● Sexual misconduct : Watching a client undress or hugging a client in a sexual way. Self-Assessment Quiz Question #4 Which of the following is a form of misconduct for a massage therapist? a. Using a client’s preferred pronouns. b. Informing a client a technique is outside of their scope of practice. c. Taking prescription drugs before attending to a client. d. Using a provocative picture in advertising. ● Harassed, intimidated, or offended by the ongoing sexually explicit language of their managers, coworkers, or clients (language that either references the massage therapist directly or is explicit in nature within the massage therapist’s vicinity but is not directed toward them). ● Asked to undrape the genitals, buttocks, or breasts during a massage or expose themselves to clients or patients who undrape themselves in a manner that is in violation of local and state laws. Sexual harassment, like sexual misconduct, is not defined by any specific sexual interaction between two individuals. Harassment may include the discussion of sexually explicit topics at a place of business, unnecessary or inappropriate references to specific body parts or functions, and visual depictions of a provocative or offensive nature, such as posters or calendars featuring photos of nude or scantily clad models. Sexual harassment can occur between men and women, women and women, men and men, or any other combination of sexual or gender identity. Sexual harassment may feel humiliating or shameful, making the victim reluctant to report the incident (U.S. EEOC, n.d.). Of course, the best option is to prevent sexual harassment from ever escalating to the point that ethical concerns are raised. Practitioners can combat sexual harassment in any number of ways; one of the easiest methods is to educate clients. As massage therapy becomes more readily accepted as a legitimate form of healthcare, today’s massage professional should be referred to as a “massage therapist” and not a “masseuse” (female) or “masseur” (male), as these terms carry with them sexual connotations. It requires little effort for practitioners to correct a client when they make this mistake in terminology, and it lets a client know that the massage therapist is a professional with ethical standards and boundaries. outlets. During the massage, the client occasionally makes sounds that signify pleasure and possibly even sexual arousal. The therapist finds the feedback flattering and puts extra effort into making the massage an increasingly sensual experience for the client. Reflection Are there any issues regarding transference or countertransference in this scenario? Is the therapist abusing their power? Are any boundaries being ignored? Analysis This case potentially violates several areas of ethical concern. The first is an abuse of the power wielded by the massage therapist in the therapeutic relationship. Having forged a close relationship with the client, the therapist has allowed an emotional response to escalate into a physical one and let a small impropriety on the part of the client escalate into egregious misconduct on the part
● Confidentiality : Name-dropping famous clients; telling a spouse details about their partner’s session. ● Contraindications : Treating a client while sick or infectious; ignoring signs of conditions that preclude physical contact. ● Informed consent : Working on a minor without parental knowledge; treating someone’s injury without permission. ● Practicing beyond scope of practice : Doing spinal adjustments, massage, or counseling without appropriate training. Harassment Harassment is a specific kind of misconduct or boundary violation in which an individual of equal or greater authority is inappropriately familiar with a coworker or junior employee. Harassment can manifest itself in abusive remarks or behavior, belittling statements and actions, and discussion or commentary of an overly personal or offensive nature. Sexual harassment is abuse of power, often exercised within the context of employment, containing a sexual or gender-specific component (U.S. EEOC, n.d.). The Equal Employment Opportunity Commission defines sexual harassment as any unwelcome advance, request, verbal statement, or physical conduct of a sexual nature, including visual displays, in which any of the following occurred (U.S. EEOC, n.d.). The therapist was: ● Repeatedly asked out on a date by a manager, co-worker, or client after the invitation was initially declined. ● Propositioned to have sex with a manager, coworker, or client. ● Propositioned to have sex with a manager, coworker, or client as a condition of employment or in order to receive promotions or other awards. ● Continually touched on the body by a manager, coworker, or client after they were asked not to. ● Touched on or near the genitals, buttocks, or breasts by a manager, coworker, or client. ● Instructed to massage a manager, coworker, or client that the massage therapist has declined to provide therapy for (due to sexual harassment) as a condition of employment or in order to receive promotions or other awards. ● Instructed to massage a manager, coworker, or client in a specific manner so as to elicit a sexual response. Case study A massage therapist and client have had a professional relationship for four months now. During this time, the client has received a massage once per month. There has not been any inappropriate activity during this time, and there has not been any nonprofessional contact outside of the massage sessions. Lately, however, the client has been scheduling weekly massages. Moreover, the appointments have been at the home of the client, and the conversations during a massage appointment have typically been personal in nature, often speaking freely. Although it is unspoken, both the client and the therapist believe they would make great partners socially. The client has been physically attracted to the therapist since their first appointment, and the therapist has become increasingly attracted to the client as well. The client is aware that the therapist is also getting over the recent dissolution of a long-term relationship and has few social
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