Category: Politics of Massage

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Civil Discourse

Civil discourse, according to Wikipedia, is engagement in conversation intended to enhance understanding.

I’ve seen the good, the bad, and the ugly, when it comes to that. The good took place recently at the MAAP meeting I attended with the folks at the NCBTMB. It was a great meeting of intelligent people who were all invited to participate in a discussion about continuing education, and not an ugly word was spoken.

The good was exemplified again this past week in the comments on my previous blog post, and on the AFMTE LinkedIn page in response to Rick Rosen’s position paper “Vision for the Optimal Role of National Certification.”

Some very bright minds have weighed in on that. Some of them support Rosen’s position; some disagree; some like parts of it. And somehow, the conversation has managed to take place without name-calling, insulting anybody’s mama, or the questioning of people’s ethics and/or credentials in a rude manner. People have been free to express their opinion and have done it in a polite manner.

That is completely contrary to what has been happening on a couple of the other discussion forums that I participate in.  A few weeks ago I made a post on the massageprofessionals.com website, entitled “Stop the Insanity.” It was a plea for people to engage in civil discourse and leave behind the bad behavior. I’m sad to say that it hasn’t happened; the mudslinging has continued, and several people who really have a lot to contribute to intelligent discussions have left entirely on account of it. It happened again this week on another website when the owner sent out a notice to everyone on the site making an accusation against a fellow therapist. He later admitted his error in judgment as an emotional response to something he was passionate about and apologized publicly, and I’m glad.

Participating in a conversation on an Internet forum comes with a few inherent flaws. You cannot hear the tone of anyone’s voice, nor see their body language. What you perceive as sarcasm may in fact just be passion for the subject at hand, that would come off sounding entirely different to you if you could hear and see the person saying it.

There’s a song that says “free your mind, and the rest will follow.” Some people would do well to take heed of that. The close-minded set who think their way is the only way, and who refuse to remotely consider that someone else might have a valid point, cause the conversation to deteriorate into a combination of the bad and the ugly. I have been embarrassed to see otherwise professional people calling each other names, making wild accusations about people’s credentials, refusing to address a legitimate question directed at them, but instead turning around and replying with a snarky comment or answering it with another question and evading the issue altogether.

If I was a member of the massage-seeking public, and I had witnessed the behavior of some of these people on some of these discussion boards, there’s no way in hell I would allow such an angry, bitter, and closed-minded individual to place their hands on me.  I would reach the conclusion that anyone carrying around such an angry and superior attitude couldn’t possibly bring any peace and well-being to me.

I happen not to agree with Rick Rosen; it’s not the first time I’ve disagreed with him and if we both live long enough it probably won’t be the last. In fact some of his own board members at the AFMTE have expressed their concern in response to the comments that have come in on LinkedIn.  It was done civilly and without any wild accusations and bad behavior.  When I run into him at a meeting, I’ll still sit down and have a drink and a chat with him, or anyone else who disagrees with me.  It’s called civil discourse.

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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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Report from the NCBTMB Approved Provider/CE Meeting

I just got back from Chicago, where I participated in the Massage Approved Provider Panel convened by the NCBTMB. I have to say it was one of the best meetings I have ever attended. Everybody left their egos and their agendas at the door…not one single moment of tension or dissension occurred, in spite of the fact that competing entities were represented.

MAAP Meeting at the NCBTMB

I spent the weekend sitting next to Bill Brown, Deputy Director of the AMTA. I’ve heard through the grapevine that Bill has wanted to strangle me a few times over my blog, and I’m glad he got the opportunity to know me a little better. I might have managed to convince him that I have a few redeeming qualities and I’m not just the crazy blogger he thought I was.

Cynthia Ribeiro, President-Elect of AMTA, was also present, and what a class act she is. I had supported Cynthia during the AMTA election, and there’s no doubt in my mind that was the right move. She is one fine lady who has made many contributions to our profession, and had a lot to contribute to the task at hand this week.

Bob Benson, Chairman of ABMP and Anne Williams, Director of Education for ABMP were there. Bob brought his considerable business acumen to the meeting. I’ve worked with Anne before and she’s just a go-getter who shares my philosophy of “make it happen.” She has a great sense of humor, too. There was a lot of laughing this week, which is always a great ice-breaker and good for the cohesiveness of the group.

The facilitator, Drew Lebby, provided exactly the right balance of keeping things moving, listening, and explaining. We had breakout groups and larger discussions and the whole meeting just had a great flow. Having been in meetings with some very boring facilitators in the past, I thought he was wonderful and I would highly recommend him to groups who are looking for a great facilitator. He has 35 years of experience at it and it shows.

I heartily applaud the Federation of State Massage Therapy Boards for sending Kathy Jensen, VP of the FSMTB, and kudos to the NCBTMB for inviting the Federation to participate. Since the MBLEx has taken a huge chunk of the NCBTMB’s exam market share, and the Federation has also recently announced plans to jump into the CE approval arena, I can think of past administrations at the NCBTMB that would have spent the time sniping about the Federation as competition instead of inviting them to attend, all the more reason why I appreciate their willingness to play in the same sandbox. That theme was reiterated by Ribeiro and several others this week–this isn’t about your organization, or my organization, or who’s the biggest or the best–it’s about massage and increasing the quality of massage education.

COMTA was also represented by Commissioner Randy Swenson. Several state board members were in attendance, as were approved providers and a couple of nationally certified massage therapists.

The AFMTE was not represented, although they were invited to participate, and as a founding member of that organization I personally found their refusal to attend distressing. This meeting was about education, and in my opinion, they should have been there. I contacted Rick Rosen to give him the opportunity to explain their absence, and his response was that since the AFMTE has decided to partner with the FSMTB in developing their CE program, he felt it would blur the issue and divert their focus to attend.

Nice try, Rick, but since the Federation was invited, and in fact chose to participate in the meeting, I don’t buy it. The mere term “Alliance” suggests that you are representing education, and not just one faction of it. The Alliance could have made some great contributions to the meeting and you missed out on a good opportunity to do so. Rosen is of the opinion that the Federation should replace the NCBTMB and the individual states who do their own approvals as the only provider/CE approval entity. We’ll just have to agree to disagree on that issue.

No one has been a more vocal critic of the NCBTMB than I have in the past, and I have defended the right of the FSMTB to offer their competing exam, as I don’t believe that any entity is entitled to a monopoly. I will go further and say that I don’t believe any entity is entitled to a monopoly in any arena, so I am not in support of the Federation having a monopoly on continuing education. They have the undeniable right to jump into the market if they choose, and the marketplace will decide. I am personally not going to be dictated to of which entity I have to throw my CE approval business to unless my state makes it a law that I have to choose one or the other. I’m not going to hold my breath waiting for that to happen.

There are 42 member boards in the Federation and so far, although many states have voted to accept the MBLEx, and some have adopted it exclusively, many others have refused to throw out the NCB exams, and continue to give their licensees a choice in which exam to take. I believe the same thing will happen when it comes to continuing education. Some states will go with the FSMTB CE program, and others will continue to allow providers to make their own choice. It’s the American way. Furthermore, in many places legislative changes will be required in order to switch from one to another or add another approval entity, and we all know that legislation most often moves at the speed of molasses. That is also the American way.

There were a number of problems identified with the NCBTMB’s current system. For one thing, some providers have taken advantage of the fact that once they received approval, they could add on classes at will. Some have ignored the fact that there is a prohibition on classes that are based on a product they sell. Some have ignored the fact that there is a prohibition against classes based on religion and/or spiritual practices. Some have ignored the fact that they need to be genuinely qualified to teach in their subject area.

Bruce Baltz, an NCBTMB Board member, mentioned people who teach NMT techniques suddenly throwing in a class in lymphatic drainage needing to be looked at carefully…sorry, but your attendance at a weekend workshop does not qualify you to suddenly start teaching it yourself. The people who have been guilty of these offenses are going to have a little awakening when some of the changes to the program are implemented.

The suggestions for solutions were great and it was interesting to see that when we broke up into small groups to do problem solving, most of the groups were on the same page. Some of the suggestions included requiring providers to submit videos of their classes, a much stricter and more frequent auditing process, an improved evaluation process where students can go online anonymously and evaluate teachers and class content, a required online class for teachers themselves to improve instructor competence…lots of good ideas that the NCBTMB is going to consider and decide which ones to implement.

Every organization and individual at the meeting expressed a genuine interest in assisting the NCBTMB in this endeavor. Even better, they all agreed that all the organizations, not just a choice few, need to come together once or twice a year for the good of the profession. Bob Benson stepped up to the plate on that front and good for him for doing so…AMTA and ABMP can take a few swipes at each other, but in the final analysis, there is room in the sandbox and he knows it.

All in all, I thought it was a wonderful gathering of some of the best and brightest, with the intent of creating a positive outcome, and I was honored to have been included. Paul Lindamood and his team did a great job in organizing the gathering and assembling the best people they could get. And hey, any meeting that includes keeping chocolate on the table at all times does it for me.

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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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10 Questions for Alexa Zaledonis, New Chair of the NCBTMB

Alexa Zaledonis, LMT, CPT, NCTMB, is the new Chair of the National Certification Board for Therapeutic Massage & Bodywork. She is the owner/operator of Even Keel Wellness Spa, a therapeutic massage and skin care center in Annapolis, Maryland. Even Keel employs seven full-time and several part-time employees who specialize in Thai, sports and rehabilitative massage.

A graduate of the Baltimore School of Massage, she passed the NCE in 2002 and has spent the past seven years building her practice in the community. Zaledonis is a certified Lotus Palm Thai Yoga Massage practitioner and a Certified Personal Trainer through the National Strength Professionals Association. Zaledonis currently is completing her Yoga Teacher Training (RYT200). She also teaches Thai Massage at Even Keel Institute for Continuing Education and is an NCBTMB-approved provider.

A former Certified Public Accountant, Zaledonis specialized in healthcare and nonprofit organizations for more than 15 years. She received her bachelor’s degree from Albertus Magnus College in New Haven, Connecticut.

I am NCTMB myself since 2000, and I’ve seen the good, the bad, and the ugly at the NCBTMB. They had a few rocky years and have been the target of my pen on numerous occasions…and in the past year or so, have received my accolades as well, as I feel they’ve made a big effort to right themselves. I don’t expect perfection from any person or organization, but I do expect effort, and I’m glad to report it when I see it happening. I’m glad to see Zaledonis take over the helm of the 9-member Board of Directors, and recently took the opportunity to find out more about her and her future plans for the organization. I recently seized the opportunity to ask her a few questions. My interview follows, and her answers are printed verbatim:

1. How long have you been involved with the NCB, and what previous roles have you been in there, if any?

By definition, I am not your “normal” volunteer. I joined NCB as a Board member in 2007, became Chair Elect in 2009. I had no prior volunteer experience with NCB before joining the board, outside of being a proud certificant. Volunteering prior to 2007 was not a possibility. I moved to Annapolis in 2003 and began my practice while still working part time as a CPA—there was no time for sleep, much less time to be a valuable volunteer. I believe if you can’t commit then don’t raise your hand.

2. What first led you to volunteer?

I raised my hand. I had figured out how to be a competent therapist, teach the community the value of quality massage and help other therapists to succeed in a viable career. Then, one morning, I asked myself, “What is the future for my employees, for myself, for the industry?”  I was one person helping a village. I knew that I needed to belong to a bigger village, and because national certification was always the backbone of my career as a CPA, becoming a volunteer at NCB was a natural next step for me.

3. What do you feel are the biggest challenges facing the NCBTMB today?

While massage therapy may be an ancient art, the industry in this country is young and will continue to evolve. There are incredible opportunities for our profession, but that can be a double-edged sword. What I mean is, it’s easy to lose focus without input and guidance from stakeholders. That’s why we always base what we test for and what we do programmatically on what the profession tells us is important. So the challenge is really to listen—and to always make sure that the individual therapist is heard, has a say and stays involved.

Ralph Waldo Emerson said, “Do not go where the path may lead, go instead where there is no path and leave a trail.” At NCB we are trying every day to listen, and then help lead our industry to grow in new ways. Sometimes, that requires forging new paths—like the advanced practice credential for example.

4. What are your priorities for your term as the Chair?

We have so many great things going on, but my top priorities surround the execution of the National Certification for Advanced Practice, or the NCAP, and future specialty credentials. Also, addressing the issues of continuing education and nurturing and enhancing our school compliance program. I look forward to seeing all of our programs work hand in hand, each one helping the next one to add value to and take the industry to new heights.

5. In your From the Top letter on the website and the one that was recently mailed out to the associations and regulatory boards, you talk about revamping the Continuing Ed/Approved Provider program and vetting individual courses. One of the most serious problems at the NCB in years gone by was overwhelming inefficiency, which was the main reason for switching to the present system of audits instead of requiring each class to be vetted. How do you plan to keep that from happening again? Are you going to hire new staff?

Yes, NCB is developing a new National Approved Provider and Continuing Education program, but at this point, nothing is written in stone. We have invited thought leaders, subject matter experts, state board representatives, peer organizations, approved providers and certificants to engage in high-level discussions and participate in the Massage Approved Provider Panel. The response has been impressive.

I think people in the profession are ready to take the next logical step for Continuing Education. And that is to define, differentiate and identify the educational level of the wide variety of modalities and subjects offered. We are looking to design a user-friendly review and approval process, but the panel will help inform the best way to go about accomplishing that.

The magnitude of continuing education has grown far beyond the conventional methods of administering and maintaining a program. We have to think outside of the box. Forge a new path. We have a rough framework of ideas and have are asking subject matter experts to share their best thinking. This truly involves the entire profession.

Imagine this: what if it were possible that in its final form, the national program could consist of an array of industry-wide workgroups comprised of key stakeholders as part of the “engine” that vets CE for the entire profession. All-inclusive involvement. Now that would be groundbreaking! And at the end of the day, it’s everyone together working to move the profession forward while protecting the safety of the public. Blazing new trails.

6. The NCBTMB has taken a substantial financial hit in the past year or two, but as I reported in my annual financial series, there’s been a great job done in cutting expenses. Do you think the NCB can remain financially viable?

Laura, there is no doubt we have had to make some important strategic decisions. But we are proud of our accomplishments, and in fact, independent auditors have said that NCB has exhibited a textbook turnaround during the last two years.

The NCB Board, along with senior leadership, have worked hard to ensure that our current programs, personnel and operational concerns are sound, support one another and offer real benefits for our certificants and the profession. This is how we are building value. With Paul Lindamood as CEO and my love of financial statements, you can bet we will keep close watch on the fundamentals…and the finances!

7. There are now a couple of other organizations looking at getting into the approval of continuing education. Do you think the NCB can stay competitive in the marketplace if that happens?

Thus far, everyone seems to be showing great interest in being part of our Massage Approved Provider Panel. I don’t see this as competition. I see this as the industry putting forth their best effort on something, and that is a beautiful thing.

8. How is the NCAP progressing? I need to know since I plan to be the first one to take it!
And Laura we want test number one to have your name on it! NCB has spent more than a decade polling the profession and has witnessed the growing demand for an advanced credential. Not only that, but the medical industry is showing exceptional interest in it as well. We have spoken to numerous doctors who all support an advanced credential. This is incredibly exciting for the profession—and we are only scratching the surface.

Regarding our progress on the NCAP, a Job Task Analysis survey was sent out the latter part of 2010 and we have just received the preliminary report. NCB would like to thank all of our partners in the field from professional organizations to schools and students as well as industry media for spreading the word about the survey. We had a tremendous response.

Our next steps involve the development of test specifications, which will be sent out for public comment in March. After that, item writing will begin in earnest. It is a very comprehensive and rigorous process.

9. Your term is for a period of two years. Do you think you can accomplish all the things you want to accomplish?

Two years is not a long time. However, as I quoted Emerson earlier, I will be happy with my accomplishments if I can help to blaze a path to advance this profession, and most importantly leave trail markers clear enough for the next person to follow.

10. What’s your fondest hope for the organization going into the future?

I hope that the organization can help to bring this scenario to life:

Therapist calls prospective employer:

Ring Ring

Employer: “Hello, Human Resources at Community General Hospital”

Therapist: “Hello I am a Massage Therapist and was wondering if you are hiring?”

Employer: “Well your timing couldn’t be better. We are always looking for qualified  people. Tell me about yourself.”

Therapist: “I am a Licensed and Certified Massage Therapist. I hold a National   Certification in Advanced Practice, am working toward a specialty in                      Medical Massage and have a list of qualified continuing education I can                  share with you.”

Employer: “Your credentials sound great. We only hire Licensed and Nationally Certified Therapists. Why don’t you send over a resume and we can set up a time to talk.”

You gotta think big, Laura. Thanks for giving me the chance to be a part of your blog.

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