wants to meet with the therapist over lunch to describe the opportunity. He also wants the therapist to meet his spouse during lunch, since she is heavily involved in the business. The therapist doesn’t know much about the client beyond the clinic and has never spoken to him about anything but massage therapy and his treatment plan. Reflection: Should the possibility of this dual relationship necessarily be avoided? Is it appropriate for the client to broach this subject? Could this scenario be a potential case of financial exploitation by the therapist? Analysis: Here, the client is seeking to engage in a dual relationship with the massage therapist; in this case, the client is proposing a business relationship that goes beyond the therapeutic relationship and may not be inappropriate from the perspective of the client’s profession. Although it is generally considered best to avoid dual roles or multiple relationships if it appears that the relationship might interfere with the therapeutic relationship, the possibility of a dual role or multiple relationships is not necessarily a violation of ethical boundaries. However, what is the potential impact of agreeing to accept this business opportunity with the client? Conversely, what consequences may follow from turning down the client’s business opportunity, regardless of the reason? Any dual role or relationship may impair objectivity or therapeutic effectiveness, permit exploitation, or create an actual, apparent, or potential conflict of interest. Furthermore, engaging in any business besides massage therapy with this client may lead to other conflicts, such as the lending and borrowing of money, gift giving, soliciting donations, and the unsolicited marketing of massage to other business partners. Maintaining proper boundaries is critical to the effective and ethical practice of massage therapy.
effective, and ethical massage therapy practice. Although practitioners and clients may be similarly affected by these psychological processes and equally capable of showing poor judgment or acting irrationally, licensed practitioners are bound by their professional affiliation to act responsibly, even when the client does not (Institute for Therapeutic Massage, 2018). Appropriate behaviors reinforce professional boundaries. Massage therapists should try to maintain the same structure and rules of conduct in each session and with each client. Therapists should examine the rationale and potential repercussions of any changes or exceptions they make for specific clients, even at the client’s request, before they implement them. Bending a rule may not always endanger the therapeutic process, but impropriety can be a “slippery slope.” If massage therapists uncharacteristically deviate from normal session structure or protocol, they should consider that their impulses may be motivated by self- interest. Or, if they are having strong emotional responses to a client, they should seek peer support or supervision (Institute for Therapeutic Massage, 2018). CASE STUDY A massage therapist working in a clinical setting has been treating a client who seems like a good person: fun, smart, and dedicated. During massage appointments, there has been no indication of either client dependency or physical attraction. The verbal and nonverbal feedback that the client provides during the session seems to facilitate the professional relationship. After the last appointment, though, the client began to discuss what appears to be a great business opportunity that he thinks the therapist might be very interested in. The client feels that this opportunity is so good that the therapist will probably want to share it with her friends, acquaintances, and other clients. He
TERMINATING A PROFESSIONAL RELATIONSHIP
assessment of the client’s condition from one session to the next. Therapists should follow customary procedures for client assessment, and document relevant information about the client’s progress or lack of progress toward treatment goals (Giroud, 2014). Before terminating the client, therapists should: • Consult appropriate informational resources and supervising personnel. They can also contact a professional colleague or supervisor about the situation with the client, post a question on a professional massage therapy website, or refer to professional organizations with which they are affiliated. Therapists may be able to find an alternative to terminating the client, or a sensitive way to present the issue. If therapists appeal to any of these resources, they must maintain strict rules of confidentiality and privacy, ensuring that the client’s name or other identifying information is never revealed. • Do a reality check. Therapists should make sure that they are “on the same page” as the client. Therapists should compare their understanding of a therapeutic relationship with the client’s, and discuss disparities in the way the relationship is perceived, difficulties, and desired objectives. This kind of clarification can help to determine the scope of the problem and whether it is the result of miscommunication or misinterpretation, something that can be remedied or requires termination.
If therapists feel it is appropriate, either because a specified, finite course of treatment with a client is concluding, or because they believe the relationship with the client has become dysfunctional, unproductive, or emotionally damaging, it may be necessary to terminate the professional relationship with the client. While this can be a difficult and uncomfortable task, it should not be postponed out of a desire to avoid confrontation or discomfort (Giroud, 2014). responsibilities. Practitioners must realistically assess their own limitations and/or their client’s potential for therapeutic benefits, and make a determination in their client’s best interests, without feelings of failure or guilt. Therapists must develop a plan for termination that is considerate of the client, understanding that the client may receive the news with emotion or distress. Terminating a potentially damaging relationship is an important professional obligation with specific Informed consent provides a framework for termination because it specifies the need for an ongoing discussion between the client and practitioner regarding the expected goals and anticipated timeline for therapeutic benefits. Therapists should involve clients in the process so they are aware of treatment objectives and can ask questions and make determinations about clients’ progress toward them. Therapists should discuss obstacles to client progress as they come up, so the client is not surprised by an unexpected pronouncement or abrupt changes in
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Book Code: MMD0926
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