Ethics and massage therapy
Susan Stockton, a Boise massage therapist, had a client years ago who reminded her of how diligent massage therapists must be in maintaining boundaries between themselves and the people they treat.
She was working the soft tissue in a male client’s abdomen, near his heart. A certified neuromuscular therapist with years of experience, Stockton could feel a breakthrough moment when the tissue relaxed. Just then, the client sat up with a surprised expression and told Stockton he was falling in love with her.
That could have made things weird. But it didn’t. Stockton said the declaration was an opportunity for her to talk to her client about the emotions that can arise when someone eases your pain, or when your brain gets a rush of happy chemicals.
Massage therapy is unlike any other profession. It involves prolonged physical contact, sometimes without clothing. The client is vulnerable. So is the practitioner: Therapists told the Statesman that it is common for women and men in their profession to be propositioned or grabbed at by clients.
But therapists must maintain boundaries or put their jobs at risk. An increasing number of disciplinary actions by the Idaho Board of Massage Therapy involve boundary violations. They range from a female therapist dating a client she hadn’t treated for many months to a therapist who had sex with multiple clients.
Idaho massage therapists have been regulated by licensing rules for only four years. Of the 2,260 therapists currently licensed, state records show, there have been 14 disciplinary actions for problems more serious than failure to keep up with continuing education — a common offense in all professions. Half of those 14 involved boundary violations.
“Before we had a licensing board, it was just the therapist’s word against the client’s word,” said Susan Beck, the massage therapy program director at Idaho State University in Pocatello.
“The law is doing what it should,” Beck said. “We’re getting bad actors out, and that’s important. And that’s why we have this, so people can be identified who are maybe ... their ethics are not professional, and maybe their intentions in massage therapy aren’t really ‘massage’ in nature. That’s why so many of us really pushed to get this law through.”
Beck and other industry leaders note that massage therapy is a health care profession. Practitioners use massage therapy to reduce pain, aid in recovery from injuries, promote relaxation and relieve stress. When prescribed by a medical provider, federal law allows massage therapy bills to be paid using a health savings account.
I did ‘wrong things’
Under the 2012 law, a five-person board oversees the profession and sets up standards and rules for practitioners. Rules specify what massage therapists can and must not do, with an emphasis on preventing any ambiguity in their relationships and behaviors.
Simon Goodwin surrendered his license in September 2014 after his former employer — not identified in public records — filed a complaint alleging that Goodwin had sex with at least three female clients and inappropriately touched two others.
Goodwin had been fired that June after one of the clients called his employer, the board said. “The employer reported that the client was crying and confused and did not understand why [Goodwin] had touched her inappropriately,” it said.
Goodwin told the board’s investigator that he had done “wrong things” and “should not work as a massage therapist,” the report said.
Goodwin, whose license listed a Meridian address, did not respond to a message from the Statesman.
Aaron Sundgaard, of Eagle, lost his license in September 2016 for at least five years. The board’s disciplinary action said he “engaged in improper sexual contact with a client” in March 2016.
The Ada County Sheriff’s Office said in May 2016 that the female client told officers Sundgaard groped her and made several sexually explicit remarks during the massage session on March 1, 2016. He later pleaded guilty to misdemeanor battery.
Sundgaard declined to talk about the incident and asked the Statesman not to publish his name, a request the newspaper denied. “I’m just getting over this,” he said. “I couldn’t afford a trial, and I kind of got screwed.”
‘This is not massage’
Hayli Williams, of Eagle, was fined $250 and ordered to reimburse the board for $1,686 in costs after her license lapsed in October 2015.
Williams practiced massage therapy with an expired license for at least two months in mid-2016, according to the massage therapy board’s disciplinary-action report. During that time, she “laid on top of a client’s back without the client’s consent and which made the client uncomfortable,” the board said.
Williams told the Statesman she remembers little about the incident, except that the client was a man. She plans to travel and teach people “exactly what it is like to connect to yourself and others,” but she does not consider her work to be massage therapy.
“I’ve been telling everybody this forever,” she said. “I use Reiki work and tantric energy and grounding techniques. This is not massage, this is healing. ... To ground, we will hold legs down, ground you with our bodies, and it’s completely clothes on.”
Stockton, the Boise massage therapist, said communication is key — and therapists have a responsibility to make sure clients understand what they offer. Many of her clients are referred from other health care providers, such as doctors.
Intake forms help clarify any confusion about her approach as a neuromuscular specialist, she said. She tells clients what to expect at every point in a session — so that, for example, it is not jarring when she moves her hand quickly from one part of the body to another.
Stockton has been in good standing with state and national massage therapy boards and has practiced since 2004. She agreed to talk with the Statesman because of her “desire to promote the growth of the profession in a healthy way,” she said.
A humiliating experience
Afton Naranjo graduated from massage therapy school at ISU in 2013, just as the licensure law was taking effect and the ethics code was still being written.
The school gave her plenty of training in anatomy, physiology and kinesiology.
“The ethics portion of my training was inadequate,” she said. “We needed to spend more time there.”
She went to work for a massage-therapy business in Southeast Idaho. In her first year of practice, she worked on a certain client twice. She ran into the client 10 months later outside of the massage studio, and she didn’t think it was a big deal for them to start dating.
The relationship turned sour, and she tried to end it. She said the client retaliated by filing a complaint with the licensing board. The licensure law says therapists must wait 12 months before having a sexual relationship with a client. The board found she had violated the law and suspended her license for six months.
The experience was humiliating and cost her about $4,000, she said.
“That was about the roughest year of my life,” she said. “It has definitely impacted the way I conduct my massage therapy and work with the public.”
Naranjo said the only new clients she currently accepts are people she knows from her tight-knit community.
No sex, we’re therapists
Two massage-therapy schools in Idaho say they now strive to make sure students have plenty of training in ethics before they graduate.
Beck, who runs ISU’s massage therapy program in Pocatello, and Cynthia Mason, director of the Idaho School of Massage Therapy in Meridian, said they train students in how to maintain “healthy boundaries” with clients. They run supervised clinics, where instructors can watch students interact with the public.
When they finish school, massage therapists must be prepared to have their boundaries tested, Beck said. The school requires them to dress conservatively.
“Occasionally, people get desperate, and when they need to put food on the table or they have kids to take care of, they may be tested on that boundary issue,” Beck said. “Our students all have a dress code they have to follow working in our clinic. They’re either wearing scrubs or a polo shirt and black khakis ... instead of a tank top and a short skirt. Who’s more likely to be tested on their boundary issues?”
▪ Engage in any behavior that sexualizes, or appears to sexualize, the client/licensee relationship.
▪ Participate in sexual conduct with the client, whether consensual or otherwise, for at least 12 months after the end of the client/licensee relationship.
▪ Participate in relationships that could impair professional judgment or result in exploitation of the client.
If the client initiates sex, the therapist must clarify the purpose of the therapeutic session, then stop or refuse the session if the client continues the attempt.
3 therapists at one firm disciplined
Three male therapists who worked at a Meridian massage studio were disciplined this year. That is an outsized number in a profession dominated heavily by women.
The board found each man made inappropriate comments or broke rules.
The first, Juan Garza Jr., of Boise, allegedly asked a client for her telephone number in January 2016. Garza did not respond to the allegations, so the board revoked his license in February 2017. Garza could not be reached for comment.
The second, Ignacio Monterrubio, of Garden City, entered his phone number into a client’s cellphone, “engaged in improper touching and improper draping” and offered to provide a “Latin” massage outside of the studio during a February 2016 session, according to his April 2017 settlement with the board. Monterrubio told the Statesman that Latin massage is a play on words — his variation of Swedish massage, the most common type of massage in the U.S.
“During session, [the client] asked on different occasions if I had a business elsewhere, she pushed the issue,” he wrote to the board. “I had a weird feeling, yet, I provided my info, and invited her to try [a different type of] massage.”
Monterrubio agreed to pay about $3,000 in costs to the board, as well as take classes in ethics and proper draping of the body.
The third therapist, David Siebers, of Meridian, allegedly told a female client in March 2016 that she was “beautiful” and had “beautiful feet,” asked her why she did not have a boyfriend, and asked her to pull down the sheet “so he could work on her pecs,” which made her “feel exposed.”
He told another client that week that “his massage techniques were orgasmic.” That client was upset and complained to the studio, Massage Envy, the board said.
Siebers did not respond to the allegations, so the board revoked his license in May 2017.
Siebers told the Statesman that he did not respond because he no longer wanted to work in massage after the incidents.
He said his intention with the first client was to “give her a pep up,” because she was talking negatively about her appearance. He said he meant to tell the second client that the massage technique was “euphoric” but used the wrong word.
“What probably could have saved me was just keeping my mouth shut,” he said.
“I’m 6-foot-6, and I wear a lot of black, I wear long hair, and I’m very intimidating to some men,” Siebers said. Now, he tells himself, “No wonder you had complaints: She was scared out of her mind at you touching her.”