Explorations in Ethics
My Personal Experiences
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I have been in business for 23 years and have
a high percentage of repeat customers. I have clients who have seen me
once a week or every other week or some other variable for 4-10 years!
How can you not become friends or get to know people over that amount of
time.
Business Practices:
My practice consists of approximately
15% insurance billing or injury work. I charge $5.00 more per
session when doing these treatments. My reasoning is that I have
extra work involved such as the paper work, waiting 1 month to 3 years
for payment and extra phone calls to follow up with billing. Some
people charge more than $5.00 extra. Then there are the additional
charges for copying the chart when it is requested from the insurance company
.$.50-$1.00 per page of notes. I personally have trouble with the
excess amount. They reason that it is what happens in the medical
field. It is that way but I think it adds to the increased cost of health
care and don't feel right being a part of it.
I don't sell other products such as essential
oils, herbs or supplements only because it is more of a problem than anything.
I do recommend things that I read about and try
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myself - and I read many
health related publications. I usually preface it with " I just read
about this or heard about this treatment or If I were you I'd try this".
I only do this with people I know may be open to the information.
When deciding what treatment a client needs
it is often difficult not to do what I want to do on them -what I think
would be the best not necessarily what they may want at the moment.
I practice deep tissue and Zentherapy® and have lost some clients because
I think that the 10 session work would be the best for them when they just
want to relax and not have to work themselves. Just because you know
a certain technique or method - does that mean you can just do it on anyone?
How do you keep in mind what they really need and combine the things that
you know?
I often think of what treatments would
be like if I didn't charge at all for them and did them for free. Would
I be able to practice techniques that I want to that I believe are the
best for the client? Would I have to listen to what the client wants?
Would the dynamics change? for the better? for worse? These
are just a few questions for exploration.
Relationships:
After 17 years of business, I have
not followed any of the text book recommendations. I have become friends
with clients, I have lunch with them and I have dated clients.
Every client and every situation varies. I have some clients who
I have seen for years (10+) and I know very little about them. I
have others who I know a lot about their lives and have become a part of
their personal lives. I have lunch with a few every now and then and get
little gifts from them at Christmas. Some talk a lot on the table
-it's what they
need. Some talk very little - it is also what
they
need.
I had one guy make an appointment with
me just so he could get to know me more and ask me out. I went out
and he stopped being a client. I had another client ask me out and
he remained a client and paid for regular treatments.
I never feel like it affects my treatments.
I want to work on these people with more effort to ease their pain because
we are friends. I want to work on the quiet ones who I don't really
know just the same - the best that I can do at the time. I imagine
it does have an influence on my work, but I feel like they are responsible
adults and can take care of themselves. They have come to me for
a reason- whatever that may be. I respect that and make the most
of each moment with them.
Sex and Bodywork
I have only had one case of a male becoming
aroused during a treatment. It was when I first started my practice.
The guy requested work on the upper thigh and groin area because he said
he had a groin pull from running. He told me that he always gets
that kind of work from another respected therapist who I had heard of.
She was a teacher at a massage school that I knew and respected.
I didn't even think that it wasn't a legitimate request until I could
see the sheet rising and I knew an uncomfortable situation was at hand.
What was I going to do? I didn't really know and will never know
as the fire alarm in the building rang and I excused myself to go check
and see if we had to evacuate the building. I left and came back
about 10 minutes later and everything was all right. I finished the
treatment without further problems.
I have never had another experience like
that, but I am sure they must happen. There are people out there who don't
know the difference between being touched for therapeutic purposes and
for sexual pleasure. Some people say that you can't separate the
two because it does feel good to be touched and men in particular can't
control their biological responses or so they say. I wonder if part of it
is the way we are brought up with sex around us in advertising and television
etc.
I think I have been spared mainly because
the focus of my work is deep tissue work, which keeps people focused on
the pain and not the pleasure! I have been doing massage for 17 years and
I have only had one male reaction like that...
The
main concern is whether or not they want to act on their sexual urges or have
the therapist participate and make a "happy ending".
Determining your own code of ethics and
examining your boundaries is an ongoing process. As your work changes,
your life changes so goes your practice and relationships with clients.
I don't think it is possible to have a bodywork/massage practice without
some transference and counter-transference. It is whether you are
aware of the dynamics and constantly improving yourself to limit the influence
that crossing some boundaries has on your treatment. It is
important to always be working on your own issues outside of your practice
to improve your work. This is done best through taking care of yourself
through practicing meditation, breathing exercises, or whatever makes you
feel more alive and aware. Awareness is what will make your practice different
: more effective, more successful, more fulfilling.
