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TREATMENT PLANS

When a client presents with a condition (or conditions), research may be required, in order

to ensure the most effective treatment. This is so that the practitioner can fully understand

the cause of the condition, and therefore devise the most effective Reflexology Treatment

Plan to help the client’s body to balance.

Firstly, the Reflexologist needs to “play detective” and establish information such as:

Is this condition an ‘Inflammation’ (remember conditions ending in “itis” normally mean

inflammation, such as Arthritis) or an ‘Infection’? (perhaps a virus or bacterial infection,

such as a cold or sore throat).

If it is an inflammation – the key reflex will be adrenals for anti-inflammatories.

If it is an infection – the key reflex will be the spleen, to fight the pathogen.

What is the main area affecting the client? (These would be the Key Reflexes).

For Asthma the Key Reflex is the lungs.

For Sciatica the Key Reflex is the sciatic reflex.

For High Blood Pressure the Key Reflex is the kidney reflex.

What other areas would it be helpful to work? (These would be the Helper Reflexes).

The Helper Reflexes for Asthma would be: the diaphragm, breast, solar plexus, heart,

sinuses, ileocecal valve and adrenals.

The Helper Areas for Sciatica would be: hip, knee, leg, spine, groin and abdomen.

The Helper Areas for High Blood Pressure would be: Solar plexus, diaphragm, breast,

heart, thyroid, pituitary and adrenals.

How long has this client lived with this condition? If the condition is recent, then

treatment may be effective after only a few sessions. If the condition is chronic, it may

take some time before the client feels improvement.

How often does the client need to see you? For reflexology to be effective, a weekly

treatment (at least) will need to be made initially. Reflexologists don’t normally treat

chronic conditions more than once or twice a week, as the body needs to adapt to the

treatment. However, if the condition is acute, treatments two or three times a day can be

given. Once the treatment has been effective, ‘wean’ the client off by treating once every

two weeks, then three weeks, etc. If you treat less than once per week, the effect of the

last treatment can be lost, therefore healing does not occur so reliably.

Once the nature of the condition has been established; whether it is acute or chronic; and

how long they have had it – the next step is to examine how it is affecting the body.

In order to decide which key reflex and helper reflexes to work, it is important to know the

function, and effect, on the body of working each organ and gland – please see the list below.

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THE REFLEX LIST

The reflexes are listed by system. This list is not definitive, but will be a good starting point

when devising a treatment plan, or when needing a quick reminder on the function of an organ

or gland.

When choosing reflexes for a treatment plan, don’t forget that if the presenting condition

affects a reflex in Zone 2 (ie, the kidneys) – any reflex in that same zone can be considered

a ‘helper reflex’. This will then help balance the entire zone.

THE REFLEX WHY / FOR

Musculo-Skeletal System:

Shoulder Stress, shoulder pain, immobility of joint, referral area (cross reflex) for

hip

Neck Whiplash or postural deformity, neck pain, headaches, migraine

Temple/Head Soothe for headaches and stress

Hip / Knee If client has arthritis in these joints, working them will help with pain

relief; referral areas for shoulder/elbow; pain, injury

Nervous System:

Brain Stimulate for lack of concentration, sedate for “busy brain”

Solar Plexus Stress, emotional problems – used to calm, accompanied with slow deep

breathing

Spine Work over any area that links to a reflex imbalance, ie lumbar spine for

bladder imbalance. Also soothe spine for backache, neck and headache

problems (see accompanying Spinal Reference Chart).

Endocrine System:

Pineal If client is having trouble sleeping, for jet lag and SAD syndrome

Pituitary Stimulating labour; any hormone imbalance, such as hot flushes; pain

relief; tumours and growth of any abnormal cells - known as the Master

Hormone Gland. Important for homeostasis (balance)

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Hypothalamus Stimulating labour; any hormone imbalance; emotions such as rage, pain,

pleasure; hunger and thirst sensations; body temperature; sleep patterns;

smooth muscle activity

Thyroid For metabolism and growth. Stimulate if hypo, soothe if hyper

Parathyroids Controls calcium levels (with the thyroid) so important for bones etc; also

helps to produce Vitamin D, so helps the immune system

Adrenals Soothe for stress. Stimulate for production of anti-inflammatories, so

work for any “itis”. Important for muscle tone, so work for IBS as helps

all muscle types. Helps with hormones in men and post- menopausal women.

Also for sugar balance and energy

Pancreas Stimulate for type II diabetes

The Special Senses:

Ear Dizziness (balance), ear infection, tinnitus, deafness

Eye Eye strain (computer operators), headache

Nose For nasal polyps, sinusitis, loss of sense of smell

Respiratory:

Trachea Client has ‘lost their voice’, sore throat

Diaphragm Any respiratory condition and stress, because the body becomes tense

when emotionally stressed and breathing is impaired

Lymphatic System:

Tonsils Stimulate to help client’s immune system

Spleen Stimulate if client fighting off an infection

Digestive System:

Oesophagus Heartburn, hiatus hernia, acid reflux

Cardiac Sphincter Acid reflux, indigestion

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Liver Sluggishness (no ‘get-up-and-go’); skin conditions; heavy menstrual

bleeding; to detoxify body; for sugar balance, metabolism and all

digestive problems

Gall Bladder For release of bile to help emulsify fats and lubricate digestive system

Stomach Soothe for indigestion, gastric ulcer, IBS. Stimulate to

and Intestines increase absorption of nutrients.

Ileocecal Valve Mucus production in any area of the body

Ascending Colon Soothe for IBS, wind, constipation and diarrhoea.

Descending Colon Constipation, IBS, haemorrhoids (rectum and anus)

Circulatory System:

Heart Angina, hypertension, stabilised heart attack

Urinary System:

Kidney Stimulate for elimination of toxins, soothe for hypertension.

Reproductive System:

Breast Soothe for fluid retention and tenderness; PMS

Ovary Regulation of oestrogen/progesterone balance. Soothe, if client is

menopausal

Prostate Stimulate, if male client cannot void urine normally, ie has to urinate

frequently during the night (nocturnal micturition)

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To further help prioritise the reflexes that need work, there is a Golden Rule. Firstly, this

involves reflexes that must be worked for every client, in every session. These are called:

Regular Maintenance Areas

Certain organs are vital for life, so these must be worked at every treatment:

Brain and Central Nervous System

Liver

Kidneys

Lungs

Heart

If even just one of these organs fail, the whole body will be in immediate danger of failing!

The Golden Rule – Helper Areas

Certain systems have common reflexes that help all conditions of that particular system.

The Golden Rule is to understand, and work on, the appropriate Helper Areas for each

system.

Most, but not all, systems have a Golden Rule (the helper areas) to learn! Once the helper

areas for each system are known, it is easy to prioritise reflexes for each condition – as long

as there is knowledge of which system is affected by the condition!

The golden rule/helper areas for the Respiratory system are - in addition to working the

Direct Reflex (chest/lungs etc):

The Adrenals – for inflammation and muscle tone.

The Diaphragm because it aids breathing and helps to relax someone who is stressed

or in pain.

The Ileocecal Valve to help with mucous problems (chest and sinus congestion)

The Spinal Nerves appropriate for the respiratory system.

The golden rule/helper areas for the Endocrine system are:

All glands – to balance body chemistry (the hormones).

Diaphragm – for emotions (stress, fear, tension, worry – all affect breathing)

Spinal nerves for the nerve innervations.

The golden rule/helper areas for the Reproductive System are:

Pituitary for FSH/LH.

Thyroid (because it is known as the third ovary).

Adrenal for the androgens (sex hormones).

Diaphragm /Solar Plexus for the emotions.

Spinal nerves for nerve innervations.

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The golden rule/helper areas for the Digestive system are:

Adrenals for muscle tone and inflammation.

Liver/gallbladder for bile (lubrication) as well as the other related functions.

Diaphragm / Solar Plexus for emotions.

Spinal nerves for nerve innervations.

The golden rule/helper areas for the Urinary System are:

All the system, plus the adrenals, for ADH, muscle tone and inflammation.

Spinal reflexes for the nerve innervations.

For ALL Systems: Remember that working another reflex in the same zone as the Key

reflex will support that reflex, and can be considered a ‘helper reflex’.

Also, it is important to work the appropriate Nerve Innervations for the client’s condition.

Each pair of spinal nerves sends messages to and from the brain to inform the body about

what is happening internally and externally - it assesses this information, and then acts upon

it to create change. If a part of the body is out of balance, it may well be due to a blockage

in the nerve supply or, if the spine is out of alignment, the nerve is compromised and

dysfunction in the associated part of the body may result.

Use the chart of Spinal Nerve innervations, on the next page, to help decide which nerves

would be the most beneficial to work for the client’s particular condition.

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Image reproduced by kind permission of Tony Porter © ART Reflexology

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So, armed with Key Reflexes, Helper Reflexes, the Regular Maintenance Areas, and

incorporating the Golden Rule (ie, Helper Areas), as well as the nerves involved - the tools

are available to create a highly effective treatment plan for individual clients.

Seven Point Protocol for devising a Treatment Plan

1. Identify the condition (or conditions) that the client needs help with.

2. Decide which system of the body each one belongs to.

3. Look up the Golden Rule (Helper Areas) for that system and list those reflexes to work

4. Decide upon the Key Reflex to work

5. Decide upon the Helper Reflexes to work

6. List the Spinal nerves which need to be incorporated

7. Check the list of Regular Maintenance Areas to see if any have been missed off the list

made so far - if they have, make sure that they are added in.

Example:

1. Client Mr D presents with long term, chronic bronchitis – this is an inflammation, and he

has had it for a long time.

2. Bronchitis is a condition that affects the Respiratory System.

3. Following the Golden Rule, the reflexes for the Respiratory System that need to be

worked are: the adrenals, diaphragm, ileocecal valve, and the spinal nerves for the areas

involved.

4. The Key Reflex must be the Chest/Lung/Bronchial reflex on the plantar and dorsal aspect

of the feet, as it is the affected area.

5. The Helper areas to work are basically the Golden Rule reflexes (you can see how helpful

it is to learn this rule!): the adrenals for the inflammation as it is an “itis”; the ileocecal

valve for the mucous in his lungs; the diaphragm to aid his breathing, and for the pain

from coughing. However, there also needs to be concern about his body’s ability to cope

with this illness, so it would be advisable to work the spleen for his immune system too.

6. The spinal nerves that need work would be: T3 for the lungs, bronchial tubes, pleura,

chest; T8 for the diaphragm; T9 for the adrenals; T12 and L1 for the ileocecal valve.

7. On the Regular Maintenance List, it is important to give attention to: the Brain and rest

of the spine; the liver; the kidneys. The Lungs are already covered as the Key reflex and

the Heart has probably also been covered when working the chest/lung area on the feet.

Mr D’s Treatment would look something like this (following the initial Investigatory Session

to make sure that there isn’t anything else going on):

Opening relaxation sequence:

Work chest/lung/bronchial area several passes plantar and dorsal. Work T3.

Work diaphragm well, and then T8. Work adrenals and T9, carry on to T12 and L1.

Work intestines, ileocecal valve and colon.

Work the liver and kidneys, work the spleen and then work adrenals again

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Return to Lungs/chest/heart/bronchial tubes plantar and dorsal.

Work the whole spine and the brain

Work the big toe too, as all the zones are in the head

Return to lungs/bronchial tubes

Sedate both adrenal reflexes

Hold solar plexus points on both feet, but do not ask client to deep breathe (he won’t be able

to with bronchitis)

Finish with relaxing massage.

Remember to get feedback from the client and give safe aftercare advice.

Each session might be slightly different, depending on the client’s response, feedback and

any change in health. For example, if he wasn’t sleeping well, it may be advisable to include

the pineal/hypothalamus glands. If he had pain in his ribs and shoulders from coughing, then

include the intercostal muscles and upper back and shoulders. If his sinuses were blocked,

work his toes well.

It is important to be adaptable and “think on your feet”, so to speak!

Ideally, it would be best to see Mr D weekly, for six weeks, reviewing after each session and

aiming for improvements in his breathing, pain reduction, to lessen his coughing and mucous

production, improve his sleep, energy levels and his overall quality of life. It would, of course,

also depend on his aims and his commitment to the sessions. The ultimate aim would be to get

him on to a maintenance programme of monthly appointments.

Aftercare advice could involve the recommendation of safe dietary changes, such as reducing

mucous forming foods, and increasing anti-inflammatory and immune-boosting foods;

breathing through his nose as much as possible, using some simple breathing techniques to

help with this. Research about his condition shows that, in a study, a group of chronic

bronchitis sufferers, who were asked to blow up a balloon each day (compared to the control

group) had a huge improvement in their condition. Mr D might want to have a look at the

study, or contact the hospital where it was conducted.

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GROUP WORK: CREATING TREATMENT PLANS

Think about one of the people going to be your case study:

Write what his/her condition is ………………………………………………………………………………………………………………

A bit about their lifestyle …………………………………..……………………………………………………………………………………

……………………………………………………………………………………………….…………………………………………………………………………

……………………………………………………………………………………………….…………………………………………………………………………

Now, go through the seven point Treatment Protocol (above) and create a complete

Treatment Plan for one of your Case Study Clients using the chart below:

Reflexology Treatment Plan

Objectives / Aim (what you and they hope to achieve):

Frequency (how often are you going to treat?):

Key Reflex Reason

Helper Reflexes

(remember Golden Rule!)

Reason

Nerve Innervations Reason

Regular Maintenance

Areas:

Reason/Effects

Brain, Spine, Liver,

Kidneys, Lungs and Heart.

As Reflexology is a holistic therapy, these organs

are always included. Also, these organs are all vital

for life.

N.B When you have studied the Meridians see if there are any appropriate points to

include in your treatment plan that could help your client.

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CRITERIA FOR PRACTICAL ABILITY HKCY008 4.1

Element of Competence Performance Criteria: Candidates must ensure that they:

Presentation of self in an

appropriate manner and to

appropriate standard of

appearance

satisfy all Health and Safety standards in relation to:

a. having clean, tidy hair; long or mid-length hair tied back off the

face;

b. having clean hands with short, clean nails;

c. covering any open cuts or abrasions with waterproof dressings;

d. removing jewellery from hands and arms, with the exception of

a wedding ring (other jewellery or body piercing to be discreet);

e. wearing clean, neatly pressed and hygienic clothing; ie tunic and

smart trousers (no denim).

f. wearing socks/tights and clean footwear appropriate to the

teaching environment.

Preparation of the Work Area a. arrange the appropriate equipment in accordance with Health

and Safety Regulations and treatment requirements;

b. use safe equipment and accessories that are clean and hygienic;

c. have hygienic facilities close to hand for disposal of soiled

materials;

d. have access to, and use, hand-washing facilities.

Receiving the Client a. introduce themselves;

b. guide the client to the work area, using positive body language

and a welcoming manner.

Carrying out the Consultation

Process

a. provide the client with an explanation of the theory and

philosophy of reflexology, together with the treatment procedure;

b. conduct the consultation in a quiet and respectful manner;

c. show sensitivity to the client throughout and demonstrate an

awareness of the confidentiality of the relationship;

d. communicate in such a way as to show their awareness of the

two-way nature of the process;

e. discuss with the client the treatment plan and gain their

agreement/signature.

Carrying out the Treatment a. assist the client onto the couch/into the chair, checking their

requirements for comfort as relevant;

b. record any visual and tactile observations, on relevant

documentation;

c. carry out a coherent, flowing relaxation sequence and treatment

routine appropriate to the client's needs;

d. note and record their findings of the reflex areas, together

with any client response or questioning.

Ending the Session a. wash their hands prior to offering a glass of water to the client;

b. allow the client a period of rest;

c. discuss the treatment outcomes, a possible future treatment

plan with the client and possible referrals to other practitioners;

d. explain the possible reactions to treatment in a positive and

encouraging manner;

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e. offer any after-care advice that is appropriate to reflexology

eg, self-treatment;

f. store all paperwork and treatment records in a safe manner.

Client's Departure a. assist the client off the couch or up from the chair, escorting

them out of the work area using positive body language;

b. return to the work area and ensure documentation is completed

accurately and clearly.

Evaluating the treatment process a. draw a conclusion from the client's response to the treatment;

b. with the tutor, or within the peer group, evaluate the

treatment, identifying one positive feature, and one area for

improvement, for future practice;

c. discuss the client feedback received.

By fulfilling the above Criteria, candidates should meet the requirement of the National

Occupational Standards for Reflexology: