Category: Legislation of Massage

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Massage Regulation: A Comedy of Errors

I’ve spent the last hour reading legislative updates pertaining to the regulation of massage…in the past, I’ve sometimes referred to this as the good, the bad, and the ugly. This time, I’m just going to call it a comedy of errors. I don’t know whether to laugh or cry.

I’m not even going to address all the discrepancies in the number of hours of required education and/or exams required for licensure, or the discrepancies in the hours of required continuing education, or even the wide variances in licensing fees. I’ve commented on that a number of times, and that situation isn’t likely to change at any time in the near future.

Everybody has seen those “outdated laws” posts before, silly laws that are still on the books, like “It’s illegal to ride a horse without a saddle on Main Street after 5 pm every other Sunday.” You get the picture. Some of our massage laws seem about as archaic. You just have to wonder at the logic that goes into some of these things…and you also have to believe that these most assuredly were not proposed by, nor are they likely supported by, massage therapists. It’s the bureaucracy at work.

Many of the statutes that have been proposed or enacted in the past few years are a direct result of the economy and state governments being so deep in dept. Several states are now taxing, or considering taxing services (like massage, hair and nail services, even grass-mowing). Even self-supporting boards have in some cases had their monies raided in the interest of feeding the state’s general operating fund. NH is seeking to abolish their massage board altogether, in the interest of saving money. And in the state of West Virginia, HB 2502 seeks to combine the administrative functions of the massage board with the acupuncture board (not so weird) and with the forestry board (weird), the board of licensed dietitians, and the hearing aid dealers board (at least the last two are still health-related). It makes you wonder what we have in common with foresters. Are foresters out there planting trees while naked or committing some other unethical act? Maybe so.

A lot of states don’t require any fingerprinting and/or criminal record submissions of applicants for a massage license. A convicted rapist or violent criminal can get one. Some states require licensees to provide proof of liability insurance, but most don’t. I personally think that one’s a good idea.

There is so much discrepancy between the states on modalities that have to be licensed. In NC, where I live, Bowen therapy, craniosacral, Rossiter, Zero Balancing, and 24 other modalities are specifically spelled out as requiring a massage and bodywork license.  We don’t regulate reflexology, which I really don’t get. I’ve had plenty of reflexology and I would have to say that there is at least as much tissue manipulation going on as there is during a session of acupressure, which we do require licensing for.  NY licenses both acupressure and reflexology, and Polarity therapy. I know practitioners who will argue that every modality mentioned in this paragraph is energy work and not massage. You might as well agree to disagree and get a license if it’s required of you.

Speaking of NY, earlier this year SB 1030 was proposed, got stuck in the Higher Education committee, and may have expired due to lack of action. It provides that the commission of prostitution offense by any person upon premises at which a massage therapist regularly engages in his or her profession, or the commission of any such offense by a massage therapist constitutes professional misconduct; provides that upon 3 or more convictions of such offenses upon such premises, or any conviction of a massage therapist of any such offense, the massage therapist’s license shall be revoked. So basically, you can prostitute once or twice, but don’t do it three times or you’ll lose your license. You might even lose it if you weren’t personally prostituting but someone else on the premises was. It’s worded a little vaguely, in my opinion.

In the summertime, not much is happening, because legislatures tend to pack it up and go home. Some things are always left on the table for the next session, and some (hopefully) will never see the light of day again. And some things are urgently needed, like regulation in the 8 states that don’t have any. In each of those states, there are therapists working for licensing, and just as many fighting against it.

You can find regular updates about what is going on in the regulatory world of massage on the legislative briefing pages on the websites of both ABMP and  AMTA.

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Teaching the Teachers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“My teacher has had affairs with several students.”

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

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

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

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

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

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

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

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

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

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

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

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

Resources:

ABMP Massage School Instructor Resources

Alliance for Massage Therapy Education

AMTA Schools Resource Center

 

 

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A Matter of Opinion

Last week, the AFMTE released a position paper authored by Executive Director Rick Rosen, “Alliance Offers New Vision for National Certification.” Update 09/20/2025: This no longer exists on their website and I was unable to locate a copy online.

The AFMTE also recently announced that it is partnering with the FSMTB in their initiative to begin approving continuing education.

Both of these have attracted quite a bit of discussion on the various social media sites. And like any discussion, people agree, disagree, and agree to disagree.  I’m glad to say there hasn’t been any mudslinging of the nature that goes on at times in some of these venues. I think these discussions are useful and informative.  They sometimes bring to light a lot of misconceptions that people have about which entity does what, and how they do it.

I encourage everyone to read Rosen’s paper in its entirety, but to make a long story short, it is a plea to the NCBTMB to reorganize, and get out of the continuing education business and the entry-level exam business. The FSMTB has been stating the opinion since their founding 5 years ago that NCBTMB exams are inappropriate for licensing purposes, and encouraging the states to drop those exams and use the MBLEx exclusively. That hasn’t happened.  If the map on the FSMTB is current, 33 member boards are using the MBLEx. If the map on the NCBTMB website is current, 38 states are still accepting their exams, meaning the majority of states are accepting both, and offering their licensees a choice. The AFMTE is also supportive of the Federation’s stance, as is AMTA and ABMP. Still, the facts show that either the 38 states are doing the wrong thing, or else they are exercising their undeniable right to conduct their business the way they want to.

I haven’t been in this profession nearly as long as Rosen or some of the other players here. I became a massage therapist in 1999, and it seems like I joined at a time when everything was just really starting to swirl. I was in the first wave of licensees in North Carolina.  Mr. Rosen actually has license #00001…first person licensed in our state. He has seen and been instrumental in a lot of things happening. I would never try to minimize the contributions he has made to this field. I won’t criticize his career, his integrity, or his belief that he is suggesting something for the good of the profession on the whole.

My criticism is this, and it isn’t directed entirely at him; it’s directed at the concept of any organization trying to mandate to another organization how to run their affairs. We get enough of that from the feds, don’t we?

I believe that the FSMTB and their mission of public protection is a great thing. The member boards come together for the purpose of discussing common problems and looking for workable solutions. Anytime people sit at the table together to try to solve a problem, that’s wonderful to me. I also believe that the AFMTE was started with the noble intent of acting as the voice, advocate, and resource for massage schools and educators. What I don’t believe is that either one of them can unilaterally force the NCBTMB to change their way of conducting business, nor do I think they should have that right.

The FSMTB is developing a model practice act, in addition to developing a CE approval program. They can and do suggest to the member boards that their exam is the appropriate exam, their CE approval (will be) is the appropriate approval, their model practice act (will be) the premier example of an appropriate act, and so forth.  It’s part of the quest to streamline things  in a uniform fashion and promote portability.

However, suggestion is the key word. The member states aren’t bound by any legalities to do what the FSMTB offers in the way of suggestions. If they want to keep the NCBTMB exams, they can. If they want to keep their own practice act, they can. If they want to keep NCBTMB approved providers or continue to approve their own, they can. They all have the right to conduct their business as they see fit within the law.

There is certainly room for improvement, on the practice act front, in particular, when you see all the variance that’s out there between the states. Keith Eric Grant has summarized that. You can access it here.

The bottom line, to me, is that all of these entities, including the NCBTMB, also have the right to conduct their business as they see fit. Unless and until there is a federal law governing massage, the individual entities can continue to do whatever they do however they want to do it. The FSMTB and the AFMTE could spend days pointing out past shortcomings of the NCBTMB, but it wasn’t “the NCBTMB” as an entity that had the shortcomings. It was the human beings running the organization.

As the FSMTB is only 5 years old, and the AFMTE less than half that, neither of these organizations have been in business long enough to have been plagued with the personnel problems, inefficiency problems, financial problems and so forth that happened in the past at the NCBTMB. Board members come and go. Executive directors come and go. Priorities of boards and organization come and go. Even organizations come and go. Last week I learned from Dr. Kory Ward-Cook, CEO of the NCCAOM, that there was previously a Federation of State Acupuncture Boards that fell apart.

AMTA and ABMP have their own missions and their leadership has their own opinions. As do we all. And any organization, just like any individual, has the right to run their business as they please, as long as they are not breaking the law. The NCBTMB is not breaking any laws by continuing to conduct their business as they see fit. The other organizations are not breaking any laws by conducting their business as they see fit. They all have that right. You don’t have to like it. I don’t have to like it. One organization doesn’t have to like what the other organization is doing. But until the federal government steps in and says, “you must do this,” they can all do as they dang well please. If any of them don’t do well enough at whatever it is they choose to do, they won’t survive.

Everybody has their own opinion on what’s good (or not good) for this profession, what’s good for licensing, what’s good for certification, what’s good for teacher standards, what’s good for education, what’s good for continuing education. There are just as many opinions on all of that as there are opinions on what kind of massage oil you ought to use.  Everyone is entitled to that. And everyone is entitled to conduct their business the way they choose to, as long as it’s within the law.

The AFMTE posted on LinkedIn that they had posted Rosen’s position paper directly to the NCBTMB. I suggest that if the folks at the NCBTMB are interested in hearing more about it or discussing it that they will get in touch. And if they don’t, then I suggest that the AFMTE, and in fact all organizations, concentrate on being good at what they set out to do for their organization, and leave the NCBTMB to do as their board and their leadership sees fit. Their Board is elected by their certificants, and their ED serves at the pleasure of their board.  They may well thrive and survive by doing things their own way, or they may fail altogether.

Either way, I think the burden to make it or break it is on them, just like the burden that is on all the organizations, and on any of us as practitioners and business people. And any insinuation of the NCBTMB being “uncooperative” is an opinion, not a fact. I can tell you how to run your business, you can decline to take my advice, and I will not refer to you as uncooperative. I will assume that you are exercising your right to conduct your business in the manner that you see fit, whether it suits me or not.

That’s just my opinion.

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You Say To-may-to, I Say To-mah-to

Actually, I’m from the south, where we often say “mater.” A ‘mater sandwich should be on white bread, slathered with an artery-clogging amount of Duke’s mayonnaise, and eaten standing over the kitchen sink so it can run down your chin and drip appropriately.

Everybody has their opinions…I’m out here regularly expressing mine, and not everybody agrees with them. That’s fine by me. The world would be a boring place if we all thought the same thing, and the world of massage is no different. This morning, as is my habit when I’m drinking my coffee, I looked at the comments on my blog, hung out on FB, checked out the massageprofessionals.com website to see what kind of arguments were brewing, all a part of my usual routine.

There are so many wonderful and dedicated people in our profession.

Some of them think the standards for entry-level education should be raised, and some of them don’t.

Some of them think massage therapy should be regulated to the nth degree, and some think it shouldn’t be regulated at all.

Some think continuing education requirements are nothing but a burden on their time and finances, and some look forward to taking it.

Some think teacher standards need to be raised, and some don’t.

Some think they have good representation from their professional association, and some don’t . Some don’t belong to one at all, nor do they care to.

Some massage therapists think of themselves as health care providers, and some don’t.

Some think evidence-based practice is the only way to fly, while others immerse themselves in energy work and all manner of woo-woo that can’t be proven.

Some get involved in politics, pay attention to what’s going on in regulation and legislation, and some don’t.

Some step up to the plate and volunteer, and some just want to be left alone to practice massage.

People have their own opinions on what constitutes dressing appropriately for massage, whether or not they should discount services, whether or not it’s okay to give away free massage, whether or not it’s okay to massage friends and family, whether or not it’s ethical to retail products, whether or not it’s okay to give undraped massage.

Every morning, during my routine, I am always noticing the differences of opinion. As I just posted on FB this Easter morning, my friends include Christians, Pagans, Buddhists, Muslims, Hindus, Jews, atheists, agnostics, and pretty much every other religion or lack thereof on the planet. It’s the same with my massage colleagues. The fact that you don’t share my opinions doesn’t make me like you any less, anymore that the fact that you have different religious beliefs would make me like you any less.

We’re all here for the same reason: we know the awesome power of touch. We know massage restores and heals. As for the rest of it, take what you like, and leave the rest. I’m going to go have a ‘mater sandwich.

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My Organization is Better Than Your Organization

The massage profession has a plethora of organizations these days.

AMTA (American Massage Therapy Association) is a non-profit organization that has some executive staff at the top, a board elected by the members, and a hearty band of tireless volunteers that keep the wheels turning. AMTA has about 57,000 members.

ABMP (Associated Massage & Bodywork Professionals) is a for-profit concern, and frankly I’m just sick and tired of hearing that fact stated as a criticism. What is inherently wrong with making a profit? I want to make one in my massage therapy practice, don’t you? ABMP has around 77,000 members.

The NCBTMB (National Certification Board for Therapeutic Massage & Bodywork) , for 17 years, was virtually the exclusive provider of certification exams that were used for licensing in many states, and the approval body for continuing education providers. A few states had/have their own exam. About 90,000 massage therapists are nationally certified. The NCBTMB also has a board elected by their certificants.

Then along came the FSMTB (Federation of State Massage Therapy Boards) with the MBLEx test as a route to licensure, which many of the 40 or so member states have adopted. The Federation also recently announced plans to get into the business of approving continuing education, and they are creating a model practice act. They also have a board, which their state delegates elect.

The new kid on the block is the AFMTE (Alliance for Massage Therapy Education), which aims to advance the quality of education and develop a model of teacher standards. The Alliance has announced that they would be collaborating with the FSMTB on the continuing education project. They still have their first board seated; that’s how new they are.

We’ve also got COMTA (Commission on Massage Therapy Accreditation) in the business of giving accreditation to schools and programs who meet their standards of excellence. Getting COMTA approval is voluntary, expensive and time-consuming. There are only 100 or so that have earned it.

The majority of states now regulate massage, some by their own self-supporting massage board, some lumped in with nursing boards or other health boards. I am often asked by therapists what their state board does for them. Other than issuing their license and in some states licensing schools, the answer is not much. A public board serves the purpose of public protection. Some do a better job than others. State board members are appointed by politicians. The average board is usually composed of a few dedicated people, often includes one or two clueless slackers, and a rebel redneck like me. I’m sure my board is glad I’m at the end of my service. My blog makes them nervous.

I’m a member of both AMTA and ABMP. I’m a member of FSMTB by virtue of my seat on the North Carolina Board, which I will be vacating later this month after five years. I have been a past delegate to the Federation. I am a founding member of the AFMTE. I’ve been nationally certified for over ten years, and an approved CE provider under the NCBTMB as well. I am soon to go on my first site visit for COMTA. I attended their reviewer training after I wrote a few derogatory blogs about them and they invited me to attend. Positive change usually happens from within, doesn’t it?

I have a stake in all these organizations so I’ll pat them on the back when I think they deserve it, and I don’t mind calling them out when I think they deserve it. I have the same attitude with them that I have with other massage therapists who act competitive instead of collegial. This isn’t a contest. If one organization has to fail in order for another to succeed, that’s just a big shame as far as I’m concerned. When one organization slams another and presents half-truths and posturing, it starts to look like a playground fight–better call that a turf war, I guess–and it’s not attractive in the least.

None of these organizations would exist without their constituents–the massage therapists. And none of them can represent all of the people all of the time. They’ve all made moves that didn’t suit me at one time or another, and what ticked me off may have made other MTs perfectly happy, or vice versa. And the therapist who isn’t represented by any of them probably couldn’t care less what they do or how they act. In fact, many of their own members couldn’t care less what they do or how they act. When it comes to the professional associations, many therapists just join for the insurance and have no interest in the political fray at all–until something detrimental happens that affects their license or access to education.

If you don’t like a piece of proposed legislation, contact your legislators to tell them. And if you don’t like the direction your professional organization is taking, contact them to tell them. Get yourself in there as a board member or volunteer and change it from within. Cancel your membership, or switch organizations.  Money still talks. It’s akin to voting…if you don’t exercise that right, then don’t gripe about the outcome. Go to your state board’s meeting and sign up for public comment. You have a voice. It’s only effective if you use it.

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Local Legislation Often A Disgrace to Massage Therapy

I usually report on state legislation, but the fact of the matter is, educating legislators about massage therapy has to begin in your own backyard. In many places, whether there is state regulation of massage or not, local laws are so archaic and penalizing to massage therapists, it is just disgusting.

The latest thing to hit my radar is from the city of Indianapolis. The application required to practice massage in the city is entitled “Application for Massage Therapist/Escort/Body Painting/Nude Model License.” Update 09/20/2025: Thankfully, this is no longer on their website. 

I am shocked and appalled that this still exists. Where are the massage therapists who should be up in arms about this? Is everyone so complacent they just fill it out and don’t complain? Has anyone ever brought it up to the city government? Have any of our professional associations seized this opportunity to protect the rights of massage therapists?

A few years ago in the small town of Canton, NC, one of my former students excitedly opened her massage therapy practice, and within two days was cited for “massaging a member of the opposite sex.” She had no idea her hometown was a throwback to the Dark Ages, and she wasn’t going to take it lying down. She printed off copies of our Practice Act for every member of the town council, and got herself put on the agenda for the meeting, where she proceeded to enlighten them about the realities of being a professional therapist. The end result was the repeal of an ordinance that was enacted back in the 50’s in an effort to thwart illegal “massage parlors.”

I hope that the massage therapists in Indianapolis will take a lesson and rise up to do something about this. Unfortunately, it isn’t the only place where idiocy like this is perpetuated. After I posted this on my FB page, therapists started coming out of the woodwork with their own stories of unfair local laws. …locales requiring massage therapists to take tests for sexually transmitted diseases, applications that still say “Massage Parlor” and all manner of derogatory and unfair laws aimed at us.  All I can say is what I’ve been saying for the past few years: Don’t wait for someone else to do something about it. Take the initiative and get the ball rolling. Call your colleagues and ask them to appear with you at a town council meeting. Write letters and call your local legislators. Don’t sit on your hands. If we don’t educate legislators, nobody will.

 

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Texas Hold ‘Em

Update 09/20/2025: If there is no blue link, the referenced legislation no longer exists and the representatives email address no longer exists. 

Texas has a few pieces of massage legislation in the offing. And while I don’t think most of it is as detrimental to the profession on the whole as the recent amendments to Utah’s regulations, I can’t say I’m crazy about it. I have a fundamental problem with regulations that are not clearly defined, and this seems to be one of those cases. Their language just plain ticks me off, as well.

HB 722 starts out with “relating to the regulation of massage therapists, massage schools, massage establishments, and sexually oriented businesses, providing penalties.” Do we see any legislation that starts out “relating to the regulation of bowling alleys, physician’s offices, funeral homes” etc that has to include “sexually oriented businesses?” No, we do not. Texas is far from the only state who refers to us in this manner.

As we read further, we come to an amended section (there are several amended parts) stating that it shall be against the law to provide or offer to provide massage “while nude or in clothing designed to arouse or gratify the sexual desire of an individual.”

Update 09/20/2025: Thankfully, the link to this bill no longer exists. 

Now here is where the language is offensive, to me. Of course, I am glad to know it’s against the law to massage in the nude. However, I think the second half of that sentence is extremely ambiguous, and is going to be open to the interpretation of whichever board members or judge in a civil or criminal court hears the first test case. While it’s obvious that lingerie from Victoria’s Secret might fit the bill, what about a v-neck top or a tank top? What about a pair of tight jeans, leggings, or yoga pants? A form-hugging sweater if you have large breasts? What about a pair of shorts, who is going to say how many inches from the knee they can be before they look “sexually arousing?”  There are some people who could manage to look sexy in a flour sack, and others who couldn’t look sexy no matter what they are wearing. In my opinion, that is a bad piece of legislation because it isn’t clearly defined. Furthermore, a couple of lines later it goes on to say that while you are in a massage establishment you may not “possess” clothing designed to arouse or gratify the sexual desire of an individual.  If you have a date after work, you’d better not hang your little black dress in the office so you can change, lest you be accused of something.

This bill also includes reflexology as a method of massage subject to their practice act. HB 722 is sponsored by Rep. Garza, (512) 463-0269,  or e-mail him here.

HB 556 seeks to exclude Muscle Activation Techniques from being covered under massage licensing. Muscle activation techniques include the detection and correction of muscle imbalances through the use of palpation and isometric exercises. HB 556 is sponsored by Rep. Howard, (512) 463-0631 or e-mail her here.

HB 1716 will exclude from licensure a lot of techniques that are commonly used by massage therapists–mostly energy work techniques including Healing Touch, polarity, craniosacral, body/mind techniques, Ayurveda, and a host of others. Strangely, the bill also includes the admonition to the public that people performing these techniques are not licensed and that they are free to seek a diagnosis from a licensed physician, chiropractor, dentist, nurse, etc and actually includes massage therapists and personal trainers in that group. Really? Diagnosing is out of our scope of practice as massage therapists and while I am usually concerned about our rights being taken away, I really don’t think it’s a good thing to say we can give a diagnosis just because we have a massage license. What’s to prevent some newbie fresh out of school from diagnosing someone?  It doesn’t matter if you’ve been practicing 25 years, you still shouldn’t be diagnosing people. We aren’t trained for that.

HB 1716 is sponsored by Rep. Harless, (512) 463-0496or e-mail her here.

I urge you to contact theses legislators to say Texas, hold ’em. None of these bills look like a good thing for massage therapists.

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If You’re Not Moving Forward, You’re Backing Up

 

There have been several developments in the regulation of massage in the past few weeks that I personally find distressing. Earlier this week, Florida Senate Bill 584 moved a step closer to passage. This piece of special-interest legislation would amend Florida’s massage therapy law to allow graduates of certain board-approved schools to obtain a temporary permit and practice for six months without a license, until such time as they fail the exam or become licensed, whichever comes first. Although the bill states that they must work under the supervision of a licensed therapist, the terms of that are not spelled out. Does that mean the supervising therapist is on the premises, in the treatment room, or giving an occasional phone call? This is where boards frequently get into trouble and spend a lot of time with something bogged down in a policy committee—when something has not been clearly defined—and in this case, “supervision” isn’t clearly defined. Update: This bill did not pass. You must be licensed to work in Florida.

New Hampshire is trying to abolish massage licensing altogether, as a cost-cutting, government-reducing move. That would of course mean back to square one, where anyone who knows absolutely nothing about contraindications for massage, endangerment sites, or professional ethics can feel free to call themselves a massage therapist. Update: This failed. You must be licensed to work in NH. 

Utah just amended their practice act to remove the key word “therapeutic” from the scope of practice definition and added in the word “recreational”, in what is in my opinion a misguided attempt to thwart sexual activity being conducted in the name of massage. Other than the fact that I think House Bill 243 is a big step back for our profession, I was just as shocked that the government relations folks in the Utah chapter of AMTA supported it to start with. I’m an active member of the North Carolina chapter, and I cannot imagine the leadership of our chapter supporting that. Update: as of 09/20/2025, the word “recreational” does not appear in Utah’s Practice Act. 

I was gratified a few days ago to see Les Sweeney, President of ABMP, and a few days later Bob Benson, the Chairman of ABMP, weigh in with the same attitude I have about this legislation. Rick Rosen, who is a former Chair of the North Carolina Board of Massage & Bodywork Therapy, former Executive Director for FSMTB, and currently the Executive Director of AFMTE, made a comment on Bob’s blog (Update: no longer available) that I think nailed the important points of this issue:

The most critical component of the state law for any regulated profession is what’s known as its Scope of Practice definition. The list of prohibited acts in a law is important, but less so than the scope definition. If what you want to do in your massage therapy practice is not listed in the scope, you can’t legally do it.

The Utah action that removed the term “therapeutic” from the scope definition, and added the term “recreational massage” may have the effect of narrowing the scope of practice for massage therapists. At the very least, it takes massage therapy out of the realm of health care and into the murky world of “other business activities”, which includes adult entertainment.

Considerations around enforcement of a Practice Act should not take precedence over the scope itself, and it is not a sound justification for downgrading the law. That’s what has occurred in Utah, and the Licensed Massage Therapists of that state will have to deal with it.

Every single word in statues and rules that regulate the practice of massage therapy is important. What you think it says is not always what it means — or what it will produce in the daily administration of a regulatory program. That’s why we need experienced and competent government relations professionals representing our interests.

I report on the legislation of massage, and I have future aspirations of working in government relations. I’ve spent a lot of time in the past few years doing research on boards and practice acts, and while I’m certainly not as experienced or learned as Rosen, I think I’m at the point of recognizing a piece of bad legislation when I see it. The way I see it, if you’re not moving forward, you’re backing up.

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The Utah Brouhaha

A couple of the officers of the Utah Chapter of AMTA are upset with me for a video I put out yesterday about H.B. 243 that is in the works in their state. You may read the bill here.

This bill removes the term “therapeutic” from the description of massage. It also modifies the language in their Practice Act to include “recreational massage.” Is there anyone among us who would like to be known as a recreational massage therapist? Please weigh in on that. I am personally not acquainted with anyone who would like to be known that way.

I read the bill in its entirety, when it was brought to my attention, and then, AMTA member that I am, went to the Utah Chapter’s website to see what they were doing about this. I was shocked to see no mention of it anywhere, so during the course of the video I encouraged AMTA members to get in touch with their board members and mobilize them to take action on this, and I urged all Utah therapists to contact their legislators to protest what in my opinion is a detrimental change in their language. I posted it on the Utah Chapter’s FB page, as well as my own.

Imagine my disbelief when I received a communication from one of their officers on my YouTube channel telling me that I should have contacted them before making my video and telling me to take it down asap. They are of course free to remove it from their own page. They are not free to tell me to remove it from mine. It has had over 700 hits in the last 24 hours and been shared by over 400 therapists. One therapist had made a positive comment about H.B. 243 on FB, the last time I checked. Too many others to count were all as distressed about it as I was.

I also received a lengthy and polite response from one of their officers, that stated  “There is no mention of this on the Utah Chapter website. This matter has purposely not been published on our website at AMTA Utah Chapter precisely for the purposes of NOT bringing attention to the fact that the Massage Therapy Practice Act was being “opened for changes” in this legislative session,” and ended with the request that I remove the video without comment, and to check with them in the future before I make any reference to Utah again.

Sorry, but that will not be happening. Perhaps you have heard of the First Amendment.

Perhaps you have also heard that all legislation is an open book–or it is supposed to be. It is the public’s right to know. If something is affecting massage therapists, it is the massage therapist’s right to know. And it is the mandate of any public board and any non-profit organization to operate in a transparent manner. Anything less than that is unacceptable. Nothing is, nor should it be private, about changes in a Practice Act.

The two AMTA representatives, one of whom emailed me and the other who left a comment on my YouTube page,  obviously feel differently than I do about this, and that’s their right. We can agree to disagree. But as much as I am personally mortified by this bill, I am even more mortified that someone would think that massage therapists shouldn’t be informed of what is going on in their own state, given the opportunity to weigh in on it, and to openly hear their professional organization’s stance on it, until after the fact. That doesn’t work for me, and it shouldn’t work for you. I have preached this sermon many times about knowing what is going on in your state, and this is a prime example of that.

Any state’s Practice Act may be up for changes at any time.  And when a precedent is set in one state, it’s that much easier to get it passed in another. Practice acts are always “open” to changes, assuming any interested party can manage to get it on the legislative calendar. Here in NC, we had a detrimental change that our Board had no knowledge of  at all until it was a done deal. That’s not a good thing–and keeping secrets from the massage therapists who are affected by proposed changes in legislation is not a good thing, either. I refuse to apologize for spreading the word, or for expressing my opinion on it.

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Competency vs. Hours

I have long desired to see the standards for massage therapy education raised in my state and across the nation. Here in North Carolina, the requirement is only 500 hours. That varies in the US, from the unregulated states that have no requirements at all, to the 1000 hours required by New York, Nebraska, and Puerto Rico. The rest fall somewhere in between.

Our neighbors to the north in Canada have a few provinces that are unregulated, but those that are regulated have a much higher hour requirement than the norm here in the US. However, in looking over their documents pertaining to their regulations, I see that it is not really about the number of hours; it is about the basic competencies that they have set forth for an entry-level massage therapist, and I must say that I find it quite impressive.

I imagine that the higher number of hours is merely a by-product of the competencies that are required. It would take a lot more than 500 hours to pack all those competencies in. And I couldn’t find any fault with any of them. It actually bears a lot of similarities to our recent document, the Massage Therapy Body of Knowledge. That’s not a perfect document; it’s just a start on defining what an entry-level therapist should know here. I’ve heard a good many complaints about it. In fairness to the dedicated volunteers who gave of their time and expertise to work on it, they offered a long period for comments from the profession, and I was personally appalled at how few they got. I think they got about 600 or so, and about 50 of them were mine. Textbook author and school owner Sandy Fritz wrote twice that many. It was also very telling to me that when our Board sent out a survey to the approximately 40  school owners and program directors recently about raising the standards, only 7 of them bothered to reply. There is a big lack of interest in raising the bar.

The complacency here is staggering, and people just tend to complain after the fact instead of offering input on the front end. It’s the same thing I’ve seen over and over again when it comes to detrimental legislation in our profession; a few dedicated people will contact their legislators before something awful gets passed into law, and the rest will just gripe about it after it happens. That’s another blog, and one that I’ve written several times.

I’ve actually been pushing for our Board to raise educational standards, which like anything a public board is considering gets passed along to a committee for study. It is unfortunate that we could not find any concrete evidence that requiring more hours leads to better test scores. Then again, is that what it’s all about? The ability to pass a test? In our paradigm, yes, it is. We are lacking here in measuring competency in any other way.

I am the author of a popular book on how to pass the exams that are required here, and for over ten years I’ve been teaching a test-prep class as well as tutoring students privately. Let me tell you what I’ve observed. There are some people who can’t pass a test. Does it mean they can’t give a good massage? Not at all. They might be perfectly capable of putting me to sleep on the table or helping my aching back. And on the other hand, we’ve got the people who happen to be good test-takers and who are good at regurgitating information, who couldn’t give a decent massage if their life depended on it. They just don’t have what it takes. The ability to pass a test doesn’t make you competent, in my humble opinion. It just demonstrates that you know a certain amount of information.

When I was reading the Canadian document, I was more than a little envious of it. I kept comparing it to what I learned in massage school, and thinking, “Wow, I wish I had been taught that at the beginning.” In the dozen years since I went to massage school, I have managed to learn most of it through continuing education, self-study, and on-the-job experience. I’m the resourceful type and a go-getter, and I’ve had a modicum of success in spite of not knowing these competencies right out of the gate. I’ve learned a lot of them through the school of hard knocks. There’s no doubt I could have avoided some of those hard knocks if I had known these things at the outset of my career.

As a provider of continuing education, I’ve often been distressed and appalled when people call me up and say something like, “I need 6 hours, do you have any classes that long?” They don’t give a rip if the subject matter interests them or not. I’ve also been informed that “I don’t know why I have to get continuing education, I already know everything I need to know.”  They are clueless.

One of my North Carolina colleagues stated on a forum this week that his poll showed that people were very satisfied with the 500 hours, and of course, a lot of people are. Going beyond that requires money and effort, and many people don’t want to spend any more money or effort than they can get by with. I’m personally not interested in just getting by.

Education is never wasted, and hopefully, I still learn something new every day. That’s my goal, anyway.  My education didn’t end at 500 hours. It hasn’t reached 3000 yet, but I intend for it to, and I still won’t know everything there is to know.

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