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The holiday season is fast approaching! Many people view gift giving and receiving as being based in reciprocity and obligation. The idea being that when gifts are exchanged, they must be of equal value in order to maintain equality in the relationship. This can “present” challenges when we think about gifts and our professional relationships with our clients.

There are two schools of thought when it comes to giving and receiving gifts in the massage therapy practice. First, there is the non-gifting school of thought. It believes that the therapeutic relationship is one in which there is an imbalance of power, and therefore we should not accept gifts from clients who may feel obligated to give to us. And we should not give gifts, so as not to be perceived as putting our clients into a situation where they owe us in any way.

No Gifts, Please

In fact, the ABMP Code of Ethics, number nine says: “…I will not accept gifts, compensation, or other benefits intended to influence a decision related to a client (ABMP).” It could be argued that a small gift is not intended to influence a decision related to a client, but many feel that by not accepting or giving gifts at all, there can be no misunderstandings. They will also argue that even a small gift can make people feel obligated and come back to bite us.

In one example of gift-giving turning into obligation, a therapist was doing outcall for a very wealthy family who would tip well above the normal amount each time. The family began to cancel at the last minute, even after the therapist had arrived, expecting to work. When the therapist finally said something about their last minute cancellations, they flipped out saying, “Don’t we always tip you very well?” and “You’re taking advantage of us.” They fired her on the spot. This was a very tough situation as the “gift” was given in the guise of a gratuity, which makes it difficult to refuse, yet clearly this family felt it bought them immunity from common decency and courtesy.

Similar to the ABMP, the NCBTMB Code of Ethics, section XVII tells us to: “Refuse any gifts or benefits that are intended to influence a referral, decision or treatment, or that are purely for personal gain and not for the good of the client (NCBTMB).” Again, the goal of the professional therapist is to remain above reproach, not allowing for a situation to develop where the client, or themselves, may feel obligated in any way.

Just a Token…

In the second school of thought it is believed that a small token gift is allowable as it does not create obligation. Those who feel this way point out that their clients are adults and would not be swayed by a small dollar value or a token gift. They feel that it is okay to give and receive between therapist and client, so long as some basic boundaries are recognized.

Holiday Gifts Given

  1. Any gift given by a therapist must be small, a token, generally worth less than $10 and almost always worth less than $20.
  2. Gifts given are usually some sort of self-care item.
  3. A gift should be given by the therapist to clients as a group, either to all regular clients or to all clients who come in during December. By giving to clients as a group no one is singled out, and therefore does not owe anything for the special favor.

Holiday Gifts Received

  1. Any gift received by the therapist needs to be worth a small dollar value, generally less than $10 and almost always worth less than $20. Any gift worth more than that should be politely refused so as not to be perceived as accepting it as a sort of bribe for extra special attention.
  2. When a regular client tips extra during the holiday season it is always appreciated, however there is still a limit to what is acceptable. Most therapists are comfortable accepting around $20 over the normal tip as a holiday tip, and some may feel comfortable accepting up to the price of the service. Few therapists would accept a gratuity over the price of the service itself, as this would be viewed as too much and would be perceived as putting the therapist “in debt” to the client. (This was played out in our earlier example.)

Examples of Perfect Holiday Gifts

So what kinds of gifts are usually acceptable to the gift-giving group? Usually they will give sample size massage oils or lotions, especially of a signature blend they may use in their practice. A small hand-crafted soap or a small amount of rich, dark chocolate is also commonly given. Christmas tree ornaments are somewhat popular. Candles and potpourri are also common gift ideas.  Typically, gifts given by therapists tend to lend themselves to relaxation, allowing the client to de-stress at home, as well as on the massage table.

All in all, the gift giving season can be difficult to navigate. It is a good idea to clarify your values and position on gift giving beforehand as we head into the holidays. It may be a good idea to let clients know where you stand in a newsletter – especially if you are not receiving gifts – so as to avoid any uncomfortable situations.