Book Review of The Ethics of Touch

International Association of Yoga Therapists (IAYT)
International Journal of Yoga Therapy
Volume 14, 2004
by Kimberly Gavin, R.Y.T.

Managing ethical conflicts is challenging for anyone, but it is particularly so for wellness practitioners who make their living by touching others, whether they practice massage, acupuncture, chiropractic, physical, Yoga, or some other therapy. Too often, ethical training is not covered in formal education.

The authors of The Ethics of Touch, Ben Benjamin, Ph.D., and Cherie Sohnen-Moe, believe this oversight causes confusion at best and sets up touch practitioners or their clients for harm at worst. Their textbook is an exhaustive resource for helping touch therapists expand their knowledge of ethics, better manage client-practitioner boundaries, and in general run ethical practices.

Benjamin and Sohnen-Moe wisely begin by defining ethical principles in the first chapter. For example, ethics are defined as the study of moral principles and appropriate conduct, while values are defined as tangible and intangible convictions an individual considers of worth. This chapter includes a discussion of ethical dilemmas--when two or more principles are in conflict--and offers a model for conflict resolution. Here the authors also lay the groundwork for core psychological concepts they will apply throughout the book.

Chapter Two continues to build the foundation by defining boundaries and exploring the types and extent of borders that we use to separate ourselves from others and the environment. The practitioner and client ideally meet boundary to boundary, but when boundaries are crossed or violated problems can result. This chapter includes boundary clarification and indicator exercises to help practitioners explore their own attitudes. This chapter, like others in the book, also is peppered with scenarios to help clarify important concepts. An understanding of boundaries is important, the authors stress, because it helps practitioners to improve their relationship with clients as well as avoid inadvertent slips into unethical behavior.

Equally important in maintaining an ethical practice--or living an ethical life for that matter--is effective communication. Frequently boundaries are crossed (and problems created) because the practitioner is not communicating clearly with the client or does not clearly understand what the client is communicating. Thus Chapter Three is devoted to understanding communication dynamics.

There are two key concepts in this chapter: understanding reflective listening to assure clear interpretation of what the client is saying; and interactive speaking, which allows the practitioner to clearly get the point across and get feedback from the client. This chapter also covers body awareness--sometimes a client will speak volumes with posture or reflexes without saying a word. Practitioners can and should train themselves to see what the client may not be saying. The authors conclude this chapter with communication techniques that allow clients and practitioners to maintain their boundaries, thus fostering an ethical and professional relationship.

Having established a platform of understanding, the authors delve into the meat of their subject in the remaining chapters. Chapter Four explores dual relationships and how those can offer both opportunities as well as ethical challenges. A friend asking for massage therapy is an example of a dual relationship. Two practitioners exchanging services would be another. Examples like these are fairly benign, the authors contend, but are not without pitfalls. At the other extreme are instances where a client and practitioner embark on a romantic relationship, something the authors clearly discourage, at least while the professional relationship exists. This chapter concludes with methods to evaluate the potential risk in dual relationships and ways to minimize concerns. Professional supervision is an invaluable tool for navigating gray areas, something Benjamin and Sohnen-Moe encourage and emphasize throughout the book.

Chapter Five deals with sex, touch, and intimacy and is really the heart of The Ethics of Touch. The authors clearly define the difference between sex, touch, and intimacy and explore the implication of each in depth. This chapter includes an in-depth discussion of sex and touch therapy. Because humans are sexual beings, Benjamin and Sohnen-Moe contend that keeping sexuality totally out of touch treatment is not possible. What they focus on is helping practitioners acknowledge that sexuality exists in an environment where sex is absolutely taboo, the ultimate ethical challenge. Sexual misconduct is covered in depth, including a risk assessment questionnaire to help practitioners determine the danger they face of moving into unethical territory. Repeatedly, the authors stress that sexual relationships between practitioner and client are absolutely forbidden. And they candidly present the pitfalls of ignoring this advice.

Ethical practice management and ethical business practices are covered extensively in Chapters Seven and Eight. The authors walk readers through the scope and standards of touch therapy practice filtered through the eye of the law, which is pivotal but very often difficult to interpret. Business ethics include issues ranging from attitudes about money to product sales, fee structures, taxes, referrals, marketing materials, insurance, and legal issues.

Any practitioner who deals with trauma victims will find Chapter Eight valuable. Here Benjamin and Sohnen-Moe present the basics of understanding trauma and abuse and the cycle of recovery. They then put in context the benefits of touch therapy to trauma victims and clearly delineate what practitioners need to know to work with these clients. They support this chapter with and appendix offering specialized protocols for dealing with trauma, abuse, and cult victims.

The final chapter explores the role of supervision in the touch practitioner's career. The authors believe that supervision is an essential ally in maintaining an ethical and professional practice. The say so repeatedly throughout the book, but in this chapter discuss in more depth what makes a good supervisor and how to find one, as well as how to use peer supervision as a acceptable substitute.

This book is valuable as a resource for exploring a wide range of sensitive issues. Benjamin and Sohnen-Moe support their thorough work with quotations in the margins throughout the book from a wide variety of sources. Also useful are margin references that lead readers to other related sections. Where appropriate, sources of information are listed alongside the applicable text. In addition, the authors have created three useful appendices. Aside from the aforementioned appendix on trauma, another offers sample office policies and other useful practice forms. The final appendix presents the codes of ethics of [over a dozen] different organizations, such as the American Chiropractic Association, the American Massage Therapy Association, the American Polarity Therapy Association, and the Kripalu Yoga Teachers Association.

In the chapter on sex, touch, and intimacy, Benjamin and Sohnen-Moe sum up the raison d'etre of their book: "Widespread education about ethical behavior is necessary to prevent the next generation of health practitioners from compromising their client's welfare and the public trust." Training has already begun in some schools, but what about those who have received no formal training? The authors answer, "It is never too late to learn." For any touch therapist concerned about maintaining an ethical practice, this book offers an excellent place to start.

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