Issue link: https://www.massageandbodyworkdigital.com/i/465652
F r e e m u s i c d o w n l o a d s f o r C e r t i f i e d m e m b e r s : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 31 A large body of psychology research suggests that the relationship between the therapist and the client is the single most important predictor of therapeutic outcome—even more important than the types of techniques used in the session. 1 One group of researchers refers to the therapeutic relationship as an alliance, defining it as "the observable ability of the therapist and client to work together in a realistic, collaborative relationship based on mutual respect, liking, trust, and commitment to the work of the treatment." 2 In the massage profession, the therapeutic relationship is defined as a professional partnership between a massage therapist and a client in which safe, structured touch is used to help the client achieve reasonable and clearly defined treatment goals. The work is client- centered, which means it is always provided to benefit the client, with the client's needs at the forefront. THE POWER DIFFERENTIAL In massage, a power differential is the authority a massage therapist is granted by a client, based on the client's perception of the massage therapist as a knowledgeable and skilled health-care provider. During a massage session, clients share details of their personal health history and are situated at a level below the therapist, in a vulnerable reclining position, while unclothed under a drape. The therapist by virtue of knowledge and skill in the area of massage is granted control of the situation, and so has a power advantage over the client. Ethical massage therapists remain aware of the power differential and seek to minimize it as much as possible to ensure the emotional, mental, and physical safety of clients. When the power differential is minimized, clients are better able to: • Take an active role in the decision-making process to determine reasonable treatment goals. • Alert a therapist to an uncomfortable technique or otherwise voice their concerns. • Give honest feedback on the quality of strokes or the effectiveness of sessions. • Maintain their boundaries, personal power, and responsibility for health. • Actively practice self-care activities and other types of therapy to augment the results achieved from massage sessions. You can actively minimize the power differential by listening carefully to clients and responding compassionately to their needs, while representing the benefits of massage and your personal skill level realistically. You can give clients choices about the types of techniques that might be used in the session or about which body areas will receive the most attention during the massage. If you remain attentive, you will notice when a client tenses because of discomfort and urge the client to speak up if a technique causes pain. Finally, you can encourage clients to seek out other therapists who might help them meet treatment goals and discuss self- care options that speed or enhance treatment outcomes. If you or the client maximize the power differential, it is likely to be unhealthy for both of you. Clients who turn over all of their healing power also tend to place unreasonable amounts of responsibility for their well-being on your shoulders. Over time, they may express resentment or bitterness at their lack of progress and blame you for poor treatment. Clients without power are less able to question your decisions or voice concerns about the quality of sessions. They are less able to protect themselves in the event that you act unethically during the session. In all cases, whether the client actively gives all of the power to the therapist or not, the therapist is always responsible for what happens in a session and must constantly strive to understand and minimize the power differential. TRANSFERENCE Transference is a normal subconscious psychological phenomenon that occurs when there is a power differential. Clients may try to establish the therapist in a place of importance in their personal life. Instead of viewing the