Featured image for an article about the massage reporting gap. Image of keyboard with report button.

When a massage therapist experiences misconduct from a client, reporting the incident is an important first step, but what happens when that same client does it again to someone else? In a profession where therapists, businesses, and law enforcement often operate independently, critical information about repeat misconduct can remain scattered and disconnected. This article examines the massage reporting gap and asks whether the profession needs better ways to connect reports while protecting practitioner safety, privacy, and due process.

Key Takeaways

  • Individual reports often remain fragmented across employers, police, and jurisdictions.
  • Reporting an incident does not necessarily help identify repeat patterns of misconduct.
  • Therapists need better training on documentation, reporting, evidence preservation, and legal rights.
  • The massage profession should explore responsible ways to connect safety information while protecting practitioners, privacy, and due process.

When Client Misconduct Follows the Client

A massage therapist ends an appointment after a client intentionally exposes himself. She gets herself safe, documents exactly what happened, tells the owner and reports the incident to law enforcement. The business places the client on its do-not-book list and tells him he cannot return. She did what we tell massage therapists to do.

The next morning, that same client books with another massage therapist 200 miles away and across a state line. Therapist number two knows nothing about what happened the day before. That afternoon, he drives another 150 miles and does it again. We can do everything right, and the next therapist can still start from zero.

That is the reporting gap.

Imagine that client encounters ten massage therapists over the next two years. One experiences intentional exposure. Another receives increasingly sexual messages. Another is offered money for sexual contact. Another is threatened when she refuses. One reports him to her employer, one calls police, one writes an incident report and several simply block his number and decide they never want to hear from him again.

Each therapist has a piece of information, but the client possesses the entire puzzle. He knows who he contacted, which businesses have banned him, who confronted him and who reported him. The therapists do not know about one another.

That matters in a profession as large and decentralized as ours. The American Massage Therapy Association estimated 355,075 massage therapists in the United States in 2025.¹ Massage therapy is regulated differently across the country, with state, county and municipal requirements varying by jurisdiction.² We work in franchises, spas, medical offices, gyms, private practices, home offices and clients’ homes. When information about a potentially dangerous client cannot move with him, hundreds of thousands of practitioners can become hundreds of thousands of islands.

That fragmentation raises a question our profession has not had to answer nearly as clearly as the question of protecting clients: What happens when the person creating the safety concern is the client?

Who Protects Massage Therapists From Client Misconduct

Massage regulation exists for an important reason: public protection. FSMTB describes public protection as the primary role of its member regulatory boards and agencies. ³ If a massage therapist engages in professional misconduct, a client may report that practitioner to an employer, licensing authority or law enforcement. Those protections are necessary, and clients should have meaningful ways to report practitioners who harm them.

Those protections are necessary, but they address only one side of the safety equation. When the client is the person exposing himself, making sexual requests, touching a therapist without consent, threatening her or engaging in other potentially criminal conduct, the therapist can document what happened, tell her employer, contact law enforcement, refuse future appointments and block his number. Those actions send information into separate places, each with a different purpose. Her employer may know what happened inside that business. Police may have a report within that jurisdiction. Her massage regulator is primarily concerned with the conduct of licensed practitioners and regulated businesses. ³

The problem is not that there is nowhere to report. The problem is that there is no single professional system designed to recognize when the same client is generating reports across multiple therapists, businesses or jurisdictions.

Reporting Client Misconduct Is Not the Same as Recognizing a Pattern

That distinction becomes important when we consider what happens after an individual therapist reports an incident. Therapist number one may report to her employer. Therapist number two may call police. Therapist number three may write an incident report. Therapist number four may tell no one. Each of those choices may be understandable and appropriate, but where do those pieces of information meet? Often, they do not.

Reporting and pattern recognition are not the same thing. Ten incident reports inside ten separate businesses are still ten disconnected reports. Ten blocked phone numbers do not create a warning. Ten businesses placing the same person on separate do-not-book lists may never know they have all banned the same client. Reports to law enforcement may also be separated by cities, counties or states.

The information exists. What doesn’t exist is a place for the information to meet. Other areas of health care have already confronted versions of this problem, so massage therapy does not have to invent the concept of connecting fragmented safety information from scratch.

What Health Care Can Teach Us About Connecting Reports

The federal National Practitioner Data Bank collects certain adverse actions involving health care practitioners so authorized organizations making licensing, hiring and credentialing decisions can access information that might otherwise remain scattered among jurisdictions. ⁴ The system is designed to protect patients by helping important information follow the practitioner.

The comparison is not perfect, nor should it be. Clients are not licensed health care practitioners, and no one is suggesting they should be treated as such. But the underlying principle is worth examining: when safety depends on recognizing a pattern, disconnected information has limits.

And we do not have to imagine what that fragmentation could look like in massage therapy. A highly publicized case involving dozens of massage providers gives us an unusually visible example.

When One Client Sees Multiple Massage Therapists

A New York Times investigation reported that one high-profile professional athlete booked massage appointments with at least 66 women over approximately 17 months. ⁵˒⁶ The group included women who sued him, women who filed criminal complaints, therapists who provided statements supporting him, team-associated therapists and other providers whose appointments were confirmed through interviews and records.

Receiving frequent massage is not evidence of misconduct, and the number itself is not the point. The information structure is what matters. Many of those providers were contacted individually, including through direct messages and social media. A therapist receiving a message from a prospective client could see the interaction in front of her, but she could not see his entire massage history. He could.

That is what makes the case relevant far beyond professional sports. Most massage therapists will never treat a famous athlete, but we will treat strangers. We receive online bookings and direct messages. Mobile therapists enter clients’ homes, and home-based therapists invite clients into theirs. If something happens, we need to understand not only whether to report it, but what reporting can and cannot accomplish. Recognizing the gap does not mean that any method of connecting information would be appropriate. A reporting system must improve practitioner safety without creating new risks.

What Better Reporting Could Look Like for Massage Therapy

The answer is not a public national blacklist of massage clients. Such a system would raise serious concerns involving due process, mistaken identity, privacy, defamation, discrimination and data security. Nor should massage therapists become investigators, search for other alleged victims or attempt to determine guilt themselves.

What we do need is better practitioner preparation. Massage therapists need practical legal literacy so they can recognize when behavior may have crossed from inappropriate into potentially criminal. Employers need clear procedures for client misconduct, not just therapist misconduct. Practitioners need to know where to report, what to document, how to preserve evidence and what happens to that information after the report is made.

Most importantly, the profession needs to begin talking seriously about responsible pattern recognition. We have spent decades asking how to protect the public from massage therapists, and we should keep asking that question. But practitioner safety deserves the same seriousness.

A therapist can document everything correctly, report appropriately and still leave the next therapist completely unaware of what happened before her. That is the gap. We tell massage therapists to report. Now we need to ask: Who connects the reports?

About the Author

Image of headshot of the author Kaci Jones

Kaci Jones, LMT, has practiced massage therapy since 2010 and is the founder and CEO of ProHealth Defense, an education and advocacy organization focused on practitioner safety. She created Safeguarding Practitioners from Inappropriate Behavior, a continuing education course that helps massage therapists and other hands-on professionals recognize inappropriate and potentially criminal client behavior, understand state and federal protections, document and report incidents, and develop safer practice policies. Her education also incorporates state-specific massage laws and continuing education requirements, allowing the material to address the regulatory environment in which practitioners actually work.

Jones also researches massage therapy regulation and practitioner-safety laws across the United States and is developing a comprehensive database examining state and local massage laws, regulatory requirements and legal protections affecting massage professionals. Her research focuses particularly on gaps in practitioner protection, reporting systems and the ways massage laws differ across jurisdictions.

Learn more at ProHealthDefense.com.

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Sources

  1. American Massage Therapy Association. Starting Your Massage Career. American Massage Therapy Association. Accessed September 2, 2026.
  2. Federation of State Massage Therapy Boards. Regulation; Regulated States. Federation of State Massage Therapy Boards. Accessed September 2, 2026.
  3. Federation of State Massage Therapy Boards. About FSMTB. Federation of State Massage Therapy Boards. Accessed September 2, 2026.
  4. U.S. Department of Health and Human Services, Health Resources and Services Administration. National Practitioner Data Bank; NPDB Guidebook: State Licensure and Certification Actions. Accessed September 2, 2026.
  5. Vrentas, Jenny. “How the Texans and a Spa Enabled Deshaun Watson’s Troubling Behavior.” The New York Times, June 7, 2022.
  6. Barshop, Sarah, and Jake Trotter. “Cleveland Browns QB Deshaun Watson Saw at Least 66 Massage Therapists over 17-Month Period, Report Says.” ABC News, June 7, 2022.