fact, the amount of personal space is reduced even before a massage session begins, as therapists welcome clients and subsequently review their intake information. During the massage itself, the distance of personal space is reduced to skin-on-skin contact. Although there is an agreement between the therapist and the client to reduce the amount of personal space during a massage, this is not an invitation by either party to circumvent any or all physical boundaries. The focus of both parties should be on therapeutic goals that are established in part by standard protocols for physical safety. Such protocols include but are not limited to consent for working sensitive areas such as the abdomen, gluteals, and female pectoralis muscles, what part of the therapist’s body touches the client, not touching the client inadvertently with loose clothing or hair, keeping a client draped in accordance with local laws and regulations, how the draping is moved, not working underneath draping, reassuring clients that they are allowed to remain clothed, and reassuring clients that they are empowered to stop the massage if they feel uncomfortable during the session. By respecting and adhering to such protocols, particularly with new clients, therapists establish the boundaries for future sessions (Fritz & Fritz, 2020). Medical preparedness • Learn to administer first aid, including CPR. • Keep your first aid kit easily accessible. • Remind clients to dispose of candy or gum before they get on the massage table. • Practice universal precautions as standard procedure. • Take a thorough intake before performing a massage. Personal security • Screen first-time clients to verify that they clearly understand the nature of massage. • Ask clients to read and sign an information form, which explains what to expect during the massage. • Set office policies regarding personal property, loss, restricted access and personal privacy. • Install an emergency buzzer in case you need to call for assistance. • Have a plan for handling inappropriate comments or behavior by clients. Creating a safety and security plan is not a one-time event. With periodic review and ongoing attention to security concerns, your clients can relax and enjoy the full benefits of massage. • 24% of Americans have taken three or more prescription drugs in the past 30 days. • 12.8% have taken more than five prescribed drugs in the past 30 days. The massage and bodywork professional must realize that many clients are taking prescribed medications that may impact the type of modalities, procedures, positions, duration, and frequency of care they plan. The professional must have information on drug administration routes, drug interactions, dosages, adverse reactions and allergies, safety considerations, medical conditions being treated, and other health care providers to contact for further information. Treatment planning guidelines related to client drug information include the following (Goodwin, 2016): • Carefully review the health history form during the interview with the patient.
practice. Therapists who have found an effective nutritional supplement or exercise program that relieves the same symptoms the client is experiencing may have a strong impulse to share that information with their client. Therapists may also want to warn the client away from a health regime that they consider ineffective or potentially dangerous (DiSilvio, 2023). When giving their point of view, therapists should make sure they delineate a professional recommendation, based on years of experience and study, from suggestions or opinions of a more personal or general nature. They should help their clients distinguish between subject matter in which they, the therapist, are not professionally qualified. If a health or medical issue is outside of a practitioners’ scope of practice, they should recommend that the client see a qualified health professional regarding the matter (DiSilvio, 2023). Safety is not limited to hygiene, skill, and scope of practice concerns, however. For example, when considering the importance physical boundaries play in maintaining a safe environment for the client, in American culture, the generally accepted rule for personal space puts approximately three feet between one person and another. However, this distance is quickly minimized for the sake of treatment. In Safety, security and risk management In order to provide the critical and ethical element of safety to ensure client welfare, the practitioner must address safety and security precautions in all phases of the practice. According to the AMTA, the best safety measure is prevention (AMTA, 2016b). Awareness of the potential hazards is fundamental to creating a plan to address safety risks. One of the first steps should be to assess what areas of your business could provide potential safety hazards. The AMTA provides the following guidelines (AMTA, 2016b): Physical safety features • Check the sidewalk and entrance to your office for obstacles and toe catches. • Assure that all ice and snow is cleared prior to your first appointment. • Review and approve your building’s maintenance and cleaning plan. • Keep stairways and hallways free of clutter. • Check the stability of railings along stairways and hallways. • Keep throw rugs to a minimum, and make sure they do not pose a safety risk. • Assure that your massage table is in good repair. • Create a standard protocol for collecting an incident report from a client that does have an accident due to the physical feature of your building. Treatment planning and pharmacology An important element of safety, informed consent, and client welfare is the consideration of medical conditions and pharmacology when determining the plan for massage and bodywork care. The increasing demand for massage and bodywork for a variety of physical and medical conditions through integrated, multi-disciplinary approaches to health care requires competency in the area of pharmacology. The following Centers for Disease Control and Prevention statistics outline the prevalence of prescribed drug use in the U.S. today (Centers for Disease Control and Prevention, 2019): • 48.6% of Americans have taken a prescription drug in the past 30 days. • 88% of those 65 years and older have taken a prescription drug in the past 30 days.
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Book Code: MMD0926
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