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Lad_Kucis

As a lawyer who regularly represents registered massage therapists in CMTO matters, I have seen far too many cases in which an RMT faces false allegations of sexual abuse. Unfortunately, the very nature of massage therapy places RMTs at a higher risk of such complaints compared to other health professions.

Being the subject of a sexual abuse complaint is extremely distressing and can carry serious professional consequences, including the potential revocation of one’s certificate of registration.

In my experience, most sexual abuse complaints are preventable and arise from misunderstandings, shortcomings in communications, or lapses in maintaining appropriate professional boundaries.

To help address this, I have prepared 12 key tips aimed at reducing the risk of a sexual abuse complaint being filed against an RMT:

1. Do not treat a sensitive area without having the patient complete the Consent for Assessment and Treatment of Sensitive Areas Treatment Form (the “Sensitive Areas Form”)
   • It is a legal requirement to have a patient complete this form before treating a sensitive area (i.e. gluteals, upper inner thigh, breasts, chest wall)
   • A failure to have this form in place could make someone question whether you followed other standards and your professionalism in general

2. Ensure that you carefully explain the Sensitive Areas Treatment Form
   • It is insufficient to merely have a patient sign the form. Rather, you must ensure that you carefully explain all aspects of the form

3. Be very careful in respect of draping
   • Discussing draping before commencing treatment
   • Always keep patients properly draped except for the area being worked on
   • Ask for verbal confirmation before adjusting or moving sheets/towels
   • Ensure proper draping when a patient turns over

4. Be very explicit about treating a sensitive area
   • Advise a patient before treating a sensitive area
   • Obtain a further verbal consent before treating a sensitive area

5. Communicate continuously and transparently
   • Ensure that you clearly communicate the areas to be treated at the outset of the appointment
   • Advise the patient before proceeding to a new body part
   • Consistently check in with the patient regarding pressure and comfort
   • If a patient expresses any concerns about treatment - stop and discuss
   • Open communication reduces misunderstandings

6. Maintain professional boundaries
   • Keep conversations professional and neutral
   • Avoid any discussions of a personal nature, especially relating to relationships, dating, sexuality, etc.
   • Avoid accepting or sharing inappropriate disclosures
   • Avoid flirting or complements

7. Be especially vigilant in the way you interact with new patients
   • In my experience, the vast majority of sexual abuse complaints involve new patients, often first-time patients
   • New patients have no history with you and are much more likely to jump to incorrect conclusions

8. Control the environment
   • Be careful to ensure that the treatment room remains professional
   • Avoid using romantic music or overly dim lighting
   • Dress professionally

9. Mandate parental attendance while treating a minor
   • Treating a minor, including a teenager, without parent attendance is a very risky practice, and exposes RMTs to a heightened risk of complaint
   • Accusations from minors often come across as more believable and carry a heightened level of stigma

10. Look for cues
    • If a patient does not appear to understand what you are saying, it is imperative that you repeat/revisit the issue involved
    • If a patient appears uncomfortable, ensure that you immediately check in to see what is going on
    • Minimize discussions with a patient who is not engaging in two-way discussion

11. Be careful with documentation
    • Avoid any commentary of a personal nature in the clinical note
    • Ensure that clinical notes are detailed and that any issues/concerns are clearly documented

12. Avoid “surprises”
    • Do not say or do anything that could surprise the patient (i.e. treating body parts not requested/discussed, utilizing techniques not discussed, unanticipated draping practices, disclosing highly personal information)
    • Surprising a patient often makes them question your professionalism – and can make them re-assess the appropriateness of your other conduct

I hope the above guidance proves useful and motivates RMTs to consider further strategies for reducing the risk of such complaints.

About the Author

Lad Kucis is certified by the Law Society of Ontario as a specialist in health law and provides advice and representation to registered massage therapists in respect of all types of regulatory matters, including complaint and disciplinary matters before the CMTO, and complaint reviews before the Health Professions Appeal and Review Board.

Lad can be reached by telephone at 416.864.3114 or by email at lkucis@grllp.com.

Tags: cmto, complaints, legal information