Self-care to maintain a successful practice The AMTA provides the following information of the importance of self care to support a successful practice: Practicing self-care is as important to your business success as your client and business skills are. If you injure yourself through poor use of body mechanics or physical exhaustion, the effect on your business could be devastating. A healthy self-care routine allows you to take on the demanding yet satisfying work required of massage therapists. Take care of yourself and your business at the same time (AMTA, 2016f). The AMTA provides the following tips for self care on and off the job: On-the-Job Self-Care tips include: ● Consistently good body mechanics. New clients Massage therapists should assume that a new client knows nothing about massage therapy. Many massage therapists create an information sheet to acquaint new clients with basic massage concepts. Office personnel, customary procedures, Written policies: Contracts Fee schedules and office policies are another area that can interfere with a positive client relationship and lead to ethical conflicts. Policies concerning late or missed appointments, cancellation fees, fees for different time periods or modalities must be clearly explained and agreed to at the time of booking the appointment. Establishing and explaining policies to clients prior to booking sessions can save everyone time and money and clients and ensure that the practice operates in a coordinated, organized, and professional manner. This will also help to maintain an effective schedule that keeps the office running on time, which clients and therapists expect and deserve. As an employer, written policies are essential to maintain a professional practice, in which staff understands their duties, responsibilities and uniform procedures to ensure quality care for clients. Employees must understand all administrative policies and expectations prior to accepting a position. There should be a written employee handbook that includes all policies, procedures and the code of ethics for the practice. In-service training should be provided for new staff and held periodically on topics of importance to all staff to provide continuing education and training.
● Breathwork. ● Meditating or praying. ● Quiet breaks. ● Healthy eating. Off-the-Job Self-Care tips include: ● Sacred ritual practice. ● Physical exercise. ● Regular massage for yourself. ● Participation in sports and games. ● Vacations. ● Time spent with friends and family (AMTA, 2016f).
and other useful points regarding their place of business, such as bathroom locations, and what to expect in a typical session, can be distributed to clients in the waiting room before their first session. is to a particularly vulnerable area, such as the abdomen. Therapists should also cover the following areas prior to the session: ● Assess sensitivity and tolerance, and inform the client as they progress to deeper movements. ● Perform tapotement only with client permission, and after the individual is adequately informed about the process. ● Take care not to startle a client in a relaxed state. ● Inform the client regarding potential massage after-effects, such as tenderness or soreness, and the expected duration of such effects. ● Ask the client near the end of the session if any particular area needs further attention. ● Invite feedback and implement changes based on client comments.
Some ethical issues are easy to avoid, but other areas fall into the grey areas that require introspection, study of the ethical standards and codes, and state regulations sometimes guidance from supervisors or agency administrators. Providing basic instructions and answers to common questions in a brief information sheet can put new clients at ease, especially when these clients are new to the experience and unfamiliar with a facility’s personnel and way of conducting business. At the end of each session, therapists should discuss the clients’ treatment plan and health objectives. They should ask the clients to assess their progress or lack of progress toward treatment goals. Massage therapists should also answer any questions the client may have, and note the following information in the client’s record: ● If the client feels nauseated, or light-headed. Check blood pressure, and monitor, if necessary. ● The length of the massage session. ● When the client should return for another session, session intervals, and frequency. ● Anything the client can do to accelerate progress toward treatment goals. ● Anything the client should do or not do between sessions. ● What results the client can expect, and when. Practitioners who recommend clients replenish fluids after a session may want to provide bottled water. INTERPERSONAL DYNAMICS AND POWER IN THE THERAPEUTIC RELATIONSHIP During the session, the therapist should inform the client when moving from one area to another, especially when the movement
Interpersonal dynamics exist in all relationships, and are a normal and necessary part of a therapeutic relationship between client and practitioner. An important part of this dynamic is a power differential, i.e., the imbalance in authority or power that results Balance of power Ginn (2013) explains that the most common ethical dilemmas are often subtle and overlooked. Many ethical gray areas concern what Ginn calls the power differential or the complex balance of power between client and therapist. The power differential is an imbalance in authority or power that results from the massage therapist’s greater expertise in massage therapy. “The key is to acknowledge the complexity,” says Ginn, “and understand one’s own history of power.” According to Ginn, massage therapists can create ethical dilemmas by overusing their power.
from therapists’ greater expertise in the area of massage therapy. Massage therapists’ education, skills, experience in the field, and professional certification give them an authoritative advantage over their clients (AMTA, 2014). Sometimes the overstepping of the use of power is obvious, as with inappropriate touch, for example. Other times, however, the overuse of power is more subtle, like being late for a client’s massage therapy appointment, or not listening to your clients concerns and questions carefully. In addition to overusing power, massage therapists can also underuse their power, for instance, massage therapists who do not have any established practice policies or who fail to directly
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