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Massage Today
December, 2004, Vol. 04, Issue 12

An Accreditation Quagmire

By Cliff Korn, BS, LMT, NCTMB

In September, Massage Today featured an article concerning the Department of Education's approval of the National Accrediting Commission of Cosmetology Arts and Sciences (NACCAS) to accredit massage programs in post secondary schools (www.massagetoday.com/archives/2004/09/01.html).

Two years ago, when NACCAS was still petitioning for approval as a massage accrediting entity, I wrote an editorial expressing my generally negative opinions (www.massagetoday.com/archives/2002/11/11.html).

Since this month's issue features several "point-counterpoint" pieces on accreditation in general (see front page), I revisited some of my thoughts.

I hope you read these articles carefully because they express some poignant but divergent thoughts on this complex issue that will impact the future of massage therapy as we know it.

Two years ago I wrote, "I am all for ubiquitous accreditation of massage schools. I think it would solve a multitude of sins, including easing the job of massage therapy regulation and reverting national certification to the voluntary credential it was designed to provide. However, I do think massage school accreditation should have a programmatic theme, with massage therapy taught by massage therapists as a core requirement."

While I still agree with that statement in theory, I now question the practicality of seeing it happen in the near term.

In keeping with "theory," I submit that the quality of education and ultimate competence of a graduating massage therapist should not be affected by the accrediting body. If approved by the Department of Education, one must assume that the same standards are applied to the approval of one entity as to all. Since a standard is a constant against which all models are judged, it makes no logical sense that one accrediting entity should provide superior criteria to the commonly accepted ones of a competitor. If this theory could be proven true, it then would make no difference at all who accredits as long as the standards remain constant.

Thus, it seems to me that the correct question for now is not the "who" of accreditation, but the "why" of accreditation. In the world of academia a degree from an unaccredited institution is less than worthless. (The term "match book diploma" is used to show the disdain. I'm sure you get as much spam as I do from purveyors of "degrees by mail," who promise you can be an ND, PhD, or other postgraduate-degreed person by submitting life experience and a healthy check.)

Massage therapy has never traditionally required a degree, however, and therefore falls out of the academic realm; it has historically fit into the craft or trade school model. Massage therapy has also shown itself to be a profession where one can succeed through mentoring and apprenticeship. This longstanding route into the field is still used and is one of the primary reasons that the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) has a portfolio review process as an alternate method of determining eligibility. If there was an accreditation requirement for every massage-education program, it is doubtful that this portfolio review process would remain a method of determining equivalency to massage school graduation.

So what, then, are the pros and cons of mandated massage school accreditation? Who has the potential to benefit and who doesn't? Certainly, massage therapists relocating to other states could benefit. I feel it is highly likely that ubiquitous accreditation would enable ease of license reciprocity from state to state. Massage boards would know that the transcript a candidate for licensure had from a distant state was equivalent to a transcript from the home state. The massage boards themselves could also benefit, as they wouldn't have to generate their own educational eligibility criteria or use criteria developed by NCBTMB, NCCAOM, or other outside credentialing bodies. It is likely that those who employ massage therapists might also benefit.

The largest single massage therapist employer group is the spa industry, which is forced to spend large amounts of time and money training massage therapists to integrate into spa therapists. As ubiquitous accreditation would frequently increase the hours of massage education needed to graduate, it is most likely that more schools would have additional curriculum elements to fulfill those needs. An argument for the public benefit is that the basic knowledge of therapists everywhere would be similar; therefore, equivalent levels of care would be available equally all over the country.

The potential exists for the schools to benefit from accreditation as they would become a much more significant force in the industry. Their impact and voice could approach the power that accredited chiropractic and naturopathic colleges now have in the realm of integrated health and wellness. Finally, the accrediting bodies themselves would certainly benefit, as that is how they generate their longevity and cash flow.

Opposing arguments also abound. Individual therapists may be adversely affected by having to pay more money to enter the profession, as costs to attend an accredited school could be higher. Schools have the potential to see reduced enrollments due to the higher tuitions they would likely need to charge to cover costs of added curricula and more stringent teacher criteria.

The professional massage associations could lose clout as the voices of accrediting bodies and schools overtake their influence. The NCBTMB would potentially lose its desirability as a front-end hurdle for state licensure. The public could theoretically lose as the tougher entry requirements into the field may actually reduce the number of therapists available to choose from.

So, for me, the jury is out on the overall benefit of ubiquitous massage school accreditation. Logic tells me that accreditation makes education better. I have had that logic bubble punctured by a recent discussion with a good friend and school owner who, at the tip of his tongue, was able to generate a long list of examples why accreditation does not always mean enhanced education or a better school. They were not knee-jerk responses to a perceived threat, but thought-out, concrete examples of accredited institutions that regularly turn out less-qualified therapists than other schools, and ones who have not had their educational ability affected other than to increase their costs. I heard his arguments and agree with his examples but still feel that industry-wide we would have better educated therapists if accreditation were the norm.

I ponder the paradigm shift that would evidence itself though, due to the higher costs. Fewer people would likely take advantage of massage as a part-time opportunity to make additional income from home-based businesses. I don't need to check the surveys and studies to know that a significant portion of working therapists do not use massage as their primary income source. Would one impact of ubiquitous accreditation be that the demographics of the profession would shift to only careerists? Would that be good or bad? Hmmmm...

At present I support massage schools going for accreditation, but I'm pretty pleased that it is a voluntary process.

What do you think?


Massage Today encourages letters to the editor to discuss matters related to the publication's content. Letters may be published in a future issue or online. Please send all correspondence by e-mail to , or via regular mail to:

Massage Today
P.O. Box 4139
Huntington Beach, CA 92605


Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.

 

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