This seems to be the ever ending dilemma of whether you should tip your therapist or not. It’s really a simple question to answer. It all depends on what type of service you are receiving. Usually in a spa environment it is expected for the client is to tip the therapist. In a medical setting when you are paying insurance tipping is not necessary. When uncertain do not be afraid to ask if gratuity is customary for that business. If service is satisfactory a tip may be in order.
In my business tipping is not necessary but appreciated. It is your choice to give gratuity or not. It should never be opposed or enforced in any establishment.
Sometimes the client does not know gratuity etiquette. The client may assume the gratuity is included in the service fee. Another reason could be the client may only afford the service but not the tip. They might be embarrassed because of the lack of funds for the tip. No explanation is ever needed in why you can not give one. If you received exceptional service, in lieu of a tip you can schedule another session or refer friends and family out to the therapist. I personally would rather for you to be a returning client. Save the tip for your next session.
When paying for your massage session by credit card, my processing company will give you options to leave a tip. This is normal procedure with all credit card companies. It gives you options to choose to tip or not. The choice is yours to do so or not.
Gratitude is an exchange of energy. It manifests in many ways for both the client and the therapist. I am always grateful of the returning client. In appreciation I give up to 15 minutes to frequent clients (when I am not booked back to back in sessions). I give this freely. I do not expect anything in return for the extra session time nor a tip. It is my gratitude to you for selecting me as your massage therapist.