Practice makes perfect

Image credit Nick Youngson CC BY-SA 3.0 Pix4free

by Rebecca Barnett

An auspicious milestone snuck by with nary a whisper last month. On 13 February 2013, the very first edition of the AMT Code of Practice rolled off the printing presses and was posted out to AMT members. That big moment was the culmination of 5 years of discussion, dialogue, research, drafting, consultation, revision and iterative refinement. There was a requisite amount of hair loss, sleep loss, headache, angst, frustration, manic laughter, cups of tea, Black Russians, and at least one international assassination plot. (Hang on, that might just have been an anxiety dream.)

Anyone who has entered the industry over the last decade would probably struggle to get their head around the concept of a BC (before COP) era in the massage industry. But, in fact, there was a monumental Code-of-Practice-shaped hole that wasn’t being filled by the scattered and disjointed practice guidelines that existed at the time, including AMT’s well-intentioned but sparse Practice and Procedure guideline booklet that flagged a tiny handful of issues (My memory is a bit rusty but I think the 90s edition of this document included some broad statements about not touching breasts, using adequate draping, and wearing suitable professional attire.)

A page from the 2011 Practice and Procedure guidelines. By this time, we were working in earnest on the Code of Practice obviously …

I still have a crystal clear memory of sitting in AMT Head Office with some constables from Newtown Police station. It was 2008 and the police were seeking information about formal guidelines and standards that massage therapists were subject to, in connection with an alleged assault by a massage therapist. I suppose the memory stuck with me because of the powerful sense of mortification I felt having to inform them that there was very little AMT could provide by way of detailed formal standards of practice. The AMT Practice and Procedure guideline looked embarrassingly scant that day and failed to address most of the specific and rather distressing inquiries put by the police.

If you were looking for a conception date for the AMT Code of Practice it was that day.

You can imagine how surreal it felt to sit in a court room two and a half years after the Code of Practice had been released and listen to a barrister quote whole sections of the Code, chapter and verse, in a sexual assault case. (The therapist was found guilty and given a 3-year custodial sentence.) It’s disheartening that a comprehensive Code of Practice needs to be quoted in that kind of context, especially since the case involved an AMT member, but it was deeply validating to see the hours of work invested in articulating comprehensive standards of practice contribute to a just outcome.

Constant renewal

Of course, the Code of Practice you can download from the AMT website today is not the same document that was published 10 years ago. It is diligently reviewed and updated annually to reflect changes to legislation and other developments that relate to clinical practice. Even as I type this blog, there are tweaks and updates that need to be made to ensure that the Code remains current. For starters, the NHMRC moves the Australian Guidelines for Prevention and Control of Infection in Healthcare every bloody year. *Shakes fist*. And don’t talk to me about government departments changing names and web domains. This is actually one of the manifold reasons you should review the AMT Code of Practice once a year. After all, you make an annual declaration when you renew your membership with AMT that you abide by it.

However, one of the tweaks on the horizon this year is far more substantial than the usual annual review. The Code of Practice will soon include a new Social Media Standard. Much like the original impetus behind the Code, this new Standard is somewhat overdue. We have witnessed the inexorable rise of social media over the past 15 years and, over the past decade, it has become pivotal to how people do business, including massage therapists of course.

But without a map or compass, it’s easy to end up in dangerous terrain. It’s therefore not surprising that AMT has started to see social media behaviours feature more frequently in complaints against massage therapists, particularly in relation to professional boundary violations. AMT’s social media standard of practice will provide a framework for massage therapists to navigate the risks associated with social media use and maximise the benefits it offers as a tool to communicate and engage with clients, promote services, and support clients through their care.

Much like the court case I mentioned above, the Standard will end up being quoted in expert witness statements for the courts and advice to health complaint entities. In fact, history repeated itself a few years ago when I was asked to provide input to the Office of the Health Ombudsman (OHO) in Queensland in a complaint that included alleged social media boundary violations. Yet again, I had no formal standard to refer to in my assessment beyond a single sentence in the AMT Code of Practice. It’s hard to adequately express just how much it feels like being in cowboy-country when you’re called to provide advice to a government body and there is a vacuum where a comprehensive guideline or detailed standard should be. In the joint report prepared by the expert witness for the therapist and me, we were requested to provide a definition of social media. We had zip.

One of the great foundational strengths of the AMT Code of Practice was the lengthy and exhaustive consultation process we embarked on before it was finalised. This was a year long process involving AMT members, government agencies, health complaint entities, health departments and basically any stakeholder we could think of. We had one incredibly fruitful face-to-face consultation with the delightful Commissioner and Deputy Commissioner at the Office of the Health Services Commissioner in Victoria. It was early in the consultation process but that meeting gave us a great insight into the kind of contested issues we would face. (One Commissioner said that no healthcare practitioner should ever treat a family member and the other was more pragmatic, taking the view that, if family members were patients/clients then industry standards of practice had to apply at every consult. One Commissioner was a lawyer and the other a doctor. Both had powerfully persuasive arguments. Can you guess which was which?).

We need your input

Divergent opinions like this featured in every one of the feedback sessions we facilitated. Many of these were fiery and volatile but every one of them helped to make the final Code stronger. Some of the greatest early detractors of the draft became its fiercest defenders and admirers.

Which is precisely why we are calling on you to provide feedback on the draft version of AMT’s Social Media standard. You answered the call over a decade ago and we are reaching out to you again now to help us identify ways to improve the draft of this new standard.

The consultation survey is open until Friday 10th March. We think it will take between 10 and 20 minutes to complete, but a lot hinges on how deeply you delve into the detail. You can view the full draft of the standard here.

We look forward to your feedback.

About the author

Rebecca Barnett is not entirely certain she has fully recovered from the great underwear scandal of 2012. However, on this auspicious 10th anniversary of the AMT Code of Practice, it seems only fitting to acknowledge the gigantic contributions of the main authors of the Code – Tamsin Rossiter, Desley Scott (and me). Alan Ford and Colin Rossie also played a huge part in shaping the dream into reality. AMT members and the industry at large owe them a debt of gratitude.

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