Regulated states usually include in their rules that the client has right of refusal—the right to decline treatment or any part of it—including after they’ve already given consent. The therapist generally has the same right to refuse a client or refuse to honor a specific request.
Right of refusal on the part of the client can be for any reason. If they’re uncomfortable with the pressure or where you’re touching them and they ask you to stop, don’t argue or make excuses. Just be accommodating. Adjust the pressure, move to another area, and check in to make sure what you’re doing is OK.
It can be trickier when the therapist is the one to refuse. We should never have to put up with inappropriate sexual behavior from a client, although there are some inconsiderate employers with the attitude of “just deal with it.” If you’re seeking employment instead of being self-employed, it’s wise to know a company’s policies on the therapists’ right of refusal before agreeing to work there. Some employers don’t want anyone turned away—usually owners who are not trained massage therapists.
Right of refusal isn’t always related to sexual misconduct. There are times when a client wants something they shouldn’t have . . . like a neck massage two hours after they were rear-ended in a car accident, a deep-tissue massage when they’re in treatment for lymphatic cancer, or any massage when they have a contagious condition.
Educating clients is part of our job. We don’t want to make them feel ignorant; most clients are not knowledgeable about contraindications unless we tell them. Gently say, “I’m sorry, but since your car accident just happened this morning and you haven’t been to the emergency room, it’s possible you got whiplash from being rear-ended. I don’t feel comfortable working on your neck until you’ve been seen by a doctor.” Or, “Now that you’ve been diagnosed with severe osteoporosis, we need to lighten up on your massage. I know you’ve always liked really deep work, but I don’t want to put you at risk for a broken bone.”
Any time we suspect that what the client is asking for is not safe for them (or for us and our other clients, in the case of a contagious condition), we should always err on the side of caution. If a client says they have a condition you’ve never heard of, question them to find out more about it and take a moment to look it up. If they state they are taking a medication you’re not familiar with, ask what it is prescribed for and look it up. People on blood thinners may bruise easily. You don’t want them leaving the massage looking like they got a beating. There are numerous drugs that cause bone weakening and density loss. Some blood pressure medications make people more prone to falling and they may need help getting off the table. We may be able to modify the massage to help a client, but sometimes we just need to say no.
