Preventive Measures

Proper procedures lead to peace of mind

By Dennis Walker

Thinking about personal safety is often the furthest thing from your mind as you work to provide professional services in a serene environment. In fact, a practitioner’s nurturing mindset can cause resistance to taking even the most simple of cautionary steps. While making the client’s comfort and privacy paramount, it’s important to remember to factor in considerations for your personal safety.

Setting the Stage

The first step in protecting yourself as an MT isn’t necessarily taking a self-defense class, although that’s a wise choice for anyone in today’s world. The first safety step for massage professionals is to properly set the stage—it’s the old “ounce of prevention” notion. Experts say you can avoid most bad situations entirely by planning wisely.

For example, when choosing a location for your office, be smart. Choose a well-lit area where there will commonly be plenty of traffic during the hours you will operate. As Cherie Sohnen-Moe, coauthor of The Ethics of Touch and a home study massage ethics series, puts it, “Don’t be the only place open, the only car in the lot. Set up your practice so that you don’t look like a target.” Examine nearby businesses and think about the kind of impression a walk-in client might get. Use these same criteria if you are considering employment in an existing spa or clinic.

Another way to set the stage is to evaluate your advertising to ensure you convey a professional tone. Make sure your telephone listing is in an appropriate category, such as Licensed Therapeutic Massage and not something too generic, like Massage Services. Likewise, your business cards should include your full credentials so that potential clients understand the service you provide is therapeutic. Given the potential for confusion with those providing entirely different services, be especially careful about placing advertisements or business cards in public places, on bulletin boards, or with certain lists and publications.

The next step is to evaluate your work space and environment. Give some thought to your basic setup. Place the massage table and other furnishings so that you will naturally tend to keep yourself between the client and the door as much as possible throughout the session. You should never need to turn your back on a client who is not on the table.

Proper clothing can be both a boundary issue and a safety matter. Resist the temptation to dress informally and keep jewelry to a minimum. Professional attire sends an appropriate signal. Don’t set yourself up to be misunderstood.

Meeting the Client

As we all know, there are those in our culture who sell sex under the guise of providing massage services. This can lead to confusion and misunderstanding on the part of prospective clients who may be seeking something entirely different than therapeutic massage. Given societal barriers toward touching, the innately personal nature of massage can sometimes cause even well-intentioned clients to become confused, which can then lead to inappropriate behavior. The key to avoiding most expectation or behavior problems before they materialize is to have strong client intake procedures and to use them routinely.

Nina McIntosh, massage therapist, ethics expert, columnist, and author of The Educated Heart, says that the initial phone conversation with clients has many facets beyond appointment scheduling. This includes personal screening, new client inquiries, and outcall restrictions. She emphasizes that the naturally caring nature of the profession leaves many therapists unprepared for the worst. “It’s true on a lot of levels,” she says. “Our mindset is not that way. Use your common sense. Use the phone for screening. Trust your intuition. If you have a feeling about somebody, don’t make the appointment.” (For more information about telephone screening, be sure to read MiMi Zannino’s article “Screening New Clients,” page 46, and Nina McIntosh’s Heart of Bodywork column “Clear Communication and Self-Protection,” page 116.)

Unfortunately, as the French author Voltaire famously noted, “Common sense is not so common.” Be specific on the telephone. Find out what the client expects and ensure that your intake process plainly states that you only provide therapeutic massage service. Be alert; intake is your best opportunity to identify potential problems. This doesn’t mean you have to worry every time you book an appointment. Exactly the opposite is true. Alertness and a prepared attitude give you the peace of mind to relax and practice calmly, knowing you have properly set the stage, screened your clients well, and ensured that there are no misunderstandings as to the nature of the service you will be providing.

Be especially on guard for danger signals with first-time clients. It’s what solo practitioner Marianne Bashista remembers as the pay phone background noise in the days before cell phones. Over the years, Bashista has developed her own clear, no-nonsense screening forms and procedures for client intake. Her language is quite specific:

“Therapeutic massage is strictly nonsexual. Genital areas are covered at all times ... If the client expresses interest in sexual massage, the massage session will be terminated and the police may be notified ... Clients are draped with a sheet for the entire massage. The sheet is adjusted to uncover only the areas of the body which are receiving therapeutic massage at the time …”

You need to be very direct with your intake forms and procedures, experts say. You simply cannot be too clear in this area. Other danger signs Bashista notes are first-time clients whose need seems particularly urgent or immediate, those who want fully undraped and unclothed sessions, and those who are vague or reluctant to provide screening information.

Wendy Marsh teaches ethics classes for massage therapists. She strongly agrees with a direct, no-nonsense screening approach. She dislikes the trend toward online scheduling. “Have some kind of direct, evaluative contact before they get in the door; not just for your safety, but to properly assess their needs and condition as well.”

One problem Marsh notes is that “a lot of the younger therapists are in group practices where they are not even part of the intake process.” That can put therapists in a tough position with their own employers. She recommends a full and frank discussion with the workplace manager who sets the intake procedures. Emphasize that everyone is really on the same page. Clients, office staff, and therapists all benefit from clear understandings and proper evaluation.

Sohnen-Moe believes strong intake procedures are the key to therapists’ personal safety and she much prefers telephone screening over Internet scheduling. The more specific information you can gather, the better, she says. Ask first-time clients, in particular, whether they have had previous massage therapy and what outcome they are seeking. If you sense something inappropriate, seek more information. Generally, this will end the call. Be willing to refuse the appointment. State that you don’t believe you can help meet this client’s needs.

To give yourself an extra layer of protection, if your practice permits, consider scheduling  first-time clients when other therapists will be around. “You need to be doing good screening anyway to properly assess client needs, injuries, and health conditions,” Sohnen-Moe says. She adds there are even more practical benefits to this type of procedure, since telephone-screened and confirmed new clients are less likely to be no-shows.

Problems During the Session

Proper setup and strong, clear intake policies go a long way in protecting yourself from inappropriate behavior. With those safeguards, most clients will not be a cause for concern. But you still need to recognize and be prepared to deal with clients whose expectations or actions are unacceptable. You have to be ready to say no, to end the session if appropriate, and to simply get out if necessary.

Many massage therapists may have difficulty in properly recognizing or assessing a problem situation. Marsh emphasizes this in her seminar, Embodying Ethics. “Massage therapists work with bodies, but don’t listen to warning signs from their own. Self-care and personal safety are part of the journey of listening to our bodies and living in our bodies.” She has found this to be an area not covered in-depth in many training programs. She sees many new therapists in her ethics seminars who need a better comfort level in dealing frankly with personal contact issues. Marsh incorporates role-play exercises to help bridge the experience gap.

Sohnen-Moe likewise uses role-playing training to get massage therapists comfortable with direct communication. This sort of frank communication can diffuse a misunderstanding, work past a purely physiological reaction, or forgo other awkward situations. It also helps the therapist to recognize when something more could be going on, and to increase their willingness to put their needs first and end the session.

Fortunately, few inappropriate requests lead to physical confrontations. Despite your stage setting and intake procedures, the client may have misunderstood the nature of your practice. The client still may simply be confused as to the boundaries of therapeutic massage contact. Be direct. Firmly explain that you only provide professional therapeutic massage and that the request is inappropriate. It is possible, after making this clear and seeing that the client truly understands, that the session could continue if you are comfortable with the situation. If not, do not be reluctant to terminate the session and ask the client to leave.

As Marsh says, listen to what your own body is telling you. The appropriate response depends on several factors. A client lying supine on the table making a verbal request is not (yet) as threatening a situation as a client who is standing. The setting is very important. If you are within earshot of other therapists in a large office, your risk exposure is not nearly so great. If you’re the only one there or if you’re isolated, in solo practice, or on an outcall, your exposure is much greater. In those situations, you will need to have a much higher level of caution.

Instances of actual physical assault on massage therapists are fortunately rare. But the bottom line—both for peace of mind and for your safety—is that you need to be ready for even that sort of assault, just as you would when alone on a dark street. Here is the most basic rule: when in doubt, move. If you feel threatened, or sense that you could be in physical danger, or even are feeling unsure whether you’re entirely safe or not, just go. Don’t hesitate, don’t let the situation escalate, don’t worry about explanations or the rest of the session. Get out.

Worst Case Scenarios, Solutions

Just as many of us keep a fire extinguisher on hand without necessarily fearing a fire, consider the worst case scenario and be prepared to deal with it. If, despite all precautions, you are confronted with physical violence and can’t leave, what will you do? While the ideal solution might be to have several robust coworkers within shouting distance, in the worst case scenario, you’ll be alone.

You might consider carrying any of several common personal safety items or keeping them in your office. Some self-defense tools are more practical than others in a massage therapy setting. Personal sonic alarms that resemble pagers are loud enough to disorient attackers, as well as alert others. Some of these work automatically once pulled off your belt. “Tactical” flashlights small enough for your key chain or belt are available with astonishingly bright, disorienting strobes. They can also simply light up the way to your car. Disabling repellent (pepper spray) are a step up the spectrum toward more active self-defense for emergencies. Some report keeping these in a handy cabinet. There are also sprays available for personal wear that are made to closely resemble a cell phone or pager. For outcalls, many remote car lock controls have a panic button that sounds the horn. A cell phone, and someone expecting you to call with your status, are also important parts of an outcall routine (see Outcall Safety Checklist, page 42).

In the final analysis and in the reality of the private physical contact setting massage therapists work in, and rightly cherish, personal safety can ultimately come down to physical training and the mind-set to use it. This is the ultimate acknowledgement of personal responsibility for your own well-being. It is also the ultimate empowerment for your own peace of mind and self-confidence. Many therapists are reluctant to consider taking this step, but it doesn’t need to be intimidating and it doesn’t require black-belt levels of mastery to be effective. There are two basic ways to go here: self-defense training and martial arts.

The best source for a proven, no-nonsense short course on practical self-defense is often through local college or university community outreach programs or women’s centers. These programs generally emphasize mental awareness aspects, as well as physical responses. Many are available in a women-only setting. You may also find this type of training through government or nonprofit rape crisis centers or victim assistance programs. A good self-defense class can be an educational, enlightening, and energizing group activity, important for not only your professional training but your personal development as well. Purely from a business point of view, it might turn out to be an opportunity to network with potential clients.

Martial arts can also be a particularly effective choice for massage therapists, for more reasons than you might think. Linda Wilkinson, a practicing massage therapist who is also a nurse practitioner, highly recommends taking a martial arts class. She took a hapkido class with some other parents after signing her daughter up for a children’s tae kwon do class. She found that she greatly enjoyed it. The weekly class “was fun, low-key but effective; and not intimidating or scary.” Beyond the social aspect, she felt she learned enough after a few months for useful physical protection. The hapkido form of martial arts emphasizes self-defense, simple joint locks, and pressure points.

There are other benefits that make martial arts a natural complement to massage therapists’ work. Most forms of martial arts training emphasize chi (energy) and awareness of your own body and of others. For Marsh, the choice was aikido. “Aikido is all about your relationship with the other person, their body language, directing their negative energy back at them.” Sohnen-Moe also highly recommends martial arts training. “It increases self-confidence,” she maintains. “It also strengthens your body, which increases your safety in terms of injury.”

The final step, after developing strong procedures, evaluating your workplace, and preparing yourself, is to stick to your plan. As Sohnen-Moe says, “Don’t get sloppy. Always do an intake, even if shortened. Be smart no matter how much you think you need the appointment.”

 Dennis Walker is an attorney and massage therapy client. He is a sport shooting enthusiast and has taught personal protection and defensive pistol use. Contact him at