Chapter 4: Ethics for Therapeutic Massage and Bodywork 3 CE Hours
Learning objectives After completing this course, the learner will be able to: Identify the principles of the professional Code of Ethics from the American Massage Therapy Association (AMTA), the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), and the Associated Bodywork and Massage Professionals (ABMP). List and define five standards of practice from the AMTA, the ABMP and the NCBTMB, and give an example of each standard. Course overview This course emphasizes the principles and standards of ethical practice for massage therapy and bodywork, and ethical issues that impact the professional in daily practice. The course includes steps to identify potential ethical conflicts, and strategies for ethical decision-making to avoid and resolve
Explain the concepts of power dynamics, transference and counter transference related to the scope of practice in massage and bodywork. List five key elements of documentation and records maintenance, including the HIPAA Privacy Rule. Define the risks involved with dual or multiple-role relationships between therapists and clients and list four strategies that reinforce appropriate boundaries. Explain the relationship between patient autonomy and therapist/client agreements, including the client’s bill of rights, informed consent, and right to refuse treatment. ethical issues before they become problematic. The components of informed consent, documentation and records maintenance, establishing boundaries, and collaboration with supervisors and colleagues for integrated healthcare, are detailed based on ethical standards of best practice.
INTRODUCTION
Ethics is a part of philosophy that deals with systematic approaches to moral issues and problems; ethics refers to the rules or principles that govern right conduct and includes the study of morality (Dail, 2012). Professional massage and bodywork therapists have the responsibility to practice according to ethical principles and standards of conduct set by their professional, educational, and certification organizations. Professional relationships with clients involve setting clear boundaries that must be upheld for the safety of the therapist and client. Boundaries allow a therapist to work within his or her scope of practice based on education, training and certification following the code of ethics and professional standards. Within the practice of massage therapy
and bodywork, ethical dilemmas may arise and therefore sound and ethical decision making skills must be developed. Ethical practice involves technical competence and knowledge in the specific areas of massage and bodywork. A professional therapist offers significant mental and physical health benefits to a client based on competency gained through education, certification or licensure, and experience. The practice of massage and bodywork are integrated into many multidisciplinary approaches to mental and physical health today. The professional practitioner has the added responsibility to understand a variety of massage and bodywork modalities that can effectively treat a wide variety of mental and physical disorders. licensing agency or state regulations for additional guidance when working with pregnant clients. It might be prudent for the massage/bodywork professional to institute a standard release form to be signed and maintained in the client’s record in these cases. ● People with some conditions such as bleeding disorders or low blood platelet counts should avoid having forceful and deep tissue massage. People who take anticoagulants, known as blood thinners , also should avoid these modalities. ● Massage should not be done in any potentially weak area of the skin, such as wounds. Again, the massage professional should understand any regulations that govern their practice with these clients. ● Deep or intense pressure should not be used over an area where the patient has a tumor or cancer, unless approved by the patient’s health care provider. Always document all medical conditions and discuss the safety and effectiveness of massage and bodywork with colleagues or supervisors. ● The procedures for informed consent must include any medical diagnosis, massage and bodywork modalities to be used, and documentation must reflect any discussions and explanations conducted with clients. The informed consent section of this course will outline the important, specific, and ongoing components of informed consent that must be included in client records (NCCIH, 2016).
The National Institute of Health on benefits of massage (NIH) The use of integrative approaches to health and wellness has grown within healthcare settings across the United States with more than 30 percent of adults and about 12 percent of children using health care approaches developed outside of mainstream Western or conventional medicine (National Center for Complimentary and Integrative Health, 2016). The 2016 National Center for Complementary, and Integrated Health (NCCIH), a division of the National Institute of Health (NIH), notes that scientific research on massage therapy and bodywork is in the preliminary stage, but significant evidence points toward beneficial effects of integrative healthcare in a variety of situations (NCCIH, 2016). These benefits include pain management for military personnel and veterans, relief of symptoms in cancer patients and survivors, programs to promote healthy behaviors, and symptoms associated with a number of medical conditions (NCCIH, 2016). Research evidence has documented positive short term effects and if clients continue massage and body work care health benefits may continue (NCCIH, 2016).
According to the NIH, Massage therapy appears to have few risks when performed by a trained massage therapist, though some precautions must be considered when practicing on clients with certain health conditions: ● In some cases, pregnant women should avoid massage therapy. Clients must consult with their health care provider before getting a massage if pregnant. Always consult the
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