When a client begins sharing about their divorce, death of a pet, or work anxiety during a session, many massage therapists immediately think, “I need to refer them to a counselor.” While referrals are certainly appropriate in some situations, this knee-jerk response can rob both you and your clients of the profound healing that happens when we remain present.
The False Dichotomy
Many of us have been taught that we have only two options when clients share emotional content: either become an unlicensed therapist (inappropriate and unethical) or immediately redirect them elsewhere (dismissive and often unnecessary). This creates a reductive binary (I mean, aren’t all binaries reductive?) that overlooks a third, more nuanced path: therapeutic presence within our defined role.
As massage therapists, we’re not counselors, but we are health-care professionals whose scope includes work with the whole person, not just their soft tissues. The body holds emotion, and emotional responses during bodywork are not only normal, they are often part of the healing process. When we automatically deflect or refer emotional moments, we miss opportunities to support our clients through a healthy experience.
What Staying Within Scope Actually Looks Like
Staying within our scope doesn’t mean becoming emotionally unavailable—we’re not robots, my friends. It means being present without trying to fix, analyze, or counsel. Here’s how this can look in practice:
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Instead of: “You should really talk to a therapist about that.” Or “Do you have a therapist?” (Translation: “Please take your feelings elsewhere.”)
Try: “That sounds hard/rough/difficult. I’m glad you feel safe enough to share that with me.” (Or some other acknowledgment in your words.) -
Instead of: “I can’t help you with emotional issues.” (Translation: “I’m not qualified to care about your feelings.”)
Try: “I hear you.” Then, wait a bit and mention, “Earlier you mentioned feeling frustrated that your boss undermines you. Do you have any thoughts about where that frustration might live in your body?” -
Instead of: Changing the subject immediately. (Translation: “Emotions make me uncomfortable, so let’s talk about the weather.”)
Try: Allow them to finish or at least to come to a place where you can organically interject without being rude, then ask, “Would you like to take a few breaths together before we continue?”
The Power of Presence and Gentle Curiosity
Sometimes the most therapeutic thing we can offer is simply witnessing someone’s experience without judgment and maybe with some caring curiosity. You may not have to say much at all. Shocking concept, right? When clients share emotionally charged information, they’re often not asking for advice—they’re seeking to be heard. The massage table can be a safe space for this kind of expression, and frankly, it beats talking to their gerbil about their problems.
When we automatically deflect or refer emotional moments, we miss opportunities to support our clients through a healthy experience.
Consider this: Your client mentions feeling overwhelmed by caring for an aging parent while also raising a teenager. Rather than immediately suggesting they find a support group, you might say, “That sounds like a lot to carry.” Then, ask them what that care entails. This could give you a sense of how those responsibilities might show up in their body, and this can bring the focus to the work you’re doing with your hands. This acknowledges their emotional reality while making it clear that, in addition to generous listening, you may be able to support their body and lessen the physical toll of caregiving.
Managing Your Emotional Response
The key to staying present with clients’ emotions is learning to manage yours. I know this may seem like a no-brainer, but many of us have little experience and even less training in this. Here are a few thoughts about what managing your emotions might require.
Emotional Regulation Skills
Have mindful awareness of your physical and emotional responses when clients share difficult content.
Clear Internal Boundaries
Remind yourself that you’re holding space for their experience, not taking it on as your own.
Professional Confidence
Trust that listening with compassion is always within your scope, even when you can’t help a client solve their problems (which you won’t generally be able to do).
Self-Care Practices
Develop rituals for emotional integration and spaciousness between clients and at the end of your workday.
When Referrals Are Appropriate
This isn’t to say referrals are never appropriate. Consider referring when:
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Clients ask for specific psychological advice or therapy
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You notice signs of serious mental health crisis, including thoughts of self-harm1
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Clients repeatedly process the same traumatic content without progress
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You feel consistently overwhelmed by a client’s emotional needs; this may require not only referral, but perhaps, at some point, “firing” this client2
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The emotional content dominates sessions and interferes with bodywork
The Ripple Effect
When we stay present with clients’ emotional experiences—without overstepping our professional boundaries—we create ripple effects of healing. Clients learn that their emotions are acceptable, that healing happens in many forms, and that their bodies are a big part of how they experience the world. As a practitioner, you can feel confident in your ability to offer meaningful support through your unique skills and training.
The next time a client shares something emotionally difficult, pause before automatically reaching for a referral. Ask yourself: Are they asking for counseling or simply sharing their human experience?
Massage therapy has always been about more than just muscles and joints. Learning to stay present with emotions while honoring our professional boundaries deepens our practice and expands our capacity to truly serve our clients’ healing.
Notes
1. For more about suicide and how to handle thoughts of self-harm, I highly recommend these two articles by Corey Rivera: healwellorg.substack.com/p/the-secret-health-crisis-of-massage and healwellorg.substack.com/p/from-recognition-to-response.
2. Struggle with firing clients? Laura Allen offers some advice in her column, “Dismissing a Client” in Massage & Bodywork (November/December 2024), abmp.com/massage-and-bodywork-magazine/dismissing-client.
