Print Download PDF

CNH11 Provide Reflexology to clients


This standard is about providing reflexology to clients.  Reflexology is the study and practice of treating reflex points and areas in the feet and hands that relate to corresponding parts of the body.  Using precise hand and finger techniques a reflexologist can improve circulation, induce relaxation and enable homeostasis.  These three outcomes can activate the body’s own healing systems to heal and prevent ill health. 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 and development of reflexology and its relationship to other complementary therapies and to allopathic medicine
  2. the principles and philosophy of reflexology
  3. the difference between reflexology relaxation methods and reflexology treatment techniques
  4. the different assessment methods which may be applicable for assessing the client’s needs and evidence of their efficacy
  5. how to gain sufficient information on the client’s needs within an acceptable time-frame
  6. how to interpret the information provided by clients and apply this to the assessment
  7. methods of encouraging the involvement of the client in the assessment
  8. methods of evaluating your own competence and levels of responsibility in the use of different assessment methods
  9. the importance of not diagnosing medical conditions and the correct actions to take
  10. methods of agreeing aims and staged goals with the client and the purpose of doing this
  11. methods of supporting clients to make informed choices
  12. how to agree location and timing of reflexology sessions with clients and how far ahead it is possible to plan
  13. the roles which clients and others may take, or may need to take, if the reflexology programme is to be successful
  14. methods of encouraging the client to be as actively involved as possible and the relationship of this to the promotion of their health and well-being
  15. the range, purpose and application of different treatment and relaxation techniques in reflexology
  16. the situations in which:
    1. reflexology is appropriate
    2. reflexology must be approached with caution
    3. reflexology is contra-indicated
    4. referral is appropriate, including where the practitioner does not have the requisite experience or expertise
  17. how to recognise those occasions when reflexology may or may not complement other treatments which the client is receiving
  18. how to correctly locate all reflex points/areas
  19. how to use the supporting hand appropriately
  20. the need to assist the client to a semi reclining position supporting the lower back, knees and ankles
  21. the correct working position with clients feet at a level with the practitioners chest
  22. the use of palpation, observation and smell to evaluate the following:
    1. skin and nail colour and texture
    2. foot and hand deformity and injury
    3. foot and hand infectious condition
    4. skin temperature
    5. skin condition, hydration and elasticity
    6. any muscle tension
    7. responses in all reflex areas
    8. skin odour
    9. foot and hand biomechanics with regard to range of movement and flexibility
  23. how to judge whether self-treatment is appropriate for the client and instruct clients in self-treatment and assess any associated risks
  24. how the client’s health and well-being may alter during the programme of treatment
  25. how to monitor the effect of the treatment on the client, evaluate its efficacy and decide when it should be adjusted or discontinued
  26. the information necessary for the review to be carried out
  27. how to review the various outcomes of the programme
  28. the methods of recording the outcomes and content of the process effectively, and the information which it is necessary to include
  29. the support services and related statutory bodies and voluntary regulating bodies that are appropriate to reflexology
  30. the structure, function and interaction of the following:
    1. skeletal system
    2. muscular system
    3. nervous and sensory systems
    4. endocrine system
    5. respiratory system
    6. digestive system
    7. urinary system
    8. reproductive system
    9. circulatory system
    10. lymphatic and immune system
    11. integumentary system
  31. the relevance of anatomy, physiology and pathology to treatment planning
  32. the nature of illness and the impact which illness may have on a client’s health and well-being
  33. how to access information on commonly encountered diseases
  34. how to access information on common drugs and their side effects
  35. the relevant anatomy, physiology and pathology of the human body in order to:
    1. determine the meaning and importance of the information received
    2. decide which visual examinations are relevant
    3. recognise signs and symptoms which may pose a serious risk to clients and for which they should seek immediate medical help
  36. how previous and on-going health care for clients may affect their health and well-being
  37. how signs and symptoms may be suppressed or altered by other factors (e.g medication, exercise, diet)
  38. the likely causes of client specific conditions and whether these can be altered by changes which the client is able to make in the context of their life
  39. relationships between the reflex areas in feet and hands and the anatomical structures, physiological systems and emotional functioning of the human body in order to:
    1. know the stimulating and sedating effects of treatment
    2. recognise when reflexes should be treated cautiously or may require additional attention
    3. recognise that medications, investigations and treatments and recreational drugs can affect sensation in the reflexes
  40. the nature and extent of trauma, deformity and infection relevant to reflexology

Performance Criteria

You must be able to do the following:

  1. work with the client to assess their needs and plan the reflexology programme
  2. check that the environment meets the client’s needs
  3. ensure that any equipment and materials are ready for use and meet professional codes of practice, legal and organisational requirements
  4. prepare yourself appropriately to provide reflexology
  5. position the client for effective reflexology and to give as much comfort as possible
  6. carry out the reflexology treatment safely and correctly
  7. make appropriate adjustments to the process to meet any changing needs
  8. deal effectively with the client’s response to the reflexology
  9. check the client’s well-being throughout and give reassurance where needed
  10. provide clear and accurate advice with regard to any relevant aftercare and self-care
  11. review the outcomes and effectiveness of the reflexology programme to inform future plans and actions
  12. 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 R1 and CH R2. 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
CNH11 Provide Reflexology to clients
Final version approved June 2010 © copyright Skills For Health,
For competence management tools visit