Keep it Ethical and Professional: Set Client Boundaries

Every profession has a set of ethics to establish and maintain trust between service providers and their clients. Ethical standards protect and safeguard both parties and ensure successful outcomes for each other. Massage therapy is no exception and may even be held to a higher ethical standard than other professions because of the close physical contact between therapists and clients. Then, too, massage therapy is rooted in compassion, care, and healing so a violation of trust is hard to repair.

An ethical and professional relationship between the therapist and client is dependent on setting appropriate boundaries. They protect both parties and uphold the integrity of the profession. Boundaries also ensure therapists operate within the legal framework, adhering and upholding laws and regulations regarding practicing massage therapy in their state. Boundaries foster a safe environment for clients, emotionally and physically, providing them with comfort and protecting them from potential harm. Boundaries also ensure private or sensitive information shared during a session remains confidential, which builds trust so that the client will be more comfortable opening up.

Massage therapy boundaries

Common boundaries for the massage therapist include:

·         Physical boundaries

·         Emotional boundaries

·         Professional code of ethics

·         Social boundaries

Physical boundaries

Physical massage boundaries encompass several things from the way the treatment and dressing rooms are set up for client comfort and privacy to proper draping and respecting a client’s personal space and preferences.

No matter how enthusiastic new clients may be about the benefits of massage, some still will be apprehensive about the experience, especially since it involves removing clothing. As part of your initial intake conversation when you find out what pain or discomfort a client is experiencing, you also want to find out if they are at all uneasy or self-conscious about the new experience. Communicate which areas will be appropriate for touching unless they consent to others that are necessary for a medically indicated treatment.

Upholding physical boundaries also involves recognizing contraindications, which means identifying conditions where massage therapy may not be appropriate or even may be harmful. In such situations, you should refer clients to proper medical professionals. [1]

Emotional boundaries

Setting emotional boundaries involves recommending that a client seeks out proper psychological treatment or counseling when they demonstrate behavior or express emotions outside the scope of your role as a massage therapist. Relaxation and stress relief massage may not be sufficient to address severe anxiety or depression. You may harm the client, too, by allowing an emotional situation to reach a critical stage beyond your professional knowledge and skills. By migrating into the role of a counselor when a client is in crisis, you may be opening yourself up to licensing violations or even malpractice claims.

You also need to be wary of taking on a client’s emotional issues, which can be draining. For that reason, try to maintain a professional detachment and avoid becoming too personally close to clients.

Professional boundaries

Professional massage boundaries involve adhering to an established set of ethics for your practice, such as those set the American Massage Therapy Association or other professional organizations that set standards for professional conduct.

Professional boundaries also impact the professional atmosphere of your massage practice, and cover areas such as hygiene and cleanliness, proper dress and communicating with the client in a respectful manner. Timeliness is also important. Sessions should begin and end on time. Proper representation of the business also involves clear communication about services, pricing, and policies.

Social boundaries

Social boundaries address interacting with clients beyond your professional relationships. For example, clients may extend an invitation to a social event. Your attendance blurs the line between professional and personal relationships with your client. Along these lines, communicating with a client during the session should stay within the boundaries of the treatment and avoid exchanging personal information.

Social media activity also should stay within the boundaries of professional decorum and privacy.

Set massage therapy boundaries

Setting boundaries with clients starts when the relationship begins. From the first appointment, clients should come away with a positive impression of your professionalism, your respect for them, and concern for their safety and comfort. To do so requires the following steps:

1)      Define your boundaries – physical, emotional, professional, and social – and set them into clear policies. If you have a team, make sure members understand them as well. At the beginning of a new relationship, discuss your boundaries with clients as they relate to cancellations, late arrivals, payment, draping and conduct during the session. You can discuss them at the initial consultation, before the session starts or in email communication.

2)      Be consistent in applying your policies to all clients. Never assume they are understood. Consistency avoids confusion or clients crossing boundaries. Before the first session, have clients sign consent forms that outline what they can expect during the massage session and what is expected of them.            

3)      Adjust policies, as necessary. If you find a boundary crossed during a session, think about how you can avoid such a situation in the future. You may need to communicate your policies in another way.

4)     Seek outside resources if a boundary issue comes up and you are not sure how to manage it. Ask advice from a business associate or a member of a professional organization you are in. If necessary, seek legal counsel.

5)     As needed, periodically reviews and discuss boundary policies with clients.

Maintain massage therapy ethics and boundaries

Things change so you want to be up to date on the latest best massage therapy practices. Continuing education classes can help you maintain a high standard of professional and ethical practices. Attending industry trade shows or tuning into webinars are other information channels where you can learn about changes in the industry that involve ethics and boundaries.

Clear and consistent boundaries set clients’ expectations and assure them of a secure and professional experience during treatments and a therapeutic environment of compassion and respect.