Earlier this year, I came across a paper that put into words something I have believed since I started practising massage therapy …
Earlier this year, I came across a paper that put into words something I have believed since I started practising massage therapy …
At Centred, we work with individuals seeking to reconnect with their body through massage therapy and bodywork.
Earlier this year, I came across a paper that put into words something I have believed since I started practising massage therapy: the person in front of me matters more than the problem they have come in with. This is what has come to be known as ‘Person-Centred Massage Therapy’.
The paper, published in the International Journal of Therapeutic Massage and Bodywork in 2022, is titled Massage Therapy: A Person-Centred Approach to Chronic Pain. It was written by a group of registered massage therapists and researchers from Canada and the United States, and it argues that the massage therapy profession is well placed to deliver what health care often fails to provide: care that treats people as individuals, not as collections of symptoms.
Reading it felt like recognition. Not because it told me anything new, but because it articulated principles that guide how I work every day at Centred. And it did so with research to back it up.
In this post, I wanted to share the key ideas from the research, explain why I think the recommendations are vital for massage therapists and explore how we put the principles of person-centred massage into practice.
Person-centred care is a collaborative approach in which health care professionals partner with clients to deliver personalised care. The focus is on physical comfort, emotional well-being, and client empowerment. It places the individual at the centre of their own care, rather than treating them as a passive recipient of treatment.
This might sound obvious. Of course, we should treat people as individuals.
But, in practice, much of health care does the opposite.
Appointments are short. Conversations are rushed. Treatment follows protocols rather than preferences. And clients can leave feeling like their concerns were not fully heard.
The research paper argues that massage therapists are well-suited to deliver person-centred care. We typically spend longer with clients than most health care professionals. We work with touch, which creates a different kind of connection. And many of us already see ourselves as empathetic practitioners who focus on therapeutic relationships and individualised care.
But here is the important part: wanting to be person-centred is not the same as actually doing it. The paper sets out specific strategies that make person-centred care real rather than aspirational. And that is where it becomes genuinely useful as person-centred massage therapy.
The paper focuses specifically on chronic pain, which affects an estimated 30% of people worldwide. That is a staggering number. And for many of those people, conventional medical treatment has not worked.
The authors point to research showing that common medical interventions for chronic pain, including opioids, steroid injections, and certain surgeries, carry significant risks and often have minimal benefit compared to a placebo. This does not mean these treatments never help. But it does mean that for many people with persistent pain, the standard medical approach is not enough.
One reason for this is that chronic pain is not simply about tissue damage. The International Association for the Study of Pain updated its definition in 2020 to recognise that pain is an experience influenced by biological, psychological, and social factors. Two people with identical physiology can have completely different pain experiences.
This shift in understanding has major implications for treatment. If pain is not purely structural, then chasing structural fixes will often miss the point.
A person-centred approach acknowledges this complexity. Instead of searching for a single source of pain to fix, it works with the whole person to improve function and quality of life.
One of the most striking parts of the paper is its discussion of language. The words we use as practitioners matter. They can reassure and empower, or they can frighten and disempower.
The authors warn against overly pathoanatomical language, meaning language that emphasises damage, weakness, or structural problems.
Phrases like “your spine is out of alignment or your muscles are weak or you have the back of a seventy-year-old” might feel like useful explanations. But research shows they can create nocebo effects, making people feel broken, fragile, and fearful of movement.
This matters because beliefs about the body influence outcomes. If someone believes their body is damaged and fragile, they are more likely to avoid activity, more likely to catastrophise about pain, and less likely to recover. The language health care providers use can reinforce these beliefs, sometimes for years.
I see this regularly. People come in having been told negative things about their bodies; their posture is “terrible“, their shoulders are “a mess“, or their hips are “crooked“. They have internalised a story about their body being fundamentally broken. And that story often does more harm than whatever is actually going on in their tissues.
At Centred, practising person-centred massage means that I am careful about the words I use.
I avoid language that implies damage or fragility. When I explain what I am finding during a session, I focus on what is happening rather than what is wrong.
Tension is not the same as damage. Tightness is not the same as weakness. And most importantly, nothing I find during a massage appointment means someone is broken.
Another key principle from the paper is shared decision-making. This means that clients and therapists work together to develop a shared understanding of the situation and decide how to respond.
This differs from the traditional model, in which the practitioner assesses, diagnoses, and prescribes while the client follows instructions. Shared decision-making recognises that the person receiving care is the expert on their own life, body, and priorities.
In practice, this means asking questions and listening carefully to the answers.
What matters most to you? What are you hoping to achieve? What has worked before, and what has not? What does your pain stop you from doing that you wish you could do?
At Centred, every first appointment begins with a conversation.
I want to understand what has brought you here, who you are, and what you care about. An athlete, or someone training for a marathon, has different needs from someone who wants to sleep better at night. An office worker who spends long hours at their desk and experiences neck tension needs different support from a tradesperson with lower back pain.
During the session itself, I check in regularly.
Is this pressure right? Would you like me to spend more time here? Is there anything you would like me to do differently?
These questions are part of making sure the treatment is genuinely useful for you, not just technically correct.
The paper also discusses therapeutic alliance, which refers to the quality of the relationship between practitioner and client. Research shows that a positive therapeutic alliance, one based on empathy and mutual trust, can improve treatment adherence and amplify the benefits of treatment itself.
This is not about being nice for the sake of it but creating the conditions where someone feels safe, heard, and respected.
When those conditions are present, people are more likely to engage with their care, follow through with self-management strategies, and experience positive outcomes.
Building this kind of relationship takes time and attention. It means remembering what someone told you in the last session. It means noticing when something seems off and asking about it. It means being genuinely curious about the person in front of you, not just the symptoms they have brought in.
I think this is one of the things person-centred massage therapy can offer that many other forms of health care cannot. The format of a session, typically 60 or 90 minutes of one-to-one time in a calm environment, creates space for connection. It would be a waste not to use it.
The final strategy the paper highlights is promoting active self-management, particularly through physical activity.
Exercise and movement have strong evidence supporting their effectiveness in reducing pain, improving function, and supporting overall health. The World Health Organisation recommends 150 to 300 minutes of moderate-intensity activity per week for adults.
But here is the key: the best exercise is the one you will actually do.
The paper emphasises that programmes should take into account people’s specific needs, abilities, and preferences. Walking, swimming, yoga, cycling, gardening: what matters is finding something sustainable and enjoyable.
At Centred, I see massage as one part of a bigger picture.
The work I do on the table can help with immediate discomfort, reduce tension, and create a window of opportunity for movement. But lasting change usually requires something more. That might mean gentle stretches at home, a gradual return to activity you have been avoiding, or simply moving more during the day.
When relevant, I will discuss this during sessions. Not in a prescriptive way, as if I am handing out homework, but as a conversation about what might help. Some people want specific suggestions. Others prefer to figure things out themselves. Both approaches are fine. The point is to support you in taking an active role in your own well-being, not to create dependency on treatment.
Reading academic papers is one thing. Putting principles into practice is another. Here is what person-centred massage actually looks like at our practice.
Every new client gets a proper conversation before we begin. This is not a tick-box health questionnaire (though we cover the necessary safety information). It is an opportunity to understand what has brought you here, what you are hoping for, and what matters to you. I want to know about your life, not just your symptoms.
No two sessions are identical, even for the same person. I pay attention to how your body responds and adjust accordingly. If something is not working, we change it. If you discover during the session that you need something different from what we planned, that is fine. The treatment serves you, not the other way around.
I avoid catastrophising about what I find. Tight muscles are normal. Tender spots are common. None of this means you are broken or that something terrible is wrong. I explain what I am noticing in neutral, accurate terms and answer questions honestly without creating unnecessary worry.
During the session, I check in about pressure, focus areas, and comfort. After the session, I am available if questions come up. Between sessions, you can contact me if something changes or you want to adjust your approach.
Massage can help with many things, but it is not a cure-all. I am honest about what massage can and cannot do. Sometimes the most helpful thing I can offer is a referral to someone else, whether that is a physiotherapist, a GP, or another specialist. Person-centred care means putting your interests first, even when that means acknowledging the limits of what I can provide.
The Lebert paper concludes with five key takeaways for massage therapists seeking to practice person-centred massage therapy:
I would recommend adding a sixth, based on my experience of person-centred massage: remember that the person in front of you is a person, not a problem to be solved.
Person-centred massage is not a technique. It is not something you can learn in a weekend course or add to a list of qualifications. It is a way of thinking about what we do and why we do it. It requires genuine curiosity about other people, a willingness to listen more than you talk, and the humility to recognise that you do not have all the answers.
If you have tried massage before and felt like you were processed rather than cared for, I understand. That is not how it should be.
At Centred, we do things differently.
We take the time to understand what you need. We adapt our approach to suit you. And we treat you as a whole person, not just a body on a table.
That is what person-centred massage means to us. And that is what you can expect when you book an appointment.
Lebert, R., Noy, M., Purves, E. and Tibbett, J. (2022) ‘Massage therapy: a person-centred approach to chronic pain’, International Journal of Therapeutic Massage and Bodywork, 15(3), pp. 27-34. Available at: https://doi.org/10.3822/ijtmb.v15i3.713.
Centred is a therapeutic and wellbeing practice based in Hessle, serving clients across Hull and East Yorkshire, offering integrated mental health and bodywork services.
Founded by Ben Campbell and Zac Botham, the practice combines counselling, psychotherapy, massage therapy, sports massage, somatic bodywork and breathwork to support whole-person wellbeing.
Zac Botham is an ITEC-qualified, FHT-registered Massage Therapist and SMA member, offering person-centred massage, sports massage, deep tissue massage, Swedish massage, and the Centred Bodywork Method.
Our integrated approach means you can address what you need, when you need it, through massage therapy, sports massage, deep tissue, and trauma-informed bodywork.
