As an ethics educator, business coach and massage industry expert witness, one of the recurring issues I have observed in complaints and lawsuits related to assertions of sexual misconduct by massage therapists is poor client communication.
While addressing the prevention of the serious issue of intentional, inappropriate touch is far beyond the scope of this article, better communication between client and therapist can make a big difference in the way each other’s actions and inactions are perceived and interpreted.
Although the suggestions in this article are aimed specifically at helping prevent misperceptions and misunderstandings during a massage related to inappropriate conduct, they can be used in almost any area of life or business.
As a framework, I will reference material from “The Four Agreements: A Practical Guide to Personal Freedom,” a best-selling self-help book written by Don Miguel Ruiz. The book outlines a personal code of conduct that may help reduce suffering in one’s life. I re-read this book every few years, and the four core concepts are regular reminders about how to conduct myself in day-to-day actions, interactions and reactions.
This code of conduct, although not specific to the workplace or massage therapy, can also be a helpful guide on how to conduct oneself as a professional massage therapist. In particular, this article will offer the framework of the book as a guide to help improve communication between massage therapists and their clients with the aim of creating safer, more rewarding experiences for all.
Agreement #1: Be Impeccable with Your Word
Although the first agreement is quite nuanced, the basic idea is to say what you mean and mean what you say. In other words, keep the promises you make and don’t agree to do things you will be unable to fulfill. It also means to use care to only speak truthfully, avoiding gossip and not making disparaging comments about yourself and others.
On a professional level, this relates to all ways you communicate about your business. From the moment you begin to interact with clients as a massage therapist, whether in person, by phone, in print or virtually, everything you put forth from and about your business should provide a clear, professional and positive representation of who you are, what you do and what clients can expect. Your word is your bond and may very well be the first thing clients know of you.
Photos of you and your office should be clear and professional. Service descriptions, steps and anticipated results should be in line with what the client will experience. Pricing and payment information should be up to date and accurate. Above all else, a golden rule in business is to under-promise and over-deliver. In other words, provide a higher level of service than what the client expects.
That being said, this agreement can backfire if it is used incorrectly. For example, the client schedules a 60-minute massage but “really needs more work,” so you run over by 10 or 15 minutes without asking or charging them. This over-delivery may be intended and perceived as a gracious favor; however, it could also plant a seed of distrust and concern in the client, if they wonder why you spent extra time working on them without telling them or charging them.
Agreement #2: Don’t Take Anything Personally
Ego has no place in the treatment room. To that end, if a client complains about anything, we have to let any feelings of rejection, hurt and sometimes an attitude of “I know better” go in order to honor the client’s perspective, voice and body.
To be truly client-centered, we must, whenever possible, cater the service to their requests, needs and preferences. We can facilitate this when we honor their feelings; put our need to be right to the side; and ask questions to find out more about their discomfort or their needs. Are they OK to continue? Is there pain? Do they feel safe, secure and covered?
We must also be aware of the nonverbal complaints and feedback conveyed by tone, inflection, body language and sometimes silence. As we recognize ourselves as vessels that healing passes through, we must also let the sting of any criticisms wash through us, keeping only the feedback that is useful to the client and our growth.
As a therapist, I have long had a practice of telling my clients at the beginning of a session that nothing they say will hurt my feelings, and thus I give them permission to (and request that) they tell me if anything I do during the session makes them uncomfortable in any way. Truthfully, it can hurt if they criticize one of my “best” moves, but if that technique feels bad to them, “my best” is definitely not “the best for them.”
Agreement #3: Always Do Your Best
This agreement seems like it should be obvious, but unfortunately that is not the case. In some of the legal cases I have seen, the question of whether sexual misconduct occurred is exactly that—a question. However, what is often clear is that one or more parties in the business, whether the front desk, therapist, manager or owner, were not doing their best.
• Inadequate pre-screening of clients prior to scheduling
• Poor consultation before or during the massage
• Sloppy language, techniques or draping
• Inconsistent use of written or verbal informed consent
• Poor focus, lack of attention or boredom during the session
• Unclear guidance or information about what will happen during the service
• Little to no explanation about why specific techniques were used, required, or suggested
• Poor follow-up, concern or care for clients making complaints
Unfortunately, sloppiness and a lack of care in one area can affect other areas negatively. For example, if your treatment room or office is haphazardly organized, it can create problems with finding client files, keeping proper documentation and keeping up with your schedule. Such behaviors can contribute to a client feeling dissatisfied and can compound problems when they are unhappy with your technique or the results they receive during a session.
If you find yourself in a situation where there is a complaint or problem of some kind and you haven’t done your best in the past, do your best right now to right the situation. Rather than ignoring it, acknowledge the problem, apologize, strive to do better and make amends. No one is perfect, but trying to pretend a mistake or slip-up didn’t happen can almost be worse than the event itself.
Agreement #4: Don’t Make Assumptions
A common statement made by massage therapists accused of inappropriate conduct is something along the lines of, “Well, she didn’t say anything when I did ___, so I thought everything was OK.”
Whether you fill in the blank with “put an eye pillow over her eyes,” “worked on her pectoral muscles” or “ran over five minutes,” all of these are assumptions. In some situations, it is perfectly normal and OK to make assumptions, like assuming your client wants the change back from a cash transaction or that if they wanted their feet massaged, they would be OK with you touching their toes.
However, when you are massaging people for money, it is a better practice to ask more questions than not. Specific areas I would get clarity on every time, especially with new clients or those of the opposite sex, are:
• Using an eye pillow or other face covering
• Using aromatherapy
• Massaging the head or hair
• Breathing deeply during the massage
• Removing a blanket or towel
• Doing any stretching during the massage
• Working on a new area or using a technique or product unfamiliar to the client
Some states and businesses require written, informed consent to work on such sensitive areas of the body as the abdomen or glutes. Regardless of what your state or local licensing guidelines are, I would explain the benefits of techniques and procedures while also getting written or verbal permission to provide work before touching:
• Pectoral muscles, armpit area, ribs or sternum on women
• Abdominal and front waist area
• Gluteal muscles, hip rotators and sacrum
• Inner thigh, upper inner thigh, muscle attachments around hip, sitz bones
Taking a cue from Agreement #1 (Be Impeccable with Your Word), it can also be helpful to point out the exact areas you are suggesting work on so the client can see what you are referring to.
Use layman’s language rather than anatomical jargon. The average person doesn’t know the difference between the rectus abdominus, rectus femoris or erector spinae. In a moment of fear, all three sound a lot like “erection” to an untrained or nervous ear, and referring to them may do more harm than good.
Raise Awareness of Client Communication
UsingThe Four Agreements as a guide to help you communicate more effectively with clients and others will raise your levels of awareness and professionalism. Using it as a tool for self-management for directing your thoughts, words, intentions and actions can help you become your best self in and out of the treatment room.
Learn more about Don Miguel Ruiz’s “The Four Agreements,” order the book or watch a free video at miguelruiz.com/the-four-agreements.
About the Author
Felicia Brown, LMT, LMBT, is the president of Spalutions, a firm that provides business and marketing coaching and consulting for massage, spa and wellness professionals. She is a Certified Guerrilla Marketing Coach and NCBTMB/FL/GA Approved Continuing Education Provider.