advertising that massage therapy can treat stress may be in violation of some states’ laws (Armstrong, 2012). Questions to consider about scope of practice include the following (Lee, 2016): ● Does the state regulate or prohibit certain spinal manipulation, cupping, intraoral massage or Gua Sha, which is a Chinese method that involves scraping the skin with a flat tool to relieve pain, aid circulation, and remove toxins? ● Does the scope of practice involve teaching exercises to practice at home without supervision? ● What are the parameters of evaluation and assessment vs. Diagnosis? ● What type of muscle testing is permitted? ● If the practice is multidisciplinary, how do chiropractic assistants, Emotional Freedom Techniques (EFTs), PT, OT, and Certified Athletic trainers (ATC) interface to deliver safe and legal services to clients?
Misrepresenting one’s educational achievements, credentials, or abilities is a serious breach of responsibility that endangers client safety and reflects poorly on the massage profession as a whole. If a subject is outside a massage therapist’s area of expertise, they should not hesitate to say so. The therapist should then direct the client to the appropriate informational resources or professional services. Massage therapists should make sure any information or suggestions they pass along are supported by the professional community and recent research findings and are appropriate and safe for the client (DiSilvio, 2023). Consult the state of licensure including rules, restrictions and regulations concerning massage and bodywork for definitions and limits to the scope of practice. Many states that regulate massage therapy align the functions of diagnosing, prescribing and treating with the practice of medicine, and prohibit massage therapists from using these terms to describe what they do (Lee, 2016). For example,
HEALTH AND SAFETY
should document the referral and the reasons for it in the client’s record (Fritz & Fritz, 2020). Massage therapists should keep scope of practice in mind when they give advice or make recommendations to clients. While listening attentively to a client is a relatively risk-free venture, sharing opinions is not. Depending on the topic of conversation and the therapists’ specific comments, they may be engaging in high-risk behavior whenever they have casual conversations with a client. Therapists should resist requests for advice in any subject outside of their areas of expertise, even though it is natural to be drawn into discussions with a client, especially a client they’ve come to know well (Fritz & Fritz, 2020). Advice can be a dangerous and slippery slope for practitioners, in large part because they may have some knowledge and experience regarding a health-related topic, but that topic may not be strictly within their scope of practice. Therapists who have found an effective nutritional supplement or exercise program that relieves the same symptoms the client is experiencing may have a strong impulse to share that information with their client. Therapists may also want to warn the client away from a health regime that they consider ineffective or potentially dangerous (DiSilvio, 2023). When giving their point of view, therapists should make sure they delineate a professional recommendation, based on years of experience and study, from suggestions or opinions of a more personal or general nature. They should help their clients distinguish between subject matter in which they, the therapist, are not professionally qualified. If a health or medical issue is outside of a practitioners’ scope of practice, they should recommend that the client see a qualified health professional regarding the matter (DiSilvio, 2023). Safety is not limited to hygiene, skill, and scope of practice concerns, however. For example, when considering the importance physical boundaries play in maintaining a safe environment for the client, in American culture, the generally accepted rule for personal space puts approximately three feet between one person and another. However, this distance is quickly minimized for the sake of treatment. In fact, the amount of personal space is reduced even before a massage session begins, as therapists welcome clients and subsequently review their intake information. During the massage itself, the distance of personal space is reduced to skin-on-skin contact. Although there is an agreement between the therapist and the client to reduce the amount of personal space during a massage, this is not an invitation by either party to circumvent any or all physical boundaries.
Practitioners must abide by industry standards of safety and hygiene. Client draping, towels, the massage table surface, and other relevant items or materials must be cleaned according to accepted standards of sanitation and meet all legal health and safety requirements (including universal precautions relating to communicable diseases). Practitioners should know how to cover cuts and use sanitizing supplies, such as disinfectant hand wipes, effectively (Fritz & Fritz, 2020). Healthcare Consideration: Information on universal precautions relating to communicable diseases can be found on the Center for Disease Control and Prevention’s website under “Disinfection & Sterilization Guidelines.” The Occupational Safety and Health Administration also provides guidelines on their website under the regulation header “Sanitation” in regard to worker safety (CDC, 2024). Practitioners must have the skills and knowledge to assess a client’s condition and provide safe and appropriate therapy. They must be attuned to verbal and nonverbal client feedback and alert to possible contraindications for massage. Sometimes these decisions are less than clear- cut, requiring a bit of research or consultation with medical personnel more familiar with the client’s condition. Massage therapists should never allow the client, the client’s relatives, or even the client’s doctor to pressure them to proceed if the therapist has any doubts regarding the safety of a specific procedure for a specific client. Therapists are ultimately responsible for any injury sustained by the client during or resulting from massage and the medical and legal liability associated with it—even if the client’s physician specifically recommended or prescribed the bodywork (Fritz & Fritz, 2020). If massage therapists have strong concerns about the client’s health related to medication or procedures received through another source, they should suggest that the client have a trusted healthcare professional review the course of treatment. Pronouncements like this should not be made flippantly, as they could be the basis of legal action against the therapist for practicing medicine without a license. If therapists believe a client has a serious medical condition or may have suffered an injury, they should tell the client immediately and refer the client to the appropriate healthcare professional. Therapists should not discuss the condition with the client’s doctor or anyone else unless they have explicit permission from the client to do so. Therapists
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Book Code: MFL1225B
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