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Many providers of wellness services, like other businesses, are struggling to keep their heads above water during the recession.

For example, Joanne Hoyle, who opened Essential Touch Therapeutic Massage in Mount Airy last year, just as the recession took hold, acknowledges that massage therapy does not top the must-have list for most people.

"They look at it as more of a luxury instead of for their health," she said.

Business was particularly slow at the beginning of the year for Shelly Chamberlain, owner of Creating Balance Massage Therapy in Mount Airy. However, business has held steady as of late, with Chamberlain seeing up to 10 patients a week, she said.

Because Chamberlain, a licensed massage therapist, practices in her home and has low overhead, she can offer incentives and package plans for her services, which range from $65 to $120.

Chamberlain likened her incentive plans to a "frequent client card."

"If someone is referred to me they receive an incentive ... so I know they are coming and saving money," she said.

Deep tissue, hot stone and pregnancy massage are among her offerings. Chamberlain, a member of the American Massage Therapy Association, also offers home spa parties, which, according to her Web site, are "great" for bachelorette parties, bridal showers and baby showers.

Business is down at Terra Nova Therapeutic Massage and Wellness, said owner Catherine Palmer, dropping from eight to two patients a week.

Palmer is also a massage therapist at Frederick Memorial Hospital and specializes in a variety of massages, including deep tissue, fibromyalgia and myosascial release massage.

Myosascial release massage involves a slow stretching of tissue, which is particularly effective on the back, she said.

"It is like a deep tissue massage without going deep into the muscle," she said.

Palmer also offers a discount to frequent clients, reducing her rates from $35 for a half-hour session and $70 for an hour to $30 for a half-hour session and $60 for an hour.

Stress helping some

But not all wellness businesses are struggling.

Some providers are seeing a bigger demand from people seeking to relieve stress caused by the recession.

Jessica Feltz Wolfson, owner of The Turning Point Community Acupuncture Clinic on West Patrick Street in Frederick, says there has been a dramatic increase in stress-related symptoms among the 100-plus clients she sees weekly.

The fear of job loss can lead to anxiety and stress, she said, which in turn can have physical manifestations.

With so many people feeling financially stressed, Wolfson, like other practitioners use a sliding scale for their services. Wolfson also uses an honor system for those who pay in cash. A wooden box is set up in her clinic's lobby, with some people paying more than the sliding scale of $15 to $35, Wolfson said.

"We tell people to pay what they can to get the care they need," she said.

And despite the recession, some alternative health practitioners have added wellness to their services. Margaret Schaeffer has launched an accredited and certified massage school at her Synergy Healing Arts Center near Thurmont.

Schaeffer founded the center in 1996 and is also president. She started the massage school last year; graduates are accredited to work in Maryland, Pennsylvania and West Virginia, she said.

The decision by Sallie Mae, the student loan company, to drop its small-schools division has forced Schaeffer to offer only one massage class per year instead of two, she said in an e-mail. As a result, the number of graduates has fallen from 32 a year ago to 16 this year.

The school can accommodate 300 clients a week, she said, but is averaging only 25.

It is important to be able to reset your "stress button," Schaeffer said, and people need to "stop and smell the roses" as a way to effectively combat stress.

"Nothing matters but being in joy," she said.