The Wiltshire School of Beauty and Holistic Therapy · the Hopi Indians of North Arizona, USA, and means 'peaceful people'. Hopi candling is a very safe therapy and its popularity

The Wiltshire School of

Beauty and Holistic Therapy

VTCT Level 2 Award in Thermal Auricular Therapy

Practitioner’s Training Manual

W: www.wsbht.co.uk E: [email protected]

T: 01793 73 77 33 M: 07824 337333

mailto:[email protected]

The Wiltshire School of Beauty and Holistic Therapy

VTCT Level 2 Certificate in Thermal Auricular Therapy Training Manual © 2

CONTENTS

1. Aims & Objectives p3

2. Course Details p4

3. Thermal Auricular Therapy p5

4. Hygiene, Health & Safety p11

5. Professional Ethics & Standards of Practice p18

6. Related Anatomy & Physiology p21

7. Client Consultation p33

8. Contra-Indications p38

9. Contra-Actions p40

10. Aftercare p41

11. Equipment & Products p42

12. Storage & Insurance p43

13. Routine p44

14. What Happens Next? p46

15. Contact Details & Recommended Reading p47

16. Self Assessment p48

17. Notes p49

18. Accreditation p50



1. AIMS & OBJECTIVES

AIMS

The aim of this manual is to teach you the basics of health and safety, and anatomy and physiology in relation to this course. This manual also covers the background, benefits, treatments, consultation, contra-indications, contra-actions, aftercare, equipment and products needed. You will also learn the movements and techniques required to perform a professional treatment during the practical sessions.

OBJECTIVES

The objectives of this course are that by the end it, you will be able to perform a professional treatment in a safe and hygienic manner in a commercially acceptable time, along with experience of carrying out a consultation with the knowledge of the background, benefits, consultation, contra-indications, contra-actions, aftercare, equipment and products needed.

WSHBT advise you to read this training manual thoroughly along with other research before you take part in your practical

session.



2. COURSE DETAILS During this course you will learn how to perform a professional Thermal Auricular treatment. You will learn how to:

prepare the treatment area

prepare the client for treatment

carry out a client consultation

carry out a thermal auricular treatment

provide aftercare advice. You will also study:

related hygiene, health and safety

related anatomy and physiology

the history behind thermal auricular therapy

benefits of thermal auricular therapy

ear symptoms and treatments

client consultation

contra-indications

contra-actions

aftercare. Studying the VTCT Level 2 Award, requires you to attend a 4 hour practical training session, and a 4 hour assessment session, to include sitting a multiple choice assessment paper Once you have successfully completed the course and training, you will receive The VTCT Level 2 Award in Thermal Auricular Therapy.

Good luck and enjoy!



3. THERMAL AURICULAR THERAPY The History of Thermal Auricular Therapy Thermal Auricular Therapy, also known as Hopi ear candling, is an ancient form of therapy practiced by many people on a worldwide basis. Its name is taken from the Hopi Indians of North Arizona, USA, and means 'peaceful people'.

Hopi candling is a very safe therapy and its popularity is growing as more people become aware of its positive benefits. Ear candles are an ancient and natural therapy handed down by many civilisations. They were used as far afield as Asia, the Siberian prairies and, most notably, native America. It is believed that the Ancient Greeks used ear candles, initially probably for cleansing, purifying and healing on a spiritual basis, but then, much later, on a purely physical basis. However, the practice reached the modern world via the native North American Hopi Indians. Ear candles were used traditionally by Shaman healers. Ancient wall paintings (such as those found within the caves of the Grand Canyon) show the importance of ear candling in initiation rituals and healing ceremonies of the tribe.

How Thermal Auricular Therapy Works The candles and cones used are special spiral shaped, and made from natural ingredients such as beeswax, honey extracts, St Johns Wort, sage and chamomile. Ear candling looks to remove blockages within the ear canal without the need for syringes or solutions, but does work better as a preventative so it is a good idea to have treatments before the ears become too impacted with wax. The spiral shape of the cone causes air to be pulled down into the ear. As it burns, the cone's ingredients turn to vapour and the airflow creates a vibrational effect. Warmth, vibration and vapour massage the ear-canal, breaking down any blockages. Wax, toxins and impurities are then loosened to be able to come out of the ear naturally.



Benefits of Thermal Auricular Therapy Many conditions can be helped, including:

Glue ear

Sinusitis

Migraine

Tinnitus

Excessive wax

Vertigo

Blocked tear ducts

Cold and flu symptoms

Loss of sense of smell

Lymphatic circulation (can be increased)

Stress

Ear pain

Lack of hearing, or even taste and smell (can be enhanced)

Loss of pressure in the ear (caused by, for example, frequent flying/sports such as driving).



Ear, Nose and Throat Although the ears may appear to be isolated structures, they are directly linked to the nose and throat. The visible part of the ear, the pinna, is connected to the ear canal, which ends at the eardrum. Beyond this membrane lies the middle ear, an air-filled space connected to the back of the nasal cavity and to the throat by a channel called the Eustachian tube. This tube ensures that the air pressure is the same on both sides of the eardrum. Our ears provide us with two vital but very different senses: hearing and balance. Sound detected by the ears provides essential information about our external surroundings and allows us to communicate in highly sophisticated ways, such as through speech and music. In addition, our ears contribute to our sense of balance, the largely unconscious understanding of the body’s orientation in space that allows us to maintain an upright posture and move without falling over. Ear problems and infections can upset this delicate balance.

Ear Symptoms and Treatment Hopi Ear Candles have been effective at treating a number of conditions that are associated with the ear, nose and throat. These are listed below for your information.

Colds

Colds can occur at any time of the year, although infections are more frequent in the autumn and winter. The initial symptoms of a cold usually develop between 12 hours and 3 days after infection. Symptoms include:

frequent sneezing

runny nose

sore throat

cough.

Bacterial ear infections are a common complication of colds.

Hopi Care - We recommend that, whilst suffering from a cold, Hopi ear candles are used every other day for a week, Whilst these treatments will not cure a cold, they may help to clear congestion and ease discomfort.



Sinusitis

The sinuses are air-filled cavities around the nose and eyes. Within the lining of the sinuses are many mucus-secreting glands. Mucus passes continuously through narrow channels that lead from the sinuses to the back of the nose. Sinusitis is an inflammation of any of the sinuses. Sinusitis may be acute (developing and clearing up rapidly) or chronic (long term). The most common cause of sinusitis is a viral infection such as the common cold. If the channels connecting the nose to the sinuses become blocked due to the viral infection, mucus collects in the sinuses. Symptoms depend on which sinuses are affected and may include headache, pain, and tenderness in the face that tends to worsen when bending down. If symptoms do not improve within 3 days, you should consult your doctor. Hopi Care - In the first few days of acute sinusitis we recommend daily treatment. Monthly treatments may then help to prevent the severity and frequency of attacks. Chronic sinusitis will probably require a weekly treatment for the first month, then once or twice per month for a further 2-3 months.

Ear Blockage

Blockage of the ear canal by earwax often causes a feeling of fullness and irritation in the ear. Earwax, produced by glands in the ear canal, cleans and moistens the canal. Usually, wax is produced in small quantities and emerges naturally from the ear. However, if the canal becomes blocked with wax, it causes a feeling of fullness and discomfort, and sometimes hearing loss. Hopi Care - To help clear wax blockage, one treatment may be sufficient, however 2-3 may be needed depending on the extent of build-up. Regular treatments every 6-8 weeks may help to relieve and prevent excess build-up.

Chronic Secretory Otitis Media (glue ear)

This is a persistent collection of fluid in the middle ear, common in children under 8 years old. Sometimes referred to as glue ear the middle ear becomes filled with a thick, sticky, glue-like fluid. It is the most common cause of impaired hearing in children under the age of 8. The middle ear is normally ventilated by the Eustachian tube. However, if this tube becomes blocked, possibly as a result of infection, the middle-ear may fill with fluid. Often, the blockage persists, causing chronic (long term) Secretory Otitis Media.



The symptoms may develop gradually and may initially go unnoticed. The symptoms tend to fluctuate and tend to be worse in the winter months. They may include: partial deafness, immature speech for the child’s age, and ear infections. If symptoms persist for several months, grommets will probably be inserted under general anesthetic to allow air to circulate around the middle ear. Hopi Care - An initial treatment of once per week for 1 month may be sufficient. Regular monthly treatments thereafter may be beneficial.

Allergic Rhinitis

Allergic rhinitis is the inflammation of the membrane lining the nose and throat due to an allergic reaction. It affects people who experience an allergic reaction after they inhale specific allergens. Allergic rhinitis may occur only in the spring and summer, in which case it is known as seasonal allergic rhinitis or hay fever, or it may even be perennial, which would mean it would occur all year round. The symptoms of allergic rhinitis can include:

itchy sensation in the nose

frequent sneezing

blocked, runny nose

itchy, red, watery eyes. Allergic rhinitis is more common in people who also have other allergic conditions such as asthma. Hopi Care - Dependent upon the severity of the condition, 2-3 Hopi ear candle treatments may be needed in the first week, then 1-2 times in the next 2-3 weeks. A monthly treatment may help to reduce the frequency or severity of attacks.

Tension Headaches

Moderate or severe pain affecting one or more areas around the head, often as a result of stress. Hopi Care - The pressure relief and relaxation brought about by a Hopi ear candle treatment can really help this condition. The frequency of treatment will depend upon the severity of the condition.



Tinnitus

Tinnitus is sounds heard in one or both ears in the absence of any external noise. People with tinnitus hear sounds that originate within the ear itself. These sounds may include ringing, buzzing or whistling. Hopi Care - Hopi ear candle treatment can help to reduce the symptoms of Tinnitus by aiding relaxation, however there is no known cure for Tinnitus and whilst some sufferers may find Hopi beneficial, others may not.

Ménière’s Disease

Ménière’s Disease (pronounced min-years) is a disorder of the inner ear that can affect hearing and balance. It is characterised by episodes of dizziness and tinnitus, and progressive hearing loss, usually in one ear. It is caused by an increase in volume and pressure of the endolymph of the inner ear.

Hopi Care - Hopi ear candle treatment can help to reduce the symptoms of Ménière’s by aiding relaxation, however there is no known cure for Ménière’s and whilst some sufferers may find Hopi beneficial, others may not.

http://en.wikipedia.org/wiki/Dizziness

http://en.wikipedia.org/wiki/Tinnitus

http://en.wikipedia.org/wiki/Endolymph

http://en.wikipedia.org/wiki/Inner_ear



4. HYGIENE, HEALTH & SAFETY

Maintaining a high standard of hygiene is essential. Whether you intend to work for yourself as a self employed therapist or as part of a salon, clients will not return if the salon, treatment area, or equipment is not clean. Your hands should always be washed after you have carried out the consultation, before you commence the treatment, and then again once treatment has been completed. Spillages should be cleaned up immediately, with a floor sign if the floor is still damp. The therapist should have a good access to their trolley and any product they are using. Dirty towels should always be placed in a covered bin after use on each client. If you are working in a salon, it is a legal requirement for employers to display an approved health and safety poster or to supply employees with an equivalent leaflet or information. If you employ 5 or more members of staff, it is law that you provide a health and safety policy. It is recommended that you get copies of the following from your local council:

Health and Safety in the Workplace

Trade Descriptions Act

Data Protection Act

Sales of Goods Act

COSSH Regulations and Risk Assessment (Control of Substances Hazardous to Health)

Local Government (Miscellaneous Provisions) Act 1982

The Management of Health and Safety at Work Regulations 1992

The Workplace Regulations 1992

The Manual Handling Regulations 1992

The Personal Protective Equipment at Work Regulations 1992

The Health and Safety (Display Screen Equipment) Regulations 1992

The Electricity at Work Regulations 1992

Health and Safety (First Aid) Regulations 1981

RIDDOR – The Reporting of Injuries, Diseases & Dangerous Occurrences Regulations 1995

Fire Precautions (Workplace) Regulations 1997

Consumer Protection Act 1987.

All businesses are required by law to comply with the following health and safety acts, which are monitored and managed by The Health & Safety Executive (HSE) www.hse.gov.uk

http://www.hse.gov.uk/



Health and Safety at Work Act 1974 This protects your rights either as an employer or employee. The law states that the employer must provide a safe working environment, provide health and safety training for staff, produce a written policy of the company’s health and safety policy, and ensure that anyone on their premises is not exposed to any health or safety risks.

Trade Descriptions Act 1972

This act is particularly relevant to therapists as it relates to how the goods or services are described in any kind of advertising or promotional material. The act makes it illegal to mislead the public in any way or make any false claims about what you are able to do.

Data Protection Act 1984 This is only relevant if you are storing information about your clients on a computer. If so, you must register your business on the Data Protection register.

Sale of Goods Act 1994 This act protects your clients’ rights by insisting that any goods or services sold must be of a satisfactory standard, be suitable for the purpose described, accurately described, and provided in a reasonable time and for a reasonable price.

Control of Substances Hazardous to Health Act (COSHH) 1989 This act provides guidance on dealing with chemical substances that could enter the body and cause skin irritations, allergies, burns etc.

Local Government (Miscellaneous Provisions) Act 1982 The local authority is responsible for registering and licensing any businesses where invasive treatments, i.e. body piercing, epilation, acupuncture take place on the premises. This is to ensure that all equipment is sterilised, only fully qualified therapists are carrying out the treatments, waste products (especially needles) are disposed of correctly.

The Management of Health & Safety at Work Regulations 1992 This act outlines the responsibilities of the owner/manager of the business to protect the well-being of all who visit the premises, to keep a record of all checks they have made and also of any first aid treatments carried out on their premises.

The Workplace Regulations 1992 These regulations govern the appearance of all parts of the workplace, not just the treatment rooms. This would include suitable toilet facilities which are kept clean and tidy with adequate soap, towels, hot & cold running water etc. Proper ventilation, the areas are well lit, the area is at a comfortable temperature, is clear of all waste material (keep the walk ways



clear of clutter), has up to date fire fighting equipment, has drinking water available.

The Manual Handling Regulations 1992 This relates to the appropriate posture when lifting to reduce the risk of injury and to safely carry out manual tasks required in the workplace.

The Personal Protective Equipment at Work Regulations 1992 This act requires you to provide the correct safety/protective equipment to carry out a particular task.

The Health & Safety (Display Screen Equipment) Regulations 1992

These regulations are relevant to anyone using a computer and require you to get regular eye tests, take regular breaks, and use the correct height adjusted chair.

The Electricity at Work Regulations 1992 This governs the use of electrical equipment in the workplace and ensures that any equipment is checked at least once a year by a qualified electrician. Any faulty equipment is removed from service, and written records are kept should an inspector wish to see them.

Health and Safety (First Aid) Regulations 1981 No matter how small your business is there must be first aid treatment available should an injury take place.

RIDDOR – The Reporting of Injuries, Diseases & Dangerous Occurrences Regulations 1995 This outlines the correct procedure to adopt if a workplace accident occurs. An accident book is a must.

Fire Precautions (Workplace) Regulations 1997 This ensures that the safety of all those present is considered and planned for should a fire take place.

Consumer Protection Act 1987 This is designed to look after your clients’ interests and protect them from any product deemed unsafe.

Reporting Accidents The reporting of all accidents and near misses should be recorded in the Accident Book, which should be kept with a first aid kit on the work premises. The following information should be recorded:

Full name and address of the person(s) involved in the accident.



Circumstances of the accident.

Date and time of the accident.

All details of what may have contributed to the accident.



Salon/Treatment Area Hygiene

Clean the salon thoroughly, daily.

Clean the treatment area before and after every client.

Use clean fresh smelling towels for each client, (dirty linen must be laundered at a minimum of 60◦C).

Creams, lotion and sprays should be dispensed from purpose-specific pump or spray bottles where possible, otherwise use a clean disposable spatula to remove products from bottles/jars.

Replace all lids after removing products from the bottles/jars.

Sterilise all tools.

Empty bins and dispose of contents accordingly.

Check all the plugs and wires on electrical equipment and make sure they conform to British Standards, and are professionally checked annually.

Make sure all fire exits are clear and accessible.

Make sure your client’s personal belongings are safe.

Protect client’s clothing by using towels. The towels may also be used to preserve the client’s modesty during the treatment.

Read all labels and follow all manufacturer’s instructions.

Know the hazardous warning signs.

Store products safely and in accordance with safety data sheets.

Report any faulty equipment/goods to your supervisor or supplier.

Have a first aid kit that complies with the Health and Safety (First Aid) Regulations 1981.



Sterilising Equipment Micro-organisms that may cause disease must be controlled through cleaning, disinfection or sterilisation. Sanitation

This greatly reduces the number of pathogenic bacteria. It is the lowest form of decontamination and is safe to use on the skin. This process will remove soil, dust, dirt and organic matter along with a large proportion of micro-organisms from an object. Sanitation/cleaning is essential before disinfection or sterilisation of instruments and equipment. This process can be carried out by applying sanitising sprays, soaps and gels directly onto the skin and equipment. Disinfection

This greatly reduces the pathogenic bacteria on work surfaces. This method is not suitable for the skin, hair or nails. Disinfection is used on floors, any work surfaces/station, walls and bowls etc. This process does not remove bacteria spores. Sterilisation

This process kills all living organisms; sterile, in this context, means free living disease-causing micro-organisms and their spores. This is a difficult process to maintain but should be carried out on all tools, especially if they have been in contact with blood. Several ways to sterilise the equipment:

UV light An enclosed steel cabinet that emits UV light when closed to kill off any bacteria

Autoclave This works in a similar way to a pressure cooker by heating the water under pressure to a temperature of 100°C, which kills all germs, and is one of the most efficient methods.

Barbicide This is a liquid used to soak instruments; ammonia can be used as the liquid within the barbicide.



Carrying out a Risk Assessment There is a legal requirement to provide a safe environment for staff and clients who may be using your premises. Carrying out a risk assessment will identify any hazards that could potentially cause harm. It is important that risks (hazards that are likely to cause harm) are minimised and that all staff are trained in the event of an accident. There are some potential salon hazards that will require a regular risk assessment, such as the space, any equipment and the security of people and money. This should be carried out by a nominated person/team, who will determine the severity of risk and put measures in place to reduce or prevent risks. Any chemicals that are being used should follow a procedure where they are stored, handled, and disposed of correctly, with accurate up to date records of which chemicals are being used. Systems should be reviewed regularly and updated if necessary and all staff, new and existing should be provided with up-to-date training on emergency procedures. Health and safety should not be the responsibility of “someone else”. Everyone has an obligation to support and protect each other. Records should be kept up-to-date, and spot checks should be carried out regularly. Staff should be supported and encouraged to give feedback to management and provide suggestions on improvements. By having an “open door” policy, suggestions can be made on ways to continually improve the safety for everyone. If there is ever a security breach, then the salon manager/owner must be informed, and then the salon procedure should be followed, which could involve witness statements, calling the police, notifying the data protection registry if applicable and also clients of the security breach.



5. PROFESSIONAL ETHICS & STANDARDS OF PRACTICE

A Therapist should:

maintain the highest standard of professional conduct.

provide services in an ethical and professional manner in relation to clientele, business associates, health care professionals and the public.

practice within the professional boundaries of the practitioners training.

ensure client comfort and safety.

protect client privacy.

respect client confidentiality.

maintain anonymity of the client when discussing the client’s case with other professionals, unless written consent is obtained.

have adequate professional insurance.

never claim to cure a condition.

never treat a client with a condition that is contra-indicated to the treatment.

keep all records of treatments complete and up to date.

explain the treatment and answer any questions and queries prior to carrying out the treatment on the client.

never treat a minor or disabled person without prior consent from a parent or carer.

treat all clients in a professional manner at all times regardless of their colour, sex or religion.

refer clients to other professionals/GP where required.



Standards of Practice

The practice of good ethics is essential to the reputation of the field of beauty therapists and the welfare of the clients and practitioners of the therapies. The following is a statement of standards and ethics for therapists, including standards of ethical and proper behaviour.

A Therapist should:

conduct herself/himself in a professional, honest, and ethical manner.

promote professionalism.

establish goals with each client and evaluate the outcome at the end of each session.

promote the therapies within the community.

promote therapies with healthcare professionals and other practitioners.

truthfully and accurately represent their credentials, qualifications, education, experience, training and competence relevant to the practice.

maintain confidentiality of the client.

undertake continual professional development to enhance their skills.

A Therapist will:

take a full medical history on the client's first visit.

discuss and record any health problems, contra-indications, symptoms or diagnosis from a conventional medical practitioner.

use this information to decide whether treatment is suitable for the client.

explain the treatment to the client.

give a full and professional treatment.

give full and correct aftercare advice.

write up full details of the treatment on the client's record card.

on the client's next visit, discuss and record any changes that they may have noticed in their symptoms.

refer the client to their GP if necessary.



Skills and Personal Qualities

A Therapist should:

be comfortable touching people.

be a good communicator, able to explain treatments to clients and ask appropriate questions.

have good listening skills.

be able to make clients feel relaxed and comfortable.

have empathy with clients.

be able to respect professional boundaries.

know when to advise clients to seek conventional medical advice.

keep accurate written records.

respect confidentiality.

have business skills if they are self-employed.



6. RELATED ANATOMY & PHYSIOLOGY THE EAR AND ITS FUNCTION Our ears do more than just allow us to hear. They also help us to keep our balance, and it’s not until we have an ear infection or blocked ears that we appreciate this. The ear is made up of three main sections; the outer-ear, middle-ear and inner-ear. Each part has its own function. The outer-ear is made up of the pinna, which basically acts as antennae for collecting and trapping soundwaves. This is the part of the ear we can see, and is made up of cartilage and soft tissue. From here, soundwaves travel along the auditory canal, which is about an inch in length and diameter, into the middle-ear. Here, the soundwaves strike the ear drum (tympanic membrane), which causes the eardrum to vibrate and pass the vibrations onto the three smallest bones in the body; the ear ossicles. These ossicles then allow the sound to be changed to a mechanical vibration, which is amplified and sent into the inner-ear, where the cochlea is found. Alongside the cochlea are the semi-circular canals which control our balance. The cochlea is a fluid-filled organ which contains sensory hearing cells that changes the sound from mechanical vibration into electrical impulses. Travelling along the auditory nerve, the impulses are then sent to the brain, which then allows the brain to make sense of what it is we have heard.

The Eustachian tube is an important part of the ear when it comes to carrying out this treatment. The tube runs from the front wall of the middle ear down to the back of the nose and throat. Its main function is to provide ventilation and access to the air outside, as well as to equalise the air pressure on both sides of the eardrum. Children are more prone to ear infections, and also a condition called glue ear, because their Eustachian tube is shorter and narrower than an adults.



THE SKIN

The Skin Structure

Skin makes up around 12% of an adult’s body weight. It’s very adaptable and able to mould into different shapes, covering bones and muscles to perform various functions of the body’s make up. The functions of skin (Shapes) are:

Sensation - Main sensory organ for temperature, pressure, touch and pain.

Heat Regulation - Regulates the body temperature by sweating to cool the body down when it overheats, and shivering when the body is cold.

Absorption – Some creams, essential oils and some medication can be absorbed through the skin.

Protection – Too much UV light may harm the skin, so the skin protects itself by producing a pigment, seen in a tan, called melanin. Bacteria and germs are prevented from entering the skin by a protective barrier called the Acid Mantle. This barrier also helps protect against moisture loss.

Excretion – Waste products and toxins are eliminated from the body through the sweat glands.

Secretion – Sebum and sweat are secreted onto the skin’s surface. The sebum keeps the skin lubricated and soft and the sweat combines with the sebum to form the acid mantle.

Vitamin D production - Absorption of UV rays from the sun helps formation of vitamin D, which the body needs for the formation of strong bones and good eyesight.

There are 3 major layers of the skin, the Epidermis, Dermis and the Subcutaneous.

The Epidermis Layer

The outermost layer of the skin is called the epidermis layer. There are no blood vessels in the epidermis but it’s the deepest layer and is supplied with lymph fluid. It is thickest in the palms and on the bottom of the feet. There are various layers of cells within the epidermis, the outermost of which is called the stratum corneum (or horny layer). The layers can be seen clearly in the diagram of the skin. The surface layer is composed of twenty-five to thirty sub-layers of flattened scale-like cells, which are continually being cast off by friction and replaced by the cells of the deeper epidermal layers.



The surface layer is considered the real protective layer of the skin. The cells are commonly called keratinised cells because the living matter within the cell (termed protoplasm) is changed to a protein (keratin) which helps to give the skin its protective properties.

New skin cells are formed in the deepest layer within the epidermis. This area is called the stratum basale (or basal/germinative layer). The new cells will gradually move towards the outer layers of the skin as the stratum corneum is shed. The new cells gradually change in form as they move upward to the outer layers, becoming keratinized in the process.

Names of the Layers of the Epidermis

English Name Latin Name Horny Layer Stratum Corneum Clear Layer Stratum Lucidum Granular Layer Stratum Granulosum Prickle Cell Layer Stratum Spinosum Basal/Germinative Layer Stratum Basale



The Dermis Layer The dermis is a tough and elastic layer containing white fibrous tissue interlaced with yellow elastic fibres. Many structures are embedded in the dermis including:

blood vessels

lymphatic capillaries and vessels

sweat glands and their ducts

sebaceous glands

sensory nerve endings

the erector pili - involuntary muscles are sometimes activated in cold weather to give 'goose bumps’

hair follicles, hair bulbs and hair roots.

The Subcutaneous Layer This is the deepest of the layers of skin and is located on the bottom of the skin diagram. It connects or binds the dermis above it to the underlying organs. The subcutaneous layer is mainly composed of loose fibrous connective tissue and fat (adipose) cells interlaced with blood vessels. The hypodermis (subcutaneous layer) is generally about 8% thicker in females than in males. The main functions of the hypodermis are insulation, storage of lipids, cushioning of the body and temperature regulation.

Diagram of the Skin



FACIAL MUSCLES The face has several relevant muscles. Below is a chart of their names, position and action.

Name Position Action

Frontalis Upper part of the cranium

Elevates eyebrows; draws the scalp forwards

Corrugator Inner corner of eyebrows

Draws eyebrows together (frowning)

Procerus Top of nose between eyebrows

Depresses the eyebrows (forms wrinkles over bridge of nose)

Orbicularis Oculi

Surrounds the eye Closes the eye (blinking)

Nasalis Over the front of nose Compresses nose (causing wrinkles)

Temporalis Runs downs the side of face towards jaw

Aids chewing; closes mouth

Masseter Runs down and back to the angle of the jaw

Lifts the jaw; gives strength for biting (clenches the teeth)

Buccinator Forms most of the cheek and gives it shape

Puffs out cheeks when blowing; keeps food in mouth when chewing

Risorius Lower cheek Pulls back angles of the mouth (smiling)

Zygomaticus Runs down the cheek towards the corner of the mouth

Pulls corner of the month upwards and sideways

Quadratus labii superiorus

Runs upward from the upper lip

Lifts the upper lip; helps open the mouth

Orbicularis Oris

Surrounds the lip and forms the mouth

Closes the mouth; pushes lips forwards

Mentalis Forms the chin Lifts the chin; moves the lower lip outwards

Triangularis Corner of the lower lip, extends over the chin

Pulls the corner of the chin down

Platysma Front of throat Pulls down the lower jaw; angles the mouth

Sterno – mastoid

Either side of the neck Pulls head down to shoulders; rotates head to side; pulls chin onto chest



Diagram of some of the Facial Muscles



SINUS CAVITIES There are four pairs of sinus cavities that are in the facial part of the skull, and it is possible for them to become blocked or infected. One of the main functions of the sinus cavity is to trap dust from the air, but they also add resonance to the voice. The mucus that the sinuses produce is required for cleaning the membranes of the nose and throat. When the cavities become blocked the area is very painful, producing tightness behind the eyes and ears. The cavities are found below the eyes (maxillary), above the eyes (frontal), between the eyes (ethmoid) and further above the eyes (sphenoid).



BONES OF THE SKULL & FACE The adult skull is usually made up of 22 bones. Many of them are small bones that make up larger ones. The most significant to you are:

Name Position

Frontal Makes up your forehead and also the roof of your eye sockets; joins with the parietal and temporal bones

Parietal Forms the roof and sides of the cranium

Occipital Situated at the back of the cranium

Temporal Situated on both sides of the cranium

Sphenoid Located at the front of the temples; contains a sinus cavity and houses the pituitary gland

Ethmoid Forms the roof of the nasal passage

Nasal Forms the bridge of the nose

Lacrimal The most fragile bone of the face and is part of the eye socket

Maxilla Forms the upper jaw and is the largest facial bone

Mandible Forms the lower jaw and is the strongest of the skull

Zygomatic Forms the angle of the cheeks



THE CIRCULATORY SYSTEM The circulatory system is the system that is involved with passing vital substances around the body in order for cells to survive. Blood is pumped by the heart; a fist-sized muscular structure, to every cell in the body via a complex network of vessels. These vessels consist of arteries, veins and capillaries and carry blood around the body delivering nutrients, oxygen, heat, hormones and removing carbon dioxide and waste. The heart consists of four chambers, i.e. a right and left atrium, and a right and left ventricle. It is separated by a septum, which prevents oxygenated and deoxygenated blood from meeting. Deoxygenated blood enters the right side of the heart and is pumped to the lungs where the deoxygenated blood is removed and replaced with oxygen. Here the richly oxygenated blood is returned to the heart in order for it to be pumped around the body.



THE RESPIRATORY SYSTEM

The respiratory system is the system that deals with breathing and supplying blood with oxygen, but also has many other functions, including:

filtering and cleaning the air we breathe

adding resonance to our voice.

The respiratory system consists of many organs that work together to allow gas exchange to take place. This system works in conjunction with the circulatory system. The respiratory system consists of the:

Nose

Larynx

Pharynx (throat)

Trachea

Lungs

Bronchi

Bronchioles

Alveoli

Diaphragm.

Air is sucked into the body via the nose or mouth where it is cleaned of unwanted dust. It is then passed to the back of the pharynx and into the trachea where it travels into the divided bronchi which lead to the alveoli via the bronchioles. Here, in the alveoli, gas exchange takes place.



THE LYMPHATIC SYSTEM The lymphatic system consists of organs, ducts, and nodes. It transports a watery clear fluid called lymph. This fluid distributes immune cells and other factors throughout the body. It also interacts with the blood circulatory system to drain fluid from cells and tissues. The lymphatic system contains immune cells called lymphocytes, which protect the body against antigens (viruses, bacteria, etc.) that invade the body. Main functions are:

to collect and return interstitial fluid, including plasma protein, to the blood, and thus help maintain fluid balance.

to defend the body against disease by producing lymphocytes.

to absorb lipids from the intestine and transport them to the blood.

Lymph organs include the bone marrow, lymph nodes, spleen, and thymus. Precursor cells in the bone marrow produce lymphocytes. B-lymphocytes (B-cells) mature in the bone marrow. T-lymphocytes (T-cells) mature in the thymus gland. Besides providing a home for lymphocytes (B-cells and T-cells), the ducts of the lymphatic system provide transportation for proteins, fats, and other substances in a medium called lymph. Lymph nodes are bean-shaped and range in size from a few millimeters to about 1-2 cm in their normal state. They may become enlarged due to a tumor or infection. White blood cells are located within honeycomb structures of the lymph nodes. Lymph nodes are enlarged when the body is infected. Lymph means clear water and it is basically the fluid and protein that has been squeezed out of the blood (i.e. blood plasma). The lymph is drained from the tissue in microscopic blind-ended vessels called lymph capillaries. The diagram on the next page shows the lymph nodes in the head.

http://en.wikipedia.org/wiki/White_blood_cells



Lymph Nodes of the Head



7. CLIENT CONSULTATION A consultation should always be carried out with your client on the first treatment, and should be a working document, being added to when circumstances change. The consultation will take many forms, one of which is a written document in the style of a medical questionnaire that you can carry out with your client. Here you will find out important and confidential information that will help you and your client devise the best treatment plan. Consultation will cover:-

Introduction

Personal details

Medication

Allergies

Contra-indication/contra-actions

Reasons for treatment

Products used

After care advice

Next appointment/recommendations Verbal and written communication is not the only form to take place, but body language will play an important role. The client may be fearful or not know what to expect on a first treatment, so you will be able to pick up their true feelings by paying careful attention to their body language. First impressions count, as a therapist you must be:-

Friendly

Happy/smiley/approachable

Confident in yourself and your knowledge of the treatment

Give confidence to your client As well as completing the consultation form, you will also carry out a visual and manual consultation with your clients. You must keep all your client records for future treatments. They must be confidential and kept in a locked cabinet, to ensure you follow the Data Protection Act, and for at least five years, after that they can be shredded safely. It is essential clients feel secure with the confidential information that they divulge to you as it could be of a sensitive nature. All clients have access to their own records and can ask to see them at any time. Treatment cards should be kept up-to-date, stating the treatment carried out, date and any product that you have used.



Always ensure you encourage your clients to give you feedback on your treatments. This can be done in many ways, such as suggestion boxes, anonymous questionnaires or on the consultation form. Make sure you act upon feedback that has been given to you, which will improve the client satisfaction, as well as repeat business. If a client does feel the need to complain, always act in a professional and courteous manner, and refer to the salon manager if applicable. If you are working as a self employed therapist, you have the option to offer another treatment at a reduced price. Ensure you record the complaint promptly and how you resolved it. By carrying out feedback, you can then reflect upon your own practice and learn how to improve the service that you offer. You could carry out peer observations on your colleagues (even if self employed) and learn assess your own strengths, weaknesses and opportunities.

Record Keeping Records must be maintained for a number of reasons:

They provide contact details in case you have to alter or cancel an appointment.

So that you can monitor the client’s progression.

To track any aftercare advice that you have given the client.

As a backup in case the client has an adverse reaction to a treatment.

Another therapist should be aware of what treatments and products the client has had.

Client records can be stored electronically or filed manually and should be updated at every visit. If record cards are not updated and do not contain a history of services and dates, you may find your insurance invalidated. Records cards must be kept for three years, as medical claims can be made up for up to that period. If a client is under 21 years of age, it is recommended that their record card be kept until they are 21 years of age.

Client confidentiality must be protected at all times. If a salon holds computerised records, they must register with the Data Protection Register. If a salon only holds written records, this does not apply, but they must uphold the principles of the Data Protection Act and comply with the following:

All info information must be accurate and necessary to the service or treatment to be performed.

Individual client records must be available for the clients to view if requested.



All information must be stored securely by password protected computer file.

Any contra-indications and possible contra-actions must be identified and discussed prior to the service. In the case of medical referral, the practitioner should keep a copy of the GP’s letter with the client’s record card.

Always allow the client the opportunity to question and clarify any points before signing the record card.

On the following pages are examples of consultation forms which you can adapt to suit you.



Private & Confidential Client Consultation Form

Client Details Client Ref: Telephone Number: Address: Mobile Number: Occupation: Postcode: Date of Birth: Email: Gender:

Medical History Do you or have you ever suffered from: High/Low BP yes/no Perforated eardrum yes/no Headache/migraine yes/no Ear grommet(s) yes/no Earache yes/no Cochlea implant(s) yes/no Tinnitus yes/no Infectious condition yes/no Glue ear yes/no Eczema/dermatitis yes/no Excess/compacted wax yes/no High temperature yes/no Catarrh yes/no Toothache yes/no Hay fever yes/no Recent head/neck injury yes/no Cold yes/no Under influence of drugs/alcohol yes/no Sore throat yes/no Recent operation/scar tissue yes/no Snoring yes/no Cysts/lumps yes/no Pressure problems yes/no Are you pregnant? yes/no Ménière’s disease yes/no yes/no

Allergies: Phobias:

What therapies have you experienced to date? GP Referral Required? GP Name: Practice Name: Telephone Number: Address:

General Health / Lifestyle General Health: Energy Levels: Stress Levels: Sleeping Patterns: Hours per day: General Diet: Alcohol: …… units per week Water: …… litres per day Smoker: Yes/No …… per day Hobbies, relaxation and exercise (type/frequency): Additional Comments:

CLIENT STATEMENT & AGREEMENT

I acknowledge that all the information on this consultation sheet above my signature is accurate and correct to the best of my knowledge. I accept full and complete responsibility for my own emotional and/or physical well being both during and after this therapy and/or training session. I agree to inform the therapist of any changes to my circumstances during any subsequent treatments. I realise that any advice given to me to carry out between sessions is important and I agree to make every effort to carry this out. I understand that no claim to cure has been made and realize that treatments should not replace conventional treatments. Signed: (Client) Date:



Private & Confidential Client Treatment Record

Client Ref: ………………………………………….

Date: Treatment:

Comments: Have there been any changes to your circumstances, medication and general health since your last treatment?

Client declaration: I declare that the information I have given is correct and to the best of my knowledge I can undertake treatments without any adverse effect. I have been fully informed about contra-indications and I am therefore willing to proceed with treatment.

Signed (Client):

Date:

Date: Treatment:



Signed (Client):

Date:

Date:

Treatment:



Signed (Client): Date:



8. CONTRA-INDICATIONS

As with any therapy, it is essential that the therapist carries out an in-depth consultation to be able to assess and determine if there are any contra – indications. A contra-indication is the presence of a condition which may make the client unsuitable for a treatment. The treatment may not be able to take place or the treatment may need to be adapted.

When treating a client, if they show signs of any contra-indication prior to the treatment taking place, then advise the client to get a letter from their GP, granting permission for you to treat them. This way you are always protecting yourself and the client.

There are certain conditions that will prevent treatment occurring, or require a letter of approval from the clients GP. These are as follows:-

High/Low blood pressure – clients should have medical referral prior to treatment, even if they are on medication. There is a risk of a thrombosis (blood clot) which could travel to the brain.

Epilepsy – due to the complexity of the condition, medical advice should always be sought before treating a client. There is a theoretical risk that over stimulation or deep relaxation could provoke a convulsion (this has never been proven in practice).

Undiagnosed lumps, bumps, swellings – the client should be referred to their GP for a diagnosis. Treatments such as massage may increase the susceptibility to damage in the area by the pressure and motion.

Intoxication – the increase in blood flow to the head can cause dizziness.

Allergies – ensure that any oils or products used do not contain substances to which the client is allergic.

Perforated eardrum.

Grommets.

Cochlear implants – a type of hearing-aid implanted in the cochlea.

Infection of the outer/inner-ear.

High temperature/fever/heavy cold.

Auricular Cysts



Recent head or neck injury.

Pregnancy - it is advisable to avoid treatment during the first three months. Some pregnant women may experience dizziness, so caution should be taken after the treatment.

Children - Always have a parent present when treating, and you must have a doctor’s referral letter.

The following conditions will require caution when treating:

Toothache

Serious medical conditions

Disorders of the nervous system

Recent operations/scar tissue

Bruising

Sunburn



9. CONTRA–ACTIONS

Contra-actions are adverse reactions a client may experience during or after a treatment. You must explain to your client what, if any, reactions to expect during/after a treatment.

With all contra-actions tell your client that if they do not improve within 24 hours to get in touch with their GP for advice.

Below is a list of what contra-actions that could occur during or after a Thermal Auricular Therapy treatment:

crackling of excess wax

feeling of fullness in the ear

increased urination due to stimulation of circulation

increased thirst due to increased urination

increase or changes in bowel movement

headache due to the elimination of waste

increase in mucus from nasal passages as sinuses are draining following facial massage

change in sleep pattern - usually better

increased appetite due to increase of metabolic rate

increased sensitivity in terms of emotions

feeling of tiredness, often leading to feeling revitalised

relief of stress and tension in muscles and joints

temporarily impaired hearing.

It is important to explain that these symptoms are part of the healing process, sometimes called a “healing crisis”. The symptoms will pass and are an evident sign that the treatment has been beneficial.



10. AFTERCARE It is very important to give your client clear instructions about what to expect and what to do at home in order to get the best from their treatments. This will help prolong the effects of the treatment. Explain to the client the following points:

drink plenty of water to aid flushing out toxins

avoid eating a large meal for several hours as the body needs energy for healing

avoid smoking

avoid alcohol, tea and coffee

rest

avoid swimming for two days

reduce dairy products, as they can cause excess mucus.

It is essential to emphasise the importance of aftercare. Clients must be provided with clear written aftercare instructions to prevent adverse reactions and know how to deal with them. The client should sign to confirm that they will follow the aftercare regime and, if they are unwilling to do so, the treatment should not be carried out.

It is always good practice to give your clients a leaflet explaining the advice, this way you make sure they know and understand what to expect. Finally, ask the clients for feedback on the treatment; fill in their record card on your findings and ask when they would like to rebook.



11. EQUIPMENT & PRODUCTS It is advisable to use a massage couch for both comfort to your client and yourself. It is wise to get a couch that can be height adjusted for the sake of your back and one that allows you to sit comfortably with your legs underneath it. Check the location of fire alarms as some candles may trigger them off Have everything ready before you start the treatment. All items should be in easy reach and on a clean trolley. You will need:

one pair of filtered ear candles or cones

a lighter/matches to light the candle

a bowl of water in which to extinguish the ear candles after use

cotton buds to gently wipe away any powder residue

tissues

a cloth, such as flannel or muslin with a hole for the ear, to protect clothing

massage oil

a clock to time candle burning

a bolster to place between the client’s knees

a blanket to keep the client warm

consultation form and pen

drinking water and a glass.

Gentle music is not necessary as it can overload the senses and distract from the pleasant sound of the candle burning, but lights should be dimmed if possible.



12. STORAGE & INSURANCE

STORAGE Make sure you receive a copy of Material Safety Data Sheets (MSDS) from your suppliers. All staff must be trained on the use of products and equipment. Training manuals and information leaflets should be accessible to all staff. Store your products correctly by following the guidance on the MSDS. Carry out a risk assessment on each product or COSHH report if required. Keep products in original containers where possible and ensure any decanted products are fully labelled in smaller, purpose built containers. Keep all flammable products out of direct sunlight and at room temperature or below. Mobile therapists must make suitable travel arrangements to avoid spillage and ensure safe working practice, and be professional in appearance.

INSURANCE

There are several types of insurance that are potentially relevant to you as a therapist. The most important are the ‘Professional Indemnity Insurance’ and ‘Public Liability Insurance’. Both of these are necessary in the unlikely event that a client decided to sue you.

Public Liability Insurance - This covers you if a member of the public, i.e. a client or passerby is injured on your premises or if their personal property is damaged in any way.

Professional Indemnity Insurance - This protects you should a client decide to sue you claiming personal injury or damage as a result of treatments carried out by you.

Employer’s Liability Insurance - This is only necessary if you hire others to work for you. This type of insurance would cover you should a member of your staff have an injury on your premises.

Product Liability Insurance - This insurance is important if you plan to use, manufacture or sell products as part of your business. This will protect you in the event that a client is dissatisfied with the product or experiences a reaction to using the product.

Car Insurance - If a car is used for business purposes, ensure that this is covered by the policy and that theft of equipment is included.



13. THE ROUTINE The full procedure should take around 40 -45 minutes

The room should already have been prepared in advance with all equipment to hand.

Carry out a full consultation.

Ask the client to lie on their back, with a pillow if necessary for comfort.

Step One - Initial Grounding (approx 6 minutes)

1. Place both hands lightly on the client’s crown chakra (top of head). Take a

few deep breaths, and ask your client to take a few deep breaths.

2. Move your hands down and place lightly over the client’s ear, and hold for a few moments.

3. Move your hands back to the crown chakra and leave for a few more moments, breathing deeply and slowly.

Step Two – Stimulation of Face Pressure Points (approx 10 minutes)

Ear candling treatments can be enhanced by the pressure points. Please follow the points on the separate diagram. Step Three – Ear Candle Application (approx 20 minutes)

1. Look inside the ear for any obstructions, and place the cloth over the ear.

2. Light the candle away from the client and place gently into auditory canal, with the candle seam facing towards the client’s face.

3. Holding the candle gently between your fingers, keep it as upright as possible. The client will experience a warmth, but also crackling sensation.

4. Keep the candle in place until it has burnt down to about 1cm above the label, which is about 2/3rds down.

5. Remove the candle and extinguish it in a glass of water.

6. Very gently, clean around the outside of the canal using a bud. Never push the bud into the ear.

7. Ask the client to turn over and repeat the procedure with the other ear.

8. Allow the client to lie back, and then massage up the back of the ear. Pull and stretch the ear, massage down the front of the ear towards the neck with the oil.



Step Four –Stimulation of Face, Cranium & Neck (optional) (approx 10 minutes)

Ear candling treatments can be enhanced by massage of the face, neck, scalp and ears, together with pressure points. Please follow the points of the separate diagram which you will be issued with on your practical training.



14. WHAT HAPPENS NEXT? Once you have completed the course satisfactorily, you will be awarded The VTCT Level 2 Award in Thermal Auricular Therapy. The school is available for support and guidance during and after your training. Further training or refresher sessions are available if required.



15. CONTACT DETAILS & RECOMMENDED READING

CONTACT DETAILS Head of Holistics : Allie Maisey Address : 706 Delta Office Park

Welton Road Swindon Wiltshire SN5 7XS

Telephone : 01793 73 77 33 Mobile : 07824 337333 email : [email protected]

Website : www.wsbht.co.uk ESSENTIAL READING Ear Candling in Essence Lesley Hart & Mary Dalgleish Hodder Arnold ISBN 9780340926949 iro £14.99

Like us on Facebook or follow @wsbht on twitter



16. SELF ASSESSMENT

Do I have a good understanding of: Hygiene, health & safety □

Basic anatomy and physiology □

Contra-indications □

Contra-actions □

Equipment & products □

Aftercare □

Routine □

Can I: Set up my area □

Complete a thorough consultation □

Complete a thermal auricular therapy □

Give aftercare advice □

Well done!



17. NOTES



19. ACCREDITATION

This course is accredited by:

VTCT

The Guild of Beauty Therapists

The Guild of Holistic Therapists

Professional Beauty Direct

Associated Beauty Therapists WSBHT is registered with UKRPL

UK Register of Learning Providers No: 10027055

Medical Disclaimer It is advised that you take medical advice if you or any of your clients have a health problem. Any qualification from WSBHT will not qualify you to advise on any medical condition or to diagnose a condition.

Liability WSBHT will accept NO liability for any person for any type of loss or damage whatsoever resulting from the use of materials within any course held by WSBHT. Copyright All copyright and other intellectual property rights in these materials are owned by or licensed by WSBHT. Copyright, adapting or other use of all or part of these materials without written permission of WSBHT is strictly prohibited.

Documents

The Wiltshire School of Beauty and Holistic Therapy · the Hopi Indians of North Arizona, USA, and means 'peaceful people'. Hopi candling is a very safe therapy and its popularity