can hinder caregivers in their efforts to provide effective interventions or to attain important public health goals. Disclosure of personal health information should protect patient confidentiality as much as possible. Where confidentiality cannot be maintained, clients should be informed about how their personal health information will be used and whether the information will be identifiable or anonymous. Coordination of health care, in daily practice, requires limited disclosure of information to other health care providers, companies related to client reimbursement or payment, etc. ● Inform the client regarding potential massage aftereffects, such as tenderness or soreness, and their expected duration. ● Ask the client as you near the end of the session if any area in particular needs further attention. ● Invite feedback and implement changes based on client comments. At the end of each session, discuss the client’s treatment plan and health objectives. Ask the client to assess his or her progress or lack of progress toward treatment goals. Answer any questions the client may have, and note the following information in the client’s record: ● If the client feels bruised, nauseated, or light-headed (check blood pressure and monitor). ● The length of the massage session. ● When the client should return for another session (session intervals/frequency). ● Anything the client can do to accelerate progress toward treatment goals. ● Anything the client should do or not do between sessions. ● What results the client can expect, and when. Practitioners who recommend clients replenish fluids after a session may want to provide bottled water at their office. It is not unusual for clients to unintentionally test professional boundaries, or practitioners to unknowingly relax them. When practitioners and clients are motivated by countertransference and transference, respectively, they are more susceptible to inappropriate impulses that can lead to misconduct. Transference refers to all the feelings experienced by the client, related to his or her past experiences and relationships, stirred up by or in the session. Transference is neither negative nor positive, but is “always a distortion; a projection of emotions from the past to current objects.” 3 Countertransference refers to 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. Be aware that transference and countertransference can activate strong emotional reactions and/or feelings of sexual attraction, raising unrealistic expectations on the part of clients and practitioners. Learn to identify emotional red flags of blurred professional/personal boundaries in your behavior. If you overreact, are preaching or lecturing or are uncomfortable, unsure of yourself, or dissatisfied in your interactions with a specific client, you may be experiencing countertransference, bringing emotions and reactions from your personal life into your professional environment.
All information and matters relating to a client’s background, condition, and treatment are strictly confidential and should not be communicated to a third party (even one involved in the patient’s care) without the client’s written consent or a court order. Treat clients with respect and dignity: Handle personal information with sensitivity and keep the content of written records a private matter. Practitioners who can’t resist telling secrets or repeating gossip in their personal lives should be aware of the heavy penalties associated with jeopardizing client confidentiality in a professional context. Without an understanding that their disclosures will be kept secret, clients may withhold personal information. This New clients It is generally a good idea to assume that a new client knows nothing about massage therapy. Many massage therapists develop an information sheet to acquaint the client with basic massage concepts. Office personnel, customary procedures, and other useful points regarding their place of business, such as bathroom locations, and what to expect in a typical session, can be distributed to clients in the waiting room before their first session. Providing basic instructions and answers to common questions in a brief information sheet can be very effective in putting new clients at ease, especially when clients are new to the experience and unfamiliar with a facility’s personnel and way of conducting business. During the session, be sure to inform the client when you move from one area to another, especially when the movement is to a particularly vulnerable area, such as the abdomen: ● Assess sensitivity and tolerance and inform the client as you progress to deeper movements. ● Perform tapotement only with client permission, and after you are certain the individual is adequately informed about the process. ● Take care not to startle a client in a relaxed state.
Interpersonal dynamics and power in the therapeutic relationship Interpersonal dynamics exist in all relationships, and are a normal and necessary part of a therapeutic relationship between client and practitioner. An important part of this dynamic is a power differential; the imbalance in authority or power that results from your greater expertise in the area of massage therapy. Your education, skills, experience in the field, and professional certification give you an authoritative advantage over your clients.
With any position of power comes the potential for abuse. Massage therapists, like many health care professionals, forge close relationships with people in their care. The combination of physical and social interaction between practitioner and client can trigger strong emotional responses in one or both parties, leading to small improprieties as well as egregious misconduct. Asking your client, who is a lawyer, for free legal advice; requesting a church donation or selling your daughter’s Girl Scout cookies at the office; mentioning personal details about a client or repeating what was said during a session to a friend or spouse: All are subtle ways practitioners take unfair advantage of their relationships with clients. Even when clients appear to welcome, rather than resent, such requests or behavior, they are never appropriate and do not belong in a professional environment. It is equally inappropriate for practitioners to accept favors, free merchandise and services, or confidential information (such as stock tips) from a client. These interactions can distort the therapeutic relationship and obscure its primary objective.
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Book Code: MFL1225
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