Choosing a Massage Therapist - Trust & Safety
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Massage therapy is an important health service which has been proven to reduce stress, reduce general pain, reduce or heal muscular tension and pain, improve sleep quality, and can help to prevent muscular injuries and increase range of motion. Massage isn't just some luxury (although it certainly feels amazing and luxurious), it is an important part of many people's self-care, stress management, pain management and mental health management, as well as an important therapy for athletes. Massage encourages the release of feel good hormones such as dopamine, serotonin and oxytocin which assists many people to cope with stress, anxiety, depression and grief, as well as feel more relaxed and focused. Reducing stress also leads to increased immune activity as cortisol (the stress hormone) reduces immune activity which can lead to illness - acute or chronic. I also believe that massage therapy will become an important part of healing from post-traumatic stress disorder as a massage from a trusted therapist can really help a person to become embodied and feel safe in their body. If you are interested in learning more about this please refer to my very first blog: Restoring the Mind-Body Connection during Trauma Recovery.
Safety
Disappointingly, from time to time a person may come into the health industry and instead of wanting to provide a healing service like the majority of people drawn to this industry, they are a predator/abuser or under-qualified (not equipped to deal with many health conditions clients may present with).
Predatory people are seeking some sort of gratification because of their unhealed psyche (possibly due to their own trauma), and it is not always easy to spot them as they may come across as charming so it's important to recognise the signs.
I'm providing this guide to help you choose a genuine massage therapist, who provides an honest healing service, without an agenda. You see, in any health service - whether you see a doctor, dentist, counsellor, psychologist, psychiatrist, chiropractor, physiotherapist, acupuncturist or massage therapist (and so on), the therapist has implied authority - because the client/patient usually trusts that they are an expert in their field. Because of this power dynamic, sometimes when a client/patient feels uncomfortable about what a therapist is doing they neglect to speak up and say "no" or "stop" because they question whether their feelings are right, and whether they are overreacting. The other issue is the stress response kicks in "fight or flight or freeze" and unfortunately the response may be to "freeze" because of the shock of what is happening - the client's body can actually shut down and stop them from moving or they can faint - it is not under our conscious control which response we will have.
Occasionally there are reports involving so-called "massage therapists" abusing clients. This makes me angry, even with it being rare in this industry. Most often, these aren't fully qualified massage therapists but sometimes they are. The majority of properly trained massage therapists provide an important and very beneficial service, so it is frustrating and awful when an abuser is associated with my profession. The big issue here is that if a client has a bad experience they may never have a massage again because it can trigger their trauma. It takes trust for a client to receive a massage in the first place, especially if that client has ever been abused before or experienced any trauma. Therapeutic touch is very nurturing and healing and I would argue that those who have been abused before have an even greater need for it, but before that can happen there needs to be trust. Unfortunately if trust has been broken with one therapist the person is unlikely to seek out that same service with another therapist. I feel sad that the people who most need this service are then unable to bring themselves to experience it.
Signs of a Qualified Massage Therapist - first things to check for
A genuine massage therapist will:
Be Transparent about what they do
They will provide information of their services on a professional website, with an explanation of each service and what it is for. When you call, they will explain their services and together you decide if they are the right therapist for you. Tip: always be direct and advise what you need help with and ask if they have experience with it. If you have a health condition give the therapist an opportunity to offer you reassurance (or not) about whether they can still help you.
Note: I am a qualified oncology massage therapist and I sometimes get clients with serious health conditions (e.g. cancer, or heart condition) who advise me that another massage therapist incorrectly advised they can't be massaged at all. The other scenario that sometimes happens is the client goes to a cheap massage place (e.g. in a shopping centre) and receives a rough generic (not personalised) treatment which hurts them and now they are scared to have another massage. So if you have a health condition, sometimes you need to phone around before you find someone who can help you.
Evidence their Qualifications
I have my qualifications (Diploma Remedial Massage, Diploma Aromatherapy, Certificate Oncology Massage) listed on my website as well as displayed in my massage treatment room. Most qualified massage therapists will do the same.
Be registered with an Association
I belong to the Australian Traditional-Medicine Society who only accept people with professional qualifications to government vocational education standards. The association requires me to continue my professional education each year, follow a code of conduct including a vow to not cause harm, have a current first aid certificate, and have appropriate levels of public indemnity insurance. In addition, I'm only permitted to practice modalities I am properly trained for. All of these rules are in place to protect both the therapist and the client.
Continue Professional Education
Being in the health industry means that we massage therapists need to keep up to date with the latest research and training to ensure we are keeping up with industry standards and providing the most beneficial services. Therefore we will continue our education by attending courses, workshops, and reading research to expand on our skills and knowledge.
Work in a Clean Environment
I work from home and I provide mobile massage. However just because I work from home doesn't mean I'm unprofessional - I dress appropriately, and my massage clinic room is kept very clean, in line with industry standards. Fresh linen is used for every client and the massage table is cleaned between clients. These are minimum requirements. If you have visited a massage therapist who hasn't provided a clean environment then they shouldn't be working in the health industry. Infection control is very important.
Gain Informed Consent - advise you of the treatment plan including what areas will be massaged
Before you get on the massage table, the massage therapist should have taken your health history (should be quite thorough), discussed the reason for your visit, assessed your posture and condition (for remedial massage), and discussed which areas you would like included. Then they should advise you of their treatment plan. Only when you have consented to the treatment plan should the massage proceed.
Always Drape Appropriately
Professional massage therapists take draping seriously. We expect clients to wear underwear and we only uncover the area being worked on. We are very careful to maintain client privacy while they roll over, too. I only enter the room when the client is on the table with the towel or sheet covering them - this is normal practice.
Remain in their Scope of Practice
Simply put, we only practice what we are qualified for.
Be Experienced in Massage, and Care About You
As the client, you want to know that you matter. A massage therapist who is passionate about what they do will want to give you a wonderful experience, and work out your muscular tension. They will want you to feel relaxed too. In addition, if you have a health condition you will probably want to know the massage therapist has experience working with other people with a similar condition to know that you are in safe hands, quite literally! I mindfully massage my clients and I tailor their treatment to them. Additionally, I only work with people who I believe I can help.
Warning Signs: The Unsafe Therapist
1 - The Predatory Person
From time to time, in any health profession a person achieves the qualification (or maybe not, people can commit fraud by pretending to be qualified), who shouldn't be in such a profession because they are inclined to harm others and abuse their power. The instances of this are very low in the massage industry, however it does exist so it is good to be aware of the warning signs:
Photo by Isaac Castillejos on Unsplash
- They don't fit into the guidelines above. Especially if it's more than one thing. For example, an immediate deal breaker (i.e. grounds to walk out) is - if they aren't transparent about what areas they will be massaging before you get on the massage table. A professional massage therapist always gains informed consent.
- Your body tells you. I'm referring to your innate instincts, for example you meet someone and you get the instinct to get away from them - your body just knows. Listen to your body. Leave.
- They are unprofessional with you, or downright creepy! For example they cross a boundary or make an inappropriate joke, or they or their clinic is unclean/unprofessional. I have a few of my own stories, but I'll share just one. I went to a male massage therapist in 2015 who (because he knew I was also a massage therapist, and I tend to put people at ease) was telling me that his dad didn't respect his profession until one day his dad was helping him with some work doing up his clinic and spotted one of his clients - an attractive young woman. After the woman left the massage therapist's dad said something like "wow you get to massage women like that!", and he went on to say that he replied to his dad "Yes, I get to massage attractive women all the time". The massage therapist actually said this to me while I was being massaged by him. It was disgusting, completely unprofessional and frankly scary - I felt vulnerable and any relaxation that I had prior to that was now replaced with stress! If you've ever had a similar experience I'm sorry, and please understand that the majority of therapists aren't looking at clients this way at all. We are interested in affecting positive change in your muscles and nervous system. We maintain professional boundaries and we genuinely want to help you. We don't care what you body looks like, only that it is clean/hygienic for health and safety reasons.
- They insist that they need to work on an area you are not comfortable with. For example, if you don't want your gluteal muscles (buttocks) massaged and they go against your wishes. Leave. I never massage an area a client doesn't want touched.
- They ignore your request to stop. The request may be to reduce pressure, stop touching a particular area, or to stop the massage completely. If it is ignored they are assaulting you.
2 - The Under or Non-Qualified
There is another type of unsafe therapist - the person who is not qualified. Do you really want to trust someone with your body if they may do harm? Note that non-qualified massage therapists are, unfortunately, wide-spread. There are massage shops all over Brisbane for instance where the "massage therapist" (not a title they have earned) has had just a weekend or a couple of weeks of training. I'm not joking, I've seen the job advertisements for some of these places - they train the people themselves. They cannot possibly cover the content or practical experience covered in a 12 month + Diploma qualification.
Unfortunately, with massage being an unregulated industry, there's nothing to stop anyone calling themselves a massage therapist.
Be aware that when a person with a health condition goes to an under/non-qualified massage therapist, the therapist is lacking the anatomy, physiology and pathophysiology knowledge that a massage therapist sharing my qualification level knows. Therefore if a massage therapist treats a person with a health condition just like their fit and healthy clients, they may cause harm. Also, consider that really we all have vulnerable areas, no matter what our age or health status is, for example the neck and sometimes the spine so anyone can get injured by someone who doesn't know what they are doing and is rough or presses down on an area that should be handled carefully (there's lots of those areas on the neck - so you definitely want someone qualified treating you).
Here are some points to consider:-
- Some massage places offer the same routine to all clients and don't personalise your treatment. For example you purchase their "40 minute back, neck and shoulder massage" and they use the same pressure on you whether you are 20 years old or 60 years old and the exact same routine even though one person has lower back pain and the other has upper back pain. You get what you pay for - it is likely the person has limited training and knowledge. This is quite dangerous for people with a health condition - a rough massage could cause irreparable damage/injury. People especially at risk include: people with a serious health condition such as cancer (even if they had cancer years ago, there are lymphoedema risks), heart condition, the elderly or physically weak, anyone who has ever had a spinal injury or slipped disc or neck issues, or DVT, whiplash, kidney condition, and many other health conditions, including PTSD.
- If they don't take your health history please leave, this is a basic requirement in any health practice. Massage therapists need to know about your health history and current condition to treat you safely.
- There's a trend of people being massaged too firmly and the client may second-guess themselves and think that the therapist knows what they are doing. A properly trained therapist will check with you if the pressure is to your preferred level and adjust accordingly. If a person ignores your request to reduce pressure, you have every right to ask for the massage to stop.
- Another less obvious sign that you have an under-qualified practitioner treating you is a Health-fund provider number is shared amongst more than one therapist at a clinic. This is fraud. Each massage therapist is required to have their own number if they are providing health fund rebates.
Exceptions
As a separate note: I do believe there is a place for alternative healing and massage practices, and there are massage therapists who have only trained in a specific modality - for example Lomi Lomi or Kahuna massage. These modalities certainly have a place in the community and are appropriate for healthy individuals, seeking a relaxing treatment. Note however that these massage practices have different guidelines. Regardless of different practices, informed consent is always required - you don't have to go along with the usual routine - you can ask them to alter the massage to suit you and what you are comfortable with.
Trust, Safety and Respect Goes Both Ways
Sometimes we need to address the elephant in the room! Unfortunately massage therapy has been associated with another industry when in reality they have nothing to do with each other. It really frustrates me because at times I have been harassed for a service I don't provide. [Note: I can't risk using the "s" word or any related word, being that I don't want someone looking for those services to google the words and then think I offer it because my page would show up due to this article, but I'm sure you get the picture.] So to make it clear - massage therapy is a legitimate health service and has nothing to do with that other industry. Just because some people commit fraud by posing as something other than what they are, doesn't mean an entire industry should be associated with that illegal activity (it is illegal if not legally declared and licensed by the government).
As a massage therapist (and human being) I have every right to refuse treatment if a client or potential client makes me feel uncomfortable or unsafe. As with any health service - trust, safety and respect goes both ways. Boundaries are there for a reason - to keep the therapist and the client safe.
There are many wonderful massage therapists out there, and I have so many wonderful clients, who I really enjoy treating. It's those clients, who come to me because I make them feel better by reducing their pain, stress, anxiety and help restore them to back to a state of relaxation; who inspire me to keep providing a great restorative service. Massage therapy is such a beneficial and enjoyable treatment. I regularly enjoy receiving massages myself as it is my favourite way to reduce stress and muscular tension, and feel good.
If you live in Brisbane, I invite you to make an enquiry to check if I'm the right massage therapist for you, please call me: 0433 523 678. If I miss your call, please leave a message so that I can return it. I prefer to talk to prospective clients before I accept them to ensure we are the right fit. This is why I don't offer online bookings. When you come into my environment it is safe, and we will have already had a discussion prior to our meeting.
Thanks for reading.
- Belinda
References
For some research on the effects of massage therapy see the Touch Research Institute website: http://www6.miami.edu/touch-research/Index.html
Related News Articles
I provide the following news articles that demonstrate inappropriate behaviours and that many of the women involved felt frozen at the time of the abuse/assault. I'm very passionate about other people avoiding abuse and hope that the information I have provided will equip you with the confidence and knowledge to say "no" if a boundary is crossed, and to report it straight away. Most people will not need to worry about this as most massage therapists are honest, caring people but it is worth knowing and much of this advice applies to any health setting.
Information provided by Essential Restorative Massage is not intended to be a substitute for medical advice, diagnosis, or treatment. If you have a health condition or symptoms of one, please consult with your doctor before using complimentary remedies and therapies.
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