Pilot Course delivered at the University of Salford 2009 / 2010
(This course no longer runs at the University of Salford, but continues to be delivered in other outlets. This reflective over view is posted here with the intention of supporting others who want to integrate the use of essential oils in a health care context).
Heather Godfrey BSc PGCE FIFA
This post course report aims to present a reflective overview of the Essential Oil Therapist module, delivered as a pilot project at the University of Salford (Directorate of Public Health). The course content, context, delivery and learning outcomes will be considered. It is anticipated that the information provided by this reflective evaluation will support future planning and delivery of aromatherapy courses that focus on the application of essential oils using methods other than applying massage as a medium of delivery, therefore, with relevant appeal to a broad range of professional healthcare practitioners. The remaining content will be presented under the following subheadings:
- Background Context and Justification
- Course structure and delivery
- Assessment Procedure
- Reflective Commentary and Observations
Background Context and Justification
Aromatherapy, delivered as an HE level six module, is one of the matrix of complementary Health Science and Counselling Studies modules (others, for example, include Research Methods, Applied Biomedical Science for Complementary (Integrated) Medicine, Patho-physiology for Complementary (Integrated) Medicine and The Client Therapist Interface) which comprise the BSc Health Science & Complementary Medicine and Counselling Studies & Complementary Medicine Degrees, and the BSc Integrated Therapy in Practice and BSc Complementary Therapy in Practice Top up Degree. The Top up degree is available to health care professionals, professional practitioners and Foundation Degree students studying Complementary Medicine. The Aromatherapy Module, already delivered at the University for over a decade, is reviewed each year in the interest of maintaining ‘best’ or ‘good’ practice. Considering professional evolvement and development, the nature of our students needs and aspirations and the ever progressing face of health care in general (political, public need and socio-economic trends) it was apparent to me that there was a void in training which did not accommodate those health professionals who were very interested and inspired by the therapeutic application of essentials oils but who did not want to use massage as a medium of delivery; for example, counsellors, psychotherapists, health trainers, physiotherapists etc. In response to this observation I developed the Essential Oil Therapist criteria in 2008, a strand of the existing Aromatherapy Module.
The teaching and learning programme continued to embrace the existing underlying benchmarks and standards set out by the National Qualification Framework (NQF) and Aromatherapy Council (AC), which guide the module content, to ensure continuity in terms of setting universally recognised and accepted training standards. However, massage training was omitted from the EOT training curriculum. Emphasis was directed toward the therapeutic blending of essential oils for clients self application (for example, creating ‘therapeutic perfumes’), counselling skills, the client-therapist interface, reflective practice and the role of professional supervision (Supervision & Continual Professional Development is delivered as a separate module at the University of Salford; the Aromatherapy module, now embracing the EOT, provides a very useful experiential connection). The practical elements of the Aromatherapy module are accredited by the International Federation of Aromatherapists (IFA), who externally examine the practical massage component of the aromatherapy module (awarding those successfully completing this and their academic assessments with a professional practitioner diploma), and were automatically invited to accredit the Essential Oil Therapist component too. When I approached them regarding this role, however, the IFA informed me that they already had copyright to the title ‘Essential Oil Therapist’, but had not (and still have not to date) developed or written course criteria to complement this [Since writing, a course using this title is provided by the IFA. The outcome of this pilot study was applied to inform this course content, however, emphasis of the IFA course leans toward applying essential oils as skin care and beauty therapy products]. Therefore, I agreed to re-title my course the ‘Essential Oil Technician©’ in respect of the IFA’s ownership of my original choice of title and ran the EOT© course as a pilot during 2009/2010. It is important that the EOT©, or any other related training I (or others) develop, be recognised and supported by an appropriate Professional Body to ensure objective guarding of professional good practice, training standards, continual professional development and communication. The IFA and The International Federation of Professional Aromatherapists (IFPA) and Federation of Holistic Therapists (FHT) are recognised nationally and internationally as the most prestigious aromatherapy specialist Professional Bodies.
Student’s practical process (that is, their blending skills, appropriate conduct and interaction with clients etc.) and Case Studies were externally examined by Beverley Higham, HE Development Support Manager, Aromatherapist and IFPA accredited assessor employed at a local FE college, to ensure objective appraisal and professional continuity of teaching and learning benchmarks and standards. Employing an external examiner/assessor also provides opportunity for valuable feedback, constructive criticism and an opportunity to share good practice.
Course structure and delivery
The EOT© module was delivered over an academic year (September to June) at HE level six (i.e. third year of an undergraduate degree) to BSc Integrated Therapy in Practice top up degree students. These students tend to be mature, entering the module with a range of background skills and knowledge; some had progressed from the Complementary Medicine Foundation Degree delivered at local FE Colleges, others were already practicing professional practitioners. On entry, students completed an Acquired Prior Learning (APL) questionnaire. All students had related experience and qualifications, most having completed a FHT, some an IFPA, course in aromatherapy (although it did became apparent that their background training and knowledge varied depending on which college or training school students had attended). Two students decided to upgrade their FHT practitioner qualification, opting to complete the EOT© assessments. All students completing the module followed the same EOT© teaching and learning programme, completed formative complementary workbooks or tasks (devised to support the teaching and learning content), and final summative module academic assessments. Elements covered through the module content include:
- Botanical families
- Methods of extraction and evaluation (GLC / MS)
- Related organic chemistry
- Functional Groups – general overview
- Profiles of 56 selected individual essential oils (incorporating IFA list)
- Therapeutic application of essential oils; including blending and appropriate methods of use and application.
- Safe Practice, Health & Safety: contra indications /actions
- Consultation procedures – process and protocol; client therapist interface
- Experiential work with clients – clinical practice
Workbooks and tasks support teaching delivery and revision and were completed as homework, or self study, projects. Examples of the workbooks include:
- Olfaction and the Absorption of Essential Oils
- The Integumentary System
- Essential Oils: Quality Control
- Using Essential Oils: Safe Practice
Teaching time was divided between theory and practice. Aromatherapy (and EOT©) students have use of a purpose built clinic for practical sessions, which comprises nine individual treatment rooms (allowing private space for students to work with their client’s in a safe, discrete environment), a teaching room and a reception area.
Students completed twelve formative assessments tasks (set in their workbooks) and two 2,000 word summative module assessments (a Case Study and Therapeutic Evaluation of Essential Oils) which contributed to their degree as well providing significant evidence of achievement for the EOT© qualification. The two academic assignments demonstrate student’s ability to enquire and deliberate about, as well as present information, knowledge and understanding of, the subject, in this instance, Aromatherapy and the therapeutic application of essential oils. Due to the academic context of delivery, students chose whether or not to complete the additional EOT© assessments; obtaining their degree takes precedence in the circumstances and students have to decide whether they can manage the extra work load entailed in achieving practitioner competency. Students working toward the EOT© qualification were required to complete five additional case studies and undertake a practical examination assessing their ability to prescribe and blend essential oils, apply appropriate methods of application and work with their clients appropriately. Each case study comprised five consecutive treatments with one client; six clients in total (6 clients x 5 treatment sessions = 30 treatment sessions). Six case studies appear to provide reasonable, sufficient evidence of student’s practitioner competency, as well as providing useful additional experiential learning, without overwhelming their time and energy in the context and time span available (i.e. aromatherapy being one of six related modules undertaken over the same academic year).
Reflective Commentary and Observations
Delivering Aromatherapy as an academic and practical subject is challenging in the timeframe available. However, because the module forms one part of a whole programme of study, students enter the module with sound background knowledge in terms of related health studies and client-therapist interfacing skills. Students tend to be mature and, in their final year, have already demonstrated tenacity and commitment to their studies. The Top up Degree students who were offered the EOT© course appeared to receive the concept of studying the use and application of essential oils without massage well, viewing the module as a significant CPD opportunity.
The word aromatherapy immediately, intrinsically, sums up an image of someone relaxing on a massage couch being anointed in essential oils by an attentive therapist, the word ‘relaxation’ resonating through the ambiance created in this picture. Indeed, this image is constantly promoted through media advertising or representation of aromatherapy (as well as the image of someone relaxing in a candle lit bath). It is true that massage provides a wonderful vehicle and plays a very significant, valuable role in terms of enhancing the effects of essential oils, promoting wellness and a sense of wellbeing. However, massage is not the only method of application and is not always appropriate; for example, a client/person might be contra-indicated or uncomfortable with intimate physical contact. There are many examples of therapeutic situations where a professional therapist might wish to include the use essential oils, counselling being one example, but not apply massage. Indeed, as well as promoting relaxation and wellbeing, essential oils can be applied topically for stress and many stress related conditions in the form of ‘therapeutic perfumes’, ointments, lotions, creams, compresses etc. and diffused environmentally to create a specific ambiance or influence mood and emotion. Yet, it remains virtually impossible to gain a professionally recognised qualification in these arts alone without the inclusion of massage, which clearly represents one of many other methods of application.
Essential oils are available to purchase through mail order or in high street shops; the purchaser is not required to have a qualification to use them. However, the user must have a professional qualification and have professional insurance cover to apply essential oils to others in a therapeutic context. The counsellor (or other health professional), for example, who chooses to diffuse essential oils in their treatment room to create a pleasant ambiance does not have to have an aromatherapy qualification to do so because they are not applying the essential oils directly to their client, yet they might be very interested in, and would benefit from, learning and understanding more about the nature and chemical influence essential oils have on, for example, mood and emotion; physical contact in the context of this type of therapeutic process is undesirable. In order to promote the safe and appropriate use of essential oils as a health care commodity it makes sense, therefore, that professional training should be appropriate and appealing to as many health professionals as possible. Aromatherapy is currently delivered in some universities, but is mainly delivered in the hair and beauty departments of FE Colleges and some private training schools. There are post qualifying courses delivered that adapt to need, for example, in hospices, but these are usually complementary to professional training and do not alone licence the student to deliver essential oils therapeutically. The Essential Oil Technician© aims to bridge this gap.
Overview of The Pilot Course
The EOT© criteria continued to deliver the prescribed background knowledge and skills set out by the IFA/IFPA/FHT for aromatherapy training, but excluded massage training and application as a delivery medium. Students completed additional workshops focusing on blending essential oils for clients self application, whether as a therapeutic ‘perfume’ prescribed in a roller bottle or a nasal inhaler, or in a cream, lotion or ointment (all students completed these as part of the module criteria regardless of whether they continued on with their EOT© assessments). EOT© students organised a clinic. They spent time working with their client’s, listening to their background ‘story’ and selecting essential oils to create a personalised blend specific to the client’s individual need for their use at home. Emphasise was placed on the students reflective evaluation; they kept a reflective journal and attended regular reflective ‘check ins’ or reviews with me. This way of ‘being an aromatherapist’ represented a shift from the usual training pattern where treatments generally evolve around body massage (the students who participated had already completed aromatherapy training prior to attending this module) so there was also an element of re-programming expected behaviour; ongoing evaluation and feedback were necessary to manage this ‘pioneering’ process.
Clients attending the practice clinic appeared to respond very well to their treatments. They were positive about their experience and said they liked their essential oil ‘perfumes’. Each client attended five consecutive appointments over the period of one month (two of these were conducted as telephone interviews). All clients presented with symptoms of stress or stress related conditions, such as, for example, insomnia. Roller bottles were the preferred medium of delivery in these circumstances; 10 ml ‘roller bottles’ were used to apply the essential oil ‘therapeutic perfume’ infused in jojoba oil to the client’s wrist. If a blend needed altering or replenishing during the course of treatment, then a fresh blend of essential oils in a clean bottle were used (the bottles are recyclable); blends or bottles were never ‘topped up’ for prolonged use. Clients were encouraged to keep a treatment diary where they scored how they rated their symptom/s (identified during consultation) on a scale of 1 to 10 (1 = no difference, 10 = completely cleared) and record their observations following use of their essential oil blend. The purpose of using this diary, apart from providing tangible data, was to encourage the client’s continued involvement in their treatment.
One client rated her symptom (insomnia) improvement at 4 and commented “Slept well last night, feel calmer than usual”…commenting four days later “Had a dream!!!, feel like I haven’t had one for months”. The essential oils used in this clients blend were eucalyptus (Radiata), black pepper (Piper nigrum), chamomile Roman (Chamaemelum nobilis) and rose Otto (Rosa centifolia) blended in jojoba oil. Another client rated her symptom (insomnia) improvement at 7 initially, going down to 4, then up to 5, but did not comment otherwise. The essential oils used in this clients blend were bergamot (Citrus bergamia), chamomile Roman (Chamaemelum noblis), Melissa (Melissa oficinalis), sandalwood (Santalum album). Both clients presented with similar symptoms but selected a different blend of essential oils (chamomile Roman being common to both blends). Another client rated her symptom (low mood due to bereavement) improvement initially at 5, later at 7 then later at 8, commenting “using roll-on at 3 hourly intervals (when mood occurs), mood passing quickly as a result”, then a week later “using roll-on as and when required, benefits of roll-on are very good”, then another week later “roll-on continues to be effective, feel calm and unflustered in stressful situations. Coping better with other peoples stresses.” The essential oils used in this clients blend were Clary sage (Salvia sclarea L.), Geranium (Pelargonium graveolens), Jasmine (Jasmine officinalis) and Sandalwood (Santalum spicatum (R.Br.)). The fact that client’s were involved in the selection of essential oil blends no doubt served to influence the positive outcome and response to this method of treatment. The result of this pilot from the client’s perspective has been inspiring. This method of treatment delivery highlighted the significance of students underlying blending skills and knowledge of essential oils and their ability to interact appropriately with their clients in this context.
A small sample study (two therapists eventually working with six clients) was used here, however, valuable insight regarding future training content and delivery was achieved. Two students progressed to complete the EOT© qualification (others already had a practitioner qualification), however, all students said they benefited from the teaching and learning criteria in terms of upgrading and refreshing their skills and knowledge and offered valuable feedback. Some commented that they appreciated the blending workshops, which improved their blending skills, confidence and insight, stating that this component had been lacking in their previous training experience.
For me, this experience highlights the need for understanding of counselling skills, especially listening skills and the ability to ‘hold’ and manage the therapeutic space. I noticed a tendency for the student therapist to take on a ‘mothering’ role. This might be comforting for some clients, but I noticed how the therapist’s boundaries became blurred; the emphasis shifted from listening, ‘hearing’ and observing, to ‘advising’ and ‘telling’. I also noticed a tendency for the therapist to encroach upon the client’s therapeutic space through responding to their own triggers, retelling similar stories etc. that they had encountered (no doubt done in the guise of empathy), insidiously drawing attention from the client to themselves; the therapy space was filled with banter, conversation. As a consequence the therapist struggled to maintain her professional boundary, exceeding the appointment time and imparting too many personal details about herself. Significantly, some important cues in terms of the client’s needs were missed; somehow the therapists’ clarity of judgment became blurred or skewed as her focus shifted from her clients’ needs or preferences in terms of her selection of essential oils to her own, her objectivity was compromised. This issue was considered during reflective evaluation sessions.
In my role as an Aromatherapist I listen to and observe my client, and enquire if I need clarity of information or further details to gain as clear a picture as possible of what my client needs from their treatment, then I relate this to my prescription of an appropriate oil or blend of oils. However, my client’s own ‘nose’ intrinsically recognises what is best for them, so their participation, their collaboration, is vital when it comes to creating a blend which is just right for them. Part of this collaboration in allowing clients to smell and participate in the selection of essential oils is that I am able to notice how they respond; I listen to their language, observe their body movements, facial expressions and gestures. To do this I must pay attention, hold the moment space, ask the right enquiring questions; I must concentrate on my client. When I strike a common note with my client, recognise an affinity or similarity, it is easy to slip into a familiar, friendly banter, which while pleasant, can obscure my undivided attention from my therapeutic process. Aware of this, I can still remain friendly, but remind myself, in this context, my client is not my ‘friend’ and I have a professional responsibility to provide the service I am offering for which the client is paying.
Students reflected that they initially felt exposed and vulnerable themselves in this situation; giving a massage provides a sort of barrier in that there is something practical to engage in which occupies the space, consultation tends to be directed at establishing a client’s needs and suitability for massage etc.; the focus shifts more towards what they want from their massage, the consultation and essential oil blending process seems less conspicuous in this context. However, I did notice that once they relaxed and began to engage with their client, students were able to fluently draw on their professional resources and underlying knowledge. The students commented on how pleased, yet surprised, they were by their client’s enthusiastic, positive response. Clients appeared to become animated when given ‘therapeutic space’, permission, to reflect on their needs and collaborate, participate, in finding potential support or respite. My observation was that clients responded to being ‘heard’, being allowed to tell their story. I also observed that the therapists skill lies not just in listening and prescribing appropriately, but being able to hold and manage this therapeutic space, so that the client felt safe, respected and a sense of ‘unconditional positive regard’, but also so that boundaries were maintained (which appeared the most challenging aspect to contain).
Students used their reflective journals affectively and responded well (although sometimes uncomfortably) to constructive criticism and feedback. Working with clients in the clinic became a valuable experiential learning process for all concerned. I learned valuable lessons about my own methods of training. For example, the need for a clear clinical regime; to hold firm time boundaries; to offer feedback supportively and sensitively; that teaching and learning does not end (even as the ink is drying on students qualifying certificates, students continue to learn from the feedback they are given, from their awareness of their own mistakes and oversights, from their acknowledgement of what they do well and what they still need or want to learn). I also learned and discovered from observing students blending skills, and noticing their client’s response to their blends, as they combined oils in synergies or combinations I might not have considered, more about the exciting unique possibilities of blending essential oils.
From my experience of running this pilot of the EOT©, and my teaching and learning experience in general, I believe that the background training criteria set out for aromatherapists in this instance is sound and adequate as it already stands, but I am aware of areas that could be further developed (listed below). I also notice generally, listening to students comments regarding their training journey, that some aspects of training can become ‘bigger’ than the core subject or so stressful that they become counterproductive to the students sense of achievement, self confidence and desire to engage in their learning. Anatomy & Physiology is one area that sometimes, for example, in my opinion (having acknowledged students comments regarding their own experience), is pushed too hard in some instances (in others, barely at all). There is absolutely no doubt that students should have a sound background understanding of how the body functions and how this in turn relates to the application of essential oils (and body massage). However, I have seen students, who have very good interpersonal skills, who work very well with their client’s and apply their therapeutic knowledge very appropriately, ‘crumble’ and give up on their training because A & P has apparently been hijacked and pushed beyond the students needs in real terms; as if a comprehensive understanding of this subject offers the only legitimacy to the therapeutic criteria and professional practitioner status of a complementary therapy. Training needs to push boundaries but also needs to be rewarding and achievable; students work well when they are inspired. My personal experience of teaching leads me to believe that the skill in teaching, or facilitating my students learning, lies in managing a balance between pushing boundaries and maintaining inspiration and a desire and thirst to learn more; developing a ‘good enough’ student. Aromatherapy is a subject that can be developed in layers; once competent and safe to practice a student can go on to learn more about elements of A & P, organic chemistry and botany, relating this to their ongoing experiential understanding when applying their skills and working with their clients and using essential oils etc.
‘Being good enough’ is also where I want my client’s to be. If I cannot accept this aspect in myself, then I will not allow my client’s to sit in this space, to accept them self as they are, have confidence in their own decisions and choices. Training needs to ensure that students are safe and competent practitioners, brought to a point where they can start their practice because this is where their learning and development truly begins. Once students start to work experientially in ‘real life’ situations they will become aware of their strengths and weaknesses and, if they have not been ‘burned out’ by their initial training, will naturally aspire toward continual professional development.
The EOT© course aims to support students in becoming competent professional essential oil practitioners. An aspect of professional practitioner competency is acknowledgement of the need for ongoing development and continued support. Professional Supervision offers significant ongoing support and is especially poignant for the EOT© therapist because of the nature of their interaction and time spent with their clients. I have observed that, as an aspect of the ‘healing process’, client’s can begin a voyage of self discovery and emotional processing. Professional Supervision supports the therapist (therefore client) in developing and managing their therapeutic interaction with their client’s and assists the therapist in recognising and holding their own professional boundaries and recognising their own developmental needs. Counselling skills also become significant in this context; basic counselling skills are intrinsic to the therapeutic process and should form part of the EOT© practitioner training.
My recommendations for future development of the EOT© course, therefore, are:
- Benchmarks already set out by the IFA/IFPA/FHT and NQF provide sound background guidelines for existing content and levels of achievement and should continue to be applied.
- Basic counselling skills should form part of the training criteria (and be promoted as a CPD activity).
- Awareness of and participation in Professional Supervision should form part of the training criteria (and be promoted as an ongoing CPD activity).
- Blending workshops / experiential blending practice should form part of the training criteria (and be promoted as a CPD activity).
- Reflective practice and journal keeping should form part the training criteria (and be promoted as an ongoing CPD activity).
- Six case studies (6 clients x 5 treatments = 30 treatments) provide adequate experiential learning and evidence of sufficient competency. Students can struggle to find sufficient clients to provide case studies, remembering also that students cannot ethically charge a profitable fee for this service while training, there are cost implications for them (buying essential oils, time, etc) that must be regarded. Also, client’s who have paid a nominal fee or no fee are less inclined to book appointments at full price later (many clients are happy to become perpetual training subjects) which does not support the student or this practice in the long term.
- The emphasis of client’s needs in this context appears to evolve around stress and stress related conditions. Clients appeared to prefer to use a therapeutic perfume applied using a roller bottle in the above instance. Other methods of delivery should also be promoted.
- Training toward competency should be delivered in stages which allow the student to start practicing, therefore, earn a living from their skills in a reasonable time frame (without compromising standards); training duration of an academic year provides a sound basis or starting point t set a good foundation for aromatherapy training. This means that evidence of Continual Professional Development must continue to be an inseparable aspect and requirement of professional practitioner status and a pre-requisite of professional body membership and registration.
- A & P should not overshadow other aspects of the teaching and learning curriculum and practical competencies in a given teaching and learning timeframe; content should be realistic and reflect the therapist’s actual needs and the context of training. Ongoing development and CPD in this area should be encouraged rather than ‘burning students out’ with overemphasis at the initial training stage in a way that does not undermine its significance, i.e. neither should A & P be insufficiently covered; a realistic balance is required.
This pilot study presented useful insight in terms of the future planning and development of the EOT© course. Students appeared to respond well to the course content and provided helpful, critically constructive feedback. Fifteen students successfully completed the module. All clients appeared satisfied with their blends of essential oils and appeared happy using a roller bottle as a method of self-application. They all reported improvement in their symptoms following application of their personal blend of essential oils over the treatment period of one month. The content and outcome of this pilot course will be applied to inform the IFA’s development of their own EOT training curriculum.
Based on the pilot study I envisaged that the EOT© training course will provide a significant developmental route for practitioners interested in the therapeutic application of essential oils in the context of their healthcare role and for would-be practitioners interested in applying essential oils using methods of application other than massage.