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Creating Boundaries in the Treatment Room as a New RMT

By: Dylan Crake RMT & R.Kin

Setting boundaries can be tough, let alone setting boundaries as a new RMT. You quickly* go from a Massage Therapy student being taught how to file for HST and what techniques you should be doing on those with TMJ issues to all of a sudden being the person in charge of your treatment room. There may have been some grumblings of horror stories told throughout your Massage Therapy education where someone had decided to take advantage of a student during the Student Massage Clinic and those stories can still haunt you. And then there’s the time limits of the appointments and deciding if it is a good idea to prolong the treatment slightly, because you’re new and you want all your clients to like you. And who wouldn’t like the Massage Therapist that added a few extra minutes to their massage treatment?

*I say quick because we know the turnaround for the CMTO for new grads can be anywhere from 2 months to a year.

In school, setting boundaries was taught in two, maybe three different lectures. Not a lot when you think of the grand scheme of things, and it probably wasn’t a lecture that really stuck with the students. Lucky for you, I paid attention and I’ll briefly go over why it’s so important to set and keep boundaries as a new RMT and how you can do it.

The Different Types of Boundaries

Before you can set your boundaries as an RMT, it’s important to know the different types of boundaries. There’s:

• Rigid

• Semi-permeable

• Permeable

• Physical

Now, of course there are physical boundaries that Massage Therapists have to deal with, but the other three are more psychological boundaries. When it comes to physical boundaries, RMTs work within an intimate range of a client. So the most important thing you can do as a RMT is acknowledge there is a power differential and you hold more of that power, therefore it’s incredibly important to gain the trust of your client in order for them to let you into their bubble. Moreover, let’s talk about those psychological boundaries.

First, there’s permeable boundaries. You can think of this boundary as a garbage bin with holes in it. It’s not doing much to keep things in or out. It’s really not a boundary at all. This is not a boundary you want to set with your clients. If you have a permeable boundary with a client, then that may mean there’s no filter between you and them, transference and countertransference may occur and it’s generally unsafe. The power dynamic between therapist and client may change and next thing you know, you may be willingly telling that client you’ll come in on your off day and have them pay for a 60 minute massage but treat them for 90 minutes. This is not good, avoid this.

Next, there’s the semi-permeable boundary. You can think of this boundary as a colander. You’re only letting the pasta water out and not the pasta. This boundary is okay, but can set you up for a slippery slope. For example, if your client is typically on time to see you and then one day they’re 15 minutes late and you decide to give them a 60 minute treatment still, it may go one of two ways. They may show up on time for the next appointment, or they may think it doesn’t matter if they’re late because they’ll still get their full treatment. This can put you in a tricky spot. You have to weigh the pros and cons of your decision to break the boundary. Can you deal with the consequences of doing so? Think of that next time you decide to change your boundaries slightly.

The semi-permeable boundary is the boundary commonly used by parents. They’re willing to change their set boundaries for particular reasons. But remember, you are not the parent to your clients, you’re their RMT, so there is no real reason you should change your boundaries that you created for them.

Finally, there’s the rigid boundary. Remember this name, because this is the type of boundary that we, as RMTs, should all strive for. Rigid boundaries are exactly what they sound like. You’ve come up with a list of things in your head that you know what is and is not okay to do in your treatment room. For example, for myself, if a client is late to their appointment, their appointment is still going to end at the time it would have ended at if they showed up on time, and they’ll be paying the full amount. It doesn’t matter if my client is new or an old client, this is a boundary I have set up. Creating rigid boundaries helps set up the power dynamics within the treatment room, and it also establishes trust and understanding between the therapist and the client. This is because, as the Therapist, I’m the one in charge of the room and I want my clients to feel safe. They can’t feel fully safe and trust me if it’s noticeable that I’m not in charge of setting the boundaries for their treatment.

So now you know the three types of psychological boundaries. Permeable (not a boundary), semi-permeable (okay if you’re a parent), and rigid ( aim to have rigid boundaries everyone!) but how can you set your boundaries?

How to set your Boundaries

How are we going to set our boundaries for our treatment rooms? First, let’s go over setting boundaries for conversations. Acknowledge what is important to you when treating. Are you a serious therapist or a laid back therapist? If you’re more serious, then you can let a client know if a joke crosses a line. If you’re a laid back therapist, determine what type of joke crosses a line.

As a RMT you’re a professional, so even though we don’t have conventional office jobs, it’s important to remember we are still at work and certain subjects and jokes aren’t work-appropriate. Therefore, determine what you are comfortable with and then dial it back a bit, so that you know your client would be comfortable with any subject of conversation as well. And if you’re still unsure about how to set a boundary when it comes to conversing, keep the conversation related to their treatment.

Then, there’s setting boundaries of the treatment time. If you’re comfortable with it, you can always add in a few extra minutes to the end of your treatments with your clients.

However, for myself, I will always end the treatment on time. And my reasoning is simple. My client booked in with me at that specific time for a reason, I don’t know what their plans are after their treatment and I risk interrupting those plans if I decide I want to give them a few extra minutes at the end of their massage. If you do want to treat for a few extra minutes, be sure to ask your client if it’s okay. This will help establish trust with them and maintain client-centered care. Moreover, as mentioned previously, if I have a client show up 15 minutes late, they are getting a 45 minute massage for the price of a 60 minute massage. They chose to spend their first 15 minutes of their treatment getting to my clinic, instead of on my table and I don’t want to risk thinking they can always be late to their appointments. So, decide on the leeway you want to give your clients who are late. Now, for the most part, a lot of my clients come 5 minutes early, which is much appreciated.

Finally, there’s setting boundaries for communication post treatment. Or communicating with your clients outside of your clinic. Anytime you are communicating with a client, it should strictly be about their treatment plan or scheduling appointments.

Some RMTs do it solely through email and some do it through social media. I have different clients email to adjust appointments and I use my email to communicate home care routines for them. I also have a few clients that follow me on social media and they’ll ask if they can book in with me or about specific exercises. I have set this boundary with my clients and let them know these are two avenues they can reach me on. However, it is always about their current treatment plan or for getting them to book in with me.

“As a RMT you’re a professional, so even though we don’t have conventional office jobs, it’s important to remember we are still at work and certain subjects and jokes aren’t work-appropriate. "

- Dylan Crake

Therefore, when it comes to setting boundaries, remember you have to be the one to set them and understand that the more rigid they are, the more trust that can be established between you and your client. It’s not easy setting boundaries, especially as a new RMT, but it is up to you to do and you will figure it out. If you don’t feel comfortable with something that’s happening within your treatment room or even through post-treatment communications, then you have to change where your boundaries lie.

In the end, there are a number of different boundaries you can set as a RMT and the sooner you understand where your values lie as an RMT and a professional, you can quickly set them and you’ll be well on your way as a RMT with a rigid set of boundaries. If you ever need any help with setting boundaries or with something that's happened to you regarding boundary setting, don’t be afraid to email me at : or on instagram: @dylan.dynamic.rmt


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