CE INSTITUTE LLC BLOG

by Selena Belisle, CE Institute LLC Founder/Instructor 

Massage therapists, bodyworkers, occupational therapists, nurses and even my veterinarian are using essential oils for therapeutic benefits.  Aromatherapy is our first medicine, which is a skilled and balanced practice that’s somewhere between an art and a science. Aromatherapy uses plant extracts which usually create various essential oils for different restorative values or purposes. Adding aromatherapy to your medical practice can provide some of the following therapeutic effects:

• Stimulant
• Relaxant
• Decongestant
• Antimicrobial
• Diuretic
• Analgesic
• Astringent and more

So why isn’t aromatherapy practice more popular? Or why isn’t aromatherapy treatment available in all medical practices?  Wouldn’t everyone want to consume natural plant extracts instead of modern-day pharmaceuticals?

The answer to all of these questions is largely factored by unreliable essential oil harvesting and production.  Plants can be exposed to drought, disease, spoilage and other uncontrollable elements of nature. So, while most medical pharmaceuticals have been developed in a controlled lab environment with reliable precision, using plant extracts that are born from nature is another matter.

Aromatherapy essentially works through a harvested plant’s chemical constituents.  Different plants are made up of different natural elements which aid in their own protection, survival and reproduction in the wild. Chemical constituents are known as the different elements from the Periodic Table of Chemical Elements that makes up a plant’s properties to survive and reproduce.

Today we have well documented formulas of elements for almost every known plant species that still exists. Plants that are harvested for aromatherapy use can be effectively identified through their elemental composition, and combining different plant elements can share a variety of different therapeutics uses. Those benefits are multiplied when different combinations of these specific elements are blended together in different quantities. The most common example of using elements to make a variety of substances on the Periodic Table would be the creation of water. O represents the element for oxygen and H represents the element for hydrogen on the Periodic Table of Chemical Elements.  Combining 2 elements of hydrogen with 1 element of oxygen is known as H2O or water.  Hydrogen or oxygen by themselves are not water, but when combined with a specific formula you have water.  The  same types of formulas can be developed with plants in aromatherapy practice. 

Today, we might have over 400 different species of the geranium plant alone.  While we can visibly tell the difference between some of the geranium plant’s different species, it’s their nonvisible chemical constituents that sets them apart. And remember it’s those different combinations of chemical constituents that create the various therapeutic uses of every plant.

Have you ever wondered why some flowers can smell so pretty?  That aroma may repel some, but it’s designed by nature to help attract fauna or bees to visit and spread their pollen to aid in the plant’s reproduction.  It's a plant’s unique combination of chemical constituents that creates a plant’s signature aroma that can be used for human therapeutics, beyond its initial natural design.

The same applies to a plant’s survival or protection.  There are various insects, fungus and other potential natural harms that could infect or kill a plant.  And just like some plants have different aromas to aid in their reproduction, they can have other aromas to deter harmful insects or other naturally occurring threats.  Those aromas would be a different combination of chemical constituents to aid in a plant’s protection or survival. An aromatherapy example of using a natural plant’s protective chemical constituent combination would be citronella essential oil, which is used to produce candles and bug spray as an insect deterrent.

Over time, whether through accidental surprise or academic study, we have learned which natural chemical constituent combinations can provide different therapeutic benefits.  Many of these human aromatherapy uses were founded thousands of years ago, such as using mint leaves as a digestive aid. Humans were even tattooed with plants materials instead of inks for health benefits.  So why hasn’t our oldest medical practice continued with better prevalence?

Why don’t we have essential oils with anti-inflammatory chemical constituent properties in the same drug store aisle next to the other NSAID’s such as ibuprofen or Advil? While some aromatherapy practices still continue to this day, many do not. 

One of the main reasons natural aromatherapy is not more prevalent is due to harvesting and production practices which include manmade chemical pesticide use.  In today’s world, manufacturing processes seek the fastest and cheapest methods to produce salable products, regardless of what’s being produced. This includes GMOs used for food production and chemical pesticides used with essential oil production.

Some pesticides are considered carcinogens and are generally considered harmful to human health.  And unlike food production/distribution which is widely regulated by governments to protect public health, essential oils do not enjoy the same monitoring.  In addition to less monitoring or laws applying to essential oil production, there are some essential oil manufacturers that make claims that are simply not true. This leads to unreliability and breaks public trust with aromatherapy practice.

The truth is, some essential oil manufacturers would go out of business if they lost an entire year’s crops. And many crops are lost to natural pests or disease.  Please ask yourself, how would you fare if you lost an entire year’s income while still having to pay your bills to exist?  Are you willing to take the chance to learn or see this?  Because that’s the choice a crop manufacturer faces on a regular basis when applying pesticides. It is our belief that most essential oil manufacturers are not going to risk a year’s harvest when they can easily use pesticides to protect their crops and income.  It’s just good business to protect your product, and pesticides are some of the quickest and cheapest methods to produce a reliable crop from nature, that is until there are better health regulation laws with crops used to produce and manufacture essential oils.

So that leads us to this painting included at the top of this article.  Do you know what that relaxing scene depicts?  That is a painting from 1890 by the artist Anna Boch which depicts a young woman picking various plants and flowers.  Please take notice that there are a variety of plants shown in the painting, unlike what would be grown today. 

Today we have monoculture fields of lavender, rosemary and other plant materials that can be used for their chemical constituents or essential oils, where the crop can be easily harvested and produced as one.  But before today’s fairly reliably manmade pesticides, harvesters would sow various plant species amongst one another for increased plant protection.  Various plants have different aromas with their various unique combinations of chemical constituents, so while some plants might be more susceptible to some harmful insects or natural disease, other plants might have aromas or chemical constituents that could provide better protection from those specific pathogens.  This painting from 1890 perfectly depicts organic plant protection, where various plants have been grown together to protect the harvest of all of them. It's the various plant's chemical constituents that not only protect themselves, but also organically assist in protecting the other surrounding plants through their various compositions of chemical constituents.

Why don’t we continue to grow different plants amongst one another for better natural protection instead of using harmful chemical pesticides?  The reason is harvesting.  Organically picking various parts of individual plants grown amongst others is difficult; and in most cases, would require human labor which is expensive.  It’s cheaper to use a tractor or machine to mow down a field as one, rather than pay for a human to pick clary sage from a mixed field. The amount a tractor can harvest in a single monoculture field versus what a human can manually pick in a mixed field is incomparable.

So, if you’re interested in adding organic aromatherapy to your medical practice, please try to find quality manufacturers with responsible harvesting and production practices.  Obviously, the situation depicted in this painting would be best, where natural resources are skillfully used to protect various plants instead of manmade chemicals.

There are many other considerations with organic aromatherapy practice which we teach here at the school, however, this important point was made example of by Musee d' Orsay’s 100 Works That Tell the Climate Tour in Paris, where they used 100 paintings to provide examples of how climate change and other factors are affecting our existence.

We want to thank the Musee d' Orsay for pointing out this important point of plant harvesting that can be used to improve aromtherapy's essential oil production and quality.  This is an incredible story that will hopefully be memorable through the example and use of fine art.

We’ve been wanting to introduce Thai massage education at the school for a while now; however, it’s usually quite inexpensive to fly to Thailand to study this modality over there, at one of several Thai massage schools that welcomes Americans to their studies.

Thai massage is usually performed on a floor mat, fully clothed, with a balance of passive stretching exercises and compressions where some clients might describe it as being twisted into a pretzel in the best imaginable way possible.  Thai massage gently and passive moves human joints through normal ranges of motion to increase function, relieve stress and other health benefits.

In this Thai Spa that I got to visit as a walk-in client on the streets of Paris, I found a well decorated and clean establishment with welcoming staff.  We looked through their menu of services and while I had originally wanted a Thai massage, I thought it would be a better learning experience to see what or how a Thai practitioner would provide an oil massage, so I booked the oil massage instead. Oil massage is the more typical practice of what we teach at CE Institute LLC, so I have been consuming as many different massage appointments as possible to see if I can learn or experience anything different to continually share in updated education at our training facility.

After I had established which type of appointment I would experience at this Thai Spa, the service provider immediately had me remove my footwear in place of theirs.  This is a Thailandese traditional and cultural norm that promotes sanitation and conveys mutual respect and care. I asked to use the bathroom first which every practitioner should offer prior to massage, so that the appointment is not disrupted with a need to use it!

For this Thai oil massage experience, the massage therapist brought me into a small treatment room and asked me where I wanted the massage focused. I told her my legs were sorest of all from walking the city of Paris, and then she told me to disrobe and to lay pronated on the massage table.

The table was covered with a narrow sheet of paper over what looked like a cotton printed sheet from Thailand which was beautiful.  Towels were folded on the corner of the table to cover myself with and the therapist split a hole in the paper where my face was to be placed to breathe.  I opted to put my sweater over the hole and leave my head turned to the side for sanitation reasons.  The room was dimly lit and beautifully decorated with wallpaper; however the lighting in the ceiling was neon in color which gave off the wrong vibe for me.  I would have enjoyed lightning to be in a soft warm yellowish tone which would have felt more comforting than being in a neon lit room. I believe soft yellowish lighting would significantly improve the spa’s existing beautiful assets.

When the therapist re-entered the room, she started her service with hot towels to my feet, then strong compressions on the soles of my feet.  She worked superiorly moving into compressions with her palms over my heels and upwards through my calves and hamstrings.  At some point during the posterior lower extremity compressions, she jumped onto the table between my legs and continued her compressions through my hips and low back without missing a beat. Most clients would probably not know the practitioner was now on top of the table instead of beside it; however, it was clear the direction and pressure she was provided could only be achieved from being directly over the top of me. A while ago, some massage organizations required that a massage therapist maintain one foot on the ground at all times during a massage appointment.  I’m not sure if that requirement still exists, but it would be hard to follow in Thai practice where therapists usually hop onto the table for better leverage.

The massage began with warm oil with a bottle she kept in an oil warmed in the corner of the room.  For sanitation reasons, we would recommend to elevate this oil warmer onto a higher shelf area, and to wash both the oil warmer itself and the oil bottle between clients to avoid cross contamination.

The massage itself was slightly disappointing, as the therapist repeated the same strokes over and over again.  I was surprised when the initial oil application started from the hips and was applied towards my feet inferiorly which is against venous return and ill-advised.  Once the oil was applied, the massage therapist changed direction and started strokes superiorly from the feet to the hips, to promote venous return.  Unfortunately the same stroke was applied over and over again, repeatedly, in a manner that simply felt boring and uninteresting.  It’s almost like she was going through the motions of providing the massage without any clear intention or care for its purpose.  It’s been a long time since I’ve felt such a detached massage as this one.  The speed and contact of the massage were decent, but it felt like the massage therapist was not mentally present, in the moment, and that feeling was overly emphasized when she left our treatment room in the middle of the massage without explanation, to speak to other incoming customers and staff at least three times within a 30-minute period.

We did have a language barrier where I speak enough French to get by; however, no attempt to discuss contraindications or goals were made other than asking where I wanted the oil massage applied on my body.  In the end, I regretted not scheduling a Thai massage in this Thai spa, wondering if that would have been a better service than what I had received.

When I dismounted the massage table, my legs did feel better so I was glad to experience some therapeutic effect from the appointment because when I was on the table, it felt like there would be little to none.  I did notice that the paper sheet that had been used to cover the table was no longer intact, which concerns me from a sanitation standpoint, especially if they are not changing that beautiful cotton sheet directly underneath it.

When I re-entered the reception area to pay, I encountered another client who was putting on the spa’s footwear so I asked her what she had scheduled. She responded she did not know but was a regular client who lived on the same street.  I was pleasantly surprised to find this regular client going to this establishment for her own benefit despite not knowing what she was receiving.  I asked her if she was disrobing for oil massage or being stretched through her clothes, and she described a Thai massage that was finished with some brief oil massage application which she said she thoroughly enjoyed and has come back many times to receive.

In the end, what I received at this Thai spa would not be the same experience for all Thai establishments.  The phrase “when in Rome” kept coming to mind during my massage here, which said to me that while I’m in a Thai spa, I might have benefited most from a Thai service such as Thai massage.

Have you ever wondered where spa’s come from?  Who thought of this concept?  When? How? Why?  Modern day spas today are most closely related to ancient Greek practices with an eventual Roman evolution of bath houses from thousands of years ago.  Our earliest known spa use is tainted by muddled history stories, with whatever evidence feels strongest for one to follow or believe. 

In ancient Greek and Roman times, bath houses were frequented amongst multiple classes of society. While the wealthiest may have had a private bath within their own home, they would still frequent the public bath houses as a way of life. They were places for recreational, health and social activities, in addition to the most obvious use of bathing for personal hygiene and sanitation.  

Detoxifying and Vasoconstriction with a Cold Plunge and Contrast Baths at the Spa

Did you know that Roman bath houses had different baths, usually at different levels and with different temperatures? Public bath houses could be heated with fire under the floors, and cold baths or cold plunges would usually be the lowest level of the bath house, where they are dug deep into the ground to preserve a chilly temperature.  

So, while today, cold plunges are all the rage as it can vasoconstrict soft tissues which helps eliminate waste products held within the body in an ultimate detoxification, it’s likely this cold plunge process started in Roman public bath houses, with its multi-temperature baths which would also known as contrast baths. An ancient Roman bath house is where these multi-temperature baths were collected and housed or used together in one establishment.

Muscular Soft Tissue Healing, Recouperation and Vasodilation at the Spa

Today’s modern day spas will offer a variety of bodywork and massage services that will manually increase circulation whether it’s pressing the soft tissue to create an ischemic effect, then releasing the soft tissue which will in turn produce a resurgence of blood and nutrients to the affected area.  This increases circulation and all the riches of newly oxygenated blood to an area for increased cellular metabolism and healing.  By contrast in ancient Roman bath houses, participants would exercise in a yard or dedicated area to sport to increase their circulation.  

We have gone one step further today by creating machinery and electrical devices to increase circulation within the spa business.  This is anything between pressotherapy garments that even hospitals use, with air pressurized balloons gently squeezing the soft tissue then releasing it, which will help increase cardiovascular circulation as well as help prevent blood clots if an individual is sedentary.  We also have massage chairs that we can sit in to help increase circulation with pressing and releasing soft tissues, as well as hand held devices and much more.

Do Any Ancient Spa Establishments Still Exist?

Yes, many old bath houses which might also be known as the world’s first spas still exist, although most fell into a period of disrepair until being rehabilitated or repaired for mostly tourism attractions today. For example, it’s the Musee de Cluny at 28 rue Du Sommerard, 75005 Paris, France which is the ancient Roman spa that is mostly pictured throughout this article. 

Today’s modern Paris Museum which is called the Mussee de Cluny was built on an approximate 2,000 year old ancient Roman bath house which was actively used for approximately 200 years. The museum’s curators suggest that any Roman city conquered was fairly worthless without a set of Roman baths, and in this particular area, there were three of them.  The bath house we have pictured throughout this article at the Musee de Cluny was the center of the area’s social activity, where people came to relax, exercise, have their hair cut and read.  Some ancient Roman baths had a public library. That’s fairly similar to what is practiced today, where magazines and travel books are shared common fare in a modern day’s spa reception area.

The Musee de Cluny’s ancient Roman bath or spa was split into three different levels.  This included an area deep underground, where hydraulics and drainage were routed.  

The ground floor entrance was an open exercise area.  This ground level area consists of both indoor and outdoor rooms with more rooms above.  

The museum curators suggest that bathers would start at the bath house with a hot bath, which was also called the caldarium. Then bathers would move onto the warm baths with tepid water in a tepidarium.  The last place the bathers would go in their spa ritual would be the frigidarium which is also known as the cold room.  

The Archaeological Crypt from the Ile de la Cité, just in front of Notre Dame Church, has another ancient Roman Bath in ruins available for public display with the purchase of a ticket, similar to how one would view the Musee de Cluny.  The crypt's Roman bath was believed to have been in use until the 4th century. Below shows a map of how this 2nd Roman Bath was configured. 

The following video without narration shows the Roman bath ruins that were buried for centuries and recently unearthed between 1965 and 1970 at the Archaeological Crypt from the Ile de la Cité.  The map showing above is flipped or in reverse to what will be shown on the video below, so the video starts at the left of the unearthed baths and starts with the entrance, then leads to the frigidarium, them moves on to the tepidarium and ultimately ends in caldarium.  

There are many other spas or bathing houses throughout the world that still remain, some in better conditions than others with one of the most popular being “Bath” in Somerset England, where many have gone throughout time to “take the waters.” And pictured below is a peasant spa in Yugoslavia where public bathing and cupping was practiced for health around the 1900s.

The oldest spa in the world may be in Pakistan which is dated back to 2500 BC, approximately 4,500 years ago.  But the truth is, we may never know where the oldest spa originated given volcanic eruption, time and dust has covered most of the earth’s surface as well as the loss of areas due to sea erosion and more.  What we do believe is that the ritual of spa is a centuries old practice that has evolved into a wonderful modern day marvel that continues to restore health through the ages.

Did you know that lifting one leg while seated can help relieve low back pressure or pain (for most)?

In this salon in Paris, they have foot rests in front of their chairs to help clients feel more comfortable while seated for hair styling services. These comfortable foot rests are almost non existent in American salons. 

While this salon is not the nicest in Paris, nor in the best area, they have provided this wonderful and useful foot rest/asset to provide their customers some comfort.

When setting up your treatment stations and work areas, think about how you can make your clients more comfortable. It's the little things like this that can improve a customer's experience without much effort. 

Seeking services from others can help expose practitioners to new products and items that may be used to improve your own business. Industry trade shows also offer a wonderful education of new products available on the market, and they usually provide show prices with massive discounts to purchase at the event as well. 

It's important to learn and use what's accessible or available in the marketplace for your business or practice, so that you can provide the best service to your customers of all.

By: Selena Belisle, Founder/Instructor, CE Institute LLC. The images included in this article are stock photos and not from the spa itself because they prohibited photos to protect client privacy.

The following information is a professional evaluation conducted of an add-on facial service provided in London's hotel spa luxury market.  It is our hope in sharing this one-time experience that both practitioners and business owners can learn how to maximize operations with add-on services, such as this mini facial appointment example: 

From a business perspective, providing add-on services should not just be about scheduling extra services for extra income. That would be an extremely narrow view of such a wonderful business opportunity.  Add-on services also diversify a practitioner’s work, sometimes exposing practitioners to new clients. Other times you might expose clients to new products that are used during the add-on.  Clients may be exposed to a mini-service with the add-on, and then upgrade or rebook for the full service as well.  So, there is a LOT  potential to be had with an add-on service, but it’s up to each individual spa or massage establishment business to offer or maximize it.

Most establishments enjoy an approximate 100% mark-up on spa products.  They might pay $20 for a product and then retail it to customers for $40.  Retailing products is a wonderful method to increase income without much effort.  Providing add-on facial services to massage and bodywork appointments is a wonderful way to increase income both through added service, potential service upgrades and rebooks, and with retail potential income as well.   Of courses massage therapists and bodyworks should not provide esthetic or facial services without proper training and licensure.

What we have found is there are some who provide add-ons like the service I had at this establishment, the YĀTRĀ Urban Spa at Montcalm Royal London House. But the potential of this extra business is minimized when extended services or retail are not offered with it.  Service providers should be compensated approximately 10% of the sale price on average with retail sales, so it is in their financial interest as well to provide retail sales suggestions with their services.  Plus, massage therapists, estheticians and other personnel are usually paid a commission of each service, so it’s in the practitioner's best interest to suggest to upgrade to longer and greater services when they have the time to do so, to continue to maximize their income while at work.

Regardless of all of this added business potential, this was my personal experience at this London spa with my Radiance Lift add-on. 

The Radiance Lift add-on was advertised as a "kombucha-infushed sheet mask" and showed a picture of a face and facial sheet next to the service description. Applying these facial sheets only takes a minute or two at most to apply. I was curious what the spa would do for the remaining 14-minutes of this appointment so I booked it! The service provider will usually just pull a sheet from an enclosed source and place it over the client’s face, to their comfort level.  Almost anyone can place a facial sheet over their own face, but regardless of applies it, allergies or other contraindications such as skin burn, rash, etc. must be considered first.  This is why the practitioner must be properly trained to provide this service.

To my pleasant surprise, no facial sheet was offered, but a mini facial was provided instead.  I didn’t ask why they didn’t provide the facial sheet as advertised and prepaid for.  The entire spa service provided was not a great experience, and I did not want to add to the negativity by asking or pointing out that what they were providing was different than what I had scheduled.  In reality, I was thrilled to receive the mini facial instead of the facial sheet application that I had already paid for. 

If the massage therapist who provided the mini facial performed a skin analysis, she did so silently, without questions, so her analysis was incomplete at best. The reason why you want to ask questions if I do have some red tones in my skin, and if I had exfoliated that morning, then a service provider would not want to provide a double cleanse or exfoliation within a few hours a later.  That could result in a medical error with skin burn or other soft tissue damage. Her mini facial was provided in the following order:

She started with a facial cleanse which was wonderful and then ended with wiping the cleanser away with a cold towel while standing on the side of the table which was awful.  The spa establishment was unaware and not prepared for the facial add-on which I had scheduled and prepaid the day before this appointment, so I’m not sure if their hot towel cabi or hot water was broken; however, cleanser should be removed with a  warm to hot towel to open the skin’s pore for a greater cleansing effect when wiping the skin.

She repeated a second cleanse followed by another awful wipe with a cold towel.

This was followed by a wonderful facial massage, when she later told me was a facial oil when I had asked her what it was after the service had concluded. A third cold towel wipe of this facial oil was used with poorest skill level of all.  After wiping my entire face, the towel was not adjusted so the dirty area of the towel that had just wiped my face was now applied to wipe over my eyes. As a trained and licensed esthetics instructor myself, this disgusted me and made my eye area feel dirtier than when the facial service started.

In professional spa services, a new towel should be used after every step as well.  In this service, I’m not sure if she used a new towel with every wipe, but it did not feel like it.

Toner was applied next with what felt like some form of cotton, in a manner that could have been improved.  At least I think it was toner.  I would have to guess because she did not tell me what she was using nor doing, and I did not ask her so that I could evaluate her service as she provides it, instead of possibly making her nervous with questions or giving suggestions on how to improve the service through questions, etc.  The contact between the cotton and skin was firmer than necessary, and the order to which the cotton was applied to the skin was erratic.  She moved between my cheeks to the forehead to the chin and other areas in a nonsensical order that I have never felt before and simply felt like a misapplication. A more standard application of cotton to the face would be working upwards, downwards or laterally, with working upwards the regularly preferred method with facial services.

I believe the therapist finished with dabbing moisturizer on my face.  The beautiful massage strokes she used with the cleanses and facial oil were gone, and a rougher quick spread of product across my face was applied instead which was an extremely unpleasant finish after the cold towels and inappropriate use of cotton.

This practitioner provides incredible massage strokes and has beautiful hands. She would likely benefit from another practitioner emulating what it feels like to have a cold towel, too much pressure with cotton and a rough moisturizer application on her own face, so that she could learn from this and know from feeling it that those steps can be seriously improved.  However, in the end, human services are usually a personal preference, and what I enjoy, another may dislike and vice versa.  However, after decades of education, personal practice, employment, employing others and teaching these types of services, I believe I have a reasonable opinion of what the general population likes or expects with this type of service, and these are my opinions.

I do not know if this spa establishment offers retail skin care products.  I did not see any publicly available in a very small and sparce reception area of one of the nicer hotels in London.  If the spa does not provide retail, then they are missing added potential business income in addition to not providing the best service of all to a client.  With facial services in particular, we would want a client to be able to continue with appropriate facial cleansers, exfoliators, moisturizers and other specialized requirements for ongoing skin improvement and glow. If a client purchases a retail product that is only available at your establishment, and if they like the product because its providing results, then the client may have to return to your establishment for more product when they run out, which could result in additional scheduled services upon their return with other greater business opportunities.

We do not recommend substituting services without a client’s knowledge or consent, like what happened with this service at this establishment.  Every business, as some point, will usually run out of supplies.  Sometimes manufacturers discontinue products and there also can be supply shortages, shipping issues and other problems.  The reason why it’s important to gain the clients’ consent prior to altering their service regardless of the reason is a provider may complete an altered service, and then the client has the right to request the service they paid for, which means you could provide an alternative service without payment if consent was not acquired beforehand.  It is our opinion that clients do not have to pay for services that were provided but not scheduled.  We believe substituting services without a client’s consent, whether it’s prepaid or charged after the fact, could be seen as a fraud upon the client, which is usually illegal, or criminal is US based practices.  So, I believe the massage therapist ran the risk of providing this mini facial service for free, if I had requested the paid Radiance life appointment I had scheduled afterwards.

I do not enjoy writing critical reviews that point out poor skill level and execution; however, it is written for our students and other practitioners to learn from, because we often do not see constructive criticisms like this in writing.  We wrote this analysis here solely for our school’s teaching purposes where our students can hopefully learn from this experience and use it to improve their own services.

By: Selena Belisle, Founder/Instructor, CE Institute LLC

We are utilizing stock images in this article to help define regular facials and mini facials; however, many of the images do not depict appropriate eye protection.  When cleansing, exfoliating, masking, etc., the client should have cotton eye pads over the eyes to help prevent skin care products from entering or harming the eyes.

A mini facial is usually an abbreviated service of a regular full facial.  It might only include a few steps of a full facial service to:

• Save time and provide a shorter service when greater time for the full service is not available
• Provide a more economical service option to the client
• Use as a paid advertising option to get clients on the table with hopes they will upgrade to the full service once they start to experience the steps
• Provide as an alternative service is a client is contraindicated or cannot have the full facial service, such as:
  • when a practitioner is fully booked and the client is running tardy
  • the client cannot receive certain aspects of full facial service such as they had:
    • a recent exfoliation
    • facial radiation oncology treatment
    • other contraindications

Full facial services are usually between 50-60 minutes long, with luxurious or specialty facials reserved for 80-90 minute services.

Full Facial Services Usually Include Any Combination or Multiplication of the Following Steps:

1. Professional Skin Analysis Including Oral Intake & Questions
2. Cleansing, including manual, brush, machinery and other methods.
3. Exfoliating, including manual/mechanical, chemical, machinery and other methods.
4. Toning, including spritzing, wiping, atomizer
5. Steaming, and other steps and applications to open pore for deeper cleansing
6. Extractions, including manual extractions and using tools to provide a deeper cleaning of the skins pores
7. Electrical applications for various purposes
8. Machinery applications for various purposes
9. Masking
10. Massaging
11. Serum applications of many different varieties and uses.
12. Eye cream applications
13. Moisturizing
14. SPF application for daytime appointments
15. Steps may be deleted or added upon at a service provider of establishment's discretion

Facials with greater steps or additional products including tools and machinery than what is listed above might qualify as a specialty facial instead of what’s considered to be a normal or regular facial service.

Mini-facials can be provided in a multitude of different methods or steps which can  include any of the following:

1. Cleanse
2. Tone
3. Moisturize

1. Double Cleanse
2. Tone
3. Moisturize

1. Cleanse
2. Tone
3. Massage
4. Moisturize

1. Double Cleanse
2. Tone
3. Massage
4. Moisturize

The Following Alterations Could Made to the Suggested Mini Facial Routines Above

• A facial masque could be substituted for the massage.
• An exfoliation or exfoliating cleanse can be substituted for the 2^nd cleanse instead of a double cleanse. 
• Serums, eye moisturizer and machinery services that are quickly applied can be added as well.

All facial services regardless of length should always be subject to a professional skin analysis to ensure:

• appropriate products are used
• avoid allergens  
• accommodate precautions
• learn of contraindications
• meet client goals

Mini facials can be executed somewhere between a 10-to-30-minute service, depending on how many tasks are performed.  We believe a decent mini facial would take approximately 20 to 30 minutes for the best efficacy and experience. Regardless of how long you offer your mini facial for, the time should be advertised similar to massage therapy appointments, so that a client is not upset if they feel the service should have been longer than what was provided.  It’s difficult to start a mini-facial over again after the client has already been moisturized. We want to avoid negative experiences as service providers, nevermind the waste of moisturizer or products when identical steps must be repeated to correct a problem.

Licensed service providers including estheticians should develop a working relationship with a professional skin care brand where they can develop reliable use and application of known products, and then retail those products for at home use and continued client benefit.

I sought a walk-in foot reflexology appointment at an eastern influenced Reflexology establishment in Paris.  Upon entering, one of the first things I saw or realized was that it was the cleanest, most sleek or professional in appearance when compared to our similar establishments in ANY country. They provided open services which allowed a greater amount of clients to be served than an establishment that has set up private treatment rooms instead.

I was seeking to analyze various eastern modalities practiced in European cities and this experience did not disappoint.  By its own standard of eastern Tuina practice, it was likely the best reflexology asian fusion appointment I have ever experienced which I found in a small establishment in the southside of Paris.

They had a variety of appointments available which included both Reflexology and Tuina, with a small retail area on shelves. The different appointments, time-lengths and combinations provided busy tourists and walk-ins appropriate options to select or more importantly upgrade into longer services.  So they have maximized their business opportunities with the available space, which was good to see the excellent forethought in this establishment. I speak a little bit of Chinese from my time studying at the Beijing Massage Hospital in China, so I engaged the women in Chinese and they were pleasantly surprised to hear my attempt at their language as an American tourist in Paris. All of the women appeared to be extremely well trained Tuina practitioners of Chinese descent. This was my opinion from viewing their methodical hands-on application which was continued effortlessly and without missing a beat regardless if they were directly looking at their work, or the walk-in patrons.  Their speed, thoroughness, anatomical foot movement with joint mobilization and other professional anomalies exposed their expertise.

The practitioners gaze up from their work as new potential patrons walk-in on the busy streets of Paris, to welcome them and encourage them to enter for service.  In most Tuina establishments, client privacy or speaking to others while providing open services is normal, despite it not being or feeling the most professional when providing a one-on-one medical or massage service, especially to a client who is used to more discreet western practices.

At first, I attempted to book a 60 minute service which would include 30 minutes foot reflexology and 30 minutes tuina. The Tuina was defined or explained as body massage on their service menu with pricing.  I was told they had availability for my appointment and they asked me to sit in one of the relaxing chairs next to other customers, and then I waited for a period of time while the providers continued to work on other clients who had arrived and started service before me.  Pictured below is what I would consider a relaxing chair or lounge chair which further reclines for client comfort.  Relaxing chairs allows access points to a client from three different positions for massage therapists, reflexologists and other service providers:

1. Providers can sit in front of the client to work the feet and lower extremities.
2. Providers can sit to the sides of the client to work their hands and upper extremities.
3. Providers can sit or stand in back of the client to work the head, neck and upper torso.

After sitting for a considerable period of time waiting, I told them I had another appointment and would only be able to do the 30-minute reflexology due to time constraints, and the woman who appeared to be running the front desk then went and got a bucket of tepid water lined with clear plastic for a foot soak and placed my feet in it.  This plastic should be replaced between clients for sanitation reasons.

When I put my feet in the soak for my 30-minute appointment, I wondered how much of my 30-minute appointment was going to be spent in the soak after already sitting there for so long.  However, the manager immediately proceeded to the back of my chair and started a dry facial tuina application.  After putting my feet in the soak she had then left to go wash her hands, so I thought I was going to be left there sitting again as I had watched some of my staff treat clients. Instead, I was very happy to see that my time in the soak would be spent with an upper body massage.  The manager started with facial massage in clearing my 3rd eye and worked her way superiorly to apply quick pressure and stimulation on various meridians throughout my scalp, around my ears and continued posteriorly and inferiorly to my cervicals.  She used extreme pressure through my masseter and buccinator muscles, all through touch and feel given she was standing behind me and could not see what she was touching from behind the chair.  She continued to use the bony landmarks of my face to start and finish different strokes while my feet were in the soak. She then turned my head to one side and then the other, as she applied grasping techniques from my upper to my mid-back, reaching between my soft tissue and the chair as she worked superiorly to inferiorly down my erector spinae muscles.  It was all completely wonderful, and a real bonus to a 30-minute reflexology session.

Once she finished with my upper body massage and foot soak, she removed the bucket of water and sat in front of me. She then applied baby oil to one lower extremity and foot.  While Tuina or reflexology would usually be applied without a massage medium in China, baby oil is typically used in establishments outside of China for its excellent glide, including on the palms of hands and soles of feet, plus its inexpensiveness.  My provider's initial application of her reflexology felt like I was going to receive Tuina on my feet instead of a reflexology application; however, when she started manipulating around my toes with excessive pressure, I asked her to use less pressure and she then said she was working around my ear reflex points, so that helped me realize and differentiate that she was truly practicing reflexology with what felt like some sort of Tuina influence.  The following are some notes of this foot reflexology session from an obvious Tuina expert practitioner:

1. There was no care working around broken toe joints.  I have several broken toes and some of the joints have started to fuse with the fractures; however, this therapist manipulated those long-time broken joints with force and without hesitation which made me nervous; however, no harm was done, and it does seem like my toes feel and move a little bit better with this manipulation too. In American application, if we manipulated similarly and accidentally damaged or broke a toe joint with such force, we'd likely be sued and find ourselves as a defendant in court.

2. She worked one foot at a time and didn't wrap the second foot while working on the first or vice versa.  The other providers in the establishment did, which was good practice and what we teach here at our school.  I believe the manager working on me might have been a bit out of practice with client comforts, and performed the appointment herself when all of her other staff were busy, and I had already waited an excessive period of time for my appointment to begin.

3. The practitioner used excessive pressure where it felt like a 10 VAS Score.  I repeatedly asked her to use less pressure, which was sometimes followed for about 10-30 seconds before excessive pressures resumed. In America, it is considered unethical to ignore a client's request or direction for legitimate therapeutic service, and could also have greater consequences if a client is injured after not appropriately adjusting to a customer's request.

4. After approximately 10-minutes instead of the foot reflexology session on just one foot, I started feeling euphoric.  It felt like channels of energy within my body were awakened with good spirits.  It's hard to put it into words beyond simply stating that I overall felt better health, despite the excessive pressure being applied to my feet which was quite painful. It is typical in western or any application to feel better during reflexology, massage or other bodywork during and after service.

5. Approximately 25-minutes into my 30-minute reflexology session I felt an overwhelming feeling of nausea.  I have taught and practiced reflexology for decades, and while I had never personally experienced this feeling despite receiving hundreds of reflexology sessions myself, I did have my first experience with it during this appointment and it was overwhelming.  It is possible that I could have felt nauseous with or without the reflexology application and we'll never know otherwise.  It's so irregular amongst recipients that it's hard to say nausea could be a reflexology side-effect, and while it is rare, it has been repeatedly reported throughout the years.  I simply allowed the reflexology to continue and the feeling eventually subsided.  In an western reflexology application, I might continue the reflexology for a few minutes similarly.  If a client starts to rapidly deteriorate during reflexology, I would immediately stop and seek appropriate medical attention.  But in this case here, the nausea became an afterthought that I had forgotten about once I stood up, until I wrote this article. I never mentioned my feelings of nausea to the practitioner due to our language barrier, and I was more focussed on trying to help her understand my need for less pressure, nevermind the new feeling of nausea!

6. During the reflexology application, I couldn't help but notice the poor ergonomics of hand, finger and knuckle use, which includes pressing into soft tissues which puts excessive pressures on a practitioner's joints.  Unfortunately this is mostly unavoidable during reflexology practice, unless you use a tool which we also do not feel is appropriate.  Foot reflexology application is not appropriate work for any practitioner who is experiencing pain, arthritis or other medical deterioration of joints of the hand, regardless of your training, practice or background.

7. On a more positive note, the practitioner did move my foot around in many to many different angles with her continuous application.  I personally usually just leave a foot in its normal anatomical position and work around the foot as it lays.  After viewing this methodical alteration of foot positions, I may start new reflexology routines here at the school in which more vigorous repositioning of the foot for different access is applied.

8. In this reflexology application, the practitioner worked the lower extremities in addition to the feet which we feel is acceptable and good practice when the provider has time.  The most important focus would be spending the majority of the appointment time stimulating the reflex points though, which this practitioner did.

9. This reflexology application was laser precise, thorough and fast.  I thought I worked quickly and recommended students to not exceed the speed of my application; however this practitioner was even faster than I am with her stimulation of points which is surprising.  I had doubted true reflexology's effectiveness when points are merely quickly passed over with stimulation versus purposely applied with greater intention and time. This quickness and speed seemed effective by this extremely experienced reflexologist.

10. Her foot reflexology application was similar to what we teach in regards to the different areas and thoroughness of the foot which receives various strokes and stimulation.  While the speed remained quite fast throughout, she did use simultaneous and alternating strokes similar to how we apply reflexology with both hands over an individual foot.  Even the knuckles are used singularly for stimulation and simultaneously, similarly to how we teach to apply our foot reflexology lung press here at the school.

11. The reflexology application included pinching, pushing, striking, rubbing, pressing and other soft tissue stimulation applications. There was practically no gliding which we teach to help relax a client, with the exception of a very fast application of gliding strokes which almost amounts to friction, when she used the heel of the palm over the lateral dorsum of the foot.

12. Probably because baby oil had been applied, she finished her service on each lower extremity by taking the paper towel from under my foot and using it as a barrier to massage my lower leg and foot with various compressions which felt quite nice. These compressions with the paper towel allowed most of the oily residue to be removed. When she removed the paper towel from underneath my feet which was placed there for likely sanitation reasons, it left my feet directly on a red towel.  I am concerned about the reuse of these red hand towels from one client to the next.  Linens such as these with direct client contact should be laundered between clients and not reused.

13. While we do love utilizing relaxing chairs and offering open services which maximizes establishment service provider space, in this particular case the setup hyperextends the client’s knees (seen in the picture above) which we do not feel is good practice, and in some cases, could leave a client’s knees feeling worse than when they started. I am only 5’4”, and every client who was taller than me suffered the same joint hyperextension. This can easily be adjusted by properly bolstering the knees with some type of support such as a professional bolster, pillow or rolled towel.

14. The 30-minute reflexology session was completed with very significant and hard striking tapotement, where practitioners raised their hands high in the area and then struck the lower extremities, in addition to using force with their strikes, including pounding the calcaneus of the sole of the foot with their fists.

When I stood, the first thing I noticed was how light I felt. It felt like I had lost 50 pounds! There was a certain lightness in my feet where my legs didn't feel heavy, which was an unusual feeling after spending so much time walking through Paris, seeking places like this one. Any feeling of nausea had dissipated and was forgotten.  The next morning, I did have some soft tissue soreness in some areas of the feet, where they had likely been overworked with too much pressure, however I would not call it significant pain.  My feet still felt great but the obvious feeling of lightness no longer remained.

What was nice to experience in Paris with this European influence on reflexology service provided with eastern influence was slightly better sanitation and visual esthetics than what is normally found in some of these foot reflexology establishments. I had a tuina massage in London that was so unsanitary and professional that I was not able to write about the experience without being overly critical.  For example, one of my legs was bolstered with a roll of toilet paper.  In writing professional evaluations and reviews of the massage and bodywork services, we want to review good examples and provide learning experiences to avoid poor examples as well for overall business and career improvement.

In conclusion, there are a lot of similarities and some stark differences with foot reflexology applications between western and eastern practitioners.  In the end, both application styles are effective.  It is my opinion that western reflexology applications are taught to be more sanitary, professional and discreet while eastern applications may result with more immediate noticeable effectiveness.  Now if we could only merge the two together while avoiding legal liabilities, we'd likely have the most effective and therapeutic service of all. 

This establishment, the providers and its location are purposely not disclosed to protect their privacy.  While we would recommend services there given the quality when compared to the rest of their unique class, the intention of this article is to provide an analysis for learning and improving our own individual practice, with no other ulterior motive or purpose.

This is professional evaluation of the 15-minute 20 pound (that’s $27 US at the time of service in 2025) Radiance Scrub add-on service that was offered with my 60 minute massage at the YĀTRĀ Urban Spa at Montcalm Royal London House. This is merely a professional opinion of a one-time experience at this establishment.

The massage therapist was assigned to perform both add-ons I had prepaid for with my massage therapy appointment.  There was some serious disorganization at the spa because apparently no one was aware that I had added and prepaid for these services the day before (DON’T).  After I added my massage appointment and appointment time to schedule on this establishment’s website, I was then given the option to schedule some add-ons with it (DO’s). There were around 5 different add-ons to choose from(DO’s), and there was not much to any description of what the service would be.  All of the add-ons were 15 minutes and 20 pound each (DO’s), and you were able to add more than one as well (DO’s). It is great business for both the spa and customers to offer add-ons (DO’s).

I chose the Radiance Scrub as an add-on which I assumed was a full body scrub given its 15-minute advertised application.  I had to guess what it would be, because there was no description of the service on their website (DON’T)and no contact information on the spa’s website pages (DON’T).  I believe a 15-minute scrub application wouldn’t be appropriate for the back or decollete because both areas would be raw after 15 minutes. While 15 minutes for a full body scrub is quick, it is perfectly doable. They do advertise a 15-minute foot scrub because if it was only an arms or legs scrub, then it would say arms or legs seeing they defined the foot scrub.  I tried to ask the practitioner twice if the scrub I paid for was a full body service, and she appeared puzzled and seemed to say yes, but I wasn’t really sure of what I would be receiving.

I had two prepaid add-ons with my massage (DO’s), and she chose to prioritize the scrub add-on over the facial add-on.

When the therapist asked me to return to the same room we had just left for the massage, she asked me to disrobe and lie face up on the massage table (DON’T).  I asked her if she wanted me to do that right now because she was standing far from the door and gave no indication that she would leave, and she responded, yes now.  So I took off my robe in front of her which left me naked, and then crawled naked in front of her onto the massage table into supinated position.  She placed a bath towel to cover my private areas, then began the scrub on my anterior legs.

The scrub application itself was poor.  The massage therapist used slow strokes with fairly firm pressure and it was fairly dry (DON’T).  To improve this body scrub application, a therapist could use slightly more scrub product, add a little bit of water to give the product better glide over the skin, and quicken her strokes with very little pressure. Scrubs in almost any area should be applied with quick light strokes to lift the outer layers of the epidermis in an attempt to remove dead skin and exfoliate the body.  

After the therapist finished with my legs, which she was able to complete on both anterior and posterior sides with flexing my knee on the table and reaching under for the posterior leg as well (DO’s), she moved onto my arms.

The scrub application to my arms was equal to my legs.  She was able to complete scrub the 360 degree surface of my arms while in supine position (DO’s); however, she used similar slow firm massage strokes with the scrub which was not enjoyable.  Here's an example of providing a full body scrub with steam to enhance the experience. This video visually demonstrates an appropriate application speed of light scrub strokes:

Then the therapist asked that I roll over onto my stomach in pronated position.  This was slightly unpleasant with the scrub application on the anterior side of my body.  We would recommend that if a practitioner can scrub 360 degrees around the arms and legs, then to have the client sit up on the table and swing their legs over the side so that the back can be scrubbed in a 15-minute full body application. Clients should be provided a towel or sheet to cover their anterior body while sitting, leaving their back exposed. This massage therapist chose to apply the body scrub similar to a massage appointment instead (DON’T), and started scrubbing my posterior legs once I turned over into pronated position.

My calves were scrubbed with the same slow firm strokes as her massage (DON’T); however, this therapist seemed to become more alert when scrubbing my hamstrings.  My upper posterior thigh scrub had quicker strokes and the pressure lightened (DO’s), so I was happy to feel like the therapist was remembering that scrubbing is supposed to be light and quick, and hoped she would continue that type of appropriate application to my back.  She did not.  After finishing with the legs, she undraped my back and continued the same slow firm strokes on my back with the scrub product, similar to how she applied it on my anterior body (DON’T).

Because this scrub was only 15-minutes and left on my body so that I could shower it off (DO’s), I would recommend the spa to provide waterproof slippers.  For my several hundred dollar spa treatment that included a massage with two add-ons, they provided me an ill-fitting robe and cloth slippers which are not appropriate with hydrotherapy services (DON’T).  We would consider a 15-minute scrub a partial hydrotherapy service because the client is going to have to shower it off, hence using water to complete the appointment by showering off the scrub (DO’s).

It is also appropriate with water soluble scrub such as salt or sugar, for the therapist to wet the scrub until it’s dissolves and then wipe the residue from the client’s body instead of requesting that they shower it off.  Regardless of the type of scrub application, the scrub must be removed to provide an appropriate and effective spa service (DO’s).

After she finished with my full body scrub, the practitioner moved on to provide my facial add-on.  This is ill-advised because she left me on the table slightly wet with the tacky feeling of the scrub on my body while performing the facial (DON’T). When providing a spa scrub that must be showered off in combination with a facial, the facial should be performed first and the scrub second.  For the 15-minute scrub, we would recommend scrubbing anterior and posterior arms and legs while in the supinated position, and then have the client sit-up and swing their legs over the side of the table to finish the scrub on the back, and then leave the treatment room so that the client can put a robe on or shower in privacy, if the shower being used is in the treatment room.

Images of the spa and staff are purposely not named or pictured in this evaluated due to the constructive analysis, and to protect their privacy. The pictures on this article are stock photos from other establishments. This was a poor experience at this spa and we are not trying to amplify the fact here beyond providing this information as  a teaching example of do’s and don’ts. This evaluation here is purely written from an educational standpoint of what to do or not do during a massage therapy appointment.  This is a personal opinion and experience to as learning and teaching opportunities to improve overall massage therapy industry practice and spa operations. This is an extremely fair and accurate description of what was experienced .  To claim it was better would be a false representation.

I scheduled an Indian Head Massage and Foot Reflexology appointment at the Calmer Clinic in London’s Dolphin Square.  This health clinic offers multiple holistic approaches for optimal wellbeing. There is an impressive array of healthcare services provided which include: Acupuncture, Coaching, Counselling, Osteopathy, Physiotherapy, Massage, Nutritional Therapy, Reflexology, Reiki and possibly more. It is an extremely well-rounded holistic establishment.

I went to the clinic first to inquire about the services and met a very pleasant Dolphin Square resident who was working in reception. She gave an extremely favorable review of this service and encouraged me to text the practitioner to schedule it. I texted the practitioner and her first available appointment was scheduled approximately a week later.

I arrived at my appointment and was greeted by the provider herself.  She was pleasant, professional and confident.  She brought me into a private treatment room and conducted a thorough health intake which included reviewing present disease, treatment goals, potential contraindications and more.  Once the intake was concluded, she had me sit in a chair without arms to start the Indian Head Massage first.  She placed a paper towel roll over the chair to increase sanitation measures and washed her hands before she began and after the session concluded as well.  Washing her hands after service concluded was important, despite still needing to provide a second service on me (foot reflexology).  The reason why a practitioner should wash hands between services like this is because she needed to setup the reflexology treatment area, and one would not want to touch equipment immediately after working on a client to prevent cross contamination.

She started and concluded the Indian Head Massage service with deep breathing exercises and reiki holds.  I sat still in the chair and she stood behind both me and the chair to execute the hands-on service, as pictured below:

After the introductory work, she started massage techniques with beautiful fingertip plus heel or palm of the hand friction techniques on the upper back through clothing, followed by deeper friction techniques, particularly around the shoulder blades which feels wonderful for almost any American.  Working through the trapezius around the levator scapulae and rhomboids are one of the top requested areas to work on in massage therapy practice, and that’s where she started which felt wonderful. She was fairly precise in following the strict protocol of Indian Head Massage which has specific orders of manipulation for therapeutic benefit.  She even included manual techniques that are similar to regular massage tapotement which were fairly intense.  She warned me of their intensity prior to beginning the striking technique.  Close to a minute into this technique, I told her that I would prefer to move onto something else and she happily obliged with complete understanding.

The service continually progressed up the cervical area and through the scalp, head and face with a wonderful combination of soft tissue manipulative strokes that were skillfully applied to each area.  It felt incredible and I never wanted her to stop!  I thought I would be uncomfortable sitting in a chair without arms, but there was some ritual feeling with the precise execution that made it feel more comfortable than I could have ever imagined. My guess is if the service is not properly executed, then a customer may not feel entirely comfortable in that chair for half an hour while the massage therapist gently moves about in many different motions and directions.

At the end of service, I felt relaxed and relieved.  There was a significant reduction in stress and pleasant euphoric feeling.  I would rate the hands-on application 5 stars and the clinical environment 4.5 stars.  While this authentic massage treatment was provided in a clinic, the chair for me to sit on was placed close but not exact to the middle of the room, and I kind of felt like I could have enjoyed it more if I had been seated in front of something visual, to close my eyes to as a lasting relaxing thought.  To me, plopping a chair in any place and providing service does work, especially when you’re as skilled as this practitioner, but environment matters, and the environmental execution of this appointment can be improved.

Regardless of the clinical environment, I would repeat this appointment over and over again on a weekly basis if I was local.  It was wonderful, incredible and everything special that it should be with any well-trained practitioner like this one.