ELAP: Now that I’ve Read the Whole Thing…

I spent most of my spare time during the past week reading the Final Report and the Entry-Level Education Blueprint of the ELAP. Again, I will offer my appreciation for the collaboration of the Coalition and the team that actually performed the work on this. It was a big project and obviously, people took time away from their own pursuits to participate in it.

Now that I have read the whole thing in its entirety, I have a few observations on it. I quote from the Coalition statement:

We aspire to have this report influence several profession audiences:

• the Federation of State Massage Therapy Boards, which can use The Core as it builds guidelines for a model practice act;

My comment on that: The press release announcing that the FSMTB was going to create a Model Practice Act first appeared on April 1, 2011. In a letter I received dated Jan.31, 2014, FSMTB Executive Director Debra Persinger stated that the Task Force is currently completing the final revisions before releasing it for public comment.

It’s just my opinion that the ELAP will be a last-minute inclusion in that, if it does in fact get included.

• state licensing boards, which can use The Core in setting education requirements for licensees;

My comment on that: What is the Model Practice Act doing, if not that? It seems very possible that this is a duplication of efforts. While there are of course other things included in a practice act, one of them is spelling out the hours of required education. I don’t know any state board that goes much beyond setting the total number of required hours, and how that should be broken down in a general list of required subject matter. Not to mention changing a practice act requires legislative action.

the Alliance for Massage Therapy Education, which can refer to The Core in creating teacher training standards and curricula;

My comment on that: Aha! And therein lies the clincher and the biggest issue I have with it. Since I couldn’t say it any better myself, I am going to share the comment that Rick Rosen left on my FB page:

“The critical missing element that will prevent the ELAP Core Curriculum from being implemented on a wide scale is the lack of teacher training in our field.

I simply cannot fathom why the cash-rich organizations in our field (AMTA, ABMP, FSMTB) would spend significant sums of money on a curriculum development project, while they continue to turn their back on providing the financial support needed to carry forward the Alliance’s National Teacher Education Standards Project. Without this long-term investment in teacher development, educational outcomes and the quality of massage therapy services delivered will remain inconsistent at best.

My comment on Rosen’s comment: Nailed it on the head. And it would be another interesting research project to determine what the average training is of teachers in massage schools across the US.

I will repeat Rosen’s sentiments by saying I would like to see all the organizations give this kind of support to the Alliance for Massage Therapy Education and their National Teacher Standards Education Project. 

The Alliance is the youngest organization out there, and does not yet have the kind of cash reserves built up to move this project along at a better pace. The fact is these kinds of projects do require money in order to come to fruition. The Alliance membership is made up of educators and industry partners, and will never have the kind of membership numbers enjoyed by the other organizations by virtue of that fact. I can visualize the ELAP being very useful to the teacher training project–but they need the money to make it happen. I urge our other organizations and industry supporters to put your money into this project.

• the National Certification Board for Therapeutic Massage & Bodywork, which can use The Core as it identifies beginning vs. advanced knowledge and skills for its Board Certification credential;

My comment on that: The Board Certification exam is already out there and is still practically new. I don’t see any major revisions taking place on it any time soon. The NCBTMB is using their “old” certification exam for their entry-level licensing exams, and has been for years. As a certification exam and a licensing exam should require two different job task analysis surveys and one should not be interchangeable with the other, they are already in muddy water, and I don’t really see how this will clear it up. And, as is the case with the MBLEx, the exams that the NCB is using for entry-level licensing are geared to a 500-hour education requirement. Again, this would require major changes to that as well.

• professional membership organizations, which can use The Core in shaping membership criteria;

My comment on that: Pay the money, show proof that you are either a student or a licensee or a practitioner in an unregulated state, and boom! you’re a member. Within the past few months, myself and others made well-documented complaints about an unethical practitioner who was scamming fellow massage therapists and try as we might, we could not get her removed from the membership rolls of AMTA or the massage listing service. She has now finally been removed, after it was reported that she was also scamming her clients. Or she just didn’t pay her membership renewal fee. Either way, she’s no longer listed, but it took months to get any action on that front.

• the Commission on Massage Therapy Accreditation, which can use the Core in evaluating massage and bodywork curricula for programmatic accreditation;

My comment on that: COMTA has had their competencies spelled out for years. The basic difference I see is that ELAP is spelling out the number of hours to be spent in each subject matter area.

• other accrediting organizations, which can use The Core in shaping their accreditation criteria;

My comment on that: COMTA is the only accreditation organization devoted to massage therapy (and they now also include asthetic programs). The other accreditation programs I am aware of approve of all kinds of schools and programs and use the same evaluation criteria for a massage program as they would an engine repair program. I don’t realistically see it having impact on these types of accrediting agencies, although it would be nice if it did.

• school owners, administrators and faculty, who can use The Core to strengthen or validate curricula and to adopt consistent learning outcomes;

My comment on that: I wholeheartedly agree. I encourage all school owners, administrators and faculty to read this document…and I know the majority won’t take the time. I have seen the prevailing attitude of “I’m not going to let anyone tell me what to do at my school,” when I have tried to promote COMTA accreditation (disclosure: I have been a COMTA peer reviewer). It doesn’t matter if it would vastly improve their existing program. Stubbornness is hard to overcome.

• and potential massage therapy students, as they consider where to enroll.

My comment on that: I would be shocked to know that any potential student is ever going to read the 527- page document to help them choose a school. Just my opinion.

More of my unsolicited opinion: I am not critical of this document on the whole. I think it spells out a good foundational education for entry-level massage therapists as it was meant to do, and it requires 625 hours to do it in.

There are still 26 states here with a 500-hour minimum requirement. While it is very true that there are many schools that exceed their state’s hour requirement, there are also a large number of school owners that are determined they are not ever going to do more than the state requires. Neither do I see it having much effect, if at all, in states that already have higher requirements for education.

The ELAP report states that a 2012 survey showed schools are teaching an average of 697 hours. Still, if this were to be legally adopted, which I think is a long shot at best, it would undoubtedly put some schools in the position of “cooperate or close down,” which in the general scheme of things, might not be a bad thing, if their students are not truly well-prepared.

I am just of the opinion that being prepared to pass an entry-level examination, and being prepared for the real world of massage, are two very different things. It also isn’t about hours, per se, but about competencies–a statement, in fairness, made in the ELAP–but it does take a certain number of hours to teach those competencies, and this is what the work group decided on.

Bottom line: I like it, but I do think that in spite of the Coalition statement of support, that there has been some unnecessary duplication of efforts on some of their parts here, and that a good curriculum can only be effective with good, well-trained teachers. I’d like to see an equal amount of time, money, and effort spent on the National Teacher Standards Education Project. 

 

 

Report from the AFMTE 2013 Annual Meeting

I just returned from attending the fourth annual meeting of the Alliance for Massage Therapy Education, held this year in St. Charles, MO. I’m a founding member of this organization, and once again, it was a fabulous event. I would have to say that this was the best one in the history of the organization. Kudos to Nancy Dail and Cherie Sohnen-Moe, who spent the last year organizing the event, along with the other board members–all volunteers, I might add. This is the kind of thing that can’t be pulled off by just one person. Many people worked behind the scenes to make it happen.

I arrived on Wednesday night in time to visit with Ryan Hoyme (aka the MassageNerd), Greg Hurd, Allissa Haines, and Ralph Stephens. The Embassy Suites puts on a heck of a nice free happy hour, as well as a nice breakfast, and their staff was very efficient and attentive to our group. The meeting kicked off Thursday morning, and the next two days were filled with informative keynote speakers, great classes for educators, and plenty of visiting with friends, old and new.

During the annual reports, President Pete Whitridge reported that the organization now has over 300 members. About half were in attendance, and the rest missed out on a great time! Treasurer Sue Bibik reported that the organization is debt-free, which is quite an accomplishment since the Alliance is less than five years old.

Whitney Lowe’s keynote, Developing the 21st Century Teacher, really hit the nail on the head with the need to utilize technology and advance our own skills as educators. He is always a dynamic speaker. I had a visit with Jan Schwartz, who along with Whitney is one of the educators behind Education Training Solutions. Thursday evening, I missed the opening reception in order to go speak to Bloom, a networking group of massage therapists in St. Louis. The founder, Sara Newberry, took me out to a fabulous dinner at a rustic Mexican restaurant before the meeting, which was attended by about a dozen MTs. I really enjoyed my time with them.

Friday morning, Dr. Janet Kahn presented Massage in the Age of Healthcare Transformation: Our Opportunities and Responsibilities. Kahn has the inside track on the Affordable Care Act and how that stands to affect integrative health practitioners. After Kahn’s presentation, I ran into AMTA President Winona Bontrager, who assured me that AMTA was indeed going to take some action to support massage therapists as participants in the ACA, a move that she had just a few moments to explain during a panel presentation from the leadership of all 7 national massage organizations. She stated that they would be unveiling that very soon. It was very gratifying to me to see Karen Armstrong, VP of the FSMTB,  Sue Toscano, President of the NCBTMB, Anne Williams, Director of Education for ABMP, Winona Bontrager, President of AMTA, Ruth Werner, President of the Massage Therapy Foundation, and Kate Zulaski, Executive Director of COMTA, on the dais together. Later that afternoon, Kate and Dr. Tony Mirando of NACCAS, presented together on Coming to Agreement on Core Curriculum–another warm and fuzzy moment since these two organizations are competitors. It was a great presentation.

Friday was also the day for memorial tributes to our colleagues who have departed this life in the past year. One of the highlights of my trip was the tribute to Bob King, who just passed a couple of weeks ago. I joined David Lauterstein, one of the Educators of the Year and a primo guitarist, and Cherie Sohnen-Moe onstage to offer Bob a little musical tribute. Bob was a fan of “Blind Al” Wilson of Canned Heat, so I played a little harp and Cherie and I provided the backup vocals while David played and sang Canned Heat’s song, “On the Road Again.” I hope someone got a video of that!

Friday night, I attended the ELAP meeting facilitated by Anne Williams of ABMP and Cynthia Ribeiro, Immediate Past President of AMTA. Both of these ladies have a passion for education, and I acknowledge that wholeheartedly even though I have had plenty of concerns about the ELAP. About 20 or so of us piled into the room to hear about the ELAP and to get our questions answered. I was amused to see that their Power Point presentation referred to “angry bloggers,” and I assume that meant me and Sandy Fritz…we’ve both stirred the pot on that front, but in the end, I hope that some good information comes out of this. It was quite momentous in any case to hear that AMTA and ABMP, the two largest competing organizations in massage therapy, have shared some of their top-secret data with each other in the interest of the common good in order to facilitate this project.

Saturday, I attended the NCB CE Provider Update presented by Sue Toscano and Donna Sarvello of the NCBTMB. Their presentation was peppered with questions from the crowd regarding the new Board Certification and the (yet-again) revised version of the Approved Provider CE program. which they stated would be rolled out on November 1. I seized the opportunity to give them an earful about all the pseudo-science classes they have approved for CE, and also to inquire about how many people have earned the new Board Certification. The answer was over 1200, and that almost all of those have been grandfathered in from the ranks of those who were already Nationally Certified and met the new criteria. I gathered that it has been a very small number that have actually taken the new Board Certification exam. Toscano’s explanation was that due to the fact that the new exam just rolled out in January, and requires that people have 250 hours of work experience within six months (among other things), that newer graduates are just now starting to take it.

We also had our annual Author’s meet and greet organized by the lovely Nancy Dail–there were more than 20 textbook authors present.

Other highlights for me were having my blog and Sandy Fritz’s blog recognized for driving a lot of traffic to the AFMTE website, finally meeting longtime FB friend Emmanuel Bistas, and spending a few moments with Sandy Fritz, Bob Jantz, Gabriela Sonam, Benjamin McDonald, Sally Hacking, Allissa Haines and Greg Hurd, Stephanie and Brian Beck, and many more. Saturday morning I had breakfast with educator and author Elaine Stillerman, whom I had never met, and she is a ball of energy in spite of her recent back surgery. My plane was delayed both coming and going, and I visited with Linda Beach while we were waiting an inordinate amount of time to depart–actually got on the plane and then had to get back off an hour later. I had a little nap in the St Louis airport and woke up to find I was about to fall over on Dr. Janet Kahn–I hope I wasn’t snoring and drooling–and chatted with her for about an hour.

Every annual meeting of the AFMTE seems to get better and better. I urge all educators to join this organization and to PARTICIPATE. They have recently started a Human Energy Bank, so that those people who may not have time to take on a full-time volunteer position can volunteer to handle a specific task. There are many other benefits to belonging, which are detailed on the AFMTE website. As a founding member, I feel like I have definitely gotten my money’s worth every year. We are also looking for industry partners to join us. This is THE organization for schools, school educators, and CE providers. We’re doing more than just holding a meeting. The Alliance provides a comprehensive range of services to this community, and represents their interests in all domains. This advocacy comes into play in dealing with regulatory issues, accreditation, standard-setting initiatives such as the Alliance’s National Teacher Education Standards Project, as well as ongoing efforts to get massage therapy better recognized by and integrated into the health care delivery system. As Jan Schwartz said during one of our previous annual meetings, “if you’re not at the table, you’re on the menu.” Janet Kahn, during her presentation, said “you’re in the door, or in the dust.” Don’t be left out.

ELAP: Stop Insulting Our Intelligence!

I spent a big part of last week responding to the first draft of the Entry Level Analysis Project (ELAP). I shared it on my social media several times and encouraged everyone in the massage profession to respond. While I do still encourage everyone to respond, I must say that I have some distress at the way this is being presented.

The powers that be seem to be worried that the massage community is lacking enough intelligence and ability to comprehend information. 

The framework being used to disseminate the first draft of the ELAP prevents anyone outside of the closed-door system that launched and produced this document from being able to read, comprehend and comment on it as a whole. Being restricted to viewing one learning objective at a time does not allow the reader to place individual elements in a larger context, which is vital for being able to properly evaluate this kind of work. We are finally being shown the Curriculum Map that the ELAP Workgroup developed, but only in small bits through a keyhole. This strategy is sure to reduce the number of people who would otherwise want to take the time to read and comment on something that is of potential importance to the field.

Over the past three years, people in our field have successfully reviewed and commented on two drafts each of the Massage Therapy Body of Knowledge and the Alliance’s Core Competencies for Massage Therapy Teachers — both lengthy and complex standards documents.

In addition, there are some other flaws in the document and the entire process. Instead of my repeating every word Sandy Fritz has said, I suggest you click on this link and read her blog. Fritz makes it very clear she wants this project to succeed, but brings to light a lot of issues that need to be corrected.

If you’re a regular reader, you know I haven’t been thrilled about this from the beginning–and I do mean the very beginning — starting with the way it was initially presented at a Leadership Summit when it was not on the approved agenda for discussion. If anyone other than Bob Benson, Chairman of ABMP, had done that, they would probably have been told to sit down and request that it be a possible agenda item for the next meeting.

In the meantime, I have warmed up to the idea — in theory — but I have some issues with the way it is presented. Like Sandy, I object to the document telling us how to teach. This is supposed to be about entry-level information and what that is–not how to get it across. There are also some faulty assumptions–like the one that all massage teachers are familiar with Bloom’s Taxonomy. Sorry to disappoint you, but some teachers couldn’t tell you what a taxonomy is if their life depended on it — particularly at those schools where last year’s students are this year’s teachers.

This is a research project. It’s not going to be the law — at least not in my lifetime. It’s intended to be the road map for what should be presented in entry-level massage programs. A lot of work has gone into it, and I do have appreciation that it has been a collaboration among our professional organizations. However, these organizations need to realize that there are intelligent people out here who want to look at the big picture instead of having it spoon-fed to us in kibbles and bits. I believe the Workgroup will get more and better feedback if the Curriculum Map as a whole was available for comment.

If you think this is a good idea, then contact the leaders of ABMP and AMTA. In the meantime, this is what we have, and I urge you to take the time to read it, take the surveys, and comment.

ELAP First Draft and Call for Comments Released

The first draft of the ELAP (Entry-Level Analysis Project) has finally been released. It’s been more than a year since I first blogged about it.

This research project proposal was introduced by ABMP and has come full circle from the first statements put out about it, which put me out quite a bit. The initial proposal stated: There is no step in this proposal to obtain input from the broader massage profession or from other health-care or bodywork organizations during this project. The reason is simple—the work group is simply performing a work task in writing learning outcomes and objectives for job tasks defined by surveys already conducted by FSMTB and NCBTMB. It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught. The work group would be responding to what therapists report they do, on a day-to-day basis, in their massage-related environments as part of their jobs.

They had to back up and punt on that. The ELAP website now contains the following statements clarifying the purpose and scope of the project:

The Entry-Level Analysis Project (ELAP) is a research project that defines the minimum number of training hours necessary to acquire knowledge and skills essential for safe and competent practice as an entry-level massage therapist. The project was initiated through conversations between the Alliance for Massage Therapy Education, American Massage Therapy Association, Associated Bodywork & Massage Professionals, the Commission on Massage Therapy Accreditation, the Federation of State Massage Therapy Boards, the Massage Therapy Foundation, and the National Certification Board for Therapeutic Massage & Bodywork.

ELAP aims to obtain and use research data and analysis of findings from other massage profession projects to inform the creation of an entry-level curriculum map. The map will define the essential elements of an entry-level curriculum necessary for safe and competent practice in a massage career, as well as the number of hours deemed necessary to teach these learning objectives and outcomes. The project outputs will be used to inform the Federation of State Massage Therapy Boards (FSMTB) Model Practice Act designed to promote interstate portability of credentials in the massage profession. The recommendations of the ELAP project will be available to the massage profession as a resource to enhance consistency of entry-level curricula in massage and bodywork training programs.

The ELAP website now contains five webinars explaining the various facets of the project, and numerous surveys to complete. You do not have to complete all of them; the option is to pick and choose those areas that interest you the most.

I urge everyone to give feedback. It happens too often in our field that there is either no opportunity to give feedback, or the opportunity is presented and ignored….the MTBOK (Massage Therapy Body of Knowledge) was a prime example of that. Only a smattering of people responded to that, and then it came under all kinds of criticism when it was released. If you don’t take the opportunity to express your opinion, then don’t gripe when it comes out and you don’t like it. Visit the website and take advantage of your opportunity to participate.

If at first you don’t succeed….

Try, try again. That’s what the regulatory board in my home state of North Carolina is recommending when it comes to getting the Federation of State Massage Therapy Boards to do something about the confusing status of continuing education approvals.

Two years ago, the NC Board of Massage & Bodywork Therapy introduced a resolution at the Annual Meeting of the FSMTB (which was held in Puerto Rico). This document instructed the Federation’s Board of Directors to “begin the process of developing a new national approval program for continuing education providers and courses.” The organization’s leadership responded positively to the resolution, and announced to the profession in the Spring of 2011 the launch of a comprehensive project to do just that. They also invited AFMTE, AMTA and ABMP to work with them to provide input that would help shape the project.

In spite of this clearly stated intention to develop a “centralized quality assurance process for all courses taken by massage and bodywork therapists for the renewal of State licensure or State certification” (quoted verbatim from the FSMTB press release dated 3/29/11), the outcome of this process missed the mark by a country mile. The MOCC Proposal, which stands for Maintenance of Core Competencies, failed to deliver what the state boards asked for, and what FSMTB promised.

To remind you, the MOCC Proposal was based on a new (and unproven) concept of separating continuing education that relates to “public protection” from all other CE that is taken for “professional development”. MOCC recommended that only CE related to “public protection” be required by state boards for renewal of licensure, and everything else be put into the voluntary category, to be regulated by… well, the proposal didn’t even mention NCBTMB. If this all weren’t bad enough, FSMTB would become the exclusive provider of coursework needed to maintain “core competency” in the subjects related to “public protection”.

For more background on the MOCC issue, refer to my blog posts of 3/14/12 and 4/15/12. It’s also illuminating to read the press release AMTA issued on 4/23/12 which contained a complete repudiation of the Federation’s proposal.

In a friendly game of golf, you can take a “mulligan” every now and again–a “do-over”. My colleagues at the NC Board are giving the FSMTB leadership an opportunity to take a mulligan on this vitally important CE approval issue. They have recently submitted another resolution to be discussed by Member Boards at the upcoming FSMTB Annual Meeting in New Orleans on September 27-29. This resolution is much like the original from two years ago, and its appearance at this point in time indicates that the need for a single-source national CE approval program has not gone away.

The primary rationale is contained in this statement from the new resolution:
“Reliance upon the NCB Approved Provider program has been problematic for state boards because (a) NCB is a private, non-profit corporation that lacks oversight from and accountability to state regulatory boards; (b) its program has not adequately evaluated the quality or relevance of CE courses; (c) administration of this program has had notable service delivery problems over an extended period of time.”

That’s all true, but the opera ain’t over ’til the fat lady sings. The NCBTMB has the infrastructure already in place–and this will be nothing more than another case of duplicated efforts if the Federation steps in and tries to take it away without consideration of the NCB’s position in that marketplace. I think a collaboration would be more appropriate; by contracting with the NCB to administer CE approvals, FSMTB could establish the accountability structure that state boards must have with NCB, and FSMTB wouldn’t have to reinvent the wheel. They could just improve upon it.

Yesterday, I conducted one of my Scientific Facebook Polls, and asked the questions: How many MTs REALLY care what is happening with our professional organizations and what they are doing? How many people care about the MTBOK, the ELAP, the MOCC (don’t y’all love all these acronyms) or even know what they really are? How many people care about the legislation and regulation of massage? How many people care that there are initiatives to raise standards for teachers of massage therapy and for massage education in general? Do you care about all those things, or would you rather just be left alone to do massage?

I got 75 replies in a 24-hour period, and one thing is apparent: to the average massage therapist trying to make a living, many perceive our organizations to be all about politics and all about money. To some extent, that’s true…the one with the most money wins. The perception is also that they all have their own agendas. Actually, recently some of them seem to have the same agenda, but they’ve wasted time and money in duplicating efforts, or opposing each other’s efforts, and scrapping over turf wars. In a recent blog I urged the NCBTMB to take themselves out of the entry-level exam market and suggested that the FSMTB assists them financially in return for their doing so. Earlier this week, in a piece published in Massage Today, Ralph Stephens called on AMTA and ABMP to offer “substantial and ongoing financial support” to COMTA and AFMTE, to further their important efforts to improve the quality of massage therapy education.

FSMTB and the NCB have recently conducted new Job Task Analysis surveys, both of them seriously flawed, in my humble opinion. These surveys show a strong bias towards the clinical/medical side of massage therapy, and contain virtually nothing about the KSA’s related to delivering massage therapy as a primary means of facilitating well-being and integration. From my perspective, the latter is of equal or greater importance.

In addition, the FSMTB survey has a special add-on section to gather data for the Entry-Level Analysis Project (ELAP). This dual-purpose survey does ask lots of questions about specific medical conditions, but it contains nothing about the client/therapist relationship. The word “relax” does not appear anywhere, and the word “relaxation” shows up just once.

There’s also an over-focus on the huge number of modalities that are marketed in this field. Many of these listed are obscure and little-understood. It’s wrong to ask a therapist to define themselves by a single named modality. Practitioners typically use a broad range of methods with clients. The modality is not the treatment — it’s the totality of what a practitioner brings to the session.

Finally, this Federation JTA is similar to the recent JTA from NCBTMB: another duplicated effort that still falls short of giving an accurate picture of what happens in the real world of massage therapy. You can count how many times a week we give a massage or take SOAP notes, but that’s not what it’s really about. It’s about our rapport with the client, and what kind of results we are able to produce, and what kind of trust we can inspire in our therapeutic relationships. The MTBOK generally missed the boat on this as well, although I have high hopes that the line-by-line analysis and re-mapping of the MTBOK that was conducted by AFMTE will give us a usable body of knowledge.

As a result of these large-scale projects, it’s likely that the kind of incomplete and disjointed training that is typical in our field will get further enshrined as the baseline for education. Skewed survey questions produce skewed data. Using that data to build a new standard for the entire field is not just wrong, it’s a crime against the lineage of massage therapy. Just look at what has happened to the other health care professions who have organized themselves around the mechanistic/reductionistic model. People are treated as parts, and no discipline ever looks at the whole person. Massage therapists still have the ability to treat holistically. Relaxation is being relegated to a lower-class status of therapeutic effect, when it’s one of the most valuable aspects we offer with this work.

This whole scenario illustrates one thing: the time has never been more ripe for getting our act together, and that isn’t going to happen while there’s all this push and pull and one-upmanship going on with the organizations. When the leaders of the seven primary stakeholder groups sat down at the table for the first time last September, the ELAP proposal appeared out of nowhere–it wasn’t even on the agenda and it got slid in anyway. I would like to see them sit down again, and take a serious look at these issues. Put ego and profit aside. Take a real look at the flaws in your information-gathering processes. If you want to see what massage therapists really think, sign on to my Facebook page and you might get a rude awakening at their opinions of you. You wouldn’t exist without us, and what we think does matter. A Job Task Analysis survey asks what we do--and frankly, it isn’t near as important as what we think. Consider that.

 

The ELAP Flap Continues

Earlier this week I received the ELAP (Entry-Level Analysis Project) Description from ABMP. I’ve been blogging about this for several weeks, first because I was upset that it was shrouded in secrecy; then last week because I finally got word of who is serving on this work group. While that information didn’t exactly smooth my ruffled feathers, I was gratified to see that I know some of the people working on it and know that they do the best job they can at whatever tasks they take on. And the document has changed quite a bit from the first proposal I saw, which I had numerous objections to (see previous blogs under this one). That being said, I’m still not thrilled with it.

I feel that there are some big pieces missing here, and that the profession would be better served by pointing resources in a different direction. To begin with, the document makes the point that how regulatory agencies arrived at the 500-hour minimum that has been a benchmark of entry-level education is unknown…that’s true, but it’s also unknown of how states with more hours arrived at those requirements. One thing that’s mentioned is the influence of federal financial aid, which presumably has led some schools  to offer more hours (or states to require them). As is the case with a lot of things, following the money trail often gives insight into real motivation.

Personally, I don’t think financial aid, or the lack of it, should be influencing this project at all. As a former school administrator, I’ve been involved in the financial aid process first-hand in the past. Whenever a recession and massive job layoffs happen, as they have here in my home state for the past three years or so, there’s a phenomenon that occurs. There’s an influx of displaced workers into the community college system, where financial aid is a given, and I’ve been told by students who had never even considered massage as a career that “the job counselor said I could get my schooling paid for if I would study massage.” That’s just not the reason I want to see people coming into the profession.

I feel there are some other tasks that need to be completed before anything like this is undertaken. The ELAP description states only two goals, one of which is to assess how many program hours are needed to attain this KSA (knowledge, skills, and abilities) goal, assuming capable instruction.

That’s a major issue, in my opinion—because you can’t and shouldn’t assume capable instruction. The Alliance for Massage Therapy Education is working on a National Teacher Education Standards Project to define the KSAs needed by teachers, both entry-level and more experienced/advanced. There is also a line-by-line review of the MTBOK going on. To charge headlong into the ELAP before these two initiatives are complete seems like putting the cart before the horse.  In all fairness, I am glad to see our organizations collaborating instead of refusing to play nice, but I would prefer to see them applying their resources to the National Teacher Education Standards project. The ELAP claims to be addressing what it takes to make a therapist able to practice competently. The fact is if the teachers aren’t competent in a 500-hour program, they’re not going to be any more competent in a 750-hour program until they are educated. We need educators who are competent enough to teach competencies, not just stand in front of a classroom for a longer number of hours.

Part of the rationale for this entire undertaking is the perceived  lack of competence of entry-level therapists. While the FSMTB is about to launch a new Job Task Analysis Survey, and the NCBTMB recently did the same, we ought to bear in mind what it is that a JTA shows. They tend to be snapshots of a day in the life of a massage therapist: see the clients, do the laundry, keep up the paperwork. If the perception is that therapists are not doing what they need to do in order to keep the public safe and practice competently, is asking them what they do all day really effective for this purpose? I don’t think it is. As one of the comments on last week’s blog said, “They don’t know what they don’t know.” There will be also be an accompanying survey within the JTA survey, intended to eliminate the “experience bias” present in these types of surveys, but I think that’s a tricky proposition. The return rate on these surveys tend to be very small–and usually answered by the minority of us who actually give a rip about the state of things. JTA surveys tend to be long and somewhat boring and it’s a very small percentage of people who will even fill them out to begin with.

Reportedly, the ELAP project was conceived to help address the problem of portability of massage between the states. One of the statements reads in part “we need to identify the key KSAs required to pass a national licensing exam and provide competent, safe massage in an early massage career.”

Right there is another problem. While the FSMTB would like to see every state exclusively using the MBLEx, it hasn’t yet happened. Since the NCBTMB is increasing the requirements for National Certification, leaving them with only the NESL options for entry-level exams in the states that accept those, the MBLEx will undoubtedly become exclusive in some places, but New York is not going to throw over their exam for the MBLEx, in my opinion. There is no such thing as national licensing, and there is never going to be. National licensing doesn’t exist in any profession I am aware of. If you’re a doctor, you still have to get licensed in each state in which you want to practice. While portability is a pain in the butt for massage therapists, it has never been shown to be harmful to the public or to the profession on the whole. Inconvenient, yes; but harmful, no.

The FSMTB is also working on the Model Practice Act, as mentioned in the ELAP description. While I wouldn’t go so far as to say it’s a waste of time, I don’t expect any influx of the regulated states lining up to change their existing practice acts to whatever the FSMTB comes up with. I’m sure it will be a helpful guideline for the unregulated states if and when they decide to join the fold, but it will be interesting to see how that document ends up harmonizing with the ELAP. Since the MBLEx has been an exam that uses the 500-hour threshold (and in fact, you can take that exam at any point during your education, prior to graduation), if this project somehow demonstrates that more hours are needed, is the FSMTB going to jack up the requirement to sit for the MBLEx? The Model Practice Act project was also undertaken prior to the ELAP project starting up, and while I haven’t seen a draft and don’t know what it includes, my prior knowledge of state practice acts demonstrates that those generally spell out required education and the breakdown of those hours, so presumably the ELAP would affect the Model Practice Act project as well.

Another part of the hoped-for result of this project is to cut down on the number of lawsuits and ethics complaints against entry-level massage therapists. Personally, I believe someone who is going to act unethically is going to do it regardless of how much education they have. When it comes right down to it, the injuries resulting from massage are a tiny fraction of what they are in other health-care related fields. I’m not saying there aren’t any, but on the whole it’s relatively insignificant when compared to the number of practitioners.

Lest anyone think I am against raising the standards of the profession on general principles, that’s not so. I don’t own a school, and I’m already licensed, so it’s not like this is going to inconvenience me personally. In fact, a few years ago when I was on the North Carolina Board of Massage & Bodywork Therapy, we looked at raising the hour requirement here (currently it’s 500 hours). Like any good organizational beaurocracy, the result of that was to appoint a committee to study the situation. The research they conducted was to ascertain whether or not students from schools with higher number of hours had a better pass rate on the exams than students from 500-hour schools. The answer to that was a big fat “no.”

I’m not sure how much money is being spent on this project; the first proposal I saw mentioned between $60-70,000 to be shared as an expense between the organizations. I urge, or rather, challenge, all of these organizations to pour an equal amount of money into the AFMTE Teacher Standards project. Improving the KSAs of entry-level educators—many of whom tend to be last year’s star students, who may be talented at massage but without a whit of experience and training in teaching methodology—will improve the KSAs of the students, the entry-level practitioners. That should be the important first step—the key word there being first. Don’t try to build a house without a good foundation. It’s a waste of time and money, and ultimately, it doesn’t work.

Top Secret Standards Project: No News is NOT Good News

I’ve been on vacation…I took a deliberate ten-day break from the Internet and from all the politics of massage while I was enjoying my annual sojourn in Ireland. I didn’t visit any Internet cafes. I didn’t read the paper and I didn’t watch the news. I left my cell phone at home, too. It was quite refreshing and restorative to be unplugged for that period of time, but now it’s back to the grind. From the look of things, it would seem that the powers that be are enforcing a news black-out as well. They have apparently been sworn to secrecy. It looks like a covert operation from the CIA.

The press release from the Leadership Summit, held in Chicago May 1-2, and attended by the leaders of our national organizations, was released May 9. I was expecting a white-washed version of the events, and I was not disappointed.

Out of nowhere, the press release mentions casually: “An ongoing discussion of the Entry-Level Analysis Project (ELAP) occurred and input from the leadership organizations was discussed.”

Wait just a minute… isn’t this the very first public mention of this project? No one outside of the inner circle of secret-keepers knows what the ELAP is, who the driving forces are behind it, and what its real purpose is. They can’t just drop a profession-altering project onto the landscape like it’s a known quantity, wave a little flag that promises us some future opportunity to have input into the project, and then expect us to salute the results whatever they may be.

The Leadership Summit press release mentions that massage therapists are going to get some input into this project—through a “companion” survey to the FSMTB Job Task Analysis. That may sound promising, but let’s remember that FSMTB is an exam provider, and their major focus is on the MBLEx. The Job Task Analysis survey is not necessarily the best way to determine what an entry-level massage therapist needs to know.

The big problem with the use of these and other surveys in our profession is that many therapists received insufficient education in their entry-level massage training programs. It’s unfortunate, but these folks don’t know what they don’t know. Asking this group what constitutes safe and effective massage therapy practice is barking up the wrong tree.

If all you’re looking for is a snapshot of the hours per day one spends doing massage and performing the laundry and other mundane chores that go along with that, it will suffice. But what about seeking opinion and honest-to-goodness input? What about addressing the concerns that the people who will be affected the most by whatever plan comes down the pike? Primarily, that will be small school owners, many of whom are already struggling to survive.

There are still so many things I find disturbing about this whole process, not the least of which is that none of our massage news outlets is saying anything about it. You’d almost think I’m the only one who cares. With the possible exception of a surprise birthday party, I tend to mistrust anything that has to be carried out in secret. So the nice sentiment (which I am glad to see has replaced the “we aren’t seeking input” statement that I found so offensive in the original document) that “A key component to the success of this project will be broad input by the massage profession” notwithstanding, I’ll repeat the call to action from my last blog:

A really good first step would be for ABMP, AMTA and FSMTB to release a full description of the project, including what they plan to do, how it will be done, who sits on the new workgroup, what the timelines are, and what money will be spent. And most importantly, we want to know what they intend to do with the “evidence”. When organizations that represent us are making major decisions that affect us, we deserve to be involved in the process.

In spite of my objections to this whole cloak-and-dagger scene we’re being subjected to, I am comforted by one thought…and that is that the wheels of government turn slowly. Whatever plan the ELAP work group comes up with is just that: a plan. I don’t visualize state lawmakers running to the legislature floor intent on helping them get it off the ground. AMTA is not a regulatory body, and neither is ABMP. For that matter, the FSMTB isn’t either. The individual member boards are regulatory bodies, but the organization in and of itself is not. They don’t have any law-making power.

I don’t know what’s happened to the transparency that we should expect from our organizations, but it seems to have gone to hell in a hand basket. Frankly, I think that would be a good topic for the next leadership summit. The peons like me who pay your membership dues deserve it.