Standard-for-Maintaining-Professional-Boundaries-and-Preventing-Sexual-Abuse-FINAL-revised-Nov-2019

PART 1: MAINTAINING PROFESSIONAL BOUNDARIES

Importance of Professional Boundaries

• RMTs must maintain professional boundaries to prevent abuse.

• Boundaries are critical to ensuring a therapeutic and safe environment for clients.

Purpose of the Standard

• The Standard includes two parts:A) Maintaining Professional BoundariesB) Preventing Sexual Abuse

• Definitions are provided at the end of the document.

Part A: Maintaining Professional Boundaries

• The relationship begins with understanding the client's goals through interviews and assessments.

• Informed consent is essential for assessments and treatment plans.

• RMTs must maintain trust and respect throughout the therapeutic process.

Standard A1: Establishing a Practice Setting

• The practice setting must align with public expectations for healthcare professionalism.

• Requirements include:

  • Clean and organized environment

  • Client safety and appropriate lighting

  • Free from potential hazards

  • Respect individual needs like allergies (e.g. scents, dust)

  • Ensure privacy and confidentiality

  • Informed consent for any recording devices used in practice

  • Ensure all devices not related to recording are inactive during sessions

  • Visual media must be appropriate for all clients.

Standard A2: Interpersonal Behaviours and Non-Verbal Communication

• Professional behaviour is imperative at all times.

• RMTs should:

  • Wear appropriate healthcare attire

  • Maintain personal hygiene

  • Ensure adequate physical space between therapist and client

  • Limit touch to that which is consensual and necessary for treatment

  • Acknowledge and respect client non-verbal cues.

Standard A3: Verbal Communication

• Communication should be respectful, professional, and relevant to healthcare.

• RMTs must:

  • Ensure informed consent throughout treatment

  • Provide opportunities for client questions

  • Use non-sexual and culturally respectful language

  • Maintain boundaries in discussions, limiting personal information that does not enhance therapy.

Standard A4: Draping Techniques

• Draping is essential for physical boundaries, promoting client comfort and trust.

• Steps for proper draping:

  • Inform clients about draping protocols before treatment

  • Explain areas of treatment and draping requirements

  • Ensure client comfort and the option to remain clothed

  • Only uncover areas being treated and ensure client safety.

Standard A5: Treating Friends and Family

• Extra vigilance is required when treating individuals known personally; avoid treating romantic partners due to clear conflict of interest.

• Maintain professional principles and confidentiality at all times.

Standard A6: Giving or Receiving Gifts

• Gifts can blur professional boundaries; significant gifts must be documented.

• RMTs should assess whether gifts could imply favoritism and should decline if so.

PART 2: PREVENTING SEXUAL ABUSE

Overview of Sexual Abuse Regulations

• Sexual abuse of clients by health professionals is strictly prohibited under the RHPA (Regulated Health Professions Act).

• RMTs must report any suspected sexual abuse by other health professionals.

• Zero tolerance policy; definitions of sexual abuse are clearly defined, including any form of sexual contact or inappropriate remarks.

Defining Sexual Abuse

• RHPA defines sexual abuse as:(a) sexual intercourse or physical sexual relations with the client,(b) sexual touching of the client,(c) sexual remarks or behaviour towards the client.

Standard B1: Treatment of Sensitive Areas

• Treatment of sensitive areas requires extreme caution due to potential for misuse perception.

• Treatment requires clinical validity, thorough communication, and obtaining written consent.

• Under no circumstances, should RMTs touch genital or anal regions as it constitutes sexual abuse.

Standard B2: Mandatory Reporting

• RMTs must report known or suspected cases of sexual abuse to the College.

• Reports must include details of the alleged abuse and comply with the time frames outlined in the RHPA.

Standard B3: Post-Termination Relationships

• The power imbalance does not disappear post-relationship, hence a mandatory waiting period is enforced.

• Engaging in romantic relationships with former clients is prohibited for at least one year post-termination.

DEFINITIONS

Therapeutic Relationship

• A purposeful interaction aimed at promoting the client's health, based on trust and respect.

Boundaries

• Define personal and professional limits; violations can result in harm.

Power Dynamics

• RMT-client relationships are unequal; the RMT holds significant knowledge and influence over the client.

Different Types of Abuse

• Verbal, Physical, Financial, and Sexual Abuse are all forms of abuse violating the therapeutic relationship. Each form of abuse exploits the power differential within the client-RMT relationship.