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Modesty and Cultural Sensitivity

Felicia Brown, spa consultant and owner of Spalutions!, sees a large overlap between boundaries, ethics and cultural sensitivity. She believes that cultural insensitivity starts with the assumption that everybody is just like us. “We have to be aware that just because something feels good to you, or fits with your value system, does not mean that it feels good to someone else,” she says. Language is a powerful part of the therapist-client relationship. But it also bears the capacity for misunderstanding. “There are so many slang terms that have become part of our language, which means people can say things without realizing they are being potentially disrespectful,” Brown says. Likewise, Brown cautions therapists about using industry lingo that others may not understand, such as “intention,” “palpate,” and “insertion.” Although it could be overwhelming to try to understand all the nuances of different cultures, she says you can go a long way toward cultural sensitivity by asking yourself a simple question: “How would I feel if this comment was made to my mother, sister or child?” Brown says that when clients know what to expect, they can relax and be more comfortable. Knowing that their one-hour session is truly 60 minutes, that a full-body session consists of work on these specific areas, and that the therapist will communicate any changes in the schedule, technique or areas to be touched, all help them be at ease, as much as knowing the sheet is a boundary that protects their modesty.

Group practices and spas can start by teaching staff members to be more sensitive to each other. In her continuing education classes on cultural sensitivity, Brown helps staff learn about each other’s backgrounds and experiences through games, partner exercises and group discussions. These exercises help them understand that everyone’s perspectives and boundaries are different. By acknowledging their differences and similarities, they begin to lay the foundation for a deeper acceptance and respect for their clients’ different value systems. This also holds true for preventing sexual harassment. In Brown’s seminar entitled “When Intention Doesn’t Matter,” she helps therapists protect themselves by first implementing good boundaries in the workplace. Some of her suggestions include:

  1. Ask everyone in the workplace permission to touch them. “As touch providers, we tend to think that everyone loves massage, especially if they work in the environment. We need to be sensitive to the differences.”
  2. Make your massage session with co-workers as professional as with your clients. “Casual touch in the workplace is confusing. Therapists should exercise caution when they have the urge to massage their coworkers off the table.”
  3. Respect people’s sensitivity about touch and modesty. “To a touch provider, hearing someone has a headache or aching shoulder means they want hands-on time. This isn’t necessarily the case.”

Crossing Generations: special considerations for modesty

Type of Client Remember... Special Considerations
Children The power differential is quadrupled.
  • Always have parents in the room.
  • Allow children to choose everything in the session.
  • Do not have children remove clothing.
  • Just work on what’s injured—think subtle and minimal.
Teenagers Things move through their body very quickly—less is more.
  • Get informed consent from a parent. Consider having the parent in the room.
  • Always “undertreat” rather than “overtreat.”
  • Remember the slightest thing can cause a teen to have sexual feelings (and feel guilty)—proceed carefully.
  • Avoid stomach and thighs.
Seniors Each person is different. Don’t make assumptions.
  • Some are extremely modest—accommodate their comfort level.
  • Some ask for no covering because they are “hot”—turn on an air conditioner or open a window, but insist on using a sheet.
  • Have clear boundaries whether you will help an infirmed client undress, get on the table, etc.
  • Consider either having them bring a caregiver to help, working in the chair or working on them fully clothed.

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