Appropriate Professional Touch

Being aware of client boundaries and appropriate touch is essential for any practitioner. The NHPC specifies how its members should interact with clients to ensure safety and comfort.

Appropriate Touch Requirements

The NHPC requires that all massage therapists touch clients only for therapeutic purposes. As NHPC members, therapists must:

• know what is considered appropriate touch
• restrict treatments to therapeutic touch only
• avoid accidental contact
• be able to address perceived inappropriate touch

Massage therapists are prohibited from touching the genitals, anus, or nipple/areola of all clients. Interaction with these areas is not part of the massage therapy scope of practice and is considered sexual misconduct.

Treatment of Sensitive Areas

Areas of the body that risk misinterpretation when touched include:

• chest wall muscles
• breast tissue
• gluteal region
• upper inner thigh
• anterior pelvic region
• groin area

Given the risk, the NHPC has set standards of practice for therapists dealing with the above areas or any other client-specific "sensitive" areas.

Massage therapists should only treat sensitive areas if it is clinically indicated and they have the skills, knowledge, and training to treat the area. They also must do the following:

• perform a full assessment of the client's health history and the treatment area
• discuss all aspects the treatment in detail with the client
• obtain informed consent from the client to perform the treatment
• drape the area appropriately and securely during treatment, as discussed with the client
• get feedback and consent from the client during the treatment when appropriate to ensure their comfort
• document treatment details and informed consent in the client's record

Informed Consent

Clients should provide informed consent for any treatment, especially treatment of sensitive areas. Informed consent must be given voluntarily by the client, and the practitioner must:

• obtain consent prior to the scheduled treatment of the area
• discuss the treatment goals, expected results, and alternatives, as well as the consequences of non-treatment
• discuss draping and positioning
• let the client ask questions or withdraw consent
• record the informed consent in the client's file

More Information

For greater detail on the above guidelines, including specifics on touch, draping techniques, and obtaining informed consent, see the full NHPC Position Statement on Appropriate Touch (PDF).