the client has not mentioned anything personal to the therapist, he gets the sense that she is being physically (and possibly verbally) abused. The therapist has heard rumors that the client's husband is involved in illegal activities and organized crime. The client begins to visit the massage clinic even when she does not have an appointment scheduled. Sometimes, she just reads the magazines and asks questions about massage. On appointment days, she arrives very early and lingers long after her session is over. She continues to increase the frequency of her appointments so that she receives two massages a week. The therapist senses that this is not a case of physical attraction and that the client just wants someone to talk to. Reflection: Should the therapist circumnavigate the client’s confidentiality and report their concerns to the authorities? If the therapist wanted to offer an alternative to such assistance, what kind of assistance might be appropriate? Analysis: In this situation, it may be difficult for the therapist to avoid a breach of the client’s confidentiality, as she has not disclosed that she is being either physically or emotionally abused, regardless of appearances or hearsay. All information and matters relating to a client’s background, condition, and treatment are strictly confidential and should not be communicated to a third party without the client’s written consent or a court order (and in this case, there is no method for obtaining a court order). If the therapist finds that he cannot in good conscience let the alleged abuse go undetected by the proper authorities, the therapist is left with two options: either refer the client to a social worker and/or terminate the therapeutic relationship. In giving the client a referral to a social worker, the therapist does not violate the client’s principle of autonomy (self-rule), which holds that individual persons have the right to make their own choices; if the client wants to seek support for abuse (if it is taking place) she may do so of their own volition. And, in giving the client the referral, the therapist does not violate any professional boundaries, since he is remaining within his scope of practice. But the therapist may also choose to terminate the therapeutic relationship because the relationship with the client has become dysfunctional. The obstacle for the therapist should be relayed to the client as early as possible so that the client is not surprised by any unexpected pronouncement that the therapeutic relationship will come to an end. 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 understand 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. Some ethical issues are easy to avoid, but other issues fall into a grey area that requires introspection, study of the ethical standards and codes, study of state regulations, and sometimes guidance from supervisors or agency administrators. It is important to turn to resources for assistance in ethical questions. Additionally, providing basic instructions and answers to common questions in a brief information sheet can put new clients at ease, especially
1. Electronic claims submission. 2. Enrollment checking. 3. Eligibility verification. 4. Health care explanation of benefits. 5. Health plan premium payment. 6. Health claims status. 7. Referral certification and authorization. 8. Coordination of benefits.
If the practice conducts any of these eight actions electronically, they qualify as a “covered entity” under HIPAA. Covered information includes anything that can uniquely identify a client, such as his or her Social Security number, phone number, or even an IP address that identifies the client online (Neeley, 2016). In 2014, a new law was added stipulating that if a health care provider or his company is required to be HIPAA compliant, then anyone he releases information to must also be HIPAA compliant. This includes any subcontractors who work for the employer or agency.For further clarification, contact the employing agency, review state board requirements, and the official HIPAA website and documents. There is contact information on the HIPAA website to ask questions directly. State boards have requirements to protect client privacy, confidentiality, documentation, and record retention. Codes of Ethics address these issues as well. Even if the practice is not a covered entity under HIPAA, it is important to keep client information private and confidential. Records should be secured in a locked cabinet, and electronic files should follow encryption and password security protocols and be accessed only by appropriate staff. CASE STUDY A massage therapist has a private massage therapy practice in a small town. The therapist works at a clinic located in the center of town where five therapists share the office. One of his clients, an unemployed housewife, noted on her initial intake form that she rarely leaves the house, and that she arrived late because she got lost on the way to the clinic. Since then, she has been a punctual client for several months. Recently, though, she has been arriving to her appointments with bruises on her back and shoulders. Today, she arrived early with a bruise over her eye, which was covered up with make-up. When asked about the bruises, the client said that she “fell down.” Although 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, 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 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, and 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 ensure that the practice operates in a coordinated, organized, and professional manner. This will also help to maintain an effective schedule room before their first session. Written policies: Contracts
Page 19
Book Code: MMD0926
EliteLearning.com/Massage-Therapy
Powered by FlippingBook