Guidelines for Practice
Communication
* Massage therapists will accurately inform patients/clients, other health care practitioners and the public regarding the scope of their discipline and will represent their personal qualifications honestly, including education, experience, and professional affiliations upon request or in advertising.
Providing Treatment
* Massage therapists will have a sincere commitment to provide the highest quality of care to those who seek their professional services, and will provide only those services which they are qualified to perform.
* Massage therapists will provide treatment only when there is a reasonable expectation that it will be advantageous to the patient/client. The therapist will acknowledge the limitations, precautions, and the contraindications for their practice, and will refer patients/clients to other licensed health care professionals when the patient's/client's needs are outside of the therapist's scope of practice.
* Massage therapists will conduct their business and professional activities with honesty and integrity, and will act with respect toward colleagues, including all other health professionals.
* Massage therapists will avoid any interest, activities, or influences which might conflict with their obligation to act in the best interest of their patients/clients.
Confidentiality
* Massage therapists will safeguard the confidentiality of all patient/client information, including patient/client records, unless disclosure is required by law or court order. Any situation which requires the revelation of confidential information should be clearly delineated in records of massage therapists.
Consent
* Massage therapists will respect the patient's/client's right to an informed and voluntary consent for the release of patient/client information. Massage therapists will obtain and keep a record of the informed consent of the patient/client, or, in the case of a minor, of the person in parental responsibility before releasing information, unless required by law to do so.
* Massage therapists will respect the patient's/client's right to refuse, modify or terminate treatment, regardless of prior consent for such treatment.
* Massage therapists will not cause the patient/client more pain than the patient/client is willing to accept, nor will they exert any psychological pressure to induce the patient/client to accept a level of pain higher than the patient/client has expressly agreed to experience.
* When massage of breast tissue is therapeutically indicated, the female patient/client must be fully informed and give consent before the therapist undrapes the breast for treatment.
Boundaries
* Massage therapists will respect the patient's/client's boundaries with regard to privacy, exposure, emotional expression, beliefs and reasonable expectations of professional behavior. Therapists will respect the patient's/client's autonomy.
* Massage therapists will avoid exerting undue influence on patients/clients and will never engage in sexual behavior during the course of the professional relationship. The therapist should not engage in sexual conduct or activities, even if the patient/client attempts to sexualize the relationship.
* No manipulation of the genital areas is permitted, even at the patient's/client's request.
Immoral Conduct
* Massage of genital areas and massage of a patient/client who is not properly draped for massage shall be considered immoral conduct.
* The practice of massage by a massage therapist who is not properly dressed shall be considered immoral conduct.
* Draping includes methods used by a massage therapist to protect modesty, privacy, warmth and/or comfort of a patient/client by the use of sheets, towels, blankets or any item that serves this purpose.
Discrimination
* Massage therapists do not discriminate in providing services to patients/clients based upon culture, ethnicity, age gender, belief, or sexual orientation. Massage therapists may, however, restrict their practice to specific age, gender groups, or to specific conditions as long as this is consistent and not arbitrarily applied.
Hygiene
* Massage therapists will maintain their premises, including supplies, in a sanitary manner. This includes adherence to techniques of communicable disease control (universal precautions).
Competency
* Massage therapists are expected to maintain competency in their practice. This can be done by taking continuing education classes and workshops, and by the independent reading of research and technique materials.
* Massage therapists will not practice under the influence of prescription medication, over-the-counter medication, alcohol, drugs or any other illegal substances which can impair their functioning.
Precautions for Massage/Bodywork Therapy
The following precautions should be observed by Massage/Bodywork therapists when conducting their practice.
Massage/Bodywork therapists should not treat a patient or client:
* When the therapist or patient/client is in an altered state of cognitive awareness from the use of prescription, and/or over-the-counter medications, alcohol, or other substances, and the patient/client cannot give informed consent and/or the therapist cannot provide appropriate treatment. Consent for the patient/client may be given by guardians and other caregivers when authorized to do so.
* If a patient/client refuses to give the therapist consent to confer with his or her health care practitioner regarding massage/bodywork therapy when such consultation is essential to the patient's/client's health and safety, the therapist should not treat the patient.
Massage/Bodywork therapists should use caution in treating a patient or client:
* When the therapist or patient/client has a fever or contagious disease
* If the patient/client is on any medication that would be expected to weaken bone structure and/or connective tissue or lead to enhanced bleeding
* When the patient/client has edema due to chronic heart failure or kidney failure
* When the patient/client has decreased sensation, as for example, with diabetes
* If the patient/client has an inflammatory condition in the acute stage
* When the patient/client has acute phlebitis and/or deep venous thrombosis
* When the patient/client has had an acute trauma or recent surgery
Practitioners should observe these guidelines:
1. While massage of splint muscles around a swollen joint is appropriate, direct pressure to the joint itself should be avoided.
2. Avoid the local site of unstable fractures, open wounds, hematomas, varicosities, recently healed scars, burns, and foreign bodies or implanted hardware.
3. In the first trimester of pregnancy, no deep sacral work or abdominal massage should be done.
4. If the patient/client has cancer or other tumors or has acute or chronic infection in the skin or deeper tissues, seek the recommendation of the patient/client's physician or nurse practitioner after obtaining the consent of the patient/client.
5. If the patient/client is overheated due to hot tub, sauna, or exercise, apply appropriate techniques.