Post-Termination Relationships

Legislation and Policy

The Regulated Health Professions Act, 1991(RHPA) prohibits sexual contact between clients and their treating healthcare practitioner. It also prescribes a mandatory penalty of revocation of a member’s certificate of registration if he/she is found guilty of this offence.

In addition, it places a mandatory obligation on regulated health professionals to report incidents of sexual abuse between clients and professionals that comes to their attention in the course of practising their profession. The College has adopted a philosophy of zero tolerance with respect to sexual abuse of clients by its members. Practitioners who violate this policy will be prosecuted.

Position

The College advises that Massage Therapists should not enter into in a sexual relationship with a former client for a period of one year following the date of the last professional contact with the client. This means that a Massage Therapist may not initiate or respond to any client-initiated invitation to begin a sexual relationship.

Guidelines

The College recognizes that a variety of factors need to be considered before deciding when or if a post-termination relationship can commence. These include:

  • Determining whether a personal or professional relationship exists with the individual; and
  • Evaluating the nature of the treatment provided, the duration of the professional relationship, and the location of the practice.

In some situations, it may never be appropriate for a post-termination relationship to develop (such as cases involving fragile or vulnerable clients).

Key Factors in Assessing the Therapist/Client Relationship

1. Clarification of the Type of Relationship

A client is any individual who attends upon a Massage Therapist to receive therapeutic services. The client may be a member of the public, another regulated health profession or another Massage Therapist.

A client encounter may include, in addition to treatment, some or all of the following: the taking of a case history, the establishment of a treatment plan, the maintenance of client records, and the charging of a fee for services rendered. The providing of services on a voluntary basis or the exchanging of services with another healthcare provider, does not in and of itself, make the relationship personal and therefore, does not remove the obligations inherent in the therapist/client relationship.

Massage therapists must make clear distinctions between those individuals with whom they have personal versus therapeutic relationships. These are known as a “dual relationships.” An example of a dual relationship is a Massage Therapist who also provides Massage Therapy to a family member.

2. Nature of the Treatment

The context in which Massage Therapy services are offered varies greatly. Clients who receive Massage Therapy treatment to relieve the aches and pains associated with sporting activities may be very different from clients who receive treatment for stress management as an adjunct to counseling. Some clients who attend for treatment will have a history of previous sexual abuse. This fact may or may not be disclosed to the therapist. Massage therapists, therefore, need to assess the vulnerability of their client when contemplating a post-termination relationship.

3. Location of the Practice

Massage therapists who work in small communities may be required to provide healthcare to the entire population. It is not the intention of these guidelines to prohibit the Massage Therapist from having a social life.

4. Duration of Treatment

A single or irregular professional encounter with a client does not develop the same intensity of relationship as a long-term, ongoing professional relationship with a client.

Scenario

Susan operates a Massage Therapy clinic close to a large university teaching hospital that runs an alcohol and drug treatment centre. Clients are often referred to Susan’s clinic for treatment to assist them with stress management and helps them deal with muscular-skeletal aches and pains associated with withdrawal.

John began attending for treatment twice weekly. He was pleased with the results he received from treatment and told Susan that he appreciated both her technical skills as a Massage Therapist and the attentive way that she listened to him. He advised her that in the past people had not responded to him in a positive way.

After a couple of weeks of treatment, John began arriving with a cup of coffee for Susan. Soon after, he started to give Susan small personal gifts. Susan began to get uncomfortable with the interest that John was showing in her. Susan found John to be very attractive and personable but recognized his vulnerability at this stage in his treatment process.

At the next visit, John asked Susan out for dinner. Susan thanked John for the invitation and declined. She spent some of the treatment time talking to John about the client/ therapist relationship, the prohibitions on personal involvement and the reasons for these rules.

John appeared satisfied that Susan’s refusal was not a rejection of him personally and continued to attend for treatment.

Conclusion

Susan’s response to John was ethical and professional. She recognized that John was at a vulnerable stage in his life and had misinterpreted Susan’s interest in him as being of a personal rather than a professional nature. Susan realized that this had much to do with John’s difficulty with personal relationships in the past. She was able to clarify the nature of their relationship without offending John.

 

Adopted: June 14, 1996 
Amended: April 28, 2000 
Amended: May 25, 2007