Acknowledging the Unavoidable: Addressing Dual Relationships in Massage Therapy.

In massage therapy, it is generally advised to avoid dual relationships because they are believed to be difficult to manage and cross professional and personal boundaries. However, dual relationships are difficult to avoid in small, rural, and other communities. This paper is written from the perspective of a massage therapist who lives and works in a rural town and who works within dual relationships regularly. It discusses ideas around the ethics, management, and benefits of dual relationships as well as the need for supportive ethical guidance informed by the realities of living and working in small or rural communities. Research is lacking in massage therapy around ethical issues and dual relationships; therefore, this paper draws in research from other areas of health care such as rural health ethics and rural health care. The aim of this work is to encourage contemplation, discussion, and research around dual relationships in massage therapy. Dual relationships should be further studied in massage therapy to better inform ethics education, practice standards, and guidance, which may positively impact patients and massage therapists.