Guidance & etiquette | natstatetherapy

Guidance on what to expect with a massage treatment, and some notes on etiquette.

Right, we’ve been thinking for some time that we should write something here about what to expect when going for a massage treatment, and in particular what is often referred to as the ‘etiquette’ of massage treatments.

For the seasoned client, they know what to expect, and how to explain what they need. Newer clients maybe uncertain on both of these, and may be confused with a lot of conflicting guidance.

Many therapists provide this sort of guidance, verbally, and on their promotional material and websites, tailored to their particular practice, and they typically take one of two approaches: either in the form of FAQs, or under subject headings. We have adopted the latter, to try to ensure that we make the guidance comprehensive.

It’s important to stress that whilst the guidance here is all correct for our practice, it will only fully apply to some, not all, other therapists.

Of course, if you do have a question that isn’t covered here, please feel free to contact us.

Also, you can refer to the Federation of Holistic Therapies (FHT) Code of Conduct, a link for which can be found at the bottom of this page under 'More information'.

When thinking about booking

For whatever reason (stress, pain, insomnia, relaxation, a treat, etc.) you will probably have been thinking for a while about having a massage. Assuming that you are not one of those ‘seasoned clients’, you will probably have done some research (like looking at this website) and spoken to people who have had massages. You may now be quite clear about what sort of massage treatment you require.

If not, please feel free to contact us to discuss this. We can get an early assessment of your needs, and recommend a possible treatment; you can understand better what we offer and whether we’re the right therapy practice for you.

Whatever the outcome of this early assessment, a full consultation is done at the beginning of the treatment session, and the treatment will be the one that best meets your needs. We are able to mix and match elements of the various treatment types we offer. So, don’t get too hung up on it having to be one thing, be it ‘deep tissue’, ‘Thai’, ‘therapeutic’, etc.

When booking

You can book through the website, by email or text/Messenger/WhatsApp/Skype.

You will need to provide your full name and a contact number.

Our treatments are normally for a minimum of one hour. We do offer half-hour treatments, but only when there is a single specific physical issue to be addressed (e.g. a stiff neck), and the location is local to our home or at our home clinic.

For a full body massage, we strongly recommend a 90 minute treatment, particularly if there are parts of the body that need more focussed treatment. One hour can be sufficient but we may need to omit one or more parts of the body.

When cancelling

Hopefully, you will never have to cancel an appointment!

However, if you do, and plans change for all of us from time to time, we just ask that you do so at least 24 hours prior to the appointment. Just not turning up for an appointment, or sending a message just before, needs to be avoided, except of course if you’ve a crisis on your hands!

Cancelling within 24 hours normally requires full payment.

Prior to your/my arrival

Please take a shower or bath not too long before your appointment. Massaging an unclean body is not pleasant, and you will not get the full benefit from the treatment.

Also, use the toilet if you need to. Receiving a massage whilst having a full bladder isn’t very relaxing.

Wear clothing that is either appropriate for the treatment or is easily removed if required. (See ‘Undressing’ and 'Draping' below.)

Please arrange to be ready for your appointment on time. We will do likewise. Delays are occasionally inevitable but best endeavours should be used to avoid them. We will typically wait up to 10 minutes if a client is delayed but that may depend upon what other appointments we have booked.

If you are providing the space for the treatment, please ensure that:

There is sufficient room for the massage table/mat to allow movement around it.
The room is warm enough (obviously more important if clothing is to be removed).
There is adequate privacy for you.
For a Lomi Lomi massage (which uses a lot of massage oil), surfaces beneath the table will not be damaged by stray oil. (A sheet is provided for that purpose.)

On arrival

On arrival, you will need to fill out the Case History consultation form, if it is to be your first treatment with us. Also, please think about whether you need to use the toilet before we start the treatment.

You can pay for treatment now or at the end of the session. Sometimes, it is easier to get this out of the way at the beginning.

Preparing for the massage

Consultation

The first part of all treatments is the consultation. It is an essential element regardless of how many treatments you have had before, with us or with anyone else. For a first treatment with us, the consultation may last as long as 10 or 15 minutes, and will be based upon your completed Case History form. For later treatments, the consultation is typically much briefer, comprising a short discussion about anything about your health that has changed since the last appointment, or any other change in requirements.

The purpose of the consultation is to ensure that we have a common understanding as to your current state of health, medical history, issues to be addressed in the massage, type of massage to be given, and any contraindications we need to be aware of that need to be accounted for in the treatment plan. Please note that some contraindications can completely preclude certain massage treatments.

Please ask any questions you may have about the treatment plan.

Areas of the body that may be included in the treatment are:

Head
Face
Neck
Shoulders
Upper back
Middle back
Lower back
Buttocks
Chest (excluding the breasts)
Abdomen
Arms
Hands
Feet
Upper legs (front and back)
Lower legs (front and back)

We will also discuss the following: positions on the massage table/mat, extent of undressing, extent of draping, choice of music (if provided).

Positions on the table/mat

For a table massage, positions are prone (face down) and supine (face up), normally changing from one to the other during the treatment, depending upon which parts of the body are to be worked on. If lying flat is not comfortable, this can be aided using bolsters, cushions, pillows and/or rolled-up towels. Or a side-lying position can be used.

For Thai massage, a mat on the floor is used. Again, typically, both prone and supine positions are used.

Undressing

The extent of undressing depends upon two things:

Type of massage treatment
Comfort level of the client

For Thai and chair massage, no removal of clothing is required.

For oil-on-body massage, due to the direct application of oil, removal of clothing is required. This is dependent upon the parts of the body being treated. (Please refer to the 'Draping' section below.)

If a treatment requires massaging the buttocks, it is easier to work with underpants/knickers removed (with the side not being massaged draped).

However, clients must only ever undress to their comfort level. We will never ask you to remove more clothing than you are happy to. Not only would that be unethical, if you feel too exposed, you will not relax and not fully benefit from the treatment. If underpants/knickers are left on, we work around them, or ask your permission for us to adjust them to get access to the buttocks. For female clients, if a bra is left on, we will ask to undo the straps whilst working on the back. For male clients, please wear briefs rather than boxer shorts.

For Lomi Lomi massage, bras should not be worn, and if underpants/knickers are to be worn, we will usually provide disposable thongs, as they need to be very brief and will get oily. Ideally, Lomi Lomi massage is performed on a naked body.

Please remove all jewellery from areas to be massaged.

Draping

Draping is the use of towels, sheets or blankets to cover the body during a treatment.

We use a variety of normal and lightweight towels and sarongs, depending on type of massage, temperature of the room, and client preference.

Typically, draping is adjusted during a treatment to keep covered parts of the body that are not being worked on at that time. As a rule, the level of draping is a compromise between keeping the client warm, preventing the client feeling over-exposed, giving easy access for the therapist to work, and minimising distracting and awkward repositioning of drapes.

The diagram below shows a variety of draping (and undressing) options. It is not exhaustive but helps to facilitate discussion on what is best for each client.

Unless otherwise agreed, we take the ‘Western Sheet’ approach for front and back (except we would normally keep the shoulders covered, too), regardless of the level of undressing.

For Lomi Lomi massage draping is at most very limited. The 'Island Lomi Towel' draping or 'No Draping' options are usually used here.

Music

Many spas and clinics use traditional soothing Eastern-style, South American or natural soundtracks.

We prefer to use a range of music types, including jazz, classical, blues, progressive, folk, etc.

If we are providing music for the treatment, we usually have the full library of Spotify to call upon. So, hopefully, we can find something that you like (including the aforementioned traditional choices!).

Starting the treatment

Once the consultation has been completed, you will undress as agreed (if required), and position yourself on the table or mat. If you prefer, we can go out of the room whilst you do that. We will have given you a towel with which to cover yourself as best you can.

We will then adjust the draping and any bolstering, and ensure that you are comfortable.

During the massage

Providing feedback

From time to time we will ask you about whether you are warm enough and comfortable, whether the amount or pressure or force is OK, and whether you are experiencing pain.

Please give whatever feedback you want to.

If you start to feel uncomfortable at any point (physically or emotionally) please tell us.

If you would like to deviate from the agreed treatment in any way, or are concerned that we may be, please tell us.

Dealing with pain

For some types of massage (e.g. deep tissue) feeling some pain is inevitable, and is associated with releasing tension and stretching tissues. However, the pain should never be so great that it becomes counter-productive. Typically, on a scale of 1 to 10, with 10 being unbearable pain, the aim in a massage is to not exceed a level of 6 or 7, and then only for limited periods.

Deep controlled breathing can help in dealing with any pain and discomfort.

Conversation

We are happy to have a conversation during the treatment but there is no requirement for you to speak other than to give us any of the feedback as mentioned above.

Complete silence on your part is fine, although we will have to assume that you have no feedback to give.

Falling asleep (you not us) is perfectly acceptable!

Involuntary responses

When relaxed during a massage, it is common for clients’ stomachs to grumble. They also fart from time to time. Both are perfectly normal, and not a problem.

Men sometimes get an erection (although this is rare in our experience). This is a reflex action in response to stimulation of nerves in the upper legs and pelvic region when working in those areas. Providing the client does not make this obvious (and it will not be seen anyway when draped), then it is of no more of a problem than stomach-grumbling and farting.

Happy ending

We do not provide a sexual service. Any request for anything sexual before or during a treatment will be firmly declined. It will lead to a refusal to take, or a cancellation of a booking; and may lead to termination of a treatment in progress.

After the massage

On completion of the treatment, you will be given a few minutes to get up from the table/mat and dress again (if required). Again, if you prefer, we will go out of the room whilst you do this.

We will have a brief discussion about the treatment, sharing our findings and your experience.

Advice & recommendations

We may give advice and recommendations based upon our findings. Please ask any questions you may have about the treatment, or about our advice and recommendations.

We will not normally advise drinking plenty of water, which is a usual post-massage recommendation. That is not because it’s not a good thing to do. It’s because there is actually very little evidence that the need to ‘flush out the toxins released by the massage’ really exists. We may, however, make recommendations about stretching, exercises, posture, and future massage treatments.

Payment

If you did not pay at the beginning of the session, we will take payment now. Normally, we are able to take cash or card payments.

We mention tipping here as it is often included in guidance and FAQs. We have no expectation of receiving a tip. It happens sometimes, and it’s nice, but please do not feel in any way obliged to do so.

Client feedback

If we remember (and we usually don’t) we will ask whether you would be prepared to fill in a client feedback form. Again, there is no obligation for you to agree to this but we are always keen to learn from our clients, and sometimes this feedback can be invaluable.

Further treatments

We will always encourage you to make another appointment, or series of appointments. (We would, wouldn’t we?) Actually, though, a single treatment almost never fixes a body. Usually, a few treatments over a period of weeks are needed, followed by regular (monthly or six-weekly) maintenance massages.

More information

If you would like more information about the conduct expected of therapists and their clients, please see the Federation of Holistic Therapists (FHT) Code of Conduct, which can be found here: https://www.fht.org.uk/code-of-conduct-and-professional-practice.