Boundaries between massage and counselling

[longvines]

I work part time as a reflexologist at a local mental charity. I worked with a new client today who was suffering with long-term depression and work related stress. She discussed her issues openly, and I tried to respond in ways that I would find helpful - suggesting local support groups, more positive ways of thinking about her situation, small changes she could make to her lifestyle. I also spoke about things that had helped me when I was going through a period of anxiety and work related stress. But I felt that the focus of the session had changed from a reflexology treatment into a counselling session.

For the next session I was thinking of (tactfully!) suggesting to the client that they would get more benefit from the treatment if they closed their eyes and tried to focus on relaxing. Then again, maybe the treatment is enabling the client to 'unload' and speak about their problems.

I am not a qualified counsellor and have made the client aware of this. But looking back involving myself in a discussion about the clients issues was probably sending out mixed messages. Then again, I think some discussion of the issues are appropriate, after all it is the main reason the client booked a treatment.

Any advice, constructive criticism or experiences on these matters would be much appreciated

[1246TEACH]

Hi there
No matter how hard you try - as a caring therapist this will often be an issue for you - it is for me too. The important thing is not to advise anything that you're not qualified to - some clients will take on everything you say and will assume that you are qualified to advise them so make sure that you're not sharing opinions in the way you may do so with a friend. This is particularly important with clients that you see really regularly. It sounds to me that your advise to look into local support groups and small ways to look at things more positively was within our 'boundaries' as a complementary therapist and so often it just helps to offload so you undoubtedly helped just by listening - so don't be too hard on yourself.

[longvines]

Thanks for the reply 1246TEACH

With hindsight I think I definately went to far with my 'self-disclosure'. But i've read up on it, and can see why this is not a helpful approach, and I can see the reasons why I strayed over that boundary so I will be more aware of it next time.

[BayWhitaker]

It's hard not to let the boundaries slip sometimes. You have figured it out yourself and I think you're attitude of be more careful next time is a healthy one. You can forgive yourself and move on... after all, it's clear that if you let a boundary slip for once, it's purely because you are a caring person.

Thanks for sharing, I'm sure many others will have been there too.

[ChrisRams]

Well, do try and get them to relax next time, but you may also wish to investigate getting a basic training in counselling, which will help you with your own boundaries.

[Urban_Hippy]

Originally Posted by longvines

Thanks for the reply 1246TEACH

With hindsight I think I definately went to far with my 'self-disclosure'. But i've read up on it, and can see why this is not a helpful approach, and I can see the reasons why I strayed over that boundary so I will be more aware of it next time.

Counselling skills are invaluable for a therapist, however, I'd not worry so much about ethical boundaries that are set purely for counsellors. There are many differences between being a therapist and being a counsellor. It is acceptable to offer advice and self-disclosure as a therapist. I have a better relationships with my clients who have a anxiety and depression than those with conditions I have no experience of such as M.S.
As long as the session was not dominated about you, I'd not worry.

Sometimes telling the client to relax when they are unable to makes them more stressed. Go with the flow and let the client guide the session.

[Reikiangel]

Hi there

years ago, before ever going down the therapist path I found that I had a stream of friends continually knocking on my door and telling me about their problems. One day, as one friend was leaving another pulled up in her car and called out "put the kettle on I've had a terrible day". It was at this point I wondered what I was doing. Was I helping my friends and was I giving good advice (and was it my place to do so)?
I then decided to take a basic Counselling course and it was the best thing I did. It came in really useful when I went on to become a therapist as I knew the bounderies for my clients etc and more importantly I knew when to refer on. I couldn't know EVERYTHING and it was more professional to admit when I didn't but to have a list of trusted other professional people who I could refer my clients to.

I think what you have done so far has been good hearted and caring and it WILL affect you more if it it's a problem you have dealt with yourself so no harm done. It might be an idea to think about taking a basic Counselling course for your own sake?

Take care

Love and light

reikiangel
xxx

[Rassy]

I work in a hospice and since I've been here have observed that when we work so intimately with people, it can create an environment of trust. I have found that many people open up to me more than a healthcare professional.

You may find the following book useful if you are experiencing this:

"Relating to Clients - The Therapeutic Relationship for Complementary Therapists"
by Su Fox (Jessica Kingsley Publishers)

I found this to be of great use in examining this aspect of my work.

[DaveUK]

I suspect you're right, you probably would benefit from a basic skills course. Boundaries are one of the big areas such a course would cover, both in terms of what is / isn't ethical and what constitutes (in) appropriate self-disclosure.

The whole touch issue in therapy is a hot potato and there are very mixed opinions. There can me a place for some careful, considered, touch, but massage would, almost always, be a (bit) step too far.

However, your situation is almost the opposite - you're offering massage but giving some counselling, Be very careful, you could, potentially be sued for giving inappropriate advice etc. I suspect your insurance for massage probably wouldn't cover you for any "counselling" or advice you offered,

One option may be to get cards from local therapists and offer them to your clients. You may be able to negotiate a referral fee with the therapists.