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Report from Seattle and Some Further Explanation

I was invited to Seattle by Dr. Ravensara Travillian to speak at a fund-raising dinner this past Monday night, to kick off her efforts to get a university-level certificate massage program started. Dr. Christopher Moyer was the other invited speaker, so I felt like I was, as we say in the South, “in high cotton.” I had a great time visiting with Ravensara and her husband Iain, and Christopher.

Most of our visit was spent discussing the project. Raven invited me on the basis of my knowledge of regulation and legislation, of what our massage organizations are up to, and the state of massage therapy education in the US. Prior to my going out there, I contacted some of our leaders to make sure I had up-to-date information on what’s going on with them. In fact, this week the Coalition (previously referred to as the Leadership Summit) is taking place in Florida…the CEOs/EDs and Chairs of the Boards of ABMP, AFMTE, AMTA, COMTA, FSMTB, NCBTMB, and the MTF are coming together to discuss the state of the union, so to speak.

I truly enjoyed seeing old friends and meeting some new ones that I had previously only met on FB, and some I didn’t know at all. I appreciate the fact that they came to hear more about this initiative. Good conversation was stimulated, good questions were asked. The speakers were videoed and that will be released in a day or two, so I’m not going to rehash everything that happened there; I’ll share the video when it comes out.

I particularly appreciated the presence of Bodhi Haraldsson, who is the Research Director at the Massage Therapists Association of British Columbia. Bodhi was appalled at my report on the financial status of MTs in the US, provided to me in the form of the Annual Report from the FSMTB. Their information was obtained by a survey of MTs in the member states, and compiled from surveys that were sent out by the AMTA and ABMP to their members, and the NCBTMB to their certificants. All in all, about 200,000 MTs were surveyed. The piece of news that shocked Bodhi was that 61% of MTs in the US say that they cannot support themselves/their families with their income from massage.  Only 2% of therapists surveyed stated that they make over $70,000. According to Bodhi, the five busiest therapists in his own clinic make more than that. Personally, I think that’s a direct reflection of the high standards of education and the devotion to research practiced by our neighbors in BC.

Ravensara’s plan to take massage education up another notch has been criticized by people who don’t understand what it’s about. No one is going to be forced into getting higher education. Since I said this was the report on Seattle and a little bit more, I’m going to seize the moment to repeat a little of what I said there and go a little in depth about the environment of massage. There seems to be a lot of confusion about many different things that are currently on the horizon. One of them is the Affordable Care Act, which contains the stipulation allowing massage therapists to direct bill insurance as long as they are licensed as health care providers in their state. I see the comments all the time that “I don’t want the government telling me what to do.” “I don’t want to get bogged down by the insurance companies.” The ACA does not mandate that anyone has to file insurance. If you want to run a cash practice, you can carry on as usual. Those who don’t want to participate in insurance billing should not interfere with those of us who do.

Another thing that seems to be confusing people is the ELAP (Entry Leval Analysis Project). As I have stated on my blog on several occasions, I had issues with the way that project was rolled out and the way it was presented. However, I do think it will turn out to provide valuable information, and we’ll all know on December 16, which Anne Williams of ABMP informed me will be the unveiling of the 776-page document.

I have seen school owners stating that they didn’t want more regulations telling them what to do and how to run their school. Again, this seems to be a point of confusion. The ELAP is a research project. Period. It is not regulatory in any way. No one will be forced to adopt whatever policy recommendations might come out of it, because they will be just that–recommendations.

AMTA, ABMP, and the AFMTE all have benefits and annual conferences for educators. They have projects going on to educate teachers in research literacy, as does the MTF. AMTA has teacher-track classes and research-track classes at the annual convention. ABMP has an upcoming class in teaching the teachers to write core curriculum. None of these organizations are regulatory. They can show you how to write your core curriculum, suggest what should be included in it, and show you how to teach research literacy. They can’t make you do it, or make you do it their way.

COMTA, which is a strictly voluntary accreditation body and the only one that was founded for the specific purpose of accrediting massage therapy, although they have now also taken in aesthetic accreditation, spells out standards for excellence in education. I hear from school owners that they don’t seek the accreditation because they don’t want anyone telling them how to run their school. The Standards are on COMTA’s website for anyone to see, and I think it would behoove any school owner to do their self-study report to see how you stack up. COMTA does not limit what you can teach to evidence-based modalities, which personally I find unfortunate, but if you’re using that for the argument against it, you’re wrong. If you are teaching belief-based energy work at your school, you’re free to carry on. They want to insure that you are teaching what you say you are teaching and that you are including the subject matter that matters to massage. They spell out standards for good record-keeping, good financial practices, insuring that teachers are competent to teach their subject matter, having and abiding by policies and procedures, and other such things, and they ask you to document it in writing. COMTA is not a regulatory organization. There are other accreditation bodies out there that take in massage therapy, among other things, and they are not regulatory, either. It’s a voluntary process that allows you to say “Here are the standards we have chosen to meet.”

Even the Federation of State Massage Therapy Boards is not regulatory, in and of itself. They are an association of the boards in regulated states. They are soon to unveil a Model Practice Act that they have worked on for the past few years, and they would like for the states to adopt. Notice I said “they would like for the states to adopt.” The purpose of that is to make practice acts uniform and facilitate reciprocity. It could require legislative changes in every state that already has a practice act, should the member states chose to adopt it. I don’t look for that to completely happen in my lifetime. I do imagine it will be discussed this week by the Coalition, along with the ELAP and other issues they are considering.

A couple of months ago, I sent the leaders of all the organizations my blog urging them to pool resources to get the NCBTMB written out of the statutes in every state. I am hopeful that topic will be discussed as well. The NCBTMB is not a regulatory organization–but their exams are written into the statutes in many states. That represents an improper delegation of authority; there is no government oversight and no public accountability there. This is not a vendetta against the NCBTMB; it is an attempt to rectify something that has been wrong all along.

Now I’m down to the function of state boards. I constantly get complaints from people about how long it is taking them to get their exam scores or get their license. There is no true reciprocity in the United States. The fact that you have a license in one state does not include any kind of guarantee that you’ll get one in a different state, regardless of how long you may have been practicing. Most state boards have it stated on their websites that processing out of state requests takes longer. My own experience in serving our state board for five years was that many times, a license is held up because the applicant failed to provide a piece of documentation. Sometimes, the holdup is that they have to check out your transcript to make sure your education in the state your are coming from stacks up to the education required in the state you are moving to. If it doesn’t, you can be denied a license. If you are lacking the documentation, you can be denied a license. They cannot take anyone’s word for it that “I have this, I have that.” If you don’t have the required paper trail of evidence, you’re not going to get it, period.

State boards are the ONLY regulating bodies in massage. They are the ONLY ones who can tell us what to do. The other organizations can suggest. The other organizations can lobby legislators to get laws passed or changed–and state boards can’t. State boards exist for one purpose: public protection. They are not here to serve the interests of massage therapists. They are not here to cater to us or to cater to schools. They exist to license therapists, to spell out the requirements for getting a license, to spell out what they expect from schools, and to deal with complaints from consumers.

I hope that clears up a few things for people. I see misinformation spread around on social media all the time, and all that does is perpetuate misinformation. If you are a massage therapist, you are obligated to know the law in your state. If you are planning to move somewhere, you need to learn the law in that state, prior to packing up and going there. I’ll go further and say that a board member recently said to me “I don’t know the bylaws and rules the way you do.” If you’re going to serve a board, then it’s your business to know them up one side and down the other. Ignorance is not bliss and it’s not an excuse, either. You can’t uphold the rules if you don’t know what they are. The burden is on you.

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Report from the AMTA National Convention

I arrived in Ft. Worth on Wednesday in time to attend the House of Delegates preliminary meeting, which was quite exciting. I was only an alternate this year so I did not get to participate in several spirited debates, one concerning the ACA, and another concerning delegates who arrive late for the meeting (they don’t get seated–something I am in total agreement with.) I spent the evening at the Lippincott author’s dinner, something I always look forward to. Authors and educators Ralph Stephens, Ruth Werner and her husband Curt, Pat Archer, Celia Bucci, Joe Muscolino, Diana Thompson, LWW Publisher Angus McDonald, Acquisitions Editor Jonathon Joyce, my wonderful editor Linda Francis were all present, and I’m probably forgetting someone! We dined at Reata, which served great Tex-Mex food, and the service was top notch.

Thursday morning, the opening ceremony was great. Doc Hendley was the keynote speaker. He is the founder of Wine to Water, and a fellow North Carolinian. He received a standing ovation and had some people in tears, including me. His life’s work is providing clean water to people all over the world who do without it, and it really makes you realize how much we all take for granted. President Winona Bontrager recognized long-standing members and handed out awards, including giving the President’s Award to Rick Rosen, co-owner of the Body Therapy Institute in Siler City, NC, and recognizing him for 30 years of service. Rick has contributed so much to this profession, I’ve actually written a previous blog about him. Congratulations to him for well-deserved recognition.

I had another chance to catch up with Joe Muscolino on Thursday when we shared a table at Starbucks. He is such a smart man who has been around this business for a long time. I’m hoping to attend his dissection class one of these days. Back to the House of Delegates on Thursday evening, where three position statements were considered.

Thursday night, the North Carolina Chapter went out to dinner together. Great to catch up with everybody. I walked back to the hotel with Joel Tull and we got slightly lost…which was okay…we took a good walk! Joel is a sweetheart and a gentleman, and he told me an Irish joke, which I won’t repeat here, but it was great to visit with him.

Friday I visited the Massamio booth for my appointment with Michael Reynolds. His task was to whip me into shape at using HootSuite, and he gave me some great advice. He and Allissa Haines were busy, busy, busy educating people about social media marketing. I hate I didn’t have more time to visit with both of them. That was the case with a lot of folks that I loved to see but just didn’t get to hang out with much.

Bruce Baltz saved me from a total meltdown by giving me a foot massage at the Bon Vital booth….shame on me for wearing a pair of flats all week, my feet were killing me! Note to self, don’t do that again!

On Friday I attended a presentation on the parasympathetic nervous system by Dr. Sandra Smith, Dr. Drew Riffe and Dr. Christopher Moyer. This was one of the research track classes and I was thrilled to see the room packed. The same thing happened on Saturday when Dr. Moyer taught a class on the effects of massage therapy on anxiety and depression. He’s a great teacher, and again, it was so wonderful to see the room filled with people who are interested in learning about and advancing massage therapy research.

Friday night I attended the reception for the Massage Therapy Foundation. I’m still trying to take it all in. AMTA’s annual donation to the MTF was $450,000. The Florida Chapter of AMTA made a $20,000 donation. The MA Chapter made a $10,000 donation. Massage Envy made a $10,000 donation. Then Massage Envy VP CG Funk made the offer that she would match up to $500 if someone passed the hat. Richard Wedegartner passed his cowboy hat around and in ten minutes collected over $800. He said next year he would wear a bigger hat. Biotone made a $15,000 donation, and Massage Warehouse made a $10,000 donation. Performance Health made a $2500 donation in honor of Diana Thompson, whom they honored for her many efforts on behalf on the profession. Outgoing President Ruth Werner also honored Diana, and I could not think of a more deserving person. I was really blown away by the generosity and dedication to massage therapy research that was on display. Thank you to every donor, whether your donation is big or small, it all helps!

Friday after the reception I spent some time catching up with Ariana Vincent. Ariana is dynamite in a small package! We actually roomed together Friday night and had a great chat.

After my class on Saturday I made a quick visit through the exhibit hall before heading to the airport. I missed the closing panel presentation on the ACA. According to Ariana, who took notes, the four panelists spoke knowledgeably about the health and legal ramifications. Therapists are encouraged to investigate thoroughly before jumping into the insurance waters, and reminded that you must be HIPAA compliant in order to accept insurance. The therapists in unregulated states will not be allowed to participate in insurance filing under the ACA. I’m sure there’s more but that’s the gist of it.

All in all, I had a great time. I always do! There is just something awesome about being with a couple of thousand people who do what you do! The Texas Chapter did a great job as hosts and we all appreciate it. Already looking forward to next year in Denver!

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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.

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AMTA: Supporting Massage Therapists for the Affordable Care Act (or Not?)

The Affordable Care Act goes into effect on January 1, 2014. This stands to have a major impact on the ability of massage therapists to be reimbursed by insurance. The 1300+ page document includes language prohibiting discrimination against licensed integrative health care practitioners.

Diana Thompson, well-known educator, author, long-time AMTA member and past president of the Massage Therapy Foundation, recently shared with me a letter she sent to the BOD of AMTA, expressing her concerns that the organization is not supporting the movement of massage therapy into the mainstream as a health care choice. In the letter, Thompson went so far as to call out AMTA for not operating according to their own bylaws, which include the mandates that the organization is, among other things, to

(D.) Promote legislation that supports and upholds, and oppose legislation that harms
and damages, the massage profession;

(E.) Protect and preserve the rights of its members;

(H.) To advocate the rights and interests of persons seeking massage therapy as
health care;

Thompson was moved to write the letter to the BOD after a recent meeting of representatives of CAM professions, held at Bastyr University in Seattle. After the meeting, the purpose of which was to discuss the ACA, Cynthia Price, PhD, LMP, who attended on behalf of the Academic Consortium for Complimentary and Alternative Health Care stated in her report to Executive Director John Weeks:

“I was very pleased to attend the Region X/ACA meeting on Monday held at Bastyr this week.  It was a very informative meeting and a nice first step to bring clinicians from different CAM and Medical disciplines into one room together who all want to be better informed and care deeply about this topic.   Deborah Senn did an excellent introductory presentation on the ACA and the current concerns regarding the language that may put CAM providers at risk for inclusion/coverage.  With the exception of the massage representative from the AMTA, all the clinical speakers were excellent and very supportive of the ACA and interested in doing everything possible to support coverage by practitioners within their discipline.  These clinicians expressed similar concerns regarding the ACA and how it may or may not affect CAM services.  There were also clinical examples provided about how the ACA may positively impact certain disciplines, particularly NDs who provide primary care… On a side note, I am very concerned about the position of the AMTA…”

Winona Bontrager, President of the Board of AMTA, responded with a letter to Thompson that stated:

“We have spoken with some other people who attended the recent HHS meeting.  Some of those individuals were there representing other groups and of course our chapter members, and none of them came away from that meeting with the understandings you put forward.  We have no idea how Cynthia Price arrived at the statement she has made to you.”

Thompson also stated in her letter to the BOD that Price had specifically asked that Chris Studebaker, AMTA’s Director of Government and Industry Relations and the person who was representing AMTA at the invitation-only meeting, not be invited to attend future meetings, and that others besides AMTA should be invited to better ensure accurate and professional representation of the interests of massage therapists.

These are serious accusations. AMTA’s response is that Studebaker’s statements at the meeting were conveying the results of AMTA’s last member survey, which revealed that about 50% of the membership has no interest in third-party reimbursement. Bontrager, speaking on behalf of the BOD, stated that Studebaker is being unfairly blamed for things he did not say. Thompson states that she stands by her accusations.

Thompson also stated that she spoke to AMTA leaders about the need for support and action regarding the ACA on at least a couple of other occasions, notably at the last AMTA National Convention in Raleigh, NC and again at the IMTRC held in Boston earlier this year, and that both times was given “wait and see” and “we’re not ready” responses by the leadership.

This entire brouhaha brings to light several issues and bigger questions. First, lest there be any confusion here, even if the ACA results in every massage therapist in the country being eligible for third-party reimbursement, no one is going to be forced to accept insurance. Anyone who wants to keep operating a cash-only practice will be able to do so.

Second, if 50% of AMTA’s membership doesn’t want to participate with insurance clients, that means there is also 50% that does. Since the 50% who don’t want to are not going to be forced to participate, what about representation for the half of the members who do want to?

Third, I must agree with Thompson that this is not the time to “wait and see.” This is the time to be proactive. I will point out the position statements approved by this organization that clearly demonstrate the health benefits of massage therapy! If we can make that more available to the public who have insurance that would pay for it, shouldn’t we be doing that?

Diana Thompson is a long-standing and dedicated member of AMTA. She was instrumental in gaining the right for massage therapists to file insurance in the state of Washington, where 90% of AMTA members do bill insurance. I don’t believe she is on a witch-hunt at AMTA. I believe it came from genuine concern that a major voice that should be speaking out for us is not doing so. Her letter cited the research from AMTA’s own 2009 consumer survey that showed that 97% of massage recipients believe that massage should be considered as health care.

The field of massage therapy has been experiencing growing pains for quite some time. There are concerted and combined efforts going on right now to raise the quality of education, to raise the quality of teaching and education, and to raise the image of massage in the eyes of the public. AMTA has made many efforts in the past on behalf of the membership, and I urge them not to drop the ball this time.

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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.

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A Change for the Better at the Massage Therapy Foundation and AMTA

This past week the Massage Therapy Foundation announced that Gini S. Ohlson will become the new Executive Director of the organization, effective July 1. Ohlson has been the AMTA’s staff director for the MTF since 1998.

This is part of the paradigm shift between the two organizations, and I think it’s a good one. AMTA was the founder of the Massage Therapy Foundation back in 1990, and the Executive Director of AMTA has also always acted as the Executive Director of the Foundation. I’ve always wondered how well that worked out, since both organizations carry a lot of responsibility and it would seem to me to be a full-time job to fill either position. Both organizations have come to the same conclusion and have mutually agreed that it is time for the MTF to function more independently.

The Foundation will continue to be housed in AMTA’s offices in Evanston, IL, and the AMTA will continue to support the MTF, albeit in a different way from in the past. AMTA has traditionally paid the staff salaries for the Foundation staff. Under the new agreement, AMTA will continue to contribute to the finances of the MTF, but they will be paying their own staff salaries. AMTA has also committed to donating $50K per year earmarked specifically for massage therapy research.

AMTA’s new Executive Director, former Deputy Director Bill Brown, will be taking over when current ED Shelly Johnson steps down on May 17. I spoke with both of the at the International Massage Therapy Research Conference last weekend. I had previously asked Brown to consent to an interview for my blog when he takes over, and couldn’t resist jerking his chain a little bit by telling him I was going to have Johnson do a guest blog first entitled “Final Instructions for Bill.” Both have years of service to AMTA. I wish Johnson the best in her retirement and look forward to seeing what Brown will do as leader of the organization. AMTA and the MTF will continue to work together for the good of the profession, I have no doubts.

My attendance at the International Massage Therapy Research Conference last week just reaffirmed for me how important it is to support the Massage Therapy Foundation. I urge every massage therapist to support the Foundation in whatever way you can. If each therapist donated the cost of one massage per year to the MTF, that would be a huge amount of money. Just do it! You can donate here.

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Report from the International Massage Therapy Research Conference

This past week I was blessed to attend the International Massage Therapy Research Conference. This event is only held every three years and it was my first time attending. It was held at the Seaport in Boston, a beautiful hotel right on the harbor and right across the street from the World Trade Center, in a great part of town. We enjoyed excellent service from the staff there, so kudos to them.

I arrived on Wednesday in time to view the DVD showing of the International Fascia Research Conference from Vancouver. The presentations from that conference were fascinating, and that event will be the next thing on my wish list. Nothing is better at a movie than popcorn and Milk Duds, which were provided…some of the science presented was above my head, but hey–I went there to learn!

The Conference officially kicked off on Thursday morning with Massage Therapy Foundation President Ruth Werner making some opening remarks, followed by a beautiful blessing from three Native American ladies who were present. Dr. Jeanette Ezzo was the opening keynote speaker. Her topic was “Mechanisms and Beyond: What is Needed to Prove the Effectiveness of Massage?” I must confess I was taken aback at one of her early comments regarding acupuncture. She stated that although there was no scientific proof the meridians exist, that “the efficacy of it gets us off the hook.” I was rather surprised to hear that at a research conference where the focus was on scientific evidence. There was also a poster display, including one entitled “Is There a Place for Energy Work for Children Living With Autism?” It’s just my personal opinion that it was out of place there. That was my only complaint about the entire experience.

On Thursday I also attended a presentation on “Massage Therapy for Specific Conditions,” where four different researchers presented their studies on tension headaches, osteoarthritis in the knee, vascular function, and chronic pain in opiate-addicted patients.

Thursday afternoon I attended the newcomer’s luncheon, where Jerrilyn Cambron, Ruth Werner, and Allissa Haines all gave short talks to those in attendance. Thursday night I attended the welcome reception and met up with a lot of friends.

Friday morning I met with my representatives from Lippincott Williams and Wilkins and then listened to the keynote speech from Leslie Corn, “Somatic Emphathy: Restoring Community Health With Massage,” followed by a panel presentation on “Massage in the Community; Informing Public Health.” That afternoon. I attended a workshop in “Best Practices Guidelines: Building the Framework,” presented by Michael Hamm, Keith Eric Grant, and John Balletto–all previously known to me as Facebook friends–so I was glad to meet them all in person and participate in their class.

Saturday I attended Dr. Janet Kahn’s keynote speech, “Massage in 21st Century Healthcare: Let’s Seize the Moment.” Dr. Kahn’s presentation was probably the most informative and eye-opening moment for me, personally, about the state of health care in general in the US. Let’s just say it is not a pretty picture! As Dr. Kahn pointed out, there is a trend among our politicians to act as if the US has the best health care in the world, but the statistics really show the contrary.

That was followed with a panel presentation on “Next Steps in Massage Therapy Research” moderated by Bodhi Haraldsson, Research Department Director at the Massage Therapist’s Association of British Columbia. I’m telling you now, I could nearly cry when I see how much is done in Canada to advance massage therapy research compared to what is done here. We look disgraceful in comparison. Research literacy is required of every student in every school. $100 of each therapist’s registration fee is used to fund massage therapy research.

Saturday afternoon’s final event was a workshop, “Massage Therapy Research Agenda Planning,” where the approximately 250 attendees split into small groups to brainstorm recommendations for future massage therapy research.

During the whole event I got to visit with so many people, both longtime friends and people I  had only previously met through social media. I shared breakfast one morning with Keith Eric Grant, who was blogging about massage long before I started. I had lunch one day with Lisa Mertz from New York, whom I had previously met in person at the World Massage Festival. Saturday night I had dinner with Ben McDonald and Cliff Martin, owners of Massamio, that I had previously met at another conference.

All in all, it was just a wonderful event. My only regret is that I couldn’t attend every single presentation; some of them overlapped and there was just no way to be in two places at once. Thanks must be given to AMTA as the major sponsor of this event. Other sponsors included Books of Discovery, ABMP, the MA Chapter of AMTA, Anatomy Trains, and Wolters Kluwer/Lippincott Williams & Wilkins. The staff of the Massage Therapy Foundation and numerous volunteers kept things running smoothly. A round of applause to them all.

That being said, I feel compelled to go on a rant before I close out this blog. If you are an educator and/or a school owner, you owe it to your students to see to it that they are research literate. I believe there is a serious lack of any knowledge of research literacy in this profession. I am not asking schools to turn out researchers…I AM asking that the basics of research literacy are included in your curriculum, so that your students at least know the difference in what is valid research and what is website hype, one of the numerous myths of massage, or claptrap from a magazine. There is just no excuse for not doing it.

This event only takes place every three years, and the location of the next one has not yet been decided. I don’t care if it’s held on the moon; I will plan to be there.

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Massage Therapy: Integrating Research and Practice

I have never before devoted my blog to a book review, but I’m doing that this time, because (other than my own books, of course) I think this is one of the most important books that has been published for our profession. I’m speaking of Massage Therapy: Integrating Research and Practice, edited by Trish Dryden, MEd, RMT of Centennial College, Toronto, and Dr. Christopher Moyer, PhD, of the University of Wisconsin-Stout, Menomonie. This book was published by Human Kinetics and has only been out for a few months. I got my copy about a month ago, and I’d like to see one in the hands of every massage therapist, every student of massage, and in particular, every massage therapy educator.

The contributors to this book are an impressive group of people. Besides Dryden and Moyer, there are contributions from Janet R. Kahn, PhD, LMT, who has one of the most impressive resumes in the galaxy, culminating in a recent appointment by President Obama as a Member, Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Diana Thompson, LMP, former President of the Massage Therapy Foundation; Bodhi Haraldsson, RMT, Research Director at the Massage Therapists Association of British Columbia; Albert Moraska, Assistant Professor of Research at the University of Colorado at Denver, and a couple of dozen other highly-educated people with an interest in the evidence-supported practice of massage therapy.

The layperson sometimes panics at the word “research.” People get the erroneous idea that they can’t read, much less conduct, a research project unless they have a doctorate in elementary statistics. Although this book introduces some complicated (at least to me) concepts, they’re broken down into plain enough language that anyone can understand.

The explanations of qualitative and quantitative research methods, as well as mixed methods of research, has enlightened me. I don’t mind saying that while I have supported the Massage Therapy Foundation to the best of my ability, and been a vocal proponent of the evidence-informed practice of massage for the past few years, I realize after reading this book just how in the dark I’ve been about the particulars of what actually constitutes valid research.

The main purpose of the book is to introduce massage therapists to the various concepts of research, and how to apply that information to your every-day practice of massage.  There is a whole section, Populations and Conditions, that contains chapters on working with pediatric clients, pregnant clients, athletes, geriatric clients, and adults with a history of sexual trauma. The conditions that are covered include back pain, headaches, neck and shoulder pain, fibromyalgia, cancer, and anxiety and depression–the things that we are all confronted with on a regular basis.

Ruth Werner, current President of the Massage Therapy Foundation, contributed the Foreword to the book. She states the five crucial things that this book addresses:

1. It makes the compelling case that research literacy is a necessary skill even among entry-level massage therapists.

2. It introduces key concepts in a way that is both simple and accurate. Werner states that “As a teacher of a complex topic, I know how often the tipping point between simplicity and accuracy is narrow indeed.”

3. It emphasizes the application of research by giving clear examples of tying published findings to everyday practice scenarios.

4. By emphasizing the practical application of research findings, it acknowledge the importance of the feedback loop that must exist between clinicians and researchers.

5. It lays the groundwork for its own future development as the mass of evidence about massage therapy continues to grow.

Every time a client comes out of the treatment room and says “I feel better,” yes; that’s evidence. However, resting on those kinds of laurels is a big mistake, in my opinion. There are many massage therapists (other than myself and the contributors to this book) who want to see massage therapy gain the respect we think it deserves. The way to do that is research, research, research, and more research.

We don’t all have to BE researchers. We DO all need to know where to find it and how to make heads or tails out of it. Massage Therapy: Integrating Research and Practice, is the only book that I am familiar with that explains it so that those of us who are not scientists can understand it. I urge you to get this book. And as I mentioned earlier how important I think this is for massage therapy educators, let me go a step further and say that if you are teaching in a school that does not address the need for research literacy, then you be the change in that. It is doing students–not to mention the massage-seeking public–a huge disservice to ignore the subject.

While I’m on the topic, The Massage Therapy Foundation has a free toolbar you can download from their website to keep in touch with the latest research developments. Research costs money. I encourage you to donate to the Foundation in whatever amount you can afford to give. Every dollar helps.

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It’s All About Me

It’s all about me, so here’s my wishlist for the profession. It’s difficult to place these in order of importance, because some of them depend on each other, and in my little corner of massage, they’re all important. It’s election time–aren’t we all just about sick of hearing about it–candidates mudslinging and making campaign promises? If I was the President of Massage Land, here’s what I’d do:

The Federation of State Massage Therapy Boards would sit down at the table with the National Certification Boardand hammer out an agreement to a) help ease the NCBTMB out of the entry-level test market, b) contract with them to collaboratively administer continuing education instead of trying to take it over and c) forget their MOCC-ERY plan.

The NCBTMB would a) graciously accept that it’s time for them to get out of the entry-level test market, b) focus on cleaning up the CE approval program, and c) get it together with their new plan of raising standards of certification.

Both of these entities would cease and desist in sending out Job Task Analysis Surveys that are flawed from the get-go….they both supposedly pay psychometricians to help them out with these things, and still they are falling way short of the mark in ascertaining what they really need to ascertain. Stop worrying about how many times a week we give a massage, and stop ignoring the relaxation benefits of massage as if they don’t exist.

There will continue to be Leadership Summits. They will stick to the agreed-upon agenda at their meetings and not allow major surprises  to slide in from any of the organizations, and they will practice complete transparency and stop sending out press releases that contain no more information than an invitation to a baby shower.

Every one who is involved in massage therapy education will join the Alliance for Massage Therapy Education.

The profession will come to a consensus on what constitutes required core competencies for entry-level education, while still giving school owners the autonomy and individuality to rise over and above that.

All unregulated states will get state-wide regulation and all localities will honor those and not place ridiculous additional burdens on licensed therapists.

All massage schools will be required to teach research literacy to their students, and will only hire instructors who are capable of doing so.

The NCBTMB will stop approving woo-woo courses for CE credit, and all entry-level massage schools will stop teaching it. I don’t care if you study Interplanetary Voodoo with the Archangels, but you don’t deserve any credit for doing that.

Our professional associations will conduct annual surveys that have NOTHING to do with a Job Task Analysis–the sole purpose of it will be “Tell us what you think we are doing wrong and give us your suggestions for how we could do it better.”

The Alliance for Massage Therapy Education will develop a program to offer instructor training to the masses that will be accessible and affordable–perhaps online.

Board members of all representing organizations will recognize their responsibility to not blindly follow the leader; to avoid not only conflicts of interest, but the appearance of conflicts of interest; will not put up with any cover-your-ass type behavior within their organizations; will hold their hired leadership accountable, and will have enough gumption to get rid of them if and when such behavior occurs.

All massage schools would seek COMTAapproval. If your school can’t afford that or doesn’t qualify because of not meeting the hour requirement, may I say that their standards are on their website for all the world to see for free, and you could still go about the self-study process and getting things up to snuff, even if you don’t formally seek the accreditation.

All school owners would be bound to have their school bonded, so that no school goes bankrupt and leaves students in the lurch in the middle of their program.

All schools would be required to post their pass rates on the licensing and certification exams on their websites and in their catalogs.

No school owner will be allowed to say to a potential student “Don’t worry, your criminal record won’t keep you from getting a license.” It should be mandatory for it to be disclosed that they may not receive a license. The state of Texas has a non-binding review, where for $50 a person seeking a career in any licensed profession can submit their criminal record for review prior to spending their time and money on pursuing education. Every state should do the same.

There should be a national exam for instructors to prove they are competent in teaching methodology and a subject matter expert in whatever area they intend to teach.

Each state should require a jurisprudence exam. Your licensees can’t adhere to the law unless they know what it is, and the percentage of applicants who actually read your practice act in its entirety is probably less than 5%–I’m basing that on asking that question in all the classes I teach. Hardly anyone reads them, but if they had to pass a test on it, they would.

The Massage Therapy Body of Knowledge would be about massage.If you want to have an energy work body of knowledge, create that.

Everyone involved in the profession would give financial support to the Massage Therapy Foundation. Give $100. Give $5. Give $1. Give whatever you can afford to give, just do it.

 

I could probably go on for days, but I have other chores to get to today. I invite my readers to add what they will. What’s on YOUR wishlist? What’s on mine that you object to, and why?

 

 

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A Betrayal of Trust

Any time one of the major organizations in the massage field tries to fire up a project that will “advance the profession”, I get awfully suspicious. When a group of them get together to do something on the big scale, I go on full nuclear alert. That’s the case right now with a dubious education standards project introduced by ABMP in September 2011 at the Leadership Summit in St. Louis, which I detailed in my previous post, Behind Closed Doors.

As the title of that blog suggests, 100% of the activity surrounding this project has taken place in secret, with no information about the project being released to the massage therapy community—and no opportunities for review or comment before time, money and human resources are thrown at solving a perceived problem.

AMTA and FSMTB have signed on to this project, which will involve gathering information from the Federation’s upcoming Job Task Analysis survey, to use in a process that will “identify the rudimentary knowledge, skills, and attitudes required to pass a licensing exam and provide basic, but safe, massage in an early massage career.”

That doesn’t sound like a such bad thing—in and of itself—but the group intends to use this data to create an “evidence-based minimum educational requirement” for state licensing. This would be used as a rationale for changing state laws, and would likely be used to drive the curriculum standards for entry-level massage programs—basically telling schools what to do.

Goodness knows, there is a lot of inconsistency in massage education and regulation, but there is no problem in our profession that justifies one or a group of our so-called “stakeholder organizations” seizing the ball and marching down the field without our input or permission. I don’t give a rat’s you-know-what if they claim to be doing this in our best interests; this power play is a gigantic betrayal of trust. And I might add that I am personally in favor of the evidence-based practice of massage, but I don’t think one tiny group of people should get to decide what that is.

I’ve not yet been able to confirm the status of NCBTMB, Massage Therapy Foundation, AFMTE or COMTA as it relates to this project (mum’s the word all around). These four organizations, along with ABMP, AMTA and FSMTB just gathered on May 1-2 for another Leadership Summit—this time in Chicago. I’m taking bets that they will issue another sanitized press release that gives us regular folks in the bleachers little substance about what really happened in this meeting that has the potential to alter the very nature of our profession.

The only other info I’ve been able to glean is that ABMP, AMTA and FSMTB hand-picked a new workgroup of massage educators and other “experts” in instructional design and curriculum development to start this project on May 3-4, right after the completion of the Summit. Are you kidding me? Where was the public notice of this opportunity to serve on a panel that will influence the future of massage therapy? Who gave these organizations the authority to do this on our behalf?

No one. They took it on themselves, and that’s what stinks to high heaven.

In stark contrast, the Massage Therapy Body of Knowledge project had both fans and detractors, but it was carried out with a reasonable amount of transparency. The majority of the dissent on the project concerned the inclusion of energy work in the document and dissatisfaction with the way objections were handled—or not handled—in favor of evidence-based practices. The five organizations that comprised the MTBOK Stewards (ABMP, AMTA, FSMTB, MTF, NCBTMB) did a good job of not interfering with the project once it was launched.

Right now, we have a genuine crisis on our hands. The problem is that hardly anyone knows about it. This blog only goes so far. I never set myself up to be the New York Times of the massage field, but it seems like the major massage publications are afraid to get their teeth into the real breaking news that affects the practitioners, teachers, CE providers and schools that make this profession possible.

Friends, it’s up to YOU to let these organizations know that it’s not OK for them to act in your interest without your permission. As long as these “leaders” think they can get away with it, they will. Trust has been blown out of the water, and it will take a concerted effort to rebuild it.

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.