One might say prostitution is a crime of words. The accused says an act will be performed for a price. It is the money that raises it from the level of a date or tryst. However, if the sexual event closely proceeds a therapy session, it can be suggested that the sexual service price is included in the therapy cost. This is not a strong case for the prosecution. Therefore, a common scenario is the initial charge of prostitution is reduced to the charge of lewd and lascivious or plea bargained to disturbing the peace. This may threaten the therapist's license in any case as licensing jurisdictions can include this lesser conviction in the licensing ban.

Another reason not to engage sexually with a client is that if the therapist decides to have a committed relationship with the client, the client may have a difficult time picturing the therapist not doing the same with the other clients. In any case it changes the way in which the client views the therapist. The therapist's professionalism is compromised. The client may become too familiar with the therapist after breaching that ethic and reining the client back to proper behavior may add to the awkwardness of the situation. Further, other therapists and employees of the clinic may suffer from inappropriate behavior on the part of the ruined client.

The difference between being touched for professional massage and for arousal is obvious. Erotic massage may be an effective pastime for a couple in private but it is across the boundary for what is permissible in professional massage. Dentistry is nonsexual; so is massage in a professional setting. Some clients may need to be educated to appreciate the distinction.

It might be argued that this ethic only restricts sexual activity on the therapy premises. However, read in conjunction with Standards of Practice VI (a) ("refrain from participating in a sexual relationship or sexual conduct with the client, whether consensual or otherwise, from the beginning of the client/therapist relationship and for a minimum of six months after the termination of the client/therapist relationship."), it is clear the Standards intend to regulate all interactions between therapist and client, whether professional or private, on the premises or elsewhere.

"Research and consumer surveys leave no doubt that massage is now thought of first and primarily as a legitimate, legal, and honorable profession," writes Linda Diane Feldt, past president of the American Polarity Therapy Association. That reputation can be burnished or tarnished by the actions of every therapist. Lawyers did not become a joke because every lawyer was bad and rapacious but because a small percentage were dishonest and greedy. Every therapist represents not only that therapist's practice but also the entire industry.