Confusion. Ethics. All that jazz.

About LMT or Bust

2 Comments By Kat on October 8th, 2010

Confusion. Ethics. All that jazz. (Part 1)

Category: rants, Tags: boundaries, business, community, ethics, more than massage, personal, self-study

Massage therapy ethics and why they confuse the crap out of me:

Confusion #1: Scope of Practice

I don’t talk much about my day job, but today I will.

I work for a pretty cool company that provides work-life solutions for corporate clients, mostly in the form of onsite childcare. The short version is, I hang out with two-year-olds professionally. There’s a lot more to it than that, but that’s the fun part. And it is fun, most of the time. And rewarding.

Skip to one of the rewarding bits: I got to make a real difference in the lives of two cool kids. Recently, a parent of one of my students spoke to me regarding his hesitations about raising his children bilingual. He was worried about confusing them and messing up their grasp of English. I’m not a linguist (although I am married to one!), but I’m a child development specialist, and I’ve read the studies about multilingualism in young children. I shared what I knew about the most effective techniques for raising bilingual kids, and encouraged him to give it a try.

They’re doing it. And these children’s lives are going to be changed forever. Their brains. Their employment prospects. Their worldview. Their family relationships. Their understanding of their dad’s culture. And I’m crazy thrilled to have been a part of this shift for their family.

Was this within my scope of practice?

Right now, I’m expected to weigh in on ANYTHING parents might ask me about. Got questions about nutritional requirments? Biting and aggression? Ear infections? Potty training? Birthday presents? I need to offer answers. And if I haven’t researched these things already, it’s considered bad practice if I don’t offer to look into the matter, and offer information with a healthy dose of my own better judgment.

But I’ll be a massage therapist soon.

And all of a sudden I’m supposed to quit knowing things. It doesn’t matter that I’ve got a solid grasp of nutrition. I’m not a nutritionist, so I need to shut up. Are you trying to figure out how you’ll ever fit an exercise habit into your family life? Tough nuggets, ask your life coach or personal trainer. Who cares that I’ve helped people figure these things out before?

I get that there are power differentials between a client and a massage therapist. But how can I pretend the fact that people come to me every day for parenting advice when I’m not even a parent is not indicative of a sort of power differential, too?

“Hey, I’ve noticed you’re always wearing your shoes on the wrong feet! Maybe that’s related to your joint pain.”

Okay? Not okay? I never learned it in school, but it’s pretty stinking obvious.

“Hey, I’ve noticed the soles of your running shoes are really worn down. Maybe that’s related to your joint pain.”

How about that? It’s a little more technical, plus I’m not a runner. But we DID talk about it in school, as an aside.

“Hey, I’ve noticed you claim to eat nothing but potato chips and pork rinds all day. Maybe that’s related to your joint pain.”

I have a fair bit of personal experience and am aware of both the scientific literature and anecdotal evidence showing links between chronic pain and nutrition, especially related to food sensitivities. But that has nothing to do with massage.

Where does scope of practice meet common sense? What about personal knowledge and experience? Ideas?

This thing grew freakishly huge as I went through the process of writing and reflection, and so became Part 1 of a two-part series. Check out Part 2 for more consternation from yours truly!

2 Responses on Confusion. Ethics. All that jazz. (Part 1)

By phil at October 11th, 2010

I believe that the best therapists have a good balance of educative and interventional skills. The protocol, whether it be soft tissue, energy work or bone-based is just a toolbox. In twenty years of practice it’s been my abilities as an observational detective that have saved many a day. But, as you rightly say, what should be the limit of my offering on that level?

I’ve tried to restrict my observations to those issues around fundamental operational principles of the human ‘system’. Encouragement of verticality, relaxation, lateral balance, the importance of good breathing, the relationship with gravity, the work-rest balance, the importance of stating one’s needs – things that I would apply to my own life as a matter of course. I always trust that if these fundamentals are brought into awareness, the human system knows full well how to organise itself optimally thank you very much.

And I always suggest that people ‘do this’ (always offering reasons why this is sound advice), and not that they ‘don’t do that’.

It’s being aware of the ‘stinking obvious’ in the presence of people who over-complicate their lives that will turn you into a bodywork magician.
By Rebecca Brightly at October 12th, 2010

“And all of a sudden I’m supposed to quit knowing things. It doesn’t matter that I’ve got a solid grasp of nutrition. I’m not a nutritionist, so I need to shut up.”

Yeah, I don’t really agree with this. Sure, a lot of LMTs need to shut up about things they don’t understand very well, but it’s actually common knowledge that you should eat more veggies, or that you should get various kinds of exercise.

If you don’t have a year of education in nutrition or the like, you probably shouldn’t give specific advice. But if your client comes in and says, “Man I’ve been eating too much McDonalds,” there’s no reason you can’t have a conversation around that, as it relates to how their body feels on a daily basis.

Personally, I recommend specific books to read or refer to nutritionists or personal trainers that I know and love.

Bottom line: Give advice that lies WELL within your training (massage and non-massage). Don’t recommend things that aren’t supported by research. Refer out to trusted peers who will refer back to you. And recommend books or other info sources!