Book Review of The Ethics of Touch

Council of Schools Council Communicator - Spring 2004
by Debra Curties, Executive Director

Every massage student should be exposed to this book. The Ethics of Touch is workmanlike in the best sense of that old-fashioned word--not only is its subject matter comprehensively addressed, but also great care is taken to present issues and scenarios in a manner that is relevant and true to everyday clinical practice.

It almost goes without saying that the topics encompassed in touch therapy ethics are complex, diverse, and interrelated in ways that can be quite demanding. Yet to protect the interests and well being of both client and practitioner, hands-on therapists must achieve a comfortable competence with a broad range of ethical considerations. The concern for educators, who are providing a general practical education, is scale--what is a basic yet sufficient coverage of this subject matter for our students? How do we expose them (both cerebrally and experientially) to the fundamental ethical questions so that they graduate prepared to become safe and effective therapists? Also, are resources available to our instructors that match their needs?

The Ethics of Touch is a welcome addition. After clarifying basic terms and principles, its chapters progress steadily through the core issues: ethical principles, boundaries, effective communication, dual relationships, touch and intimacy associations, special consideration for working with clients who have experienced abuse, and utilizing supervision. Each subject is addressed in an individual chapter (the boundaries chapter is especially good). The language is clear and understandable, and the text is rich with accessible personal examples and instances from professional life. Complex subjects are clarified in a straightforward manner. The importance of self- accountability is addressed early on, as the authors go out of their way to demonstrate that consistent ethical behavior stems from self-knowledge based on internalized values rather than mere adherence to externally set rules. They recognize that most unethical behavior is subtle and inadvertent, coming from a lack of understanding or thoughtfulness in the well-meaning practitioner. The goal is not to be error-free, but to grow in awareness and effectiveness in the service of a client-centered approach to providing health care. They also show how communication is the key to handling ethical grey areas that arise in the therapeutic relationship.

Two of the chapters address ethical practice management and business ethics. In keeping with the tone set in the rest of the book, straightforward guidance is provided through discussing common issues and urging full consideration of the implications of how clinical practice is conducted. As a non-American I wondered whether there would be a lot of US-specific legal or regulatory material in these sections, but the approach is more generic and the issues fairly universal, so this was not a problem. (There is a country-specific subsection on privacy legislation.)

This is not a book that most people will sit down and read cover to cover. It applies a learning and self-reflection paradigm to one major subject area at a time, drawing the reader into a series of case examples, checklists, self-knowledge exercises, and hypothetical clinical scenarios that are both pertinent and personally absorbing. Its structure is well suited to large and small group discussions in the school environment.

Readers tend to approach writings about ethics with a certain amount of hesitancy. Will it be preachy or overly black-and-white? Will it be too much on the philosophical plane? Will there be a rigid standard set without much useful help about how to achieve it? Will it be tedious to read? The Ethics of Touch does a consistent job of hitting the right level. As a reader who has been around the block a few times with these issues, I didn't agree with every point and didn't feel that the writers needed me to. I found the preachiness level low and the pragmatic relevance level very high. As an educator I was quite engaged (great countertransference checklist. . . hmm, I wouldn't use that assertion statement. . . nice case for illustrating use of supervision. . . interesting exercise about types of boundaries. . .).

The Ethics of Touch is a trustworthy book, and a useful one.

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