The Development and Validation of the Client Expectations of Massage Scale

Background: Although there is evidence that client expectations influence client outcomes, a valid and reliable scale for measuring the range of client expectations for both massage therapy and the behaviors of their massage therapists does not exist. Understanding how client expectations influence client outcomes would provide insight into how massage achieves its reported effects. Purpose: To develop and validate the Client Expectations of Massage Scale (CEMS), a measure of clients’ clinical, educational, interpersonal, and outcome expectations. Setting: Offices of licensed massage therapists in Iowa. Research Design: A practice-based research methodology was used to collect data from two samples of massage therapy clients. For Sample 1, 21 volunteer massage therapists collected data from their clients before the massage. Factor analysis was conducted to test construct validity and coefficient alpha was used to assess reliability. Correlational analyses with the CEMS, previous measures of client expectations, and the Life Orientation Test–Revised were examined to test the convergent and discriminant validity of the CEMS. For Sample 2, 24 massage therapists distributed study materials for clients to complete before and after a massage therapy session. Structural equation modeling was used to assess the construct, discriminant, and predictive validity of the CEMS. Participants: Sample 1 involved 320 and Sample 2 involved 321 adult massage clients. Intervention: Standard care provided by licensed massage therapists. Main Outcomes: Numeric Rating Scale for pain and Positive and Negative Affect Schedule– Revised (including the Serenity subscale). Results: The CEMS demonstrated good construct, convergent, discriminant and predictive validity, and adequate reliability. Client expectations were generally positive toward massage and their massage therapists. Positive outcome expectations had a positive effect on clients’ changes in pain and serenity. High interpersonal expectations had a negative effect on clients’ changes in serenity. Conclusions: Client expectations contribute to the nonspecific effects of massage therapy

A mountain not too high to climb a qualitative study exploring facilitators and barriers to smoking cessation in a regional mental health service /

Tobacco smoking is the largest single preventable cause of death and disease in Australia. Reports suggest that up to 88% of people who have mental health problems of any kind continue to smoke, even when in acute mental health units. Some organisations have adopted smoking free policies; however, implementation of smoking cessation programs in acute mental health units has had varied levels of success. This qualitative study examined the second attempt to implement a smoke-free policy in an acute mental health service in Queensland, Australia, to explore the facilitators and barriers to change. Post-process interviews conducted with ten clinicians and consumers revealed facilitators and barriers within themes of Culture, Wellbeing and Strategy. Key barriers included a negative institutional culture, fear and inconsistent application of the policy (associated with staff attrition, workloads, policy loopholes and resistance). Key facilitators were positive leadership, adequate resources, staff and consumer engagement, supportive formal policy, and staff unity. Analysis also suggested benefits in cultivating a non-restrictive, healthy and respectful environment, and deploying a clear, consistent strategy that includes planning, preparation, implementation and maintenance phases