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Massage Today
April, 2002, Vol. 02, Issue 04

Massage Education Failing, Part II

By Ralph Stephens, BS, LMT, NCBTMB

Editor's note: Part I of this article appeared in the March 2002 issue. The article is available on line at

Since last month's column, hundreds more poorly trained massage therapists and bodyworkers have graduated from lousy schools and are struggling to create a practice.

Thousands of people seeking help from massage therapy and bodywork will not find it because of the ever-increasing number of incompetent, inadequately trained practitioners.

More horror stories about sub-standard schools are pouring in: programs issuing 1,000-hour certificates but only providing 350 hours of training; continuing education providers reporting appallingly poor basic skills and vocabulary in practicing therapists. It is embarrassing when I am confronted by an individual like the shuttle driver who took me to the airport recently. She grew up getting massage from osteopaths (now a lost art). She has been trying to find a decent massage therapist for years. Of the last two she tried, one just rubbed some oil around, and the other made her sore for three days. Both were working in chiropractic offices. She said she has given up finding a decent massage and now just gets chiropractic. This is the backlash that is going to sweep over our profession if something isn't done soon about the state of our training system.

But what about the National Certification Exam for Therapeutic Massage and Bodywork (NCETMB)? Doesn't it guarantee competency, at least in the states in which it is administered? I live in one of those states. No! The NCETMB does not weed out incompetent therapists. It is a lowest-common-denominator system. It promotes mediocrity. It surveys the profession to get the basis for the exam. So, 50% or more of the people it surveys received lousy education and know little about massage. How do they fill in the surveys regarding what entry-level knowledge is essential? Most of them do not even know what they don't know The exam will continue to sink to the lowest common denominator and allow those with substandard education to become the norm. Its pass rate (over 90%) indicates that it is not a substantial filter.

Schools teach the test to make sure their graduates pass. Lousy schools do nothing but teach the test. No hands-on skills are required to pass the exam. No patient skills are required. All that is required are some short-term memorization of intellectual knowledge. This does not guarantee competency, and it most certainly does not set any standard of excellence.

Unfortunately, the NCETMB is the only "legally defensible" exam we have. State boards are almost forced to use it. I have supported and defended the exam over the years. I am sad to say I do not see any alternative available at this time, so I continue to support it. It is probably better than having no exam at all. However, as part of this discussion, I must point out the nature of the beast. The NCETMB is part of the problem of substandard education in our profession. It must be changed in some way, or it will be part of the downfall of our profession.

But what about research? If we can just validate our procedures and prove that massage is effective, won't that bring respect and creditability to the profession? Of course not -- it will just create further backlash, in that the majority of massage therapists and bodyworkers are incapable of reading a study and duplicating its results.

All those who promote research to validate massage should realize that if they prove something that the majority of the therapists cannot accomplish, their beloved research effectively becomes invalid and a waste of time and money. Further, instead of promoting massage and bodywork, it will cause a huge backlash against it. For example, if someone proves that massage therapy reduces acute low back pain, the public will go in search of such relief.

How many therapists will they have to visit before finding one competent enough to get the result predicted? Probably a dozen or so. How many will the public try? Probably one. What are the odds of them getting help? Less than 50%. What will they tell their friends about massage? They'll tell them that massage doesn't work. Will their friends try massage, after hearing that rave review? Probably not. How many people will a physician refer based on a study that claims to prove that massage will help with carpal tunnel syndrome? One, maybe two. If they do not get the reported results, not only will the physician not refer to massage therapists for carpal tunnel, he/she will probably will not refer to massage for anything. Research results cannot be duplicated in the hands of inadequately trained practioners.

Those who cry for research the loudest (who usually just happen to be researchers), should redirect their efforts toward improving the quality of education in this profession before they destroy it with their good intentions.

I want to emphasize that there are many great schools turning out well-trained, highly competent practitioners. These school operators see the degradation that is occurring in the education area of our profession. I know they are very concerned about substandard schools. We must find a way to eliminate substandard training programs without punishing excellent schools in the process.

Our profession fell into its darkest age in the 1940s because of incompetent schools. This dark age lasted for almost 40 years, during which time the majority of the public associated most massage with prostitution. Will history repeat itself? It usually does. So, shall we be relegated to the bath houses of an increasingly sexual society? Shall we again split into two groups, some of us becoming medical practitioners under the thumb of the allopaths as slave labor in the PT rooms, and the rest labeled as "sensuality workers"?

Let me guess - you don't like these options, do you? Neither do I. We will have to put on our thinking caps and figure a way out of this, and very soon. It will have to be done by the profession, that's you and me and thousands like us working together. Let the dialogue begin. Let it swell to a thunderous roar!

Tune in next month to learn how government and regulation are another part of the problem, not the solution.

Click here for more information about Ralph Stephens, BS, LMT, NCBTMB.


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