Massage Therapy Journal Summer 2026

Summer 2026 • 55

• Offers opinions about and discourages the client from taking the medications and treatments prescribed by the client’s RA care team without being a physician A practitioner’s interference with the client’s medical decisions, or their approval or disapproval, pollutes the therapeutic relationship. Because clients who have serious, chronic medical conditions are especially vulnerable, it is wise for massage practitioners to remain neutral during all interactions. Our neutrality allows client practitioner communication to continue and assures the client that our professional care will be available, regardless of events or changes in their medical condition. When a client fears that their massage therapist will be hurt or disappointed by a particular decision about medical care, or by the client’s failure to follow the massage therapist’s advice, the therapeutic relationship has been seriously compromised. Maintaining healthy neutrality can be stressful in the best of times, and exhausting when a client has a serious illness. Steps that can help to alleviate that stress and maintain healthy relationships with clients include: Perform regular self-checks after appointments with a client whose medical status creates potential for breaches of scope of practice and examine whether your feelings, statements or actions are impeding your neutrality and potentially threatening the client-practitioner relationship. You can: • Check in with a colleague and describe your concerns and ask for their input about scope of practice adherence with this client. • Reach out to a trusted supervisor or mentor who is knowledgeable about and respects ethical scope of practice and describe your concerns and ask for suggestions as to how you can reset the client-practitioner relationship so that it respects scope of practice and ensures client empowerment. • Practice self-care by getting massage, meditating and utilizing your spiritual practice. If taking such steps fails to resolve doubts about preserving this client-practitioner relationship

and the potential for harm to either party remains, it may be best to refer the client to another practitioner who can enable the client to continue

massage therapy in a safe environment. Acknowledge the Limitations of Massage

A healthy therapeutic relationship between client and massage therapist is built on trust. Because people with chronic illnesses such as RA can be swayed by miracle cures promised by unscrupulous practitioners or even targeted by scam artists who claim to have a cure, it is essential that massage therapists be accurate and complete about the potential effects and benefits that massage may have for someone with RA. Ideally, the initial interview during a client’s first appointment includes time for such a discussion, allowing the massage therapist to clarify the boundaries and limitations of massage, including that massage is not: • Medical treatment, nor is it a treatment for RA • A replacement for any prescribed medicine, nor will it facilitate lowering medication dosages • Going to have an effect on any disease process Incoming RA clients may have unrealistic expectations about massage or may have been over-promised tremendous results of massage by well-intentioned friends. It benefits the client to understand the actual results they can expect from massage, such as:

Because clients who have serious, chronic medical conditions are especially vulnerable, it is wise for massage practitioners to remain neutral during all interactions.

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