meet his spouse during lunch, since she is heavily involved in the business. The therapist doesn’t know much about the client beyond the clinic and has never spoken to him about anything but massage therapy and his treatment plan. Reflection Should the possibility of this dual relationship necessarily be avoided? Is it appropriate for the client to broach this subject? Could this scenario be a potential case of financial exploitation by the therapist? Analysis Here, the client is seeking to engage in a dual relationship with the massage therapist; in this case, the client is proposing a business relationship that goes beyond the therapeutic relationship and may not be inappropriate from the perspective of the client’s profession. Although it is generally considered best to avoid dual roles or
multiple relationships if it appears that the relationship might interfere with the therapeutic relationship, the possibility of a dual role or multiple relationships is not necessarily a violation of ethical boundaries. However, what is the potential impact of agreeing to accept this business opportunity with the client? Conversely, what consequences may follow from turning down the client’s business opportunity, regardless of the reason? Any dual role or relationship may impair objectivity or therapeutic effectiveness, permit exploitation, or create an actual, apparent, or potential conflict of interest. Furthermore, engaging in any business besides massage therapy with this client may lead to other conflicts, such as the lending and borrowing of money, gift giving, soliciting donations, and the unsolicited marketing of massage to other business partners. Maintaining proper boundaries is critical to the effective and ethical practice of massage therapy.
TERMINATING A PROFESSIONAL RELATIONSHIP
organizations with which they are affiliated. 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 the way the relationship is perceived, difficulties, 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, something that can be remedied or requires 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 to it, and regain composure. Massage therapists should try to leave the client with positive feelings about them and the practice of massage therapy. In addition, therapists can provide referrals to other massage practitioners or healthcare professionals, as appropriate (Giroud, 2014). Self-Assessment Quiz Question #3 Before terminating a client, a therapist should do all of the following except: a. Compare their understanding of the therapeutic relationship with the client’s. b. Give sufficient time to discuss the subject fully. c. Consult supervising personnel while ignoring the rules of confidentiality. d. Provide referrals to other healthcare practitioners for the client.
If therapists feel it is appropriate, either because a specified, finite course of treatment with a client 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 with the client. While this can be a difficult and uncomfortable task, it should not be postponed out of a desire to avoid confrontation or discomfort (Giroud, 2014). Terminating a potentially damaging relationship is an important professional obligation with specific responsibilities. Practitioners must realistically assess their own limitations and/or their client’s potential for therapeutic benefits, and make a determination in their client’s best interests, without feelings of failure or guilt. 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 the expected goals and anticipated timeline for therapeutic benefits. Therapists should involve clients in the process so they are aware of treatment objectives and can ask questions and make determinations about clients’ progress toward them. Therapists should discuss obstacles to client progress as they come up, so the client is not surprised by an unexpected pronouncement or abrupt changes in assessment of the client’s condition from one session to the next. Therapists should follow customary procedures for client assessment, and document relevant information about the client’s progress or lack of progress toward treatment goals (Giroud, 2014). Before terminating the client, therapists should: ● Consult appropriate informational resources and supervising personnel. They can also contact a professional colleague or supervisor about the situation with the client, post a question on a professional massage therapy website, or refer to professional
SEXUALITY AND MASSAGE
or unconsciously, 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 (ignoring signs of sexual arousal, for example) may not only be inappropriate but professionally irresponsible and a breach of ethical conduct.
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, ignoring the issue of sexuality entirely, either consciously
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Book Code: MFL1225B
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