Draping and Physical Privacy (Standard)

Standard of Practice: Draping and Physical Privacy

Bolded terms below are found in the Glossary.

Client Outcome

The client is effectively covered by clothing and/or draping for their comfort and safety and to maintain appropriate boundaries and help prevent boundary crossings and boundary violations.

Registered Massage Therapist Outcome

The Registered Massage Therapist (RMT) protects client physical/personal privacy and safety and maintains appropriate boundaries by effectively using physical barriers.

Requirements

The RMT must:

1. Obtain the client’s informed consent (consent) prior to conducting an assessment, providing treatment or modifying a treatment plan. Consent must include a discussion with the client about the following six elements:
   1. the nature of the treatment;
   2. the expected benefits;
   3. risks and side effects;
   4. alternative courses of action;
   5. likely consequences of not having treatment; and
   6. the client’s right to ask questions about the information provided and that assessment or treatment will be stopped or modified at any time at their request.

Draping/clothing are important tools to distinguish areas of assessment and/or treatment. Secure and effective visual and physical boundaries are essential to protecting the client from boundary crossings and violations. The RMT must:

2. Always drape the client, unless the client arrives for assessment and/or treatment in clothing suitable for their assessment and/or treatment and prefers to remain clothed.
3. Meaningfully engage the client in a discussion about the options for draping and clothing for assessment and/or treatment, considering each client’s unique needs, views, preferences and concerns (in line with a client-centered approach).
4. Explain to the client how to best prepare for assessment and/or treatment, including how to position themselves.
5. Explain to the client clearly what part of the body the RMT intends to assess and/or treat, and discuss whether the touch will be directly on skin or through a cloth barrier (for example, a sheet or the client’s clothing), and continuously monitor the client for change in consent and comfort throughout assessment and/or treatment.
6. If assessing and/or treating sensitive areas, discuss with the client how sensitive areas will be draped and/or clothed and how touch will occur (for example, over draping and/or clothing or on skin, and for bilateral exposure). Never expose sensitive areas without the client’s informed consent.
7. Ensure the client is protected from exposure of the genital area and the gluteal cleft. Never touch the client’s genitals or anus. Clients can only provide explicit consent to have their genital area and gluteal cleft exposed for the purpose of Massage Therapy during childbirth.
8. Not reach underneath the draping and/or clothing
   • Some clients may feel better protected during assessment and/or treatment by limiting exposure of some areas of their body, or may present with accessibility needs. In these cases, the RMT may consider modifying care in a way that does not require touch (for example, instructing client to stretch). The RMT may also consider assessing and/or treating on top of the draping and/or clothing with the client’s consent.
   • RMTs may only assess and/or treat under draping and/or clothing when requested by the client after discussing options, only when it is in the best interest of the client and with the client’s consent.
   • RMTs must not reach under draping and/or clothing in a way that could risk touch of an area of the body for which the client has not given consent to be touched.

If the client remains clothed for assessment and/or treatment, the RMT must:

9. Discuss options for maintaining client physical/personal privacy if assessment and/or treatment occurs in non-private environment.
10. Adjust clothing only with the client’s informed consent and in consideration of the client’s unique needs, views, preferences, concerns, and health goals to protect the client’s physical/personal privacy.

When the client is draped (and draping is adjusted) during assessment and/or treatment, the RMT must:

1. Drape securely using material that provides an effective visual barrier to set clear physical boundaries that separate the areas being treated and/or assessed and areas of the body where no touch will be applied.
2. Drape to prevent visual exposure of any areas of the client’s body that are not being treated and/or assessed (except for the shoulders, neck, face, and head). The RMT may uncover areas of the client’s body that are not being assessed and/or treated only at the client’s request and for the client’s comfort (such as for temperature regulation), except for sensitive areas which may only be exposed if treating and/or assessing that area and the client provided written^[1] consent.

Relevant Legislation and Regulation

• Professional misconduct in Section 26 of Ontario Regulation 544/94 under the Massage Therapy Act, 1991

Related Career-Span Competencies (CSCs)