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    Informed consent ensures clients understand a therapeutic approach fully before giving consent to begin. This also includes a discussion about the possible risks and benefits of receiving treatment, for the adult population adverse effects are often mild and transitory. Most common intervention-related adverse effects include increased pain and discomfort, aching muscles, headache, and tenderness (Skelly et al., 2020). Informed consent should involve a two-way flow of information and should include a clearly defined treatment plan. Shared decision-making will play a role in establishing a treatment goal, in doing so the patient and the clinician can work together to establish a clear consensus regarding the intended goals of treatment (Hoffman et al., 2014; Hoffman et al., 2020).

    Effective communication is fundamental for informed consent and shared decision-making. In order to provide understandable and accessible information clinicians should avoid the use of medical jargon and embrace the use of educational resources and visual aids to enhance patient understanding (Muscat et al., 2020; Wittink & Oosterhaven, 2018). During the informed consent process therapists should include a discussion with the person about:

    • the nature of the treatment;
    • the expected benefits;
    • risks and side effects;
    • alternative courses of action;
    • likely consequences of not having treatment; and
    • their right to ask questions about the information provided and that assessment or treatment will be stopped or modified at any time at their request.
    Key Takeaways

    Informed consent and shared-decision making will include a discussion about the possible risks and benefits of receiving treatment. The therapist and patient will work together to develop a plan of care based on the individualized goals and needs of the patient.

    References and Sources

    Bialosky, J. E., Beneciuk, J. M., Bishop, M. D., Coronado, R. A., Penza, C. W., Simon, C. B., & George, S. Z. (2018). Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. The Journal of orthopaedic and sports physical therapy, 48(1), 8–18. doi:10.2519/jospt.2018.7476

    Côté, P., Shearer, H., Ameis, A., Carroll, L., Mior, M., Nordin, M. and the OPTIMa Collaboration. (2015). Enabling recovery from common traffic injuries: A focus on the injured person. UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation.

    Ernst, E. The safety of massage therapy. Rheumatology (Oxford). 2003;42(9):1101-1106. doi:10.1093/rheumatology/keg306

    Funabashi, M., & Carlesso, L. C. (2020). Symptoms patients receiving manual therapy experienced and perceived as adverse: a secondary analysis of a survey of patients’ perceptions of what constitutes an adverse response. The Journal of manual & manipulative therapy, 1–8. Advance online publication. https://doi.org/10.1080/10669817.2020.17

    Gowan, D. M. (2017). Exploring patient safety issues in massage therapy and understanding patient safety incidents (adverse events) (Doctoral dissertation). University of Saskatchewan, Canada.

    Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical treatment. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne, 184(5), 533–540. https://doi.org/10.1503/cmaj.112120

    Hoffmann, T. C., Légaré, F., Simmons, M. B., McNamara, K., McCaffery, K., Trevena, L. J., Hudson, B., Glasziou, P. P., & Del Mar, C. B. (2014). Shared decision making: what do clinicians need to know and why should they bother?. The Medical journal of Australia, 201(1), 35–39. https://doi.org/10.5694/mja14.00002

    Hoffmann, T. C., Lewis, J., & Maher, C. G. (2020). Shared decision making should be an integral part of physiotherapy practice. Physiotherapy, 107, 43–49. https://doi.org/10.1016/j.physio.2019.08.012

    Kaptchuk, T. J., Hemond, C. C., & Miller, F. G. (2020). Placebos in chronic pain: evidence, theory, ethics, and use in clinical practice. BMJ (Clinical research ed.), 370, m1668. https://doi.org/10.1136/bmj.m1668

    Karkhaneh, M., Zorzela, L., Jou, H., Funabashi, M., Dryden, T., & Vohra, S. (2020). Adverse events associated with paediatric massage therapy: a systematic review. BMJ paediatrics open, 4(1), e000584. https://doi.org/10.1136/bmjpo-2019-000584

    Kennedy, A. B., Cambron, J. A., Sharpe, P. A., Travillian, R. S., & Saunders, R. P. (2016). Process for massage therapy practice and essential assessment. Journal of bodywork and movement therapies, 20(3), 484–496. https://doi.org/10.1016/j.jbmt.2016.01.007

    Miller, D. C., Smith, C. C., & Spine Intervention Society’s Patient Safety Committee (2020). Informed Consent. Pain medicine (Malden, Mass.), pnaa112. Advance online publication. https://doi.org/10.1093/pm/pnaa112

    Muscat, D. M., Shepherd, H. L., Nutbeam, D., Trevena, L., & McCaffery, K. J. (2020). Health Literacy and Shared Decision-making: Exploring the Relationship to Enable Meaningful Patient Engagement in Healthcare. Journal of general internal medicine, 10.1007/s11606-020-05912-0. Advance online publication. https://doi.org/10.1007/s11606-020-05912-0

    Skelly, A.C., Chou, R., Dettori, J.R., Turner, J.A., Friedly, J.L., Rundell, S.D., … Ferguson, A.J.R. (2020). Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Agency for Healthcare Research and Quality (US). DOI: https://doi.org/10.23970/AHRQEPCCER227

    Wittink, H., & Oosterhaven, J. (2018). Patient education and health literacy. Musculoskeletal science & practice, 38, 120–127. https://doi.org/10.1016/j.msksp.2018.06.004

    This page titled 1.2: New Page is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Richard Lebert (eCampus Ontario) via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.