AMT Code of Practice Final

Massage Therapy Code of Practice
association of massage therapists

page 2
ACKNOWLEDGEMENTS
This Code of Practice would not have come into © Association of Massage Therapists Ltd
being without the effort, commitment and energy
of a number of people. Special acknowledgement This material is copyright © Association of Massage
is due to Rebecca Barnett, Tamsin Rossiter and Therapists Ltd (AMT). You may download, store in
Desley Scott who researched and wrote most of the cache, display, print and reproduce the material in
standards contained in this document. unaltered form only (retaining this notice, or links to
it where they appear) for non-commercial use or use
Sincere thanks and acknowledgement also go to: within your organisation. You may not deal with the
material in a manner that might mislead or deceive
• Alan Ford and Linda Hunter, any person.
who drafted three of the Standards in the Code
You may not reproduce this material without
• Beth Wilson and Grant Davies acknowledging AMT's authorship.
(Office of the Health Services Commissioner,
Victoria) and Professor Michael Ward (Health Quality Apart from any use as permitted under the Copyright
and Complaints Commission, Queensland) who Act 1968, all other rights are reserved. Requests for
provided invaluable feedback and insight further authorisation should be directed to:
• Colin Rossie, whose research and contributions Association of Massage Therapists Ltd
to the Code of Practice Wiki helped to maximise PO Box 826
stakeholder engagement in the process Broadway NSW 2007
P: 02 9211 2441
• Annette Cassar and Jodee Shead, E: info@amt.org.au
who assisted in the review process
• Linda White, Paul Lindsay and Katie Snell, who
proofed the document
• All those who took the time to read the draft Code
and provide feedback.
Designed by Claudia Iacovella

Graphic Designer
Email: claudesign13@gmail.com
M: 0417 073 383
page 3
CONTENTS
About AMT 5
AMT Code of Ethics 6
Massage Therapy Code of Practice -

Delivering quality care to Australian consumers 7
AMT Standard - Complaint Handling 15
AMT Standard - Professional Boundaries 19
AMT Standard - Draping 23
AMT Standard - Informed Consent 27
AMT Standard - Breast Massage 31
AMT Standard - Privacy and Confidentiality 35
AMT Standard - Record Keeping 39
AMT Standard - Issuing Receipts 45
AMT Standard - Advertising 49
AMT Standard - Infection Control and Hygiene 53
AMT Standard - Work Health and Safety 57
AMT Standard - Dry Needling 63
AMT Standard - Treatment of Minors 67
page 4
ABOUT AMT
The Association of Massage Therapists (AMT) is a national, not-for-profit

association representing qualified Massage Therapists and Massage Therapy
Students. Established in 1966, AMT is the oldest association in Australia to
represent massage therapy in its own right and the premier representative
body for professional therapists.
Vision
Australians have access to safe, ethical and evidence-informed

massage therapy treatment within the Australian health care system.
Our mission is to:

● Support our members
● Professionalise practice
● Educate and inform the public and other healthcare professionals
AMT values
Best practice Participation Leadership Openness Client focus
We support We encourage We have We strive We put quality

our members our members set the agenda for the and safety of care
to deliver to connect for industry highest standards at the heart of
evidence informed, and engage with advocacy of transparency our agenda
skilled and colleagues since 1966 and accountability
ethical care
page 5
code of ethics
As a member of the Association of Massage Therapists, I commit myself to the highest standards
of practice:
I will:
• care for the health, wellbeing and comfort of my clients with the utmost skill appropriate to
my current qualifications
• respect the privacy, modesty and dignity of my clients and maintain appropriate professional
boundaries
• respect the beliefs, rights and values of my clients
• protect the confidentiality of my clients’ personal information
• refer clients to an appropriate therapist if their needs are outside my scope of practice
and training
• respect my fellow therapists in all disciplines
• commit myself to continuing professional development, sharing technical skills and raising
professional standards
• endeavour to enhance the reputation of the massage therapy profession
• support the Association of Massage Therapists in all its ideals, principles, codes
and standards
• refrain from conduct that adversely affects the reputation of the Association of Massage
Therapists or the massage profession
• comply with the AMT Code of Practice and all applicable State, Territory and Federal laws
Massage Therapy Code of Practice
Delivering quality care to Australian consumers
Massage Therapy Code of Practice - Delivering quality care to Australian consumers page 7
© Association of Massage Therapists Ltd
INTRODUCTION In developing this Code of Practice, AMT is
honouring its commitment to protect the public and
The massage therapy standards contained in this serve its members, by promoting the safe and ethical
Code have been set down by the Association practice of massage therapy. The Code should serve
of Massage Therapists Ltd (AMT) to provide a as a reference for:
formal framework for the safe and ethical practice
of Massage Therapy in Australia, and to assist • Therapists – to better understand their ethical,
practitioners in applying risk management policies legal and professional obligations
and procedures in their clinic or workplace.
• Educators – to incorporate in the delivery of
The Standards have been formalised to help Health Training Package qualifications
practitioners understand and meet their
• Allied health professionals – to assist in
professional duty of care. In the context of massage
making appropriate health referrals
therapy practice, duty of care pertains to the
massage therapist’s ethical and legal obligation to • Disciplinary bodies – to provide a benchmark
avoid acts or omissions that are likely to cause against which complaints can be assessed
harm to their clients. It is the appropriate and
responsible application of professional knowledge, • Legal authorities – to inform criminal and civil
skill and integrity. investigations and proceedings
In the context of massage therapy practice, • The public – to empower clients to

professional misconduct is defined as a violation assess the quality of their care against an
of these ethical standards – a failure to meet or a objective framework.
breach of this Code of Practice. The Code clearly and The Massage Therapy Code of Practice is a living
comprehensively sets out AMT’s position if called document that will evolve in line with changes in
upon to give Expert Witness evidence in court cases practice and legislation.
for criminal negligence or assault.
It is the massage therapist’s responsibility to
formulate a risk management framework around the
standards articulated in this Code of Practice.
page 8 Massage Therapy Code of Practice - Delivering quality care to Australian consumers
LEGISLATIVE CONTEXT Victoria
• Health Records Act 2001
Massage therapy is currently self-regulated in
Australia. There is no Statute or Act that applies solely • Health Complaints Act 2016
or specifically to the practise of massage. • Working with Children Act 2005
• Occupational Health and Safety Act 2004
However, massage therapists are accountable
• Code of Conduct for General Health Services
under the following statutory codes and legislative
instruments: Queensland
• Health Ombudsman Act 2013
Federal
• Child Protection Act 1999
• The Privacy Act 1988
• National Code of Conduct for Health Care
• Privacy Amendment (Notifiable Data Breaches)
Workers (Queensland)
Act 2017
• Competition and Consumer Act 2010 (which South Australia
includes the Australian Consumer Law) • Health and Community Services Complaints
• Work Health and Safety Act 2011 Act 2004
• Work Health and Safety Regulations 2011 • Children and Young People (Safety) Act 2017
• Fair Work Act 2009 • SA Code of Conduct for Unregistered Health
• Australian Charter of Healthcare Rights Practitioners
NSW Western Australia

• Public Health Act 2010 • Health Services (Conciliation and Review)
Act 1995
• Health Care Complaints Act 1993
• Information Privacy Bill 2007
• Health Records and Information Privacy
Act 2002 • Working with children (Criminal Record
Checking) Act 2004
• Children and Young Persons (Care and
Protection) Act 1998 • Health and Disability Services (Complaints)
Act 1995
• NSW Code of Conduct for Unregistered Health
Practitioners • Occupational Safety and Health Act 1984
• Occupational Safety and Health
ACT Regulations 1996
• Health Act 1993
Tasmania
• Health Records (Privacy and Access)
Act 1997 • Health Complaints Act 1995
• Children and Young People Act 2008 • Children, Young Persons and their Families
Act 2013
• Working with Vulnerable People (Background
Checking) Act 2011 Northern Territory
• Human Rights Commission Act 2005 • Health and Community Services Complaints
Act 1998
• Health and Community Services Complaints
Regulations 1998
• Code of Health and Community Services Rights
and Responsibilities
• Care and Protection of Children Act 2007
SCOPE OF PRACTICE EDUCATION STANDARDS
The practice of massage therapy is the purposeful, Massage therapists have:
respectful and evidence-informed application of
touch, manual techniques and biopsychosocial care. • a detailed knowledge of anatomy, physiology
As a client-centred framework it aims to: and biomechanics
• enhance health and wellbeing • well-developed assessment, observational and

palpatory skills
• relieve pain
• expertise in a range of manual therapy
• provide emotional and physical relaxation techniques and approaches
• reduce stress and alleviate the impacts of • an understanding of normal function in
depression and anxiety relation to the soft tissues of the body and
the ability to recognise dysfunction, including
• prevent and repair injury knowledge of cautions and contraindications to
• rehabilitate and augment function. massage therapy.
Massage therapists treat a wide variety of conditions National Competency Standards were introduced
including: for massage therapy in 2002 as part of the Health
Training Package. Nationally recognised massage
• persistent pain therapy qualifications at Certificate IV, Diploma
• neck and back pain, and headache and Advanced Diploma Levels are delivered by
Registered Training Organisations (RTOs) which are
• muscle, connective tissue and joint pain regulated by the government. These qualifications sit
within the Australian Qualifications Framework (AQF),
• arthritis
the national system of qualifications encompassing
• sports and activity-related conditions higher education, vocational education and training,
and schools.
• stress, anxiety, depression and other mood
related problems. . Graduates of Certificate IV programs
are competent to perform general health
maintenance treatments.
Graduates of Diploma programs are competent
to perform treatments involving specific techniques
to alleviate common musculoskeletal presentations
such as low back pain.
Graduates of Advanced Diploma programs
are competent to treat complex musculoskeletal
presentations with a more extensive range of
treatment protocols.
Therapists who were trained prior to the introduction
of National Competency Standards in 2002 should
be able to demonstrate equivalency at Certificate IV,
Diploma or Advanced Diploma Levels.
CONTINUING PROFESSIONAL Lymphatic drainage and lymphoedema
DEVELOPMENT management:
to support and enhance the primary care of patients
All practising massage therapists should complete whose lymphatic system has been compromised by
at least 20 hours of continuing professional a variety of chronic or acute illnesses.
development annually to maintain the currency of
their skills. Myotherapy:
to assess and treat myofascial pain and dysfunction.
Massage therapists who provide third party
services through private health funds and Workers’ Oncology, palliative care and geriatric massage:
Compensation Authorities are required to complete to support the primary care of patients with chronic
at least 20 hours of Continuing Professional illness and a broad range of quality-of-life issues.
Education per annum. Pregnancy and pediatric massage:
to support the primary care of pregnant women
TYPES OF MASSAGE THERAPY
and infants.
Massage therapists may work in one or more of the
Oriental massage:
following areas:
to enhance mental and physical wellbeing through
Therapeutic or relaxation massage: the stimulation of specific pressure points. It includes
to promote wellbeing, improve sleep, treat anxiety Shiatsu, acupressure and Tui Na.
and tension, and enhance a range of systemic body
functions such as circulation.
Remedial massage:
to assist in rehabilitation, pain and injury
management. A range of manual therapy
techniques may be employed in treatment.
Sports massage:
to treat and prevent injuries, improve recovery,
flexibility and endurance, and enhance the
performance of athletes.
COMPLEMENTARY MODALITIES ACTIVITIES AND MODALITIES
Massage therapists use a wide variety of techniques,
OUTSIDE THE MASSAGE THERAPY
approaches and modalities. Although some of these SCOPE OF PRACTICE
modalities do not fit strictly within the massage The practice of massage therapy does not include:
therapy scope of practice, AMT recognises the
need to give practitioners reasonable latitude • high velocity-low amplitude (HLVA)
in employing a diverse range of techniques and manipulations
methodologies in their clinical practice.
• prescription or recommendation of
Complementary modalities may be integrated into supplements or other ingestible substances
the massage therapy treatment plan. Therapists who
• counseling (unless the massage therapist holds
incorporate these complementary modalities into a
a recognised counseling qualification)
treatment must understand their professional duty of
care and undertake to: • diagnosis of conditions or diseases.
• adhere to the AMT Code of Ethics and Code Additionally, AMT does not endorse the use of the
of Practice following modalities. They should not be performed
as part of the massage therapy treatment plan and
• have the training, knowledge, skill and
should not be held out to be within the scope of
judgment to perform the complementary
massage therapy. This list should not be interpreted
modality competently
as a complete list of activities outside the scope of
• inform the client that they are using the massage therapy.
complementary modality
• Acu-Energetics
• obtain valid, informed consent for the use
• Allergy Testing
of the modality
• Ayurvedic Medicine
• have appropriate insurance cover for the
modality • Bach flower Remedies
• abide by third party provider requirements. • Biofeedback
However, if the complementary modality is • Biodynamic massage
performed on its own, it is not considered to be
massage therapy. It cannot be billed or receipted • Bioenergetics
as massage therapy for the purpose of third party • Body Transformation
reimbursement, such as private health fund rebates.
• Chakra Balancing
• Chakra-puncture
• Colonic Irrigation
• Colour Therapy
• Core Energetics
• Counselling
• Crystal Healing
• Dolphin Healing • Metamorphic Technique
• Ear Candling • Naturopathy
• Emotional Freedom Technique • Neuro-linguistic Programming
• Energetic Healing • Personal Training
• Energetic Medicine • Polarity Therapy
• Erotic/exotic massage • Postural Integration and Psychotherapeutic
Postural Integration
• Esoteric Breast Massage
• Pranic Healing
• Esoteric Bodywork
• Raindrop Therapy
• Esoteric Chakra-puncture
• Rebirthing
• Esoteric Connective Tissue Therapy
• Reconnective Healing
• Esoteric Healing
• Reiki
• Esoteric Massage
• Sacred Esoteric Healing
• Feng Shui
• Sexological Bodywork
• Fertility Massage
• Shamanic Healing
• Flower Essences
• Sound Therapy
• Geomancy / treatment of geopathic stress
• Spiritual Healing
• Hawaiian massage / Lomi Lomi
• Tantric Massage
• Hellerwork
• Theta Healing
• Herbalism
• Thought Field Therapy
• Homeopathy
• Time Line Therapy
• Holistic Breathwork
• Traditional Chinese Herbal Medicine
• Hypnosis
• Zero Balancing
• Iridology
• Kinesiology / Touch for Health
• Laser Therapy
• Life Coaching
• Live blood analysis
• Magnet Therapy
• Magnetic Field Therapy
page 14
AMT Standard -
Complaint Handling
PURPOSE Clients can reasonably expect their massage
therapist to:
Massage therapists understand the context in which
complaints arise and have the skills and knowledge • discuss treatment options and goals
to respond appropriately and effectively to a client
• provide information about treatment and obtain
complaint in accordance with the policy.
informed consent
BACKGROUND • deliver a professional service at a fair and

reasonable fee
Complaints and other comments from clients
are an important form of feedback, providing • respect their rights, dignity, feelings, opinions
valuable information about the quality and safety of and cultural customs
healthcare services. Complaints are a helpful learning • respect their right to give feedback on the
tool because they create a unique opportunity services provided
to identify gaps in the quality of care and address
any issues. Handled well, a complaint can lead • respect their privacy and maintain
to profound and positive changes in practice, confidentiality
enhancing the therapeutic and clinical relationship
• maintain appropriate professional boundaries.
with clients.
Massage therapists should have a comprehensive
Effective complaint handling is a key component
complaint management process that encompasses
of risk management and mitigation, potentially
the following objectives:
preventing the escalation of a complaint into a
formal legal action. • To provide an efficient, fair and accessible
mechanism for handling complaints from clients
Complaints and the reasons for them vary. People
often complain because they: • To recognise, promote and protect the rights of
the client
• want an acknowledgement that something
went wrong and an explanation of why • To collect data and monitor complaints
to enable ongoing improvement in service
• want an apology for the distress
delivery.
they experienced
Although it may seem difficult or confronting, most
• do not want to see other people facing a similar
complaints are best resolved by handling them
problem
directly, promptly and professionally. However,
• want to improve the service for themselves or advice should always be sought from the insurer
others in the future and/or professional association before responding to
a complaint.
• want someone to be blamed, punished or held
accountable for what happened
• want compensation.
The majority of complaints stem from
communication problems in relation to obtaining
consent, explanations of treatment, billing and fees,
hygiene and professional courtesy.
page 16 Complaint Handling

COMPLAINTS TO A Queensland
HEALTH COMPLAINTS ENTITY • Office of the Health Ombudsman
Each State and Territory has its own Health http://www.oho.qld.gov.au
Complaint Entity (HCE)/Commissioner with Relevant legislation:
independent legal authority to investigate consumer
complaints against healthcare practitioners, • National Code of Conduct for Health Care
including massage therapists. If a consumer makes Workers (Queensland)
a formal complaint to one of the Health Complaint
South Australia
Entities, the massage therapist will normally be
asked to respond to the letter of complaint in • Health and Community Services Complaints
writing. When responding to the HCE, the therapist Commissioner
should try to understand the situation from the http://www.hcscc.sa.gov.au/
consumer’s point of view. If appropriate, the therapist
should apologise for any misunderstanding that Relevant legislation:
may have led to the complaint. In many cases, this • SA Code of Conduct for Unregistered
will address the problem because it meets the Health Practitioners
consumer’s expectations.
Tasmania
The following is a list of Health Complaints Entities/
Commissioners in each State and Territory: • Health Complaints Commissioner
http://www.healthcomplaints.tas.gov.au/
ACT
Victoria
• The ACT Human Rights Commission
http://www.hrc.act.gov.au/health/ • Health Complaints Commissioner
https://hcc.vic.gov.au/
NSW
Relevant legislation:
• The Health Care Complaints Commission
http://www.hccc.nsw.gov.au/ • Code of Conduct for General Health Services
Relevant legislation: Western Australia
• Code of Conduct for Unregistered • Health and Disability Services Complaints Office
Health Practitioners https://www.hadsco.wa.gov.au/home/
Northern Territory
• Health and Community Services
Complaints Commission
http://www.hcscc.nt.gov.au/
Complaint Handling page 17

POLICY • formally (i.e. in writing) acknowledge that
the complaint has been received and inform
Informal/verbal complaint the client of the complaint management
Massage therapists are required to: process, including the time frame for dealing
with the complaint
• make a time to meet with the client or
telephone them to discuss the complaint • evaluate the client’s concerns and try
to understand the situation from the
• listen carefully to the client’s concerns and treat client’s perspective
them with due respect and deference
• identify any issues or gaps in the quality of
• try to understand the situation from the client’s care that have been highlighted by the client,
point of view and institute policies and procedures to
address them
• be aware of differing views of what happened
and what was said • respond to the complaint in writing. The letter
should include:
• summarise the client’s concerns to reassure
them that they have been understood - an acknowledgement of the client’s distress
• give the client a calm and clear explanation of - a clear explanation of what happened from
what happened from their own point of view the massage therapist’s point of view
• keep a record of the conversation and the - a n acknowledgement of any errors and an
client’s concerns, and all necessary details apology if appropriate
(date of incident, nature of incident, date of
conversation) and provide a copy of this to the - a n explanation of the steps taken to address
client to ensure it is factually correct the problem/concern
• offer an apology if warranted - a ppropriate remediation or an offer

of resolution.
• ask the client what would resolve their concerns
• try to negotiate a solution with the client RESOURCES
• identify any issues or gaps in the quality of For more comprehensive guidelines on complaint
care that have been highlighted by the handling procedures and policies, please refer to the
complaint, and institute policies and procedures following:
to address them. • Guide to Complaint Handling in
Health Care Services
Formal/written complaint https://www2.health.vic.gov.au/getfile/?sc_
itemid=%7b62D4E2B2-FD15-4214-A520-
Massage therapists are required to:
66EDA4876D7A%7d&title=Guide%20to%20
• investigate and respond to all Complaint%20Handling%20in%20Health%20
written complaints Services%20-%20Revised%202011
• contact their professional indemnity • Complaints Management Handbook for the

insurance provider immediately and inform Health Care Services
them of the complaint http://www.safetyandquality.gov.au/wp-
content/uploads/2012/01/complntmgmthbk.
• contact their professional association and inform pdf
them of the complaint
Approved: 17 September, 2012
page 18 Complaint Handling

AMT Standard -
Professional Boundaries
PURPOSE • receiving private calls from a client on a non-
business number
Massage therapists have a clear understanding
of professional boundaries and the principles • receiving gifts of a personal, intimate or
underpinning this standard, and can apply this inappropriate nature
knowledge in the massage therapy clinical setting in
• believing only you can offer the right treatment
accordance with the policy.
to a client.
BACKGROUND
POLICY
Professional boundaries refer to the limits and
parameters that are set within the therapeutic
relationship. The establishment of clear boundaries • be aware of the power relationship that exists
is intended to create a safe and predictable place between the client and the therapist
where treatment can take place.
• work within the massage therapy scope
Massage therapists have a duty of care to ensure of practice and refer clients to other health
that the interaction between the client and the practitioners when relevant
therapist is based on plans and outcomes that are
therapeutic in intent. • disclose information to clients regarding your
qualifications, treatment procedures and goals
To effectively manage professional boundaries,
massage therapists must understand and appreciate • establish a clinic policies and procedures
the inherent power imbalance that exists between manual that includes details of operating hours,
the client and the therapist. This power imbalance fee schedule and third party provider rebates
leaves the client vulnerable and potentially open to • maintain high standards of client history
exploitation. The massage therapist always carries the compilation, note taking and storage of
burden of responsibility for maintaining appropriate client files
boundaries due to this power differential. When a
massage therapist crosses a professional boundary, • obtain informed consent at the start of and
they are abusing or misusing this power and their throughout the treatment
professional authority.
• wear a uniform or suitable professional attire
Maintenance of professional boundaries requires
• be aware of the client’s emotional state, look for
diligence and vigilance. Boundary issues can be
signs of clients becoming dependent and make
complex, dynamic and confronting. Massage
appropriate referrals when necessary
therapists must engage in reflection on their clinical
practice to ensure that boundaries are not being • refuse or terminate a treatment if the
compromised by themselves or challenged by their client’s behaviour is sexually inappropriate or
clients. abusive
Signs that the professional boundary may have • terminate the therapeutic relationship
eroded include: immediately if there is a risk of becoming
romantically or intimately involved with a client
• developing strong feelings for a client
• refuse treatment if a client is under the influence
• consistently spending more time with a
of alcohol or unlawful drugs
particular client
• having very personal conversations with a client
page 20 Professional Boundaries

• refrain from treating clients if a prescribed particular client, including giving them more
medication may impair professional judgement time or priority in their appointment schedule,
and interfere with ability to practise. then there may already be a boundary issue.
Doing special favours for a particular client is a
Massage therapists should not: clear warning sign that the therapist needs to
• flirt or use sexually suggestive language reassess their therapeutic relationship with
or touch that client.
• tolerate sexually suggestive behaviour • All clients are created equal, even (or
from clients especially) friends and family. Massage
therapists need to be consistent in their
• touch the clients genitals, perineum or breasts. application of professional boundaries
The specific circumstances under which regardless of any pre-existing relationships
massage of breast tissue may be undertaken are outside the clinic setting. If a therapist decides
outlined in the Breast Massage Standard to treat a relative or a friend, they must employ
of Practice. the same professional standards, record keeping,
• engage in gossip or irrelevant chatter confidentiality, language and behaviour as they
with clients do for all clients. If the therapist cannot apply
these same professional standards to a relative,
• use the therapeutic relationship to initiate or friend or acquaintance, they need to refer them
foster friendships with clients to another practitioner immediately.
• use the therapeutic relationship to initiate sexual • Prevention is better than cure. Maintaining
contact with clients or groom clients professional boundaries is extremely complex
and challenging. Having an experienced
• interact with clients via personal social media
mentor or supervisor to provide objective
accounts or pages. This includes accepting
advice, clarity and guidance is an effective
friendship requests from clients on Facebook.
way to ensure that the massage therapist is
Social media interactions with clients should
keeping themselves and their clients safe at all
be restricted to pages that exclusively promote
times. Peer networking and participation in
business/clinical activities.
professional development in the areas of ethics
• become romantically involved or enter into a and professional practice play a crucial role in
sexual relationship with a client developing skills and awareness.
• engage in counselling or psychoanalysis • Know thyself. Self-reflection is essential to

of clients high-quality professional practice. Massage
therapists cannot effectively contribute to the
• practise under the influence of alcohol or wellbeing of their clients without reflecting
unlawful drugs. on their own practices, challenging their
assumptions and examining their beliefs. This
PRINCIPLES includes monitoring the appropriateness of
their needs as a therapist such as the need to
Massage therapists should be aware of the following “fix” a client, be admired or loved by a client,
guiding principles: or be perfect in their client’s eyes. Massage
• All clients are created equal. If a massage therapists also need to closely observe the
therapist makes special concessions for a appropriateness of their beliefs, such as the
perception that nobody else can provide the
appropriate treatment for a particular client or
do what they are doing.
Professional Boundaries page 21
• Respect your client. Given the inherent power
imbalance in the therapeutic relationship, the
client should reasonably assume that they will
not be emotionally, physically or financially
exploited. A client should never be expected to
consent to anything that interferes with their
dignity and autonomy, including any touch of a
sexual nature.
KEY UNDERPINNING CONCEPTS

Transference
Transference occurs in the clinical setting when the
client personalises the professional relationship. This
can manifest in the giving of inappropriate gifts,
engaging in personal conversations or demanding
longer or cheaper treatments.
Counter transference
Counter transference occurs in the clinical setting
when the therapist is unable to separate the
therapeutic relationship from a personal one. This
can manifest in the form of having sexual feelings
for the client, showing favouritism, experiencing
revulsion towards the client, or having the client
meet particular emotional needs.
page 22 Professional Boundaries

AMT Standard -
Draping
page 23
PURPOSE POLICY
Massage therapists are informed of appropriate Massage therapists are required to:
draping standards and can apply draping protocols
in accordance with the policy. • ensure that clients wear underpants during
the massage treatment. Clients may also wear a
bra. If the bra is to be undone, consent must
BACKGROUND be sought.
Draping is a cornerstone of professional clinical • explain draping procedures prior to the
practice and is essential for the client’s welfare and commencement of the session and seek
sense of security, providing the necessary privacy, appropriate consent
modesty and warmth during a massage treatment.
• only expose the part of the body
Appropriate draping assists in maintaining client/ being massaged
therapist boundaries. It can be considered as a
tangible professional boundary between the client • ensure that the client is comfortable with their
and the therapist. It provides the therapist with draping at all times
access to the relevant, targeted body part to be
• adjust the draping if a client indicates
worked and helps to delineate between areas being
discomfort. This includes non-verbal signs of
massaged and areas not being massaged.
discomfort such as pulling up the towel
AMT recommends that members develop their
• have a therapeutic rationale for any change
draping protocols and document their practice
of draping
in their policies and procedures manual. Standard
protocols must be adhered to regardless of • give the client clear verbal instructions
the client’s attitude to draping. The therapist is concerning draping procedures
responsible for maintaining draping standards.
• obtain consent when tucking linen
Types of draping may vary but commonly include into the client’s underpants and when
the use of towels, sheets and/or blankets. The moving underpants
therapist must ensure that sufficient clean draping is
always available. • adapt the treatment plan if a client wants
to remain fully or partially clothed during
the treatment
• allow the client to dress and undress in private.
Do not re-enter the room without ascertaining
that the client is ready. If a client requires
assistance with dressing or undressing, modesty
should be maintained at all times.
• provide the client with sufficient draping to
cover their body before leaving the room for
them to undress. Give clear verbal instructions
on how the client should position themselves
on the table and how to arrange the draping
and supports.
page 24Draping
• ensure that the client remains covered if they PRINCIPLES
require assistance on and off the massage table
Massage therapists should be aware of the
• use fresh draping and linen for each client following principles:
• maintain draping close to the client’s body • Draping must be comfortable for the client but
when changing their position on the table also secure and distinct
• ask the client to hold the draping in position • Draping should be adjusted quickly
for some areas, such as near breast tissue and and efficiently
the groin
• Clients must wear a gown or suitable clothing
• obtain consent to place hand(s) underneath the during postural observations and during
draping treatments that require frequent changes
in positioning (e.g. exercise shorts and top).
• check that the client is warm enough with the
Women must wear a bra and underpants at
draping used
minimum during postural observations and
• use lightweight draping if the client is too warm men must wear underpants. Informed consent
must be obtained prior to postural observations
• use draping at all times, even if the client asks for and any other techniques that require the active
it to be removed. participation of the client.
Massage therapists do not: • Draping protocols must be reviewed as skills
• undrape or touch the perineum or genitals sets broaden
• undrape or touch the breasts unless there is • Draping protocols must be maintained to the
a clear therapeutic rationale for doing so. The same standard regardless of how regular and
specific circumstances under which massage of familiar a client becomes
breast tissue may be undertaken are outlined in • Clients must be given adequate privacy to
the AMT Breast Massage Standard of Practice. undress and dress. This means leaving the
• carry used linen against the body. room to allow the client to undress/dress, and
knocking before re-entering the room.
• slide hand(s) underneath the draping or work
underneath draping without informed consent.
REFERENCES
• Andrade, C. & Clifford, P (2008) Outcome-Based
Massage. From Evidence to Practice, 2nd Edition,
Wolterskluwer. Lippincott Willams & Wilkins, USA.
• Salvo.S (1999) Massage Therapy Principles and
Practice, WB Saunders. USA
Draping page 25
page 26
AMT Standard -
Informed Consent
page 27
PURPOSE Information given to the client when seeking
consent includes:
Massage therapists understand the principles of
informed consent and use this knowledge to fulfill • the treatment plan
their responsibility to obtain informed consent in
• the duration of the treatment
accordance with the policy.
• techniques to be used
BACKGROUND • body parts to be massaged
Informed consent is the voluntary agreement by • positioning
the client to a treatment plan after proper, accurate
and adequate information is conveyed about the • clothes the client may need to remove
proposed techniques and protocols that will be used.
• outcomes of the massage
Informed consent assists both the client and the
• any associated risks, such as the chance of post
therapist to determine the treatment goals.
treatment muscle soreness.
The key premise of informed consent in the massage
For consent to be valid it must:
therapy setting is that clients are autonomous and
have control over their own bodies. This includes • be given voluntarily and not coerced or induced
control over what the therapist does to their body. It by fraud or deceit
is integral to a client-centred approach to health care.
• cover the treatment/procedure(s) undertaken
Informed consent requires the therapist to provide
pertinent information about the treatment. For • be given by a person with legal capacity (parent,
example, a therapist may describe the position and guardian or caregiver).
function of the gluteal muscles and explain why Clients may withdraw consent to a treatment at
massaging them is relevant to the client’s treatment any time. The massage therapist must immediately
plan. Access to the gluteals may require the client’s respect this.
underpants to be lowered. After describing this
procedure, the client is given the choice to proceed
prior to treatment.
It is the responsibility of the massage therapist to
provide clear information about what the client can
expect from the treatment. The intent and direction
of the treatment should be clearly defined for the
client. The client should determine if a procedure
should occur.
A signed consent form is not proof that the client
was adequately informed.
page 28 Informed Consent

POLICY AMT does not require therapists to obtain written
informed consent unless the techniques being used
Massage therapists are required to: could be perceived as invasive. If written consent
• outline their fee schedule and obtain informed is being sought, AMT members may use the form
financial consent before commencing treatment prepared by AMT for that purpose.
• negotiate the treatment plan with the client. Verbal consent must be documented in the
This may include discussing the treatment plan client file.
with the client’s family, guardian and/or carer if
the client requests this PRINCIPLES
• seek informed consent for treatment and Massage therapists should be mindful of the
document this consent in the client file, following principles when seeking consent:
including any recommendations, referrals and
advice about continuity of care • Consent is dynamic. A client may initially
consent to the massage or part of the massage
• respect the client’s right to withdraw consent for and then change their mind during the
the treatment or any aspect of the treatment treatment. If a client withdraws consent at
any time, the massage therapist must
• provide information in plain language
respond accordingly. Equally, just because
• avoid using anatomical or medical jargon unless a client gave consent during one treatment
the client clearly indicates they are familiar with does not mean that the massage therapist can
this language assume that the client will always consent to the
same treatment.
• consider the client’s literacy and language skills
when obtaining consent, including the need to • Consent must be clear and definitive. Be
access interpreter services if the client does not aware of nuances in the client’s language
have sufficient English language skills that may indicate that consent is being given
reluctantly. For example, note the difference
• seek consent from a parent, legal guardian or between ”Yes that is absolutely fine, go ahead”
caregiver if the client does not have the legal and “I suppose that is OK, if you have to”. Give
capacity to give consent alternatives wherever possible. Offering a client
• seek consent from a parent, legal guardian or the option to say no and an alternative can assist
caregiver if it becomes apparent that the client in obtaining definite consent. For example “It is
cannot comprehend the proposed treatment not necessary to lower your underpants. I can
apply some techniques through your clothes or
• maintain eye contact with the client when the draping. Would you prefer that?”.
seeking verbal consent unless it is not feasible to
do so (i.e. the client is lying prone) Simply asking "Are you OK?" or "Is this OK?"
is not an adequate way to seek consent for a
• obtain written informed consent for techniques procedure or action within the context of a
that are invasive (for example, dry needling and treatment. A client must be fully informed of
intraoral work). therapeutic intent to provide valid consent.
Informed Consent page 29

• Knowledge is power. Most people’s fear or
anxiety about having a massage is alleviated by
information and a full understanding of what is
about to occur. This should include informing
the client that they will be given full privacy to
undress and dress, and that they will be fully
covered throughout the massage, except for the
area being massaged.
• Non-verbal signals may indicate that the
massage therapist needs to renegotiate
consent. Non-verbal signals such as laughing,
excessive talking, holding the breath, fidgeting,
and clenching the hands, feet, buttocks or jaw
often indicate that the client is uncomfortable. If
this happens, it is a good time to check whether
the client is happy to proceed with the massage
or technique that is being used. Only minor
changes may be needed to make the client
comfortable, such as the use of less pressure, a
change in technique or a change in positioning.
REFERENCES
• Andrade, C. & Clifford, P. (2008) Outcome-Based
Massage. From Evidence to Practice, 2nd Edition.
Wolterskluwer. Lippincott Willams & Wilkins, USA.
• Weir, M. (2000) Complementary Medicine: Ethics
and Law, Prometheus Publications. Australia
• Yardley-Nohr (2007) Ethics for Massage Therapists,
Lippincott Williams & Wilkins, USA.
page 30 Informed Consent

AMT Standard -
Breast Massage
PURPOSE Clinical indications for breast massage
Massage therapists are aware of the necessary Massage of breast tissue is only allowed for the
preconditions for performing massage of breast following specific clinical presentations:
tissue and the accepted clinical indications for
• Post-surgical - when a client has undergone
breast massage, and can apply this knowledge in
accordance with the policy. - mastectomy
- b
reast reduction, reconstruction
BACKGROUND or augmentation
Massage of breast tissue is distinct from massage - lumpectomy
of the musculature of the chest wall (for example,
pectorals and costal muscles). • Cancer - when there is discomfort from breast
cancer treatment or during rehabilitation from
Evidence-based clinical reasoning and informed cancer treatment
consent are essential preconditions to performing
massage on sensitive and intimate areas such • Scarring - when there is adhered, restricted or
as breast tissue. Informed consent requires the painful scarring due to:
therapist to provide pertinent information about
- the surgeries listed above
the treatment. The client must have a clear
understanding of the clinical basis for breast massage - cancer treatment
before treatment commences. Explanation of the
treatment should include the risks and benefits, - injuries or accidents, including burns
alternatives, draping and positioning, and the client’s • Swelling and/or congestion - when lymphatics
right of refusal throughout the treatment. have been compromised by:
Written informed consent must be obtained prior - the surgeries listed above
to performing massage on breast tissue. However,
because consent is dynamic, the therapist must - cancer treatment
respond immediately if the client withdraws consent
- fibrocystic breast conditions
during the treatment. Clients may withdraw consent
at any time and it is the massage therapist’s duty of - primary or congenital lymphoedema.
care to respect this and to respond appropriately.
Changes in consent should be recorded in the client
file as they occur.
page 32 Breast Massage

POLICY • Remember that consent is dynamic. Consent
can change from minute to minute in any
Massage therapists are required to: given treatment or between treatments. After
• obtain written informed consent for breast obtaining written informed consent for breast
massage and retain this in the client file massage, the massage therapist should watch
for any non-verbal signs of discomfort and check
• document the clinical reasoning for breast with the client to ensure that they continue to
massage in the client file be comfortable with the treatment.
• respect the client’s right to withdraw consent for • Have a sound clinical basis for performing
breast massage at any time and document any breast massage. Due to the sensitivities of the
changes to consent as they occur work, breast massage should not be undertaken
casually or lightly. If the massage therapist
• maintain draping protocols and only uncover
cannot clearly articulate the evidence-based
breast tissue when it is being worked on directly.
clinical reasoning for treatment of breast tissue,
Massage therapists do not: they should not proceed.
• touch the nipple and/or areola • Refer if in doubt. If it is not possible to proceed
confidently or comfortably with the treatment,
• perform breast massage without being able refer the client to another therapist or back to
to demonstrate clear, evidence-based clinical their primary care physician.
reasoning to the client
• perform breast massage if it is not clinically
indicated, as per the conditions listed above Approved: 17 September, 2012
•
• perform breast massage without relevant,
specific training.
PRINCIPLES
Massage therapists should observe the following
principles when treating breast tissue:
• Respect boundaries. Breasts are a sensitive
area and must be treated with due sensitivity.
In western culture, female breasts are highly
sexualised so the massage therapist needs to
be able to clearly communicate the difference
between sexual touch and therapeutic
touch. The client must fully understand this
distinction for informed consent to be valid. It
is the therapist’s responsibility to respect and
maintain the boundary between therapeutic
touch and sexual touch at all times.
Breast Massage page 33

page 34
AMT Standard -
Privacy and Confidentiality
PURPOSE ACT, NSW and Victorian practitioners must be familiar
with their relevant Health Records Act to ensure the
Massage therapists have a clear understanding of compliance.
their legal and ethical obligations in relation to the
privacy of clients’ personal information, and apply
this knowledge in accordance with the policy. POLICY
STATUTORY REQUIREMENTS
• comply with the 13 Australian Privacy Principles
As health service providers, massage therapists have in the Federal Privacy ACT 1988
a legal obligation to protect the privacy of their
• comply with relevant state health information
clients' personal information.
privacy legislation in NSW, Victoria and the ACT.
In November 2001, the Federal Privacy Act 198
• develop a clear and articulable privacy policy
was extended to cover the private sector
throughout Australia. The legislation applies to the • treat all client information as private
collection of personal information in the massage and confidential
therapy setting. Massage therapists should be
familiar with the 13 Australian Privacy Principles in • respect client privacy
the Privacy Act 1988. • protect the personal information of clients
The NSW Health Records and Information Privacy Act • store all client records securely
2002 contains 15 privacy principles. These form the
core of the requirements in this policy. • obtain consent from the client before sharing
health information with another health
The requirements outlined in this standard should be practitioner or third party service provider such
applied in conjunction with the requirements in your as an insurer.
jurisdiction.
Health information collected from clients
There are three state Acts that specifically relate to must be:
health information privacy:
• Lawful: only collect health information for a
ACT lawful purpose. Only collect health information
The Health Records (Privacy and Access) Act 1997. that is necessary for the purpose of delivering
This can be accessed online from http://www. massage therapy treatment to the client.
legislation.act.gov.au/a/1997-125/default.asp • Relevant: ensure that the health information is
NSW relevant, accurate and up to date. Ensure that
the collection does not unreasonably intrude
The Health Records and Information Privacy Act into the personal affairs of the individual.
2002. This can be accessed online from http://
www.austlii.edu.au/au/legis/nsw/consol_act/ • Direct: only collect health information directly
hraipa2002370/index.html from the client, unless it is unreasonable or
impracticable to do so. Information can only
Victoria be sought from other parties with the express
permission of the client.
The Health Records Act 2001. This can be accessed
online from http://www.austlii.edu.au/au/legis/vic/
consol%5fact/hra2001144/index.html
page 36 Privacy and Confidentiality

• Open: inform the client as to why you are • Authorised: people must expressly consent
collecting health information about them, what to participate in any system that links health
you will do with the health information, and records across more than one organisation.
who else might see it. Tell the person how they Only include health information about a client
can see and correct their health information, for the purpose of the health records linkage
and any consequences if they decide not to system, if they have expressly consented to this.
provide their information to you. If you collect
health information about a person from Massage therapists do not:
someone else, you must still take reasonable • share a client’s personal information with a
steps to ensure that the client has been notified third party without the express permission of
as above. the client
• Secure: ensure that health information is stored • discuss a client’s personal information with other
securely, not kept any longer than necessary, clients, friends or relatives
and disposed of appropriately. Information
should be protected from unauthorised access, • discuss a client’s personal information with
use or disclosure. friends / relatives, a guardian or caregiver of
the client
• Transparent: explain to the client what health
information about them is being stored, why it is • solicit overly intimate details from clients.
being used and any rights they have to access it.
• Accessible: allow people to access their
EXCEPTIONS TO CONFIDENTIALITY
health information without unreasonable delay The following are specific exceptions where the right
or expense to confidentiality may need to be modified:
• Correct: allow people to update, • when there is a threat to the client’s safety (such
correct or amend their health information as a medical emergency) or the safety of others
where necessary
• when the client authorises disclosure
• Accurate: ensure that the health information is
relevant and accurate before using it. • when the client has requested a written report
for another health professional or agency
• Limited Use: only use health information for the
purpose for which it was collected, or a directly • when you are permitted or compelled by law to
related purpose that the person would expect. disclose client information (such as a subpoena)
For example, you cannot use health information
for a case study or research without the express,
formal consent of the client.
• Limited Disclosure: only disclose health
information for the purpose for which it was
collected, or a directly related purpose that
the person would expect. You must obtain
consent from the client before disclosing
health information.
Privacy and Confidentiality page 37

PRINCIPLES •
Therapists should be mindful of the following

principles in relation to client privacy and
confidentiality:
• Verbal communications with a client should
be conducted in complete privacy and
remain confidential. Clinic rooms should be
impervious to sound so that conversations
cannot be overheard.
• The client must consent to their health
information being given to a third party.
Permission must be sought from the client
before health information is given to another
health professional. Permission must also be
sought before sharing health information
with other practitioners working in the same
practice. Client information should never be
shared with friends, acquaintances or members
of the public.
• Physical security of client records is
paramount. This also includes the security
of records when they are being transported.
Records must always be protected from
unauthorised access.
REFERENCES
Statutory requirements outlined in:
• The Federal Privacy Act (1988)
• The ACT Health Records (Privacy and Access)
Act 1997
• The NSW Health Records and Information
Privacy Act 2002
• The Victorian Health Records Act 2001
• Website of the Office of the Australian
Information Commissioner
http://www.oaic.gov.au/
page 38 Privacy and Confidentiality

AMT Standard -
Record Keeping
PURPOSE • provide evidence of care before a court of law
Massage therapists understand the ethical and • provide accurate records for insurance and
legal requirements associated with the preparation, medical reports.
management, storage and disposal of health records
in the massage therapy clinical setting, and apply this STATUTORY REQUIREMENTS
knowledge in accordance with the policy.
As health service providers, massage therapists have
The term “health record” in this standard means a legal obligation to comply with the requirements
a documented account of a client’s personal and of the Federal Privacy Act and relevant state
health information, presenting condition and health records legislation in the collection and
treatment, in paper or electronic form. management of personal information, including
health information.
BACKGROUND
There are 13 Australian Privacy Principles that
Record keeping is an important component of regulate how private sector organisations manage
competent professional practise and essential to personal information, covering the collection, use
the delivery of quality evidence-based health care. and disclosure and secure management of the
Massage therapists must create and maintain health personal information. The Privacy Act also includes
records that serve the best interests of clients, and provisions for clients to access information held
that contribute to the safety and continuity of their about them. This information is detailed in AMT’s
health care. Privacy and Confidentiality Standard.
The purpose of documenting and maintaining The requirements outlined in this standard should
accurate health records is to: be applied in conjunction with AMT’s Privacy and
Confidentiality Standards, and the requirements in
• obtain personal information to identify the client the massage therapist’s state or jurisdiction.
• obtain health information (medical There are three state Acts that specifically relate to
information and history, including health records:
medications) to identify indications for and/or
contraindications to treatment ACT
• obtain informed consent • The Health Records (Privacy and Access) Act
1997. This can be accessed online from:
• provide an accurate and concise record of http://www.legislation.act.gov.au/a/1997-125/
client care including assessment procedures, default.asp
treatment plans, treatment evaluations, client
feedback and recommendations NSW
• record the chronology of treatments provided • The Health Records and Information Privacy Act
2002. This can be accessed online from:
• support continuity of care and provide written http://www.austlii.edu.au/au/legis/nsw/consol_
evidence that the treatment has been provided act/hraipa2002370/index.html
• meet legal, professional and
statutory requirements
• provide information for the investigation
of complaints
page 40 Record Keeping

Victoria • store health records securely and safeguard
against loss, damage or access from
• The Health Records Act 2001. This can be unauthorised personnel. This includes secure
accessed online from: backup of electronic records.
http://www.austlii.edu.au/au/legis/vic/
consol%5fact/hra2001144/index.html • retain health records for a minimum period of
seven years from the date the last entry was
• Massage therapists in Queensland, South made. For clients less than 18 years of age,
Australia, Western Australia, Tasmania and records must be retained for seven years from
the Northern Territory must comply with the the date the client turns 18.
requirements of the Federal Privacy Act. The
Privacy Act 1988 can be accessed online from: • dispose of health records in a way that will
http://www.austlii.edu.au/au/legis/cth/consol_ preserve the confidentiality of any information
act/pa1988108/ contained in them
Additional resources: • retain a record of the following when disposing
of a client’s health information:
• NSW Department of Health Patient Matters
Manual contains detailed policy and procedures - the name of the person
on the management and control of health
records and can be accessed online from: - the period covered by the health information
http://www.health.nsw.gov.au/policies/ - t he date on which it was deleted or
manuals/Documents/pmm-9.pdf disposed of.
The following information must be recorded in the
POLICY health record:
Personal Information
• create an identifiable individual health record at
• Name, address, contact numbers,
the time of a client’s first treatment
date of birth, occupation
• promote continuity of a client’s care through the
• Name of the client’s primary health
maintenance of accurate and comprehensive
care provider
health records
• A contact number for emergencies
• treat all client information as private and
confidential • History of massage therapy
• ensure all entries in a client’s health record • Lifestyle information (hobbies, diet, exercise,
are accurate and concise statements of fact alcohol consumption, tobacco use).
or clinical judgments relating to assessment,
treatment and professional advice
• ensure that all entries are relevant to that client
and do not contain prejudicial, derogatory or
irrelevant statements about the client
• document treatments in chronological order
• allow clients to access their health record
without unreasonable delay or expense
Record Keeping page 41

Health information (medical information • Treatment provided (documents region/muscles
and history) treated/techniques applied)
• Concurrent medical/therapeutic treatment • Evidence of ongoing monitoring and evaluation
of treatment, including evidence for the
• Current medication(s) and the condition(s) effectiveness of ongoing treatment
being treated
• Recommendations (remedial exercises, self-care)
• Date and nature of any surgical procedures
• All referrals to and from other practitioners
• List of allergies or skin disorders
• Any relevant communication with or
• Cardiovascular conditions about the client
• Respiratory conditions • Client’s evaluation of treatment
• Musculoskeletal conditions • Reasons for ceasing treatment, if treatment is no
• Nervous conditions longer required.
• Digestive conditions
PRINCIPLES
• Pregnancy, cancer, diabetes, epilepsy, arthritis
Massage therapists should be mindful of the
and family history of arthritis
following principles in relation to creating and
• Presence of pacemaker, internal pins, wires, maintaining health records:
artificial joints or special equipment
• Health records must be legible. All entries
• Any medical conditions that indicate/ in the health record must be readable and
contraindicate massage therapy. understandable. Any abbreviations and symbols
must be able to be interpreted by another
For each session, the health record must include: massage therapist or health professional. Health
• Date of visit records must be kept in English.
• Identifying details of therapist providing • Entries in the health record must be signed.
the treatment The massage therapist who performed the
treatment must sign their notes for each
• Update of health information, if required session. In a computerised system, this may
• Purpose of treatment require the use of an appropriate identification
system such as an electronic signature that has a
• Location and nature of presenting condition security code.
• Duration of presenting condition • Entries in the health record must not be
erased. Entries must be made in such a way
• Other treatment(s) sought and results
that they cannot be erased. All errors must be
• Client’s desired outcome of treatment appropriately corrected but an original incorrect
entry should remain readable. An accepted
• Adverse reactions to, or effects from, treatment method of correction is to draw a line through
• Physical assessment the incorrect entry and initial the correction.
This also applies to electronic entries where a
• Treatment plan security code must be used. Any added notes
following a treatment must be dated.
• Evidence of consent to treatment plan
page 42 Record Keeping

• Health records must be reproducible. If files
are stored electronically, there must be a back
up and it must be possible to reproduce records
on paper.
REFERENCES
• Statutory requirements outlined in:
- The Federal Privacy Act 1988
- T he ACT Health Records (Privacy and Access)
Act 1997
- T he NSW Health Records and Information
Privacy Act 2002
- The Victorian Health Records Act 2001
• College of Massage Therapists of Ontario, Public
Health Standard 6
• NSW Department of Health Patient Matters
Manual
• Guidelines on Dental Records developed under
s. 39 of the Health Practitioner Regulation
National Law Act 2009
• APA Position Statement on Health Records 2010
• Office of NSW Privacy Commissioner
Record Keeping page 43

page 44
AMT Standard -
Issuing Receipts
PURPOSE POLICY
Massage therapists are aware of their legal and Massage therapists are required to:
ethical responsibilities in relation to receipting
treatments, and can apply this understanding in • issue a receipt after each payment transaction
accordance with the policy. • issue an invoice for treatment if payment has
not been tendered
BACKGROUND • issue a tax invoice if registered for and charging
Receipts are a record of a financial transaction. In GST. The tax invoice must include an ABN and
the massage therapy clinical setting, a receipt is a be titled “Tax Invoice”.
written acknowledgement of receiving payment
• retain copies of receipts, invoices and tax
for treatment on a specific day for a specific fee.
invoices, either on paper or electronically
Similarly, an invoice/tax invoice is a written record
of a treatment being provided on a specific day • ensure that the details on the receipt/invoice/
for a specific fee. An invoice and receipt can be tax invoice (date, nature of treatment, client’s
incorporated into a single document. details) coincide with the client’s clinical record
A receipt should be issued as soon as payment for a • mark duplicate receipts, invoices and tax
treatment has been tendered. When payment is not invoices with ‘copy or ‘duplicate’.
tendered immediately after a treatment, an invoice/
tax invoice may be issued to the client or, where Massage therapists do not:
applicable, to a third party payer such as a workers’ • falsify details on the receipt, such as the
compensation authority. client’s name or the duration/frequency of
Massage therapists have a professional duty of treatment, to enable a client to make a false
care to ensure that details included on receipts claim with a third party
are accurate and truthful. Modifying receipts to • change the date or nature of treatment to
enable false claims on insurance is fraud and enable a client to make a false claim with a
punishable by law. third party
• use another practitioner’s details or provider
number(s) to enable a client to make a false
claim with a third party
• use correction fluid or tape to make corrections
• charge GST unless registered to charge GST.
page 46 Issuing Receipts

INFORMATION REQUIRED ON RECEIPTS CHARGING GST
The following details must be clearly printed on Massage therapists must register for GST if their gross
receipts, invoices and tax invoices (i.e. it cannot be income exceeds $75000 per annum. If massage
handwritten): therapists are registered for GST, then they must issue
tax invoices for their treatments, quoting their ABN.
• Name of the therapist who gave the treatment
• Business name if applicable REFERENCES
• Practice address. This must be a street address • ATO website record keeping and Tax evasion
not a PO Box. www.ato.gov.au
• AMT member number • The Australian Consumer Law- A guide to
provisions 2010
• ABN if applicable.
• The Australian Consumer Law- An introduction
The following details must also be included but may
November 2010
be handwritten:
• Fair Trading Act NSW (1987)
• Client’s name
• ATO fact sheet -
• Date of treatment
How to set out tax invoices and invoices
• Nature of treatment www.ato.gov.au
• Health Fund provider number(s) • Excerpts from CCH Australian Master GST Guide
July 2000
• Fee
• Date of payment.
TAX EVASION AND FRAUD •
Failing to declare assessable income, not wanting

to issue a receipt or providing a false invoice are all
considered to be forms of tax evasion.
Health insurance fraud and inappropriate claiming
is where someone receives a benefit payment using
false or misleading information. If massage therapists
issue receipts with incorrect or falsified details, such
as the date of the treatment, treatment description,
name of the treating therapist or name of the client,
then they are committing fraud. Health insurance
fraud is a criminal offence and is punishable by law.
Issuing Receipts page 47

page 48
AMT Standard -
Advertising
PURPOSE Information included in an advertisement for a
massage therapy service or clinic must be honest,
Massage therapists have a clear understanding of reliable and useful to support the consumer’s
ethical advertising standards and relevant consumer capacity to make informed healthcare choices.
legislation, and can apply this knowledge to the Using language that consumers can understand and
promotion of their business in accordance with avoiding unfamiliar jargon is crucial to conveying the
the policy. message ethically.
Advertising that is false, misleading, inaccurate
BACKGROUND
or deceptive compromises the integrity of the
Promoting massage therapy services to the profession as a whole and carries serious risks to the
public can be a valuable consumer mechanism consumer, such as exploitation, false expectation
and a positive way to enhance the standing of or hope, and/or serious compromise to their health
massage therapists in the wider spectrum of and wellbeing. This is especially relevant where the
healthcare delivery. consumer is vulnerable or insufficiently informed to
make a decision about the suitability of particular
Advertising can provide a means of communicating kinds of treatment.
general information to consumers that can help
them better understand the services and options
available to them, enabling them to make informed STATUTORY REQUIREMENTS
healthcare choices. Massage therapists are accountable under the
Consumers need reliable and accurate information Competition and Consumer Act 2010.
to make an informed decision about whether to On January 2011, the Australian Consumer Law
purchase a health service. In this sense, informed (ACL) commenced. The ACL is a schedule to the
choice is an underpinning imperative in framing Competition and Consumer Act 2010. It is a single,
ethical advertising of massage therapy services. national law concerning consumer protection
Advertising includes all forms of print and electronic and fair trading, and applies in the same way
media, and any public communication using nationally and in each State and Territory. In other
television, radio, film, newspaper, billboards, books, words, consumers have the same protections and
lists, pictorial representations, designs, mobile expectations about business conduct wherever
communications or other displays, the internet, they are in Australia, and businesses have the same
social media and directories. It also includes business obligations and responsibilities wherever they
cards, announcement cards, office signs, letterhead, operate in Australia.
telephone directory listings, professional lists, The Australian Competition and Consumer
professional directory listings and similar professional Commission (ACCC) takes action against persons
notices. Situations in which practitioners make who make false or misleading claims about their
themselves available or provide information for products or services, and profit from the desire of
media reports, magazine articles or advertorials are vulnerable people to change their appearance or
also considered to be advertising. improve their wellbeing.
page 50Advertising
Massage therapists should become familiar with Massage therapists should not promote their services
the Australian Consumer Law, specifically the in a manner that:
general protections in relation to misleading or
deceptive conduct, unconscionable conduct and • is false, misleading or deceptive or is likely to be
unconscionable conduct in business transactions. misleading or deceptive
The ACL can be accessed online from: • creates or is likely to create unrealistic
http://www.austlii.edu.au/cgi-bin/sinodisp/au/legis/ expectations about the effectiveness of
cth/consol_act/caca2010265/sch2.html?stem=0&syn the service
onyms=0&query=schedule%202
• creates or is likely to create false hope
POLICY • encourages excessive or unnecessary use of
the service
Advertisements for massage therapy services
may contain: • suggests that the service is always effective
• a factual and clear statement about the • implies that the service is better, safer or
services offered superior to other practitioners, or that the
service is somehow exclusive
• the full name of the practitioner providing the
services (not an abbreviation) • exploits or potentially exploits the lack of
knowledge of clients.
• qualifications of the practitioner offering the
massage services and details of any training
programs completed since graduation
• contact details of the clinic or practitioner
• information about operating hours
• a fee schedule
• details of any third party payment services,
such as health fund rebates. Caution should
be exercised before using an organisation or
company name of a third party provider, as
written authority may be required from
that provider.
• information about professional
accreditations with an association such as
AMT (e.g. AMT accredited)
• non-enhanced photographs of the
practitioner or clinic
• evidence and outcome based information on
the benefits of massage therapy.
Advertising page 51
Massage therapists do not: REFERENCES
• make false, exaggerated or unsubstantiated • Australian Health Practitioner Regulation
claims (for example, massage cures cancer or Agency website
removes toxins) http://www.ahpra.gov.au/
• imply that massage therapy is infallible, magical, • Australian Competition and
miraculous or guaranteed. This includes using Consumer Commission website
the terms “cure” and “heal” http://www.accc.gov.au
• use testimonials or purported testimonials to • Australian Consumer Law website
promote a massage therapy service http://www.consumerlaw.gov.au
• promote a specialty or specialised service • The Australian Legal Information Institute
unless you can provide proof of specific training http://www.austlii.edu.au/
in that specialisation
• misrepresent the standard or quality of
the service
•
• use puffery (that is, claim to be the best, the
cheapest, the most effective)
• use language that could cause fear or distress
• use the terms “masseuse” or “masseur”.
MISLEADING AND DECEPTIVE CONDUCT

If the overall impression left by an advertisement,
promotion, quotation, statement or other
representation creates a misleading impression
in your mind, then the conduct is likely to breach
the law. A specific example of this in the massage
therapy context would be claims that massage can
cure chronic and systemic illnesses such as cancer.
Any unproven claim related to massage therapy,
no matter how seemingly benign, could be viewed
as potentially misleading or deceptive. This would
include claims that massage clears toxins or makes
you look younger. In fact, the provisions in the
Australian Consumer Law are particularly stringent
and strict penalties apply to businesses and
individuals attempting to profit from the desire of
vulnerable people to change their appearance or
improve their wellbeing.
page 52Advertising
AMT Standard -
Infection Control and Hygiene
page 53
PURPOSE POLICY
Massage therapists are aware of national infection Massage therapists are required to:
control guidelines and can apply this knowledge in
the massage therapy clinical setting in accordance • apply standard precautions (previously referred
with the policy. to as universal precautions)
• apply transmissions based precautions.
BACKGROUND Treatment may be contraindicated if the client
is acutely ill with a systemic infection such as
As health service providers, massage therapists have influenza (absolute contraindication).
a common law duty of care and ethical responsibility
to take all reasonable steps to safeguard themselves, • maintain personal hygiene
clients, staff and the general public from infection.
• wash and dry hands before and after
Infection control refers to policies and procedures client contact
practised in healthcare facilities to minimise the risk
• dry hands with single-use towels (disposable
of transmitting and acquiring infectious diseases.
paper towels are preferable to cloth)
These diseases are usually caused by bacteria, fungi
or viruses and can be spread by human-to-human • use soap dispensers rather than bar soap
contact, human contact with an infected surface,
airborne transmission through tiny droplets of • keep nails short and avoid wearing any jewelry
infectious agents suspended in the air, and by such that may come into contact with clients
common vectors as food or water. • ensure hair is tied back to prevent contact
The risk of exposure to body fluids in the massage with client
therapy clinical context is relatively low. However, • clean and disinfect exposed areas of the
the risk of spreading infections such as flu and upper massage table and bolsters after each client
respiratory tract infections is significant, therefore
transmission-based precautions are an important • use clean, freshly washed linen for each client
addition to standard infection control precautions. • replace all used linen between clients
NATIONAL INFECTION CONTROL • use clean, freshly washed towels to cover ice/
hot packs or other objects that are reused and
GUIDELINES come into direct contact with clients
The National Health and Medical Research Council’s
• provide clean, dry storage for clean linen with an
(NHMRC) Australian Guidelines for the Prevention
appropriate linen rotation system
and Control of Infection in Healthcare (2019) provide
recommendations that outline the critical aspects • place used linen in a closed container and
of infection prevention and control. The NHMRC launder on the day of use. Do not place
guidelines can be accessed online from: used linen in direct contact with your body
or clothing.
• https://www.nhmrc.gov.au/sites/default/files/
documents/attachments/19269%20NHMRC%20 • wash linen in hot water and detergent
-%20Infection%20Control%20Guidelines- unless the linen has signs of human body
accessible.pdf fluid contamination
page 54 Infection Control and Hygiene

• separate soiled linen from all other linen Massage therapists do not:
wearing disposable gloves. Wash separately
in hot water using normal detergent and • perform massage when they have an infectious
appropriate disinfectant. Alternatively, place in condition that could be transmitted by direct
bio-hazard bag and dispose of at the hazardous or indirect contact (flu, upper respiratory
waste part of your local tip. tract infections, gastroenteritis, MRSA, highly
contagious skin infections such as impetigo).
• keep lubricants in contamination
proof dispensers, such as a pump action • treat clients with an infectious condition that
container, and clean with disinfecting wipes could be transmitted by direct or indirect
between clients contact (flu, upper respiratory tract infections,
gastroenteritis, MRSA, highly contagious skin
• use a disposable spatula to remove infections such as impetigo).
product from jar-type containers to avoid
cross contamination • reuse unwashed linen between clients
• ensure all products are labeled to prevent using PRINCIPLES

the wrong product
Successful infection control is based on good
• cover any cuts, sores and abrasions, and change hygiene around the range of practices that arise
the covering between each client from identifying hazards and implementing risk
• keep all areas of the workplace clean and management for those hazards. This involves
hygienic, and document frequency of understanding:
cleaning procedures • the infectious agent
• have a management procedure for cleaning up • the work practices that prevent the transmission
blood and body substance spills including the of infection
use of personal protective equipment and a
spills kit • management systems that support effective
work practices.
• have a management procedure for accidental
exposure to blood or body fluids The main principles in preventing the transmission of
infection are:
• use personal protective equipment such as
gloves when dealing with used linen, clinical • identify all possible sources of infection
waste (used hand towels and tissues), and when
• care for infected or potentially infected clients in
performing intraoral massage
such a manner that transmission of the infection
• provide and maintain a first aid kit is rendered as difficult as possible
• be well informed about infectious diseases and • safely dispose of potentially infective and other
maintain awareness of local endemics, such as injurious material.
colds and flus.
Infection Control and Hygiene page 55

REFERENCES
• Beck, MF (2006) Theory and Practice of
Therapeutic Massage. 4th Edition. Thompson
Delmar Learning, New York.
• Casanelia, L & Stelfox, D.(2010) Foundations
of Massage. 3rd Edition Churchill Livingstone.
Sydney
• Werner, R. (2005). A Massage Therapist’s Guide
to Pathology. 3rd Edition. Lippincott, Williams &
Wilkins, Baltimore.
• NSW Health website
http://www.health.nsw.gov.au/
• https://www.nhmrc.gov.au/sites/default/files/
documents/attachments/19269%20NHMRC%20
-%20Infection%20Control%20Guidelines-
accessible.pdf
page 56 Infection Control and Hygiene

AMT Standard -
Work Health and Safety
page 57
PURPOSE LEGISLATIVE CONTEXT
Massage therapists are aware of Work Health and In January 2012, Australian Occupational Health and
Safety (WHS) procedures in the massage therapy Safety (OHS) legislation was harmonised, establishing
clinical setting and can apply this knowledge in the national Work Health and Safety (WHS) scheme.
accordance with the policy. A new national body, Safe Work Australia, is
coordinating the OHS harmonisation process. Not
BACKGROUND all states have adopted the legislation. The national
model is in operation in NSW, Queensland, South
Work Health and Safety refers to the general Australia, Tasmania, ACT and Northern Territory.
requirements necessary to ensure a health and safety Victoria and Western Australia have retained their
culture, accountability and implementation of WHS own legislation.
management processes. WHS policies are designed
to reduce the number of workplace injuries and The requirements outlined in this standard should be
illnesses by imposing responsibilities on individuals applied in conjunction with the relevant legislative
and organisations. requirements in your jurisdiction.
The broader awareness of massage as a form of Federal WHS resources and information
preventive health care and rehabilitation has created • Safe Work Australia -
greater scope for massage therapists to provide www.safeworkaustralia.gov.au
services in diverse settings. Regardless of the
environment that massage therapists work in or the • Comcare - www.comcare.gov.au
nature of workplace interactions, WHS is an issue for
• Work Health and Safety (WHS) Act 2011
everyone.
https://www.legislation.gov.au/Details/
It is the responsibility of the massage therapist C2018C00293
to take reasonable care for the health and safety
• Work Health and Safety Regulations 2011
of everyone in the workplace and to work in a
https://www.legislation.gov.au/Details/
responsible manner. Therapists must be aware of
F2019C00050
and comply with WHS legislation and any workplace
requirements to ensure safe practice. Ignorance is no • Safety, Rehabilitation and Compensation
defence in law. Act 1988
https://www.legislation.gov.au/Series/
The national WHS scheme adopted by NSW,
C2004A03668
Queensland, ACT and the Northern Territory in
January 2012 has seen a change in the way work State and Territory WHS legislation
health and safety is managed in the workplace. The and resources
primary duty of care has shifted to the employer or
organisation, referred to as a person conducting a ACT
business or undertaking (PCBU). The WHS Legislation • WorkSafe ACT - www.worksafe.act.gov.au/
now imposes an obligation on the PCBU to
exercise due diligence in ensuring their business or Relevant Act:
organisation meets its safety obligations to workers • Work Health and Safety Act 2011
(employees, subcontractors), clients and the general
public.
page 58 Work Health and Safety

NSW Tasmania
• WorkCover NSW - • WorkCover Tasmania -
https://www.safework.nsw.gov.au/ www.workcover.tas.gov.au
Relevant Act: Relevant Act:
• Work Health and Safety Act 2011 • Work Health and Safety Act 2012
http://www.austlii.edu.au/au/legis/tas/num_act/
Northern Territory whasa20121o2012264/
• NT WorkSafe - • Work Health and Safety Regulations 2012
http://www.worksafe.nt.gov.au/Pages/default. http://www5.austlii.edu.au/au/legis/tas/num_
aspx reg/whasr20122012n122389/
Relevant Act: Victoria
• Work Health and Safety Act 2011 • WorkSafe Victoria -
Queensland https://www.worksafe.vic.gov.au/
• Workplace Health and Safety Qld - Relevant Act:

www.worksafe.qld.gov.au • Occupational Health and Safety Act 2004
Relevant Act: http://www.austlii.edu.au/au/legis/vic/consol_
act/ohasa2004273
• Work Health and Safety Act 2011
• Occupational Health and Safety Regulations
South Australia 2017
• SafeWork SA - www.safework.sa.gov.au http://classic.austlii.edu.au/au/legis/vic/consol_
reg/ohasr2017382/
Relevant Act:
Western Australia
• Work Health and Safety Act 2012
http://www5.austlii.edu.au/au/legis/sa/consol_ • WA WorkSafe -
act/whasa2012218/ www.commerce.wa.gov.au/WorkSafe/
Relevant Act:
• Occupational Safety and Health Act 1984
http://www.austlii.edu.au/au/legis/wa/consol_
act/osaha1984273/
• Occupational Safety and Health Regulations
1996
http://www5.austlii.edu.au/au/legis/wa/consol_
reg/osahr1996382/
Work Health and Safety page 59

POLICY Clinic area/treatment room
Waiting room/administration area Massage therapists are required to:
Massage therapists are required to: • ensure mandatory cleanliness of clinic area
• maintain a safe, clean and well ventilated facility • ensure appropriate access for the elderly and
people with a disability or refer to another clinic
• provide adequate lighting
• ensure visual and auditory privacy for
• ensure appropriate access for the elderly treatments in accordance with the individual
and people with disabilities or refer clients to privacy needs of clients
another clinic
• provide suitable lighting and ventilation
• provide and maintain toilet and hand washing and ensure the clinic area is maintained at a
facilities with soap dispensers and single use comfortable temperature
towels, and temperature control on hot taps
• maintain and service heating and ventilation
• cover electrical outlets with childproof systems/devices, and turn off when not in use
safety devices
• wash hands before and after each client
• provide strong comfortable chairs
• use clean, freshly washed linen for each client
• provide non-slip flooring (do not use floor mats
or have frayed carpet) • maintain hand washing facilities with
temperature control on hot tap
• maintain functioning smoke detectors and
fire extinguishers • carry out standard infection control procedures
on reusable items (massage table, linen, oil
• be familiar with the location and use of fire dispenser etc)
extinguishers
• carry out regular safety checks on all equipment
• clearly indicate fire exits including electrical equipment (hydraulic tables,
• be aware of evacuation plan for emergencies towel caddies, microwave ovens)
with evacuation plan clearly displayed • use ergonomic table, stools and supports that
• keep emergency information posted in plain comply with relevant Australian standards
view near all telephones • keep lubricants in contamination proof
• establish a policy regarding the use of open containers, clearly labeled
flames and candles • obtain material safety data sheets (MSDS) on all
• keep all areas free of obstacles products used
• check to make sure that clients are not sensitive
or allergic to products used
• provide closed containers for used linen
• be aware that drying linen in a dryer may pose a
potential fire hazard due to the presence of any
residual oil.

• ensure correct storage and transport of • maintain membership of a professional
potentially hazardous waste (contaminated association, keep current with industry
linen, used hand towels, tissues) developments and engage in continuing
education activities
• provide non-slip or slip-proof flooring
• have current professional indemnity and public
• keep area free of obstacles for client access liability insurance
and assessment.
• document and maintain work health and safety
Storeroom and infection control policies and procedures
Massage therapists are required to: including an ongoing risk management plan
• store oils and creams in appropriate conditions • have a spills kit available for the management of
blood or body fluids spills including the use of
• provide clean, dry storage for clean linen with personal protective equipment
appropriate linen rotation system
• be aware of management procedures for
• make sure floors are slip proof. accidental exposure to blood or body fluids.
Work processes
PRINCIPLES
To implement the principles of best practice in WHS,
• use correct manual handling processes when therapists must develop and document WHS policies
lifting equipment or assisting clients on and off and procedures specific to the activities carried out
the massage table in their particular clinical setting. A safe workplace
• use appropriate body mechanics and does not happen by chance or guesswork. It requires
techniques when performing massage to a systematic approach and is referred to as a Risk
prevent muscle strain and overuse syndromes Assessment and Management Plan. Typically, this
approach follows four steps:
• maintain healthy hands with exercises for
strengthening and stretching 1. Identify hazards in the workplace. A hazard
is anything (including work practices or
• know contraindications for massage and work procedures) that has the potential to harm the
within their own scope of practice health or safety of a person
• take adequate breaks and have realistic 2. Assess how people can be hurt and the
workloads likelihood of the hazards hurting people (level
• have appropriate strategies in place for dealing of risk)
with aggressive clients 3. Determine the most effective risk control that is
• have strategies in place for stress management reasonably practicable under the circumstances
• implement anti-bullying, intimidation and 4. Review risk controls and evaluate their
harassment policies effectiveness.
• maintain a current Health Training Package Risk assessment and management is necessary to
“Apply First Aid” certificate prevent injury and maintain workplace safety. It
ensures that the highest level of protection is in place
for both the therapist and the client.
Work Health and Safety page 61

REFERENCES
• Beck, MF (2006) Theory and Practice of
Therapeutic Massage. 4th Edition. Thompson
Delmar Learning, New York.
• Casanelia, L & Stelfox, D.(2010) Foundations
of Massage. 3rd Edition Churchill Livingstone.
Sydney
• Werman, W. (2012) Impact of new WHS
legislation on associations. Associations Journal.
Edition 32, April 2012
• https://www.safework.nsw.gov.au/
• www.workcover.tas.gov.au

AMT Standard -
Dry Needling
page 63
PURPOSE STATUTORY REQUIREMENTS
Massage therapists are aware of the statutory The standards in this policy should be applied in
requirements for the practise of Dry Needling, meet association with official statutes, regulations and
the minimum education standards, and only perform guidelines in your jurisdiction.
dry needling in accordance with the policy.
NSW
BACKGROUND The Public Health Act 2010 and Public Health

Regulation 2012 regulates massage therapists who
Dry Needling refers to the practice of inserting provide dry needling.
acupuncture needles into trigger points to treat
myofascial pain and dysfunction. It is based on • https://www.health.nsw.gov.au/environment/
western anatomical and neurophysiological skinpenetration/Documents/skinpen-public-
principles and, as such, must be distinguished from health-regulation-2012.pdf
the practice of acupuncture, which is based on the
ACT
principles of Traditional Chinese Medicine.
Massage therapists who perform skin penetration
Since Dry Needling involves penetration of the skin
procedures are required to be licensed and comply
- the body’s first line of defence against infection –
with the ACT Health Infection Control for office
massage therapists who practise dry needling must
practices and other community-based services Code
have a thorough knowledge of infection control
of Practice 2005. Businesses are inspected regularly
policy and procedure. This includes at least a basic
by Public Health Officers from the Infection Control
knowledge of microbiology and modes of disease
Unit to check for compliance with the Code.
transmission. Specific knowledge of work health and
safety requirements in relation to the handling, use • https://www.health.act.gov.au/sites/default/
and disposal of sharps is also critical to the safe and files/2018-09/Infection_Control_for_office_
ethical practice of Dry Needling. practices_and_other_community_based_
services_Code_of_Practice_2005.pdf
Since needling is an invasive procedure, massage
therapists need to be particularly vigilant in Queensland
complying with all relevant legal statutes and
guidelines, obtaining informed consent and working Massage therapists must comply with the following
strictly within the scope of their training and guidelines:
knowledge. • https://www.health.qld.gov.au/__data/assets/
pdf_file/0019/430642/infectcontrolguide.pdf
QUALIFICATIONS Victoria
Massage therapists who practise Dry Needling must
Massage therapists must comply with the following
hold a nationally recognised Diploma or Advanced
guidelines:
Diploma (AQTF standard). If Dry Needling is learnt
at a post-graduate workshop, practitioners must • https://www2.health.vic.gov.au/Api/
complete a minimum of 60 hours of face-to-face downloadmedia/%7BB03472A8-9EF4-4396-
training and 15 hours of supervised clinical practice, 9004-4E584171033F%7D
the content of which must include comprehensive
training in infection control and work health and
safety principles. Practitioners of Dry Needling must
also demonstrate a thorough knowledge of Skin
Penetration legislation.
page 64 Dry Needling

South Australia POLICY
Massage therapists must comply with the following Massage therapists are required to:
guidelines:
Premises
• http://www.sahealth.sa.gov.au/wps/wcm/conn
ect/3d4e0b8046c253089530fd22d29d99f6/skin- • ensure that the treatment area is constructed
penetration-guide-10feb05.pdf?MOD=AJPERES of suitable materials. All floors, floor coverings,
&CACHEID=3d4e0b8046c253089530fd22d29d9 walls, ceilings, shelves, fittings and other
9f6 furniture should be smooth, impermeable and
easily cleaned. Flooring should be of a colour
Please note: WorkCover SA does not endorse the and type that allows for easy identification and
delivery of dry needling by massage therapists and removal of sharps should they be dropped.
therefore such services are not payable if provided by
a massage therapist • provide adequate lighting
Western Australia • register the premises with the local authorities

(municipal council).
Massage therapists who perform dry needling are
required to notify the local government of their Infection control
registered trading name and business address. • comply with the infection control statutes and
• Health (Skin Penetration) Procedure guidelines in their state
Regulations 1998 • demonstrate knowledge of and compliance
http://www.austlii.edu.au/au/legis/wa/consol_ with standard infection control precautions
reg/hppr1998449/
• use single-use equipment (needles, swabs
Northern Territory and gloves)
Massage therapists must comply with the following • disinfect the area of skin to be penetrated.
guidelines:
Hand washing
• https://digitallibrary.health.nt.gov.au/prodjspui/
bitstream/10137/1151/1/Public%20and%20 • wash their hands
Environmental%20Health%20Guidelines%20
- before and after working with a client
for%20Hairdressing%2c%20Beauty%20
Therapy%20and%20Body%20Art.pdf - after visiting the bathroom
- after smoking
- after meal breaks
- a fter blowing their nose or touching any part
of the body
- a fter handling soiled equipment including
jewellery, towels and cloths
- before putting on and after removing gloves
- after contact with blood or body substances
- whenever they are visibly soiled
- any other time infection risks are apparent.
Dry Needling page 65
Handling and disposal of sharps Record keeping
• place sharps in an Australian Standard (AS • keep records of the date, time and details of the
4031) specified, disposable sharps container specific Dry Needling procedures performed.
immediately after use
Massage therapists do not:
• seal and dispose of sharps containers in
accordance with the environmental protection • use needles in a mobile practice
authority requirements in their state. Disposal • re-use any Dry Needling equipment
of sharps into the general waste stream is
dangerous and illegal • dispose of sharps in the general waste stream
• ensure that there is an accessible sharps • perform needling without written

container for the disposal of sharps as close as informed consent
practical to the point of generation • claim they are doing acupuncture.
• ensure that the sharps container is
not accessible to clients and visitors,
particularly children Approved: 17 September, 2012
•
• ensure that sharps containers are not overfilled
• ensure that sharps are not forced into the
sharps container
• retain records of hazardous waste disposal for
three years on the business premises where
it was generated. Records including the
generation, storage, treatment or disposal of the
waste is required.
Informed consent
• obtain written informed consent before
embarking on a course of Dry Needling
treatments
• advise the client of the evidence-based
and conventional treatment options,
their risks, benefits and efficacy, as reflected by
current knowledge.
page 66 Dry Needling

AMT Standard -
Treatment of Minors
PURPOSE Massage Therapists are included under the definition
of Mandatory Reporters in NSW, South Australia and
Massage therapists are informed of their legal and Northern Territory (in the Northern Territory, every
ethical responsibilities in relation to working with adult is designated as a mandatory reporter and
minors, and can apply this knowledge in accordance in Victoria every adult is a mandatory reporter of
with the policy. sexual offences). However, regardless of the statutory
requirements, AMT believes that massage therapists
BACKGROUND have an ethical duty to report suspected child
abuse or neglect to the appropriate statutory child
Child protection is covered under state/territory protection authority in their state/territory.
legislation in Australia. As such, there is no single
national framework setting out the requirements for STATUTORY REQUIREMENTS
obtaining Working With Children Checks or Police
Checks. Each state/territory has its own procedures. The following is an overview of the states/territories
It is therefore necessary for the massage therapist legal requirements for massage therapists working
to fulfill the requirements that are in effect in their with children, including mandatory reporting
specific jurisdiction. requirements:
ACT
MANDATORY REPORTING OF
• In the ACT a minor is legally defined as a person
CHILD ABUSE AND NEGLECT less than 18 years of age.
Mandatory reporting is the legal requirement to • The Working with Vulnerable People
report suspected cases of child abuse or neglect to (Background Checking) Act 2011 does not
government authorities. Since child protection is a currently capture massage therapists. There is
state/territory responsibility, the designated groups no legal statute in the ACT requiring massage
of people mandated to notify their concerns to the therapists to undergo a Working with Children
appropriate statutory child protection authority - or Police Check. Individual employers may have
known as mandatory reporters - differs between a screening process in place. AMT requires
states/territories. therapists to have a parent, legal guardian or
The legislation generally contains lists of particular caregiver present at all times during treatment
occupations that are mandated to report. The groups of persons under 18.
of people mandated to notify cases of suspected • Massage therapists are not defined as
child abuse and neglect range from persons in a mandatory reporters in the ACT.
limited number of occupations (e.g. Queensland),
to a more extensive list in Western Australia, to a • The Working with Vulnerable People
very extensive list (ACT, NSW, SA, Tasmania, Victoria), (Background Checking) Act 2011 may apply to
through to every adult (NT; and Victoria for sexual therapists who specialise in the treatment of
offences). The occupations most commonly named people with disability. For more information and
as mandated reporters are those who deal frequently clarification, please refer to:
with children in the course of their work: teachers, https://ablis.business.gov.au/ACT/resource/
doctors, nurses, and police. AD2307.pdf
Relevant Acts:
• Working with Vulnerable People (Background
Checking) Act 2011
page 68 Treatment of Minors

NSW Queensland
• In NSW a minor is legally defined as a person • In Queensland a minor is legally defined as a
less than 18 years of age. person less than 18 years of age.
• Massage therapists need to apply for a Working • Massage therapists are required to apply for
with Children Check if the majority of their a Working With Children Check, known as
business involves working with children less a "Blue Card". Valid for two years, Blue Cards
than 18 years of age or if they are employed in entitle individuals to engage in child-related
child-related settings, such as childcare centres, occupations/volunteering.
schools and pediatric wards. AMT requires
therapists to have a parent, legal guardian or • To apply for a Blue Card and for more
caregiver present at all times during treatment information, please visit the Blue Card Services
of persons under 18. website.
http://www.bluecard.qld.gov.au/index.html
• Massage therapists fall under the definition of
Mandatory Reporters in NSW. This means that • AMT requires therapists to have a parent, legal
Massage Therapists are legally required to report guardian or caregiver present at all times during
suspected child abuse to the NSW Department treatment of persons under 18.
of Family and Community Services. • Massage therapists are not defined as
Relevant Act: mandatory reporters in Queensland.
• Child Protection Act (Working with Children) Relevant Acts:

2012 • Child Protection Act 1999
• Child Protection Act (Working with Children) • Working with Children (Risk Management and
Regulation 2013 Screening) Act 2000
Victoria
• In Victoria a minor is legally defined as a person
less than 18 years of age.
• Massage therapists are not currently captured
by the Victorian Working with Children Act. A
Working with Children Check would only apply
to massage therapists who are employed in
child-related settings, such as childcare centres,
schools and pediatric wards, in which case a
Working with Children Check would be required.
• AMT requires therapists to have a parent, legal
guardian or caregiver present at all times during
treatment of persons under 18.
• Massage therapists are not defined as
mandatory reporters in Victoria. However, every
adult is a mandatory reporter of sexual offences.
Relevant Act:
• Working with Children Act 2005
Treatment of Minors page 69

South Australia • AMT requires therapists to have a parent, legal
• In South Australia a minor is legally defined as a treatment of persons under 18.
person 18 years or less.
• Massage therapists are not defined as
• Massage therapists are required to apply for a mandatory reporters in Western Australia.
Working with Children Check if they work with
children unsupervised for 7 or more days within Relevant Act:
a year. A single unsupervised appointment in a
day would be considered to represent a full day • Working with Children (Criminal Record
of unsupervised contact. Checking) Act 2004
• To apply for a check, please visit the Department Tasmania

of Human Services website: • In Tasmania a minor is legally defined as a
https://screening.sa.gov.au/applications/ person less than 18 years of age.
application-information-for-individuals
• The Registration to Work with Vulnerable People
• AMT requires therapists to have a parent, legal Act 2013 came into effect on 1 July 2014.
guardian or caregiver present at all times during Massage therapists are not currently captured
treatment of persons under 18. by the Act. A Working with Children Check
• Massage therapists fall under the definition would only apply to massage therapists who
of Mandatory Reporters in South Australia. are employed in child-related settings, such as
This means that Massage Therapists are legally childcare centres, schools and pediatric wards,
required to report suspected child abuse to in which case a Working with Children Check
the Department of Child Protection. would be required. AMT requires therapists
to have a parent, legal guardian or caregiver
Relevant Act: present at all times during treatment of persons
under 18.
• The Children and Young People (Safety) Act
2017 • Massage therapists are not defined as
mandatory reporters in Tasmania.
• Child Safety (Prohibited Persons) Act 2016
Relevant Acts:
Western Australia
• Children, young persons and their families
• In Western Australia a minor is legally defined as Act 1997
a person less than 18 years of age.
• Registration to Work with Vulnerable People Act
• Massage therapists are not currently captured 2013
by the West Australian Working with Children
Act. A Working with Children criminal check
would only apply to massage therapists who
are employed in child-related settings, such as
childcare centres, schools and pediatric wards,
in which case a Working with Children Check
would be required. Please visit the WA Working
with Children website for information about
how to apply:
https://workingwithchildren.wa.gov.au/
applicants-card-holders/applying-for-a-wwc-
check/how-to-apply
page 70 Treatment of Minors

Northern Territory PRINCIPLES
• In the Northern Territory a minor is legally Massage therapists should be mindful of the
defined as a person less than 18 years of age. following principles in relation to the treatment
of minors:
• Massage therapists are required to apply for a
Working with Children Clearance (Ochre Card). • Children are people too. Involve minors in
For information on how to apply, the decision-making process as much as
please visit the NT Police SAFE website: possible. Empower children by explaining the
https://forms.pfes.nt.gov.au/safent/ treatment in age-appropriate terminology and
seek consent for treatment from them too,
• AMT requires therapists to have a parent, legal
wherever practicable.
treatment of persons under 18. • Respect boundaries. Children may feel
uncomfortable about some elements of the
• Massage therapists fall under the definition
treatment, such as removing clothing or
of Mandatory Reporters in Northern Territory.
lowering/adjusting underpants to access the
Anybody with reasonable grounds is legally
lower back muscles, and working close to the
required to report child abuse or neglect in the
groin and buttocks. Massage therapists should
Northern Territory to the Department of Health
look for signs of discomfort and be flexible
and Families.
in their approach. Therapists should develop
Relevant Act strategies to work with the particular sensitivities
of each client.
• Care and Protection of Children Act 2007
REFERENCES
POLICY
• ACT Office of Regulatory Services website
When treating a minor, massage therapists are
required to: • NSW Working with Children Check website
• comply with relevant local statutes relating • Victorian Department of Justice website
to child protection, mandatory reporting and
• Queensland Commission for Children and
working with children
Young People and Child Guardian website
• seek informed consent for treatment from a
• West Australian Working with Children
parent, legal guardian or caregiver
check website
• have a parent, legal guardian or caregiver
• Northern Territory Working with
present throughout the treatment
Children website
• report suspected child abuse to the appropriate
• The Australian Institute of Family Studies website
statutory child protection authority in your state.
• Australian Institute of Family Studies website.
Massage therapists do not:
• have unsupervised contact with a minor.
Treatment of Minors page 71

NOTES
page 72
NOTES
page 73
NOTES
page 74
NOTES
page 75
AMT Ltd
PO Box 826
Broadway NSW 2007
Phone: 02 9211 2441
Fax: 02 9211 2281
e-mail: info@amt.org.au
www.amt.org.au association of massage therapists

AMT Code of Practice Final

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

AMT Code of Practice Final

Uploaded by

Copyright:

Available Formats

Massage Therapy Code of Practice

association of massage therapists

Designed by Claudia Iacovella

AMT Code of Ethics 6

Massage Therapy Code of Practice -

AMT Standard - Complaint Handling 15

AMT Standard - Professional Boundaries 19

AMT Standard - Draping 23

AMT Standard - Informed Consent 27

AMT Standard - Breast Massage 31

AMT Standard - Privacy and Confidentiality 35

AMT Standard - Record Keeping 39

AMT Standard - Issuing Receipts 45

AMT Standard - Advertising 49

AMT Standard - Infection Control and Hygiene 53

AMT Standard - Work Health and Safety 57

AMT Standard - Dry Needling 63

AMT Standard - Treatment of Minors 67

The Association of Massage Therapists (AMT) is a national, not-for-profit

Australians have access to safe, ethical and evidence-informed

Our mission is to:

We support We encourage We have We strive We put quality

In the context of massage therapy practice, • The public – to empower clients to

NSW Western Australia

• enhance health and wellbeing • well-developed assessment, observational and

BACKGROUND • deliver a professional service at a fair and

page 16 Complaint Handling

Relevant legislation: Western Australia

Complaint Handling  page 17

• offer an apology if warranted - a ppropriate remediation or an offer

• contact their professional indemnity • Complaints Management Handbook for the

page 18 Complaint Handling

page 20 Professional Boundaries

• engage in counselling or psychoanalysis • Know thyself. Self-reflection is essential to

KEY UNDERPINNING CONCEPTS

Approved: 17 September, 2012

page 22 Professional Boundaries

Approved: 17 September, 2012

page 28 Informed Consent

Informed Consent  page 29

Approved: 17 September, 2012

page 30 Informed Consent

page 32 Breast Massage

Breast Massage  page 33

page 36 Privacy and Confidentiality

Privacy and Confidentiality  page 37

Therapists should be mindful of the following

Approved: 17 September, 2012

page 38 Privacy and Confidentiality

page 40 Record Keeping

Record Keeping  page 41

page 42 Record Keeping

Approved: 17 September, 2012

Record Keeping  page 43

page 46 Issuing Receipts

TAX EVASION AND FRAUD •

Failing to declare assessable income, not wanting

Issuing Receipts page 47

MISLEADING AND DECEPTIVE CONDUCT

page 54 Infection Control and Hygiene

• ensure all products are labeled to prevent using PRINCIPLES

Infection Control and Hygiene page 55

Approved: 17 September, 2012

page 56 Infection Control and Hygiene

In the context of massage therapy practice, • The public – to empower clients to

• enhance health and wellbeing • well-developed assessment, observational and

BACKGROUND • deliver a professional service at a fair and

page 16 Complaint Handling

Complaint Handling page 17

• offer an apology if warranted - a ppropriate remediation or an offer

• contact their professional indemnity • Complaints Management Handbook for the

page 18 Complaint Handling

page 20 Professional Boundaries

• engage in counselling or psychoanalysis • Know thyself. Self-reflection is essential to

page 22 Professional Boundaries

page 28 Informed Consent

Informed Consent page 29

page 30 Informed Consent

page 32 Breast Massage

Breast Massage page 33

page 36 Privacy and Confidentiality

Privacy and Confidentiality page 37

page 38 Privacy and Confidentiality

page 40 Record Keeping

Record Keeping page 41

page 42 Record Keeping

Record Keeping page 43

page 46 Issuing Receipts

Issuing Receipts page 47

page 54 Infection Control and Hygiene

• ensure all products are labeled to prevent using PRINCIPLES

Infection Control and Hygiene page 55

page 56 Infection Control and Hygiene

page 58 Work Health and Safety

• Workplace Health and Safety Qld - Relevant Act:

Work Health and Safety page 59

page 60 Work Health and Safety

Work Health and Safety page 61

page 62 Work Health and Safety

page 64 Dry Needling

Western Australia • register the premises with the local authorities

• ensure that there is an accessible sharps • perform needling without written

page 66 Dry Needling

page 68 Treatment of Minors

• Child Protection Act (Working with Children) Relevant Acts:

Treatment of Minors page 69

• To apply for a check, please visit the Department Tasmania

page 70 Treatment of Minors

Treatment of Minors page 71