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Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 59 5. Clarify the client's intent. Once you state the obvious, ask the client a direct question as a follow-up. Something simple like "Tell me what's happening" or "What are you experiencing" allows the client to tell you what the behavior means. 6. Educate the client. Some clients experience unexpected, disturbing emotional and physiological responses during a session. When this happens and we become aware of their concern, we can share information. For instance, an educative statement for a client who has an erection and has expressed embarrassment is "Sometimes clients become aroused as a physiological response to touch (or movement). It is a normal body response." 7. Restate your intent. This statement addresses and clarifies the therapeutic contract so that client and practitioner feel safe. 8. Continue or discontinue the session, as appropriate. You should terminate the session of any client who you decide has sexual intent or is behaving inappropriately. 9. Refer client to other professionals, as appropriate. If it becomes obvious that a client could benefit from receiving professional help from a psychotherapist, counselor, or other medical practitioner, give this information to the client after they are fully dressed. 10. Document the situation. After the client leaves, document the occurrence and obtain supervision or peer support. Documenting the situation, and what you did to address the matter, is vital should a client decide to lodge a complaint against you. Demonstrate your commitment to ethics and professionalism by recording that you sought supervision or external support to address the issue. Prevention "Allowing any boundary crossings makes sexual boundary crossings more likely," as one practitioner put it. Massage therapists have had success in reducing or eliminating client boundary crossings by implementing some or all of the following procedures: • In a client's intake interview, or even earlier in the telephone screening, ask what sort of work they are looking for, how they heard about the practice, and what their problem is. • Trust your gut, and err on the side of caution. • Ensure all intake forms and establishment websites clearly state that sexual inappropriateness results in immediate termination of service and full payment for time. • Have clients sign a policy statement (when booking massage and with email confirmation). • Confirm that the client has read and agrees to your sexual conduct policy, either in writing or online. If you model a healthy comfort level talking about all physiological changes a client might experience during a session, you have provided several things: an opening for the client to express concerns, an education for a client about how the body works, good boundaries, and a safe environment. • Don't allow any sexual conversation. • Put up a visible camera system in the reception area. • Let clients know their information can be provided to the state's attorney's office. • Carry mace. As Cherie Sohnen-Moe writes in her article "Desexualizing the Touch Experience," therapists can take proactive steps to avoid client boundary crossings by doing the following: be prepared, be conscientious about your language and behavior, have a clinical-feeling office space, monitor treatment interactions, and be thoughtful about representation in marketing materials. 1 It is essential that massage therapists feel safe in the work they do. It is our field's responsibility to do all we can to educate about, prevent, intervene, and recover from boundary crossings in the massage setting. By explicitly naming the issues and offering up some suggested policies and procedures, we can contribute to minimizing these instances of sexual misconduct and their harmful effects. Note 1. Cherie Sohnen-Moe, "Desexualizing the Touch Experience: A Proactive Approach," Sohnen-Moe Associates, Inc., 2011, articles/desexualizing-the-touch-experience-part-1. Ben E. Benjamin holds a PhD in sports medicine and owned and ran a massage school for over 30 years. He has studied under James Cyriax, MD, widely known for his pioneering work in orthopedic medicine. Dr. Benjamin has been teaching therapists how to work with injuries for over 35 years and has been in private practice for over 50 years. He works as an expert witness in cases involving both musculoskeletal injury and sexual abuse in a massage therapy setting. He is the author of dozens of articles on working with injuries, as well as these widely used books in the field: Listen To Your Pain, Are You Tense? and Exercise Without Injury.

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