apply the same structure and rules of conduct in each session with each client regardless of their requests. If therapists deviate from established structure or protocol, they should have a legitimate reason that is in the best Terminating a professional relationship If therapists feel it is appropriate, either because a specified course of treatment 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. While this can be a difficult and uncomfortable task, it should not be postponed out of a desire to avoid confrontation or discomfort. Terminating a potentially damaging relationship is an important professional obligation with specific responsibilities. Practitioners must assess the client’s potential for therapeutic benefits, and make a determination in the client’s best interests. 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. Informed consent provides a framework for termination because it specifies the need for an ongoing discussion between the client and practitioner regarding expected goals, progress reports and anticipated timeline for therapeutic benefits. Therapists should involve clients in the process so they are fully informed of treatment objectives, comfortable to ask questions, and understand the process of assessment as well as able to engage in the care plan. Therapists should discuss obstacles to client progress as they occur, so the client is not surprised by unexpected or abrupt changes in assessment results from one session to the next. Therapists should follow standard procedures for client assessment, and document relevant information about the client’s progress or lack of progress toward treatment goals after each session. Before terminating the client, therapists should: ● Consult appropriate information resources and supervising personnel. They can also contact a Sexuality and massage Sexual misconduct , one of the most egregious examples of inappropriate behavior, refers to any sexual activity between the massage therapist and client. While women are less likely than men to be accused of sexual misconduct, they are not immune to such allegations. Some practitioners employ strategies of avoidance, such as ignoring the issue of sexuality entirely, either consciously or unconsciously, Strategies for client safety The emotional, financial, and legal consequences of professional misconduct for the client, therapist, and professional community are profound. Preventive policies should include an educational component that explains power dynamics in the therapeutic session, what constitutes appropriate and inappropriate conduct with individuals of the same and opposite genders, and strategies for speaking and acting in ways that clarify and reinforce appropriate boundaries. To ensure clients’ safety, therapists must identify issues that are inherently sexual and address then in a way that de-emphasizes or avoids the sexual nature of the action. Desexualizing massage emphasizes the components of therapy, acknowledging human sexuality as a given, with an emphasis on professional execution of the care plan. ● It is natural for clients to feel some anxiety or insecurity related to the process of disrobing and draping.
interest of the client. If the therapist determines they have acted based on self-interest or emotions, they should seek support from a professional colleague or supervisor.
professional colleague or supervisor regarding the situation with the client, post a question on a professional massage therapy website, or refer to their professional organizations. 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 relationship perceptions, conflicts 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, i.e., something that can be remedied or requires termination. ● Be sure to allow time to work through a sound decision- making model and evaluate all relevant factors before making a decision. This should include confidential collaboration with other professionals. This step is also important if there is the potential for legal action after the termination. If it is necessary to terminate the client, therapists should ensure it is done when they have sufficient time to discuss the subject fully. Massage therapists should take the time to respond to any questions the client may have, and give the client sufficient time to react to the news, respond, and regain composure. Massage therapists should try to leave the client with positive feelings about themselves and the professional practice of massage therapy. In addition, therapists can provide referrals to other massage practitioners or healthcare professionals, as appropriate, within their scope of practice. due to their own embarrassment or discomfort with the topic. While this approach may save an awkward moment or two, an inability or refusal to address the subject when necessary, like ignoring signs of sexual arousal, may not only be inappropriate, but professionally irresponsible, resulting in a breach of ethical conduct, and becoming embarrassing or harmful to clients’ self-worth. Massage therapists can minimize anxiety or concern by stating and/or providing written information regarding disrobing. Before the session starts, therapists should state that a draping procedure is required for purposes of modesty and physical comfort. Therapists can also have a written notice that explains that draping will cover all parts of the client’s body except the specific area receiving attention. ● Once therapists finish work in that area, they will cover it or recover it, and move to the next area. Massage therapists can tell clients to let them know if they have a question or concern, or feel uncomfortable in any way. If therapists encounter a client who prefers not to be draped, therapists should explain that they are unable to proceed with the session until the client agrees to this customary procedure. ● Therapists should reassure the client that it is not necessary to remove any more clothing than personal
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Book Code: MTX1325
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