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Why it's important to be your clients' massage therapist and not their counsellor

by Samantha Jenkins January 23, 2019

female massage therapist writing down notes whilst speaking to client on massage table

Entering a room, undressing, lying on a table, being touched by someone who, to begin with, is a stranger….the entire process of going for a massage is one that is open for people to feel at their most vulnerable!

Over time the trust developed between massage therapists and their clients is enormous. Massage therapists' work often helps to relieve the stress and negative emotions clients carry with them, but it can be easy for the conversation to spill into topics more commonly seen in a counsellors office. Especially when life throws it’s inevitable curveballs, our clients & patients can be left extremely vulnerable.

Client dealing with grief facebook post from Ellie Nole

Client dealing with grief facebook post from Jo Tylor

We all want to do our best to help our clients in these distressing times. However, it is easy for the bond that develops between massage therapist and client to cross the line into one of counsellor and patient.


So why is this such a problem?

As a massage therapist, it is crucial to understand that if you find yourself in situations where lines are becoming blurred, whilst you might have the best of intentions, crossing the boundary from massage therapist to counsellor can lead to legal trouble, threaten your massage therapy business and do serious harm to your client.  

To be a counsellor requires years of training and hours of supervised sessions before finally being allowed to work one on one with clients. Whilst offering friendly advice might seem harmless, by entering into these types of conversation with clients, in what is a therapeutic space, massage therapists would be stepping beyond the scope of their training and can lead to legal issues in the most extreme of cases.


Protecting your client ...and yourself!

Another reason why it is important to maintain the boundaries between massage therapist and client is that it can have a negative impact on your mental health and a knock on effect on your career as a massage therapist.

Counsellors are trained, for years and in depth, to spot the signs of different mental health challenges and more importantly to know how to support someone who is experiencing these difficulties.

As massage therapists, we are not trained to deal with these situations, situations which can be uncomfortable and challenging. As therapists, we can feel out of our depth and as a caring bunch we are reluctant to upset or offend people we can see are in pain.

Add to this many massage therapists are often entrepreneurs, who work hard to get clients onto their books and you have a pretty exhausting melting pot! If dealing with your clients’ emotions enters into this realm of counsellor, the relationship becomes too intense. It can take away the energy you need to give great massage treatments to your other clients and over time you can burn out.

So what can you do as a massage therapist, to support your clients but not cross any boundaries?

  • Remain empathetic, listen to your clients if they need to get any of their troubles off their chest, but use the first opportunity to return the conversation to the context of the massage.

  • You can use phrases such as “It sounds like you are having a really tough time at the moment” or “there has been a lot going on for you lately, that can create a lot of stress in relationships / in the workplace etc.” to avoid giving any advice without seeming unsympathetic.

  • Quickly refer to the ways you can help them to relieve any stress. Ask where they think they are carrying their tension or whether there is a particular scent of oil they find more soothing, to help move the conversation onto the massage therapy you are delivering.

  • Trust your instincts, it is common for people to want to share their feelings of stress or upset with their massage therapist. However, if a customer is anxious or struggling with their emotions over a prolonged period of time they may need more support than you can provide.

  • Create a list of local counsellors, doctors surgeries or government services someone who is struggling can access. Print these out and have copies handy somewhere discreet in your treatment room. Be gentle when offering someone this list, it may be something they haven’t considered themselves and the stigma around mental health is still a big problem. Gently suggest that maybe it might be worth them speaking to someone to help them reduce their stress to complement your work together with massage therapy.  

  • If you are aware someone is seeing a counsellor already, either because they have been referred to you or they have told you themselves, explain that you are only hearing a small percentage of what they will discuss with their counsellor and you wouldn’t want to jeopardise the work they are doing together. A subtle reminder of how massage can help them with any tension held in the body etc. can return the conversation to the value of the work you can do together with massage therapy.

  • If you have concerns that your client is suicidal, offer them the number of an emergency helpline like the Samaritans and urge them to seek help. If they continue to speak to you about their suicidal feelings without seeking help, speak to them softly about the impact this is having on the boundaries you need to keep and consider ending your sessions with them. If someone tells you directly they are going to kill themselves, leave the room calmly and call 999 for assistance.

  • If you find yourself with lots of client’s suffering from a specific mental health challenge, such as PTSD, anxiety or depression, do some research and look into training options. Gaining more knowledge can help you to be more understanding, feel more confident and learn techniques to maintain the appropriate boundaries.

  • Use resources like The Grief Massage Conversations and sharing experiences with other massage therapists to lighten some of the emotional load and feel confident in your approach.


Logo for the grief massage conversations podcast

We would love to hear your thoughts on this topic. Please share your experiences or comments with us in the section below. 


Samantha Jenkins
Samantha Jenkins


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Massage Table Size Guide

Massage tables comes in many different shapes and size. It can be confusing for you, the customer, to choose the right one but we are here to help!

A lot of customers call us up after they have bought the wrong size massage table elsewhere and we would like to help you avoid this mistake. It normally goes something like this; they like the look of a picture of a massage table on a website, they like the low price and then they check the carrying weight is ok. If the carrying weight fits their needs they click add to cart and the new massage table turns up at their doorstep in a few days. They unfortunately assume all massage tables are pretty much the same width and size.

The standard size of a massage table is 28 inches wide (71cms) and 73 inches (185cms) long. One of the reasons many "lightweight" budget massage tables are so cheap is because

  1.  They are smaller in size (normally around 61cms wide) and as such have less materials
  2. They are sold by specialist retailers who also sell anything else they can import and turn a profit on. As such they just buy the cheapest massage tables they can find in China. They go for smaller sizes as they are cheaper.

Make sure the massage table is the right size for you and your clients as the narrow massage tables at 61cms can be very uncomfortable for anyone who isn't petite and many clients cannot relax with their shoulders and arms unsupported.


The Width of the Massage Table:

Almost all therapists choose the standard 28 inch wide massage table. All our massage tables are the same length so it is only the width and shape our customers need to decide on.

Your massage table should be wide enough to cater for the wide variety of shapes and sizes of your clients. It needs to be wide enough to comfortably accommodate your treatment style, while being narrow enough to ensure you don’t have to strain your own back during treatments.

Each therapist's postural training and ability is different, so only you will know what massage table width you can handle. We have spoken to therapists who are five feet tall and get the wider 30 inch massage tables, and we speak to six foot therapists who have back problems and go for a 25 inch wide massage table. Everyone is different.

Generally speaking, if you are of smaller stature, you may do better with one of the narrower 25-inch massage tables. If you're quite tall, or are particularly keen to offer your clients a very spacious experience, a 30-inch massage table might be more suitable.

If you are in doubt, see if you can go into your local training college and see whether the massage tables there suit you. However, there is another way to get a feel for what will work of you don’t have access to a couch when you are deciding:

Cut out a piece of cardboard to the dimensions of both sizes you are deciding between. Put it on top of the kitchen table and lean over it. Visualise a client lying there, and see which width will suit you and your client best.

measuring the width of a massage table

Make sure you can get close enough to the table that you can pivot at the waist and have your shoulders squared to the clients hips, with your hands parallel to the clients' spine. Working in this position will ensure an injury-free career, so it's an important factor in your decision.

The most popular massage table widths are 28 and 30 inches. We sell 25-inch massage tables but you should really only choose this width if you are shorter in height and having a wider massage table might put your own back at risk over the course of your career.

You can also choose the 25-inch if you want to have the lightest massage table possible. By reducing the width of the massage table, the weight is also reduced. Now, this can mean a trade-off of some client comfort, but this trade is often worthwhile if you are a fully mobile therapist and use public transport frequently, where saving a kilogram or two will make a difference to you over time.


The Height Of the Massage Table

Nowadays, almost all portable massage tables come with height adjustable legs. Whichever massage table you choose should come with a large height range to accommodate you, and to cater for a broad range of therapies.

A common height range of massage tables is between 60 to 80cm, and this height range should cater for everyone. To check which height you need your massage table to be at follow this rule of thumb:

1. Stand up straight with your hands by your sides. Clench your fists.
2. Measure the distance between the floor and your knuckles
3. This distance should equal the height of your massage table.
4. Add a few inches in height to allow for the body of the patient on the massage table.

The height of a massage table is usually only adjusted when different therapists are using the same massage table, or if you have a client that is outside the average size you normally treat. So for example, if someone with a lot of body depth comes for a treatment after an average size person, you may need to adjust the height a notch or two.

You should be able to adjust the height of a massage table in just 2-3 minutes. Even though you mightn't adjust the height very often, the faster the better when you do have to!

There are 2 types of height adjustment mechanisms found on modern massage tables.

1) Twisting knobs (found only on wooden massage tables):

If you are working with a wooden massage table, it is better to have two knobs on each of the four legs for greater strength and reliability. When buying online, make sure to check how many knobs are on the legs. Cheap massage tables often only have one knob, and when you raise the legs to the highest heights they are less stable and have been known to snap.

2) Telescopic push-buttons (found only on aluminium massage tables):

The mechanism to adjust the height of an aluminium massage table is much the same as the push-button method on aluminium crutches. It only takes a few seconds to adjust each leg, and the mechanism is very reliable. Check out the video to see how it’s done.


Massage Table Shape:

The following are the different shapes of massage tables on the market.

1. Rectangle shaped with square corners 

This is the traditional shape of a massage table and the one you are probably familiar with seeing. Our Combi-lite 3 in 1 and Affinity Portaflex are shaped like this.

2. Rectangle shaped with rounded corners

Same as no 1 above in every way except the corners are rounded. Does not affect function in any way, just a different design/look.


3. Hour glass shaped with gradual gradient 

A fabulous massage table innovation in recent years, which solves a lot of the problems around choosing the correct width is the hourglass shaped massage table.

This style of massage table is wider at the ends, and tapers somewhat at the middle. This provide a spacious and comfortable experience for your client (as the shoulder and feet area are 30 inches wide) without compromising your own posture and health, as the middle of the couch where you lean over is a much narrower 26 inches wide.Having recently upgraded to one of these hourglass massage tables myself, I can vouch that my working days are much more comfortable, and many of my clients have commented on the extra comfort from the wider shoulder area.


4. Hour glass shaped with sharp gradient
Same as point above but instead of the it gradually going from wide to narrow, the massage table changes quickly from normal width to narrow width so people of very short stature can get in close.
5. Oval Shaped

 The name says it all! There are no corners on the massage table. Therapists normally choose this for one of two reasons. They simply like the look of this massage table and it is aesthetically more pleasing in their treatment room and/or they find it easier to move around the massage table during the treatment without having to side step the corners. This is particularly handy when space is limited in your treatment room.

oval massage table


Have any questions or comments about anything above? Please let us know in the comments below!