlow JH, Edwards R, Turner AP. 2009. The experience of attending a lay-led,
chronic disease self-management programme from the perspective of participants
with Multiple Sclerosis. Psychology & Health 24(10):1167-1181.
Barlow JH, Turner AP, Edwards R, Gilchrist M. 2009. A randomised controlled
trial of lay-led self-management for people with multiple sclerosis including a
comparison with those who chose not to attend the intervention. Patient Education
& Counseling 77:81-89. doi 10.1016/j.pec.2009.02.
Barlow JH, Turner AP, Gilchrist M. 2009. A randomised controlled trial of lay-
led self-management for Myocardial Infarction patients who have completed
cardiac rehabilitation. European Journal of Cardiovascular Nursing 8:293-301.
doi 10.1016/j.ejcnurse.2009.02.002.
Barlow JH, Turner AP, Wright CC. 2000. A randomised controlled study of the
Arthritis Self-Management Programme in the UK. Health Education Research
15(6):665-680.
Benz Scott LA, Ben-or K, Allen JK. 2002. Why are women missing from
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91.
32 Summer 2011
Bush D, Ziegelstein R, Tayback M, Richter D, Stevens S, Zahalsky H, Fauerbach
J 2001. Even minimal symptoms of depression increase mortality risk after acute
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Buszewicz M, Rait G, Griffin M, Nazareth I, Patel A, Atkinson A, Barlow J
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Bradley LA. 1989. Adherence with treatment regimens among adult rheumatoid
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Damen S, Mortelmans D, Van-Hove E. 2000. Self-help groups in Belgium: their
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manage heart failure. Research in Gerontological Nursing 1(1):25-32. doi:
10.3928/19404921-20080101-01.
Department of Health. 2005. Self-Care A Real Choice. DH: London. Online:
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NHS and social care model to support local innovation and integration. DH:
London.
Deyo RA. 1982. Compliance with therapeutic regimens in arthritis: issues, current
status, and a future agenda. Seminars in Arthritis and Rheumatism 12(2):233-244.
Dickens C, McGowan L, Clark-Carter, D, Creed F. 2002. Depression in
rheumatoid arthritis: a systematic review of the literature with meta-analysis.
Psychosomatic Medicine 64(1):52-60.
Gibson P, Powell H, Coughlan J, et al. 2002. Limited (information only) patient
education programs for adults with asthma. Cochrane Database of Systematic
Reviews CD001005.
Griffiths C, Foster G, Ramsay J, Eldridge S & Taylor S. 2007. How effective are
expert patient (lay led) education programmes for chronic disease? BMJ, 334,
1254-1256.
Griffiths C, Motlib J, Azad A, Ramsay J, Eldridge S, Khanem R, Munni R, Garrett
M, Barlow J, Turner A, Feder G. 2005. Randomised controlled trial of a lay-led
self-management programme for Bangladeshi patients with chronic disease: A
randomised controlled trial. British Journal of General Practice 55:831-837.
Janssens A, van Doorn P, de Boer J, van der Meche F, Passchier J and Hintzen R.
2003. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety and
depression of patients and partners. Acta Neurologica Scandinavica 108:389-395.
Jolly K, Taylor R, Lip GY, Greenfield S, Raftery J, Mant J, Lane D, Jones M,
Lee KW, Stevens A. 2007. The Birmingham Rehabilitation Uptake Maximisation
Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation
in a multi-ethnic population: cost-effectiveness and patient adherence. Health
Technology Assessment 11(35):1-118.
Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Richardson G, Gardner C,
Gately C, Rogers A. 2007. The effectiveness and cost effectiveness of a national
lay-led self care support programme for patients with long-term conditions: a
pragmatic randomised controlled trial. Journal of Epidemiology and Community
Health 61(3):254-61.
Lewin B, Robertson IH, Cay EL, Irving JB, Campbell M. 1992. Effects of self-
help post-myocardial-infarction rehabilitation on psychological adjustment and
use of health services. Lancet 25;3398800.:1036-40.
Linden B. 1995. Evaluation of a home-based rehabilitation programme for
patients recovering from acute myocardial infarction. Intensive and Critical Care
Nursing 11(1):10-9.
Lorig K, Holman H. 1993. Arthritis self-management studies: a twelve-year
review. Health Education Quarterly 20(1):17-28.
Lorig K, Holman H. 2003. Self-management Education: History, definition,
outcomes and mechanisms. Annals of Behavioral Medicine 26(1):1-7.
Lorig K, Sobel D, Stewart A, Brown B, Bandura A, Ritter P, Gonzalez V, Laurent D,
Holman H. 1999. Evidence Suggesting That a Chronic Disease Self-Management
Program Can Improve Health Status While Reducing Hospitalization: A
Randomized Trial. Medical Care 37(1)5-14.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. 2007. Depression,
chronic diseases, and decrements in health: results from the World Health Surveys.
Lancet 370(9590):851-858.
National Health & Hospitals Reform Commission Final Report: A Healthier
Future for All Australians. June 2009.
Patten SB, Beck CA, Williams JV, Barbui C, Metz LM. 2003. Major depression in
multiple sclerosis: a population-based perspective. Neurology 61, 1524-7.
Reeves D, Kennedy A, Fullwood C, Bower P, Gardner C, Gately C, Lee V. 2008.
Predicting who will benefit from an Expert Patients Programme self-management
course. British Journal of General Practice 58(548):198-203.
Richardson CR, Buis LR, Janney AW, Goodrich DE, Sen A, Hess ML, Mehari
KS, Fortlage LA, Resnick PJ, Zikmund-Fisher BJ, Strecher VJ, Piette JD. 2010.
An online community improves adherence in an internet-mediated walking
program. Part 1: results of a randomized controlled trial. Journal of Medical
Internet Research 12(4):e71.
Richardson G, Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Gardner C,
Gately C, Rogers A. 2008. Cost effectiveness of the Expert Patient Programme
(EPP) for patients with chronic conditions. Journal of Epidemiology and
Community Health 62:361-367.
Sheeran P, Abraham C. 1995. The Health Belief Model. In: M Connor, P Norman,
editors. Predicting Health Behaviour. United Kingdom: Open University Press.
p. 23-61.
Van Hecke A, Grypdonck M, Defloor T. 2009. A review of why patients with leg
ulcers do not adhere to treatment. Journal of Clinical Nursing 18(3):337-49.
Wallston KA. 1992. Hocus-Pocus, the focus isnt strictly on locus: Rotters social
learning theory modified for health. Cognitive Theory and Research 16(2):183-199.
World Health Organisation. 2009. Self-care in the Context of Primary Health
Care. Report of the Regional Consultation, Bangkok, Thailand.
33 Summer 2011


Course
Listings


To advertise, contact Nadine:
888-711-7701 or nnoseworthy@nhpcanada.org

Please note that not all courses listed are recognized by NHPC,
but may still be eligible for NHPC Continued Competency Credits.

For a complete list of recognized modalities and programs, as well as
additional course listings, please visit www.nhpcanada.org







Academy of Reflexology - Have Feet Will Travel
Specializing in Reflexology and Chair Massage, Private or Semi Private courses are available. If you have a
group out of town, give us a call; arrangements can be made for our feet to travel to you.
Training- Accredited with NHPC for Certification as well as Continued Competency Credits.
Contact: Debra Cookson Phone: 780-235-3720
Email: reflexacademy@yahoo.ca Website: www.reflexacademy.com

Thai Style Massage


LevelI - Mondays 8:30 am - 5:30 pm
September 26, 2011 - October17, 2011
Cost: 625.00 plus GST

Level II - Wednesday Oc 19-Saturday Oct.22, 2011 Inclusive 8:30 am - 5:30 pm
Cost: 625.00 plus GST

In order to receive a certificate in Thai Style massage you must successfully complete both levels I & II.
If booked and paid for together cost for both levels is 1100.00 plus GST

Thai Foot Reflexology/Massage
September 26 & 27, 2011 9am - 4pm
Cost: 325.00 plus GST

If taken with the Level I & 2 Thai Style Massage course - Thai Foot Reflexology/Massage
ONLY 295.00 plus gst

Professional Reflexology
Pure & Simple
A) Full Days - Sept. 28, 2011 - Oct 1, 2011
9 am -5 pm

Or

B) Evenings - 5 pm -9 pm
Oct 5/6, 12/13, 26/27 & Nov. 16 , 2011

Fees for Foot Reflexology Pure & simple by itself is:
Cost: 695.00 plus GST

Hand/ Ear and Facial Reflexology portions of the Professional course will be decided with student input.
Price for Professional Course:

Cost 1450.00 plus 250.00 administration fee plus GST.
34 Summer 2011










BACK to BASICS Anatomy,
Physiology, & Chemistry
Correspondence Program

LIVING ENERGY
Natural Health Studies
This program is designed to give students the basics of Anatomy, Physiology, and Chemistry especially in
relation to Nutrition. This course is divided up into Four Modules:

Module 1: Chemistry basics
Module 2: Introduction to Anatomy & Physiology.
Module 3 & 4: The body systems.

ALL students are required to be proficient in these subjects. Therefore the Back to Basics course is an
essential component to the Wholistic Nutrition Program, especially for those students with limited or no
prior learning in these subjects. Exemption from Back to Basics may be granted if proof of prior study
can be given; or if you are currently registered as a massage therapist.
COST: $190 (plus GST) PER module (or)
$650 (plus GST) if all 4 modules are purchased at once.
Contact: Living Energy for more details at (780) 892-3006 (local call from Edmonton),
or visit our website www.livingenergy.ca





Five Elements Acupressure
Program

PCTIA Registered
NHPC Recognized
JSDF Approved.


This stellar 325 hour diploma program is an ideal mix of distance learning, classroom training and
externship that allows the out-of-town learner to partake of training while continuing their employment
and living in their own community. Blends the theory of Worsley Five Elements, the acupressure
technique of Jin Shin Do, the theory of Chinese acupuncture, the approaches of Neurolinguistic
Programming and Hakomi along with other related therapies to provide the practitioner with the skills to
work effectively with wide range of symptoms and issues, presented by their clients.

Dates: Entry level points are:
1) Basic Jin Shin Do (September 26, 2011) or
2) Distance Learning (start today!)
Fee: $4,498.50 (instalment payments may be arranged)
Recognized: By NHPC

For information packages contact the Canadian Acupressure College, 1-877-909-2244, e-mail:
cai@islandnet.com, website: www.acupressureshiatsuschool.com, Applications and payment may be made
on-line with Visa, MasterCard or Amex.



Canadian
Reflexology
School

Are you ready to grow your practice and your bottom line?

Experience the CRS difference! At Canadian Reflexology School we offer the best of both worlds.
Using an ideal mix of home study for the theory component and a comprehensive classroom
handson for the practical component, we provide flexibility around your schedule
and have the perfect formula for success.

Our leading edge programs include:
Foot Reflexology
Hand Reflexology
Ear Reflexology
Our popular IN A BOX series
(Business tools designed to help you grow your business)

Canadian Reflexology School is dedicated to students embracing their goals
of working in the wellness industry. Programs are personalized, convenient,
staff supported and successfully takes you to your goals as easy as 1-2-3!

NHPC approved programs and recognized by the CMTBC

Request your Information Package Today!
Schedule a complimentary consultation call to answer your questions.

Alison Rippin, B.P.E., RCRT Owner Speaker at the NHPC 2011 April Conference
Phone: 250-727-3199 www.canadianreflexologyschool.com

35 Summer 2011


Rejuvenating Face
Massage Course



Through the Canadian Centre
of Indian Head Massage with
Debbie Boehlen

Courses are ongoing throughout Canada

This 2-day course teaches you the theoretical knowledge and techniques you will need to provide a
wonderfully relaxing Rejuvenating Face Massage treatment for your clients, friends and family.
Certification is available.

This course is eligible for Continued Competence Credits with the NHPC, and approved for CEUs/CECs
with RAC and numerous other Provincial Associations and Governing Bodies in your province. Please
check our website for details.

For course dates and locations please contact Debbie or visit our website:

www.indianheadmassagecanada.com
Tel: 905.714.0298
Email: debb@bell.net



The Practice-building
roadmap

90 days to success
Do nothing and attract all the clients you want

Presenter Patrick Hercus has had a full time practice in Spiritual Counselling since 1995.
For the last 13 years he has had a waiting list, with no advertising or networking.

This webinar will give therapists, practitioners and business people the skills and consciousness to easily
attract clients.

Learn why, when two people who have equal connections and education, one thrives and the other
doesn't.

Accessing your market is becoming more difficult and expensive. This course will lead you through
exercises to connect your passion and purpose so strongly that people are drawn to you.
Is it time for you to learn a new way to be successful?

Presenter Patrick Hercus has had a full time practice in Spiritual Counseling since 1995.
For the last 14 years he has had a waiting list, with no advertising or networking.

Contact: Patrick 1-888-300-7685
Website: www.goachieve.com (for further information and to register)
Hot Stone Massage: An
Ancient Healing Technique
for the Contemporary
Therapist

with
Sheryl Watson R.M.T.
Increase your massage practice by adding the ancient healing technique of hot stone massage. This 20
hour workshop with 10 independent practicums will incorporate the science of general hydrotherapy
principles, and the sacred art of applying a full body hot stone massage.

Friday, September 30, 2011 from 1:00 5:00
Saturday, October 1, and Sunday, October 2, 2011 from 9:00 6:00 each day

This workshop included a history of hot stone massage, benefits and properties of hot/cold stones,
general principles of geothermal hydrotherapy and corresponding indications, contra-indications, special
considerations and cautions, preparation for treatment, care and cleaning the stones, marketing strategies,
full body hot stone massage including vascular flushing, a spinal layout, chakra stones, revitalization
technique, facial and foot treatment.

Sheryl has been practicing massage therapy since 1995 and is currently a techniques instructor at
MacEwan College.

Pre-requisite: massage certificate.
Investment: $425.00 plus G.S.T.
Location: Edmonton

This workshop has been approved for 5 Continued Competency Credits with the N.H.P.C. and Provider
status has been approved. M.T.A.A. has approved this workshop for 20 primary continuing education
credits.

Sheryl Watson at (780)488-3482, or info@sacreddiva.ca
36 Summer 2011



Indian Head
Massage Course

Through the Canadian Centre of Indian Head Massage with Debbie Boehlen.
Courses are ongoing throughout Canada.

This weekend course will teach you all you need to be able to provide a wonderfully relaxing Indian Head
Massage treatment for your clients, friends and family. Certification is available.

This course is eligible for Continued Competence Credits with the NHPC, and approved for CEUs/CECs
with RAC and numerous other Provincial Associations and Governing Bodies in your province. Please
check our website for details.

For course dates and locations please contact Debbie or visit our website:

www.indianheadmassagecanada.com
Tel: 905.714.0298
email: debb@bell.net


Infant Massage Training (34 hours)


Dates: October 8 & 9, 2011 (Edmonton)
Investment: $390 +gst
Location: Canadian College of Massage & Wellness
West Edmonton at Wellness Within
Register: www.wellnesscollege.ca
780-489-7799 (Edmonton area)
1-877-489-7799 (Toll-free)

Description:

Canadian College of Massage & Wellness offers a unique and exciting Infant Massage class. Help mom,
help baby. Gain invaluable knowledge for all parents. In this 2-day training you will learn how to teach
Infant Massage classes and offer individual sessions to Parents, including:
Benefits
Contraindications and Guidelines
Infant Massage Techniques and Parent Routines
o Colic, Digestion & Teething
o Common Childhood Discomforts
o Massage and Stages of Growth
o Hydrotherapy Techniques
Attachment Parenting
Addressing Parent Concerns and Questions
Developing and Promoting your Class

*This course has been approved for CEUs as a Specialization course by the NHPC!


Jade Stone Massage

Two Day
Workshop

With Shelley Willis


By
Southwind Retreat and Spa
Experience the ancient healing power of Jade Stone Massage. The new Hot Stone massage treatment; Jade
massage is a therapeutic and lucrative addition to your treatments.

Jade Stone Benefits

*Promotes relaxation & vitality while releasing toxins and inflammation
*Fewer stones with alternating temperatures for deeper results
*Jade Stones are heated or chilled non-porous for easy cleaning

Workshop schedule visit www.southwindjade.com
Private workshops please inquire

To Register contact Shelley the jade diva
1-877-545-4433 / 250-390-0185 jadediva@shaw.ca
NHPC Credentialed for Massage Therapists, Accredited CEU'S & CCC

Shelley Killeen is an educator of Jade Stone Massage offering workshops, distributor of Southwind Jade
Massage Stones and owner/operator of Southwind Retreat & Spa located on Vancouver Island.
37 Summer 2011



Maternal Massage Training (34 hours)


Dates: November 12 & 13, 2011 (Edmonton)

Investment: $390 +gst

Location: Canadian College of Massage & Wellness
West Edmonton at Wellness Within

Register: www.wellnesscollege.ca
780-489-7799 (Edmonton area)
1-877-489-7799 (Toll-free)

Description:

Canadian College of Massage & Wellness brings you a comprehensive course on Pre & Postnatal Massage
for Massage Therapists. In this 2-day intensive training you will gain practical & hands-on knowledge in the
following:

Benefits of Maternal and Postpartum Massage
Contraindications and Guidelines to Maternal Massage
Special Circumstances
Emotional and Physical aspects of Pregnancy and Postpartum
Positioning, Supports and Materials
Techniques and the Stages of Pregnancy
Labour Massage
Postpartum Massage

After the weekend course, 10 practicum massages are required.

*This course has been approved for CEUs as a Specialization by NHPC & MTAA!



Advanced Muscle Therapy
Seminars

Cheryl Stephenson RMT, MSc., BPE
Red Deer, AB

Are you looking for continuing education seminars that will increase your confidence and competence as a
therapeutic massage professional? This advanced technique seminar series is value packed with the
practical skills you require to excel at your profession. Included is:

An integrative treatment approach that employs a variety of protocols including trigger point,
active release, myofascial release, and muscle energy techniques.

A comprehensive manual with illustrations and detailed technique descriptions.

Oct 21, 2011 Introduction to Therapeutic Techniques
Oct 22, 23 Advanced Techniques for Low Back & Hip
Nov 19, 20 Advanced Techniques for Neck & Upper Back
Dec 4 Pilates for Therapists
Jan 14, 15, 2012 Advanced Techniques for Shoulder/Rotator Cuff
Feb 4,5,6 Pelvic/Lumbar Dysfunction & Correction
Mar 17,18 Advanced Techniques: TopicTBA
Apr 21,22,23 Cervical & Thoracic Dysfunction and Correction

Advanced Technique seminars present an integrative treatment approach employing Trigger Point,
Active Release, Myofascial Release, and PNF stretching techniques.

Dysfunction and Correction seminars employ Muscle Energy Technique (Onsen) protocols
designed to correct spinal imbalances

details @ www.perfectbalanceseminars.com
contact Cheryl@perfectbalanceseminars.com (403) 877-6058

38 Summer 2011







Reiki Divine Energy Program

with Master Teacher Wayne
RMT, RM, MHA, IS2, BA Rel
As an holistic non-religious healing modality, Reiki focuses on conducting Divine healing energy (Chi/Ki)
into a client thereby increasing the level of their own natural healing energy. This energy is used to heal any
issue on the physical, mental, emotional, and/or spiritual levels. Other therapeutic modalities become
"energized" and more effective. The therapist becomes truly holistic by offering a complete approach to
healing. All parties are blessed and feel an angelic peace afterward.

Students are qualified to apply Reiki therapy. Level completion certificates (5 credits) are given at the end
of each of four levels.

What:Divine Reiki Program (ongoing)
Class form: Group or Individual (custom times) -In person or long distance.
Who:.Master Teacher Wayne RMT, RM,
When:...Ongoing -starting November 1, 2009
Where:.Suite 205 5831 57St. Red Deer, Alberta (T4N 2L5)
Time:10:00 a.m. - 3:00 p.m.
Tuition..$125.00 per level -cash

Contact: Wayne at (403)347-0928 www.divinelightreikiandhealth.com Divine.Light.Health@gmail.com

Stability Ball Training

From Gaia Adventures
Stability ball exercise is one of the most effective means to rehab your patients. Its easy, for every body
type, and fun to use. Learn the very latest advancements and techniques in stability ball training during my
upcoming workshops.

Stability Ball Training is coming October 28, 29 in Vancouver, Nov 12, 13 in Winnipeg and Nov 26, 27 in
Edmonton (14 Primary Credits MTAM, MTAA, MTABC, NHPC)

Advanced Ball Training on October 30 in Vancouver, Nov 14 in Winnipeg, and Nov 28 in Edmonton (7
Primary Credits MTAM, MTAA, MTABC, NHPC)

Go to http:www/gaiaadventures.com/bodyball.html for information and to register online.

In these hands-on, fast-paced sessions, youll learn about "Core Activation Assessment and Training
Techniques", functional kinetics with the ball and how to use the stability ball to rehab shoulders, back and
correct posture.



2 day
Active Isolated
Stretching (AIS)

Stretch-for-Lifes Active Isolated Stretching, The Mattes Method 2 day seminars will teach you how to
expertly assist your clients active stretching movements.
Active Isolated Stretching is a rehabilitative form of active and assisted stretching techniques that will
help you reach optimal flexibility, improve ROM and correct postural imbalances. Register today classes
fill up quickly!
Upcoming courses in BC and Alberta:

Kamloops: January 14 & 15 (Sat/Sun) Canmore: January 25 & 26
(Wed/Thurs)

Cranbrook: February 18 & 19 (Sat/Sun) Edmonton: February 22 & 23
(Wed/Thurs)

Calgary: March 10 & 11 (Sat/Sun) Red Deer: March 24 & 25 (Sat/Sun)

Nanaimo: April 14 & 15 (Sat/Sun) Kelowna: May 16 & 17 (Sat/Sun)

Course Fee: $430.00 (includes course manual)
To register visit www.stretch-for-life.com
denise@stretch-for-life.com
NHPC credits = 10 MTAA credits = 18 CMTBC credits = 14 MTAS credits = 16 MTAM credits = 16
39 Summer 2011



Active Isolated
Stretching
(AIS)

Instructor:
Paul John Elliott,
LMT, Certified AIS Instructor, Advanced
AIS Practitioner



Active Isolated Stretching: the Mattes Method (AIS) is a cutting edge method of stretching used
by todays massage therapists, personal trainers, athletic therapists and fitness professionals.
Working with the bodys natural physiological makeup, this method of stretching improves circulation and
increases fascial elasticity, which helps eliminate physical pain and improve human performance.
AIS is an outstanding modality for improving posture, eliminating abnormal curvatures as well as restoring
proper body alignment and eliminating physical pain.
This 3-day course will empower you with stretching and myofascial protocols that will compliment your
current techniques and strategies.
Upcoming Dates:

Calgary ADVANCED AIS.
May 27, 28 and 29 Location: 400-7330 Fisher St. S.E. T2H 2H8.
Requires one Level 1 course certificate.
Register at: http://stretchingcanada.com/event/seminar/advanced-ais
Regina Level 1 AIS 3-day.
June 3, 4 and 5
Location: Holiday Inn Express and Suites Regina, Sk S4S 3R6.
Register at: http://stretchingcanada.com/event/seminar/regina-3-day
Langley Level 1 AIS 3-day
August 19, 20 and 21
Location: Langley Sportsplex Suite 3.
Register: Paul Turner at 3-peaks Kinesiology:1-778-298-3757 - threepeaks@shaw.ca

Langley ADVANCED AIS 3-day
August 19, 20 and 21
Location: Langley Sportsplex Suite 3.
Register: Paul Turner at 3-peaks Kinesiology:1-778-298-3757 - threepeaks@shaw.ca


Structural Myofascial Therapy
(SMFT)

Course Developer:
BetsyAnn Baron
Level 1: Connecting with Fascia
Taught by course developer BetsyAnn Baron

Kelowna, BC: Sept 30-Oct 2, 2011
Montreal, QC: Nov 4-6, 2011 (taught in French)
Edmonton, AB: Nov 18-20, 2011

Early Registration Cost: $525 (reg $625) - Register more than 30 days

Credits: NHPC = 15

Learn how to help your clients experience rejuvenation of injured tissue, increase in their range of
motion, deeper and easier breathing, improvement in posture, decrease of chronic pain and so much
more. We will focus on:

1. Myofascial full body protocol including anatomy/physiology
2. Postural Somatic Awareness (PSA) - a fantastic, subjective evaluation tool for you, the therapist, as well
as for your clients
3. Working within these 3 paradigms: palliative, corrective, integrative

Level 2: Creating Specificity
Kelowna, BC: Feb 17-19, 2012
Montreal, QC: Mar. 9-11, 2012 (taught in French)
Edmonton, AB: Mar. 23-25, 2012

Level 3: Delving Deeper
Kelowna, BC: Apr. 27-29, 2012
Montreal, QC: May 11-13, 2012 (taught in French)
Edmonton, AB: June 1-3, 2012

For more information or to register contact:

BetsyAnn Baron
514-577-5355
education@baronbodyworks.ca
40 Summer 2011


Back to Back Traditional
Study Retreats
on the Southeast Coast of India

From
Calming the Ocean
in combination with
The Healing Hands Center
& Wudang Wen Wu

Tui Na Massage and Healing Qi Gong
December 23 - 31, 2011
Must Register by November 15, 2011

Healing Qi Gong creates internal strength for a longer and healthier life, increasing overall power;
Tui Na Massage techniques focus on joint mobility for better circulation, which helps the body naturally
heal itself while loosening constrictive adhesions.

Honorary Doctor of Qi Gong David Wei creates a beautiful harmony between these healing practices for
effective, comprehensive treatments with priceless hand maintenance exercises.

8 - 12 Students $1,799 13 - 16 Students $1,699

Ancient Thai Massage, Yoga & Self-Healing
January 2 - 14, 2012
Must Register by November 30, 2011

Training provided by a Master of Ancient Thai Massage since 1990
Detoxify yourself physically, then emotionally with simple exercises
Strengthen your body and mind through daily strengthening yoga sets
During the two weeks you'll go through incredible life changing experiences
Awaken your healing energy through guided meditations and self-attunements
Learn the only form of Ancient Thai Massage that flows physically and energetically
The Ancient Massage, Ancient Stretches and Ancient Healing of Doctor Jivaka Kumarabhacca are a
powerful combination that will benefit any massage practitioner. To find this combination of traditional
practices in a single curriculum is rare.

8 - 12 Students $2,099 13 - 16 Students $1,999

Prices in Canadian Dollars, Based on double occupancy, add $350 for single occupancy
(includes taxes, tuition, accommodation, 3 meals/day, transportation to and from the Chennai airport)

Held at Cocoland, a resort in the middle of a coconut plantation three minutes from the beach.

Kristian Olsvik 780-701-9993 www.calmingtheocean.com info@calmingtheocean.com



STONE THERAPY SCHOOL

Course developer: NINA
GART

Level 1
Hot & Cold Stone Massage
3-day certification course
The Original Stone Therapy Training
Level I - Massage with Hot & Cold Stones
3-day intensive, instructional, hands-on course
Credits: NHPC 15

Pick up a stone from anywhere, look deep inside for captured within is the power to heal

2011 schedule:

AB
Calgary: Sep 30 Oct 2
Edmonton: Nov 4 6
Grande Prairie: Nov 18 20
SK
Saskatoon: Oct 17 - 19
Regina: Dec 2 - 4

BC
Vancouver: Oct 8 - 10
Nanaimo: Sep 16 - 18
Victoria: Sep 19 21

Main focus of the course is SAFETY:
. In depth Stone Therapy Procedures
. Bio Mechanics
. Safety principals in Stone Therapy
. Stones used, their qualities and care for stones
. Thermatherapy principles
. Indications, contraindications, benefits and so much more

Stone Therapy School offers courses since 1999 for massage therapists, energy and SPA professionals.

Ongoing classes in AB, SK, BC
CEUs: NHPC 15, MTAA 25, MTAS 21, CMTBC 21

To register: NINA GART 604-459-8646 nina@stonetherapyschool.com www.stonetherapyschool.com
41 Summer 2011




Unwind the Belly
with
Chi Nei Tsang
Workshops




Learn to Unwind The Belly with Chi Nei Tsang Workshops www.unwindthebelly.ca

Chi Nei Tsang (chee-nayt-song) is traditional Oriental Visceral bodywork. The three pillars of CNT are
breath work, applied qigong, and skilled gentle touch - all three are addressed in each exhilarating two day
module. Learn to work the body core without fear.

In Level 1A we learn the fundamentals necessary to do a safe powerful abdominal bodywork session.
Our primary focus is to open the channels of elimination the Metal organs - the skin, the lungs, and the
large intestine. We free the diaphragm & expand & relax the breath, and learn to open the 9 Wind Gates.
We root & ground with Earth Qigong, and build our life force (qi or chi), from the marrow out, with
Bone Breathing.

In Level 1B we become more assured and specific with the ancient abdominal touch techniques. We learn
powerful ways to work with and balance the Earth and Wood internal organs of the body. Our
anatomical knowledge grows. We learn to maintain our own health (& transform toxic energy) with the
Microcosmic Orbit and the Six Healing Sounds

Unwind the Belly with Chi Nei Tsang

The Fundamentals:
Part 1 - The Basics: Metal Organs (no prerequisite):
16-17 September 2011, Edmonton, AB (at the Providence Renewal Centre)

Part 2 - Wood And Earth Organs (prerequisite: Fundamentals Pt 1):
18-19 September 2011, Edmonton, AB (at the Providence Renewal Centre)

Global Body Attitude (prerequisite: Fundamentals Pt 1 & 2):
Part 1 - Fire Organs & Chasing Specific Winds
25-26 November 2011, Edmonton, AB (at the Providence Renewal Centre)

Part 2 Water Organs & Balancing Meridians
27-28 November 2011, Edmonton, AB (at the Providence Renewal Centre)

Visceral Anatomy: An East/ West Perspective
Dates TBA, December 2011, Vancouver, BC,

Qigong & Discharging for Healthcare Practitioners (no prerequisite):
Dates & Location TBA

Instructor: Peter TS Melnychuk, LMT
Certified CNT Instructor (since 2004) & Adv. Practitioner, CNT Institute (Oakland, CA)
Visceral Manipulation Practitioner & Certified Teaching Assistant (Barral Institute)

Online Info & Registration: detailed course descriptions & fees at www.unwindthebelly.ca

Contact & Registration: Laurelle at 780.428.5572 or info@unwindthebelly.ca
Please specify which class(es) you are interested in.









WHOLISTIC NUTRITION
Correspondence Program

LIVING ENERGY Natural
Health Studies

A 2-year-plus program designed for people who want to get a solid, working under-standing of nutrition
and how it relates to health and wellness, also for people wanting to further their career in the natural
health field.

This is an ongoing program, and students can start at any time. Level 1, Level 2, and Level 3 are totally via
correspondence; Level 4 (advanced nutrition) is a detailed hands-on five-day program.

COST: Levels 1-3 $750 each (plus GST)
Level 4 $800 (plus GST)
** Cost of course includes workbook, administration fees, tutorial support, and one exam for each level.

A discount is available if Levels 1-3 are purchased at the same time.
This program has affiliations with a number of organizations and colleges including Canadian Association
of Natural Nutritional Practitioners (CANNP). For detailed information contact Living Energy/Dr. Radka
Ruzicka HD(RHom), NNCP at (780) 892-3006 (local call from Edmonton), visit our website
www.livingenergy.ca

42 Summer 2011
Need space?
NHPCs Knowledge Center is taking bookings now.
For more information:
call 1 888 711 7701
or email jgabriel@nhpcanada.org
The Knowledge Center features:
Affordable rates
Member discounts
1600 square feet
Large windows overlooking downtown Edmonton
Kitchenette
Massage tables, projector, catering,
desks & chairs available
1
0
%
MEMBER
DISCOUNT
ON BOOKINGS
1
5
%
ADVERTISITNG
DISCOUNT
43 Summer 2011
I AM NHPC
One of the great benefits of being a
member of the NHPC is the associations insurance
program.
No other professional liability insurance policy
specific to your profession offers an occurrence
form policy with limits of $3,000,000 each claim and
$4,000,000 per policy period per individual.
ADDITIONAL BENEFITS
Instantrecognitionbymostinsurance
companies across Canada
Instant recognition as a competent professional
Massage Therapy Competency Assessment Process
A prior learning assessment process for 2200
hour competency equivalency recognition by the
insurance industry
Facilitates massage therapists moving into
regulated environments
Does not apply to Regulated MT Provinces
Visit www.nhpcanada.org or call 1-888-711-7701 for
more information.
Halifax, Nova Scotia
October 24
Toronto, Ontario
October 25
Winnipeg, Manitoba
October 26
Saskatoon, Saskatchewan
November 14
Regina, Saskatchewan
November 15
Calgary, Alberta
November 16
Edmonton, Alberta
November 17
Vancouver, British Columbia
December 5
Kelowna, British Columbia
December 6
Lethbridge, Alberta
December 7
The NHPC invites members
to attend a Connections Caf
in a city near you.
Connect with like minded healthcare professionals for a
powerful evening of networking and conversation.
Together we can strengthen our natural health community.
Join us.
Online registration opens mid September at nhpcanada.org
or call 18887117701 for more information.
natural health practitioners of canada association
association des praticiens de la sant naturelle du canada
2011 FALL
SCHEDULE
FREE REGISTRATION
7 - 9 pm
Locations TBA
Refreshments &
Snacks Provided
Halifax, Nova Scotia
October 24
Toronto, Ontario
October 25
Winnipeg, Manitoba
October 26
Saskatoon, Saskatchewan
November 14
Regina, Saskatchewan
November 15
Calgary, Alberta
November 16
Edmonton, Alberta
November 17
Vancouver, British Columbia
December 5
Kelowna, British Columbia
December 6
Lethbridge, Alberta
December 7
The NHPC invites members
to attend a Connections Caf
in a city near you.
Connect with like minded healthcare professionals for a
powerful evening of networking and conversation.
Together we can strengthen our natural health community.
Join us.
Online registration opens mid September at nhpcanada.org
or call 18887117701 for more information.
natural health practitioners of canada association
association des praticiens de la sant naturelle du canada
2011 FALL
SCHEDULE
FREE REGISTRATION
7 - 9 pm
Locations TBA
Refreshments &
Snacks Provided