CE INSTITUTE LLC BLOG

Anyone can join in the fight against human trafficking. The U.S. Department of State has published an online resource entitled “20 Ways You Can Help Fight Human Trafficking,” which outlines their recommended strategies:

Learn the indicators of human trafficking on the TIP Office’s website or by taking a training.  Human trafficking awareness training is available for individuals, businesses, first responders, law enforcement, educators, and federal employees, among others.

If you are in the United States and believe someone may be a victim of human trafficking, call the 24-hour National Human Trafficking Hotline  at 1-888-373-7888 or report an emergency to law enforcement by calling 911. Trafficking victims, whether or not U.S. citizens, are eligible for services and immigration assistance.

Be a conscientious and informed consumer. Find out more about who may have picked your tomatoes or made your clothes at ResponsibleSourcingTool.org , or check out the Department of Labor’s List of Goods Produced by Child Labor or Forced Labor. 

Encourage companies to take steps to prevent human trafficking in their supply chains and publish the information, including supplier or factory lists, for consumer awareness.

Volunteer and support anti-trafficking efforts in your community.

Meet with and/or write to your local, state, and federal elected officials  to let them know you care about combating human trafficking and ask what they are doing to address it.

Be well-informed. Set up a web alert to receive current human trafficking news. Also, check out CNN’s Freedom Project  for more stories on the different forms of human trafficking around the world.

Organize a fundraiser and donate the proceeds to an anti-trafficking organization .

Encourage your local schools or school district to include human trafficking in their curricula and to develop protocols for identifying and reporting a suspected case of human trafficking or responding to a potential victim.

Use your social media platforms to raise awareness about human trafficking, using the following hashtags: #endtrafficking, #freedomfirst.

Think about whether your workplace is trauma-informed and reach out to management or the Human Resources team to urge implementation of trauma-informed business practices.

Parents and Caregivers: Learn how human traffickers often target and recruit youth  and who to turn to for help in potentially dangerous situations. Host community conversations with parent teacher associations, law enforcement, schools, and community members regarding safeguarding children in your community.

Businesses: Provide jobs, internships, skills training, and other opportunities to trafficking survivors. 

Take steps to investigate and prevent trafficking in your supply chains by consulting the Responsible Sourcing Tool and Comply Chain to develop effective management systems to detect, prevent, and combat human trafficking.

Health Care Providers: Learn how to identify the indicators of human trafficking and assist victims. With assistance from local anti-trafficking organizations, extend low-cost or free services to human trafficking victims. Resources from the Department of Health and Human Services can be found on their website.

Human Trafficking Prevention Educational Materials

The Blue Campaign is a national public awareness campaign designed to educate the public, law enforcement, and other industry partners to recognize the indicators of human trafficking, and how to appropriately respond to possible cases. 

January 11, is National Human Trafficking Awareness Day, aka #WearBlueDay. Why blue? It’s the international color of human trafficking awareness.

The Blue Campaign provided training on identifying indicators of human trafficking and reporting suspected cases to over 23,000 individuals. 

Additionally, more than 280,000 people received training through Blue Lightning Initiative partnerships. Online Blue Campaign shipped more than 2.2 million pieces of outreach materials to requestors across the United States.

The Protocol Toolkit is a vital resource for healthcare institutions seeking to develop protocols to respond to human trafficking. This tool is designed for a variety of healthcare settings.

The PEARR Tool—Provide privacy, Educate, Ask, Respect, and Respond—is a robust, evidence-based framework designed to equip healthcare professionals with the skills to assess trafficking and interpersonal violence. 

PEARR fosters safe environments where patients feel empowered to share their experiences naturally, thereby opening doors to essential support. This trauma-informed, person-centered approach strengthens patient-provider relationships and enhances health, safety, and overall well-being.

Additional information about human trafficking, including resources available to trafficking victims can be found at various private, state and federal organizations.  To learn more about human trafficking, please visit:

 The Florida Department of Health (https://www.floridahealth.gov/programs-and-services/prevention/human-trafficking/index.html)

 The FBI (https://www.fbi.gov/investigate/violent-crime/human-trafficking)

The US Department of Homeland Security (https://www.dhs.gov/topics/human-trafficking)

If you think you are a victim of human trafficking, or have information regarding suspected human trafficking of a person in Florida, contact:  Florida Abuse Hotline 1-800-96-ABUSE (1-800-962-2873).

If you believe you have been a victim of trafficking or have information regarding suspected human trafficking of an adult anywhere in the U.S., or of a child outside Florida, call the National Human Trafficking Resource Center at 1-888-373-7888, text HELP to 233733 (BEFREE), or visit the National Human Trafficking Hotline online at:  https://humantraffickinghotline.org/en

Some healthcare providers might want to provide medical intervention during emergencies, but are afraid of doing so for liability reasons such as committing a medical error due to the emergency circumstances, such as when a person is unconscious and unable to provide dialog that led to their medical condition. Unless you're a trained emergency medical professional, it's possible that things could go wrong during an emergency, even if you had the proper training!

As such, it’s important to know that there is something called Good Samaritan Law, which can be different from state-to-state, and even internationally. On a recent airline flight, a flight attendant in international airspace loudly proclaimed the good samaritan law when no one volunteered to provide urgent medical care to an individual in need. The flight attendant proclaimed a caregiver cannot be held accountable for providing emergency medical assistance to that individual if any harm is done during a reasonable effort to provide care.

This Good Samaritan Law is important to know because in September 2025, Javier's restaurant in the Aria Resort & Casino and MGM Resort International was sued for wrongful death when no life saving medical care measures were attempted which they claim resulted in well-known actor Mike Heslin’s death. The wrongful death lawsuit claims:
Staff "stood by, took no immediate lifesaving action, and failed to initiate or support efforts that could have saved Michael’s life."

• Failed to perform CPR and did not retrieve an automated external defibrillator (AED).
• Failed to keep a stock and inventory of emergency response equipment, including, but not limited to, an automated external defibrillator (AED), or failed to train their staff on where the AEDs were stored.
• It was also stated that a woman allegedly attempted to perform CPR on Heslin at one point. However, the complaint alleged that an employee “forcefully interfered” and removed her from the scene.

If an attorney can sue waiters and a restaurant for failure to provide emergency medical assistance, can you imagine what they would do if a healthcare worker did not provide the same?

While it’s important to always work within your own licensed scope of practice, emergency life threatening situations when other more qualified healthcare providers are not available can become exceptions to what can be practiced. All healthcare providers should know basic emergency life saving measures. These include:

• Learn the heimlich maneuver for choking patients.
• Learn or update CPR certifications and install or locate the nearest AED device to your workplace, especially if you work on cardiovascularly compromised patients, which includes more vulnerable populations such amongst retirement villages or hospice care.
• It would also be important to learn of any medical equipment requirements that are required by law at your healthcare practice, and to ensure you are properly trained to use anything within your scope of practice that could provide life saving measures to anyone in need.

Florida's Good Samaritan Law provides immunity from civil liability for individuals who provide emergency assistance in good faith, protecting them from lawsuits if their actions are not grossly negligent or malicious, even if the aid doesn't succeed or causes minor harm. The law's purpose is to encourage people to help in emergencies without fear of legal repercussions for good-faith efforts or resulting medical errors.

A good samaritan law would generally apply to private citizens, although it could also extend to medical professionals acting in an emergency outside of their usual healthcare setting or scope of practice. 

Exceptions to the good samaritan law are, it should not to be regularly used to operate a medical facility without sufficient medical staff. For example, if patients are regularly coding in the medical facility, then there should be a doctor on staff and other trained medical professionals to run the codes. Consistently operating outside of one’s licensed scope under the good samaritan law is a manipulative abuse of practice and likely punishable by law when proper licensed healthcare is not being provided by medical staff.

Good samaritan laws usually do not protect individuals from liability if their actions involve gross negligence, manipulative conduct, complete recklessness, or malicious intent. 
An example of this would be cutting a person’s abdomen open on an airplane, without proper training, sanitation or reason to do so. There must be some good faith in your emergency medical care for the good samaritan law to apply.

To learn more about healthcare laws and medical errors prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory

Understanding human trafficking is crucial for several reasons. Recognition can save lives with the following purposes: 

• Being able to identify trafficking situations can lead to intervention.
• Effective support: Knowledge helps you support anti-trafficking efforts in your community.
• Awareness creates change: Raising awareness promotes societal change to combat this crime.

By learning about human trafficking as a healthcare worker, you contribute to creating a safer, more informed community that can help prevent exploitation and support survivors.  

Types of Human Trafficking

The United States Department of State recognizes two primary forms of trafficking in persons which are forced labor and sex trafficking. 

Forced Labor sometimes also referred to as labor trafficking, includes activities involved when a person uses force, fraud, or coercion to exploit the labor or services of another person. 

Sex trafficking encompasses the range of activities involved when a trafficker uses force, fraud, or coercion to compel another person to engage in a commercial sex act or causes a child (person under 18) to engage in a commercial sex act. Sex trafficking occurs in various settings, such as fake massage establishments, escort services, brothels, city streets, truck stops, strip clubs, hostess clubs, hotels, and motels.  

Perpetrators of human trafficking span all racial, ethnic, and gender demographics and are as diverse as survivors. Some use their privilege, wealth, and power as a means of control while others experience the same socio-economic oppression as their victims. 

Physical transportation is not required for this crime; a trafficker can control a victim mentally, compelling them to act on the trafficker’s behalf. According to the United Nations’ International Labour Organization, human traffickers victimize an estimated 27.6 million people worldwide.

77% of all victims are in forced labor

23% of all victims are in sex trafficking

57% are men and boys  

43% are women and girls

Within Sex Trafficking the Statistics are:

78% are women and girls and 22% are men and boys

92% are adults and 8% are children

Within forced labor the Statistics are:

33% are women and girls and 67% men and boys

73% are adults and 27% are children

The US Department of Homeland Security states Human trafficking has been reported in all 50 states and the District of Columbia, on Tribal land, and within U.S. territories. In FY 2024, DHS agencies helped over 800 human trafficking victims, provided protections to more than 24,000 people, and made 2,500+ related arrests. DHS supported 914 indictments, 405 convictions, and trained thousands in identifying and reporting human trafficking.   

Identifying Victims of Human Trafficking

There are several physical, behavioral and environmental indicators to consider.  These indicators may appear alone or in combination, and not all victims will show every sign.  

There is no single profile of a human trafficking victim as traffickers may target anyone who can earn them a profit regardless of age, sex, socioeconomic background, nationality, or immigration status. 

The following are examples of groups who may be at increased risk:

• Individuals who have experienced childhood abuse or neglect
• Children and youth involved in the foster care and juvenile justice systems
• People experiencing homelessness
• Individuals living in poverty
• Survivors of violence such as intimate partner or domestic violence
• Unaccompanied alien children
• Individuals displaced due to political instability, war, and disaster
• Individuals working in industries with fewer legal protections
•  Physical Indicators 
• Delayed care or an unexplained progression of an illness
• Evidence of severe workplace injuries, including prolonged and unprotected exposure to toxic chemicals or hazardous conditions
• History of multiple STIs/STDs, multiple pregnancies, or frequent requests for STI/STD testing, substance use and/or poor hygiene
• Physical signs of injury or mistreatment, including
• Long-term trauma
• Bruises in various stages of healing
• Signs of physical or sexual abuse
• Malnourishment
• Severe exhaustion
• Behavioral Indicators Include:
• Overly fearful or nervous behavior
• Use of scripted answers and/or stories about their condition
• Talk that minimizes abuse or the state of their injuries
• Being unwilling or hesitant to answer questions
• Being unaware of their location or the date/time
• Symptoms related to depression or PTSD
• Refusal of care or the need to leave despite medical advice

Environmental Indicators Include:

• An individual consistently speaks on behalf of the patient or requests to be present during examinations
• A person who may be in possession of the patient’s ID or money and/or insists on filling out all paperwork
• A person who lacks essential information about the patient’s medical history or identity, despite claiming to be related
• Reports of experiencing high-risk environmental factors, such as living at a workplace, sleeping in crowded conditions, or not having a fixed home address 

Traffickers’ methods of control

Not all control is physical – it can be mental as well.  Traffickers use force, fraud, and coercion to compel labor or services and commercial sex. Force may involve threats or acts of physical assault and sexual violence directed at the victim, others present, or family members, which makes the threat even more credible.

Controlling victims through fraud is often false promises – of education, a relationship, a specific job, good pay and days off, paying off a debt, sending money home to support the family, or generally of a new more secure life – but the reality is something different and inescapable.

A traffickers coercion with victims can be subtle or overt. Some common tactics include taking identity documents and threatening arrest and/or deportation, inhumane treatment, blackmail, shaming, isolation, addiction, and economic coercion, which can be taking advantage of existing debt or creating a debt.

To learn more about human trafficking prevention, please register for one of our courses at:  https://ceinstitute.com/collections/mandatory

Medical errors are unintended consequences of medical treatment, regardless if it was unexpected, avoidable, evident or harmful to a patient. Any type of unexpected injury to a patient resulting from medical care would be considered a medical error.

Sometimes a healthcare provider could have avoided an error but did not through negligence. Contrarily, a medical error can happen that was unexpected and not avoidable. Regardless of how a medical error occurs, a healthcare provider, and sometimes even managers and/or establishment owners are liable for the error.

Any type of medical error could result in a medical practice claim. Our newest Medical Errors Prevention training here at CE Institute LLC is to teach healthcare providers how to minimize their risk with medical errors that could result in malpractice claims, regardless of how the error occurred.

Almost all healthcare practices are filled with managers. If you’re self-employed, then you are your own manager and responsible for your entire practice. Managers could be culpable for medical errors when the error occurs under their management role. VICARIOUS LIABILITY can hold employers and managers liable for actions of their subordinates. Vicarious liability practices might be enforced differently from state to state.

In the state of Florida, even a 1-person licensed massage establishment must have an assigned DEM (designated establishment manager) registered with the state of Florida, per Florida state law. Different states could impose various management requirements in healthcare practices, beyond a private or public healthcare institution’s requirements.
While Florida’s DEMs were initially installed to help prevent human trafficking in illegitimate massage establishments, these DEMs are now being held responsible for other provider’s treatments and their results within the establishment.

If you are wanting to, or considering moving into a managerial role at work, or perhaps you are already managing, then you should request your managerial tasks be provided to you in writing, to negotiate and/or fulfill them. If you’re offered a managerial role, here are some medical error prevention issues to consider prior to accepting the position. Feel free to request a tour of a potentially new work facility and/or speak to other staff PRIOR to accepting the offer, or ask the employer if your managerial position will provide the budget and resources to create a safe, quality workplace. A partial list of possible managerial medical error malpractice issues you should look out for in addition to facility medical error risks are:

1. Staffing i.e. staff are overbooked to provide quality care.  Shortening or not providing services billed to insurance would be considered insurance fraud and could be criminally prosecuted.
2. Scope Creep i.e. staff are providing responsibilities outside of their licensed scope of practice.
3. Quality Issues i.e. existing management is unqualified to manage by leaving potential malpractice issues unresolved, and you do not have a budget to fix problems, such as the upholstery on treatment tables is ripped or torn so it cannot be properly sanitized between patients, etc.
4. Supply Issues: i.e. there’s not enough towels or sheets, so they’re being reused causing more sanitation concerns. Adding a shortage of sanitation supplies to this would create catastrophic negligence.
5. Managerial experience: if your role is to manage others but you do have managerial experience or training, or those managing you do not have the expertise to make good work decisions to avoid error.

Maintaining or accepting a managerial role in healthcare is regularly a negotiation. 
Not only would salary or compensation be negotiable, but you should also negotiate for a quality work environment or work-related training (i.e. management classes) to reduce YOUR risk of being responsible for medical errors that were completely avoidable.
Remember that your risk for malpractice claims is likely greater when avoidable medical errors are committed. These issues we just reviewed can be proactively addressed prior to an avoidable medical error occurring. For greater medical errors prevention training in healthcare, please visit: https://ceinstitute.com/collections/mandatory

By Selena Belisle, Founder and Instructor, CE Institute LLC

I experience a LOT of massage therapy and bodywork from others. The number of massages I’ve received over my almost 40-year massage therapy career would be in the thousands. Any good massage instructor would seek constant massage from others as part of an experiential learning process to continually share with others.

In this article, we’re going to discuss what an appropriate amount of massage oil, cream, lotion or gel would be appropriate for a massage therapy appointment. I will refer to these substances as massage mediums or mediums, which are common lingo in the massage therapy industry.  Mediums can be oils, lotions, powders, cream or gels used for bodywork or massage therapy services.

I recently went to a Vermont massage school student clinic for a massage therapy appointment and shared a unique experience with the student’s massage medium application.  That was, whenever the student therapist applied their massage medium to a new work area, it always felt like they were not using or applying enough.  A lack of massage medium during Swedish massage in particular can cause an undesirable drag or skin friction, which is usually contrary to a Swedish relaxation appointment.

At first, it was easy and erroneous to discount the lack of appropriate massage medium to the situation where I was receiving massage from a student; however, once the medium was applied to the new work area with longer effleurage application, it never felt like there was a lack of an appropriate medium.  In fact, their massage therapy strokes which included ringing, petrissage, bone tracing and more felt really wonderful! So, in the end, it created this puzzling feeling of what is an appropriate amount of massage medium?

Usually in massage appointments, the amount of massage medium feels less and less as appointment time continues, which requires reapplication of the massage medium to avoid drag and friction.  So how could a massage medium feel like it’s not enough at the beginning and more appropriate during later strokes, such as what happened with this student’s massage? The answer is there was not enough massage medium applied for a longer effleurage stroke, but there was an appropriate amount of massage medium applied for the remaining shorter strokes like ringing and petrissage.

So, this partly answers the question about whether you’re using enough massage medium in your bodywork or massage appointments. Enough massage medium should be used to avoid undesirable skin friction or drag.  Contrarily, less medium should be used when friction or drag are essential to the treatment.

We do not recommend using excessive amounts of massage mediums, unless you’re using massage tools such as hot stones which require quick glide over the skip and  cups where you want to reduce skin friction while working the deeper levels of soft tissue. In examples such as Orthopedic Cupping Massage or Hot Stone Massage, we refer to the phrase “make it shine”, because we want the client’s skin to shine with enough massage medium for proper modality engagement.

The correct answer as to whether you are using enough massage medium in your bodywork or massage appointments also depends on your client.  As long as you are able to execute your massage or bodywork skills with ease, any amount of massage medium the client wishes for would be appropriate, as long as it’s not excessive or causing physical harm.

The massage therapy and bodywork goal for proper medium application is to use enough but never too much. Using too much massage medium becomes expensive, can unnecessarily soil sheets, towels and clothing, make other massage equipment or floors sticky and unsanitary, can cause laborious cleaning efforts amongst other problems. Not using enough massage medium can hurt or in a worst-case scenario, cause injury such as skin friction burns.  Your massage medium application should allow the massage therapist to practice their hands-on skills with ease, feel good to the client and provide a therapeutic result from the hands-on work as well.

After almost 40-years of practice, I’ve seen all types of massage medium monitoring application by employers, most of which is unpractical.  The worst I saw was a lightweight cream provided in a 2-ounce cup per appointment, and the therapist was not allowed to use more than 2 ounces of massage medium per client which was beyond impractical. Anyone who assigns a specific number of ounces of massage medium to be used with any particular client is likely inexperience and uneducated.  That’s because:

• Massage clients can be of various sizes. A 90-pound female client will almost always require less massage medium than a 400-pound client with a larger surface area to cover. As such, providing a 2-ounce ratio per client is likely wasteful with some clients and painfully short with others.

• Massage recipients can have skin hydration differences, with anything between skin dryness and dehydration to oiliness or any other combination.  Some massage clients can have such oily skin that you might not need to use much massage medium at all.  While others can have such dry skin, that massage medium reapplication may be constant, especially if you’re using a highly absorbent product.

• The massage medium’s absorbency rate can also change the amount of massage medium required for the specific task at hand, whether it’s to glide over the underlying soft tissue, compress the underlying soft tissue, cause friction or other purposes.  Changing the massage medium being used on the same exact client can change the amount of massage medium required depending on the product’s absorbency.  Some massage mediums sit on the skin and are not very absorbent, such as Vaseline.  While other massage mediums might instantly absorb, requiring more frequent re-application.

• Some clients may have excessive body hair requiring greater massage medium application too.  Massage therapists should be prepared to use extra massage medium on a hairy client to reduce a painful pulling of the client’s body hair.

In general terms, massage oils and creams would provide the greatest amount of slip or glide with the least amount of absorption while gels, lotions and powders provide the greatest amount of friction and fastest absorption rates.  While every product is different, those generalities amongst massage mediums apply to most but not all.   Relaxation appointments usually require massage mediums with greater while deep tissue and focal bodywork such as myofascial release or trigger point therapy would generally use massage mediums with less slip, such as gels, powders, lotions or perhaps no massage medium at all.

In conclusion, there is no exact amount of massage medium that should be used for clients because this is an individual situation that is based upon client size, modality type, body hair, absorption rate and other factors which require customized amounts.  The right amount will be what feels best to you and your client with an effective result.

By Selena Belisle, Founder/Instructor, CE Institute LLC

Have you had days where you were not paid in full despite being fully booked? Why does that happen?  Sometimes massage therapists and establishments are not properly prepared to avoid last-minute cancellations or non-payment for scheduled services.

Let’s review how we can ensure better practice and more stable income with proper massage therapy preparation:

ADVANCED CLIENT INTAKE PROCESS

Why would you wait for a client to arrive at your office to determine if they are contraindicated for the appointment?  You should not.  Unlike doctor’s offices that commonly double book appointments every 20 minutes, massage therapists generally book one client per hour.  Massage therapists usually do not work on more than 5 clients per day, while doctors might see dozens of patients in the same time span.  If a doctor misses a client or two for any reason, they’ll still see dozens of others while a massage therapist could lose 20% to 40% of their income in one day if they lost one or two client appointments. This is why it is important to make sure your client is not medically contraindicated prior to arriving to your workspace.

There are different health intake processes that can now be provided online, before your client every steps foot into your practice.  This can help rule out contraindications if the client cannot receive the appointment they have scheduled.  Now you will have time to provide informed consent with the client, mention the contraindication and provide other treatment options. If the client does not want to proceed with an alternative appointment option, it can also provide a massage therapist or bodyworker the time to schedule another client for that appointment in advance with this effective type of pre-screening.

If you do not want to use an online or computerized client health take, you could also call your client and rule out contraindications over the phone, before they come to your office. This is particularly important for pregnant women and clients in pain.  While no one appreciates being inconvenienced due to lack of preparedness, having someone trek to your office while in pain or pregnant only to be turned away is unacceptable and often avoidable when appropriate prescreening is performed.

ALTERNATIVE MASSAGE & BODYWORK APPOINTMENTS OPTIONS

How many types of styles of massage and bodywork have you learned or practiced? Some health contraindications for massage are caused by cardiovascular issues, where an increase of full body circulation would be inappropriate. But that same client might still qualify for other forms of bodywork.  Clients who are contraindicated for massage due to circulation issues may still be able to receive the following massage or bodywork appointment:

• Foot, Hand or Ear Reflexology
• Sweet Session™
• Reiki
• Craniosacral Therapy
• Indian Head or Foot Massage
• Energy Sessions
• Other Bodywork That Does NOT Increase Circulation

Determining how to proceed with each individual client is a decision to be made between the therapist and client, based on their individual needs, goals, contraindications and more.

To avoid burning out and remain diversified, we recommend massage therapists become proficient in at least five different massage and/or bodywork modalities. Diversified training allows a massage therapist to keep their practice interesting and provide alternative treatments for clients who might want to try something different, or for when they’re contraindicated for their originally scheduled service.

MASSAGE SUPPLIES, SUPPLIES, SUPPLIES!

It is always good business to have plentiful supplies on hand. This ensures quality of service is maintained.  How would you like to start your day knowing that you only have 8 ounces of massage medium remaining for 5 clients. Could you stretch 8 ounces of oil to perform 5 full body massages? Or would you have to cancel someone? Or suggest a different appointment that does not use massage medium?

The same goes for linens. Have you worked in a practice where they’ve flipped the sheets?  Perhaps a massage therapist is turning the sheets over between clients because they do not have enough freshly laundered linens for all of their scheduled clients on that day. Flipping sheets is unethical and unsanitary.

It is simple good business to keep extra supplies on-hand. An extra gallon of unscented (nut-free) oil at a massage establishment should always be stored as a sacrosanct back-up massage medium, because:

It can be used to help disperse an unknown aromatherapy or essential oil allergy,

You will always have a back-up on hand for clients who are allergic to nuts,

You will never run out of massage medium that could create appointment cancellations.

Once the gallon of back-up oil is opened, it must be replaced and labelled as the sacrosanct back-up.  Syphoning off just a small portion of oil your back-up gallon and then returning it as your back-up option is not appropriate.  This could:

Allow someone to continue syphoning from it until it is also gone.

Allow the oil to spoil faster or become rancid at a speedier pace once it’s opened.

Can be mixed in with other open products and now your back-up gallon is missing or gone.

Try to create redundancies in the practice, where massage and bodywork appointments can continue even if something breaks or goes missing.  Make a list of all the assets and supplies  you require to practice and then create a duplicate or back-up plan for everything. This way your practice is less likely to be interrupted or stop due to a lack of supplies.

WAITLIST

• Find a way to keep one.
• Collect a waiting potential client’s name, email address and phone #. Request all contact methods to reach them if you can squeeze them in.
• Ask what type of appointment they could accept and document it. This plants a seed in allowing the client to digest that even if their desired service is not available, it might be possible to receive something different.
• Payment method and plan: we recommend collecting a payment method for waiting clients with a plan if it’s acceptable to book and deposit any new openings. This will help ensure their commitment on the wait list to actual show for an appointment if or when you’re able to add them to the schedule.

OLD SCHOOL BACK UP OF THE DIGITAL AGE

Most bodywork, health and massage establishments now allow online scheduling.  But what would happen if you lost internet service?  Or, how would you know who’s showing for what type of service at what time if your online software company used went offline?  We recommend daily closing tasks to include taking a screenshot of the next day’s appointments.  While this screenshot may become outdated as time goes on, it’s better than having no idea of what your workday will look like without! Be sure to copy or save the screenshot to your desktop instead of another place online, because you still want to be able to access it is you lose your internet connection.

The following two pictures are of back-up traffic lights in London England.  I've never seen these in the United States before.  They are mobile traffic lights that can be rolled to any area needed.  Wouldn't it be wonderful if we all had back-up items we could use at anytime to replace our initial need or requirement like these traffic lights?

MASSAGE THERAPY PREPAREDNESS CONCLUSION

There are many things you can do to better prepare your practice for quality service. If you have to cancel an appointment for any reason, look at the reason why. Was it avoidable? If it was avoidable, how could you better prepare yourself to prevent the cancellation from reoccurring.  There are many back-up plans that can be made in advance with a little time, preparedness and thought.

It's interesting that CNN published an article today title ‘Haute Couture’ facials and re-energizing mattresses: Inside Dior’s first permanent spa in the US, because I just had a massage at a Dior spa in Paris, and it was definitely something to write about!

If you’d like to enjoy massage therapy at its finest, then look no further than Dior Spa Cheval Blanc in Paris, France. Dior is a major luxury lifestyle brand which is deeply rooted in its fragrance and cosmetic lines. Those lines have been transferred into professional spa services at the upscale Cheval Blanc Hotel in Paris, amongst other high-end destinations, which now include New York!

The spa is decorated in a light colored modern interior with extra thick and impressively esthetic doors for soundproofing.  Upon entering the spa for your massage appointment, you will be greeted by a smiling attendant who will invite you to sit in a decent sized reception area where they will serve you a light peach refreshment and cool fragranced hand towel.  

The receptionist is the one who will review any medical conditions or contraindications with you prior to your service, so that the therapist is prepared before they even meet you.  Once you’ve completed some brief questions, your massage therapist will then greet you, and invite you to one of their private massage suites.  The suites contain two separate rooms:

A shower/changing area:

Joining the treatment room and changing room/shower into one suite/entrance has both benefits and disadvantages.  The benefits are, high profile clients can easily relax in this extremely private environment which they do not have to share with anyone, or worry about a common locker area picture being taken while they’re in various states of undress, etc.  The downside for the business is, you’ll have to schedule additional non-revenue time for the suite for changing, showering, etc.  My 30-minute massage reserved the suite for 60-minutes, so that I would have time to change and shower, etc.  Spas with common area showers and changing rooms would easily be able to more efficiently schedule a 30-minute massage in 45-minutes, and then all the client to shower and/or change in the common/shared locker room instead of massage suite where you would no longer have access to the treatment table while the client is doing things that they could probably do elsewhere, with less privacy.  

At the Cheval Blanc, the spa was SOLD OUT the day I sought services, so charging $330+ euros for a 90-minute treatment isn’t an issue. They’re sold out at that price which means they could likely increase their prices during peak times, and maintain a healthy clientele. However, if they wanted to maximize their income, then relegating the changing/shower area to a common area to allow maximum revenue use of the treatment room would be advised.  It’s possible they could have less clientele if they chose that type of standard operation, because some clients might be scheduling here for those private suites and exclusivity; although, the celebrities and royalty legitimately seeking that type of privacy out of necessity is probably not enough to offset the increased income the establishment would achieve if they separate their shower/changing rooms from the treatment stations.  Usually celebrities and royalty that are highly photographed and at risk of having their privacy invaded in public would have their spa services provided in their hotel suites, or they might rent a second hotel room to receive massage and spa services.  Rarely would we ever encounter what Dior has offered which is a fairly exclusive and unique setup.

The service and massage treatment room:

Both are elegantly appointed with the finest touches, including bottled water, slippers, robe, toiletries, spa products and of course, more fragrance.

Everything between the two rooms of the massage suite, reception area, bathroom and beyond is branded.  Dior and Cheval Blanc are never out of sight. The brand’s constant presence reminds you of where you are which is in their lap of luxury.

The therapist invited me to change into a robe and slippers in the changing room, and then had me enter the massage treatment room where she provided three different scents to choose from for the massage medium. I chose the scent that was the strongest and most exotice.  The scents were contained on patterned fabric in three different glass jars with lids.  She removed the lid of each, one at a time, and had me smell them to choose.

I only had a 30-minute massage appointment because that is all they had - the spa was fully booked. So I was lucky to even get that! I had tried to book online and call but there was nothing available. So to get the appointment, I actually went to the spa, and told the receptionist that I am massage therapist myself, and I’m trying all the various high-end spas in Paris, and I’d like to try theirs, so she squeezed me in.  I’m not sure they even offer 30-minute massage appointments to the public.  That might just be an add-on service to their other body treatment specialities and services.

When she asked me what type of pressure I wished for and where to focus, I shared again that I’m a massage therapist and was just there to try it all out, so to do whatever she wanted.  She said the receptionist had already told her and it made her very happy.  She asked me if there was any area I wanted to avoid (there wasn’t), and then asked if it was okay to massage my face, scalp, abdomen, etc. - and I told her it was all good with medium pressure.

Once we determined the style, pressure and fragrance of the massage, she then asked me for my choice of music.  I told her to play whatever she liked best because I knew the happier she was, the better my massage was likely to be, which allowed us to share a little laughter together. Then she left the room so I could disrobe and lie on the table in the pronated position. I took this picture of the massage tools in the treatment room shown below - they're quite impress and on display for sale in the retail area too!

As typical of high end European spas, they offer a 40” extra wide spa table with a hole in it instead of a face cradle.  This hole was different though. It was extra small.  My entire face did not fit in it. My eyes were closed and on the table itself because the hole was only large enough for my mouth and nose and nothing more. There was an elegant setup where a branded Dior towel was visible through the table hold but you couldn’t view this with your eyes being closed and lying on the table itself.

The massage started typically as all other high end spas, with hot towels to the feet and compressions through the sheet, and then the real luxury began.  The massage.  She undraped my back from the head of the table, and then covered me with fragranced lubricant. Then a fusion of lomi lomi magic began. Her massage strokes were long and continuous to the point that they felt neverending.  She started at the upper trapezius with a full hand and firm palm and worked inferiorly, introducing her forearms as she continued towards the ileums and beyond into the upper gluteus muscles. She then kept contact with her forearms in the reverse direction superiorly back towards my upper trapezius and repeated different variations of this.  She moved to the side of the table and performed more lomi fusion strokes in the shape of boxes over my back. The massage on the back alone was complete, engulfing and superior.  She worked both arms while pronated and she finished the back massage with repeated massage strokes that started around my sacrum and continued superior up my back, neck and over my scalp to the crown of my head.

She then worked both posterior legs individually, appropriately undraping each area as she worked on it, and redraping it when she finished.  The posterior leg work included knee flexion range of motion (ROM), where she flexed my knee and placed a fabric barrier between my lower leg and her shoulder to work my hamstrings and more. It was an experienced, detailed and wholesome extremity massage, similar to how we teach some of our posterior leg work in our lomi lomi massage training here at the school.

I then rolled over into supinated position where she worked my anterior legs and arms individually, not missing a square inch of the extremities.  Almost every massage stroke was repeated at least twice, with every toe, finger and joint in between caressed with skilled therapy.

The massage therapist then draped my chest to perform an abdominal massage.  After the abdominal massage was complete, which included strokes through the obliques to the low back, she then turned her forearm parallel to my sternum, and stroked inferiorly to superiorly over my sternum to my cervical area back to my abdomen. It was expertly executed and divine.

She finished her thirty minute full body massage with facial and scalp work. The work over my head was brief due to the limited time we had, but perfect. She used extraordinary pressure to trace my mandible and zygomatic bones and it felt wonderful.  It was fairly extreme pressure but not too much at the same time. The contact of her hands was always full, similar to how lomi lomi massage should be executed. Lomi is rarely about digging or pointing.  Lomi lomi massage is more about long strokes that feel like they never end which was terrifically mastered by this Dior massage therapist.  I never expected her to attempt a full body massage in just 30-minutes, but she did it, and it didn’t feel rushed either.  It was perfect. 

After I got up and got dressed, the massage therapist led me back to the reception area where she had a jasmine infusion tea with cookie waiting and a small gift in a canvas bag as well.  It was a really nice ending to such an incredible massage experience.

The reception area has an impressive array of retail items, that range from massage crystals to cosmetics to clothing and fragrances. There’s plenty of eye candy shopping to view before or after your spa appointment.  I especially loved the baby Dior retail line (pictured above) which allows mommy and baby to share her favorite brand with products that are formulated without alcohol and other harmful ingredients. The crystals used in the Dior body treatment and massage services were also in the retail area for sale too (pictured below). 

Far from stand alone establishments like most spa, bodywork or massage therapy practices, Guerlain spa services are primarily offered in the world’s most prestigious locations, such as the Michelin Star Relais Christine Hotel in Paris, France. Like many other top resorts, hotels or destinations, spa treatment areas are often relegated to highly modified basements given this type of treatment of business is usually an add-on operation long after the business was established.  Spa and massage services became more prevalent, popular and in demand around the 1980s. Today, a top hotel or destination would be considered incomplete without these services.

I scheduled my spa massage therapy appointment in-person at the Relais Christine because I wanted to see it first, and I was having problems scheduling certain services as well. Upon entering the spa service area in the basement, I knew I wanted to experience my Gurlain service there.

The carpet itself is extremely busy, however, it wonderfully compliments the interior design of the basement, providing an exotic warm special. Wholly together it creates a combined elegance once would hope to see of the House of Gurlain. They have wonderful welcome beverages such as homemade ginger lemonade, spa snacks and more. In fact their spa sessions end with an individually wrapped Angelina chocolate which is a sure treat!

The service provider helped me choose a Sunday service special that included brunch with a 90 minute massage therapy appointment.  I had told her I was interested in scheduling the 90 minute massage that spent 30 minutes on the face and 60 minutes on the body which didn’t seem to available at her location on the website, and she expediently offered to provide some additional facial service during the Sunday 90-minute special which was a welcomed offer and customization.

The massage appointment itself started in the supinated position. After I had mounted the table and covered myself with the sheets, the massage therapist re-entered and covered my eyes with a cloth. Then she said she was going to provide 4 different scents for me to choose from, to use for my massage medium. While I’ve rarely ever seen Guerlain promote itself in the overly crowded Aromatherapy industry, they are using plant extracts to formulate their fragrances, so their products are considered to be aromatherapy practices by definition. 

She explained the ingredients of every aromatic concoction which included a variety of scents to inspire warming, refreshing, relaxing, energizing, comforting sensations. The scents were gently and slightly provided next to my nose so that I could smell each with the various explanations of their ingredients and purpose.  I chose the fourth and final scent offered which she said was considered their strongest aroma with neroli and other fragrance, although I did not find it strong in the least.  She also used a hot towel to cleanse and compress my feet prior to hands-on massage.

The hands-on application then began with warm oil, so oil warmers were in use which separates some of the higher-end establishments with this type of premium equipment and service.  The therapist started with enveloping strokes of the decollate and back being worked together simultaneously while standing on the sides of the treatment table, which was the extra large 40” wide version.  

After opening the massage with some beautiful anterior and posterior upper torso massage, the therapist then had me roll over into pronated position, and I had to place my face in the hole of the table instead of a face crest.  The therapist then appropriately placed a bolster under my ankles to support my low back while in pronated position.  One superior touch that Gurlain spa provided was a floral bouquet in a bowl placed on the floor, underneath the top of the table where I could view the flowers instead of the floor when/if I opened my eyes.  Below is a picture of what the flowers looked like in relation to the massage therapy table:

The therapist continued her massage with confident firm strokes and was excellent at using both the heel of her hand and forearms to apply pressure without pain. Her massage was engulfing as she worked opposing areas that included working the back and hamstrings simultaneously or the hip and opposing shoulder simultaneously. She also massaged my arms while I was lying in pronated position.  She moved my arms off the table to coordinate the range of motion (ROM) of my shoulder joint with more coordinated massage strokes of the back.

Her massage strokes were expertly coordinated as she whisked about, without ever breaking contact, even as she continually applied oils to new areas.  She traced bony landmarks such as the vertebral border of the scapula and did not miss other areas like working directly over the gluteus minimus.

When she finished with the back, she did not skip a beat by covering the back with one hand while the other continued contact down my right leg. After she covered the back with one hand she used that same hand to further expose that right leg and then continued contact and massage while dispersing additional oil to this new area.  She worked the posterior legs one at a time and then had me roll over into supinated position.

As promised, she customized my 90-minute massage by adding a few mini facial steps, which included cleansing, toning, eye and facial serum applications, facial massage plus moisturizer. Adding esthetic facial steps in place of massage time is a wonderful opportunity to showcase products and hopefully make a sale at the conclusion of service.  I would also say that aesthetic facial steps are less physically challenging that providing massage, and anytime a practitioner can do easier work they should!  Massage therapy practice is mentally and physically stressful work, so anytime a therapist can provide easier work at the client’s request or enjoyment, they should! It’s a win-win for all! Please keep in mind that most European massage therapists are dually trained to practice esthetic and massage services if they work in a spa environment.  Practicing massage therapy in other countries beyond the US usually requires much more extensive training than what individual states require in America.  Massage therapists should not practice esthetics or any other service unless properly trained and licensed to stay within their scope of practice.  

The facial massage itself was complex as expected of any experienced facialist working with an upscale retail line, which in this case was Gurlain.  She included bone tracing, finger pad tapotement, grasping, kneading, sweeping effleurage with those opposing area strokes again, such as pulling up the side of the face while simultaneously massaging and depressing the shoulder on the same side. She did not include scalp massage nor offered it, which was acceptable given my hair was clearly professionally blown out and styled, and scalp massage would likely leave my hair in disarray. Furthermore, they did not have salon services on-site which could remedy any type of hairstyle.  However, we feel it is always best business practices to offer services such as scalp massage and allow a client to decide if they want it, instead of deciding for them, regardless of your reason why you think it shouldn’t be provided.  As long as a service can be reasonably provided and is not contraindicated, it should be offered to clients.

After the facial service, the massage continued to both arms and legs, one at a time.  The therapist regularly provided compressive strokes through the top cover prior to exposing the underlying extremity. Each extremity was thoroughly addressed in both supinated and pronated table positions.  She even found an old ankle injury that most therapists do not recognize, and provided specific/extra therapeutic work on it too. Foot massage was provided on one foot at a time with focal work on the dorsal side.  The plantar side of the foot was avoided, likely to not make it too greasy or slippery, given the spa is in the basement with a long set of stairs to exit. 

When finishing the massage, she undraped both lower extremities and performed long sweeping and bony tracing strokes of the tibia simultaneously. She then washed her hands (after working the leg and foot area), and proceeded with similar strokes to the opening of her massage on both my anterior and posterior upper torso with a new aromatic massage medium that felt like lemongrass gel.  It had a refreshing scent that was both awakening and enjoyable. The therapist then told me the service was finished and she would step out of the room so I could get up. I exited the room to find a refreshing beverage and Angelina chocolate to conclude the service.

The spa is equipped with a whirlpool, sauna and shower facilities.  I brought my bathing suit and hopped in the whirlpool; however, it was a little cool for my preference, so I moved on to the shower area where I got to experience the Guirlain shower gel and body lotion which was divine. The spa establishment itself is intricately laced with retail product testers for personal use which helps promote those extra retail sales which are a real financial bonus to the service appointments!

My spa day started with Relais Christine Hotel’s Breakfast Buffet which was separated into 3 different stations of pastries, fresh fruit and a hot section. All of it was included and I certainly tried it all too. The hot dauphine potatoes, fresh fruit and strawberry flavored madelines were wonderful and better than I could have hoped for. They also had fresh pressed orange juice and made-to-order specialty coffees included with the brunch as part of their special spa package.

Overall, this half day spa service experience with breakfast and hydrotherapy was well worth the $250 euros. I thoroughly enjoyed the splendid surroundings, treatment and incredible staff of Relais Christine.

One of the only critical feedbacks I could provide for this appointment was the treatment table was a little high to mount and dismount.  I forgot to look to see if this was a stationary table, but there would be an expectation for high-end adjustable electric tables at a Michelin Star hotel spa, that should be adjusted in height for table mount and dismount. Other than that, this spa service truly matches the hotel's Michelin star. 

As massage therapy and spa appointments become more prevalent in an overall approach to today’s wellness, we’re finding ourselves carving out spaces for treatment all over the place.  Some establishments are relegated to the basement, yet turn into 5 star establishments. Others might be using the closet space as an add-on service to a pre-existing medical practice.  Some will have the luxury of building their massage or spa establishment from scratch. Regardless of how your practice came to existence, most of us are all seeking the same thing which is EXTRA SPACE.

In the United States, whenever we seek to renovate or build business space, we must do things such as make sure our bathroom facilities are ADA compliant.  Handicap bathrooms can take up a tremendous amount of space, and can leave less room for other needs.  However, once you have your handicap bathroom(s) in place, you’ll likely find yourself in need of additional bathrooms.  Running late because a therapist or client is waiting for a bathroom is preventable when additional bathrooms are available.

In Paris, where there’s extremely limited space beyond comprehension with businesses and living areas piled atop one another, I found a new toilet/sink combination that I have never seen before which is shown in this article. If you’re renovating or building new space, we hope showing this combo toilet/sink combo might inspire space savings ideas to enhance your practice. We would recommend relegating this type of space saving idea for staff use only, but having this available just for staff when compared to nothing at all is a great option!