A dual or multiple role relationship occurs when an individual either at the same time or different points in time engages in two role categories, for example, in addition to the professional therapeutic relationship, there is also another relationship, such as relative, friend, student, business partner, or instructor. While it is perhaps best to avoid dual relationships, it is not always possible or practical. In small towns, for example, it may be more difficult to avoid dual relationships (Institute for Therapeutic Massage, 2018) There is a great range of opinion regarding the propriety of dual relationships. While some feel that not all dual relationships are negative, all have that potential. Some organizations suggest that dual relationships are acceptable, if not exploitive. To ensure that the relationships do not cross the line into exploitation, therapists should follow recommended procedures including informed consent, open discussion, consultation, supervision, and examination of personal motivation, all of which should be documented (Institute for Therapeutic Massage, 2018). Some professionals consider it unethical to work on friends, while others consider it acceptable to proceed as long as appropriate measures are taken to ensure there are no detrimental effects to the therapeutic or preexisting relationship. It is always best to avoid multiple relationships if it appears likely that the relationship might interfere with the therapeutic relationship. However, existence of a dual relationship is not necessarily a violation of boundaries. This is usually referred to as a prohibited dual relationship. This means a dual relationship that might impair objectivity or effectiveness, permit exploitation, or create an actual, apparent, or potential conflict of interest (Institute for Therapeutic Massage, 2018). It is the therapist’s responsibility, not the client’s, to maintain appropriate boundaries in the professional relationship. If a complaint is filed, it will be the massage therapist’s responsibility to demonstrate that a client has not been exploited or coerced, intentionally or unintentionally. Massage therapists should be especially vigilant regarding any conduct that could impair their objectivity and professional judgment in serving a client, and any conduct that carries the risk and/or the appearance of exploitation or potential harm to a client (Institute for Therapeutic Massage, 2018). Massage therapists should recognize and avoid the dangers of dual relationships when relating to clients in more than one context, whether professional, social, educational, or commercial. Dual relationships can occur simultaneously or consecutively. Generally prohibited dual relationships can include, but are not limited to: • Accepting as a client anyone with whom a massage therapist has had a prior sexual relationship • Forming a sexual relationship with a current client or someone who has been a client • Treating clients to whom the massage therapist is related by blood or legal ties • Bartering with clients for the provision of services • Entering into financial or business transactions with clients (other than the provision of massage services) Other situations that complicate the massage therapy relationship include extending the session, lending and/ or borrowing money, meeting at inappropriate places or times, giving or receiving gifts, soliciting donations, making inappropriate self-disclosure, socializing with clients, and using inappropriate language. Maintaining appropriate boundaries is an essential part of compassionate,
Some disclosure is accidental because it is not meant to be shared but is communicated through body language or tone of voice. Accidental self-disclosure also occurs in cases where a practitioner bumps into a client unexpectedly, when both are sitting in their doctor’s waiting room, for example. Therapists may or may not want to disclose information about why they are there, and it may be difficult to find a safe middle ground, revealing enough to be professional and friendly but not enough to compromise their own personal space and privacy (Cameron, 2024). It’s difficult to know where to draw the line. Massage therapists should ask themselves two questions before self- disclosing: • How will it benefit the client? • How will it affect their professional boundaries? Therapists should also consider their own privacy. For example, what if a therapist and a client attended the same Alcoholics Anonymous meeting? This might make it hard for both to get the full benefits of attending the meeting during times of stress or relapse. Self-disclosure is not always conscious and deliberate. Words can be blurted out, poorly thought out, or tinged with emotion. When in doubt, do not self-disclose (Cameron, 2024). In a similar vein, it is usually best for therapists to withhold emotional responses or judgments (both negative and positive). A good rule of thumb is for therapists to monitor their own feelings without imposing them on clients. If therapists are distracted by a strong feeling, they should mentally put it to one side, wait until after the session, and then talk with a peer or supervisor or deal with it personally. As with other boundary crossings, self-disclosure should be client-focused and based on the welfare of the client. Different clients and practitioners have different personal boundaries, so appropriate boundaries must function within the client’s comfort zone (Cameron, 2024). Personal and professional boundaries exist for the benefit of both the practitioner and the client. Changing or moving boundaries results in an unclear or ambiguous relationship that puts the safety of the client at risk, although it may not appear to have negative repercussions at that time. Transgressions often have delayed consequences that do not appear harmful initially. Detecting boundary violations is complicated by the fact that transgressions are more often a process than an individual event or occurrence. Boundary violations may be subtle or masked by the professional– The boundaries set during a therapy session must apply to interactions with clients when they encounter them in the community. If the therapist resides in the same community, it is likely that they will have to interact with clients at establishments or events, like the grocery store, church, school, recreational facilities, or community functions. The practitioner must be aware of the importance of boundaries and the need to project professional and ethical conduct when in public. A dual relationship is an alliance in addition to the client/ therapist relationship, i.e. social, familial, business or any other relationship that is outside the therapeutic relationship. Dual or multiple relationships have been researched and included in the codes of ethics for counselors, social workers, psychologists, and mental health therapists for decades, and there is a wealth of information on the topic that applies to massage therapy and body work. patient relationship (Allen, 2019). Dual or multiple role relationships
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Book Code: MMD0926
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