There’s something about getting onto a treatment couch that seems to make people talk.
A client arrives for a massage.
Ten minutes later, you know about their divorce, their difficult boss, the argument they had with their sister and something their husband did in 2007 that they still haven’t forgiven him for.
If you’ve worked as a therapist for any length of time, you’ll know exactly what we mean.
Clients often feel safe with their therapist.
And that’s a lovely thing.
But it can also create a slightly blurred line.
When does listening to your client start becoming something you’re not actually qualified to provide?
The therapy room can feel like a safe space
Think about the environment we’ve created.
It’s private.
It’s quiet.
The client has stepped away from their normal life for an hour.
Someone is giving them their full attention.
And, particularly during hands-on treatments, people can relax in a way they perhaps haven’t all week.
Sometimes things come out.
That doesn’t mean you’ve done anything wrong.
Nor does it mean you need to immediately shut the conversation down.
Listening to somebody is a normal human interaction.
The important part is knowing what your role is within that conversation.
You can listen without becoming a counsellor
A client tells you they’re having a difficult time.
You can acknowledge that.
“That sounds really difficult.”
“I’m sorry you’re going through that.”
“You’ve certainly got a lot happening at the moment.”
You don’t need a counselling qualification to respond to another human being with empathy.
Where things become more complicated is when we start trying to solve the problem.
What should they do about their marriage?
Should they leave their job?
Why does their mother behave like that?
Do you think they’re depressed?
Now we’ve moved into very different territory.
Your client came for a therapy treatment.
They didn’t come for psychotherapy, counselling or a diagnosis.
Unless you’re appropriately qualified to provide those services, that isn’t your role.
Be careful with advice
This can be harder than it sounds.
Particularly when you’ve known somebody for years.
You may have an opinion.
A very strong opinion.
You may even be thinking:
“Please, for the love of everything, leave that man.”
But your personal opinion isn’t necessarily what the client needs from you professionally.
People’s lives are complicated.
We hear one person’s perspective during a one-hour appointment.
We don’t know everything happening outside that room.
So rather than telling clients what they should do, we can listen, acknowledge and — where appropriate — encourage them to seek support from someone qualified to help.
Clients may ask questions outside your scope
Therapists can become trusted people in a client’s life.
That means we sometimes get asked questions that have very little to do with the treatment we’re providing.
“What do you think this lump is?”
“Do you think I should stop taking this medication?”
“Do you think I have ADHD?”
“Should I take this supplement?”
“Do you think this pain is caused by stress?”
The fact that a client trusts your opinion doesn’t automatically mean you’re qualified to give one.
You don’t lose credibility by saying:
“That’s outside my area, so I’d rather you speak to someone appropriately qualified.”
Quite the opposite.
Emotional responses can happen during treatments
Sometimes clients become emotional during a treatment.
They may cry.
That can feel alarming when you’re newly qualified.
You immediately wonder:
What have I done?
Often, you don’t need to do anything dramatic.
Pause.
Check that they’re okay.
Give them a moment.
Ask whether they’d like to continue.
You don’t necessarily need to interpret the emotion.
You certainly don’t need to tell them you’ve “released stored trauma” from a particular muscle or body area.
Sometimes people cry because they’re stressed.
Sometimes because something is happening in their life.
Sometimes because they feel safe enough to stop holding everything together for an hour.
And sometimes they may not know why.
They don’t always need us to provide an explanation.
Boundaries protect both people
Professional boundaries can sometimes sound cold.
They aren’t.
Good boundaries actually make relationships safer.
The client knows what your role is.
You know what your responsibility is.
And you don’t gradually find yourself carrying problems home that you were never trained or employed to solve.
That last part matters.
Therapists who genuinely care about their clients can find themselves thinking about difficult conversations long after the working day has ended.
You are allowed to care.
You are also allowed to recognise:
This isn’t mine to fix.
What if you’re genuinely worried?
There will occasionally be conversations that feel more serious.
A client may disclose something that makes you concerned about their immediate wellbeing or safety.
Those situations are different from ordinary client conversation and may require you to follow appropriate safeguarding or emergency procedures depending on what has been disclosed and the circumstances.
Again, you don’t have to become the person who solves everything.
Knowing where to signpost or refer is part of professional practice.
Confidentiality still matters
Clients may tell you things they wouldn’t tell many other people.
Treat that trust carefully.
The funny story your client told you during today’s massage isn’t necessarily yours to tell somebody else over dinner tonight.
Even without mentioning their name, details can sometimes make someone identifiable.
Professional confidentiality applies to conversations as well as consultation forms and treatment records.
You can be warm and still be professional
Professional boundaries don’t mean becoming robotic.
You can laugh with clients.
You can chat.
You can remember that their daughter started university.
You can ask how the holiday went.
You can celebrate good news with them.
For many people, that relationship is part of why they return.
The aim isn’t distance.
It’s understanding the difference between being a caring professional and becoming responsible for areas of someone’s life that sit outside your role.
Because yes, sometimes clients really will tell you everything.
Listen.
Be kind.
Know your boundaries.
And remember that you don’t have to have an answer for all of it.
