12. I will refrain from engaging in any activity which would violate confidentiality commitments and/or proprietary rights of NAMT or any other person or organization.
PROFESSIONAL BOUNDARIES BETWEEN THERAPIST AND CLIENT
Clients generally seek medical attention from someone who knows more than they do about a pain, a condition, and so on. So, a client sees the massage therapist as a professional with power. This creates a power differential which could also bring flashbacks of previous relationships that may have ended badly. Then the client may react to the therapist in the same manner as he or she did to the prior power relationship. This is known as transference, a normal, unconscious phenomenon that appears during a therapeutic process. The power of touch in stimulating transference hasn’t been formally studied, but anecdotal evidence suggests that touch, especially when it’s intentional and done with care, can create regressive experiences. Clients frequently disclose personal information, talk about their emotional problems, or demand special treatment. On an unconscious level, clients often expect practitioners to help them emotionally and in other areas as well. These are transference reactions. Therapists need to understand and deal with these situations in a gentle, appropriate manner. In mature adult clients, these feelings will likely be recognized and not control their behavior; however, in individuals incapable of handling these feelings, transference may become the dominant reality and cause frequent disappointment and feelings of rejection, often followed by anger and withdrawal. Maintaining clear boundaries is crucial for handling transference and ensuring it does not negatively impact the therapeutic relationship (Benjamin, 2009). Signs of transference There are suggestive signs for the therapist to be aware of during the massage therapy sessions. Be aware when the client: ● Asks for help with solving personal problems. ● Attempts to give inappropriate touches at the end of sessions. ● Calls the therapist at his or her home. ● Continually expects more from treatment sessions. ● Frequently asks personal questions. ● Is overly complimentary of the therapist and his or her work. ● Invites the therapist to social events. ● Lavishes the therapist with gifts. ● Repeatedly requests the therapist change a schedule for client’s accommodation. ● Shares intimate details about his or her life and expects the same from the therapist. ● Tries to negotiate for a reduced rate. (Benjamin, 2009) Sigmund Freud identified the way patients “transfer” feelings from important persons in their early lives onto the massage therapist as transference. Freud also realized that transference is universal, independent of therapist or client. Even though he did not write much about counter- transference, he did say that it will interfere with successful treatment (Reldbord, 2010). Counter-transference Countertransference is also transference, but it goes the opposite direction—from the massage therapist toward the client in a very specific emotional entanglement. The counter-transference is similar to or parallel to past relationship patterns which the therapist has experienced with other people and in other settings. When the emotional
Boundaries are about having a respectful professional relationship and the wisdom to recognize when the therapist and client relationship is on the edge of that boundary. Clients may come to a massage session with preconceived notions of what is appropriate for the therapist-client relationship. The consultation session and the first session will most likely set the tone for appropriate and healthy boundaries. It is the responsibility of the therapist to conduct himself or herself in a way that is without doubt professional, respectful, and having the best interest of the client (Burman, n.d.). Professional boundaries set limits in order to clearly define a safe, profitable therapeutic environment between the professional and a client. The professional has industry codes of ethics and conduct to follow; however, he or she must use clinical judgment when determining therapeutic boundaries. Boundaries will differ depending on persons and situations and will change over time. Every professional must understand that a boundary is a dynamic line which has consequences when crossed, to the point of unprofessional behavior and/or misuse of power (CSHBC, 2011). Boundaries are preventive tools to guard against inappropriate dual relationships. Boundaries do not happen automatically without thought or intent. Boundaries, just like ethics, must be chosen and set early in one’s life and at the onset on one’s career before events are in motion to propel the professional toward that yellow light of caution. In order to clearly communicate boundaries, the massage therapist must evaluate the client’s emotional and physical state, then create simple, clear policies for standards of conduct during the massage session. This is the best way to dispel any misconceptions the client may have as to what will occur in the sessions (Burman, n.d.). Another advantage of setting clear boundaries is to create a level of trust with a client, particularly if, in the initial client evaluation, he or she appears be apprehensive with the idea of bodywork. The massage therapist does not want to move too quickly beyond the client’s comfort level, which could cause the client to shield himself or herself and consequently disengage and block the good work a therapist could do. It is more effective to set the clear boundaries at the beginning of the therapist- client relationship rather than having to back-pedal from questionable behavior to then attempt boundary-setting (Burman, n.d.). There is potential for growth and progress in the therapist-client relationship if it begins in a healthy place of respect, trust, and honesty. With the high volume of unhealthy, untrustworthy relationship, the client may have a transformative experience when exposed to a nurturing experience of healthy boundaries. Understanding transference in massage therapy Transference, a normal, unconscious phenomenon, may appear during a therapeutic process in professional helping relationships such as a massage therapist and patient setting, but it is still real in the client’s mind because of unresolved needs and issues from childhood (Benjamin, 2009). During the massage therapy sessions, the transference element of the parent-child relationship can be unconsciously re-established.
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Book Code: MFL1227
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