Here is What You Said

Thank You For Your Feedback on CMTO’s
Standards for Maintaining Professional Boundaries and Preventing Sexual Abuse
Here is What You Said


The College of Massage Therapists of Ontario (CMTO) recently developed new Standards for Maintaining Professional Boundaries and Preventing Sexual Abuse, in response to legislative changes in the Protecting Patients Act, 2017. The legislative changes are intended to eradicate sexual abuse by all regulated health professionals in Ontario.

The legislative changes and new Standards will result in a number of important changes for Massage Therapists.  For example, the new legislation adds to the list of triggers for mandatory revocation of a Certificate of Registration in the Regulated Health Professions Act, 1991 (RHPA) which now includes any touching of a sexual nature of the breasts, buttocks, genitals, or anus. CMTO has proactively addressed these changes by providing updated Standards of Practice for the Massage Therapy profession.

Stakeholder consultation was an important part of the development of the new Standards. CMTO would like to thank all stakeholders who provided their input. CMTO made the changes to the initial draft of the Standards after reviewing a total of 2,563 responses (almost 200 of which were from the public). We hope the following changes address your concerns:

Standard A1: Establishing a Practice Setting that Maintains Professional Boundaries

  • CMTO received feedback on the use of video and photographic devices in the treatment room. The use of devices that have video or photographic functioning is allowed when used to enhance treatment and/or assessment. For example, when consent is received to use photos to assess improvement of posture over time (i.e., before/after photos).
  • Devices that have video or photographic capabilities, but which are not being used for therapeutic purposes (e.g., a tablet being used for documentation, but not for taking assessment photos), the video/photographic functions need to be inactive or blocked during client interactions.

Standard A2: Interpersonal Behaviours and Non-Verbal Communication

  • Client initiated hugging may be permitted, but the registrants/Registered Massage Therapists (“RMTs” or “MTs”) must consider the intention of the action (e.g., romantic or gratitude). MTs must never initiate hugs.
  • “Professional” attire has been clarified to indicate attire acceptable within the context and environment in which the service is being provided.

Standard B1: Treatment of Sensitive Areas of the Body

  • MTs and clients may discuss treatment options and the benefits and risks as part of the consent process, including if treatment of sensitive area(s) is an option. Should the client wish to have sensitive area(s) treated, he or she must request it.
  • MTs should determine if treatment of sensitive area(s) is clinically indicated based on a subjective and objective assessment. Clinical indications for treatment of each sensitive area are outlined in the Standard.
  • When treating the buttock (gluteal), written consent is required for the initial assessment/treatment and the treatment plan. Verbal consent is sufficient for subsequent treatments, as specified within the original written treatment plan.

CMTO received feedback that requiring MTs to wait at least one-year to commence a romantic relationship with a former client (following termination/discharge of the professional relationship) is too long. The Protecting Patients Act, 2017, requires that for a period of at least one-year, following termination/discharge of the professional relationship, a registrant cannot engage in a romantic or sexual relationship with a former client. Although this part of the Act has not yet come into effect as the formal definition of a “client” is still being determined by the government, CMTO has implemented this restriction through the updated Standards.

Please refer to the full Standards for Maintaining Professional Boundaries and Preventing Sexual Abuse to review the changes. These Standards are in effect as of September 11, 2017.  Should you have practice-related questions, please contact