Self-employed therapists may feel consent is implied if the client walks through the door or calls for appointment. Even then, the therapist needs to negotiate price and therapy. One way to ask is to say, “Which treatment are you consenting to?” The client’s answer consents to the massage. Another way is to ask “Is there any area that is giving you trouble?”

If the therapist is employed by someone else (such as a doctor or chiropractor) and finds the client already in the room, the therapist should include obtaining consent as part of the introduction of the therapist. This creates an understanding between the therapist and the client. If the therapist knows the area the doctor wants addressed, this can be described to the client and then “Is that OK with you?” can be asked to obtain consent. The client questionnaire form may also contain a consent line requiring client signature.

In the worst case, massaging a person without consent would be assault and battery. Assault is defined as “the crime or tort of threatening or attempting to inflict immediate offensive physical contact or bodily harm that one has the present ability to inflict and that puts the victim in fear of such harm or contact.” Notice that assault does not require actual touching. Just the thought that one could be touched is enough. Obtaining consent will eliminate this possibility.

Discussing the details of the whole massage will provide the opportunity for the client’s total consent. The author goes for facials. Beauticians consistently attempt to pluck her eyebrows during the facial—a procedure the author does not want. Making sure both parties know what is going to occur (full consent) obviates any problems.

The problem of consent may be particularly exacerbated where the therapist is male and the client is female. The therapist should take special pains to be aware of and respect her personal boundaries. A new therapist may feel excited to demonstrate skills. But doing so with an unwilling victim may make the recipient feel trespassed upon. Don’t insist on any treatment, technique or procedure. The first time the client says no, let it go. You can always discuss it with them afterward for the next visit. Discussing future treatment also encourages them to return.

One therapist, upon meeting a friend’s new boyfriend, was asked what she did for a living. She immediately jumped up and began massaging him, to the embarrassment of all. Obtaining consent would have avoided this gaffe.

Language may prevent consent. America is becoming increasingly multicultural. In New York City, for example, more than 170 languages are spoken. If the therapist cannot communicate in the client’s language, it is unlikely consent can be achieved and suggests the massage may need to be declined.

The point of this ethic is not to assume. The therapist’s goal is to be gentle and caring. Guessing what a client wants is less than this. So just make sure both therapist and client have a thorough understanding.

This ethic requires that the therapist make a record of the consent, even if the client consented verbally.