Massage: The Big Picture

I was just cruising through my social media sites, and it has reinforced for me something that I’ve known for quite some time about massage therapists: they’re a caring bunch. That’s not exactly a big surprise; after all, our job is helping people feel better. I’d say a certain amount of caring and compassion is a prerequisite for becoming a massage therapist. We all care about our clients…even when I see posts from people who may not be working in their ideal situation, that’s pretty consistent.

I’ve written over the years about why I think it’s important for massage therapists to care about The Big Picture–to be aware of and involved in what’s going on around them, and I want to expand on that on several fronts. It’s the 4th anniversary of my blog. Humor me, and I’ll tell you why I think it’s important.

I get a lot of “I’m busy running my business. I don’t have time to think about it,” in reply to something I’ve reported about massage regulation and legislation. If you’re in Alabama, why should you care about something happening in Michigan? Here’s the reality check: When something detrimental happens in the regulation of massage, it sets a precedent and makes it easier for it to happen somewhere else. That could be anything from the consistent referencing of our businesses as “massage parlors” in legislative language, something we’ve all wanted to get as far as possible away from, to crazy zoning laws requiring massage businesses to be located in seedy areas zoned for heavy industry, prohibitions on having a massage therapy business located in a shopping mall, or prohibiting massage being performed after 8 pm. Yes, indeed, those are all realities, but if they’re not affecting you personally, people don’t want to think about it. Based on my questioning therapists in the classes I teach, not even 10% have read the entire practice act in their own state. They don’t know the letter of the law even where they’re practicing. That’s a pretty sad state of affairs. I get questions all the time from therapists wanting to know “is it legal for me to do so-and-so?” and while I pride myself on being a fountain of information, it’s all right there on your board’s website. Read it.

Massage is suffering growing pains right now…I think of it as the evolution and revolution of massage. We’re stuck in that place in between being an industry and being a profession. Some don’t care which way it goes. I do. If something affects my right to practice massage, my license, my certification, my teaching of massage therapy, I want to be informed about it, and I want to be in a position to take action on it. I’m a provider of continuing education, approved by the NCBTMB, so I want to keep up with what they’re doing–and any other developments in the realm of teaching CE. At the current time, the Federation of State Massage Therapy Boards is working towards giving their own approval of continuing ed. I’m watching that like a hawk, because a) it could mean I have to fill out an application to get another approval from another entity–or even individual approval from each state I teach in b) it could end  up costing me more money for another approval, although that hasn’t been decided yet and c) if my class isn’t involved directly in public protection, it might not be approved at all. This initiative is still in the planning stages, and it serves me as a provider to stay informed and know what’s going on.

In the same vein of education, I am a member of the Alliance for Massage Therapy Education, and I encourage everyone else who has any involvement in education to join immediately. The Alliance is working on a project to define teaching standards on a national level…to spell out the knowledge, skills, and attributes that one needs to have in order to teach both entry level massage and CE. What if I don’t live up to those standards; will I be cast into the abyss? I don’t want to be clueless about what’s going on. I want to have some input into that project–and if you’re teaching, or aspiring to, you should want the same thing. This is going to happen; not overnight, but it is going to happen. I don’t intend to be the last to know. I’d rather make the effort to be involved in the process. I will never forget the statement made by Jan Schwartz at the last Alliance meeting: “If you’re not at the table, you’re on the menu.” I don’t intend to be chopped liver.

Then we’ve got the massage therapy associations. A lot of people just sign up for membership because they want the insurance, and they don’t care about the leadership, or the government relations, the networking opportunities, or anything else. I personally do care who is running them–and what they’re actually doing. I personally do care what they’re doing on the front of government relations. State boards cannot lobby–that is the domain of AMTA and ABMP–and any special interest group who has the wherewithal to hire a lobbyist–like the chiropractic associations, for example, or PT associations who think we’re encroaching on their territory. And if I think one of my membership associations is doing something that doesn’t protect the rights of massage therapists, or serve the highest good on that front, I am perfectly capable of calling them up and giving them an earful–or taking my membership dollars right out of the coffers. Let me add that my legislators also hear from me, and if I don’t like what they’re doing, I let them know that, and I don’t vote for them the next time.

Related to education, to me anyway, is the state of evidence-based practice of massage and the need for research literacy. I support the Massage Therapy Foundation, and if you have a single dollar to spare, I suggest that you support it, too. Research literacy should be taught in every massage school. I’ll go further and say the teaching of that should be mandated by state boards who license schools. Frankly, any school who is not teaching their students how to be research literate is not worth their salt. That doesn’t mean you have to be a researcher. It means you have to know what constitutes valid research and how to find it…which in turn will lead to throwing out some of the long-standing “myths of massage” that are perpetuated. If you’re still teaching that massage is detoxifying the body and that drinking a lot of water after the massage will flush those toxins out, you’re in dire need of research literacy. I just completed my first peer review and site visit for COMTA, and I am happy to say that the teaching of research literacy is one of their required standards. I have a new appreciation for them after really delving into their standards and it would be a great thing for every school to seek that accreditation. Basically, for a school or massage program, it means “I’m doing more than the state requires me to do in the interest of higher standards.” Amen to that.

I think a major stride was made a couple of months ago when the leaders of the profession all came together for the Massage Therapy Leadership Summit. Ego and personal agendas had to be left at the door. The ABMP, AFMTE, AMTA, COMTA, FSMTB, MTF, and the NCBTMB came together for the first time to discuss common problems. They’ll be doing it again in 2012. This wasn’t a “my organization is better than your organization” meeting. This was about The Big Picture.

So that’s where I’m at right now. I can’t roll along just surviving and only caring about my own clients and my own business. It’s not just about me. It’s not just about you. It’s about The Big Picture and massage therapy on the whole.

Teaching the Teachers

I inadvertently insulted a massage school owner yesterday by making a FB post saying that I wasn’t impressed by a school that had only one teacher to teach the entire curriculum, and that I wouldn’t choose such a school, personally. To begin with, I wasn’t speaking of his school when I made the post, and I had no idea that he was teaching his entire program himself, as his website gives a different impression, listing four faculty members. A couple of his satisfied graduates weighed in with the fact that they were pleased with their education, and many more who didn’t attend that particular school offered comments about the need for diversity and differing perspectives. Some said they’d rather have one good teacher than a bunch of bad ones. I’m going to stick to my guns on that one, and it is just my opinion and mine alone, that it wouldn’t be for me.

There’s no law anywhere that I’m aware of that prohibits one person teaching the whole program. The standards for massage therapy education vary from state to state. The quality of massage therapy education varies from school to school, and even from teacher to teacher. I also stated in my post that I’ve seen the good, the bad, and the ugly. There are brilliant and engaging teachers; there are teachers who know their subject but who are so droll and boring you can’t bear to sit through it; and the sad fact is that there are plenty of people teaching who shouldn’t be teaching at all. A good massage therapist and one who is good at teaching are two different things, many times.

Some states allow anyone who’s breathing to teach a class, and schools often take advantage of that by using last year’s graduates as this year’s teachers. At the other extreme are states with requirements that you must have a college degree in the area you are teaching, at least for science-based classes like A&P, or that you have been licensed as an MT for X number of years before you can teach hands-on classes.  There’s no consistency.

I’m at the end of my five years of service on the North Carolina Board of Massage & Bodywork Therapy, and I have served the School Approval Committee that entire time. Since I’ve been on the inside, I can state that our system isn’t perfect…we state in our rules that teachers should be “trained” but we don’t go far enough with that…there’s no set number of hours of training required, and each school basically does whatever they please on that front. One has a year-long training program. Another has a two-hour orientation and calls it their training program. The others fall somewhere in between. My pet project recently has been encouraging schools to teach research literacy to their students. It seems to be slow to catch on. Some school owners have the attitude that if something isn’t in their board’s requirements, they’re simply not going to do it, and that’s a shame.

So who teaches the teachers? The AFMTE is working on a big project, the National Teacher Education Standards Project. I applaud that wholeheartedly, but I will point out that the AFMTE isn’t a regulatory board and all they can do is put it out there, they can’t force anyone to participate. The Massage Therapy Foundation is offering classes around the country in teaching research literacy, but the same is true of them; since they’re not a regulatory board, they can’t force participation. That’s just too bad on both counts! I’d personally like to see teaching research literacy a requirement in every school. Both of these organizations are saying, “Here we are, here’s what we can do to improve education.” But again, since there’s no law requiring it, some–and by some I mean the vast majority–aren’t getting on the bandwagon. What I fail to understand is why any school owner or program director wouldn’t want to give their school–and their students–their best shot.

While I do concede that there’s a complainer in every crowd, when I see the same complaint from multiple students/graduates, it gets my attention. There is rarely a day that goes by that I don’t get emails or phone calls from students all over the country with some tale of woe about their school experience.

On last weeks’ blog, Self-Sabotage–or How I Got Your Clients, I offered up a bunch of the reasons that clients have given me about why they left another therapist and started coming to me. So here are some of the comments that I have received from students:

“Even though it’s in our school catalog that we have a dress code, our teachers don’t follow it themselves. They dress in the same way we’re told not to.”

“There’s no substitute. If a teacher has to be out the class just gets canceled.”

“The teacher is rude if anyone questions anything. Her answer is usually because I say so. I don’t think she knows the real answers.”

“Our teacher didn’t like teaching Ethics, so at every so-called Ethics class, they would just spend the whole hour talking about something else.”

“Our teacher doesn’t know anything about the licensing laws in our state.”

“Our teachers are always contradicting each other and you don’t know who to believe.”

“The A&P teacher couldn’t pronounce the anatomy terms.”

“Our teacher lets us out early all the time because she has somewhere to go. I don’t think I’m getting what I’m paying for.”

“My teacher has had affairs with several students.”

“My teacher’s girlfriend is in the class and he uses her for every massage demo.”

“All of our tests are open-book. I don’t feel like there’s any proof that we’ve learned anything.”

“My teacher tries to impose his religious beliefs on us.”

“My school told me it wasn’t going to be a problem that I had a criminal record but after I graduated I found out I couldn’t get a license.”

“The teacher just graduated last  year and in spite of the fact that she has failed the exam three times and doesn’t have a license, the owner feels sorry for her and is letting her teach.”

“There’s no diversity. One teacher teaches everything.”

“One of the female teachers gives every male student a hard time and picks on them constantly.”

“When I complained to the owner about the unprofessional behavior of one of the teachers, she told me I was free to drop out but I wouldn’t be getting my money back. She didn’t even listen to the complaint.”

“My school experience has been very disappointing but I’ve already paid the money and I’m just trying to stick it out until graduation.”

I honestly could go on for days with the comments. And like I said, when it’s just one whiner, I don’t pay much attention, but when I hear the same thing repeatedly about a school, I encourage those students to report it to the board. If our board gets a half-dozen complaints about the same school or the same teacher, you can bet we’re going to investigate it. I sometimes get emails from students who say they are afraid of retaliation if they complain, and that’s too bad. It just means that whatever problems are there will be perpetuated for the next class of students.

As a school owner or program director, your priority should be to get the best people you can get to teach your students, and to ensure that they are not only familiar with the subject, but that they are trained in teaching adult learners, that they incorporate research references into their class, that they are trained in teaching to diverse learning styles, and that they present themselves and behave themselves in a professional manner. If you allow your teachers to come to class looking like a homeless person, then the blame is on you as much as it is the teacher. If you look the other way while your teachers are having affairs with students, the blame is on you as much as it is the teacher. If you don’t listen with an open mind whenever a student has a complaint about an instructor, shame on you. If you’ve heard the same complaint more than once and haven’t discussed it with the instructor, double shame on you.

If you really want the education that you’re offering to be the best that it can be, you’ve got to teach your teachers. Don’t just hire someone and hand them a syllabus and think they’re going to do a good job. There are resources available and you should be using them.  If you’re not conducting a thorough teacher training program, or requiring your instructors to attend one, or not having teachers trained in research literacy and teaching that to students just because it isn’t a state law, then I urge you to step up to the plate and go beyond what the state law requires. Your school will benefit from it. Your students will benefit from it. The massage-seeking public will benefit from it.

Resources:

ABMP Massage School Instructor Resources

Alliance for Massage Therapy Education

AMTA School Advantage Newsletters

Center for Somatic Teacher Education

Education Training Solutions

Resource ETC

Teaching and Presentation Skills Series

Teaching Research Literacy from the Massage Therapy Foundation