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Massage Today
August, 2010, Vol. 10, Issue 08

We Get Letters and E-mail

Editor's note: Massage Today received a large response to Ralph Stephens' July 2010 article, "Marching Toward Therapeutic Irrelevance", with the overwhelming majority in favor of the article. The following are some of those letters received, along with one response from Mr. Stephens.

MTBOK "Still Evolving"

Dear Editor:

We would like to respond to comments by Ralph Stephens in your July issue and correct misinformation some seem to have about the Massage Therapy Body of Knowledge (MTBOK).
Before evaluating the MTBOK, it is very important to understand its intent. A statement of a body of knowledge is common for professions and is generally considered essential to a profession's advancement.

The MTBOK was developed as a resource to inform and guide those within and outside the massage therapy profession including massage therapy schools, massage students, practitioners and researchers. It also is intended to inform and guide the profession in the areas of massage therapy practice, accreditation, research, certification, education and licensure. It is an evolving document and none of us should expect it to be perfect. With its publication, it is available to all--for study, comment, and improvement.

Open book - Copyright – Stock Photo / Register Mark We especially want to clarify that its release does not change any massage therapy laws, regulations, curricula or legal scope of practice. The areas devoted to definitions and scope of practice are intended to speak to baseline, entry-level massage practice --taking into consideration that current entry-level standards vary widely and help define that practice. Some of the MTBOK is aspirational. The developers clearly state that massage therapists often do other things or incorporate a variety of modalities into their practices that require training and education beyond what should be expected of baseline massage therapy education.

Our profession is still evolving and so will the MTBOK. We encourage everyone connected with the profession to read the full document at and add comment and feedback at .

The eight members of the MTBOK Task Force contributed a tremendous amount of time and energy to this project; the result of which is this document. We are grateful to them for their commitment and welcome the input and guidance of the entire profession to build upon this inaugural body of knowledge for the massage therapy profession.


Massage Therapy Body of Knowledge Stewards
American Massage Therapy Association
Associated Bodywork & Massage Professionals
Federation of State Massage Therapy Boards
Massage Therapy Foundation
National Certification Board of Therapeutic Massage and Bodywork

Medical Massage Therapist?

Dear Editor:

I agree with Mr. Stephens' comments. I live in the Tri-Cities in Washington state. There are three massage schools here that crank out multiple therapists every year. Are they well trained as medical massage therapists? They all say they are. We contacted one of the local schools a couple of years ago offering a medical massage training. We asked what that constituted and were told Soap Charting and Insurance Billing were part of the curriculum. My wife and I are both massage therapists as well as health care professionals with a college degree. We found this to be laughable. I wrote to the Department of Labor and Industries in Washington state, voicing my concerns that not everyone is qualified to see their patients.

I was told that until our professional organization comes up with a definition of what "medical massage" is, the Department of Licensing could not offer a separate license for spa and medical massage. Most of the massage therapists in town were basically taught spa massage, and they lack specific technique, clinical experience and general medical backround to be therapists. The doctors don't know the difference, the public doesn't know the difference and no one is regulating who calls themselves "medical massage therapists".

Group Health has moved in the right direction creating the "Clinical Massage Therapist" designation. Until medical massage becomes at least an associates degree it will not be taken seriously. It means nothing to the medical profession if you prove the benefit of massage therapy in one or one hundred studies. They couldn't care less. I have been a respiratory therapist since 1986. Doctors are business men with stethascopes. It's about volume, money and standardization. One day they will put you in a box, take away your individuality, narrow your scope of practice and give you a discount in the gift shop on your birthday. On that day you will have become part and parcel of the great medical system.

Gilbert Pitkoff

Disappointed and Dismayed

Dear Ralph:

I just read your article in Massage Today. WOW! I've been saying that for years! I've read your articles before, (and was not offended), but this one spelled it out completely.

I have a degree in accounting, which I practiced for 20 years before becoming a massage therapist. I've been practicing for 9 years in my own massage business. I've taught in the massage schools, been a member (and officer) in my local AMTA, and sat on the massage board for my state.

This is how I see it:

When I first went to massage school, in 2001, massage therapy was just beginning to open up wide. I had great hopes and expectations for the future of massage therapy. I must say that I am disappointed and dismayed at what is happening today. The schools are charging 3 times the price for less instruction from incompetent instructors, and putting out MTs like water. Now that the FSMTB has watered down their MBLEx exam, everyone passes! Very few new MTs take the NCTMB or NCE because it is more expensive and much more difficult. I've had LMTs tell me that they could have passed the MBLEx without ever taking a massage therapy class, let alone any extensive anatomy/physiology class. So we have a lot of LMTs out there, but their abilities and education are highly questionable. It's like the box of chocolates: you never know what your gonna get!

And, we can thank the State Boards for watering down their tests, also. They love the MBLEx, because since more pass, they get more licensing fees. I don't even want to get into the politics and power struggles involved with boards and associations. It's all about money!

So, we have an influx of many LMTs, but the only ones who are making money is the schools and the State Boards. The massage therapists certainly aren't making a ton of money.

I have quite a turnover in my therapists. They don't want to work; they don't want to work when the clients can schedule (after 5 p.m. or Saturdays), they don't want to spend any money on hands-on classes so they can hone their skills or learn new ones...

I'm not sure what the answer is, but you are right! Where are all the professional LMTs who should be screaming at the tops of their lungs to make a difference? Chances are, they are afraid of the powers that be, and don't want to stir up the waters. The more mediocre LMTs, the less other medical professionals respect us. I don't blame them!

Well, I've said my piece. I wish I could say that I feel better. But, I'm glad I'm not the only one out there who sees! Keep writing your articles about the truth! Sometimes it is painful, but needs to be said.

Tina Elwood, LMT, NCTMB

Misrepresentation of MTBOK

Dear Editor:

In his July 2010 column, Ralph Stephens misrepresents the Massage Therapy Body of Knowledge (MTBOK). He says, "[The MTBOK] has become an instrument to effectively suppress clinical massage." Excuse me? Since he doesn't give the reasons why he believes that, where do I even begin to clear up his confusion? I'll simply give a counterexample: me. My practice is primarily clinical massage, everything I do is in the scope defined by the MTBOK, and my clients get spectacular results. So his claim is clearly false.

He states that, "Any therapeutic scope of practice that is left in our massage laws is being defined out of our scope by MTBOK," and, "The less we can do, the less valuable we will become in the health care system of the future." To think that defining our massage therapy scope of practice will limit what we can do in our practice is a common misconception, one that would have been clarified for Mr. Stephens if he had attended the MTBOK webinar on June 23. (Find the recording here: I highly recommend it.) In fact, you are free to combine massage therapy with other types of treatment, provided you have the training and skill to do so. So you're free to incorporate aromatherapy into your practice, or herbology, or selling fish for that matter. As long as we're clear that selling fish is not massage therapy.

He says, "'Evidence-based massage' ... will support orthodoxy, stifle innovation, and force providers to treat conditions, not people." To the contrary, the MTBOK expects massage therapists to "develop an inquiring mind and question current massage therapy practice," and encourages them to "participate in massage therapy and/or related research," so that we all contribute to an advancing body of knowledge. Which raises the question: Did Mr. Stephens even read the document?

I totally agree with him that the public needs "skilled, specific, therapeutic touch from well-trained professionals." The MTBOK is a giant step forward in raising the standards of our profession. If enough of us get behind it, it can have a major influence on massage therapy training, licensure, regulations, portability across state lines, professionalism, and acceptance by the medical community -- to the benefit of us and those we serve.

If Mr. Stephens has any informed complaints about the MTBOK, he can participate in revising it for the next version, as it is intended to be a living, evolving document. So can any of us, and I encourage everyone to do so.

Terry Kahn, BA, CMT, NCTMB

Click here for response from Ralph Stephens to Terry Kahn.

More Responses

Dear Ralph:

I enjoyed reading your article in the July issue of Massage Today.

I definetely agree with you!

Louise Leguizamon, LMT

Dear Ralph:

Love your article! I am the last person to be considered PC which is probably why I can't keep a teaching job. Students love me, but administrators have turned education into a lifestyle preservation venture. I have even ben told "I would rather work with someone I like than someone competent"!

I applaud your efforts,

Cassandra Wang

Dear Ralph:

I wrote to you about a month ago through your website regarding your article. I couldn't agree more!!! The strangling of our potential to offer true healing therapeutic work is absurd and serves no one. I have been educating the general public and corporate america in fitness and health for over 30 years as a trainer, coach, administrator, and massage therapist. I have seen a dramatic decline in the willingness to explore our craft to its true value. The fear surrounding this myopic mindset is obvious and the MTBOK just adds to it. How can I help support your stance and get massage therapy where it needs to be??


Michael Alan, LMT, CPT (1996 -2010)

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

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


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