The Therapeutic Relationship for Massage Therapists

The therapeutic relationship is the relationship that occurs between a massage therapist (or other provider) and the client. The focus of such a relationship is totally on the client at all times but challenge can and will arise. Understanding the dynamics of the therapeutic relationship can help you in determining how best to handle each situation. It is an ongoing process of learning and interacting while becoming more aware of your own issues that also come up in each situation.

To begin with understanding the concept of the power differential that occurs between a client and the massage therapist and the resulting transference and countertransference process that occurs. The massage therapist is perceived as knowing more and people look to the massage therapist for help. In every type of 'helping' relationship that I can think of the power differential occurs. From the moment a client even thinks about calling for a massage, the cycle begins. When people are looking for services to make them feel better, it can bring up unresolved issues from childhood. It is as if the parent/child relationship is recreated all over again. (Read more on the Therapeutic Relationship.)

What preserves the massage therapist/client relationship is boundaries and knowing who your ideal client is to begin with. Boundaries are often confused with barriers. Boundaries are actually part of every type of relationship. Boundaries just let you know where you begin and end and where the other person begins and ends. They protect your values from being compromised which is one of the biggest causes of burnout in the profession and other helping professions. They will let you know when to say yes and when to say no. Saying yes or no is not always easy with the many factors involved in running a business while working with clients.

Challenges for the Therapeutic Relationship

The therapeutic relationship will be challenged constantly throughout the massage therapists career. Some of these challenges include:

• Becoming friends with clients (actively or passively becoming friends with clients and seeing clients in social situations outside of your massage business or job.

• Being asked out on a date by the client or asking the client for a date or inappropriately touching a client during a session.

• Having a client ask for sexual favors on the massage table or to meet later for sexual reasons.

• Getting involved in other dual relationships with client such as trading for services (accounting, gym memberships, dental work, auto repair etc)

• Wanting to share personal details about your life with a client and a client sharing more personal details about their life.

• Being asked for discounts or special monetary favors by the client.

• Giving away your massage sessions at the cheapest rate in your area thinking it will get you more clients.

• Being asked to become a member of a clients group or organization

Creating Boundaries through policies and procedures and knowing your self and your values.

The way to protect and preserve the therapeutic relationship is by creating policies and procedures that support your values as a massage therapist and person. It is in creating and maintaining boundaries that will support you and the client in during the interactions that occur starting even before the client thinks about calling you for an appointment or information. Maintaining professional boundaries can actually help the person to heal on their own which is the key to the therapeutic relationship.

Setting boundaries around touch and things like fees and cancellation policies are the beginning of creating the container for the therapeutic relationship. When a client clearly knows where they stand they can then feel more relaxed and safe. It can also make it easier for the massage therapist to practice presencing with the client and using active listening skills to deepen the relationship with the client. This client/massage therapist is actually the place where healing happens for both parties.

Learning about and working with the therapeutic relationship is best done in supervision and in peer supervision groups. Working with a skilled supervisor or peer support group can help you build the foundation for building a successful massage business.

See more on massage therapist boundaries

More on the therapeutic relationship

Resources for understanding and working with the therapeutic relationship

Supervision is one of the ways to get help in understanding and working with the concept of the therapeutic relationship.

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