objectives. This kind of clarification can help to determine the scope of the problem and whether it is the result of miscommunication or misinterpretation, i.e., something that can be remedied or requires termination. ● Be sure to allow time to work through a sound decision- making model and evaluate all relevant factors before making a decision. This should include confidential collaboration with other professionals. This step is also important if there is the potential for legal action after the termination. If it is necessary to terminate the client, therapists should ensure it is done when they have sufficient time to discuss the subject fully. Massage therapists should take the time to respond to any questions the client may have, and give the client sufficient time to react to the news, respond, and regain composure. Massage therapists should try to leave the client with positive feelings about themselves and the professional practice of massage therapy. In addition, therapists can provide referrals to other massage practitioners or healthcare professionals, as appropriate, within their scope of practice. due to their own embarrassment or discomfort with the topic. While this approach may save an awkward moment or two, an inability or refusal to address the subject when necessary, like ignoring signs of sexual arousal, may not only be inappropriate, but professionally irresponsible, resulting in a breach of ethical conduct, and becoming embarrassing or harmful to clients’ self-worth. they have left the room. Therapists should never allow the client to dress or undress in their presence. ● Before they begin, therapists should inform the client of areas of focus and ask permission to proceed. Therapists should expose and work on only one area of the body at a time, and cover the exposed part before moving on to another area. ● Massage therapists should avoid ambiguity or the appearance of impropriety in their words and manner. For instance, therapists should dress in a professional manner, and avoid outfits that could be construed as revealing or provocative. The therapist’s demeanor should align with other professional healthcare personnel. ● In addition, massage therapists should use professional language and chose words carefully due the lack of personal space, and exposure of the body that can be intimidating, especially to new clients (Howard, 2011). When referring to physical conditions or parts of the body, therapists should use appropriate medical terminology. Therapists should never discuss sexual topics with or in front of the client, joke about sexual matters, make sexual or suggestive remarks, or use sexual innuendo. Several precautionary measures can help massage therapists to maintain a comfortable, safe, and professional environment: ● Massage therapists should avoid meeting new clients at unknown locations, at hotels, or in the client’s home, where personal safety may be at greater risk. If therapists meet a client on-site, they should set up the massage table in a neutral location, rather than a bedroom. ● Therapists can encourage relaxation through the client’s visual, auditory, and olfactory senses, but should keep the look and smell of the environment subdued and professional, avoiding creation of an overly perfumed, romantic, or sensual atmosphere. Therapists should
abrupt changes in assessment results from one session to the next. Therapists should follow standard procedures for client assessment, and document relevant information about the client’s progress or lack of progress toward treatment goals after each session. Before terminating the client, therapists should: ● Consult appropriate information resources and supervising personnel. They can also contact a professional colleague or supervisor regarding the situation with the client, post a question on a professional massage therapy website, or refer to their professional organizations. Therapists may be able to find an alternative to terminating the client, or a sensitive way to present the issue. If therapists appeal to any of these resources, they must maintain strict rules of confidentiality and privacy, ensuring that the client’s name or other identifying information is never revealed. ● Do a reality check. Therapists should make sure that they are “on the same page” as the client. Therapists should compare their understanding of a therapeutic relationship with the client’s, and discuss disparities in relationship perceptions, conflicts and desired Sexuality and massage Sexual misconduct , one of the most egregious examples of inappropriate behavior, refers to any sexual activity between the massage therapist and client. While women are less likely than men to be accused of sexual misconduct, they are not immune to such allegations. Some practitioners employ strategies of avoidance, such as ignoring the issue of sexuality entirely, either consciously or unconsciously, Strategies for client safety The emotional, financial, and legal consequences of professional misconduct for the client, therapist, and professional community are profound. Preventive policies should include an educational component that explains power dynamics in the therapeutic session, what constitutes appropriate and inappropriate conduct with individuals of the same and opposite genders, and strategies for speaking and acting in ways that clarify and reinforce appropriate boundaries. To ensure clients’ safety, therapists must identify issues that are inherently sexual and address then in a way that de-emphasizes or avoids the sexual nature of the action. Desexualizing massage emphasizes the components of therapy, acknowledging human sexuality as a given, with an emphasis on professional execution of the care plan. ● It is natural for clients to feel some anxiety or insecurity related to the process of disrobing and draping. Massage therapists can minimize anxiety or concern by stating and/or providing written information regarding disrobing. Before the session starts, therapists should state that a draping procedure is required for purposes of modesty and physical comfort. Therapists can also have a written notice that explains that draping will cover all parts of the client’s body except the specific area receiving attention. ● Once therapists finish work in that area, they will cover it or recover it, and move to the next area. Massage therapists can tell clients to let them know if they have a question or concern, or feel uncomfortable in any way. If therapists encounter a client who prefers not to be draped, therapists should explain that they are unable to proceed with the session until the client agrees to this customary procedure. ● Therapists should reassure the client that it is not necessary to remove any more clothing than personal comfort or modesty will allow. In addition, therapists should request that clients wait to undress until after
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