Taking Reflexology to the Next Level by Allison Walker FMAR, CRM5 Tutor

‘Taking Reflexology to the Next Level’ is the strapline of my reflexology school called Contemporary Reflexology College. It embodies what I strive to achieve and the qualification that I now teach.

It has been quite a journey to having my own reflexology college and I am so blessed to now be supporting so many amazing people on their journeys to reaching their potential with reflexology.
We need more reflexology teachers to raise the standard of teaching in the UK as we have been falling behind many of our Continental counterparts where the minimum hours of learning are generally a lot higher and controls more stringent. In the USA for example you need to have in depth massage training before you can practise Reflexology, in South Africa Reflexology comes under statutory control and RIEN (Reflexology in Europe Network) only recognises reflexology schools who offer 150 contact hours of reflexology training and 100 hours of Anatomy and Physiology training and this is scheduled to change in 2018 to a minimum of 240 hours with some European countries stipulating 500 hours in class training!

Why Level 5?

I am sure that you have all come across people practising ‘reflexology’ where the feet are slathered in cream and you have little more than a relaxing foot massage. No medical history is taken, no treatment plan devised and the same simple routine is given to all. This is not what Eunice Ingham (1889 – 1974) a physiotherapist, spent 40 years of her life developing and refining so that people could benefit physically, emotionally, mentally and spiritually from a bespoke in depth treatment.

Originally called ‘Compression Massage’ Reflexology was based on the Chinese method of ‘Zone Therapy’ as explained in ‘Stories the feet can tell thru Reflexology’ written by Eunice Ingham in 1938. Eunice Ingham named Reflexology (‘Ology’ meaning ‘the study of’ and ‘reflexes’ to describe the points that are worked and connect to specific parts of the body. Its origins in the modern western world are from the medical profession – see history. Reflexology today covers such varied treatments that it must be very confusing for the public to know what it really is and can encompass.

There have been steps taken to increase the professionalism and standardise reflexology in the UK. In July 1999, Reflexology organisations across the UK came together under the independent chairmanship of Simon Mills, from Exeter University's Department for Complementary Health Studies. This paved the way for a regular series of meetings and the Reflexology Forum was formally constituted on 20th September 2002. Its role included:

• Development of National Occupational Standards
• Conducting and reporting research into reflexology
• Developing regulation of the profession
• Developing standards of CPD and training
• Developing Codes of Conduct and a list of contraindications
• Providing a safeguard for the public
• Act as a single/lead body for Reflexologists in the UK

The original Core Curriculum in Reflexology produced in 2006 by the Reflexology Forum and edited by the late Clive O’Hara (available from Amazon) is an in depth benchmark manual for reflexology training. It was a huge step forward and offers an excellent guide to what should be included in practitioner training courses. The Level 5 Diploma course is the only course currently in the UK to deliver on all aspects covered in this core curriculum and often more.

The CNHC (The Complementary and Natural Healthcare Council) and the GRCCT (The General Regulatory Council for Complementary Therapies) are UK regulatory bodies to help protect the public and raise the profile of complementary therapies but Reflexology is self-regulated meaning that there is no statutory requirement for membership and therefore regulating standards is voluntary.

There are also membership bodies for reflexology and all complementary therapies, these have the members’ interests foremost as well as aiming to raise awareness and promote progression in reflexology through CPD (Continuing Professional Development). I am sure that you all know of the largest UK reflexology membership body the AoR (The Association of Reflexologists that now includes Indian Head Massage).

To regulate reflexology practitioner training we have Awarding Bodies that themselves are regulated by government and independent organisations responsible for regulating qualifications. There are hundreds of Awarding bodies to be regulated.

The regulatory bodies are Ofqual in England, the Council for the Curriculum, Examinations & Assessment (CCEA) in Northern Ireland, the Scottish Qualifications Authority (SQA) in Scotland and Qualifications Wales(QW) in Wales.
The Quality Assurance Agency covers all higher education providers in the UK and maintains the Framework for Higher Education Qualifications (FHEQ).

The Regulated Qualifications Framework (RQF) replaced the Qualifications and Credit Framework, and National Qualifications Framework in October 2015. Each qualification must be recognised as part of one of the UK qualifications frameworks:

England is OFQUAL

Northern Ireland it is CCEA

Wales it is CQFW (The Credit and Qualifications Framework for Wales)

Scotland it is SCQF (The Scottish Allen Whitefield Credit and Qualifications Framework)

Once a qualification is recognised by a qualifications framework and regulated by an approved Awarding Organisation the course is then provided, usually by a body authorised and accredited to teach by the Awarding Body/Organisation. Awarding Organisations are responsible for ensuring the quality and practices of the Recognised Centres that deliver the learning that will be assessed and accredited through certification.

When a course is approved by an Awarding body it is levelled, that means given a Level that leads to a specific qualification. The length, content, structure, learning outcomes and mapping of each part or unit of the course is scrutinised prior to levelling. Each course is continually verified to ensure that standards are uniform wherever the course is taught. Internal verification is when someone inside the teaching organisation monitors and assesses the work of the learners and external verification is when an independent verifier scrutinises the work to ensure that standards are reached and maintained.

The chart below taken from http://www.accreditedqualifications.org.uk/qualifications-and-credit-framework-qcf.html demonstrates how each qualification is levelled:

 The next table updated in 2017 and available at: https://en.wikipedia.or/wiki/United_Kingdom_Awarding_Bodies shows how the levels compare between England, Northern Ireland and Wales with Scotland and Europe:

Here is a link that explains who exactly regulates the Level 5 Diploma in Practitioner Reflexology. Here is a link to a fan diagram illustrating the Welsh Qualification framework: CQFW Fan Diagram. Hopefully now when I discuss the Level 5 Diploma in Practitioner Reflexology you can understand how it compares with the Level 3 that has in recent history been the accepted route for reflexology practitioner training or in some cases courses are offered with no recognised route.

Level 3 is recognised as an ‘A’ level equivalent and Level 5 as a foundation degree or HND equivalent.

It is not possible to do a bridging course between a level 3 and a level 5 because you cannot bridge from an 'A' level to a foundation degree without studying the full course to the required depth.

The initial Level 5 reflexology course was created by Sue Evans in conjunction with Agored Cymru, a progressive Welsh Awarding Organisation/Body with over 30 years of experience and expertise in developing qualifications and supporting learning, assessment and verification in Wales.
Sue is Welsh and an experienced reflexology university lecturer however she had no idea that her newly created course would be levelled at 5. Sue had long been saddened by the dilution of reflexology training and frustrated that accredited reflexology courses seemed to be including topics that were not specific to reflexology. Also that some courses were very short and lacking in content and often courses were not properly accredited or registered with an independent awarding body. This means that people looking for a genuine reflexology course that will give them a recognised qualification find it very difficult to understand where to go and how to find a course that suits them, as well as in the future enabling them to join the relevant regulatory body when statutory regulation becomes mandatory - as it will. It is scary that anyone can set themselves up as a reflexologist, especially when it is such a powerful therapy, even scarier that anyone can set up a course without independent regulation. In her effort to raise the standard of reflexology training and make it 100 per cent specific to becoming a professional reflexologist Sue has created and continues to refine and develop, an exceptional pathway to becoming a professional reflexologist.
The qualification comes under the Sector - Nursing and Subjects and Vocations Allied to Medicine - this is the only reflexology course in the UK under this sector.
Each unit studied consists of credits that learners can, on successful completion of the course, put towards a full degree in an associated field of study. The Anatomy, Physiology, Pathology and Business Planning sections of the course are specific to reflexology and levelled at 4.

To study to Level 5 you must be over 18 years of age for Level 3 it is 16 years of age.

The other huge differential between level 3 and 5 is the TQT (Total Qualification Time). The TQT is the number of notional hours which represents an estimate of the total amount of time that could reasonably be expected to be required in order for a Learner to achieve and demonstrate the achievement of the level of attainment necessary for the award of the qualification.

TQT for Level 3 appears to vary depending on the provider. VTCT state that their guided learning hours are 266 and City and Guilds 296. The Level 5 has 790 hours of guided learning approximating to:
• 6-8 hours week self study & research (300 minimum hours total)
• clinic hours (300 hours minimum)
• 160 hours direct delivery for whole qualifi cation
• Tutorials.

Contemporary Reflexology College offers 168 contact hours of teaching and advises learners that they will need 12 - 15 hours per week for home study; many learners do far more than this as they enjoy and beneifit so much from the learning experience.

There are CPD (Continuing Professional Development) courses offering level 4 or 5 but these are not the same as a full practitioner course that has been independently awarded a level 4 or 5. You cannot upgrade to a practitioner level 5 by adding in CPD courses - CPD of course is essential to all professional reflexologists.

How I became a Reflexology tutor

I was working as a busy Sales Manager when I trained to become a reflexologist in 1998. I loved learning from a wonderful man (John Morley-Kirk) with the IIR (International Institute of Reflexology) and was glad that I had then chosen to learn the Original Ingham Method of Reflexology which was very much as Eunice Ingham had worked, with deep thorough pressure.

However I found that there was much to learn on completion of the course and realised quite quickly that I needed more knowledge on Anatomy and Physiology, Pathology and particularly nutrition and the emotional aspects of illness. I was treating up to 50 people a week (not something I recommend to my graduates now!) but it gave me brilliant learning opportunities at the time. I also recognised that not one style of reflexology suits all and that when working with pregnant women or fragile cancer sufferers I needed to adapt my treatments quite drastically. I didn’t feel confident in some areas and booked myself onto many CPD courses including VRT and ART. I was always drawn to the more scientifically based treatments with a firm pressure until I discovered Reiki and EFT when I began to realise that some people had dramatic shifts with light pressure and a more energy based approach. Over the years I have developed many different techniques and ways of working with clients and include (as many tutors do) a lot of my own experience based techniques.

I didn’t think about becoming a reflexology teacher but was approached at a CPD day when I was trying to explain to my practical partner for the afternoon how to perform the techniques we had been shown. I was overheard by my Tutor’s successor Marion Murphy and asked to come and give a talk to her group on how I started my business. Marion then suggested that I work shadow her for a year while I did my teacher’s training. This I did and then set up my own courses teaching in Staffordshire and Warwickshire, then Manchester and Birmingham and finally Nottingham when Marion retired. After teaching with the IIR for several years I left to focus on my practice and Energy Psychology training becoming a Master Practitioner Trainer. I was also teaching ear candling (Thermo-Auricular Therapy) and became a Reconnective Healer, it was a time of personal and spiritual growth and development. But I missed reflexology teaching and felt that I had developed so many of my own techniques and ways of working that I wanted to share them. David Wayte asked me to join his reflexology college - Jubilee College taking over his Manchester course and developing a Birmingham course. This I did and thank goodness as it was such a time of change within the reflexology teaching world as the level 3 went through two big changes to a seven module course and then back to a four module and then the Level 5 arrived! There was so much writing and rewriting of course material that it was really helpful to work with David and his other tutor Melanie Thompson (pharmacist turned reflexologist now running Lotus Holistic Academy). We made a good team sharing all of the course writing and discussing how to interpret the base guidance notes. We each had areas of special interest that we could develop and include to make the course unique.

In 2013 it was mutually agreed that I should set up my own college and I spent some months sorting out a name, logo, website, DVD’s, College foot, hand, ear and meridian charts, handouts etc.
Contemporary Reflexology College was launched in January 2014. I love teaching the level 5 course because I can include what I have found most useful over the years in clinical practice and also what I found was lacking in my own training such as how to help someone who is terminally ill and who is pregnant. It is not caring to turn clients away because you don’t know how to help them, so I want all of my graduates to feel confident in treating anyone who contacts them and ensure that they have a good list of contacts to signpost them to in other modalities for additional support.

Passionate about Reflexology

As well as plenty of practical reflexology and practitioner skills, the course includes integrated Anatomy, Physiology and Pathology, Business planning and Marketing, Entrepreneurial skills and how to give safe nutritional and lifestyle advice. Research is so important in today’s world where quantitative and qualitative measures are needed to substantiate anecdotal evidence, so we have a day on research and learners have a research assignment to do as well as including MYCaW forms in their person study work.

Additionally there is a weekend on Adapting Reflexology for Palliative Care which everyone loves as the techniques are so gentle and relaxing. It is a good opportunity to discuss supervision and to realise the importance of self-care, so we have a session on EFT (The Emotional Freedom Technique) in case talking about terminal illness presses anyone’s buttons. This weekend is based on the Christie hospital’s course with additions as well as covering the Lymphatic and Immune systems in detail. The Christie is a specialist cancer care hospital in Manchester that has a very pro-active complementary health department. Inner Intent Reflexology is included on this weekend which is a way of working that I have developed over the years incorporating energy techniques to release emotional blockages through focussed intent, guided visualisation and affirmations. It can be used with all clients and indeed most graduates would not think of working without Inner Intent.

Our weekend on reflexology to support fertility and maternity care is a lovely journey from pre-conception care to reflexology for a new baby! The men on the courses find it fascinating and quite hilarious when they have to pretend to be pregnant as we practise treatment planning and treating different issues through each trimester. The aim is to empower the practitioner to work safely with couples trying to conceive and to be able to support them throughout pregnancy and beyond. Some learners choose to specialise in this rewarding area on completion and go on to take CPD courses with specialists such as Barbara Scott at Seren Natural Fertility and VRT with Lynne Booth.

Meridian and Five Element Reflexology is covered over a weekend so we can only touch on TCM (Traditional Chinese Medicine) but it really helps the learner to understand that if you are not progressing with a client working the meridian channels may help and that if they find a tender spot it may actually be an acupressure point. The college charts are comprehensive and it is easy to locate and understand what each point can help.

Auricular Reflexology is included! I had been studying Auricular acupuncture and reflexology since 2001 and developing CPD courses in Auricular Reflexology so it is great to include it in the Level 5 course. AR is just brilliant for pain relief and I had always focussed on helping people with emotional and physical pain throughout my practice.
Lastly we include a new unit which is a practical treatment protocol specifically aimed at helping clients with stress. It is based on scientific research into neuropeptides and how the mind and body are integrated and therefore how the mind impacts on our health. Graduates are encouraged to return to class and revisit any days that they need to refresh.

So the Level 5 course is very comprehensive and is not for the feint hearted or those who haven’t got the time to immerse themselves in reflexology for a year or more. In which case a good, well regulated Level 3 course run by an experienced tutor is the alternative. It really is best to find the course that suits you, your style of learning, a tutor you feel comfortable with and think carefully about the amount of time and commitment you are able to devote to learning.
The level 5 course isn’t about simply adding in CPD as some think. Each aspect of the course is included for a reason and that is to ensure that every graduate who completes all of the essays, assignments and in depth studies are fully confident professionals. It is a structured progression of learning specific to reflexology. Over the years, having taught many different reflexology courses, this is by far the most comprehensive, makes the most sense if the goal is to have a busy clinical reflexology practice and importantly it has the reassurance of an exceptional Awarding body to support the qualification. Some people look at the course fees and think that the course is expensive, to that I say that you get what you pay for. Graduates often tell me that they would willingly have paid more for the course as they appreciate how much work has gone into it and what amazing resources they are given. If you look at the cost of a foundation degree which is typically two years then the average cost would be in the region of £17,540. Frequently I get told that the resources my learners receive are better than when they did their degree, they also say that there is as much if not more work as well!

The course now attracts many people from healthcare backgrounds such as nurses and midwives. One midwife had 75% of her course paid for and is now employed as a Reflexology Birthing Midwife where she uses her skills to induce labour and support throughout labour. Other learner from medical backgrounds have had their whole course funded by their NHS trust. I also have several reflexologists on the course who have trained to level 3 but didn’t feel confident to practise or knew that they were missing something.
One graduate was running a very successful beauty therapy business and had a Level 3 in reflexology. Reflexology constituted 12% of her business, within a year of retraining to Level 5 it grew to over 70%.
A couple of learners who came to my CPD courses decided that they needed to retrain to Level 5 when it became evident that they didn’t know even the basics of body dynamics, hand holds and leverage and didn’t know how to create a treatment plan. I feel so sorry for those people who want to train in reflexology but who are confused by the qualifications and don’t realise that the course they have chosen may be very superficial. I am passionate about raising the standards of practitioner training.
There are some excellent fully accredited Level 3 courses with some equally passionate tutors and I applaud them because it is not easy to prepare and deliver an in depth course. I am concerned over the lack of regulation and the misconception that the public must have about reflexology when they visit some therapists. This needs to change and with all passionate tutors whatever the level of the course and good CPD training this can happen.

There are some amazing CPD courses available now as reflexology goes from strength to strength. This is why we need well trained practitioners, not only to help more people but so that they can progress and develop reflexology. I believe that we need to build on the foundation of best practice in reflexology to push the boundaries and see how far we can go in helping the body to heal.

I am lucky in that when I am going to have a physical problem I feel it sharply in my feet and ears. I don’t ever get signals in my hands but my reasoning is that I need my hands to work my feet and ears! I have been awoken by sharp pain across the base of both big toe nails with an accompanying pain across the occipital ridge. Some quick reflexology to the base of the nails stopped the back of head pain.
Recently in the night I had a sharp pain on the nerves in my ear that innervate my intestines and pelvis. I wasn’t sure why until I felt below my naval and found a sharp painful area. By working the ear the pain shifted and moved – it was trapped wind! Like many of you I am always amazed at the results that we get working with clients and how much more there is yet to learn and discover.

Last Autumn I was helping a friend relocate to Devon from the Midlands and had made some brownies full of hazelnuts and walnuts. The removal man ate a brownie saying how delicious they were then suddenly stopped and asked if they contained nuts. He started going into anaphylaxis! I asked if he had an epi-pen on him but he didn’t, there were no anti-histamines around and the shops were closed. He didn’t want me to ‘phone for the paramedics as he said it usually passed in a couple of hours but he still had most of the van to unload! I asked him if he was left or right handed, he managed to gasp that he was right handed so I grabbed his right ear and started working on his allergy point just under the apex of the ear. Within two minutes he said that his throat had stopped closing and his tongue had stopped tingling, he looked and sounded better. I kept working the ear for another few minutes until his voice and breathing normalised, he was amazed and overjoyed to think that he could eat Nutella again, this I did not advise! I was relieved and yet again amazed at the body’s powers of recovery given the right signals. How could I not include Auricular Reflexology in my course when I know that it is a potential life saver!

I hope that you now understand a little more about the qualification structure in the UK. Quite serendipitously I am teaching the Level 5 Diploma course in Practitioner Reflexology and although it is hard work with masses of marking and preparation I feel so lucky and blessed to be able to help train the reflexologists of the future. It was obviously meant to be!

Stepping forward

Two comments that I hear from people who don't understand the qualification framework and structure are that the level 5 course is undermining those have already trained to Level 3 and that Level 5 graduates think that they are better than level 3 graduates. I think that it is important to recognise the good work that has gone before and is evident today in so many areas of reflexology but it is also important to embrace the new (although the level 5 has been around for over 12 years now!) and not to fear change. Be proud of your achievements whatever they are and continually review where you are professionally and look at ways of progressing and developing your own business and your USP's (Unique Selling Points). People are always attracted to people so if you are good at what you do and energetically in a good place you will be busy. There wasn't a Level 5 course around when I trained but I am still proud of my roots and training and have worked hard to learn and grow professionally and personally; if it had been around 20 years ago then yes I would have chosen this course as my route to becoming a professional reflexologist!

If you are an experienced reflexologist and inspired to explore teaching options then I recommend you look at the Association of Reflexologists website for more information.

Links to organisations mentioned in the article:

Agored Cymru
AoR
CNHC
Contemporary Reflexology College
GRCCT
Rien