Key Points

• The massage profession continually deals with issues around sexual misconduct and harassment—from both therapists and clients.

• The Attention Button, produced by BEC Integrated Solutions, is an alarm system that can be used by therapists and clients to alert the front desk of an uncomfortable or dangerous situation.

• Implemented by the Hand and Stone franchise, the Attention Button has dramatically reduced reports of sexual misconduct and helped in medical emergencies.

The latest statistics show that 1 in 6 women and 1 in 33 men are sexually assaulted in the US every year. That translates to someone being assaulted every 68 seconds, or over 450,000 sexual assaults each year, according to the Rape, Abuse & Incest National Network (RAINN.org).¹ Sexual misconduct affects every profession, from politics and business to entertainment and health care. 

Based on my research and 20 years of experience as an expert witness, it’s easy to estimate that there are at least a thousand cases of sexual assault every year in the massage and bodywork profession. Most, though by no means all, are cases of male massage therapists assaulting female clients. In addition, almost all female massage therapists, as well as some males, have stories of a client who was sexually inappropriate with them. It ranges from sexual comments and requests to harassment and attempts to touch the therapist’s body. 

An innovative approach to address this serious issue is the Attention Button, a technology produced by BEC Integrated Solutions. This is a silent call button placed under the massage table that is easily accessible to both the client and the therapist should they need immediate help. It can be used any time if either feels uncomfortable or unsafe, or if there is an emergency requiring immediate assistance from the front desk. One franchiser has taken up the charge to use these buttons in all its locations.

Origins of the Attention Button

In 2017, Todd Leff, then CEO of Hand and Stone Franchise Corporation, had an idea he thought could make the massage experience safer. It was an alarm button installed under the massage table that either the therapist or client could use to call for help. 

The following year, after consulting with an industry expert, Hand and Stone began piloting these Attention Buttons. It began with its corporate-owned locations and gradually expanded to include spas across the country. 

Here is how it works. When the client or therapist pushes the button, a signal is sent to the front desk monitoring station and alerts staff which room is signaling for help. The front desk staff immediately go to that room, arriving within 15–20 seconds. They knock once and enter to help as needed.

The preliminary data from locations using the button showed a notable reduction of complaints of inappropriate touch. Word spread and other Hand and Stone spa owners began requesting Attention Buttons.

By 2019, about 250 Hand and Stone spas (approximately 50 percent of its locations) had the Attention Button system installed. Hand and Stone kept meticulous records of the number of complaints of inappropriate touch per 1,000 massages. Over the course of 12 months, Hand and Stone concluded that the number of complaints was reduced by 91 percent in the population of its spas that had installed the Attention Buttons compared to the chain as a whole. The deterrent effect was extraordinary. Based on this data, in 2020 the company made the installation of the Attention Buttons mandatory in all its US spas. The cost is about $2,000 per spa, which includes 10 massage tables and the transmitter module that connects to the front desk. Noting my work over the past 20 years helping massage clinics, spas, and franchise organizations reduce the incidence of sexual misconduct in the treatment room, I have consulted with Hand and Stone, and have seen firsthand the successful implementation of this safety protocol.

The presence of this button and the Hand and Stone executives’ concerns about safety have created a culture of safety awareness within the franchise. Front-desk personnel inform clients about the button, and signs are placed in the waiting room and on every massage table. Therapists are trained in how to inform clients about the Attention Button, including showing them where it is and how to use it. The use of this technology has had three effects: deterrence, emergency response, and reduced misconduct.

1. The Deterrent Effect

With the button, therapists know they can call for help if a client is inappropriate or sexually harassing them. Clients also know this. The presence of the button, even when not actually used, has a strong deterrent effect. Since the installation of the Attention Button, several Hand and Stone spas have reported significant reductions in complaints of inappropriate behavior by clients. One spa reported there have been no complaints since the button’s installation.  

2. Lifesaving Responses in Medical Emergencies

When there is a medical emergency, the Attention Button has proven to be lifesaving. For example, the button recently facilitated a rapid response to a client in Sarasota, Florida. When the therapist realized her client was having a stroke on the table, she immediately pressed the Attention Button. The assistant manager rushed to the room and quickly called 911. An ambulance was there within 5 minutes. 

In cases of stroke, seconds count. If there was no button, the therapist might not have been able to leave the room or act quickly to get help. The Attention Button made a huge difference. The client has almost fully recovered and is grateful for the staff working together to contact the first responders so quickly.

In October 2022, at a Hand and Stone spa in Washington State, a massage therapist had a severe reaction to a change in medication while turning over the room to get ready for the next client. Suddenly, he felt so dizzy he couldn’t walk or talk. He did a military crawl to the table and pushed the Attention Button. The front desk associate came into the room within 20 seconds. The therapist could barely speak, so he pointed in the direction of the ambulance service next door to the spa and mouthed “Help.” The associate sprang into action and had paramedics there within minutes to take him to the emergency room at a nearby hospital.

3. Drastic Reduction of Sexual Misconduct 

With such a high reduction in complaint numbers, the Attention Button has proven to be a success for Hand and Stone, as well as for its therapists and clients.  

In order to reduce sexual misconduct across the country, Hand and Stone hopes other spa franchise organizations, day spas, and massage clinics install this safety technology in their massage rooms too. “Increased safety is good for the whole profession,” says Hand and Stone Chief Experience Officer Cindy Meiskin. 

With the addition of the Attention Button in every Hand and Stone spa in the country, the hope is that therapists who are sexual predators or individuals with poorly developed boundaries will decide to leave the company or choose to not apply.

Practitioner and Client Communication 

Meiskin says the Attention Button has been positively received by Hand and Stone staff, and has the added benefit of protecting them from potential false claims. “They understand and appreciate it.” 

When asked about client receptivity, Meiskin says it’s been very positive. “They appreciate the underlying mission.” Hand and Stone communicates the presence of the Attention Button to clients through several touch points: a service orientation form delivered pre-session much like doctor forms before an appointment (“I understand the table is equipped with an Attention Button”), verbally during the intake process (“If for any reason you need to push the button, someone from the front desk will come back immediately”), and on signage in the lobby and on the massage table. 

Future Developments Underway 

In addition to the Attention Button, Hand and Stone is part of additional efforts to improve safety and security. The franchise is piloting a national “mystery shopper” quality-control program. At participating spas, therapists are visited by an experienced therapist to check that their safety and security procedures are being properly implemented. In addition, Hand and Stone is also a founding member of the National Association of Spa Franchises (NASF), which implemented a nationwide employment verification system that aims to prevent therapists terminated for breach of safety protocols from moving to the other participating spa brands of the NASF (see National Association of Spa Franchises).  

Creating Safety for Your Clients

The Attention Button does three important things never done systematically before: It protects clients from predator therapists, protects therapists from inappropriate clients, and provides lifesaving reaction time in cases of a medical emergency.

 If you work in a spa or clinic, have the conversation about the Attention Button with your employer. It is of utmost importance that the massage treatment room is a safe place for all who are present. 

Note

1. Rainn.org, “About Sexual Assault,” accessed March 2023, www.rainn.org/about-sexual-assault.

Resources

• “Mobile Massage Practice Safety,” by Michelle Roos, Massage & Bodywork magazine, March/April 2022, page 44, www.massageandbodyworkdigital.com/i/1451559-march-april-2022/46.

• “Mobile Massage with Michelle Roos,” The ABMP Podcast, January 11, 2022, www.abmp.com/podcasts/ep-187-mobile-massage-michelle-roos.

• “Respect Massage: Create a Zero-Tolerance Practice with Joyce Gauthier,” The ABMP Podcast, March 1, 2021, www.abmp.com/podcasts/ep-80-respect-massage-create-zero-tolerance-practice-joyce-gauthier.

Franchises Work to Keep MTs, Clients Safe

Massage & Bodywork reached out to other national massage franchises for their feedback about the Attention Button concept. Here are their responses: 

“The Elements Massage brand is committed to creating a safe, empowering, and wellness-oriented environment for everyone who interacts with the brand, including clients, massage therapists, and franchisees. The Elements Massage brand has always championed safety as its No. 1 priority and the brand is continually evaluating best practices, considering new safety measures, and connecting with franchisees on this important topic. Joining the National Association of Spa Franchises was another step toward creating a safer environment. By working together as industry leaders, the association can quickly scale best practices and continue to focus on minimizing risk.” 

“Massage Envy is committed to promoting a safe, professional, and comfortable environment for guests, members, and service providers of the approximately 1,100 independently owned and operated franchise locations. We pride ourselves on our industry-leading safety practices and will continue to evaluate ways to further enhance or support our policies.”

What About Solo Practitioners?

Practitioners not affiliated with a massage franchise or clinic may be left wondering, “That’s great, but what about me?” Author Joyce Gauthier penned an article titled “Security Systems for Therapists” on RespectMassage.com. When asked how a massage therapist can protect themselves and their practices, Gauthier writes: “A monitored security system is like having another person with you in case of an emergency. We can do our best to screen clients, but sometimes sexual solicitors can slip through the cracks. An affordable security system is another tool you can have to protect yourself.” In the article, Gauthier breaks down the pros and cons of several personal security systems. The primary difference between these systems and the ones used by Hand and Stone in this article are that instead of calling a front desk of a spa, they directly phone the authorities. To read the article in full, visit bit.ly/3JOeMWz.

ABMP is the owner of RespectMassage.com, a website created to protect massage therapists from sexual solicitors. The mission is to educate and empower massage therapists so they can easily spot, deter, and escape from clients who are exhibiting inappropriate or illicit behavior. 

National Association of Spa Franchises  

Setting competition aside for the good of the profession, several franchise organizations came together in 2019 to address two of the largest issues in their purview: safety and recruitment. Safety quickly became the dominating concern. The group was inspired by an article about ride share competitors Uber and Lyft developing a shared database called the Sharing Safety Program designed to expose abusive drivers. The database flags and shares information between organizations so that drivers who have been disciplined are not rehired by the competing group.

From this idea sprang the creation of the National Association of Spa Franchises (NASF). Its first mission was to create the Employment Verification System (EVS) to prevent massage therapists who have been fired, or who resigned after being sexually inappropriate with a client, from being rehired.  

Member organizations can submit a search request via the EVS to determine if a potential employee was terminated or resigned because of inappropriate conduct with a client at a previous job. For a nominal annual fee, the EVS screens applicants through a third-party company called Crimcheck. 

There are at least 40,000 massage therapists employed by massage therapy franchise organizations in the US. In the first eight months of operation, over 10,000 EVS searches were performed by the NASF member organizations, which resulted in flagging 12 therapists who had a history of being terminated for inappropriate conduct. 

Five franchise organizations are currently members of the NASF: Elements Massage, Hand and Stone, Massage Heights, Spavia, and Woodhouse. The NASF hopes all massage franchise companies—as well as large and small privately owned massage clinics—join the NASF to help protect both the public and the massage therapy profession.  

For more information, visit nationalassociationof spafranchises.com.