As mentioned earlier, wellness is difficult to define but could be simply described as the state of being comfortable, healthy, and happy while making daily choices that lead to more self-fulfillment, meaning, and success.

Wellness is broad and multidimensional. For example, physical health is only one aspect of wellness. Even top athletes in the prime of their careers have difficulty finding the balance necessary for true well-being. A strong focus on physical fitness may override other important wellness components, or training schedules may be so intense that minor or major injuries develop.

Wellness is as much a state of mind and spirit as it is a state of body. It requires a balance between work time and playtime, solid interpersonal relationships, and strong emotional coping resources. Meaningful work, family activities, social interaction, and personal interests help life feel purposeful and enjoyable.

Wellness requires good choices and some effort. People seeking wellness eat a healthy diet but allow themselves to spurge once in a while. They get regular sleep and take strides to manage stress, nurture relationships, pursue personal interests, and remain open and positive about life’s ups and downs. Massage is an activity that people can undertake to move toward greater wellness and so it is helpful to understand wellness models. The implementation of a wellness models is also useful to massage therapists as a form of self-care.

Wellness Models

Many people use wellness models to help them focus on areas of life that feel out of balance.  A wellness model is a chart, program, or document that offers basic criteria for optimum function in specific life areas and provides questions that help people explore wellness in their own lives. Sometimes, health care practitioners use a wellness model as part of their assessment and goal setting procedure with clients/patients. Many destination spas have moved toward a wellness concept. The client arrives and receives a consultation that includes the development of a wellness plan for his or her life. The client’s treatments, menu, seminars, and activities will be designed in accordance with the wellness plan.

Administering a wellness model in a private massage practice is not appropriate unless you have additional training and credentials and the session is defined appropriately because it takes the massage therapist outside the scope of a bodywork session. It can lead the therapist to ask information about a client’s life that is not pertinent to the practice of massage. It can also place the therapist in a situation where the client expects psychological or spiritual counseling.

Some therapists find that they can introduce clients to wellness concepts without crossing outside their scope of practice by providing a wellness model as a handout that clients can pick up and take home if they are interested. In other cases a massage therapist is expected to act as part of a client’s wellness team and interact with other health professional is supporting the client’s wellness goals.

Wellness components and wellness planning are described here to help you broaden your understanding of the benefits and role of massage. This model can also prove to be a useful tool in your personal self-care routine, thereby supporting massage career longevity. Additionally, massage therapists are likely to be included in a client’s wellness plan at spas and clinics, and so must be versed in wellness concepts.

Components of a Wellness Model

Each wellness model may be slightly different, but all usually address three main areas: physical health, mental health, and spiritual health (Fig. 4-11). Fig. 4-12 shows a common wellness model that promotes healthy nutrition, physical fitness, stress management, and emotional balance. As a person contemplates what he needs in life to feel wellbeing, the wellness model adapts to include areas he views as important. Fig. 4-13 shows a wellness model that incorporates a focus on personal relationship, and meaningful work. In Fig. 4-14 the wellness model is well defined and includes social, environmental, and occupational areas for focus. It is personal and written in the language of the client to best reflect her goals and areas for focus.

It works well to break wellness components into six key areas, though many different formulas for grouping wellness components might be used. For example, Fig.4-14 breaks wellness down into 7 areas that require awareness.  Each of these examples demonstrates that there is no fixed way to develop a wellness model. Each person and therefore each model will be different. Questions are developed around each wellness area and used to inventory a person’s current state of wellness. When people have insight into the state of their wellness they can set goals to improve areas they feel motivated to change. The following section breaks wellness into six key areas and provides questions for exploration. <fig4-11><fig4-12><fig4-13><fig4-14>

Physical Wellness

In the development of a wellness plan the health and fitness of the physical body are an important focus and nutrition, exercise, sleep, and relaxation strategies might be explored. Sample questions include:

• Do I have a basic understanding of nutrition and recognize the nutritional needs of my body?
• Is my diet nutritious and filled with whole foods like vegetables, fruits, lean proteins, and whole grains? How can I improve the nutritional content of my diet?
• Do I avoid highly processed foods high in sugar, salt, or chemical additives or do I eat these foods only in moderation? What foods might I eliminate from my diet to improve my health?
• Do I consume alcohol only in low risk quantities?
• Does my body receive the vitamins and nutrients it needs for optimal function? How can I ensure that I get the vitamins and nutrients I need?
• Is tobacco or other additive substances causing a decrease in my health? What actions can I take to eliminate tobacco or other additive substances from my life?
• Do I participate in regular exercise that builds strength, endurance, flexibility, balance, and coordination? What type of exercise plan might I adopt to ensure my body’s health?
• Do I maintain a regular sleep schedule that ensures my body receives no less than eight hours of sleep per night?
• Do I use relaxation strategies regularly to combat stress and revitalize my body? What improvements might I make in this area?
• Do I receive regular medical check-ups? Do I participate in personal self-care and monitoring of physical symptoms that might be warning signs of diseases or conditions?

Intellectual Wellness

Intellectual growth, curiosity, mind challenge, creative expression, and a positive self-concept are explored as important to the overall wellbeing of a person. Self-concept is a term that is often used interchangeably with the term self-esteem. It is defined as a growing belief about oneself that enhances coping skills and leads to good feelings about oneself and the ability to impact others in a positive way. Sample questions related to intellectual wellness might include:

• Do I regularly expose myself to new experiences in order to enhance my understanding of the world (i.e., the theatre, a lecture on world affairs, drumming classes, etc.)?
• Do I have hobbies, interests, and activities that stimulate my interest outside of work or school?
• Do I actively observe the world around me and question my perceptions and assumptions? Do I remain open to new ideas and curious about the experiences of other people?
• Do I stay up to date in world affairs, local news, and current thinking?
• Am I able to express myself creatively? What outlets do I use (i.e., writing, painting, music, etc.)?
• Do I want to learn new things? Am I excited about new opportunities for learning?
• Do I have personal interests that stimulate and challenge me intellectually?
• Do I possess good critical thinking and problem solving skills? How might I challenge myself to improve these skills?
• Do I have a positive self-concept? A positive self-concept is reflected by behaviors such as the ability to build trusting relationships, demonstrating respect for oneself and for others, having the confidence to take on a challenge, set goals, complete tasks, and handle disappointments. What actions can I take to develop my self-concept and build on my personal strengths?

Emotional Wellness

Emotional wellness explores the awareness and acceptance of feelings in oneself. It looks at how emotions and moods are assessed in oneself to gather information used to meet important life goals and overcome personal limitations (see topic 12-3 for information about emotional intelligence as it relates closely to the concept of emotional wellness). Sample questions for exploring emotional wellness might include:

• Can I recognize and label my emotions as they occur (For example, being able to differentiate irritation from anger, sadness, or fear)?
• Do I feel in control of my emotions most of the time or do my emotions often come on unexpectedly and overwhelm me? Do my emotions ever seem “too big” for the situation and catch me off guard with their intensity?
• Do I recognize the relationship between self-talk and mood? Am I aware of self-talk and can I chance my self-talk to feel more positive and to achieve my goals?
• Can I recognize negative moods and improve my mood through positive self-talk?
• Can I share my emotions with trusted friends and family members?
• Can I recognize and accept the feelings of other people without feeling threatened or uncomfortable most of the time.
• Can I say “no” when I need to without feeling guilty?
• Is my attitude toward life mostly positive and do I believe that I can reach my goals?

Spiritual Wellness

Spiritual wellness refers to each person’s search for meaning and purpose in life. It explores the ability to find beauty in everyday events, to feel comfort and hope even when things are not going well, the ability to express compassion and caring towards others, and the ends to which we devote our time and energy. Sample questions for exploring spiritual wellness might include:

• Can I contemplate the meaning of my life and allow myself to embrace my dreams for my future?
• Am I open to the beliefs and practices of other people and can I demonstrate tolerance and compassion for each person’s unique path through life?
• Do I make time for spiritual growth and exploration? What actions might I take to explore my spiritual wellness?
• Are my beliefs and values in alignment with my daily behaviors? Where are they out of alignment? What can I do to live my ethics more fully?
• Do I take responsibility for the events in my life and contemplate the meaning and significance of these events? Do I use this understanding to create positive change in my life?
• Do I care about the welfare of other people? Do I participate in community events or activities that allow me to demonstrate my concern for the wellbeing of others?
• Can I talk about spiritual issues with trusted friends and family members and do I feel comfortable explaining what and why I hold the beliefs I hold?
• Do I feel faith in mankind and in the world? Do I feel hopeful that things will get better and that I can make a difference in the world?

Occupational Wellness

Occupational wellness is concerned with finding personal satisfaction and enrichment through one’s work. When a person is able to utilize his or her talents and interests to contribute to society through work, work tends to feel more meaningful, enjoyable, and fulfilling. Sample questions for exploring occupational wellness might include:

• Do I feel challenged and satisfied by my current work, or am I preparing now to move into an area of work that I believe will challenge and satisfy me?
• Does my work or future work align with my ethical values and personal beliefs? If no, what is the misalignment and can change occur to make this work a good fit for me?
• Can I create positive change through my work? Are my feelings and opinions respected? Can I influence decision making if this is important to me?
• Can I accurately assess my strengths and weaknesses in relationships to my work and set goals that lead to increased capacity and skill? Do I regularly strive to improve my personal performance?
• Do I believe that I have the qualities of a valuable employee and that I can obtain and secure a meaningful job?
• Am I doing what I want to with my life and career?

Social Wellness

The ability to build and keep supportive and satisfying relationships is an essential element of wellness. Social wellness also requires the exploration of your interaction with your local and even global community, because being active participants in society can enrich life and provide purpose and meaning. Sample questions for exploring social wellness might include:

• Can I adjust to new places and make new friends?
• Do I give time and energy to old friendships and to family relationships?
• Do I value diversity and interact with people of different ages, races, cultures, and lifestyles?
• Do I maintain my values, beliefs, and ideas when interacting with other people? At the same time, do I demonstrate tolerance and openness for different beliefs and new ideas?
• Am I aware of the concerns of the different communities with which I interact (i.e., school community, work community, neighborhood community, etc.) and do I participate in problem solving or actions to build a stronger community?
• Do I feel a responsibility and commitment to the global community? How do my actions and behaviors demonstrate this commitment?

A wellness model and personal wellness inventory are used to create a wellness plan where specific goals and action steps lead to greater equilibrium. To create a wellness plan, the client/patient is encouraged to identify the area he or she is most motivated to change. Client/patients might keep track of their progress in a wellness journal or through the coaching of a health care professional. At predetermined dates progress on the plan is evaluated and the plan is revised and updated.