Analysis: This case potentially violates several areas of ethical concern. The first is an abuse of the power wielded by the massage therapist in the therapeutic relationship. Having forged a close relationship with the client, the therapist has allowed an emotional response to escalate into a physical one and let a small impropriety on the part of the client escalate into egregious misconduct on the part of both parties. Whether intentionally or unintentionally, the client’s transference (all the feelings experienced by the client, related to his or her past experiences and relationships, stirred up by or in the session) has tested the boundaries of the professional relationship leading to countertransference on part of the therapist (all the feelings experienced by the practitioner, related to his or her previous relationships and experiences, that are stirred up during the session, including the practitioner’s conscious and unconscious response to the client’s transference of emotions). Although transference and countertransference are generally neither negative nor positive, the risk of raising unrealistic expectations on the part of client or practitioner in this situation is high. Ultimately, the therapist is responsible for maintaining the therapeutic relationship and, as such, is required to maintain boundaries that do not compromise professional judgment and objectivity. This case is also a clear example of an ethical violation of sexual misconduct, as the therapist intentionally seeks to gain the client’s approval in a manner that is not within the therapist’s scope of practice. In this situation, the therapist may want to consider how a potentially negative end to any personal relationship with this client may adversely affect the massage business in the future, both legally and in the court of public opinion.
that the massage therapist is a professional with ethical standards and boundaries. CASE STUDY A massage therapist and client have had a professional relationship for four months now. During this time, the client has received a massage once per month. There has not been any inappropriate activity during this time, and there has not been any nonprofessional contact outside of the massage sessions. Lately, however, the client has been scheduling weekly massages. Moreover, the appointments have been at the home of the client, and the conversations during a massage appointment have typically been personal in nature, often speaking freely. Although it is unspoken, both the client and the therapist believe they would make great partners socially. The client has been physically attracted to the therapist since their first appointment, and the therapist has become increasingly attracted to the client as well. The client is aware that the therapist is also getting over the recent dissolution of a long-term relationship and has few social outlets. During the massage, the client occasionally makes sounds that signify pleasure and possibly even sexual arousal. The therapist finds the feedback flattering and puts extra effort into making the massage an increasingly sensual experience for the client. Reflection: Are there any issues regarding transference or countertransference in this scenario? Is the therapist abusing their power? Are any boundaries being ignored?
REPORTING MISCONDUCT
to file a complaint. The AHCA is responsible for analyzing complaints and reports involving potential misconduct and initiating investigations. The boards and councils within statewide organizations determine probable cause and disciplinary action.
Many states require a “duty to report” by their licensees. If therapists believe they have first-hand knowledge of another practitioner acting unethically or illegally, they have a responsibility to report it. They should contact their state board, the certifying organization (NCBTMB, AMTA, etc.), or the Agency for Healthcare Administration (AHCA) Sanctions for unethical behavior The following information is from the NCBTMB website and listed on the reference page (NCBMTB, 2021): Disciplinary Actions Certificant Violations of Ethics & Standards NCBTMB takes its role in serving the public’s trust very seriously. In accordance with the rules and procedures regarding ethical and professional disciplinary complaints, NCBTMB publishes sanctions imposed on certificants found to be in violation of the Code of Ethics and/or Standards of Practice. Revocation: A certificant’s certification has been revoked and that person is no longer certified. A revocation may be: 1. Permanent, meaning that the person may not sit for a certification exam in the future. 2. Non-permanent, meaning that the person may sit for a certification exam again at some designated time in the future. The former certificant may not: 1. Advertise using their credential or any NCBTMB logo, 2. Use their certificate in any other way to promote their practice, or 3. In any way make themselves out to be certified by NCBTMB.
Suspension: A certificant’s certification has been suspended for a definite period of time and may be subject to meeting certain requirements before the suspension is lifted. During the suspension period, the certificant may not: 1. Advertise using their credential or any NCBTMB logo. 2. Use their certificate in any other way to promote their practice. 3. In any way make themselves out to be certified by NCBTMB. Emergency suspension: A certificant’s certification has been suspended due to the emergency suspension or restriction of their state license, certification, or registration by a federal, state, or local government or agency authority. Certificant’s certification will remain on Emergency suspension until NCBTMB reviews all information available and a final determination is made. During the suspension period, the certificant may not: 1. Advertise using their credential or any NCBTMB logo. 2. Use their certificate in any other way to promote their practice. 3. In any way make themselves out to be certified by NCBTMB. Indefinite suspension: A certificant’s certification has been suspended for an indefinite period of time due to their failure to reply to a complaint.
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Book Code: MMD0926
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