Calling All Massage Organizations: 911

I’ve seen some ups and downs since joining the massage profession about 15 years ago, but never, in all that time, have I been as disgusted and dismayed with one of our organizations as I am today. I feel as if I have a vested interest in all of them, so I have the right to complain—and to call on them for help.

The National Certification Board for Therapeutic Massage & Bodywork was the only path to licensing in many regulated states for a lot of years. Their exams are written into the statutes of about 40 states, as is the MBLEx, which has soared in popularity as the exam of choice in the past 5 years. The exam revenue at the NCBTMB has been steadily declining ever since the MBLEx debuted. The “National Certification Exams” as they formerly existed are the same exams being used for the NESL.

It used to be that taking one exam gave you the status of being Nationally Certified and being able to use that to get your license, but that’s no longer the case. There’s no attraction there anymore. The Federation has been in a position for several years to help solve this problem by buying out the NCBTMB’s entry-level exams; they certainly have the money and the infrastructure in place, but they have apparently preferred to stand by and watch the NCBTMB die a slow painful death rather than be in collaboration. Although I have favored the idea of such a deal in the past, at this point in time I am not going to blame the FSMTB for their refusal to play ball.

The majority of regulated states also have it written into their statutes that the continuing education required for maintaining licensure must be from a provider of CE that is approved by the NCBTMB.

As a provider of CE, I was not pleased when the Federation brought up their MOCC (Maintenance of Core Competencies) plan, which would have made all CE optional, with the exception of classes related to public protection, put forth online by them. My concern was that it would put a lot of CE providers, including me, out of business. In reality, based on some of the claptrap that is approved by the NCBTMB, there are a lot of CE providers that should be put out of business. The NCB’s response to my own repeated questioning of some of the things they have approved for CE has not been satisfactory to date.

According to FSMTB Executive Director Debra Persinger, they have let go of the MOCC plan, based on feedback from the profession and member boards. Instead, they have put forth a Standardized License Renewal Recommendation. In a nutshell, the language reads: Licensed massage and bodywork therapists will be required to complete six (6) hours of license renewal requirements annually. At least three (3) of the six hours must meet the State-sponsored Ethics and Professional Practice course requirements that specifically address content pertaining to public safety. The remaining three (3) hours could be exchanged for certain Professional Development activities, including but not limited to meeting accredited certification standards, community service, and research.

Bear in mind, that has not been written into the law anywhere yet that I am aware of, and it is what it is—a recommendation.

In my conversation with Persinger this afternoon, she informed me that the online classes pertaining to public protection will roll out in 2014, and that states that require in-person classes will still be able to have that. She also stated that at the annual meeting of the FSMTB held earlier this month, the member states asked that the Federation form a new CE Task Force to look into the possibility of approving continuing education.

I can recall what I thought was the beginning of the downhill slide at the NCBTMB…and it was years ago. I’ve seen an egomaniac that was hell-bent on bankrupting the organization elected to the Chair position. I’ve seen lawsuits filed against them by two of their former executive directors that dragged on for years. I’ve seen the lawsuits they have filed against state boards for getting rid of their exams. Yes, they had the legal right to do that, but in the big picture, it didn’t win any friends for them. I’ve seen the ridiculous, totally un-credible, fantasy-land classes that they have approved for CE credit. I’ve seen the failed plan to turn into a membership organization, which cost them several years of being banished from AMTA conventions.

I’ve also seen the failed attempt at an “Advanced Certification,” and the morphing of that into “Board Certification.” The NCBTMB website states that those who are currently Nationally Certified must transition to Board Certification by their next renewal. Unfortunately, I have heard this past week from two prominent massage therapists, both of whom had let their national certification expire 6-7 years ago, that they received invitations to be grandfathered in on the new Board Certification. They declined for ethical reasons. Personally, that makes me feel as if my own certification is about as valuable as a used dinner napkin.

I’ve seen their attempts to present themselves to massage schools and certificants as if they are some sort of regulatory organization by using language that insinuated that. I’ve seen their attempts to replace lost exam income by gouging the hell out of CE providers. It was only when they were faced with a mass walk-out of prominent providers, who said they would give it up, rather than go along with the plan, that they had to back up and punt.

I’ve seen times when people could not get a phone call or e-mail to the organization answered, and times when it took months for certificates and approvals to arrive, if they arrived at all. I’ve seen an example, just yesterday as a matter of fact, of them blocking people, including me, from posting on their FB page because they had the nerve to complain—and that was after the new Chair encouraged people on my own FB page to make their comments there. I’ve seen well-respected, seasoned colleagues who are experts in massage organizations and government relations offer to help them and give them advice about how to pull themselves out of some of the messes they’ve made, and I’ve seen that help refused or ignored time and time again. I’ve seen their adamant refusals to own up to their mistakes. My distress with them is not new. It’s just been festering for a long time.

I think the NCBTMB has reached the tipping point. Some would even say they are long past it. I have, in the past, given them hell about some things, and I’ve also come to their defense many times, including some when they probably didn’t deserve it. I have stated many times that I wanted to see them survive and thrive, and I sincerely meant that.

I am sad to say I am no longer holding out that hope. I am sad to say that I think they have outlived their usefulness. I am sad to say that I think their credibility has been shot beyond repair. I am sad to say that although there are staff and volunteers there that I personally know and like, and believe have the best of intentions, things have gone too far. They’ve had years to turn this ship around, and it hasn’t happened.

Therefore, I am calling on AMTA, ABMP, AFMTE, and FSMTB to immediately pull out all the stops and use all their available resources to help get the NCBTMB out of all statutes and administrative rules, as it relates to approval of their exams and use of their Approved CE Provider program. There are only a handful of states that approve their own CE, and if the NCBTMB were to suddenly go out of business, confusion is going to reign in those states that still have the NCBTMB exams and CE provider requirements written into the law.

Removing them from all statutory language in the regulated states doesn’t necessarily mean the NCBTMB will go away. They may continue to limp along for a few more years. They may someday come to their senses and create some valid specialty certifications, and reestablish themselves as a viable entity, but at this point in time, I doubt if they have the financial resources to do so. They’ve wasted a whole lot of money on their previous missteps.

Lest anyone get the idea that I am happy about making this request of our other organizations, let me assure you, I am not. I am sad to see that one of our national organizations has fallen this far. It’s time for positive action, and since they’re obviously not going to take it, the other organizations are going to have to seize the moment. I would suggest orchestrating a hostile takeover, but one of my colleagues who knows much more about regulation than I do informs me that’s impossible due to their structure, so this is the next best thing.

The FSMTB is able to offer government relations support to their member states, and AMTA and ABMP can afford the lobbyists. As a young organization, they don’t have enough resources yet, but with financial aid from the other organizations, AFMTE could be a great alternative approval body for CE. COMTA could possibly step into that role as well, but again, they don’t have the financial resources that the other organizations have. I call on all of them to set it in motion immediately to get the NCBTMB out of all statutes. We all know how slow the government moves so it won’t happen overnight, but I believe it has to happen. The FSMTB has been working on a Model Practice Act, so the time is ripe.

I also suggest that anyone who is Certified, as I have been since 2000, examine what that really means to you. Personally, I will not be renewing mine. There was a time when I was proud to say I was Nationally Certified. That time has now come and gone.

30 Replies to “Calling All Massage Organizations: 911”

  1. This is so disheartening. I am looking to become a CE provider. What avenues do I have now? or do I just give up this dream.

  2. Sad but true Laura. I mentioned in a recent blog post of mine that NCBTMB is missing a great opportunity. Chances are when my Certification is up in 2016 I won’t renew as well. I see no advantage to it.

  3. Very well written. The NCBTMB has been a train wreck waiting to happen. I wonder how the other organizations will scoop up all the pieces left on the tracks. I like the AFMTE and its genesis and hope that somehow it will thrive for the long term.

  4. I let my “national certification” lapse years ago. After a few years, I realized they weren’t bringing me any benefit for the money I spent with them. No resources, the general public knows nothing about them so it didn’t bring me any additional credibility, and I had a hard time getting info from them.

    Turns out that dropping them changed my professional life…….not one little bit. I’ve watched with dismay their spasmodic responses to the changing field, and have been particularly offended at their blatant attempts to keep themselves financially solvent on the backs of CE providers.

    I wish they’d woken up 10 years ago and moved with the times. They didn’t, they haven’t, they need to get out of the way.

  5. This was long time coming. I let mine lapse years ago. High cost, low support to their membership and lots of politics. It used to mean something in the absence of state laws but that ship sailed long ago. The CE arena will continue to be eclectic although more states ( like NY and FL) will become ones to grant approvals. I’m not sure that’s so great either. The NCBTMB was always primarily focused on revenue with little attention to members.

  6. I’ve been saying for awhile now that they have made themselves irrelevant. I’ve dropped all affiliation with them. The school I run prepares students to take the MBlex, the state license doesn’t require it and CEs won’t either. It is disheartening that other states have written a private organization like NCBTMB into their laws. Now all of that should definitely be undone. I have had numerous phone calls from graduates who call them to ask a few questions about renewal. They have been lied to about absolutely needing to renew their certification. This organization has never operated above board in my estimation. The time for it to go is long overdue.

  7. I have spoken to Dr. Leena Guptha this morning and let her know that the NCBTMB is welcome to respond on this blog. As she has only been the chair for a little over a week, I certainly do not hold her accountable for the mess at the NCBTMB.

  8. Laura, I’m in full agreement that it’s time to pull the plug on NCBTMB. This organization no longer benefits our profession, and it fails to serve (let alone protect) the public interest. There is no joy for me in stating this, as I’ve devoted a considerable amount of time in recent years offering strategic planning recommendations to NCB’s leaders.

    Removing NCB from our organizational matrix is not like dealing with an alcoholic family member who can’t stop drinking. In this situation, we can’t just lock up the booze, take away NCB’s driver’s license and send it to rehab. Because NCB has established a formidable position in state massage regulations with its exams and its CE provider approval program, the process of change will be difficult and protracted. Amending statues and administrative rules can only be done on a state-by-state basis, and each state’s process is different.

    The exam solution is straightforward, because the MBLEx is the right tool for the job. FSMTB is the legally appropriate organization to be owning and managing the entry-level licensure exam on behalf of its Member Boards. NCB has again tried to pull a fast one with the recent rebranding of its entry-level certification tests as “National Licensure Exams”. State boards must move with all due haste to remove all references to NCB and its exams. AMTA and ABMP have the resources to devote to this task, and FSMTB needs to facilitate the effort with its Member Boards. It’s long overdue.

    The approval of continuing education courses used for state license renewal is a far more complex problem to solve. Just taking NCB out of the mix will increase the number of individual state-based CE approval programs, which would be a step in the WRONG direction. We need to bring all CE approval under one roof.

    In February of this year, I published a 25-page white paper on CE regulation in our field that examined the problems with the CE approval programs of both NCB and FSMTB. (You can access it at: Because neither organization has put forth the needed unified solution for CE providers, therapists and state boards, I proposed a new National Continuing Education Registry for this purpose.

    While the concept is eminently workable, the big question is what entity would house and manage this single-source CE registry function? NCB is now toast. FSMTB had the opportunity to step up and offer a comprehensive solution, but it instead put forth a weak program that fails to address the basic needs. COMTA is too small at this point and focused on its own existence as a specialty accreditor. AFMTE has no administrative framework at the present time — just a dedicated group of volunteers who are keeping this important stakeholder organization going. AMTA and ABMP are both large-scale providers of continuing education, so they have a conflict of interest that renders them unacceptable for this function.

    As I look at this landscape and the inherent problems with each of the organizations that Laura suggested in her blog, I believe we would be far better off with the creation of a neutral entity to handle a simplified and streamlined National CE Registry program that could be referenced by state massage boards. It doesn’t matter whether it’s a non-profit or for-profit, or whether it’s self-managing or served by a dedicated management company. It just needs to work.

    I call upon the leaders of AMTA, ABMP and FSMTB to step up and take decisive action here for the future of the massage therapy profession. It’s time for an intervention.

  9. So if it is not worth paying the NCBTMP to become a Continuing Education Instructor, what do we do to provide a course that gives credits?

  10. Thank you for posting this Laura. It’s important information and I’m grateful you’ve taken the time to write your thoughts and concerns, you said it better than I could!

  11. We have thoroughly reviewed your blog post and take your comments seriously. We will be discussing this extensively with our Board throughout the day.

  12. Thank you Laura for your due diligence.
    The reason why Tylenol is the most trusted brand in America is because Tylenol had a problem, told the truth and remedied the problem.
    Did you know that FSMTB has extended the proverbial olive branch on many occasions to NCBTMB.

  13. Quite frankly, the only time therapist cares about any professional organization’s status is when renewal of license is looming. At this point, with the proliferation of online continuing ed courses, hands on courses are on the way out.

    Regardless of certifying organization and the competency of the teacher, all these CE courses do not guarantee the competency of the attending therapists. The entire system is broken because it was never set up correctly at the onset.

    Let us not fool ourselves! We are all part of the problem. Capitalism can be a dangerous bedfellow. Massage schools are in business to make money, giving tools to the student. I use the analogy of the art student: institutions admit anyone meeting a bare minimum qualification(ability to pay), most end up house painters. A rare minority end up as true artists. Our profession suffers in the same way.

    No amount of educational book testing(online, in person), will guarantee competency. Only practical testing will give us an indication of the true abilities of our therapists.

    Ironically, back in 1993, the City of Tucson had one of the most comprehensive testing programs, utilizing both the knowledge-based testing offered by NCBTMB, and a practical exam requiring the licensee to demonstrate knowledge and ability of basic strokes. When bigger and “better” state licensing took over, the practice of onsite competency exams went by the wayside. Are we so greedy that we should bypass the most important element of our profession?

  14. I have been practicing Massage Therapy since 1997 and have never been Nationally Certified, as PA did not require it. We have now had licensing for 3 years and it is written into our law that it has to be NCBTMB approved continuing ed. I am aware of all the reasons for licensing, but it has done absolutely nothing to create any business or credibility for me. I feel that Certification and/or licensing does not make me a good and ethical therapist. My skills make me a good therapist. Most of my clients have no clue if licensing even exists. I have taken numerous continuing ed. classes over the years, on my own, and take them to increase my knowledge and skills.

    I have read about some of the issues stated above over the years and thank you for making the issues understandable and concise. I will be watching for more of what is happening and hopefully ABMP will keep their members updated. I am also willing to help with working out solutions.

  15. I let my certification lapse in 2011 and never renewed it. I didn’t see the value for my money since it wasn’t required by the state to keep it up and I had other bills that needed to be paid at the time.

  16. thanks, laura, for your writing. it gives me a view on what’s happening with a topic that is near and dear to my heart: continuing education for massage therapists. while i’m not as plugged in about which tests are used or should be used for therapists graduating from school and looking for legitimacy thru licensing, i do have opinions about teaching continuing ed classes since i’ve been ncbtmb approved since 2008.

    i knew the ncbtmb has been in trouble for quite some time, although when i was at the 1st afmte meeting in park city, utah, some years ago, i met with the then head, neal delaporta, and it seemed as though things were going to make a change for the better. i guess not.

    one thing that was really clear, tho, at that conference was that experienced therapists – those in the field for at least a decade – were all asking the saying the same thing, which was: why can’t we find a good massage? i was appalled to hear this coming from someone at a microphone at the front of a large room. but i also had to agree, and for so many reasons.

    i like what rick rosen has said about the need for a neutral entity like a national ce registry with standards for acceptance and approval of both instructors and courses. i am disgusted with the wildfire-like spread of online courses that teach modalities without any practicum. i’m equally disgusted with the proliferation of in-person courses that have NOTHING to do with massage or bodywork that can give someone 24 or more credits in 2 or 3 days. it’s ridiculous, and the ncbtmb has gotten an earful from me about it several times over the past few years.

    so, i wonder if something can be or will be done to get the afmte up to snuff for such a task as oversight for ce’s and providers thereof, or if something entirely new needs to be created???

  17. Thanks for the article Laura. My certification is coming due in February and had decided not to renew, but good to have other’s thoughts about it.

    If NCBTMB goes away, there will be a lot of scrambling by other organizations to be the Approvers for CE’s. Will also be a lot of confusion. I like the comment that there should be one agency to approve providers. I think that has been what the NCBTMB has been, but has handled itself poorly.

    I think CE’s are important and providers need to be vetted.

    There may be a few courses that can be taken online, but I think in-person learning (or enhancing) a technique is the most valuable.

  18. This was a long commentary which covered so much. I have been frustrated as well with NCBTMB but just as frustrated with our State and other entities in our profession. I would like to throw out a caution that we must watch out to just jump on the bandwagon for FSMTB to be a savior especially when they are throwing out non sense trying to get into the CE game. I am a CE provider and teach off and on in massage schools and anything like what they have been proposing we should be against. Although any National Certification that was not going to achieve easier portability from State to State in my opinion had a limited lifespan anyway. I do believe in my opinion that the NCBTMB could really make themselves valuable by going into the special certification market by getting certification approved for Asian modalities which are becoming more and more sought after like Ayurvedic Practitioners, Naturopaths, herbal medicine etc.. It seems that whenever practitioners get upset with what’s going on in the massage/bodywork profession we think or feel it makes us sound and look good that we have tougher and harder standards. How about we come up with something where our profession or the public wants to pay us what we are worth or education about the necessity of our work and service so the majority of us can make true living! since 2007/8 most of us are most likely still struggling. Employers are paying damn good practitioners crappy $10 to $20s an hr. This is sad for a profession that has to put out so much money to keep a license and what they had to go through to get it. The cream will always rise to the top on any profession so for an experienced massage therapist to say “can I get a good massage” is ego! I feel our energies could be put to better use on educating the public on our awesome Art and how much it could serve them in their medical, wellness, and over all wellbeing because our modern medical system although it has it’s place it is failing them on the most part.

  19. The Federation is still proposing continuing education be voluntary. We all know that means it will put thousands of people out of work.

    The 6 hours of State-sponsored Ethics and Professional Practice annually that Laura quotes, are to be administered exclusively by the Federation. It is basically a CE program but the Federation doesn’t call it that because doing so puts it back in the realm of the CE provider. This way the Federation will have a monopoly on education for license renewal.

    All the Federation has to do is sit back and wait. The NCB is behaving so incompetently, they may lose all influence with the states. Since most states do not want to regulate continuing education, they may drop it in favor of the Federation’s 6 hour of State-sponsored Ethics and Professional Practice.

  20. Reviewing and approving CE curriculum is a huge responsibility, one that with the advancement of sciences and the demand by this industry for evidence for efficacy it becomes even more a mountain to climb.
    Regardless of anything the NCBTMB has done, it remains the responsibility of the State Boards to ensure the CE they accept for license meets with their own missions to “protect the public safety” and “ensure the highest standards of education” they profess to support.

    Lets call out the State Boards, shall we?. It couldn’t possibly be true that any State Board handed over their legal responsibilities to the public they serve and protect to the NCBTMB, could it?

    Regardless of what the NCBTMB approves it is ultimately the State Board that must “ensure the highest standards of education” for the therapists they regulate and choose what CE courses they deem fit to support their mission and purpose for existence. Anything other than that is pure laziness and negligence, and they will honestly have to face the music very soon.

  21. Hmmm…
    Reviewing Laura’s post over the past year I see that all the major “professional” organizations in our profession have had downfalls:
    June 24, 2013 ELAP put together by AMTA & ABMP Stop insulting our intelligence!
    May 20, 2013 The Federation of State Massage Therapy Boards: All talk and No Action?
    September 28, 2012 Politics and Cliques: similar to what we are looking at here.
    Also, not in a post, October of this year AMTA has plans to change their bylaws to limit access to board positions at the National level.

    So how do we remove the Politics and Cliques?
    Barry says it well:
    “I feel our energies could be put to better use on educating the public on our awesome Art and how much it could serve them in their medical, wellness, and over all wellbeing ”

    How do we get our organizations to realize we need PROFESSIONAL help! Organizational Analysis, Check out this course on Coursera free online education (Thanks Sandy Fritz for the tip on coursera)
    There are professionals out there that can help and our organizations are not poor (Laura also has posts on their financials), so why do we continue to fight amongst ourselves? Not one of the organizations meets all our needs, nor should one. We should be able to compliment one another and build upon each other instead of tearing each one down.

    I would like to see the organizations that are suppose to be working for the people, realize the infinite possibilities when we work together.
    I always look for the rainbow when it rains.

  22. The major organizations have been coming together now for a couple of years in their twice-yearly Leadership Summits. There was collaboration on the MTBOK. There has been collaboration on the ELAP, and although I was not crazy about the way it was presented or the way the survey was conducted, I do appreciate the collaboration that has gone into it. The FSMTB itself is a collaboration–all the state boards coming together in the interest of finding solutions to common problems.

    The problem child here is the NCBTMB. Politics aside, when we have a national certification board approving “Shapeshifting” and “Creative Healing with the Flower Devas” (a deva is a fairy, in case you are unaware of that) for CE credit, how much professional credibility can we have? And maintaining that it is not their job to decide what is good or bad in holistic health? Do you think the specialty certification boards in medicine take that tactic? Do you think they would approve “Performing Heart Surgery with Your Atlantean Hologram?” or “Don’t Bother With that MRI, Use Your Psychic Power Instead” ?

  23. Thank you, Laura. It is also my opinion that the only left of value that NCB does is certify continuing education. And they are not doing it well. I am planning on NOT renewing my CE credential next year, but I worry because it is still required for the remaining certificants. I have read with interest all of the suggestions. I struggle with forming yet another organization, especially during a time where organizations are joining together to share resources in order to stay afloat. it is not financially viable to start anew, with a sole purpose. I would rather AFMTE find the support and resources to make this a part of their mission. While FSMTB could do it, it is really their purview to look out for entry level competency and consumer safety. I would rather have an organization that has a broader scope be responsible for our continuing education standards.

  24. I’ll say it before and I’ll say it again:

    It’s all too clear we’re on our own.

    They’re ALL money and power sucking organizations.

    I hope for the day when AMTA and NCB die a slow death.

  25. The Approved CE Provider program administered by NCBTMB (both previous and proposed new standards) does not CERTIFY continuing education. It’s a low-level paper review process by staff members (or volunteers on occasion) that is not sufficient to assess — let alone assure — the quality of the courses and the capabilities of the providers. That’s the heart of the problem, not the fact that some tangential courses being offered under the approved provider scheme.

    If you want to look at a true system of quality assurance for CE, visit the American Nurses Credentialing Center , where you’ll see their standards for the accreditation of CE providers and organizations. This kind of process is way out of our league, because the CE community in the massage therapy field is so diverse and diffuse. On top of that, most providers don’t have the money or the expertise to handle accreditation-level requirements.

    Since QUALITY assurance of CE is NOT possible or practical in our field at the present time, the National CE Registry proposal I put forth to the field earlier this year is based on a simpler and more streamlined system that would provide a measure of CREDIBILITY assurance for therapists and state boards. My proposal is centered on the use of a screening list of acceptable and unacceptable subject matter for CE courses.

    We’ve had a long run of hype from NCBTMB and inflated promises that could not be delivered. What we need now is a more honest and pragmatic approach that is based on where the CE community is today. Because NCB is no longer trusted by our field, we need a new and neutral entity to provide an essential service, with this National CE Registry.

  26. this is a very important topic well worth the discussion. whether it comes to governance of continuing education, or memberships in organizations we rely on to advance the profession and serve as an advocate, it is important to BELONG to a greater/larger organization. this is one of the basic needs of human beings, particularly professionals.

    I can definitely understand the lack of action by certain organizations, and thus the desire for many to discontinue their association and participation. our take however is to support organizations that are there for us, that have been formed just for us (advocates of the profession). time will tell whether these orgs survive, but for as long as they do, we are in full support. I do hope they deliver more benefits to their members however as I am an agreement with the comments left on this blog.

    thank you Laura for taking time to articulate your thoughts and give us the opportunity to provide our two cents on the matter.

  27. When I first graduated from massage therapy school in Florida in 2008, my class was told NCBTMB was mandatory. But I’ve gotten no benefit to it since, so I don’t renew through them. My first renewal year, I was so broke I took the cheapest CE I could find and it was all day about breathwork to relieve stress. Now with Groupon halving our income, I’d really like to see a professional elevation to our industry so we can continue to earn a living for ourselves and hold our heads up proudly.

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