For many of us, physical aches and pains are the trigger for making an appointment for massage. We know that massage therapy can speed our recovery from injury, and even help us live better with chronic pain.

But did you know that massage can also help with the pain of living with depression, anxiety, trauma, or stress?

Tessa Burns, a clinical psychologist and owner of Serenity Now Wellness in Calgary, uses an approach in her practice called integrated body psychotherapy. Simply put, it’s about how the mind and body are interconnected. That approach evolved into Serenity Now Wellness, an integrated therapeutic centre comprising counseling and physical therapies such as acupuncture, nutrition, naturopathy, and massage. The RMT on staff, Laura Dunlop, is a graduate of Vicars School of Massage Therapy.

Tessa says that in counseling, sometimes a roadblock can happen when a patient is delving into stress or trauma. The feedback between brain and body manifests itself physiologically.

“The patient will be holding their shoulders tight and stiff, for example, because the body is reacting to their brain telling them it isn’t safe,” says Tessa.

Helping patients relax helps with receptivity in counseling. She’s also found that when the body is physically manipulated, as with massage therapy, patients can get a more profound result from counseling and feel the benefits more wholistically.

“A lot of the work that we do will be very challenging and there will be a natural tension when you are doing really emotional work.”

In her practice, she encourages patients to have a massage after a counseling session, to help relieve that tension.

She cites books by physician Gabor Mate and the late neuroscientist and pharmacologist Candace Pert as excellent sources for research and experiences in mind-body connections.

As a graduate student in 1972, Dr. Pert discovered the brain’s opiate receptor – the cellular site where the body’s painkillers and “bliss-makers,” the endorphins – bond with cells to weave their magic. Her discovery led to a revolution in neuroscience, helping open the door to the “information-based” model of the brain which is now replacing the old “structuralist” model.

While there are centres specializing in physical health that will bring in counselors on occasion to help patients, Tessa approaches things from the other direction.

“Because I’m a psychologist I see everything from the mental health lens,” she says. “I focus on the benefits of touch therapy because I want to address the physical aspect of mental health.”

The mechanisms and effects of massage therapy are not yet as well researched as those of other disciplines, such as physical therapy, have been. Victoria-based writer, educator, and consultant Eric Purves is trying to address that. With years of experience as an RMT and with a master’s degree in rehabilitation medicine, Eric’s specialty is the biopsychosocial science of pain in massage therapy, where the emphasis is on facilitating and supporting a person rather than “curing” their disorder.

His focus over the past decade is contributing to and synthesizing the massage therapy research that does exist and incorporating it into massage therapy practice. He translates research evidence into practical applications through workshops, courses, and seminars intended for professionals who treat people with touch or movement techniques.

When it comes to massage therapy’s benefits, research by such leaders as Dr. Tiffany Field, who founded the Touch Research Institute, validates that massage therapy can reduce certain types of pain, decrease anxiety and depression symptoms, and even promote weight gain in premature babies. But the specific biochemical and biomechanical reasons that this occurs remain elusive.

In a 2011 literature review of research on massage therapy’s effect on the stress hormone cortisol showed that there isn’t conclusive evidence that can link the two. Author Christopher Moyer of the University of Wisconsin has written that “…other causal mechanisms, which are still to be identified, must be responsible for massage therapy’s clinical benefits.”

But those benefits are real, and there’s research to back it up. An earlier paper by Dr. Moyer, published in The International Journal of Therapeutic Massage and Bodywork, notes the parallels between the therapeutic alliance in massage and the private interpersonal contact between a psychotherapist and patient as an area for future research to explore. He wrote that the effects of massage therapy “on anxiety and depression, when quantified, are similar in magnitude to the effects observed in hundreds of psychotherapy studies.”

There’s evidence that the intangible aspects of getting a massage—the empathy, trust, and respect between client and therapist—have tangible benefits for the client’s mental health.

Eric Purves’ knowledge and experience confirms the importance of the therapeutic alliance, the positive relationship between client and clinician. He says it is one of two components important for the mental health benefits of massage and is the foundation of every successful massage treatment.

The second important component is person-centered care. In his former clinical practice and now in his workshops, Eric stresses the importance of listening to and validating a client’s concerns as the first step in person-centred care.

“We want to move the focus from treating a particular condition to treating the person who has the condition so that we are treating the whole person,” Eric says.

Eric has also found that that validation is often a transition point for clients. When clients feel that someone is listening to them and believing them, it helps them begin a journey towards living well.

“They are able to move from an ‘I’m trying to fix you’ to ‘I’m here to support you’ situation,” he says. “It makes a huge difference in helping them learn to manage their condition and live well with what they are experiencing.

“There is a lot of data that suggests that the person-centered care approach in massage therapy, particularly for people with chronic conditions, whether it’s mental health or a systemic disease or a pain problem, tends to work. And clients get better not because they are being fixed, but because they’re learning to live well with what they have.”

Eric joined Vicars School as a curriculum advisor in 2022. He has worked with Curriculum Director Linda McGeachy to help ensure the school continues to meet a high standards of educational excellence as required by national accreditation.

Students who train at Vicars follow an intensive two-year curriculum that incorporates knowledge and techniques addressing whole-body conditions. Part of that curriculum focuses on how to be part of an effective health team managing mental health conditions.

At the very start of the students’ first-year classes is an introduction to the different pathologies of the body, including the nervous system, musculoskeletal system, and mental health.

“The concepts in the pathology course are built on throughout the full two years of training,” Linda says. “The theory is reinforced in the clinical setting, where students will work with clients with a range of conditions and disorders, including mental health issues.”

Linda also arranges for mental health experts to speak with students in coffee chats so that students will know where and how to refer clients if necessary. Other speakers from societies representing neurodiverse populations, such as those living with ADHD or autism, also come in to share their knowledge with Vicars students.

Vicars training is based on person-centered care and the therapeutic alliance.

“We don’t look at the disorder by itself,” says Linda. “We focus on building empathy and trust so that there’s a healthy relationship with the client.”

At Vicars, effective massage treatment is always a collaboration between the client and the therapist. A well-trained massage therapist never performs a one-size-fits-all treatment. Instead, the therapist begins with a thorough interview and assessment and develops a customized treatment plan based on the client’s needs and goals.

“It’s important to understand what some of the manifestations of these conditions could be, so that the therapist can then be aware,” Linda says.

A Vicars-trained RMT will work with the client to ensure that they create a safe, calm, and welcoming treatment environment, where there’s no pressure, judgement, or stress. The RMT will explain the treatment plan before they begin and continue to check in throughout the appointment. They’ll also pay attention to non-verbal cues like muscle tension and breathing patterns to make sure that their client stays in their comfort zone. Throughout the treatments, the RMT will help their clients maintain healthy boundaries and will remain within their own scope of practice as well.

Vicars School students have been going to see physical therapists, social workers, chiropractors, and psychologists a lot lately.

But don’t worry—they’re fine!

What’s going on is that this is the time of year that our second-year students start an assignment that brings them into contact with their colleagues in health care. It’s a practical way for them to learn about other health care professionals, to learn more about what they do, how they do it, and how their profession works with ours. It is part of our community collaboration initiative.

Vicars School graduate Maggie Bruce, who secured her first RMT job through the Community Collaboration Initiative.

No single health profession has all the answers. It’s important for our students to learn the value of professional collaboration with their peers in other health care occupations, so they know where to refer their clients, and how to encourage others to refer patients to reputable massage therapists when that is appropriate.

Each health-care profession is a discipline with an approved scope of practice: the treatments and procedures that individuals in that discipline are trained for and expected to provide effectively. If a treatment falls outside their scope, they make referrals. Dentists don’t remove tonsils. Massage therapists don’t treat broken bones.

Referrals between professionals have always happened. In massage, we learn to keep detailed and clear records of each client’s health history, treatment plans, and results. Within our practices, we use that information to refer to as we prepare for their next appointment. When we get a referral, these records are used to make a report to the referring professional.

At Vicars, our community collaboration initiative brings our students together with other professionals in several ways.

The first is the simplest: throughout the year, qualified individuals are invited to be a guest for a massage at one of our supervised public clinics. The colleague meets their student therapist and the clinic supervisor, asks questions, and shares insights about how massage therapy complements their practice or profession, and then gives feedback about the treatment they received. Everyone learns something, and the encounter helps to break down barriers between different, but related, fields.

The second part of the initiative is the community collaboration assignment that students begin early in second year. Over the course of eight weeks, students connect with a health care colleague and begin to foster a professional relationship.

Each student reaches out to a professional who may refer clients or patients for massage therapy and who may hire massage therapists to work in their clinics—such as chiropractors, occupational therapists, and physiotherapists. The student sets up a meeting, during which they tour the facility and have a conversation. If time and space permits, the student will give the practitioner a massage on site.

The assignment concludes with the student later sharing what they have learned in an essay and with their fellow students in class. Instructors ensure that different students meet and report on as wide a range of health professionals as possible to contribute to the class’s shared knowledge.

As the third part of our community collaboration work, Vicars School is building a roster of multidisciplinary employers with which we have a more formal relationship. At time of writing, these include Massage Addict, with more than 100 owner-operated clinics across the country, including Edmonton and Calgary; ProActive Health Group, which works with elite and competitive athletes in their two clinics and one mobile unit in Calgary; and Serenity Now Wellness, a Calgary-based counselling service that also employs massage therapists.

These businesses are encouraged to invite Vicars students on site to shadow and learn about the organization, and to host talks on campus. At these coffee chats, students hear from community collaborators about their real-life multidisciplinary experiences, especially as it relates to massage therapy. These talks also contribute to the students’ training about the challenges and rewards of massage as a business.

Some multidisciplinary clinics, explains chiropractor Greg Uchacz, founder of ProActive Health Group, take the interprofessional arrangement further than just sharing space and facilitating connections. He says his group is an example of an integrative centre where experts work together as a team to solve problems.

“The barriers between professional designations fall away and each person plays to their strengths,” when you get professionals all around the same table to address an issue, he says. “In the sports world, this is very well established.”

Massage therapists, chiropractors, athletic therapists, and sport physicians work together to bring out the best performance from elite athletes and teams.

At Vicars, we appreciate the time and energy put in by the partner businesses who are part of this initiative. And we’re happy to say that so far, our partners are getting as much benefit from the program as our students are.

With their involvement, they get an inside track on meeting and hiring Vicars grads. We don’t mean to be immodest, but we know that Vicars grads are in great demand all around the province. They’re a bit like cookies at the holidays: when you have hired one or two, you go looking for one more.

Calgary grad Maggie Bruce is a perfect example of how this relationship works as a win-win for students and community partners. Maggie went in October for a day at ProActive and shadowed a physiotherapist, the front office staff about the business side of the practice, and Dr. Uchacz, a chiropractor.

“It was cool to glimpse the world of a few different professions, and to see how other therapists operate.

“I have never been to a chiropractor before, so I was interested. I saw how he incorporated some of the stuff I do. He warmed up with some massage and then did some myofascial work,” similar to what she had learned at Vicars.