Zero Tolerance For Abuse

CMTO is committed to taking all reasonable steps to prevent abuse and to provide appropriate support to those impacted by abuse.

Zero Tolerance Policy

CMTO’s role is to prioritize your safety and well-being as the client. CMTO has adopted a zero tolerance policy for all forms of abuse, including sexual abuse, in Massage Therapy.

CMTO’s Standard of Practice for Maintaining Professional Boundaries and Preventing Sexual Abuse was designed with your safety in mind.

CMTO recognizes the detrimental impact abuse of any kind has on those who are affected and their loved ones. CMTO has a long history of supporting the sexual abuse provisions in the Regulated Health Professions Act, 1991. CMTO:

  • Recognizes the seriousness and extent of injury that abuse causes the client and their loved ones and therefore upholds a zero tolerance policy for any form of abuse of clients by RMTs;
  • Accepts responsibility for protecting the public interest by addressing the issue of sexual abuse openly;
  • Strives to provide an accessible and sensitive reporting process;
  • Establishes deterrents through the administration of a discipline process reflecting the serious nature of the violation; and
  • Is committed to the prevention of sexual abuse through education of RMTs, clients of Massage Therapists and the public.

Defining Sexual Abuse

The Regulated Health Professions Act, 1991, (RHPA) defines sexual abuse (by a Massage Therapist or “RMT”) as follows:

“sexual abuse” of a client by an RMT means,

(a) sexual intercourse or other forms of physical sexual relations between the RMT and the client,
(b) touching, of a sexual nature, of the client by the RMT, or
(c) behaviour or remarks of a sexual nature by the RMT towards the client.

“Sexual nature” does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided.

Any sexual relationship between a regulated healthcare professional and a client is professional misconduct and against the law. It is always the regulated health professional’s responsibility to ensure that sexual abuse of the client does not occur. What that means is a client can never give true consent to a sexual or romantic activity or relationship; even “consensual” relationships are considered sexual abuse under the RHPA.

Working to Eradicate Sexual Abuse

CMTO maintains a Sexual Abuse Prevention Plan. Each year’s plan is carefully reviewed and informed by an evaluation of the previous year’s results, and changes in the legislative environment. The purpose of this Plan is to outline CMTO’s activities to prevent and address sexual abuse through:

  • Student Education,
  • Massage Therapist Education,
  • Training for College Administration,
  • Funding for Therapy and Counselling,
  • Providing Information to the Public, and
  • Evaluation of the Sexual Abuse Prevention Plan.

CMTO is committed to taking all reasonable steps to prevent abuse, including making written consent for treatment of sensitive areas mandatory. Written consent ensures you are able to have an informed discussion with your RMT about treatment of sensitive areas. It also provides you with the opportunity to specifically agree or decline to have those areas touched by your RMT for therapeutic purposes. CMTO’s written consent requirement facilitates a thorough discussion between you and your RMT about the assessment and treatment process they intend to provide to you. This will open a two-way line of communication to empower you to establish and confirm your expectations about the course of the treatment. Learn more about informed consent and written consent for treatment of sensitive areas.

CMTO also devotes resources to providing information to the public and in public engagement. CMTO has produced videos on topics such as:

The videos are shared through community news and social media. CMTO has also created a Clients’ Rights poster and brochure that can be printed and posted in an RMT’s practice. The goal is to inform clients that the Standards of Practice are the same across all practice settings, that clients have specific rights and that CMTO is here to help with concerns they might have.

If you have a question or concern about the Massage Therapy treatment you received, please contact our Professional Conduct Department at professionalconduct@cmto.com or call 416-489-2626/1-800-465-1933 extension 4149. 

Professional Boundaries in Massage Therapy

All regulated health professionals, including RMTs, are required by law to act in your best interest. This means maintaining clear professional boundaries. Professionals boundaries are key to ensuring your therapeutic relationship remains focused on providing you with the best care to meet your health needs.

This important line – called “professional boundaries” – between a professional and personal relationship when it comes to the therapeutic treatment should never be crossed. Both the RMT and client can cross or accidentally blur that line. As a client seeking Massage Therapy treatment, you can expect your RMT to maintain professional boundaries by:

  • Keeping your conversation focused on your health needs and treatment, instead of disclosing intimate personal details.
  • Always acting professionally by touching you only for the purposes of meeting your therapeutic needs and the goals of your treatment plan, instead of engaging in any unnecessary or unwelcome physical touch.
  • Always asking you for your written consent prior to treating a sensitive area. Learn more about Informed Consent.
  • Refraining from presenting you with gifts or tokens of appreciation for being their client.
  • Avoiding preferential treatment; for example, by providing you with complimentary Massage Therapy treatments.

The above list demonstrates just some of the ways RMTs establish and maintain professional boundaries throughout the therapeutic relationship.

To learn more about professional boundaries in Massage Therapy, watch the following video:

Funding for Therapy and Counselling

CMTO has established a Funding for Therapy and Counselling Program in accordance with the Regulated Health Professions Act, 1991 (RHPA). The program provides funding for therapy and counselling to Massage Therapy clients who were sexually abused by an Ontario Massage Therapist. CMTO’s Client Relations Committee administers the fund. The maximum funding available to each applicant is established by the RHPA and is equivalent to the amount that the Ontario Health Insurance Plan (OHIP) would pay for 200 half-hour sessions of individual out-patient psychotherapy with a psychiatrist. This funding amounts to approximately $16,000.00 per person and is accessible over a five-year period.

View detailed eligibility requirements and steps on how to apply.

FAQs about the Registered Massage Therapist – Client Relationship

Why is written consent for treating sensitive areas required in Ontario?

CMTO requires written consent for treating sensitive areas to improve client safety in response to the Protecting Patients Act, 2017, which aims to eradicate sexual abuse by health professionals, and to improve CMTO’s enforcement abilities. CMTO’s mission and vision include protecting the public interest and staying at the forefront of evolving regulation to inspire confidence and trust.

In the new legislation, touching of a sexual nature of a client’s breasts, anus, genitals or buttocks has been added to the list of acts for which a CMTO Disciplinary Panel must revoke a Massage Therapist’s Certificate of Registration where the conduct has been found to have occurred. As Massage Therapy can involve the appropriate touching of some of these parts of the body (e.g., the breasts or buttocks) in the course of therapeutic or clinical treatment, it was necessary for CMTO to ensure that RMTs were provided with professional Standards to help navigate the treatment of sensitive areas with their clients.

What does the written consent requirement mean for clients like me?

The written consent requirement requires RMTs to ask you for written consent prior to touching “sensitive areas” of the body as part of your treatment. CMTO defines “sensitive areas” as the upper inner thighs, gluteal muscles (buttocks), breasts and front chest wall. Written consent ensures that the conversation about treating sensitive areas has in fact taken place and that you are empowered to indicate, in writing, whether you consent/agree to having your sensitive areas
touched.

Do I have to give consent every time?

Yes, if you want your sensitive area treated, then you must consent each time. In CMTO’s experience, abuse can occur on the second or subsequent visit, not just on the first visit. This is why consent at each visit is critical to ensure client safety. Your Massage Therapist will ask for your written consent before each treatment for the breasts, front chest wall and upper inner thighs. For treatments of the gluteal muscles (buttocks), your Massage Therapist will obtain your written consent at the beginning of a treatment plan, then verbally for additional treatments within that same treatment plan. The whole process should just take a couple of minutes of your time unless you have further questions.

How does a written consent form help to prevent sexual abuse?

Written consent ensures you are provided with an opportunity to have an informed discussion about treatment of your sensitive area(s) and have an opportunity to specifically agree or decline to have those areas touched by your Massage Therapist. As a regulator, CMTO must take all reasonable steps to prevent abuse and it does so by requiring the RMT to engage you in a thorough discussion about the assessment and treatment process he or she will be providing. This will open a two-way line of communication to establish and confirm your expectations. The requirement for written consent may prevent some cases of abuse, and where it cannot prevent abuse, it will make it easier to prove that the sexual abuse occurred.

Can I still report abuse if I signed a written consent form, but was subsequently touched inappropriately?

Absolutely. If you provide consent to have your sensitive areas treated, you would be consenting to have them touched in an appropriate, clinical fashion. Any such consent does not give the Massage Therapist the permission to touch you in a sexual or sexualized manner. In fact, CMTO’s sample written consent form provides a reminder to clients that you can withdraw your consent at any time. Should you consent to a treatment of a sensitive area and subsequently believe you have been touched inappropriately, or that an area for which you did not give consent was touched, you should contact CMTO to find out the steps you can take to report this behaviour. CMTO would initiate an investigation and would collect information related to your complaint.

If you have a question or concern about the Massage Therapy treatment you received, please contact our Professional Conduct Department at professionalconduct@cmto.com or call 416-489-2626/1-800-465-1933 extension 4149.