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. 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. Self-Assessment Quiz Question #1 Regarding business practices, all of the following are appropriate except: a. File all applicable state and federal taxes b. Refrain from engaging in all illicit and illegal activities c. Provide therapy solely for the gender of the therapist’s choice d. Refrain from the defamation of other therapists
b. Recognize his/her influential position with the client and not exploit the relationship for personal or other gain. c. Recognize and limit the impact of transference and countertransference between the client and the certificant. d. Avoid dual or multidimensional relationships that could impair professional judgment or result in exploitation of the client or employees and/or coworkers. e. Not engage in any sexual activity with a client. f. Acknowledge and respect the client’s freedom of choice in the therapeutic session. g. Respect the client’s right to refuse the therapeutic session or any part of the therapeutic session. h. Refrain from practicing under the influence of alcohol, drugs, or any illegal substances. i. Have the right to refuse and/or terminate the service to a client who is abusive or under the influence of alcohol, drugs, or any illegal substance. Standard VI: Prevention of Sexual Misconduct. The certificant or applicant for certification shall refrain from any behavior that sexualizes, or appears to sexualize, the client/therapist relationship. They must recognize the intimacy of the therapeutic relationship may activate practitioner and/or client needs and/or desires that weaken objectivity and may lead to sexualizing the therapeutic relationship. The professional shall: a. Refrain from participating in a sexual relationship or sexual conduct with the client, whether consensual or otherwise, from the beginning of the client/therapist relationship and for a minimum of six months after the termination of the client/therapist relationship unless
THE PRACTITIONER-CLIENT RELATIONSHIP
the principle of beneficence may come into conflict and force difficult choices (Sohnen-Moe & Benjamin, 2013). Ideally, therapists’ relationship and interactions with clients is a partnership that promotes healthy behaviors; leads to sound, informed, healthcare decisions; and ensures the client’s voice is heard. The client’s best interests should always be the therapist’s primary goal and the guide for all actions and decisions. If therapists ever suspect they are acting out of an unhealthy need or motive, or feel the interactions or relationships with the client are impeding rather than facilitating the therapeutic process, they should seek assistance and/or supervision. Massage therapists can consult a professional massage therapy organization for guidance, supervision, and other professional resources (Allen, 2019). The following sections discuss key points of ethical massage therapy practice in more detail. Accountability Professional organizations protect public safety by certifying the competence of their members through licensing and continuing education requirements. Accreditation and professional affiliations maintain quality control and show accountability to clients, colleagues, and the profession as a whole. They confirm that massage therapists abide by prevailing health and safety standards, conduct themselves in accordance with relevant legislation and/or professional regulations, and possess the specialized knowledge and skills in their field (Sohnen-Moe & Benjamin, 2013). Once massage therapists successfully complete an approved training course, written examination (state and/or national), and, in some cases, a practical evaluation, they are deemed competent in the subject area of massage therapy despite the fact that specific skills, training, and knowledge base may be very different from that of other practitioners.
The nature of the practitioner-client relationship is a fiduciary one. This means the client trusts that the practitioner will act in the client’s best interests, and it is the practitioner’s duty to do so. This concept is central to professional practice and the therapeutic relationship. While the practitioner and client share the same primary concern and objective—the client’s welfare—it is the practitioner, by virtue of their professional status, who is ultimately responsible for the client’s safety, security, and well-being. Practitioners also bear the burden of accountability because they are often viewed by the client as being in a position of authority or power over the client (National Ethics Committee of Veteran Health Administration, 2003). Massage therapists treat individuals ethically not only by respecting their decisions and protecting them from harm but also by making efforts to secure their well-being. Such treatment falls under the principle of beneficence. The term “beneficence” is often understood to cover acts of kindness or charity that go beyond strict obligation. In this context, beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms (beneficence and nonmaleficence) (Shmerling, 2020). The principle of beneficence requires massage therapists to do good or what will further the patient’s interest. The principle of nonmaleficence requires massage therapists to avoid harm to the patient, or what would be against the patient’s interests. Both principles rest on the fundamental importance of what is in the patient’s interest. The first is the positive requirement to further the patient’s interest. The second is the requirement to refrain from doing what damages the patient’s interest. Different claims covered by
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Book Code: MMD0926
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