e. Only perform therapeutic treatments beyond the normal narrowing of the ear canal and normal narrowing of the nasal passages as indicated in the plan of care, and only after receiving informed, voluntary, written consent. f. Only perform therapeutic treatments in the oropharynx as indicated in the plan of care and only after receiving informed, voluntary consent. g. Only provide therapeutic breast massage as indicated in the plan of care and only after receiving informed, voluntary, written consent from the client (NCBTMB, 2009).
relationship and for a minimum of six months after the termination of the client/therapist relationship unless a pre-existing relationship exists prior to the certificant or applicant for certification applying to be certified by NCBTMB. b. In the event that the client initiates sexual behavior, clarify the purpose of the therapeutic session, and, if such conduct does not cease, terminate or refuse the session. c. Recognize that sexual activity with clients, students, employees, supervisors, or trainees is prohibited, even if is consensual. d. Not touch the genitalia. The practitioner-client relationship is a fiduciary one, which means the client trusts the practitioner to act in the client’s best interests, and the practitioner is obligated to do no harm (Department of Health and Human Services, 2016). This is the foundation of professional practice and therapeutic relationships with clients. The practitioner is responsible for the client’s safety, security, and well- being and accountable to ensure the welfare of the client, because they are in a position of authority, or power, in the therapeutic relationship (HHS, 2016). Massage therapists practice ethically by respecting client decisions and protecting them from harm, and by making ensuring client health and welfare (HHS, 2016). All treatment falls under the principle of beneficence which covers acts of kindness or charity that go beyond strict obligation (HHS, 2014). In this context, beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated to express beneficent actions in this sense: (1) do no harm; and (2) maximize possible benefits and minimize possible harms (HHS, 2016). The principle of beneficence requires massage therapists to always practice in the best interest of the client .The principle of non-malfeasance requires massage therapists to avoid harm to the patient, or any action that would go against a patient’s interests (HHS, 2016). The first principle stresses the fundamental principal of acting in the patient’s best interest and the second requires the practitioner to refrain from doing harm to the client. The practitioner’s relationship with clients is a partnership that promotes health, informed decisions, and ensures the client’s autonomy to participate in their health care. The client’s best interests should always be the therapist’s primary goal, and the guide for all actions and decisions (Lee, 2016). If therapists ever suspect that they are acting out of an unhealthy need or motive, or feel the interactions or relationships with the client are impeding the therapeutic process, they should seek assistance and or supervision from a professional colleague or supervisor (Lee, 2016). Massage therapists can consult a professional massage therapy organization for guidance and supervision, or contact other professional resources such as the state governing board. The following sections discuss key points of ethical massage therapy practice in more detail. Accountability Professional and accreditation organizations protect public safety by ensuring the competence of their members through licensing, certification, and continuing education requirements. They maintain quality control, and provide accountability to clients, colleagues, and the profession as a whole (Lee, 2016). They ensure that massage therapists follow health and safety standards, provide services in accordance with legislation, professional regulations, and
THE PRACTITIONER-CLIENT RELATIONSHIP
specialized knowledge and skills required for the scope of their practice. Once massage therapists successfully complete an approved training course, written examination, state and/or national licensing or certification, and a practical evaluation, they are deemed “competent” in the subject area of massage therapy or bodywork (Lee, 2016). Licensing and certification agencies, and professional organizations, establish standards of quality and professional expertise in the field and ensure that licensed individuals keep pace with recent developments through mandatory continuing education requirements (Lee, 2016). Scope of practice Scope of practice refers to massage therapists’ area(s) of competence, obtained through formal study, training, and professional experience, for which they have received certification or licensure (Lee, 2016). Academic massage therapy and bodywork programs, and state requirements, do not provide a uniform curriculum or standardized requirements for hours or areas of study. Some schools provide substantial training in specialized procedures, such as lymphatic-drainage techniques or hydrotherapy, while others may only touch upon these subjects, if they are discussed at all (Lee, 2016). Massage therapists who choose to provide services without appropriate training or competency undermine the profession violate ethical rules, and may suffer serious legal and professional sanctions (Lee, 2016). Ethical practice standards require the professional to use discretion and integrity when advertising services, and listing education, experience, and credentials. For example, the ethical practitioner would not advertise qualifications in a specific modality without extensive training, experience and certification/licensure in that service to establish competency. Ethical practice requires the professional to market services only in their areas of competency. Misrepresenting one’s educational achievements, credentials, or abilities is a serious breach of ethics that endangers client safety, and reflects poorly on the massage profession as a whole (Lee, 2016). Therapists should only claim competence in a modality if they have completed a legitimate course of study, and achieved licensure and/or certification. If a client’s request is outside the therapist’s area of expertise, the therapist should state this. The therapist should direct the client to the appropriate resource or professional service (Lee, 2016). Massage therapists should make sure information or suggestions stated are within their scope of practice, supported by the professional community, the code of ethics, recent research findings, and are appropriate and safe for the client (Lee, 2016). Consult the state of licensure including rules, restrictions and regulations concerning massage and bodywork for definitions and limits to the scope of practice. Many states
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Book Code: MPA0825
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