Ethics of professional practise

Client centered care
The main aim of a massage therapist is to provide a beneficial service to their clients, to the best of their ability. To make sure the client gets the most out of the service, the therapist must focus on what the client wants to gain from the experience, and must build a trusting environment in order to do so. Clear boundaries and communication must be estabilished, so that if the practitioner is unable to carry out exactly what the client wants, they are able to refer them onto another health care professional. The therapist must also take all necessary steps to make sure the client is not harmed during the service.

Informed consent
It is important for your clients to give consent at the start of each massage. In order to give informed consent, you must make sure your client fully understands what is going to happen during the session. This is done by the therapist going over benefits, contraindications and other approaches to massage with the client. This way they know exactly what they are consenting too.

Scope of practise
Scope of practise is the extent of what you can provide and what you cannot provide for your client. This depends on what training, experience, qualifications and ability you have as a massage therapist. For example, relaxation massage therapists are not trained in injury management or rehabilitation. Before beginning the massage, the therapist must make sure the client knows what they are able to do, and that they do not have any unrealistic expectations. The therapist must not attempt to carry out any work in which they are not properly trained.

Confidentiality
Any details or information gathered about clients must be kept strictly between the therapist and the client the information concerns. When they are not in use, records should be locked away in a filing cabinet. The therapist must not relay any verbal information about the client, received during the session, or pass on any of their recorded details, unless the client has given them permission to do so.

Boundaries
There are a number of boundaries in massage therapy, including personal space, emotional relationships, our bodies, and the terms of the service. Boundaries are in place to help establish different roles and responsibilities, and to facilitate trust and expectations/limitations of the service being provided. Boundaries can be crossed if the therapist is a friend of the client or becomes too close to them, makes comments about the client’s body, or works out of their scope of practise, or on areas of the client that should not be worked on, for medical or personal reasons. Crossing boundaries can cause clients to become uncomfortable, or may cause people to think negatively of your clinic, which can cost you clients.

Power differentials
Power differentials encompass the difference in power between the client and the therapist. It is important for the therapist to build trust quickly between themselves and their client, to make the client feel less intimidated and vulnerable. Although the therapist is the dominant one in the relationship regarding massage, it must be the client’s decision as to what the session will involve. The therapist must make sure the client knows of their qualifications and what they can and cannot do, before they start giving the massage.

Relationships
Relationships between the therapist and clients should be kept strictly professional. Therefore it is a good idea for the therapist not to have friends or family as their clients, as the friendship – therapeutic relationship line may become blurred. A therapeutic relationship is built of trust. The client must be able to trust that the therapist will give them the best service they can, without taking advantage of their vulnerability, either during the massage or with regards to the personal information they are giving. When trust is built, the client will feel happy and safe, and a good treatment outcome is likely. It is also important that therapists do not enter into an intimate relationship with any of their clients while they are under their care.

Transference and counter-transference
Transference occurs when a client becomes too attached to their therapist. Signs of transference include being given personal gifts, being invited to social events, calling more than is needed and an irregular interest in your personal life. In these situations, care should be taken to maintain a professional relationship, and supervised sessions may be of help. If the client finds it hard to keep the relationship a professional one, referral may be needed.
In contrast, counter-transference is when the therapist is the one seeking attachment to their clients. This can happen when the therapist feels the need to be perfect, heal the client, or just to be liked. This can hinder their ability as a therapist, as they may become frustrated if their plans for the session do not run as they hoped/expected, or if the client shows no emotional attachment. Again, this can be overcome by focusing on maintaining a professional relationship, supervised sessions, or referral.