and not a ‘masseuse’ (female), or ‘masseur’, (male), as these terms can carry sexual connotations. It requires little effort for practitioners to correct a client when they make this mistake in terminology, and it lets a client know that the massage therapist is a professional with ethical standards and boundaries.
Of course, the best option is to prevent sexual harassment from ever escalating to the point that ethical concerns are raised. Practitioners can combat sexual harassment in any number of ways, and one of the easiest methods is to educate clients. As massage therapy becomes more readily accepted as a legitimate form of health care, massage professionals should be referred to as a ‘massage therapist’
IDENTIFYING ETHICAL DILEMMAS
are the basis for building trust to create and maintaining a therapeutic environment. According to Middleswarth, by behaving ethically massage therapists are acting as responsible role models who help build public trust and establish a “standard of expectation for a professional therapeutic massage.” Ethical conduct also helps provide consistency in the professional behavior of massage therapists, thus maintaining the integrity of the profession, she adds. Ginn, believes ethical dilemmas are fairly common because of the nature of the massage therapy profession, “The relationship between client and practitioner can be complicated and confusing for both parties,” warns Ginn (Ginn, 2013). The complex nature of maintaining a professional relationship, Ginn explains, is compounded because of the intimacy inherent in massage therapy. ● Which clients do I feel I am most effective with? ● Which clients present the most challenge? ● Are there areas where I could benefit from additional training to make my practice more effective? ● Which parts of my practice elicit stress? ● Do I have any suggestions to make the practice better for staff or clients and am I able to discuss them with others? ● Are there any boundaries issues with my clients? ● Are there other work issues that I have not addressed? ● How are my relationships with colleagues and administration? ● How are my relationships with friends and family? ● Can I identify symptoms of stress, fatigue, burnout, anxiety or depression? ● Do I need to seek help for any of the issues above? ● What five successes did I have this week? ● What needs to be improved from my practice this week? ● Do I take work stress home and is it affecting my family life? ● What hobbies or recreational activities do I do? How often do I do things just for me? ● Am I sleeping enough? ● How are my eating habits? ● Do I exercise enough? ● Do I have any medical conditions that I need to address? Do they impact my work? impact and set the tone of future relationships with clients. If boundaries are not maintained, the practitioner may disclose aspects of their personal life that cannot be reversed. The practitioner must also decide how to handle requests from clients to be “friends” on social media, which may open the door to boundary crossings if they do not keep their personal and business networking separate. Using advanced privacy settings on personal profiles is advised. Any representation, text or visual, must be carefully considered because it not only reflects on the practitioner but the profession as a whole.
Fitch (2015) categorizes ethical dilemmas into the following general categories: ● Thoughtlessness: Simple thoughtlessness can cause frustration for both clients and therapists. ● Expectations or assumption of special status. ● Challenges to professional role and personal beliefs. ● Boundary issues that compromise integrity. ● Manipulation, abuse, and predatory behavior. In any profession, ethical dilemmas will arise and this is especially true in the field of massage and bodywork where professionals work in close proximity to clients for extended periods of time. Massage therapy is a profession built on mutual trust, which is essential to building a strong therapist/client relationship to help clients achieve wellness goals. Ethical standards Practicing self-awareness Massage and bodywork therapists can avoid many ethical pitfalls by practicing self-awareness and reflection. Middleswarth advises practitioners to ask themselves some basic questions: “Am I stressed? Am I tired? Am I emotionally running empty? Do I have a supportive social network? “If we are needy in any way,” she warns, “we are particularly susceptible to stepping over boundaries.” Most education and training programs discuss the importance of self-awareness and self care in order to remain healthy and provide the optimal level of quality care to clients. Self awareness may involve better time management, accessing stress levels or fatigue, identifying demanding clients who add stress, leaving work issues at the office at the end of the day, assessing signs of physical or emotional overload that impacts wellness and effective or healthy functioning. Practicing self awareness and self- care will make it easier to handle professional challenges to deliver effective care to clients. Self–assessment should be an ongoing process that requires the therapist to review their strengths and skills as well as areas for in their practice that present challenges. It requires the therapist to access their effectiveness with clients and reflect on what needs to be improved. The following questions should be part of the self assessment process, which should be tailored to meet the individual’s needs: ● What are my strengths? ● What do I need to improve? Internet and social media Ethical violations in the areas of confidentiality and boundary issues often occur because of inadvertent mistakes using electronic media for information storage or transmission. Websites can be an effective marketing tool to reach potential clients and they can access information on the anywhere and at any time. Social networking sites are effective in connecting with others, providing updates and advertising business topics. It is important to consider personal and professional boundaries when developing a profile that should be professional and representative of the ethical standards of your practice. The social media profile is the first impression clients will have of the practice and it may have a profound
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