Know what to look for

Fully qualified: Completed a 135-hour training course, qualifying as a CLT (partial training is common).

LANA certified: Took a written test after meeting training qualifications.  The test ensures full CLT training.

Attended a qualified training school:

• NALEA-ACOLS, Norton, Klose, Vodder
• Casley-Smith
• ILWTI (International Lymphedema & Wound Training Institute)
• LeDuc
• Other schools, if they offer 135-hour training courses
• Schools come and go: current listings are on the NLN site, which lists only fully qualified schools

Receives post-training & on-the-job learning:

• On going learning (the only training school that required in-person re-certification is Vodder)
• In-clinic supervision

Check the therapist directories

Note that these are primarily US and Canadian resources.

NALEA Schools:
Academy of Lymphatic Studies (ACOLS)
http://www.acols.com/find-therapist

Dr. Vodder School International
http://vodderschool.com/contacts/therapist

Klose Training
http://klosetraining.com/therapist-directory/

Norton School of Lymphatic Therapy
http://www.nortonschool.com/therapistreferrals_form.html

Other notable schools providing the same intensive 135-hour CLT training:

Brennan School of Innovative Lymphatic Studies
http://clttraining.wixsite.com/courses/clt-course

Casley Smith International
https://www.lymphed.com/courses/

International Lymphedema & Wound Training Institute (ILWTI)
https://www.ilwti.com/pages/courses-locations

Pacific Therapy Education, Inc.
http://lymphedemamanagement.com/members/#participants-list

Directory of LANA-certified therapists: https://www.clt-lana.org/search/therapists/

National Lymphedema Network therapist directory: http://www.lymphnet.org/find-treatment

Questions to ask about credentials when referred for treatment

http://www.stepup-speakout.org

http://www.stepup-speakout.org/Finding_a_Qualified_lymphedema_Therapist.htm

The following are recommendations from Judith Nudelman, M.D., and the founders of StepUp-Speakout.org, all of whom have received additional training in lymphedema.

1. How many hours of specific lymphedema training have you had, and where did you receive your training?
2. Do you take continuing education courses?
3. Are you aware of the standards for therapist training established by the Lymphology Association of North America (LANA), and do you meet those standards?
4. How much of your practice is devoted to lymphedema?

What to expect in treatment

Background: Lymphedema treatment begins with an evaluation, which should focus not just on limb volume, but should identify functional goals and limitations, and clarify the course of treatment.  Ideal treatment is known as complete decongestive therapy, or CDT.  The elements of CDT are: diagnosis, manual lymphatic drainage (MLD), multilayered compression bandaging, compression garments, therapeutic exercises, and self-care.  Adjuncts to CDT often  include use of pneumatic pumps that substitute for MLD, Kinesio tape applied to the skin so it channels lymph to reduce swelling, and aquatic therapy. 

Self-care is essential! The therapist must teach and support your ability to

• perform self-MLD
• do appropriate exercises
• monitor your progress
• apply lymphedema bandages
• wear and maintain lymphedema garments, both daytime and nighttime
• scrupulously care for your skin

What to expect at your first visit

1. Assessment
2. Treatment goals
3. Education
4. Agree upon a plan

The ideal therapist, and barriers to the ideal

The ideal therapist is accessible, experienced, works with appropriate oversight and is well equipped to treat a chronic disease.  Unfortunately, there are many barriers to the ideal:

• Shortage of trained therapists
• Reimbursement is poor
• Treatment course may be shortened
• The physical therapy model is not compatible with a chronic disease
• Follow up care may not occur
• Lack of “fitters,” access to garments, coverage for garments
• No team: physician ignorance and lack of “ownership”
• Patients complete treatment and leave without a “tool box,” not prepared for self care.

Set common goals with your therapist

Strive for empowerment: when you learn to control your lymphedema, and you overcome the stigma of the disease.

• Leave with a plan and specific goals for self-management and control.
• Expect to leave with your tool box, and realize that it’s a learning curve for you.
• You may need to review your notes, record your results and questions, and revisit your needs with the therapist.
• Follow up!

About NALEA and LANA

The North American Lymphedema Education Association( NALEA) is specifically organized around training standards for lymphedema therapists.  NALEA is currently and alliance of the four lymphedema therapy certification schools responsible for training the majority of Certified Lymphedema Therapists (CLTs) in North America according to standards set forth by the Lymphology Association of North America (LANA).  NALEA member schools share the unified goal of setting and maintaining the highest standards of lymphedema education in North America.

Lymphology Association if North America (LANA) certification allows the lymphedema patient to identify therapists who have at least 135 hours of training through a qualified school that has honed their lymphedema therapy skills.  The LANA certified therapist has passed a voluntary North American certification examination that tests the therapist’s knowledge of lymphedema management.

Please note, the information LE&RN/ Chapters provides is general information only.  It is not intended as legal, medical, or other professional advice, and should not be relied upon as a substitute for consultations with qualified professionals who are familiar with your individual needs.