Reflection Should the therapist circumnavigate the client’s confidentiality and report their concerns to the authorities? If the therapist wanted to offer an alternative to such assistance, what kind of assistance might be appropriate? Analysis In this situation, it may be difficult for the therapist to avoid a breach of the client’s confidentiality, as she has not disclosed that she is being either physically or emotionally abused, regardless of appearances or hearsay. 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 without the client’s written consent or a court order (and in this case, there is no method for obtaining a court order). If the therapist finds that he cannot in good conscience let the alleged abuse go undetected by the proper authorities, the New clients Massage therapists should assume that a new client knows nothing about massage therapy. Many massage therapists create an information sheet to acquaint new clients 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. Written policies: Contracts Fee schedules and office policies are another area that can interfere with a positive client relationship and lead to ethical conflicts. Policies concerning late or missed appointments, cancellation fees, and fees for different time periods or modalities must be clearly explained and agreed to at the time of booking the appointment. Establishing and explaining policies to clients prior to booking sessions can save everyone time and money, and ensure that the practice operates in a coordinated, organized, and professional manner. This will also help to maintain an effective schedule that keeps the office running on time, which clients and therapists expect and deserve. As an employer, written policies are essential to maintain a professional practice in which staff understand their duties, responsibilities, and uniform procedures to ensure quality care for clients. Employees must understand all administrative policies and expectations prior to accepting a position. There should be a written employee handbook that includes all policies, procedures and the code of ethics for the practice. In-service training should be provided for new staff and held periodically on topics of importance to all staff to provide continuing education and training. Some ethical issues are easy to avoid, but other issues fall into a grey area that requires introspection, study of the ethical standards and codes, study of state regulations, and sometimes guidance from supervisors or agency administrators. It is important to turn to resources for assistance in ethical questions. Additionally, providing basic instructions and answers to common questions in a brief information sheet can put new clients at ease, especially when these clients are new to the experience and unfamiliar with a facility’s personnel and way of conducting 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 therapists’ greater expertise
therapist is left with two options: either refer the client to a social worker and/or terminate the therapeutic relationship. In giving the client a referral to a social worker, the therapist does not violate the client’s principle of autonomy (self-rule), which holds that individual persons have the right to make their own choices; if the client wants to seek support for abuse (if it is taking place) she may do so of their own volition. And, in giving the client the referral, the therapist does not violate any professional boundaries, since he is remaining within his scope of practice. But the therapist may also choose to terminate the therapeutic relationship because the relationship with the client has become dysfunctional. The obstacle for the therapist should be relayed to the client as early as possible so that the client is not surprised by any unexpected pronouncement that the therapeutic relationship will come to an end. business. Providing basic instructions and answers to common questions in a brief information sheet can put new clients at ease, especially when these clients are new to the experience and unfamiliar with a facility’s personnel and way of conducting business (Ashton, 2010). During the session, the therapist should inform the client when moving from one area to another, especially when the movement is to a particularly vulnerable area, such as the abdomen. Therapists should also do the following (Ashton, 2010): ● Assess sensitivity and tolerance and inform the client as they progress to deeper movements. ● Perform tapotement only with client permission, and after the individual is adequately informed about the process. ● Take care not to startle a client in a relaxed state. ● Inform the client regarding potential massage after- effects, such as tenderness or soreness, and the expected duration of such effects. ● Ask the client near the end of the session if any particular area needs further attention. ● Invite feedback and implement changes based on client comments. At the end of each session, therapists should discuss the clients’ treatment plan and health objectives. They should ask the clients to assess their progress or lack of progress toward treatment goals. Massage therapists should also answer any questions the client may have, and note the following information in the client’s record (Ashton, 2010): ● If the client feels bruised, nauseated, or lightheaded. ● 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. INTERPERSONAL DYNAMICS AND POWER IN THE THERAPEUTIC RELATIONSHIP
in the area of massage therapy. Massage therapists’ education, skills, experience in the field, and professional certification give them an authoritative advantage over their clients (Allen, 2019).
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Book Code: MFL1225B
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