.
1.REFUSAL OF TREATMENT
When is it appropriate to discontinue working with a client?
When the parameters of the therapeutic relationship have changed for the negative.
When the therapeutic relationship is damaged and beyond repair.
When it is no longer beneficial to either one of the two parties involved.
When there is the threat of physical harm or abuse.
When your client feels the need to test your boundaries e.g. keeping appointments, punctuality, seeking or giving inappropriate personal disclosure.
When the client inappropriately fulfills some social or emotional need of yours or theirs.
When they need work beyond your training or scope of practice.
When you feel in your gut that it isn't appropriate to continue working with them.
When you feel in your heart that it isn't appropriate to continue working with them.
When you know intellectually/ in your mind that it isn't appropriate to continue working with them.
When they have an unrealistic view of you or your work.
How do you approach discontinuing with a client/treatment?
If they test your boundaries, make them aware of it and inform them that if it continues the therapeutic relationship will be terminated.
In the case of immediate threat or abuse, their violating the therapeutic relationship or continually testing your boundaries after warning: inform them the therapeutic relationship is terminated and don't book them for any further sessions. If they've paid in advance return their money. Make it final, no need for further discussion.
If the parameters change for the negative or you are violating the therapeutic relationship or boundaries, seek supervision or mentoring and see what your supervisor/ mentor recommends. Act on it. If you feel it is particularly serious, delay your client's sessions until you have had supervision or have more clarity around the situation.
If it is training, scope of practice, minor boundary violations (i.e. their punctuality), the gut/ heart/ mind feeling or their unrealistic thinking/ expectations, explain that you feel your work isn't benefitting them or is inappropriate for them or that you simply can no longer work with them, but give them referrals to several other practitioners who you feel may be more appropriate to their situation. Explain it to them, terminate the relationship responsibly so that they don't feel "dumped" or left hanging.
An AMT Ethics wiki contribution,2008.
You too can contribute to the wiki: http://www.amt-ltd.org.au/wiki/
2.DRAPING
The most basic rule or guideline for draping is that it should always be done with the comfort, modesty and dignity of the client foremost in the practitioners mind. It should be done in such a way that:
1) The therapist has access to the relevant, targeted body part to be treated.
2) The client is comfortable with the draping procedure.
If their comfort means they wish to remain fully clothed, then so be it.
3) No more of the body is uncovered than is required.
4) Draping procedures and their rationale should be explained prior to the commencement of the session, and consent or permission sought.
5) If the draping is to be changed during the session, ensure permission has been granted for the new draping position before doing it. There should always be a therapeutic rationale for any change of draping.
The above applies to all passive massage. In more active bodywork or if movement therapy is involved, ensure that your client is wearing appropriately modest clothing that, while allowing you as the practitioner access or the ability to visually observe, THE CLIENT FEELS COMFORTABLE IN WEARING WITHOUT THEIR DIGNITY BEING IMPINGED.
An AMT Ethics wiki contribution,2008.
You too can contribute to the wiki: http://www.amt-ltd.org.au/wiki/
3. EXCEPTIONS TO CONFIDENTIALITY
Circumstances in which client confidentality can be breached:
1) Self harm: if there is a possibility the client may harm themself.
2) If there is the real possibility of specific harm to a specific other.
3) If there is current child abuse or the danger of abuse to children.
4) As required by a court order.
5) If the client is a minor or is of diminished mental capacity: disclosure can be made to the responsible parent, guardian or carer of the client. Due respect should still be shown for the clients privacy.
An AMT Ethics wiki contribution,2008.
You too can contribute to the wiki: http://www.amt-ltd.org.au/wiki/
4. ADVERTISING:
Therapists must not advertise or otherwise promote their services in a manner that:
is false, misleading or deceptive, or
is likely to mislead or deceive, or
creates, or is likely to create, an unjustified expectation of beneficial treatment.
creates, or is likely to create, false hope (e.g. massage cures cancer or other serious illnesses or the blatant, massage rids toxins).
Therapists should not advertise or promote services or modalities which they are not certified or qualified to perform. They should not advertise or promote services that are outside their scope of practice.
An AMT Ethics wiki contribution,2008.
You too can contribute to the wiki: http://www.amt-ltd.org.au/wiki/
Showing posts with label Association of Massage Therapists. Show all posts
Showing posts with label Association of Massage Therapists. Show all posts
Saturday, March 14, 2009
THE BASIC COST OF BEING A MASSAGE THERAPIST
Appeared in the AMT Journal "In Good Hands", June 2008.
© AMT 2008, © Colin Rossie 2008
So, now you are qualified. With a busy practice, you work many hours a week with clients- perhaps in a clinic with other therapists or perhaps by yourself in a clinic or from home. Perhaps you only do a few clients a week, again maybe from home: or you have retired from an active practice and do 1 or 2 people a week. These might be old clients, perhaps friends- maybe you charge them, maybe you don't. Another scenario is that you only do voluntary work: the local nursing home, community work, the local sports team- all free of charge, the pay off being pride in your work or a warm glow inside.
The income received may vary in all these scenarios, but in all of them can you really afford to be uninsured? The unequivocal answer to this is no!
If you are qualified and practicing any massage, regardless of whether you are being paid for it or not, whether you regard yourself as active or retired, you are liable for the consequences of your work. Thus you should carry insurance. Being a member of association makes insurance cheaper. If you are qualified and not in an association, insurance costs over a $1,000 more on a per annum basis.
In AMT there are 5 levels of membership. Which can get insurance?
For the sake of ease, I'll band these 5 levels into 3 categories, based on the options available for insurance.
These 3 categories are:
1. Auxiliary membership
2. Student membership
3. General and Senior Levels 1 & 2
The easiest to address is the Auxiliary category: insurance is unavailable to this category of membership.
The second category, Student members of AMT, can get insurance with OAMPS once they have completed the basic Swedish Massage section of their training. Depending on whether they are charging people or not and what amount of indemnity they want, insurance costs students between $127 - $253 per annum. Certain requirements must be met in the treatments they offer i.e. identifying their student status to clients. Given that students if they meet certain criteria can join AMT for free, this insurance cost represents a membership cost of as little $2.50 per week. This cost is only if they choose to take out insurance: otherwise, membership can cost students nothing.
Now for the third category: General, Senior level 1 & Senior Level 2 members. The following calculations represent the basic cost of membership per annum, thus the basic yearly cost of practicing Massage Therapy:
General Level membership:
Annual membership fee $150
Insurance-$1,000,000 $197
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $467
This, if you do your sums, works out to be just less than $9 a week. Though the CEU rates I quote represent the cheapest I could readily find, you could possibly fulfill your CEU requirements for less cost. (I'm not advocating "doing it on the cheap". Personally, I think you should never scrimp on the cost of good continuing education.) I have seen someone charge as little as $50 for an hour massage recently. More frequently I've seen $65 -$70 an hour as a basic, starting rate. If you are doing 8-9 hours paid massage work per annum, you can afford to cover this cost. If you accidentally do something to your client, or are sued for any reason, can you afford to have not met this cost? If you are doing 1 paid massage a week from home, you can easily afford $9 a week- and you get to keep your home if something you do makes the massage go awry.
Similarly, for Senior Level 1 the cost with $1,000,000 insurance is $9.75 a week. The sums are:
Senior Level 1
Annual membership fee $190
Insurance-$1,000,000 $197
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $507
Even with $2,000,0000 insurance, Senior Level 1 membership costs just $10.27 a week, or $534 per annum.
Lets go deluxe with Senior Level 2:
Annual membership fee $220
Insurance-$5,000,000 $264
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $604
This represents just $11.62 a week over a year for $5,000,000 insurance. For $1,000,000 insurance it would cost $10.33 a week ($537 p.a.), for $2,000,000 insurance the cost would be $10.85 a week ($564 p.a.) Of course, SL-2 members would most likely willingly pay a lot more for their CEUs.
Again, I emphasize that these are just the basic costs of your being able to practice massage therapy. Without paying these basic costs listed above you wont be able to practice as a massage therapist. Tables, oils etc, linen & rent are all in addition- none of these others matter if the basics aren't met.
© AMT 2008, © Colin Rossie 2008
So, now you are qualified. With a busy practice, you work many hours a week with clients- perhaps in a clinic with other therapists or perhaps by yourself in a clinic or from home. Perhaps you only do a few clients a week, again maybe from home: or you have retired from an active practice and do 1 or 2 people a week. These might be old clients, perhaps friends- maybe you charge them, maybe you don't. Another scenario is that you only do voluntary work: the local nursing home, community work, the local sports team- all free of charge, the pay off being pride in your work or a warm glow inside.
The income received may vary in all these scenarios, but in all of them can you really afford to be uninsured? The unequivocal answer to this is no!
If you are qualified and practicing any massage, regardless of whether you are being paid for it or not, whether you regard yourself as active or retired, you are liable for the consequences of your work. Thus you should carry insurance. Being a member of association makes insurance cheaper. If you are qualified and not in an association, insurance costs over a $1,000 more on a per annum basis.
In AMT there are 5 levels of membership. Which can get insurance?
For the sake of ease, I'll band these 5 levels into 3 categories, based on the options available for insurance.
These 3 categories are:
1. Auxiliary membership
2. Student membership
3. General and Senior Levels 1 & 2
The easiest to address is the Auxiliary category: insurance is unavailable to this category of membership.
The second category, Student members of AMT, can get insurance with OAMPS once they have completed the basic Swedish Massage section of their training. Depending on whether they are charging people or not and what amount of indemnity they want, insurance costs students between $127 - $253 per annum. Certain requirements must be met in the treatments they offer i.e. identifying their student status to clients. Given that students if they meet certain criteria can join AMT for free, this insurance cost represents a membership cost of as little $2.50 per week. This cost is only if they choose to take out insurance: otherwise, membership can cost students nothing.
Now for the third category: General, Senior level 1 & Senior Level 2 members. The following calculations represent the basic cost of membership per annum, thus the basic yearly cost of practicing Massage Therapy:
General Level membership:
Annual membership fee $150
Insurance-$1,000,000 $197
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $467
This, if you do your sums, works out to be just less than $9 a week. Though the CEU rates I quote represent the cheapest I could readily find, you could possibly fulfill your CEU requirements for less cost. (I'm not advocating "doing it on the cheap". Personally, I think you should never scrimp on the cost of good continuing education.) I have seen someone charge as little as $50 for an hour massage recently. More frequently I've seen $65 -$70 an hour as a basic, starting rate. If you are doing 8-9 hours paid massage work per annum, you can afford to cover this cost. If you accidentally do something to your client, or are sued for any reason, can you afford to have not met this cost? If you are doing 1 paid massage a week from home, you can easily afford $9 a week- and you get to keep your home if something you do makes the massage go awry.
Similarly, for Senior Level 1 the cost with $1,000,000 insurance is $9.75 a week. The sums are:
Senior Level 1
Annual membership fee $190
Insurance-$1,000,000 $197
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $507
Even with $2,000,0000 insurance, Senior Level 1 membership costs just $10.27 a week, or $534 per annum.
Lets go deluxe with Senior Level 2:
Annual membership fee $220
Insurance-$5,000,000 $264
Cheapest CEU requirement (E.G) $120
TOTAL Per Annum $604
This represents just $11.62 a week over a year for $5,000,000 insurance. For $1,000,000 insurance it would cost $10.33 a week ($537 p.a.), for $2,000,000 insurance the cost would be $10.85 a week ($564 p.a.) Of course, SL-2 members would most likely willingly pay a lot more for their CEUs.
Again, I emphasize that these are just the basic costs of your being able to practice massage therapy. Without paying these basic costs listed above you wont be able to practice as a massage therapist. Tables, oils etc, linen & rent are all in addition- none of these others matter if the basics aren't met.
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