Tuesday, May 19, 2009


As within any profession, certain ethical and moral standards are set, and none more so to an individual Massage Therapist. As a massage professional, by staying within the boundaries that are set between you and your Client, or a profession as a whole, you can ethically serve clients best by understanding their rights and needs. Ethics is defined, “as a moral principle or set of moral values held by an individual or group” (Collins, 1991). The following are Ethics for a Massage Therapist to consider:

Client-Centered Care
Focusing on the best interests of the Client by providing the highest quality of service possible. Most importantly identifying their goals and aiming to meet those goals will help in the process to make them feel safe and well-attended. By sharing in the decision-making process and the planning of the course of treatment with your client will build a professional relationship based on trust and respect.

Informed Consent
The Client should always consent to any treatment that they receive (defined in the Health & Disability Commissioners Act, 1994) and understand exactly what they are agreeing to e.g. clinical procedures (before, during and after the massage), terms of payment, record taking and assessment and the likely effects of massage. If the Client is a minor, consultation with the care-giver and getting them to observe throughout the treatment process would be advisable. This can also apply to a client with a disability.

Scope of Practice
Knowing our own limits and physical abilities (training and experience) when forming a professional relationship with a client ensures the client safety. If the treatment the client is requiring is outside our knowledge, recognize this and refer a client elsewhere if or when the need arises. “Taking on a client whom we cannot serve well is unethical” (Salvo, 2007).

The Client’s name, details of their treatment and information shared during sessions must NOT be divulged to anyone (Privacy Act 1993). If a third party (other healthcare provider) is involved and wanting to access the Client’s records, written consent MUST be obtained from the Client first before releasing them. Also, avoid initiating contact with a client in a social setting as this too is a breach of confidentiality.

“Boundaries clarify each person’s role, responsibilities, expectations, and limitations…”. “Being aware of boundaries and limitations is crucial to having healthy relationships…” (Salvo, 2007). By having client and therapist boundaries it defines our personal and professional space – our sense of autonomy. These professional boundaries should be communicated with your client which will promote the trust necessary for a therapeutic relationship.

Power Differentials
Power Differentials can be physical or psychological. If the client is lying down in an inferior position and the therapist is standing in a superior position this can create an impression of authority. This is usually not a problem, however, problems can arise when the therapist uses their power in their own interests rather than the clients. Also, if the client is in a deep state of relaxation the client may not be able to say no easily.

The relationship between client and therapist needs to be approached by a treatment plan that acknowledges, respects and focuses on the needs and expectations of the client. Relationships also go beyond client care by encompassing professional relationships with health care providers or physicians from referral.

Transference & Counter-transference
Transference can occur when the client makes the professional relationship personal. They may start thinking of you as more than just a friend. This can be transferred by acts of kindness (gifts), talking about their personal life and asking for advice. They may even ask you on a date. As a therapist you need to deal with transference issues in a mature, ethical manner by setting boundaries. You may even consider referring the client to another therapist. Another option could be to seek help from a professional supervisor.

Counter-transference is when the therapist transfers their feelings towards their client. By having a “bad day” you can subconsciously transfer negative feelings toward your client. Another example is the therapist is unable to separate the therapeutic relationship from their personal feelings surrounding the client by feeling inadequate if the client is not making progress with the treatment they are providing for them.

By demonstrating the commitment to provide the highest quality massage therapy to those who seek our professional service and adhering to the ethical relationship between yourself and client will be important in building a successful practice.

Salvo, S. (2007). Massage Therapy Principles & Practice (3rd ed.). Missouri: Saunders Elsevier
Collins, (1991). The Collins Dictionary & Thesaurus. Glasgow: HarperCollins Publishers

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