Balance of power Ginn (2013) explains that the most common ethical dilemmas are often subtle and overlooked. Many ethical gray areas concern what Ginn calls the “power differential”, or the complex balance of power between client and therapist. The power differential is an imbalance in authority or power that results from the massage therapist’s greater expertise in massage therapy. “The key is to acknowledge the complexity,” says Ginn, “and understand one’s own history of power.” According to Ginn, massage therapists can create ethical dilemmas by overusing their power. Sometimes the overstepping of the use of power is obvious, as with inappropriate touch, for example. Other times, however, the overuse of power is more subtle, like being late for a client’s massage therapy appointment, or not listening to your clients concerns and questions carefully. In addition to overusing power, massage therapists can also underuse their power, for instance, massage therapists who do not have any established practice policies or who fail to directly establish boundaries when working with clients (Ginn, 2013). Not being able to quickly and properly address conflict is another way massage therapists underuse their power. Ginn (2013) notes that clients can over or underuse their own power, though she is quick to point out that massage therapists need to take more responsibility than their clients. She offers the following insights: ● A healthy client-massage therapist relationship is not equal, but balanced. ● In order to achieve a balanced relationship, massage therapists must learn to “teach your clients to be clients.” ● Before beginning a massage therapy session with a new client, take time for introductions and explanations of practice procedures and policy. ● Create guidelines for the session room and explain client and therapist roles, including the expectations and objectives of therapy. ● Let clients know what their responsibilities are in the relationship, such as a policy to pay at the time of service, to arrive on time, and to speak up if something makes them uncomfortable. With any position of power comes the potential for abuse. Massage therapists, like many healthcare professionals, forge close relationships with people in their care. The combination of physical and social interaction between practitioner and client can trigger strong emotional Boundaries in the patient-practitioner relationship Boundaries define the limits of appropriate behavior between professionals and their clients. By establishing boundaries, a massage professional creates a respectful and protective space for the therapeutic relationship to occur. A boundary violation occurs when a massage therapists’ behavior goes beyond appropriate professional limits (Allen, 2019). The intimate nature of massage therapy involves practitioners in important and sometimes highly stressful life events, and the mutual dependence of colleagues working in close concert, all of which present the potential for blurring of limits to professional relationships. Remaining within the bounds established by the purpose of the relationship can be especially difficult in prolonged or long-term relationships. Even so, in all encounters, practitioners are responsible for maintaining their professional boundaries (Allen, 2019).
responses in one or both parties, leading to small improprieties as well as egregious misconduct (Allen, 2019). Asking a client who is a lawyer for free legal advice, requesting a church donation, selling their 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 can 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. It is not unusual for clients to unintentionally test professional boundaries, or for practitioners to unknowingly relax them. When practitioners and clients are motivated by countertransference and transference, respectively, they become more susceptible to inappropriate impulses that can lead to misconduct. Transference refers the redirection of 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.” Countertransference refers to redirection of 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 (Allen, 2019). Massage therapists should 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. They should learn to identify emotional red flags of blurred professional/personal boundaries in their own behavior. If massage therapists overreact, preach or lecture, are uncomfortable or unsure of themselves, or are dissatisfied in their interactions with a specific client, they may be experiencing countertransference, bringing emotions and reactions from their personal life into their professional environment (Allen, 2018). A variety of standards establish the limits of appropriate professional behavior, whether those limits are explicitly enumerated in standards of conduct, codes of ethics, or law, or tacitly conveyed through professional training and widespread acceptance. Individuals who seek help must rely on the professional they consult to be trustworthy: When practitioners behave in ways that call their professional judgment and objectivity into question, the trust on which the relationship depends is compromised. And when trust is compromised, the efficacy of the therapeutic relationship is negatively affected (Allen, 2019). Part of massage therapists’ responsibility in maintaining clearly defined boundaries is to protect the client should the therapist act or speak inappropriately or be motivated by anything but the client’s best interests. Inappropriate behavior tends to make people uncomfortable. If therapists notice that a client is not responding positively to massage
Page 15
Book Code: MFL1225B
EliteLearning.com/Massage-Therapy
Powered by FlippingBook