As we approach the end of the year, those Best and Worst lists are cropping up. Here are my thoughts on some of the most, least, best, and worst when it comes to working within our professional boundaries.

Most Frequent Complaint from Clients

Massage therapists talk too much.

Over the years, the most common complaint I’ve heard from an unsatisfied client is that the therapist yammered on about his or her personal life or opinions during the massage.

Remember, clients can’t listen to us and fully relax at the same time, and their relatively passive, dependent state makes it hard for them to speak up when we’re bugging them. They want to stay on our good side, and they’re afraid of offending us. Even normally assertive clients are reluctant to gripe in those circumstances, and rather than complain, they just won’t come back.

Talking too much is an easy mistake to make. Our work is relatively isolated and we don’t always have the interaction with colleagues that we would have if we were working in another setting.

Try to build enough social time into your life so you’re not tempted to use clients as a captive audience and put them in an uncomfortable position.

Most Important Skill You Probably Weren’t Taught in School

Set limits gracefully.

Your ability to say no—whether it’s to the client who wants an unreasonable discount, the one who shows up 30 minutes late and wants a full hour, or the one who wants to turn the session into a date—is crucial to a healthy practice. If you’re too wishy-washy, you end up resentful and burned out. Too hard-nosed, and you may alienate clients. 

To set limits well you need to educate clients from the beginning about your policies concerning fees and time. Having new clients read and initial a list of your financial and other agreements is helpful. It’s not fair to try to hold them to a rule that you haven’t made clear ahead of time.

If you have to lay down a boundary, you don’t want to sound like a scolding parent or a whining child. Don’t make personal remarks about clients such as, “You’re always late.” Also, avoid justifying your rules, “I have to make a living too, you know.” Be more professional. Speak in terms of “my policy,” as in: “It’s my policy not to go over the time we already scheduled.” Be fair, be clear, and be friendly. “I’m sorry, but, as you know, my policy is to charge if you cancel without giving 24 hours’ notice.”

There’s no need to be rigid about it, either. You can give a client some leeway when there are emergencies. Be sure you’re comfortable making that allowance and not just feeling intimidated by the client.

Remember, clients feel safer when the boundaries are clear, so you’re doing them a favor too.

Least Desirable Line to Cross

Having a dual relationship with a client.

Working with people with whom you have another type of relationship often seems so convenient. But having friends or family members as clients or bartering for sessions can often become a complicated mess that you end up regretting. It’s a good idea to give careful thought to what could go wrong before you enter into a dual relationship.

All dual relationships require that both you and the client go back and forth between two different roles—and that can be confusing. Friend Bob may take you for granted, showing up late and not wanting to pay full price (especially if you practiced on him for free while you were in school). Or you may have trouble taking care of friends and family as well as you do other clients: you may want to turn their sessions into social visits and forget that they need quiet time and the same considerations as other clients.

Occasionally, dual relationships work well. If you are determined to try one (or you live in a small town and can’t avoid them), it’s a good idea to spell out the expectations beforehand. For instance, tell your friends you’ll treat them as you do regular clients and not use the hour for catching up on personal news. Let them know your usual expectations about late arrivals or cancellations and fees. Set up barters on a one-time or short-term basis to give you a chance to see whether they will really work for you.

Best Way to Impress Clients

Be a good listener.

You may think you need to dazzle clients with your encyclopedic knowledge of anatomy. While those are great assets to have, you’ll find that, for clients, simply being heard and being listened to with acceptance and compassion can be deeply impressive and profoundly healing.

Listen to the reasons they came to you. What is their chief concern? What words do they use to describe it? If they want to unwind by talking about their lives, listen to that. Usually what they talk about isn’t random. The problems that come to mind while their muscles are being loosened are often the problems that caused the muscles to tighten in the first place, so it can help clients to talk about them. You don’t need to be a therapist (and it’s better not to try) and you don’t want to distract them by engaging in a detailed conversation with them. All you have to do is make sympathetic noises to indicate that you’re listening.

Avoid telling a client to be quiet. Some people unwind by talking about their day-to-day problems. If you notice a client getting tighter as she talks, you can point that out to her by saying, “It’s fine if you want to talk, but notice how tense your shoulders are becoming.” Or if you think a client is talking because she thinks it’s rude not to, you can say, “This is your time for yourself, so feel free to drift away and quiet your mind during this time if you want.”

Least Comfortable Admission

You can’t be all things to all clients.

Part of your job is knowing when to refer out: knowing when a client needs someone with more technical skill, a different method, or a practitioner he or she might click with better. You may really like the client but not have the skill he needs. Or your work with this client may be fine, but in addition, he or she needs a trained counselor or some other kind of help.

And when you’re referring a client to a counselor or suggesting they see a counselor, be careful that the client doesn’t feel rejected or demeaned. Try, “I enjoy working with you and I hope you will continue to work with me. However, you’ve reported feeling depressed (overwhelmed, sad, anxious) for several months and I wonder if you’d also like to talk with a counselor. It’s up to you, but I have some names of people who have good reputations if you want them.”

Worst Boundary Mistake

Sexualizing your work.

Without a doubt, sexualizing your work is potentially the most destructive boundary mistake you can make. These types of behaviors range from flirting, dressing seductively, and dating clients to the most destructive act of being sexual with a client during a session.

Nothing hurts your reputation more than being linked with sexually inappropriate behavior. And no rumor travels faster or sticks with you longer than a sex-related one. Compare, “She’s late for her sessions,” with, “She dates her clients.” Which one are you more likely to remember and repeat?

In addition, nothing hurts the reputation of the profession more. It reinforces the persistent and erroneous public image that massage therapists offer sexual services. Nothing will bring more hostility from your colleagues. 

And no violation is potentially more destructive to clients. Because of your role as the caring massage therapist, clients will feel affection toward you. Some will even develop a crush on you. Most of the time they do not want an equal, real-life relationship with you. They want you to keep being that all-caring nurturer that you are during a session. It’s a mistake, an ethical violation, and possibly an illegal activity to try to turn a vulnerable client’s affection into a romantic or sexual relationship.

Worst Aspect of Your Job to Neglect

Self-care. Self-care. Self-care.

Taken a vacation lately? Sometimes you can’t afford not to take some time off to recharge your batteries. Even a weekend away can help clear your mind.

Make sure you take care of your own body. How long has it been since you’ve had a massage? For the next one, instead of going to the same old predictable buddy, you might try someone you haven’t seen who has a great reputation. You’ll get good work and learn something new.

Make sure you have enough professional support. Go to a conference and get re-inspired or just get together with other massage therapists for an informal gathering. Call a favorite teacher and see if you can take her to lunch and get a fresh perspective on some of those problem clients. Remember that investing time, energy, and money in yourself pays off.

Best Feeling

A full appointment book.

Looking at your appointment book on Monday and seeing a week full of clients you love to work with,

Or . . . seeing the client who came in looking glum and harried walk out the door with a smile on his face and a spring in his step.

Or . . . insert an example from your practice here ___________.

Maybe you have some categories or examples from your own experience to add to this list. We’d love to hear from you. You can e-mail your additions to editor@abmp.com.

 Nina McIntosh combines more than 20 years of experience as a bodyworker with her previous years as a psychiatric social worker. She is the author of The Educated Heart: Professional Boundaries for Massage Therapists, Bodyworkers, and Movement Teachers. To learn more about professional boundaries and ethics, visit www.educatedheart.com.

  To learn more about illustrator Mari Gayatri Stein, visit www.gypsydogpress.com.