Q: My massage therapist has birds in her massage room, and they really take away from the experience. Can I tell her they bother me? It is her office after all.

A: The answer to this question lies in the quality of communication between the practitioner and the client, according to Nina McIntosh, ethics expert and author of The Educated Heart: “By all means, you should speak up about anything that diminishes your enjoyment of, or ability to focus on, your session, no matter whether the problem is the therapist’s office or her behavior. And yes, it is her office, but it’s your session, and you have the right to an environment that supports your relaxation.

“Even though you have a right to do it, it’s not always easy for clients to assert themselves with their practitioners. However, a good professional should be open to feedback and even welcome it. After all, if you are bothered, others probably are too. She may even be losing clients because of the birds.

“I’d suggest that, to give her time to remedy the situation, you phone her before your next appointment. I don’t know what specifically the birds are doing that is particularly distracting, but you could say something like, ‘The birds in your office are so beautiful, however, I find that their singing/flying about free/chirping makes it difficult for me to relax and get the full benefits of your good work. I’d prefer not to have them in the room during my session. I hope you understand.’

“The type of response you get will tell you a lot about how dedicated and sensitive your therapist is to your needs.”