It’s all about me, so here’s my wishlist for the profession. It’s difficult to place these in order of importance, because some of them depend on each other, and in my little corner of massage, they’re all important. It’s election time–aren’t we all just about sick of hearing about it–candidates mudslinging and making campaign promises? If I was the President of Massage Land, here’s what I’d do:
The Federation of State Massage Therapy Boards would sit down at the table with the National Certification Boardand hammer out an agreement to a) help ease the NCBTMB out of the entry-level test market, b) contract with them to collaboratively administer continuing education instead of trying to take it over and c) forget their MOCC-ERY plan.
The NCBTMB would a) graciously accept that it’s time for them to get out of the entry-level test market, b) focus on cleaning up the CE approval program, and c) get it together with their new plan of raising standards of certification.
Both of these entities would cease and desist in sending out Job Task Analysis Surveys that are flawed from the get-go….they both supposedly pay psychometricians to help them out with these things, and still they are falling way short of the mark in ascertaining what they really need to ascertain. Stop worrying about how many times a week we give a massage, and stop ignoring the relaxation benefits of massage as if they don’t exist.
There will continue to be Leadership Summits. They will stick to the agreed-upon agenda at their meetings and not allow major surprises to slide in from any of the organizations, and they will practice complete transparency and stop sending out press releases that contain no more information than an invitation to a baby shower.
Every one who is involved in massage therapy education will join the Alliance for Massage Therapy Education.
The profession will come to a consensus on what constitutes required core competencies for entry-level education, while still giving school owners the autonomy and individuality to rise over and above that.
All unregulated states will get state-wide regulation and all localities will honor those and not place ridiculous additional burdens on licensed therapists.
All massage schools will be required to teach research literacy to their students, and will only hire instructors who are capable of doing so.
The NCBTMB will stop approving woo-woo courses for CE credit, and all entry-level massage schools will stop teaching it. I don’t care if you study Interplanetary Voodoo with the Archangels, but you don’t deserve any credit for doing that.
Our professional associations will conduct annual surveys that have NOTHING to do with a Job Task Analysis–the sole purpose of it will be “Tell us what you think we are doing wrong and give us your suggestions for how we could do it better.”
The Alliance for Massage Therapy Education will develop a program to offer instructor training to the masses that will be accessible and affordable–perhaps online.
Board members of all representing organizations will recognize their responsibility to not blindly follow the leader; to avoid not only conflicts of interest, but the appearance of conflicts of interest; will not put up with any cover-your-ass type behavior within their organizations; will hold their hired leadership accountable, and will have enough gumption to get rid of them if and when such behavior occurs.
All massage schools would seek COMTAapproval. If your school can’t afford that or doesn’t qualify because of not meeting the hour requirement, may I say that their standards are on their website for all the world to see for free, and you could still go about the self-study process and getting things up to snuff, even if you don’t formally seek the accreditation.
All school owners would be bound to have their school bonded, so that no school goes bankrupt and leaves students in the lurch in the middle of their program.
All schools would be required to post their pass rates on the licensing and certification exams on their websites and in their catalogs.
No school owner will be allowed to say to a potential student “Don’t worry, your criminal record won’t keep you from getting a license.” It should be mandatory for it to be disclosed that they may not receive a license. The state of Texas has a non-binding review, where for $50 a person seeking a career in any licensed profession can submit their criminal record for review prior to spending their time and money on pursuing education. Every state should do the same.
There should be a national exam for instructors to prove they are competent in teaching methodology and a subject matter expert in whatever area they intend to teach.
Each state should require a jurisprudence exam. Your licensees can’t adhere to the law unless they know what it is, and the percentage of applicants who actually read your practice act in its entirety is probably less than 5%–I’m basing that on asking that question in all the classes I teach. Hardly anyone reads them, but if they had to pass a test on it, they would.
The Massage Therapy Body of Knowledge would be about massage.If you want to have an energy work body of knowledge, create that.
Everyone involved in the profession would give financial support to the Massage Therapy Foundation. Give $100. Give $5. Give $1. Give whatever you can afford to give, just do it.
I could probably go on for days, but I have other chores to get to today. I invite my readers to add what they will. What’s on YOUR wishlist? What’s on mine that you object to, and why?
Love the last part re:jurisprudence exam. I have spent the last 2 weeks “helping” MT’s in PA apply for their license as an existing practitioner. The original deadline was Dec.31, 2011. It was extended to July 31, 2012 because of the number of therapists that “didn’t know ” they now needed a license to practice in PA. One person actually contacted me on July 28. Wait until they find out they need 24 CE’s for renewal.
May all your wishes come true! I’m with you! Thanks for this list. P>
As a new therapist, I don’t have much knowledge about these issues but I’m learning the more I read. So thank you for that!
The first thing that comes to mind to add would be that schools should be required to have more than one instructor. And instructors should allow students to experience, try out, think out of the box and FEEL massage – so we can learn, firsthand, what works and what doesn’t. What angles feel right and what happens when I do _________.
I could go on but I think you just lead me to my next blog post. 🙂
As an instructor, I can’t agree with you more. While I tend to stay out of the politics of the bigger picture I do what I can at a school and classroom level. The biggest one for me would be competencies for instructors. As the only instructor on my campus with a teaching degree, which doesn’t rule out that my peers are not as qualified to instruct, does say something as to my understanding of teaching methodology. I don’t know what it’s like on other campuses, but I would envision that there is a great diversity of classroom proficiency of instructors. With years of experience of public education teaching prior to for-profit education, the industry has to change to support its instructors even more. The ABMP only goes so far for entry level instructors. Campuses should support their instructors by sending them to conferences and offering some financial support. Classrooms should not be compromised in any way with teaching materials. The MTF should have open access to the case studies that students submit. Marketing materials for massage should show the diversity of the places therapists work. Many holes to fill to elevate our field to the next level. It’s good to dream big. I teach that everyday!
That’s all fine as long as they teach massage therapists not to be afraid of massaging pregnant women, and actually learn the importance of trigger points when it comes to working on people with pain. And stop teaching them to tell their clients to drink a lot of water because massage releases toxins. Teach them how to heal carpal tunnel instead of instructing them to run to the doctor if they think they have it…And to teach and instil enough basic knowledge for them them to know that once any underlying pathology is eliminated that they have a high art. Teach them how to handle abusive clients and bosses that have know Idea of massages true potential…Instil some pride in our profession…And it would be nice if they would teach a therapist how to determine the difference between muscle pain nerve and ligament pain. In other words..Have something real on those exams of competency.
Brava, Laura! You’ve hit several nails squarely on the head.
Thanks for sharing Laura…..that said, it makes me sad that professional courtesy, focus on serving the interests of massage therapists, and removing the obstacles that prevent this great profession from growth and respect has to be on a wish list of a blogger as opposed to the mission statements and daily practices of each and every one of us, regardless of our affiliation or title.
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Good job! Love your wishlist! You echo alot of sentiments.
This is a great wish list. I think some of your wishes are actually in progress. My concern in your list is the Woo-Woo stuff. It really depends on how you define woo-woo. For instance, “intention” is a major factor in successful communication and business, yet that can be considered woo-woo by many since you can’t touch or see it….
No worry! I don’t think intention is woo-woo–or being present with the client–or being grounded when you work with someone.
Now if you insist on walking around the massage table banging on a gong before you start the session, or persist in doing energy work on clients that you have not discussed that with, who don’t want it and don’t believe in it, that’s woo-woo. If you are teaching a class called Reiki with the Angels–as was one class that the NCBTMB recently rescinded the approval of, that’s woo-woo. And everyone is welcome to be just as woo-woo as they want to be–but I will still maintain they shouldn’t get educational credit for it.
I appreciate much of your wish list. Wanted to address two sore spots in particular:
> The NCBTMB will stop approving woo-woo courses for CE credit, and all entry-level massage schools will stop teaching it.
This sounds dangerous. Who gets to determine what’s too “woo” (an insulting, pejorative, judgmental word choice on your part) and what’s not? By what criteria? Is Barnes style myofascial release too woo to be included? Craniosacral therapy? Various forms of shamanic bodywork? I could go on. I’d rather deal with some bathwater than let scientism throw any babies in the dumpster.
> The Massage Therapy Body of Knowledge would be about massage.If you want to have an energy work body of knowledge, create that.
On what basis do you say that energy work is not massage (and that massage is not energy work, for that matter)? Just because it doesn’t fit the way you might want to define it? Of course you’re welcome to your opinion, but an opinion is just that. Why should an entire field conform to one person’s opinion, or this opinion in particular?
Hello Josh,
I was practicing energy work for five years before I started practicing massage, and I taught it for over a decade. I used to use the word woo-woo to describe myself, back in the days when I WAS woo-woo, and I personally don’t find it insulting at all. I do find it descriptive of “Unproven Methods That Have No Scientific Validation but That Plenty of People will Be Happy to Take Your Money For Performing on You.” That pretty much describes a lot of what I am referring to as woo-woo. It’s much shorter to just say woo-woo.
As for craniosacral, I have personally taken craniosacral in years gone by. It was part of the core curriculum in the school I attended. I have not taken John Barne’s class so I can’t speak to that. There is no scientific proof of the existence of the separate cranial sacral rhythm, and no scientific proof that the cranial bones move. If you have replicated, peer-reviewed studies emanating from somewhere other than the Upledger Institute, or from any entity other than those which sell the courses and have a vested interest in perpetuating that, please share them here. Although–strangely, the US government has defined craniosacral as part of the knowledge that a massage therapist should have, under their DOE coding system. They have also included reflexology, while ignoring neuromuscular therapy. Go figure.
Here’s a statement from the JAMA, published back in 1998, that pretty much sums it up:
Editorial | November 11, 1998
Alternative Medicine Meets Science
Phil B. Fontanarosa, MD; George D. Lundberg, MD
JAMA. 1998;280(18):1618-1619:
There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is “Eastern” or “Western,” is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. We recognize that there are vastly different types of practitioners and proponents of the various forms of alternative medicine and conventional medicine, and that there are vast differences in the skills, capabilities, and beliefs of individuals within them and the nature of their actual practices. Moreover, the economic and political forces in these fields are large and increasingly complex and have the capability for being highly contentious. Nonetheless, as believers in science and evidence, we must focus on fundamental issues—namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy.
Here is a good article about craniosacral from Paul Ingraham: http://saveyourself.ca/articles/reality-checks/craniosacral-therapy.php
You will notice his pesky habit of putting research references into everything he writes.
Massage is the manipulation of soft tissue. Energy work is not–it is the manipulation of the energy field. Two different intents; two different things. Too many massage therapists think it is their duty to perform energy work on everyone who gets on their table, when it in fact goes against all principles of energy work to perform it on people who haven’t asked for it, don’t believe in it, and don’t want it.
As for the NCBTMB, it is the National Certification Board for Massage Therapy & Bodywork, not the National Certification Board for Massage Therapy & Energy Work.
I welcome other people’s opinions. I don’t expect everyone to agree with me. I don’t delete people for disagreeing with me. However, this is my blog, and I am free to express my own opinions here, in whatever language I choose to use. If I get through a day and I haven’t insulted someone, you will need to check my pulse.
Thanks for your reply.
I don’t want to get too caught up in a discussion on word choice, since I wasn’t actually offended by your use of the word woo—I feel quite neutral, emotionally, in my replies—but I do note its offensive connotation. The Skeptic’s Dictionary itself concedes at http://www.skepdic.com/woowoo.html that “when used by skeptics, woo-woo is a derogatory and dismissive term.” Since you sound like a skeptic when you say the things you have in your article and reference skeptic material like Ingraham in your reply, I find it much more likely that your word choice will be interpreted by readers according to the common usage described in the above link rather than your own personal (perhaps more neutral but debatably so) meaning.
Cranio is a good example to discuss because I am more familiar with it than MFR also.
The scientific studies of craniosacral look obviously misguided to me, and I’m a rank beginner at CST. I don’t know why there’s no one doing better studies of it. The study I saw most recently (http://www.ncbi.nlm.nih.gov/pubmed/17154138) made me ask myself, “Who did this study? Do they have any real understanding of CST at all? Why wasn’t that understanding on display here? (Really, attempting to explore CST with an experiment that fails to include a practitioner and thus consciousness? You really don’t get it, do you researchers?) Why would they even bother to do this study? Except in the interest of leaving no stone unturned (which the wording of the conclusion does suggest to me)?” The “true believer” approach to CST and outdated theories are irritating, but so are simplistic, psuedoskeptical approaches to “debunking” it.
In no way would I call that Ingraham article you link to “good”. It reflects a common and obvious reality tunnel, that of the reductionist rationalist. Said reality tunnel limits his experience and perspective, as glaringly reflected in his writing. For example, he experiences craniosacral as no more relaxing than “a good nap”, whereas many CST receivers regularly experience subjective interior states and objective physical phenomena distinct from other massage modalities, let alone the normal sleep state. And while he struggles to imagine a CS therapist who can hold the modality without falling into “true belief” (raises hand) he’s comfortable generalizing them as ideologues (I would submit that Ingraham is the ideologue here). Meanwhile, in his flurry of citations he’s neglected to cite his most important claim, that of “substantial scientific evidence that CST is ineffective”. More on that shortly…
An osteopath he quotes lays it out: “Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”
While I can agree on the need for (really good) outcome studies, I can’t agree on his prescriptions. I have always been left wondering why researchers mess around with research on the theories about how things work rather than going straight to testing outcomes. I’m told by one scientist that it’s because outcome studies are generally more expensive. This isn’t really an excuse, however, for the kind of dismissive treatment such untested modalities get—they are treated as if they are disproven rather than unproven (a hallmark of so much runaway rationalist skepticism). Which is why I must disagree vehemently that they stop being taught and explored by practitioners and clients. As a client or patient, my life is finite and precious—I cannot always wait for science to catch up to what may be true. I need help now. So I will absolutely avail myself of “unproven” methods in the meantime.
Have you read Hugh Milne’s Heart of Listening? His approach speaks to the non-reproducibility of the work without either buying into dogma or dismissing the entire enterprise. And it’s clear from various parts of his writing that he acknowledges that there are things we still don’t understand scientifically about e.g. what we call cranial wave and what it “is” while providing his own educated conjectures about what it might turn out to be.
Ok, moving on. Of course this is your blog and you get to express your opinion. But you still haven’t answered my question: on what basis should the rest of us submit our entire field to your opinion? I get that the JAMA editorial sums up your opinion and worldview. Do you get that many people disagree with accepting that kind of wholesale reduction of either medicine, massage, or both? That the kind of system described isn’t “evidence-based”, it’s “evidence-limited”? As science is a process whereby theories become *less bad* over time, on what basis do you or anyone else propose to assert power over me and every other client/patient such that we limit ourselves only to the current least worst scientific understanding of things?
I love your wish list Laura, and especially love the part about cooperation and agreement between FSMTB & NCB in determining who does what with entry-level licensing exams vs. CE credentials. And 100% agreement on massage and energy being 2 different things – without de-valuing either. You gave all the appropriate references and definitions, so can’t add anything but “hear-hear”!
Thank you, Laura, for striving for greater accountability among massage therapists. I think we as a profession are held back, in the public eye, by the many unsubstantiated ideas our colleagues promote and sell. I would rather be identified with physical techniques that are verified as effective.
Laura, please allow us to address each item on your wish list where NCBTMB is concerned.
NCB’s exams were first used by the states for licensing in 1992, and over the past two decades we have maintained a fair and legitimate exam process. It would be short-sighted of us to abandon the entry-level exam and turn our back on the states, schools, students, and certificants who accept, and rely on, our time-tested process as part of licensing requirements.
We can assure you that – on points B & C – your wish will come true very shortly! Starting with the feedback we received at the MAPP meeting, we have been collaborating with many massage professionals and organizations to ready our new Approved Provider Program. Full details will be announced later this month on the new process of vetting all courses and reviewing instructor qualifications for teaching. This initiative will be phased in over a period of time and it will improve the quality of education for those who have made a commitment to lifelong learning. You will be able to truly identify those courses that are NCB Approved and will see a real value in completing those courses. There is no question that improving the level of continuing education, and helping to differentiate higher level instructors from others, will improve the quality of continuing education available to everyone.
One way in which we are elevating the standards of certification is our new Board Certification program launching in Q1 of 2013. Board Certification will require more education, hands-on experience and cannot be achieved the day after graduation. This will be the first true Board Certification Credential available to the massage profession. Additionally, all Board Certified Massage Therapists along with NCBTMB Assigned Schools will be asked to uphold an anti-human trafficking pledge. This pledge—which is designed to inform and educate–also contributes to elevating the profession.
For NCBTMB Assigned Schools, we are reviewing all school operational and educational requirements. We are asking all schools to complete a new application and submit new materials based on their accreditation status. Again, we are reviewing information not just on the school but instructor credentials as well. We want future massage students to use NCBTMB as a resource when choosing a massage school. Students should be confident that schools that hold the NCBTMB Assigned School Code meet the qualifications to safely and competently help them enter the massage profession.
These improvements are just the beginning of our continuing process to elevate the standards for the profession. We are changing all of our requirements and internal processes to ensure that everything we do is directed toward elevating the standards of the profession. In many ways, we are laying the groundwork to help massage professionals achieve excellence, not only today, but for many years to come.
It’s about time you weighed in here, Mike! We’ve got to agree to disagree here. I think it’s time for a paradigm shift, and for Certification to be the aspiration of therapists who want to go over and beyond entry-level credentials. The MBLEx has all but obliterated the entry-level exams from the NCBTMB…the marketplace has spoken and I check (and publish in this blog) the financial reports on Guidestar every year. It’s patently obvious. Yes, some people have continued to take it as entry-level because they wanted that credential at no extra cost–but that’s about to change when you jack up the requirements.
I intend to maintain my National Certification under the new rules and I encourage everyone to do so, but I urge this organization to be a true Certification Board and make that your focus. It will be much more meaningful. The old way is gone and the new way is here.
And by the way, I’m still waiting for your answers to that big list of questions I sent you!
Laura I think it is time for you to run for President. You would get my vote.
I mean no disrespect to Mr. Williams, and perhaps it’s just me, but as I read his response I feel as if he has dug into the back of the file cabinet and provided the same exact response that nearly all of his predecessors have used. Understanding that he has limited experience with massage therapists, and a relatively short history with NCB, I believe he should get a pass on the recycled statement. That said, I do understand that he has vast experience with interim roles and turn-around/transition leadership. I’m sure the statement “What got you here, won’t get you there” is a statement that he has used before. Perhaps it is “short-sighted” to abandon the entry-level exams as you state in your response above. Unfortunately, NCB has historically been short-sighted. Perhaps a new pair of “far-sighted” lenses are needed here. The profession has been asking for quite some time that NCB actually provide certification services as stated in the name of the organization. So long in fact, that I believe the profession is growing very weary of talking to NCB about it anymore. Everyone laughed when they heard that a group of people were meeting to discuss the possibility of creating a licensure exam. That exam became known as MBLEX. How long will it take for another group of people to meet with the intent of creating certifications for massage? Is it already happening? Speaking only for myself, the criticisms that I offer are not from an anti-NCB position, but rather out of concern for an organization that has the potential to catapult our profession unlike any other current organization. Put “the way we’ve always done things” on the shelf and start thinking about tomorrow.
Josh Alexander,
Re your question: on what basis should the rest of us submit our entire field to your opinion?
You are getting a lot of exercise jumping to conclusions. This blog is entitled MY Wish List. At the bottom of the blog, I ask the question “What’s on YOUR wishlist? What’s on mine that you object to, and why?”
I’m not really sure how you got from there to “submitting our entire field to your opinion.”
This blog is ALWAYS strictly MY opinion, and you and everyone else on the planet is free to take it or leave it.
Laura, as always, your writing is engaging. I love your wish list and agree very much so.
However, I will only make one disagreement – you stated in a reply “Unproven Methods That Have No Scientific Validation but That Plenty of People will Be Happy to Take Your Money For Performing on You.” – I agree Reiki with Angels is probably best not suited in massage for continued ed, however, Reiki as one example does have a lot of research behind it, especially in hospital settings – go into any research database, like EbscoHost which nearly every university and college has, and search ‘reiki and medicine’ or ‘reiki and hospitals’ or ‘reiki and nursing’ – you will likely find 2000+ PEER-REVIEWED medical and academic journal articles.
Now, to make nice – I agree the standards need to be made higher. I am so glad Mike Williams chimed in and can only hope that the NCB Board is hearing all of the comments made. I personally think they have such a great place in the profession if they go the route you recommended.
I love your list. I can only add one thing–a practical exam for licensing. It’s one thing to answer a multiple choice question on a test, quite another when you have to demonstrate that you really know where that muscle is and that you really know how to perform that stroke. I’ve only been licensed for two years and consider myself an infant massage therapist and yet I’ve been hearing with monotonous regularity that “this was the best massage I’ve ever received”. Since I’m levelheaded enough to know I’m not THAT great, I seriously have to question the quality of the therapists that are getting licensed.
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