Sunday, May 24, 2009

Sustainable massage practice

Fundamentals, task 5. Sustainable Massage Practice.
Due date: May 25th 2009 Barbara Newton

Sustainability nowadays (post 1980’s) relates to the human integration with regard to economic, social and environmental principles. That is: "meets the needs of the present without compromising the ability of future generations to meet their own needs” as defined by the 1987 World Commission on environmental development report.

Massage practice can relate in its own small way to all three areas in maintaining sustainability. Because we are dealing with people we need to look at this through the human aspect.

1) Human sustainability context
On the human side we can:
a) Support the health and well being of others by assisting in a number of ways;
· by managing client stress
· reduction of pain
· the improvement of circulation
· and in turn the cleansing of accumulated toxins.

In addition to the massage effects by;
b) Educating the client in
· body awareness – from physical & verbal assessment
· way to prevent and cope with stress as part of their stress management in conjunction with massage plan
· incorporation of exercises and stretching to compliment and maximize the massage therapeutic effect and plan.

c) As a practitioner &/or an employee ensure;
· that we continue up skill, and as an employer offer opportunity to up skill
· maintain manageable work loads
· routine self care
· work within a safe environment based around Health & safety guidelines.

As I see it this human factor has the biggest impact that massage practice can have on sustainability, by ensuring the social and economic viability of our clients through their development, productivity and social interaction.
That is: The ripple effect of them being fit and healthy and therefore able to contribute socially and economically (in an environmentally sustainable way of course) to the wider community as opposed to just solely a client/therapist benefit.

2) Social sustainability
This is all about our interaction with the people we are treating and those we associate with in a professional context.
a) Clients: How we relate to our clients and the resulting relationship ideally compounds to form a positive effect on both parties.
For example: the more comfortable the client (trust, professionalism etc) is with the therapist then the more likely a more positive outcome from the therapy.

b) If we show to our peers, other businesses and health professionals that we are competent, reliable and work well within, or above, our principles and ethics then we can strengthen our social networks and relationships.

3) Environmental sustainability.
Ideally we should use materials within our practice that are from renewable resources and not disposing of goods that cannot be reabsorbed back into the environment without ill effect.

4) Economic sustainability
At the end of the day we all wish to make a profit, in order to sustain our own living. In turn our profit helps sustain other businesses in general with regard to our living, and other health related businesses should we choose to sell health related products or equipment. Financial sustainability now encompasses the environment and social sustainability otherwise known as “triple bottom line”.

How can my massage practice be made more sustainable?
Looking at the practice there are many small ways in which I can contribute to sustainability. These include materials used such as stationery, lubricants, draping and table linens, and fuel in the form of electricity. Together they encompass two of the three areas of sustainability: environmental and economic.
I purchase all of the above and thereby contribute economically, but are they environmentally sustainable?
a) Stationery is manufactured from a renewable source (trees) and
as a waste product is easily assimilated without environmental degradation. To be more sustainable I could consider saving the use of this resource by concentrating printed material into less- by either using both sides of the paper or reducing the size of the print to use less.
The lubricant I use at present is grape seed oil imported from Italy so I am unable to say with out any surety whether or not it is environmentally sustainable. I do however occasionally use a totally natural locally sourced massage wax which I consider being environmentally sustainable, and perhaps I should be using more often.

With regard to both and in the small scale of my operation this would have very little impact on the nations and worlds sustainability.
Apart from my self there are limited recycling opportunities in the practice.

b)Draping and table linens are however another matter. Much against my personal principles of using natural fibres I have made one small concession in setting up my clinic by using artificially man made material for table covers. These materials are made from recycled materials from a non renewable resource.
My justification for initially using them was that they are affordable, are easily washed and take little time to dry, and hence less fuel resources.
At present I am using large cotton towels for draping, which do attract a considerable cost if artificial drying is required, thereby making an economical and environmental impact, some of which is more sustainable than the other. To address this my intention in the long term is to replace these drapes with something that does not use so many resources – sheets of some description that are less bulky (less water required etc) are faster to dry and require less heat to keep them warm.

c) Fuel usage is a large factor relating to economical and
environmental sustainability and the one that I feel I can make a valuable contribution to. By nature of our climate heating is a necessity. It is required to keep the clinic at an optimum temperature for my own and client comfort, and to warm draping materials. This incurs a cost, which contributes in one area while taking away in the other so in effect I believe it balances out economic sustainability. To ensure this is turned around to my advantage I have recently incorporated a more energy efficient heating system, in the form of an electric heat pump, to compliment existing heating so as to reduce “cold heating”. This has the added advantage of being able to be used as a drying mechanism for the laundry.

By actively being sustainable in my practice, socially, environmentally and economically, I am making not only a valuable contribution our clients wellbeing but to that of “our planet”

Personal thoughts
Class notes


McQuillan, D., (2009)). Retrieved May 22, 2009 from

Wikipedia, Retrieved May 20, 2009, from, and

Tuesday, May 19, 2009

Fundamentals Blog: Task 4: The ethics of professional practice. Due date: May 20th 2009
Barbara Newton

Ethics are a set of principle or system of moral values with respect to their rightness and wrongness of certain action ( Dictionary Reference), defined as rules or standards, of expected conduct governing the conduct of an individual, groups, or members of a profession ( Merriam Webster, McQuillan ( 2009) and Salvo (2007).
For the purposes of our study the ethical considerations for massage therapy fall into four main categories: client orientated care; therapeutic relationship; scope of practice; and ethical decision making. Here in New Zealand for registered therapists and members these are mapped out by the Massage New Zealand ( MNZ) Code of Ethics.

1) Client orientated care“ A practitioner shall endeavor to serve the best interests of their client at all times and to provide the highest quality service possible”( MNZ, Code of ethics)
Treatment must first and fore mostly focus on the best interests of the client: according to their goals, be undertaken with respect, and ensuring all communications are clear and understood especially when denoting clear boundaries with regard to role, responsibilities, expectations and limitations to the client, and that this is done with compassion and awareness of power differentials.

2) Therapeutic relationship
The therapeutic relationship between the therapist and client is all about trust, integrity, experience and whether or not he client feels comfortable in all aspects of the treatment by the therapist. This is probably the most important category and consists of two areas: professionalism and informed consent.

a) Professionalism is conveyed to the client through image and behaviour.
As the massage industry is an emerging one it must differentiate from itself from other health providers by, at least meeting expectations but preferably exceeding them, in the therapists presentation, appearance, attitude and behaviour.
Image: clean, hygienic, tidy therapist and premises.
Behaviour: From the MNZ Code of Ethics: respect for client, refraining from being under the influence of any mind altering drugs or alcohol during treatments, and “a practitioner shall not enter into an intimate or sexual relationship with a patient while the patient is under their care”. This is easier said than done however as adjudged by breaches to other health professional code of ethics reported in the media.

As part of professionalism the therapist must avoid at all costs any conflict of interest, and personalization of the relationship by either transference or countertransference as they must be above reproach in this area.

b) Informed consent
The client should be informed on every aspect of their treatment session:
· of the process: such as clinical procedure, scope of practice, terms of payment, likely effects of massage etc
· their rights as per the Privacy, Health & Safety, Consumer Guarantee and Health & Disability Acts
· right to be informed of initial proceedings, feed back systems, sensitive body area and subsequent treatment plan
· Their right of refusal
· Right of confidentiality
· Clients personal privacy/space.
· Complaints procedure.
· Power differentials: Because the therapist is in both a physical and psychological advantageous position over the client, the aspect of informed consent is of paramount importance and cannot be stressed enough to ensure any power differentials are kept to a manageable level.

The importance of a therapeutic relationship is that it keeps the client not only safe, but happy, building belief and trust in what you are and what you are doing which will in turn relaxes the client. If the client believes and trusts the therapist, and your treatment then more positive outcomes are more likely,
(McQuillan, 2009 (Moerman, 2002)).

3) Scope of practice“A practitioner shall acknowledge the limitations of their skills and, when necessary, refer clients to the appropriate qualified health care professional” (MNZ, Code of Ethics)
This is about what you do and don’t do with relation to your training, experience, competency and qualifications. It is worth noting that training does not automatically mean competency, as this comes with experience.
It is important that others are aware of exactly what we do, not what they think we do, and whether or not it is appropriate, so it is necessary to have well defined communicated boundaries not only for client safety but so that they are aware of your capabilities.
Examples: As defined by MNZ i) A Certified massage therapist (CMT)) as a relaxation massage therapist as one who can manipulate soft tissue for pleasure and stress related reduction and management, and a
ii) Registered massage therapist (RMT) a therapist who can manipulate soft tissue for pleasure, stress reduction/ management, pain relief, injury management and limited exercise prescription.
It is worth keeping in mind the nonmaleficence of client centered care which is to “First do no harm” as massage therapy should benefit the client or “to help, or at least do no harm”! If treatment is not within your scope of practice then the client needs to be referred to someone who is practiced in the required skills.

4) Ethical decision making

Ethical decision making is based on all of the aforementioned. Should you ever be in the predicament of potentially putting your own interests before that of the client, have any doubts what so ever about its ethical status then you must ask yourself if this is in the clients’ best interest. If it is not then it is unethical. Treat every client as you would like to be treated yourself.

In order to provide the best possible massage experience for each and every client every time the therapist must have a thorough understanding of what
client orientated, professional therapeutic care, based on mutual respect, within well defined boundaries, and practiced within the therapists capabilities in a professional manner by informed consent actually is. Ethics help us define these parameters.

Class notes
Text books


Dictionary Reference. Ethics. Retrieved May 18, 2009 from

Fritz, S., (2009), Mosby’s fundamentals of therapeutic Massage, 4th ed., Missouri: Mosby Elsevier.

McQuillan, D. (2009). Ethics. Retrieved May 17, 2009 from
Merriam Webster Dictionary. Ethics. Retrieved May19, 2009 from
Salvo, S., (2007), Massage therapy, principles and practice, 3rd ed., Missouri: Saunders Elsevier.
Velasquez, M, Andre, C., Shanks, S., & Meyer, M., What is ethics?. Retrieved May 17 from
Whats happened to my ethics blog I wonder- missing in cyberspace no doubt. Wll give it a few more hours to come down to earth