Anne Williams of ABMP has confirmed to me today the members of the group that are working on the Entry-Level Analysis Project that I have been blogging about for the past few weeks. Since the secrecy surrounding this project has been my main complaint about it, I will share that information here. The members are:
Cynthia Ribeiro, President of AMTA (National), educator, and school owner.
Tom Lochhaas, University-level educator, author, editor with 24 years experience in developing college-level textbooks and ancillaries.
Elan Schacter, Massage therapist, instructor, text reviewer, contributing author.
Clint Chandler, Massage therapist and instructor, experienced in curriculum development.
Rick Garbowski, Massage therapist and instructor, experienced in curriculum development.
Jim O’Hara, Instructional designer.
Anne Williams, Director of Education for ABMP.
Williams stated that she was in the process of compiling the comments of those who were present at the Leadership Summit; that everyone present was now in support of it, and that much more information about the project would be forthcoming in the next two weeks. She further stated that this was intended to be a research project, and that what people do with the information will be their choice. As I said in my last blog, neither ABMP, AMTA, or any of the other organizations present at the Leadership Summit are regulatory organizations, and none of them have the power to dictate legislation. (Clarification: the FSMTB is an organization of regulatory boards, but is not regulatory in and of itself).
I am acquainted with several of the people on the work group. Cynthia Rebeiro, Pat Archer, and Elan Schacter do good work in all they endeavor to do. I would have liked it if this information had been put out there immediately, along with the rest of the details, but you don’t always get what you want. And actually, the fact that you don’t always get what you want is sometimes a good thing. As I also previously stated, the wheels of legislation turn very slowly…and just because our organizations want something to happen doesn’t mean it’s going to. If the evidence produced by this project turns out to show that 750 hours ought to be required for entry-level education, it will take many years for that to happen in every state. That’s my prediction, and I’ll be glad to take any bets on that.
I’ve been reviewing COMTA standards for the past couple of days in preparation for a site visit, and it would be great if those were a requirement for every school. I think the quality of education would increase exponentially if every school had to jump through the hoops to prove they’re doing things diligently and going beyond what most of the state boards require. I’ve also been revisiting the MTBOK, and while I still have a few issues with it, I certainly hope it is taken into consideration.
I personally still think that education should be about quality, and not quantity. 500 hours is arbitrary to me–and so is 750. Look at some of the Canadian provinces…their required hours are 4 digit numbers. Those are arbitrary too, when it comes down to it. It should be about competency, not about hours. From my own experience, and someone has made this comment to me before–in entry-level massage school, you learn what not to do. It’s when you begin practicing that you begin knowing what to do. My real education started when I walked out the massage school door, and it’s been that way for a lot of us.
This project is going to be released for comment in a couple of weeks, according to Williams. I urge everyone to take the opportunity to comment–beyond any job task analysis survey that gets spread around. Those show tasks, and don’t reflect opinion. This is of too much magnitude to the profession for opinion not to be considered. School owners in particular need to speak up. If you run a 500 hour school, how many of you can afford to increase that be 250 hours? How many would just fold? I advise you not to sit on your hands. It’s like an election. If you don’t vote, you can’t complain, and complaining after the fact doesn’t have any impact. Express your opinion.
Hi Laura,
A point of clarification. The project description will be released so that people understand how the project is designed. As part of the project there will be a period for the massage profession to give formal comment on the first draft of the project documents before the document is revised into a final draft. There won’t be a formal comment period on the project description itself, but we are happy to gather any comments people want to send us and factor them into our thinking as we complete the tasks outlined in the project plan. Anyone with additional questions can reach me at anne@abmp.com and I’ll be happy to share what I know. People can also send comments to this email and I will gather them for the work group. Thank you! Anne
It should be about compentency not hours.
Arbitrary numbers? YES. Competency based education ? YES PLEASE! I agree that COMTA’s minimum requirements ensure essential competencies and responsibility. Of a minimum required number of contact hours, those hours must include specific competencies. There are schools that offer training with greater numbers than 650 / 750, but do not contain these essential competencies. Hours do not equip, necessarily. I do however, appreciate the opportunity for assimilation that a school with more contact hours can provide.
I wish there would be a few real research studies done on just what is needed to become a massage therapist and also be a successful one – I don’t think it has anything to do with the number of hours in training but I do want someone to know the basics on how to massage. When I was at the research conference a few years ago, I talked to some teachers from Canada in the 3000 hours group and they said there were still many issues and that more hours wasn’t really necessary. The thing is though that more kids out of high school are getting into massage so they don’t have to take math classes, but the schools are also geared more toward teaching adults since the ave. age of MT is 45 and has been for years. How could we really figure out what is really needed?
Sounds very promising! Thank you Laura! I agree about your statement about COMTA standards and about competencies over hours too.
Who founded this group? Is it part of AMTA, ABMP, or other association? How is this group funded? By what process were work group members appointed?
Good questions Susan.
Thanks Sandy. As I read Laura’s wonderful blog, the definition of insanity keep coming to my mind. Meaning that we seem to be doing the same thing over and over again and never making progress. This effort seems strange to me, especially after NCBTMB’s announcement regarding a new board certification.
We will see. There has also be an excellent effort on the same topic which began as a thread on Alliance linked in. Ravensara has done a wonderful job taking on the collaborative effort. Read more at —phttp://poem-massage.org/
Ravensara Travillian
http://poem-massage.org/content/defining-and-distinguishing-massage-and-bodywork
and all the work we’ve done is under the umbrella page http://poem-massage.org/content/proposed-list-core-massage-competencies-vocational-and-degree-levels-training
.
Ravensara Travillian
more info
http://poem-massage.org/content/defining-and-distinguishing-massage-and-bodywork
and all the work we’ve done is under the umbrella page http://poem-massage.org/content/proposed-list-core-massage-competencies-vocational-and-degree-levels-training
Curious.. why does it matter how this group is funded? Would this collaborative process be less credible if George Soros funded it than if it was funded by a “make a donation” link on a website and university dollars?
Also, how is this the same as what was attempted before? The beauty of these organizations coming together is that we can finally have “crossbreeding” of ideas and hopefully a shared vision about the profession with the massage client in mind.
Emmanuel, my request is referred to as transparency. As a writer, I am interested in the back story.
If I may paraphrase a brilliant colleague, “I think there are too many groups directly or indirectly working on this. And none of them have any actual weight or authority to impose standards (for better or for worse).”
Emmanuel – There is no crossbreeding of ideas in this project and no shared vision. This is the work of one organization who is giving patronizingly accepted input into the project hoping to get “buy in”. Transparency is exactly what is lacking, not only with this project, but with the majority of the leadership of this profession. The AMTA Board of Directors agenda is kept secret from its members and the public. The AMTA BOD meets in secret or inaccessibly most of the time. The “Summit” is in secret. Why are our leaders so paranoid? If they are doing what is best for US, there should be no need for secrecy. If they are doing what is best for them, they must hide behind closed doors and spin (Propaganda). What is wrong with this picture? What is our leadership doing that needs to be in secret? Yes, there are justifications for closed sessions but not for general business and most certainly not for projects that have the potential to dramatically alter the profession. Trust not – the price of freedom is eternal vigilance .
I will have much more to say about this ELAP project once it officially released.
Ralph, it’s seven organizations talking. There is more than one mindset in those meetings. If you think that they come from the same belief system, please elaborate, I am not following.
Even if it were true that any of these organizations is “giving patronizingly” hoping to get “buy in”, is giving not valuable unless it is done solely out of altruism and high ideals? Value can still be derived from these talks. Many of us have called for these organizations to come together for years, and it is finally happening; it should be a welcome event.
Susan, I agree with the statement that there are too many groups working on this, and that none have actual weight or authority to make standards. That is perhaps why I am not very alarmed by this project. Some of the online discussions on the topic of entry-level standards, in particular those that take place in the open, are more alarming to me because they seduce the audience into simplistic thinking.
So many questions need answering by “us”, the profession, before we can truly approach this project seriously.
• What is the “entry” level for a practice with options that span the gammut from gentle, palliative touch to serious corrective interventions?
• Is entry level “pre-clinical” and clinical is advanced? Does everyone need clinical knowledge to work in all settings?
• How important is taking a history? Is this needed in all settings? How detailed? Written or verbal?
• Should we distinguish the profession along the lines of clinical/non-clinical (location), wellness/medical (intention) or some other idea? If so, should this be done at the legislative level or at the diplomate level (advanced certifications)?
• What is “needed to be known” to be “safe and effective” or “safe and competent” in non-clinical settings?
o How much physiology is needed; how much pathology?
o Do we believe that being “safe” includes really understanding the diseases and dysfunctions of the body to recognize them in clients?
o Do we believe that one must know a bit about pharmacology to give a massage at a hotel or day spa?
How much knowledge will make us “safe” to spot a problem with a client when they list the myriad drugs and supplements they take on a daily basis. (remember, many, if not most spas do not take written histories)
Without becoming pharmacists ourselves, how much should someone know to make this information useful? Is a little knowledge potentially dangerous, especially when so many of us explore and share some of the most esoteric trends in folk remedies, health experiments and modern healthcare innovations with our clients?
What should we be allowed to do with that information (pharmacology or trends)? Is it just so we can recognize contraindications and pass the client to a doctor or can we make suggestions of things for them to use in a self-care regimen or to support the positive changes your work has made?
These, and other questions like them, when answered, would really help make this an achievable process with support from the profession as a whole. It will help clarify the muddy waters we are currently in that has us all jockying for territory and spheres of influence.
We are all on the same team, just playing different positions. We must, collectively, look at the bigger picture and see the intertwining of energies we can bring to the support of the greater goals and needs of our profession. The summits provide the opportunity. Let’s use them wisely.
Twenty-five years ago, we spoke of being an adolescent profession, just beginning the phase of self-determination, discovering our options. I would say that now we are in the post-pubescent phase when we declare ourselves clearly and set the tone and direction for our journey into adulthood. Whatever the outcome- simple basics/enriched basics, one tier/two tiers, non-clinical/clinical, or something else- we need to work together as we bring our profession into the “maturation phase”. Are we adult enough for the task?
iris
Iris, you ask truly excellent questions.
Those are definitely issues that we need to take into account as we figure out what path we want to commit to, and whether we want to take that path together, or whether different groups of us have different goals that are irreconcilable.
We have a great deal of work ahead of us in figuring that out.
“Some of the online discussions on the topic of entry-level standards, in particular those that take place in the open, are more alarming to me because they seduce the audience into simplistic thinking.”
I can see why you might think that it is simplistic, Emmanuel, but the point of the discussion that we’re having over at LinkedIn is that–in order to be fair–educational objectives have to be clear, understandable, and reproducible in a way that a teacher can fairly evaluate whether the student has succeeded at the competency being evaluated.
The client needs to be able to depend on the MT reliably delivering what is promised, and showing that they can deliver that reliably as a competency for a teacher to evaluate in a classroom situation is a way of attempting to ensure that they can deliver that competency reliably in a practice situation without supervision.
It’s very hard to put massage as art or massage as self-expression into a box like that, but if you have any ideas how to go about it, we’d love to hear them.
You can think of competencies as a floor, rather than a ceiling–we’re not putting any limits on how high you can go if you want to, just that there is a floor of what is considered core to massage, and if this foundation is missing, it is not massage.
To clarify my previous statement, I did not mean that the work done in the LinkedIn group was simplistic – it was quite involved. But it comes only from the education angle, and that can lead the audience to think that this is all. It is not. It is only one angle.
There are many other aspects to the profession – starting with the client who as correctly Ravensara pointed out needs to depend on the MT to deliver what’s been promised. Just like educators, employers, therapists – those who seek integration in healthcare and those who do not, schools, and of course the states boards who are called to enforce those entry-level standards.
Market efficiencies, hidden costs to the consumers, the ability to find a job that pays decent wages to pay back entry-level education are often are not considered.
There are also many angles to massage. The way that states were lobbied to regulate massage therapy, much of the work that could be done by MTs is left to others. This does not serve the clients and leaves a lot of money on the table for others to take. Right this moment, there are people out there are performing what looks like and feels like massage therapy and who take business from MTs, but they are unregulated because they fall under ‘asian bodywork’ or ‘personal training’ or ‘pilates’ or ‘reflexology’, etc. In the eyes of the public they do massage therapy.
Back to my original statement, I am less concerned about 7 organizations that reseprent all of the profession (it would be nice if employers had a seat at the table too) than just one aspect of the topic being discussed and causing people to line up behind it.
In this discussion of what constitutes “entry-level practice”, it’s essential to look at the status of regulation in the massage therapy field, the overall nature of the marketplace, and the real problems are that hurting this emerging profession.
While the number of instructional hours required for licensure in the regulated states varies from 500-1000, all of these state credentials are “generalist” in their scope of practice. There is no separation between so-called “relaxation/wellness” massage, and “clinical/medical” massage. A broad scope of practice gives therapists the greatest ability to work as they see fit, according to the needs of their clients and the limits of their training.
The many points of differentiation within the massage/bodywork field are more appropriately addressed through specialty certification that would come into the picture after state licensure. (NCBTMB is said to be working on this as a future goal.)
Without migrating to a 2000+hour educational standard like four of the Canadian provinces, it is not possible to deliver a massage school graduate with 500-650 hours of training who is fully qualified to address a full spectrum of medical/clinical applications of massage therapy (or other areas of advanced practice). That’s where post-graduate training comes into the picture.
Looking at the massage marketplace in the U.S., there is strong demand for relaxation/wellness massage services, as evidenced by the astonishing growth of massage franchises and massage services within the spa sector. From the information I hear, many of these businesses are always on the lookout for qualified therapists. It is not realistic to expect a practitioner who has gone through a two- or three-year massage curriculum (like the Canadian standard) to work at this level.
The option of two-tiered licensing has been tossed about for a long time, but I do not believe it is a sound solution to the core problems we face in our field. The sequence of mandatory generalist licensure at the entry level followed by voluntary specialist certifications at the post-graduate level would provide the needed credentialing and recognition for those who seek to advance their careers. This would keep state regulation out of micro-managing the practice of massage therapy — something which it is not designed, or is well-equipped to do.
The real challenge is how to improve the quality of entry-level massage training programs. As I’ve written about in other venues, there are several identifiable factors: 1) lack of instructors who have been trained in the theory and methodology of teaching; 2) poorly-designed curricula; 3) lack of admissions standards in many institutions; and 4) the loss of fundamental knowledge of what constitutes an effective basic massage treatment within the context of a secure client/therapist relationship.
As I understand it, the Entry-Level Assessment Project was introduced to address the issue of the different number of hours required for licensure in the many states. This project is being pushed through by the major massage associations in an effort to reduce the “portability problem” by coming up with an “evidence-based” number of instructional hours that should be used by states.
Impediments to professional mobility may be a bother to therapists who seek to work in other states, but this long-standing situation is not hurting the public or the overall growth of our field. There are more important needs on the table. If the major organizations in our field are going to band together to solve big problems, let their focus and resources be devoted to the places where it will make the most dramatic difference. The solutions are not quick, cheap or easy — but they will pay off in the long run.
Rick Rosen, MA, LMBT
Founder & Co-director, Body Therapy Institute
Founding Chairman, North Carolina Board of Massage & Bodywork Therapy
Past Executive Director, Federation of State Massage Therapy Boards
Past Executive Director, Alliance for Massage Therapy Education
WELL SAID RICK