Sometimes life can be a real jerk.
Whether it’s work, relationships, friends, study, health or finances, at some point all of us can feel like our proverbial cheese has slid off our cracker. At times like these when behaving like an adult seems impossible, and bingeing on Netflix and Nutella is inevitable, we have a few choices: 1) retreat to the couch in pyjamas or 2) go out and relax with a massage.
Surprisingly, in stark contrast to its core objective, a growing number of unusual practices in massage clinics are leaving many young Australians with ongoing stress and trauma. With incidents ranging from mild to serious cases of sexual assault, we explain what you can reasonably expect from your massage therapist, your rights, and what options may be available to you if your massage therapist behaves inappropriately.
What You Can Expect From A Massage
When it comes to massage sessions, a vast knowledge gap exists regarding:
a) what behaviour or techniques should be considered part of normal treatment. For example, how you can determine whether your experience is part of routine therapy.
b) the nature of the relationship between massage therapist and client. For example, what can you do if you feel uncomfortable with the professional manner, environment or technique used by a massage therapist.
Before performing any type of massage, your massage therapist must obtain informed consent.
This means that you must receive clear information about what you can expect from your session and the purpose and outcome of your session before you agree to the treatment.
“For example, a therapist may describe the position and function of the gluteal muscles and explain why massaging them is relevant to the client’s treatment plan. Access to the gluteals may require the client’s underpants to be lowered. After describing this procedure, the client is given the choice to proceed prior to treatment.” (Massage Therapy Code of Practice)
A signed consent form does not mean that you have been adequately informed.
What Is Informed Consent?
In order to provide valid consent:
- you must agree to the treatment voluntarily, and not be coerced or induced to agree, through fraud or deceit
- your agreement must cover the treatment or procedures undertaken
- agreement must also be given by a person with legal capacity. For example, a parent, guardian or caregiver if you do not have the legal capacity to give consent personally.
Consent is dynamic. This means that while you may initially consent to the massage, or part of it, you can change your mind at any time during the treatment. If this happens, your massage therapist must immediately respond and stop.
Equally, if you consent to a specific treatment during one session, this does not mean that your massage therapist can assume you consent to the same treatment the next time, or any subsequent time. You must provide consent again.
You may also indicate through your actions or language that you are not consenting.
For example, ”Yes, that’s absolutely fine, I am happy for you to ahead” verses “If you have to, I suppose that is okay.”
It is the responsibility of your massage therapist to give alternatives wherever possible. For example, it may not be necessary for you to lower your underpants, but rather for techniques could be applied through your underpants, clothes or towels.
What Constitutes Abnormal Behaviour By A Massage Therapist
Key warning signs that your massage therapist is behaving unethically, in a way that endangers your safety or is failing to comply with the Australian Association of Massage Therapists Code of Practice include where they:
- do not leave the room when you are dressing or undressing
- do not make an effort to adjust towels so that you remain covered, particularly if you are asked to flip over when receiving a full body massage
- place their hands beneath towels, or work underneath towels, without your informed consent
- remove the towels and massage your breasts or upper inner thighs, without any therapeutic reason, without discussing the technique with you prior to commencement, and without confirming your consent during the massage
- remove towels and touch your groin area or genitals
- move your underwear to massage your buttocks without seeking your permission
- tell you that a specific technique, for example a breast massage, is ‘normal’ particularly where you feel uncomfortable or have raised concerns which negate your consent to the procedure
- tell you that they ‘did not know’ that you were uncomfortable, or did not consent, to a specific technique because you ‘didn’t say anything’ during the massage.
Evidence-based clinical reasoning and informed consent are essential preconditions to massages on sensitive areas such as breast tissue. For example, in cases of post-surgical treatment, cancer patients or to treat scarring.
Your massage therapist may perform a breast massage where they:
- obtain written informed consent for breast massage and retain this in your client file
- document the clinical reasoning for breast massage in your client file
- respect your right to withdraw consent for a breast massage at any time and document any changes to consent as they occur
- only uncover breast tissue when it is being worked on directly
“If the massage therapist cannot clearly articulate the evidence-based clinical reasoning for treatment of breast tissue, they should not proceed.” (Massage Therapy Code of Practice)
What This Means For You
It is never okay for a massage therapist to continue with a course of treatment where you do not feel comfortable and do not provide your permission.
Massage therapists are trained to observe non-verbal signs of discomfort (for example, pulling up the towel, shifting around and tensing) and to check with you throughout the session to confirm that you consent to each stage of the treatment.
When you are in a vulnerable position, it is not easy to come to terms with an unexpected and confronting situation. In cases of sexual assault during a massage, often the immediate shock of the situation is so overwhelming that your first reaction may be to:
- question yourself
- question whether it is really happening
- wonder whether what you are experiencing is normal; or
- whether the problem lies with you.
In most assault cases at massage clinics the victim is too stunned to speak up.
Remember that it is not your fault if your massage therapist touches you inappropriately or if you do not immediately stop it from happening. When you receive a massage, you expect a relaxing experience from a trained professional. You do not expect the massage therapist to initiate sexual contact.
What You Can Do
1. Be proactive. Close the knowledge gap between you and your massage therapist by speaking with them before your session starts. For example, what you can expect, what areas will be massaged, whether you can keep your bra and underpants on, whether there will be draping and whether they will ask you before any new area is massaged. Being informed places you in a strong position to assess whether your session deviates from the agreed treatment plan – and can help you prevent a potentially dangerous situation from escalating too far.
2. If your massage therapist seems reluctant to explain procedures and techniques or to answer your questions, this is your first major warning sign that something is not right. It may not be in your best interests to proceed.
3. You may have an underlying injury or other sensitivity. Tell your massage therapist up front and continue to remind them during the session if you feel that the techniques used are not suitable.
4. If anything about your session makes you feel uncomfortable, raise it with your massage therapist straight away. They are obligated to respond immediately and either clarify the treatment with you, or provide you with an alternative technique.
5. If you experience something more serious, such as unexpectedly being touched on the breast or another intimate area, never assume it is normal! As with many cases of sexual assault, one party is able to carry out abuse because they hold a position of trust or authority over the other. While healthcare practitioners are entrusted to act in your best interests, you cannot assume every one will do so. Don’t be influenced by a casual explanation that this sort of thing is ‘normal’ or that ‘you never told them to stop’.
6. If you feel you cannot speak up to stop your massage therapist, simply sit up. This will immediately break the physical contact, equalise the power balance and give you time to organise your thoughts.
7. From here you can raise your concerns verbally. For example, “We did not discuss you massaging that area of my body and I don’t wish to continue.” Or you can simply ask them to leave the room while you get dressed. You do not need to explain why.
Modern culture is paralysed by politeness. An unintended consequence is that, to our own detriment, we can frequently allow the feelings and interests of others to usurp our own. We may be fearful of being wrong, embarrassed or concerned that we will be ridiculed for not coping.
Don’t allow yourself to be crippled by kindness.
The law exists to protect you from anyone who pressures you into doing something (either physically or psychologically) against your will, particularly if that person is in a position of power or trust.
If you receive a massage that does not seem right, trust your instincts!
In the end, the only person you can rely on is yourself.
If you think your massage therapist has behaved inappropriately, or that you have been assaulted:
1. Notify your local police in the city where the massage occurred.
Local police assistance line: 131 444
- New South Wales
- Western Australia
- Australian Capital Territory
- South Australia
- Northern Territory
2. Notify the Department of Health in the State or Territory where your massage therapist is licensed. You may wish to submit a letter that details the inappropriate contact initiated by the massage therapist.
3. Make a complaint to the Australian Association of Massage Therapists
4. Contact a counselling service:
- National Counselling Helpline: 1800 737 732
- National Sexual Assault & Domestic Family Violence Counselling Service
- Sexual Assault Services Throughout Australia
- Reach Out