Have you ever had to tell a client "no" or cut short a massage therapy treatment?

Many therapists have had uncomfortable and awkward encounters with clients (for a variety of reasons) and very experienced MTs have learned to deal with inappropriate behaviors.

Gathering stories and real life examples from massage therapists, we've put together a short guide to communication strategies and scripts.

1. Dealing with Inappropriate Comments

Whether it's vulgar comments, innuendo, hate speech or plain rudeness, how do you determine whether or not to end the client relationship or try to repair it?

In general, most therapists have their own standards of acceptable and unacceptable behaviors and they know where to draw the line for their own comfort levels. If your client makes inappropriate comments to you or your staff, you should have a plan for dealing with.

A remedial massage therapist shared this example of how she confronted a client who made inappropriate comments:

"I was in the middle of a treatment with a male client and he made a very inappropriate comment. This client had also made a comment, slightly less offensive, but still unacceptable, to a younger female therapist on a previous visit. I simply stopped the treatment and said. 'I'm sorry sir, but I'm afraid that comment was incredibly inappropriate and as a result we are going to have to end the treatment there. You will not be charged for the treatment today, but you will not be welcome back to the spa.' It was the first and only time I had to end a treatment, and it was terrifying. I'm generally a very bubbly, smiley person, so it was hard for me to be so direct. The fact that he had made one of the younger uncomfortable kind of gave me a sort maternal courage because I knew I didn't want any if the other girls to go through that. He was very apologetic and embarrassed, but the fact the he even tried to push the boundaries was not on."

In this instance, the MT knew that the client had a history of making these types of comments that made some of her younger staff members uncomfortable. She wasn't going to tolerate it and she had a plan for communicating that in a direct way.

2. Dealing with Alzheimer Disease or Dementia

Elderly clients who are in early stages of conditions like Alzheimer's Disease or Dementia may not be able to control their behavior. You as the massage therapist may not even realize what is going on at this point, if you or even your client are unaware that the condition exists. What to do when you begin to feel uncomfortable or unsafe with the therapeutic relationship?

A massage therapist discussed an event she dealt with, and we will change some of the details for anonymity:

"Several years ago I had a very uncomfortable experience dealing with an elderly client. He was a very nice gentleman referred to me by a physician I partnered with. During the first visit I noticed his behavior was very suggestive, but he was also very childlike. After another visit or two, and some research of my own, I realized I was dealing with early onset Alzheimer's.

I then contacted his wife and the physician that had referred him to express my concerns and that I would unfortunately have to discontinue treatment. At the time, my office was in my home and I had a children that seemed a bit frightened by his presence. Fortunately, his wife was very understanding and aware of his condition, however not aware of the behavior I was seeing.

For all of you new to the practice, if someone's behavior doesn't seem quite right, never hesitate to speak up."

Some MTs may be more comfortable dealing with clients who have these behaviors, and may not refuse to treat early onset patients who are not exhibiting any aggressive or threatening behaviors. You have to know your own comfort level and decide ahead of time what your standards of care will be so that when the time comes you can feel confident about how to handle the situation.

3. Dealing with Hypersensitivity

In rare cases, some clients are so sensitive to touch that their bodies respond reflexively with spasms and jerking. Take this example from a massage therapist who described a situation with a client who had a very severe response to massage:

He responded to touch in such an extreme way that its hard to describe. Just from applying the lotion he jumped like he was getting an electric shock...a full body jerk reflex. This continued throughout the massage no matter what kind of pressure or technique I used and I was concerned that it was a neurological condition and suggested he see a doctor."

In this particular situation, the client relationship turned very sour. Nothing she could do helped, but she tried to keep working with the client. Eventually the MT had to make it clear that she could not help him and in the end, she wished she had ended the client relationship more quickly.

4. Dealing with Manipulative Behavior

What is a massage therapist to do when a client becomes emotionally involved and manipulative? What are your personal boundaries when it comes to how you talk with your clients, how much personal information you share or allow your clients to share with you? It is necessary to establish clear boundaries with your clients up front to avoid unprofessional situations.

One example comes from a massage therapist who had to deal with an emotionally manipulative client. The client accused her of making comments that sent him into a depression, and manipulated her into continuing the relationship.

Looking back she saw some red flags that the client was being dishonest, suffering from psychological issues that were completely out of her scope, and she felt manipulated and unsafe.

Her takeaway, and this is a fitting summary for this post, is to trust your gut.

When things don't feel right and the chemistry between client and therapist is way off, you should trust that feeling and act accordingly. It's better to end the relationship then to put your safety and your career at risk.

What are your techniques, strategies, and plans for dealing with inappropriate behavior in your massage treatment room? I'm curious to hear your stories, so share in the comments below!