avoiding creation of an overly perfumed, romantic, or sensual atmosphere. Therapists should also remember that a client might be allergic to certain odors, have strong negative reactions to certain smells, or associate a given odor with Misconduct Misconduct has been a persistent and troubling issue in healthcare and medical professions since modern medicine began. Written more than 2,000 years ago, the Hippocratic Oath is the basis for the principle of “do no harm” as it states, “I will keep them from harm and injustice” [Hasday,2013). It continues, “Come for the benefit of the sick, remaining free of all intentional injustice, of all mischief, and in particular of sexual relations with both female and male persons” (Hasday, 2013). In recent years, accusations of misconduct in the healthcare and personal service industries have become increasingly common, due in part to formal regulation of the profession, standardization of the complaint process, and greater awareness of the issue and client rights among the general public. Misconduct takes many different forms that vary in type and degree of severity. Misconduct can occur in every aspect of business practice, from organizational matters, to billing, to social interactions. Even in cases where inappropriate behaviors are the unintended result of poor record-keeping, lack of staff training, errors in judgment, or improper planning, they risk harm to the client and serious penalties for the practitioner. Victims of misconduct may face long term emotional and physical issues and allegations of misconduct. Even if allegations are proven false, they can damage the reputation of the therapist and the profession at large. Misconduct may take many forms. The following list provides some examples of misconduct based on violations of ethical guidelines and standards of practice: ● Misrepresentation of educational status : Identifying oneself as a craniosacral therapist after taking a two-hour course. ● Substance abuse : Practicing under the influence of alcohol, drugs, or any illegal substances. Harassment Harassment is a specific kind of misconduct or boundary violation in which an individual of equal or greater authority is inappropriately familiar with a student, co-worker, or junior employee. Harassment can be abusive remarks or behavior, belittling statements and actions, and discussion or commentary of an overly personal or offensive nature. Sexual harassment is abuse of power, typically exercised within the context of work, containing a sexual or gender-specific component. The Equal Employment Opportunity Commission defines sexual harassment as any unwelcome advance, request, verbal statement, or physical conduct of a sexual nature, including visual displays (United States Equal Employment Opportunity Commission, 2016). The examples of sexual harassment below occurred in the context of massage therapy and bodywork. Therapists have experienced the following: ● Propositioned to have sex with a manager, co-worker, or client. ● Repeatedly asked out on a date by a manager, co-worker, or client after the invitation was initially declined. ● Propositioned to have sex with a manager, co-worker, or client as a condition of employment or in order to receive promotions or other awards. ● Continually touched on the body by a manager, co-worker, or client after they were asked not to. ● Touched on or near the genitals, buttocks, or breasts by a manager, co-worker, or client. ● Instructed to massage a manager, co-worker, or client that the massage therapist declined to provide therapy for, due to sexual harassment, as a condition of employment or in order to receive promotions or other awards. ● Instructed to massage a manager, co-worker, or client in a specific manner so as to elicit a sexual response.
an unpleasant memory or incident. Music should also be soothing and subtle, and played only after therapists have asked the client about a preference for music or silence during the massage. ● Financial impropriety : Charging a cash-paying client a different fee than an insurance-paying client. ● Exploiting the power differential : Asking a stockbroker for financial tips during a treatment. ● Misleading claims of curative abilities : Guaranteeing a client that his/her pain will be gone in two sessions. ● Accessibility : Refusing to adapt the office, or make a reasonable accommodation for those with physical challenges. This is also illegal under the Americans with Disabilities Act. ● Bigotry : Refusing to work with someone due to race, religion, size, national origin, gender, or sexual orientation. ● Inappropriate advertising : Using a provocative picture in advertising or presenting misleading qualifications. ● Dual relationships : Dating a client, providing therapy to a student, or hiring a client for personal work. ● Violation of laws : Practicing out of one’s home when not permitted by law, not reporting legal adjudication, or practicing with a suspended or expired license. ● Confidentiality : Name-dropping famous clients or telling a spouse details about his partner’s session. ● Contraindications : Treating a client while sick or infectious or ignoring signs of conditions that preclude physical contact. ● Informed consent : Working on a minor without parental knowledge or treating an injury without permission. ● Practicing beyond scope of practice : Doing spinal adjustments, massage, or counseling without appropriate training. ● Sexual misconduct : Watching a client undress, hugging a client in a sexual manner, or inappropriate touching. ● Harassed, intimidated, or offended by the ongoing sexually explicit language of managers, co-workers, or clients that either references the massage therapist directly or is explicit in nature in the massage therapist’s vicinity, even if not directed towards the therapist. ● Asked to undrape genitals, buttocks, or breasts during a massage or to expose themselves to clients. ● Or patients who undrape themselves in a manner that is in violation of local and state laws. Sexual harassment, like sexual misconduct, is not defined by any specific sexual interaction between two individuals. Harassment may include the discussion of sexually explicit topics at a place of business, unnecessary or inappropriate references to specific body parts or functions, and visual depictions or notes of a provocative or offensive nature, such as posters or calendars featuring photos of nude or scantily clad models. Sexual harassment can occur between men and women, women and women, men and men, or any other combination of sexual or gender identity or orientation. Sexual harassment may feel humiliating or shameful, making the victim reluctant to report the incident. Of course, the best option is to prevent sexual harassment from ever escalating to the point that ethical concerns are raised. Practitioners can combat sexual harassment in any number of ways, and one of the easiest methods is to educate clients. As massage therapy becomes more readily accepted as a legitimate form of health care, massage professionals should be referred to as a ‘massage therapist’ and not a ‘masseuse’ (female), or ‘masseur’, (male), as these terms can carry sexual connotations. It requires little effort for practitioners to correct a client when they make this mistake in terminology, and it lets a client know that the massage therapist is a professional with ethical standards and boundaries.
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Book Code: MLA1224
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