As a massage therapist, understanding the power differential in the therapist/client relationship can help you to deal with challenging clients and to create a safe place for people to get massage therapy. The power differential can happen in any type of relationship like school teacher/student, Pastor/Priest and church member, parent/child, doctor/patient and any number of relationships. With a massage therapist, when someone is seeking care for stress, pain or whatever condition that they have, the client/patient may come to see the massage therapists as someone more knowing who has the right answers and has their best interests at heart. Clients often put blind trust in people with authority. It is also an important part of the therapeutic relationship that occurs between massage therapist and client and that is why you need to know what it is and understand how it could affect people and learn how to set boundaries so that you do not take advantage of this power differential and that clients know where they end and you begin.
From the moment people begin searching for a massage therapist or get the idea that they want a massage, the power differential has the potential to begin. They are looking for someone to help them feel better. This holds a lot of power for the person that they find to do this. When the client chooses someone, they have already agreed to put themselves in the hands of this person, hoping that they can help them. They may have been given a referral by a friend, family member or doctor and value the referral. They may have found the massage therapist searching online and reading their website and reviews and have chosen a massage therapist who they think can help them the most. It may just be decided on the basis of you are closest to where they live or work and expect convenience.
The power differential is often enhanced by the fact that clients undress and lay on the massage table even though covered, it is an additional vulnerability to recognize. They share detailed information about their health.
Clients will look to the massage therapist for help and may often talk about other aspects of their life – work and family life. Most often they just want someone to listen. Sometimes they ask for advice on their health and other areas of their life.
As a result they often will be unable to say no or give feedback on the session.
The Massage Therapist
As a massage therapist, it is your job to figure out what the client needs (what outcome they want) and be able to give that to them. Your role is to maintain the therapeutic relationship.
Whatever happens in the massage room you have to remember to not takes things personally. Whatever happens with their body as a result of the massage, what the client says or does in the session is NOT about you! It is common for massage therapists to make assumptions based on their own learning, bias and past experience with clients. Massage therapist will assume they know what the client needs and are often wrong.
Informing them of what you are doing and why and getting their informed consent that they understand everything is one of the best ways to preserve the therapeutic relationship and reduce the power differential. Having a client centered practice means the client gets to choose their treatment.
The power differential makes it so clients don’t always say what they mean or speak up when they should. They will not tell you when something is painful or doesn’t feel right. They assume that you know what you are doing and accept everything you do without question. Asking open ended questions that require people to say more than just yes or no can help. Reflective listening or rephrasing and repeating things back to the client can also help the client expand on their sharing.
It is important to understand this power differential so that you can provide the best care for clients. This includes keeping up to date on the latest science of massage. It also comes into play when selling products to clients on the side and even when rebooking clients. Many clients want to be told how often to come in as if they need permission to do so.