Find the Career Balance : Pause for Confidentiality

This blog post is part of the "Finding the Career Balance" Series; where you will get to hear from currently practicing massage therapists and health practitioners on how they balance their career for longevity -physically, emotionally, and monetarily.  My vision is allow a light to shine on all the opportunities that are available. Use these opinions as a platform for growth. 

Guest Blog Disclaimer:  The views, opinions and positions expressed within this guest post are those of the author alone and do not represent those of Urban Therapeutic.  The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.  - Brenda Stebbeds, LMT / Urban Therapeutic Owner

“Hey, can I ask you something as a professional?”

This question always makes me pause. As someone who works both as a massage therapist, and on a crisis line, a wide spectrum of things can follow that particular inquiry. A result of a wider truth: there is something about our job - probably more than one thing, really - that makes people feel like they can trust us. I expect if you’re reading this and you’re a massage therapist, you know what I mean. You’ve had the experience of a client opening up to you in a session and sharing something deeply personal (if you’re new to the field and this hasn’t happened yet - don’t worry, it will) sometimes with no warning whatsoever.

On the one hand, it’s deeply humbling and a privilege to be entrusted in this way. Personally, I’ve always taken it as a sign that I’m doing my job right and well. But at the same time, it can be a struggle. How do you balance listening presently while also paying attention to the massage work? How do you know whether it would be most helpful to offer your client resources or to listen without judgement? And what do you do with the emotional weight that can come from these conversations?

With the rollout of the new ethics and communication continuing education requirement I’ve noticed this last question comes up in various forms in every ethics class I take. Practitioners, some who have been doing massage work for decades, come forward asking for advice on how to handle the emotional workload. My answer to this has always been the same - you have to debrief.

For anyone unfamiliar with the term, debriefing - at its core - just means talking with someone about your experience(s), and in our profession, it can be an essential form of self-care. As unpopular or uncaring as it can sound to admit it out loud, listening to people talk about trauma or grief or deeply personal struggles takes a toll. It’s not a character flaw - it’s just the truth. The type of bodywork you do, the setting where you do it, and the frequency with which you see the clients who are dealing with these issues will all affect how often you need to debrief, but unless all your clients are in flawless mental and physical health, you’re likely going to need to talk to someone eventually.

“But, Alex,” you’re saying.

“What about client confidentiality and HIPAA?”

And you’re totally correct. Like other medical and medical-adjacent practitioners, there are literal laws that prevent us from going home and venting about the details of our day to a loving partner or a good friend. But that doesn’t mean we’re entirely without options. Having talked with other massage therapists, I’ve come up with the following possibilities:

Talk to other LMTs. This can take a couple of forms:

If you work in a spa or a clinic - take advantage of your coworkers! It’s the one opportunity where you can actually share the client’s name and still be HIPAA-compliant, which means you have the unique ability to pick your cohort’s brains about a client they may have seen themselves. And even if they haven’t, maybe they’re dealing with something similar. It - I hope - goes without saying is of the utmost importance that these conversations happen in a place where they won’t be overheard. But for therapists who need to process things in detail and out loud (of which, I am one) this is the best option.  

If you have a private practice, or share a space with another practitioner but don’t share clients you can still talk to other LMTs. In this case, you do have to worry about HIPAA compliance. You won’t be able to share your client’s name and you may need to censor or change some of the details so that they can’t be identified, but it can be tremendously helpful to get feedback and support from other people who are doing the same work you are. Something I’ve been hearing more and more about is peer feedback & support groups - meetings of varying sizes organized by LMTs where folks get together and chat about the challenges they’re facing in their practices. If you’ve got other LMT friends, ask if they’d be interested in such a group and set something up. If you don’t, hop on the Eugene LMT Facebook page and inquire as to whether anyone would be interested in starting one. Getting everything organized does take work, but once you’ve got a system in place the hardest thing will be making sure everyone shows up.

Call a Helpline:

Contrary to popular belief crisis-lines/helplines/hotlines do not exist solely for people who are in the middle of a crisis. Most offer services not only to survivors but to those who are working to support them. A quick Google search is all it takes to find the phone numbers of both national and local helplines for a variety of issues - many of which run 24/7. A particular benefit of this option is that the worker you speak to may have resources or tips to help you and your client during the massage sessions. Additionally Oregon has incredibly strong confidentiality laws for crisis line and advocacy workers, so you don’t have to worry about what you talk about being shared. That being said, the confidentiality laws they abide by don’t mean you don’t still have to obey HIPAA, so be careful about revealing details.

In the same way that it’s important for massage therapists to receive bodywork to maintain our physical ability to do this work, we’ve got to make sure we’re taking care of our mental and emotional health. To do so while protecting client confidentiality can require some extra work or creativity, but in the end it’s more than worth it.

"I strive to create a safe and empowering healing space that allows survivors of trauma to be re-introduced to touch."

Alex Poling, LMT

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