Summer 2003

Confidentiality

The comfort and intimacy of the massage school setting often provides a family-like environment: while having benefits, it has its drawbacks. Too much comfort can cause carelessness in regards to confidentiality for both instructors and students. If students have an environment that protects their right to privacy and safety, they are more likely to embrace client confidentiality in the future.

In the school setting students have legal rights to confidentiality. Personal information sheets, schedules, grade reports and the like are usually stored in locked cabinets. Work-study students should never be authorized to see the records of fellow students.

Details from those records should be revealed on a need-to-know basis only. So if a student has revealed a distressing home situation to an advisor, the information does not automatically get forwarded to every teacher or administrator who comes in contact with that student. Your school probably has specific policies and procedures regarding confidentiality. But, do you know them? And how do you apply them to the classroom? Far too few schools handle this aspect routinely.

Thinking of your students as clients may help you in framing your approach. When an issue comes up, think about how you would handle the situation with a client, refer to your legal responsibilities and school's policies, and consider the classroom dynamics. How would you handle a student who tells you about her blood-borne disease? Of course, the student decides how to proceed but the impact on the class needs to be taken into consideration. It can be a powerful positive experience if handled appropriately.

You can explore confidentiality issues that are important to your class and their future clients. They will probably come up with different lists. Discussion items you might consider are:

Describe situations where it could be easy to inadvertently break confidentiality.
Identify circumstances when it is okay or even necessary to break confidentiality.
Specify actions to minimize confidentiality problems.

Other valuable issues you may choose to discuss are state and federal laws, the Health Insurance Portability and Accountability Act (HIPAA), and survivors of trauma or abuse.

The school setting is similar to a supervision group. Students are generally expected to discuss their questions about "client" interactions. Client names are withheld in these circumstances. Yet, confidentiality becomes even more important when students gather informally, especially regarding classmates. How students interact with their teachers and their "clients" sets the stage for their professional interactions. Graduates are more likely to deal sensitively with issues of power dynamics, transference, countertransference, dual relationships and confidentiality if their education comes from professional and ethical teachers.

Classroom Capers

TOPIC: Confidentiality & Empathy

Objective: Create awareness of how a stigmatized medical condition affects a client and the role confidentiality has in that.

Background: Although HIV/AIDS is a prominent issue, it is still not fully addressed. Even in the helping communities we direct our energies and education toward Universal Precautions. Physical safety must come first, yet it is also important to consider the safety of the client's emotional, mental, sexual and energetic well-being. Confidentiality is an important tool in this regard.

Procedure: Discuss the experience of a person with HIV/AIDS. Introduce role-playing after the students have a better understanding of the fear and discrimination people with HIV/AIDS endure. Each group of 2-6 designs a role-play from an assigned scenario and performs it for the class.

Role-play Scenarios: Daily routine; Practitioner in group contracts HIV; Practitioner witnesses a peer acting in a discriminatory way toward a client; Client requests special care; Client asks the practitioner how s/he handles working with HIV/AIDS; Practitioner respond to a client who has just disclosed his/her HIV+ status.

Debrief: What stood out to you in the role plays? Did anything seem uncomfortable to you? How will you treat an HIV+ client in your practice?

Discussion: How has HIV/AIDS impacted your life? How has this particular infection changed our society, the world? Do you think it is fair? How are people with HIV/AIDS discriminated against? Do they have good reason to be fearful? Why or why not? What is the purpose of confidentiality? Does it really matter whether you know if someone is infected? There are people who are infected and don't know it, what about them? What about you, how would this effect your life if suddenly you found out you had HIV/AIDS? How would you want to be treated?

Materials Required:

Handouts on HIV/AIDS and Universal Precautions
Confidentiality excerpt from The Ethics of Touch

Time Required: 60-90 minutes.

Web sites about HIV/AIDS

Confidentiality Caper Ideas

Research how confidentiality is addressed in various Codes of Ethics. Assign specific codes to each group, have the groups report back to the class, make a complete list and then design the "ideal" list.
Design the required HIPAA forms for confidentiality.
Develop confidentiality policies for private practice.
Pair students in dyads and have them simulate client/therapist conversations regarding confidentiality questions and policies.
Design a class project to research the requirements for your profession regarding HIPAA or state and city standards.

E-mail Us Your Capers!

Please use the format:

Topic
Objective
Procedure
Discussion
Materials Required
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New Resources

Rave Reviews!

In case you missed the excitement The Ethics of Touch is now available. In less than two months since its official release, The Ethics of Touch is a required text in 20 schools and many others are incorporating it into their curriculum and recommending it to their students. Review copies have been sent out to the schools and official reviewers. We are receiving rave reviews! Instructors are excited about how user-friendly and applicable it is to both the classroom and their practices.

Check out The Ethics of Touch book reviews for the complete buzz. . . .

American Polarity Therapy Assn (APTA)
Energy Newsletter -- Spring 2003
John Chitty, RPP, RCST

This new textbook is a thorough summary of all aspects of training in ethics for body workers, custom-designed for classroom use. My first impression was that this is a match for Sohnen-Moe's Business Mastery, the well-established textbook for that curriculum topic area. That book fulfilled a real need in touch therapy schools. I expect this new book to take a comparable place in the educational setting.

Sohnen-Moe has a long history in the field of touch therapy education, and also a long history with APTA. She has presented at our conferences and provided articles and other support materials for at least a decade, so it is great to see this latest expansion of her work.

The book covers every conceivable angle in ethics training, and adopts a "high road" approach that avoids too-strict interpretations on such complex subjects as dual relationships. Case history vignettes, cross-references, great quotations, checklists and activities make the teacher's job easy by providing a built-in lesson plan that can be used in segments or all as one comprehensive training.

The chapter headings show how comprehensive this book is. Ethical Principle, Boundaries, Communication, Dual Relationships, Sex and Intimacy, Practice Management, Business, Special Considerations for Trauma and Supervision: every area gets its treatment with the same basic format. This approach is a boon for teachers and students. Learning is easier with standardized content such as this because we quickly know what to expect. I thought the Appendices were a great resource as well. Forms are given for every conceivable purpose, plus protocols and sample codes of ethics (including APTA).

I recommend The Ethics of Touch highly for all educators and students; this will provide everything you need to learn and develop in this all-important area of professional competence.

Massage Today and
Acupuncture Today and
Dynamic Chiropractic
-- June 2003
Larry Gray, PH.D., LMT

The Ethics of Touch is, to my knowledge, the best and most thorough book on ethics available for the touch therapist. Both authors have tremendous experience and resumes in the field of ethics. The discussion of ethical principles and the particulars of case studies is even-handed, nondogmatic, logical and ultimately persuasive, Furthermore, the whole tenor of the book is aimed not at simply stating rules and regulations, but at guiding readers to make ethical decisions for themselves.

To be truly useful, any book on ethics must avoid two pitfalls: being too abstract and philosophical, which could allow the reader to agree with everything, but not know how to apply it to practical ethical decisions and behavior; and being a list of do's and don'ts without a firm intellectual set of principles on which the advice is based. The Ethics of Touch avoids both of these potential pitfalls. It is plenty abstract and full of principles and values, but it also is eminently practical, discussing such issues as dual relationships with lots of anecdotes and case histories. [...] The Ethics of Touch engaged me with its discussion and forced me to think about ethical questions.

I highly recommend it.

American Massage Therapy Association (AMTA)
Indiana Chapter Newsletter
-- April 2003
Barbara Lis, Chapter President

The challenge of creating an ethical, safe and rewarding practice for bodyworkers has been made easier now with the newest book to enter the field. The Ethics of Touch will help even the most experienced therapist through any uncomfortable circumstances that may occur with a client. Massage therapists are perpetual students always learning and responding to change consequential to the power of touch. This book will give you the resources to problem solve in a clear, safe and logical manner. You will want this book on your shelf as a resource. It's a great tool.

Mission Statement

Teacher's Aide is a cooperative venture among all of us who teach business: a support system to make our job easier, more effective and fun. This newsletter is a forum for exchanging creative techniques on teaching business as well as a resource for exercises, handouts, quotes and tools for use in class. We welcome contributions, so please send them today.

Classroom Confidentiality Tips

Do

Do have students write questions/responses on 3x5 cards if the discussion topic is of a sensitive nature.
Do meet with students privately.
Do secure student records.
Do emulate confidentiality in the way you discuss others in the classroom.
Do provide private areas for the intake interview in the school clinic.
Do be aware of your environment and potential listeners when having a personal conversation.
Do have clear policies for all employees, faculty, students and student clinic personnel.
Do make yourself available to students for private conversations.

Don't

Don't say student's grade out loud.
Don't have students correct each other's papers.
Don't ask direct questions of a personal nature during class time.
Don't treat Teaching Assistants as confidants.
Don't leave sensitive information unattended.
Don't discuss classroom interactions beyond the classroom.
Don't press a student for the reason he is late to class when he comes in.
Don't correct students who have breached a classroom agreement in front of the class, unless it's an appropriate issue for the class to address together.