Issue link: https://www.massageandbodyworkdigital.com/i/867515
difficulty maintaining boundaries may run into trouble. All of the basic warning signs and guidelines outlined here apply equally to any therapeutic interaction, regardless of the genders of the client or the therapist. Disrobing There is no rule that clients have to be nude to have a massage. If the client is perfectly comfortable being naked, that is fine. But if the client is more comfortable leaving on undergarments for the massage, that is fine as well. A practitioner should never pressure a client into getting naked for a therapy session. Clients faced with that pressure should consider it a warning sign and probably terminate the session. However, the client is not in the best position to know this and may believe that getting fully nude is required and/or at least expected. It is both a spa's and practitioner's responsibility to always inform the client that they may undress to their comfort level. The spa/ practice should have procedures and safeguards in place to ensure that all practitioners follow these guidelines—for example, providing a written statement for clients to read. Therapists should always give clear and specific directions about what the client should do (e.g., disrobe to your comfort level, lie face down/face up under the sheet), and ask if they have any questions, before leaving the room while the client undresses in preparation for the massage. Draping Some bodywork is done with the body fully clothed so no drape is used, but when clothing is removed, drapes must be used appropriately. Proper draping techniques are not difficult to teach, to learn, or to perform, and should be taught well in all massage schools. Prior to hiring, a massage therapist should be evaluated on proper draping techniques by a knowledgeable supervisor. Many clients, especially new ones, are not clear about what constitutes appropriate draping. It is the practitioner's responsibility to use proper draping to ensure their clients feel secure and unexposed. And it is a spa's responsibility to ensure their practitioners are appropriately draping their clients. As for draping protocols, the genital regions (and female breasts) should always be covered (Image 1). The drape may be lowered to the base of the sacrum (Image 2) when the client is prone. The buttocks may be undraped only with explicit permission from the client, and usually only one side at a time (Image 3). When putting the drape in place, the therapist may lift each leg slightly to bring the drape securely under the There is no doubt that the vast majority of massage therapists and bodyworkers are honest, hardworking professionals who would never engage in sexual misconduct of any kind. Unfortunately, some individuals who enter our profession lack the integrity, psychological boundaries, or mental and emotional stability to practice ethically. It is a few predatory therapists who cause profound damage to the clients on their tables, as well as the profession as a whole. Knowing what to look for will only help us be better at policing the profession from within. CULTURAL CONTEXT Certainly, sexual abuse and harassment are not unique to the massage therapy profession. However, the physical intimacy involved in hands-on bodywork heightens the level of vulnerability for a client. Think about what happens in these therapeutic relationships: a client makes an appointment with someone they've never met; enters a dimly lit, private room with this person; removes most, or all, of their clothing; and lies passively while being touched—usually skin to skin—for an hour or so. The client is highly vulnerable, both physically and psychologically. Add to that the fact that many of your clients come to you with a variety of experiences, including some having been sexually abused. Research estimates that approximately 1 in 53 boys and 1 in 9 girls experience sexual abuse at the hands of an adult before the age of 18—often in trusted environments such as homes, schools, and places of worship. 2 This means that although they may never tell us directly, some of our clients are survivors of abuse and are likely to be highly sensitive to any physical boundary crossing (even an accidental one) and can be easily retraumatized. Because we don't always know, we must treat every individual with the care, respect, and clearly defined boundaries we would offer to someone with a known history of sexual trauma. Guidelines for ethical practice must always err on the side of caution and client safety. MAINTAINING SEXUAL ETHICS WITHIN A SESSION Clear guidelines for therapeutic practice are essential to protect the public, practitioners, employers, and the profession as a whole. The sections that follow describe parts of a typical massage therapy session, including necessary precautions and areas where therapists with 58 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 7