For Professional Practitioners

Legal Rights and Prohibitions

Be aware that certification in energy work techniques does not necessarily make it legal for you to accept money for touching people to help them heal. Some states grant this right only to physicians, nurses, occupational and vocational therapists, and massage therapists. Ministers who use healing touch in their religious practice (sometimes called “laying on of hands”) are allowed to do so legally throughout the country.

Note also that in some places you cannot legally “diagnose”or “prescribe.” You can, however, “suggest” and “recommend.”


Be aware of health issues regarding your hands and your healing table. Hand-washing is vitally important, as you will be touching many people. You can easily pass germs from one person’s face to the next. You must always wash your hands before touching each client. Also, be aware of the state of your hands if you are moving from a person’s feet to their face.

Another reason to wash is to clean the energy field around your hands.

Your healing table should be clean. If you do not use linen, wipe it down. Think of the most sensitive, finicky person you know, and wipe your table whenever that person would wish you to do so.

If you use linen, change it frequently. The pillowcases for pillows used under the head should be changed for each client. This is for physical reasons (so as not to pass sweat, tears, head lice, make-up, etc.), to clear the energy field, and because many people have allergies to various perfumes, shampoos, hair sprays, soaps, and other common products which the person on the table before them might have used.

The Necessity for Personal Psychotherapy and Peer Support Groups

For most professional energy work practitioners, personal psychotherapy or counseling will eventually become necessary. Peer support groups can also be of great help. A peer or colleague support group is a group of energy workers or other health care providers, who share their difficulties. Usually, clients’ names are disguised or details are changed so as to maintain confidentiality. If this cannot be done, it is essential to keep private any information shared. Just “getting it off your chest” is often enough to give you the relief and equilibrium you need. Sometimes the advice or experiences of others in the group will get you through the difficulty. If you need more help, see a psychotherapist.

Following are some of the reasons why you will probably require help from time to time.

Perceiving and interpreting perceptions correctly

In order to perceive how our clients are, we use our own energy system. Therefore it must be quite clear and working well. Unprocessed emotional defenses and trauma will affect your energy system, and so limit your ability to perceive. After you perceive information about your clients, you must interpret your findings. Here again, your own unresolved issues can muddy your understanding. It is important to ensure, as much as possible, an unbiased viewpoint.

If there are certain conditions which you find in every client, it is likely that you, rather than all of them, have a problem in that area. On the other hand, if none of your clients ever have a problem with a particular chakra, it is likely that you have a problem there yourself. Work with a psychotherapist as needed to become or remain emotionally healthy.

Serving your client, not yourself

It is important to serve your client’s needs. You may feel a client should change in a particular way, or that certain types of people should, or even that “everybody” should—in other words, you may have treatment goals of your own for the client. Sometimes you may have financial needs which affect your determination of the course of treatment. It is important to remain in the capacity for which you were consulted. A counselor can help you separate your needs from the needs of your clients.

Hearing difficult stories

Some clients will tell you their stories, either as part of their health history or because strong feelings surface during treatment. A story may be more than you are able to bear. Sharing it with a peer group can lighten your load and help you remain able to listen to your clients.

Client Deaths

If you work with seriously ill people, eventually a client will die. This is difficult to handle, especially at first. It may bring up self-doubts or guilt. It may bring anger if the client did not come as often as you suggested. Family members or friends of the client may have a low opinion of you or your work. A peer group with experience in this area, or a counselor, can help.

Handling Success

If you are successful in your work, it can bring emotional challenges. People may look up to you—see you as extraordinary, wise, powerful, even god-like. It is easy to let your abilities “go to your head.” It feels good to be admired, thanked, and blessed for taking someone’s pain away, or saving their life. Counseling or a peer group can help you remain careful. It can help you keep a true idea of who you are, rather than thinking yourself a guru or superhuman.

Surfacing of unhealed issues

As you spend more hours of the day running energy, your own health will improve. Any unresolved emotional issues will become apparent as the energy flow pushes against them.

Surfacing of unresolved psychological issues is so common that some energy work training programs require psychotherapy at various points before students can progress to the next level of training. Don’t feel you can no longer work if you discover deep-seated biases or issues. Get the help you need, and then resume your practice. It happens to most of us from time to time.

A final word about getting help: though we are not psychotherapists, we have some of the same stresses and challenges in our work as they do. Psychotherapists are required by their licensing boards to be part of a peer support group, called a “supervisory group,” under the direction of someone more experienced. Based on sound observations, many physicians, hospice workers, and other professional health care workers also consider peer support groups to be vital for their emotional health. We are wise to do the same.

Ethics and Professional Practice Issues

Saving People/ Failure of Clients to Complete the Course Of Treatment

You cannot save people. You can only help them if they allow you to. It is perplexing and disturbing to have someone refuse your help, especially if they are seriously ill, or if they are an important part of your life. In discussing why people won’t let you help them, Dr. Bernie Siegel says in Love, Medicine & Miracles:

“About 15 to 20 percent of all patients unconsciously, or even consciously, wish to die.... In the middle of the spectrum of patients is the majority, about 60 to 70 percent.... They’ll do what they’re told—unless the doctor suggests radical changes in their lifestyle.... These are the people who, given a choice, would rather be operated on than actively work to get well.... At the other extreme are the 15 to 20 percent who are exceptional.”

It may be hard to believe that only about one-fifth of clients will work hard to get well, but it’s true. Because energy work is considered unconventional, and people must pay for it themselves, it is likely that a far larger percentage of your clients will complete your course of treatment. However, you will still have clients who, seemingly inexplicably, terminate treatment even when it is obviously helping them.

Siegel also discusses the characteristics of patients who recover from cancer:

“They are generally successful at careers they like, and they remain employed during illness or return to work soon. They are receptive and creative, but sometimes hostile, having strong egos and a sense of their own adequacy. They have a high degree of self-esteem and self-love. They are rarely docile. They retain control of their lives. They are intelligent, with a strong sense of reality. They are self-reliant.... They tend to be nonconformists with a permissive morality—they are unprejudiced, and they appreciate diversity among other people....They interpret problems as redirections, not failures. They are the ones who read or meditate in the waiting room instead of staring forlornly into space. As an [exceptional] patient once put it, ‘Pessimism is a luxury I can’t afford.’”

Later, Siegel adds:

“Acceptance, faith, forgiveness, peace, and love are the traits that define spirituality for me. These characteristics always appear in those who achieve unexpected healing of serious illness.”

Why would people not want you to help them get well? Or not want to learn to self-treat in order to help themselves get well faster? Here are some of the reasons people have told me.

Now I’ve tried everything, leave me alone. These clients try the “weird” treatment to satisfy their families or friends. They do not either expect or want it to work.

The pain isn’t that bad. When a client said that to me, I struggled to understand for a long time. What could be so painful about learning self-healing that she would rather live with physical pain? But learning to self-treat can be painful. Some people feel rage or sadness because of all the pain and death they have seen, which might have been needless if energy work was widely known and accepted. They avoid energy work because they fear intolerable feelings of anger, grief or guilt.

Fear of a new reality. Changing one’s mind, changing one’s beliefs—like moving a limb which has been bound for years—can feel agonizing for a while. When mental structures collapse, it can feel like disintegration, like death, until new ones come to replace them. One is left, for a while, with no framework with which to order the world, and with a tumult of feelings about how one has lived one’s life up to this point. It is also frightening, for if this new idea is true, this new reality of energy and personal power, what other things might also be true!

“What will other people think?” With unconventional treatment, this can be very important. A client can be afraid of the losses which might come from banging up against other people’s belief systems and comfort zones. (Some of my clients won’t tell anyone—doctors, friends or spouses—that they are coming to me, even when my work is the turning point for them and they get well.) There can be loss of friends, of reputation or of self-respect if the people they love and trust ridicule them. There can even be loss of the healing itself if they are talked out of continuing treatment, or convinced that it never really helped them.

Fear of self-love. Doing hands-on healing puts caring for oneself before caring for others. This goes against the beliefs of some people. Others are raised with the idea that one is a sinner, or that loving or touching oneself is selfish, improper, or immoral. Energy work can be intensely pleasurable; some people have barriers to such self-pleasuring.

Fear of taking responsibility/Desire for control. There can be a control issue: if the client takes control, makes an effort, and fails, what then? They prefer not to try, believing that then if they don’t get well they cannot be blamed. Then they are not responsible for their illness or death.

Another way of taking control is to choose to die. Refusing energy work treatment or self-healing is a part of this choice. This is part of the reason why it is unethical to work on people who don’t want you to. You would be taking away their control over their own life. Secondarily, the Reiki will not be accepted by them anyway, so why not respect their choice?

With all these barriers, it is not so surprising that only a small percentage of people actively work to get well. You cannot save people, no matter how much you might wish to.

Transference and countertransference

Some people are going to fall in love with you, because they will feel awe when you help them, and awe leads to love. Also, Reiki energy often feels loving to the recipient, and even to the practitioner. Psychologists call transfer of an emotion from the person to whom it would rightly be directed to the therapist, “transference.” Though not exactly the same process, it is helpful to call inappropriate love of the “healer” by the same term. If you, feeling loved by your client, begin to love them back, that is called “countertransference.” Sometimes rather than love, your client will transfer hatred to you, or fear, or some other emotion. You generally will not see those people return for more treatment. But if they feel love, they will certainly return. It is inappropriate to return the love of a client, as the potential for abuse is large because of the power differential between you. I recommend using the American Psychological Association’s ethical guidelines to set appropriate boundaries with your clients. If you do not return the transferred emotion, if you continue to act in a professional manner, usually the client will stop feeling the inappropriate emotion and be able to continue working with you.

Counseling Clients and Dealing With Clients In Altered States of Consciousness

It is unethical to counsel clients unless you have training as a counselor. Be careful when interpreting energy flow. For example, if the energy is not flowing well through the heart area, an appropriate way to mention it would be to say, “energy is not flowing well through your heart area,” and suggest energy work self-care for them, or add a “Heart Sandwich” to your Reiki protocol, or take other action. It would be counseling to say, instead, “your heart is closed,” or “you need to love more.” Simply state what is happening with the energy, without coloring it with your advice or opinions. Some clients will practically beg you to tell them what to do about some aspect of their life. Remember that it is unethical—and in some states, illegal—to act as a counselor without professional training.

It is unethical to suggest, during a Reiki treatment, that people take any particular kind of action or think any particular way. When receiving Reiki, people usually relax into a very deep state of rest. They often end up in an “alpha state,” which is a light trance. This means that anything you say may be accepted by them as if it were a post-hypnotic suggestion. They will not think about it and decide if they wish to agree with you or not—instead they simply obey. You may feel that since they have entrusted their health to you, they want you to give them direction towards better health. However, deciding what they need and “inserting” the idea while they are in a suggestible state is not the act of an energy worker. If you wish to work in that way you must train as, and present yourself as, a hypnotherapist. Otherwise the possibilities for accidentally harming your client are enormous.

The best time to discuss the client’s health and your self-care suggestions is when the treatment is over, the client is off the table, has had some water, and is fully alert and rational. If your self-care suggestions are psychological in nature, keep them to yourself! Instead, suggest they see a psychotherapist or counselor, and you can consult with that person about your thoughts of what the client needs.

Working on friends and family.

This presents a particular challenge. When I feel conflicted, in order to help me evaluate how much is too little or too much, I imagine I am a dentist instead of an energy worker. If I were a dentist, would this person ask me to help them in this kind of circumstance? Would I wish to do so? That usually clarifies the situation. Once I even asked a person, “If I were a dentist, would you ask me to clean your teeth once a week?” They got the point immediately. If energy work is your profession, you are entitled to NOT work on all your friends for free, any time they wish. Cases of emergency are different, of course.

When you work on a friend there can be a power differential if you take their pain away, or in other ways seemingly heal them. Some people cannot tolerate friendship after that because they feel inferior. Or they may pay you for your work and then resent it. It is a rare person who can pay you for your services and remain your friend on an equal basis (you may have to stretch, too).

If you are perceptive, you may learn things about the person which are more private than they would wish. Sometimes people feel embarrassed later by what you know about them. I warn friends and family that if I work on them I may perceive things about their sexual or emotional life which they might rather I didn’t. This usually makes it clear, and they can then decide whether they really want to experience my work or not! I am able, with certain close relatives, to work “blindly;” just let the Reiki flow without perceiving at all. This works fine for them, but it is frustrating for me because I feel I could do so much more if I followed my perception. However, it is better than no Reiki at all.

I would discuss all of the above concerns before accepting a friend as a client.

The foregoing is excerpted from Heal With Your Hands, ©1995 by Barbara Clearbridge.

Ethical Guidelines for A Professional Practice

I have summarized the following from the American Psychological Association Ethical Principles and Code of Conduct. I feel they are relevant to all professional energy work practices. I have added a few words here and there.

1. Strive to maintain high standards of competence. Recognize the boundaries of your competence and the limitations of your experience. Provide only those services, use only those techniques and teach only those classes for which you are qualified by education, training or experience. Exercise careful judgment and take appropriate precautions to protect the welfare of your clients.

2. Integrity. Promote integrity in the science, teaching and practice of energy work. Strive to be aware of your own belief systems, values, needs and limitations, and the effect of these on your work. Avoid improper and potentially harmful dual relationships (see No. 10 and No. 14). Don’t work with a client, student, colleague, etc. if you suspect your personal problems may lead to harm to another person. Be alert for signs of, and immediately get help for, your personal problems at an early stage in order to prevent significantly impaired performance. If you are not providing adequate work immediately consult with a teacher or counselor to determine if you should stop working until your problems are eased. Be alert to and guard against misuse of your influence over people. Misuse can be financial, personal, social, organizational or political. Arrange for consultations and referrals based on the best interest of the client, not yourself. Do not misrepresent yourself in public or private statements concerning your training, experience, competence, credentials, services, degree of success in healing or teaching, fees, or research. Misrepresentation can include statements that are false, deceptive or misleading because of what you say, imply, suggest or leave out. Do not make an audiotape or videotape of a session without permission from the client or student anday of the appointment.

3. Professional Responsibility. Accept appropriate responsibility for your behavior. When appropriate, consult with colleagues in order to prevent or avoid unethical conduct.

4. Respect for People’s Rights and Dignity. Accord appropriate respect to the fundamental rights, dignity and worth of all people. Respect the rights of individuals to privacy, confidentiality, self-determination [freedom to decide matters for themselves] and autonomy [freedom, independence].

5. Concern for Others’ Welfare. Be sensitive to real and perceived differences in power between yourself and your clients, and do not exploit or mislead other people during or after professional relationships.

6. Social Responsibility. Work to mitigate the causes of human suffering. Strive to avoid misuse of your work by yourself or others. Comply with the law.

7. Sexual Harassment. Do not request sexual services, touch inappropriately, harass verbally or in any way that is sexual.

8. Other Harassment (Honoring Diversity). Do not knowingly engage in behavior harassing or demeaning based on age, gender, race, ethnicity, religion, sexual orientation, disability, language, literacy, economic status, etc.

9. Avoiding Harm . Take reasonable steps to avoid harming clients, students, colleagues or others, and to minimize harm where it is unavoidable.

10. Multiple Relationships. Do not enter into a second relationship with a client if it seems likely that the second relationship might impair your objectivity or otherwise interfere with your doing effective energy work, or if it might harm or exploit the other party because of the power you hold as their energy worker. Such a second relationship can be social, personal, financial or result from certain kinds of barter or trade arrangements. Do not have sexual or romantic involvements with clients, students or supervisees over whom you have authority, as it is very likely to impair your judgment or be exploitative (see No. 14).

11. Record-keeping. Create, maintain and dispose of records as appropriate.

12. Fees. Do not discriminate between clients based on the amount of fees they can afford. Do not misrepresent your fees. Participate in barter only if the relationship is not exploitative. [Always clearly outline the barter completely in all its details before beginning treatment or class. Writing it down is advised.]

13. Testimonials. Do not ask for a testimonial from anyone who is vulnerable to undue influence [i.e., who may think they have to do it because you asked; who feel obligated to you, who feel under your control, who want something from you such as treatment, and so on].

14. Sexual Relationships with Present or Former Clients.Because sexual intimacies with a former or present client are so frequently harmful to the client, do not engage in sexual or romantic activities with current clients. For former clients, do not engage in sexual or romantic activities for at least 2 years after you have stopped working with them, and only if you intend never again to work with them on a professional basis [even in this case it is recommended that you do not].

15. Confidentiality. Take reasonable precautions to respect the confidentiality rights of people you work on, work with, or with whom you consult. This includes written and oral reports, and tapes made of sessions. Give only information important to the purpose for which the communication is made. When consulting with colleagues or teachers, do not share confidential information that could lead to the identification of a client unless you have the permission of the client. These same rules apply to your writings, lectures or other public statements. Always disguise confidential information so discussions do not cause harm to subjects who might identify themselves. [i.e., you say: “My first client was masochistic.” In another setting, someone says: “I was her first client.”]