How do you know if the client’s behaviour is abusive? We break it down using two case scenarios. See the definition in CMTO’s Standard of Practice Glossary as well.

Case Study 1: Sexualizing the Relationship

Case Study Summary

During Massage Therapy treatment for chronic low-back pain, a client makes an explicit request for a sexual act from the RMT/MT. This shocks the RMT/MT, and they decide to immediately stop treatment, state the request was abusive and unacceptable, and leaves the room to ensure their safety. The client is discharged from care immediately. When the client asks for a referral to another practitioner for more low-back pain treatment, the RMT/MT directs them to CMTO’s Public Register.

CMTO’s Perspective

The client’s behaviour in this case is classified as sexual abuse. It sexualizes the therapeutic relationship, violates the RMT’s/MT’s professional boundaries and right to a safe workplace. CMTO’s Standards of Practice empower RMTs/MTs to immediately discharge clients for such actions without notice. If additional treatments are needed, a referral to CMTO’s Public Register will meet the requirement for referral.

Key Takeaway

Massage Therapy is clinical healthcare. Explicitly sexualizing the relationship is abuse, not part of care, and justifies immediate discharge.

Case Study 2: Poor Hygiene

Case Study Summary

A client arrives for an appointment with a strong, offensive body odour that makes the treatment difficult. The RMT/MT, while finding it unpleasant, understands they cannot discharge the client for this reason. The RMT/MT asks the client questions to better understand the client’s background and needs; and assesses whether additional measures are needed in the practice setting to provide safe and effective care.

CMTO’s Perspective

The client’s hygiene is not abusive behaviour. Poor hygiene may be unintentional, and/or linked to health or social factors, but is not an abusive act against the RMT/MT. Abusive client behaviour threatens or violates an RMT’s/MT’s safety, dignity, or professional boundaries.

Key Takeaway

Address the issue with sensitivity and professionalism, using additional measures in the practice setting, if necessary. It requires empathetic communication with the client, and may require additional measures in the practice setting, but it is not a reason to discharge the client.