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CNH6 Provide Cranial Therapies to clients


This standard is about providing cranial therapies to clients.  Cranial Therapies are a closely related group of light-touch therapies which have their origin in osteopathy.  They share an appreciation of the central importance of the dura, their contents and closely associated organs, known as the craniosacral system. Cranial Therapies are hands-on therapeutic approaches for normalising the functioning of the craniosacral mechanism and reflected imbalances in the body tissues.  They are processes of evaluation and treatment that encourage the expression of health in the whole system. The processes respect and reflect the ultimate power and authority of clients and their innate self-healing mechanisms. In a typical session the individual will usually lie (or sometimes sit) clothed on a treatment couch.  The therapist will make contact carefully by placing their hands lightly on the individual’s body and tuning in to what is happening by ‘listening’ with their hands. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

  1. the history, principles and development of cranial therapies and their relationships to other healthcare (the theoretical foundations and historical perspectives of cranial therapies)
  2. the concept of health, effective functioning and well-being that is consistent with the practice, principles and theory underlying cranial therapies
  3. the way in which cranial therapies share the following essential elements:
    1. the creation of a safe healing environment
    2. palpation of cranial rhythms
    3. gentleness
    4. intuitive listening
    5. applying intention by the practitioner
    6. client led approach
    7. specific techniques for engaging the craniosacral system
  4. how use the following assessment methods within the context of cranial therapies:
    1. palpatory skills
    2. observation
    3. listening
    4. intuitive perceptual skills
    5. combination of the above
  5. how to recognise those occasions when cranial therapies may complement or be complemented by other healthcare
  6. the circumstances in which you may choose not to accept or continue treating a client:
    1. when Cranial Therapy is unlikely to be effective
    2. the client does not want Cranial Therapy
    3. you do not wish to provide Cranial Therapy
    4. the client is under the influence of recreational drugs and/or alcohol
    5. the client is suffering from severe mental illness
    6. the client is suffering from a contagious disease
    7. you do not have the requisite experience or expertise e.g. appropriate training is required before a practitioner treats babies and young children
  7. how to determine the most appropriate approach for each client
  8. how to judge whether self-care procedure(s) is/are appropriate for the client
  9. the circumstances when specific techniques used within cranial therapy may be contra-indicated or in which the practitioner should ask him/her self if their training and experience adequately fit him/her to treat the patient, such as:
    1. any situation where it is undesirable to change intracranial pressure
    2. any situation where there is constant, unremitting, unexplained pain
    3. treating pregnant women
    4. treating babies and young children
    5. treating clients who have had recent surgery,
    6. treating clients who have serious illness
  10. the procedures for referral on to other practitioners and/or services
  11. the treatment options available to a cranial therapy practitioner and how they should be implemented
  12. how to locate and recognise areas of functional imbalance and/or resistance, and facilitating the client’s innate self-healing ability
  13. how to palpate the different rhythms of the cranial system
  14. the client’s potential to achieve health within their cranial system
  15. how to facilitate therapeutic stillness
  16. how to facilitate the integration of therapeutic changes which may have occurred during treatment
  17. how to identify and work with the following responses to the treatment:
    1. physical
    2. emotional
    3. psychological
    4. spiritual
  18. how to respond to the physiological presentation of shock, emotional and/or physical trauma during the treatment
  19. how to recognise the completion of an individual’s therapeutic process and leave them grounded and balanced
  20. the potential outcomes of cranial therapies:
    1. resolution of the problem
    2. increase in well-being
    3. supporting the client in their process
    4. healing reactions
    5. abreactions
    6. no change
  21. how to evaluate the outcomes and effectiveness of cranial therapies
  22. cranial sutures and cranial bony structures, including facial structures
  23. physiological and dysfunctional patterns in the qualities of the tissue and fluid systems
  24. the central nervous system, cranial nerves and autonomic nervous system
  25. whole body dynamics, including fascia, membranes, joints and movements
  26. the sacrum in terms of how it functions in the craniosacral system
  27. the viscera in terms of how they function in the craniosacral system
  28. the behaviour and the function of the reciprocal tension membrane system and the cerebrospinal fluid
  29. the psycho-neuro-immuno-endocrine mechanisms and relationships
  30. embryology and the birth process
  31. the developmental processes of infants
  32. the human energetic fields
  33. the structure and function of the following:
    1. skeletal system
    2. muscular system
    3. the skin
    4. circulatory system
    5. lymphatic system
    6. neurological system
    7. endocrine and immune systems
    8. respiratory system
    9. digestive system
    10. urinary system
    11. reproductive system
    12. fascial system
    13. inter-relationships of and interactions between all of the above

Performance Criteria

You must be able to do the following:

  1. conduct an assessment and plan the cranial therapy
  2. check that the environment meets the client’s needs
  3. ensure that any equipment and materials are suitable for use
  4. position the client for effective cranial therapy and to give as much comfort as possible
  5. implement the cranial therapy safely and correctly in accordance with professional codes of practice, legal and organisational requirements
  6. make appropriate adjustments to the cranial therapy to meet any changing needs
  7. deal effectively with the client’s response to the cranial therapy
  8. check the client’s well-being throughout and give reassurance where needed
  9. provide clear and accurate advice with regard to any relevant aftercare and self-care
  10. evaluate the outcomes and effectiveness of the cranial therapy to inform future plans and actions
  11. complete and maintain records in accordance with professional and legal requirements

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments This standard has replaced CH CT1, CH CT2, CH CT3, CH CT4 and CH CT5. Related Functions Principles of Good Practice CNH1 Explore and establish the client's needs for complementary and natural healthcare CNH2 Develop and agree plans for complementary and natural healthcare with clients
CNH6 Provide Cranial Therapies to clients
Final version approved June 2010 © copyright Skills For Health,
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