NCBTMB Professionalism, Ethics, and Law 2 — Questions and Answers
Question 1: A client discloses they are HIV-positive before a massage session. What is the legally and ethically correct response?
- Refuse service to protect your own health
- Treat the client the same as any other unless contraindicated (Correct answer)
- Require a physician's clearance before every session
- Inform your next client as a precaution
Correct answer: Treat the client the same as any other unless contraindicated
HIV status alone is not a contraindication, and refusing service based on it may constitute illegal discrimination under the ADA.
Question 2: Which document describes the mutual expectations, boundaries, and policies agreed upon between therapist and client?
- SOAP note
- Intake form
- Informed consent agreement (Correct answer)
- Insurance superbill
Correct answer: Informed consent agreement
The informed consent agreement outlines policies, risks, and client rights, forming the ethical foundation of the therapeutic relationship.
Question 3: A massage therapist posts a photo of a celebrity client on social media without permission. This violates which ethical principle?
- Beneficence
- Justice
- Confidentiality (Correct answer)
- Non-maleficence
Correct answer: Confidentiality
Sharing identifiable client information without consent breaches confidentiality, a core ethical and legal obligation.
Question 4: Under HIPAA, who is considered a 'covered entity' in the massage therapy context?
- Any massage therapist who accepts cash
- Therapists who electronically transmit health information for billing (Correct answer)
- All licensed massage therapists regardless of billing method
- Only therapists employed by hospitals
Correct answer: Therapists who electronically transmit health information for billing
HIPAA applies to covered entities that electronically transmit health information, such as for insurance billing.
Question 5: A client asks you to massage a severely bruised area they say 'doesn't hurt much.' What is the ethical course of action?
- Massage it lightly since the client consented
- Defer to the client's preference as they know their body best
- Explain the contraindication and avoid the area (Correct answer)
- Proceed but document it thoroughly
Correct answer: Explain the contraindication and avoid the area
A massage therapist must apply clinical judgment; severe bruising is a local contraindication regardless of client preference.
Question 6: Which behavior best demonstrates professional boundaries in therapeutic massage?
- Accepting a small gift from a long-term client
- Sharing personal relationship problems with a client to build rapport
- Maintaining draping standards consistently for all clients (Correct answer)
- Offering discounted sessions to clients you find attractive
Correct answer: Maintaining draping standards consistently for all clients
Consistent professional draping regardless of personal feelings is a cornerstone of maintaining appropriate therapeutic boundaries.
Question 7: A therapist's license lapses but they continue practicing for two weeks. This is best described as:
- A minor administrative oversight
- Practicing outside scope of practice
- Unlicensed practice, which is illegal (Correct answer)
- A violation of ethics only, not law
Correct answer: Unlicensed practice, which is illegal
Practicing massage therapy without a current valid license is unlicensed practice and is illegal in all US jurisdictions.
NCBTMB Professionalism, Ethics, and Law 2
A client discloses they are HIV-positive before a massage session.
What is the legally and ethically correct response?