Friendships between client and therapist

A while ago I wrote about the relationship between client and therapist. It is generally recommended that a client/therapist relationship never develops into a friendship, even less a romantic relationship.

I have been asked if friendships can be appropriate, to which I will say, that in the vast majority of the cases, no they are not. In this post I will discuss the main reasons as to why.

From the client’s point of view.

A massage is about the client. The client is at the centre, not the therapist. It is your problems, health and well-being which should be discussed. When the therapist begins to talk about their own problems and issues, focus is removed from the client; their healing and treatment.

If the relationship between client and therapist is too familiar or friendly, it can be very difficult to maintain that professional approach of focusing only on the client.

Lack of objectivity. Once we become emotionally involved in other people, we lose our objective view. We begin to assume things. Knowing about what you as a person did last week will influence how we treat you as a client.

As a professional therapist it is essential that we are objective and do not jump to any conclusions. Our treatment of you is based on your past health and massage history, not your personal life. It is based on what you tell us during the massage and in the treatment room, not what you told us when you were tipsy last Saturday.

Hurt feelings. When we are in a friendship we will encounter situations where that friend hurts our feelings, or we become angry. Only a very few people are fully capable of not letting their emotions influence and determine how they treat the person who caused the harm.

How will you handle the situation where your therapist-friend doesn’t give you a massage to your satisfaction? Will you be able to tell her without hurting her feelings, or will you be inclined to keep quiet in order to preserve the friendship? Can you be completely open and honest that situation?

Can you as a client be confident that your friend who hurt you last week will give you a massage in your best interest? Do you want anything to do with the person who made you so angry? Do you even want them to touch you? Can you be sure that the pain from that sore trigger point isn’t because your friend and therapist is still angry at you?

Try to ask yourself these questions. I think the answers speaks for themselves.

Lost focus. Another risk is that the focus of the therapist becomes social instead of professional. It influences not only how you are treated, but how the next client is treated as well.

This is one of the compelling reasons why we as therapists focus on leaving our personal life and problems by the door when we enter the treatment room. We want to give you, our client our full energy and attention. Not be distracted by personal thoughts and feelings.

Too much familiarity. When we become too familiar with a person, we become sloppy. The therapist might assume that the you will mention about all your issues and problems on you own. You might assume the therapist can guess and remember all your problems based on out-of-treatment conversations.

This can lead to the situation where we forget our professional role of asking into the state and being of the client and thereby cover all potential angles before the massage starts.

Confidentiality. Often therapists are told many personal and sensitive things. What happens the day the friendship no longer is healthy? Can you be certain that your therapist will keep that confidentiality when you longer friends? Will your therapist break your confidentiality with your other friends and family?

Lower priority. When your therapist is also your friend, there is an increased risk that you as a client will hold lower priority. Your therapist might book a new better paying client into that timeslot where your massage used to be. She might juggle your appointment around her other clients because you are her friend.

From the therapist’s point of view.

Setting limits. For the therapist it is much about setting limits and be able to say “no”. We are professional body-workers. We go to work like anyone else and when we’re off work, we’d like to have time to relax and not have to think about work. As with a range of professions especially within health and IT, friends tend to ask questions about their health or IT problems.

One thing is to help family and friends out with their computer problems or give them health advice. But if that friend is also a client it can be very hard to stand up and say; “This is part of your treatment/contract, so you have to pay for it.” or “We will discuss this at your next appointment.”

We’re generally kind people who just want to help as much as we can. Saying “no” is difficult when a client-friend asks us for help. We can easily feel frustration, annoyance and feel exploited.

Discounts and friend’s favours. This is related to setting limits, but deserves its own spot. It is natural for many of us to want to offer a discount to friends and family because we care for them. We are running a business though and if all our clients are friends and thereby get discounts, we’ll soon find ourselves out of business.

The other aspect is that often family and friends expect to receive that discount or free service. Refusing and setting limits can cause the friendship tensions. They might begin to wonder if we don’t love them since we don’t offer them special treatment.

So a client turned friend might expect special treatment and favours, which a therapist can find it very hard to turn down. The cost might ultimately be losing both client and friendship, resulting in a double loss.

Social visits. When a friend visits us in our clinic or office, there is a high risk that the visit becomes social instead of professional. Catching up on the latest news and discussing common interests can quickly take time away from the actual treatment, administrative work or even from the next client.

Casualness. With friends you are much more casual than you would be with strangers. The need to call well in advance when we want to change plans is often not there, and we easily forgive a forgotten or last-minute cancellation of plans.

This can cause problems for professionals. The friend might come in late and still expect a full treatment. They might cancel their appointment last minute and demand not to pay for it. Or they might even forget to cancel and just not turn up, assuming they will be forgiven.

Not only is this sort of behaviour a cause of frustration and annoyance, we also lose an income and we waste our time. Time we could have given to another client.

Losing friendship and client. Do we really want to lose a friendship because a client no longer comes to see us? Do we want to lose a client because the friendship went sour? Or the more vague cases of a client no longer coming to see us without explanation. We might not know why and that uncertainty might fester the friendship and over time ruin it. What about when the client-friend finds another therapist they like better, does that mean it’s a personal thing or a professional thing?

Conclusion

Mixing professional relationships and friendships can turn very messy, and unless you know yourself really well, are completely balanced and can separate professional and personal life 100%, then it is bound to consume your thoughts and energy more than is good.

This said, there are many levels of friendships. A light casual friendly relationship between client and therapist will probably in most cases be without conflict. This could include sharing a cup of coffee together, or perhaps a lunch.

Anything more than this is not recommended. Not only by me, but by most teachers and professionals out there. Both for the reasons listed here and in my previous articles.

Related articles:
http://blog.starkeys.com/2010/05/relationship-between-client-and.html
http://blog.starkeys.com/2010/05/massage-of-friends-and-family.html