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Massage Today
July, 2012, Vol. 12, Issue 07

Moving Massage Therapy Toward a Brighter Future

By Ralph Stephens, BS, LMT, NCBTMB

Exciting things are happening in our profession of massage. I am more positive about the profession's future than I have been in many years. We are being included in the development of the new Integrative Healthcare Paradigm largely through the work of the Academic Consortium for Complementary and Alternative Healthcare (ACCAHC – "The Consortium").

The Massage Therapy Foundation is representing massage at international research conferences and promoting massage research. Both of these organizations deserve our support. Many of our stakeholder organizations are stepping up and moving us toward being accepted as a real profession. I want to share more of the good things that are happening with you and point out some problems that will hold us back from reaching our potential, while making some constructive suggestions. In the spirit of full disclosure, while I am on the Board of Directors of the Alliance for Massage Therapy Education, I am not speaking for the Board. All opinions in this column are my own.

So, let's start about a year ago when the youngest stakeholder organization in our profession, the Alliance for Massage Therapy Education (Alliance) published a position paper recommending a change in focus for the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The paper proposed that NCBTMB let go of its entry-level certification and testing program and replace it with a voluntary post-graduate certification credential that would follow mandatory state licensure. This new and upgraded program was suggested as an alternative to the so-called "advanced" certification program that NCBTMB was promoting. For its part, the Alliance took a lot of heat for having the audacity to "tell other organizations what to do."

massage therapy - Copyright – Stock Photo / Register Mark Then, in mid-March, NCBTMB took us all by surprise by announcing that lo and behold, it will sunset the National Certification program in 2013, and replace it with a new post-graduate credential called Board Certification (with specialty certifications to follow). Kudos to NCB's leadership for finally being able to break out of an operating model that was heading off the cliff, but also kudos to the Alliance for planting the seeds and advocating a bold position for the future welfare of the whole profession.

Time for Teacher Standards

Separate from all of that, the Alliance has proposed the single most important step needed in the advancement of our profession – the development of standards for massage teachers. The National Teacher Education Standards Project (TESP) is a five-phase plan that will establish core competencies for massage therapy teachers, along with model teacher-training curricula, training resources and ultimately, certification programs. Phase one of the TESP, The Core Competencies for Massage Therapy Teachers, has just been released for public comment and input.

Once again, the Alliance is ahead of the curve in putting forth a project of this nature. It is an ambitious, long-term effort, estimated to take five to ten years. The goal of this effort is to create a culture of teaching excellence in our field with the downstream result of therapists being able to deliver a better massage to the public.

The nursing profession went through a similar process many years ago and there are additional excellent model(s) to draw from. The massage profession must begin the training of our teacher corps, turning them into true educators, rather than simply therapists with a textbook publisher's lesson plan in hand. Just because a therapist can give a good massage does not mean they have the knowledge, skills and attitudes (KSA's) to effectively teach beginning massage therapists. It will take time, but it will be worth it. If you are a massage educator and want to be on the cutting edge of massage education, check out the Alliance website to become involved in this process. In a national survey conducted by the Alliance, 80.4% of respondents agreed that competency-based teacher training standards are needed in the massage profession. Only 6.8% disagreed. The time has come.

Massage students are only as good as the quality of instruction they receive. Better instructors make better therapists. The only way to elevate our profession to the status it deserves, and that most of you desire it to have, is to improve the knowledge and skill level of our teachers. If you are a massage instructor, view this as an opportunity to improve your teaching skills. We can all get even better than we are now – right? The standards will be phased in over time in a supportive way. Our entire industry needs to support this endeavor, as nothing else can do more to get the public higher quality massage than developing and implementing a teacher standards program. Just as we are what we eat, a profession is what its practitioners have been taught.

The Storm Clouds

However, the two largest stakeholders – our major membership organizations – have set out on a wayward mission to standardize the hours required for licensure and to come up with a learning objectives map for entry-level massage programs, the "ELAP." PLEASE – don't just do something!

The number of hours required for licensure are currently completely meaningless quantities. They are dartboard numbers that have been picked out of convenience to school operators or for accessing Federal Student Aid. Standardizing the country on an arbitrary number of clock hours will not magically improve competency or portability. There is simply no data that shows the public is getting a safer massage from graduates of a 1000-hour program as opposed to a 500-hour program. One thousand poorly taught hours will not produce a better therapist than 500 poorly taught hours. In fact, it may produce a worse therapist with more substandard habits and lack of awareness, burned out and broke. The number of clock hours that will eventually be nailed to the wall by the ELAP, if it is allowed to proceed, as the "evidence-based" standard will be completely meaningless if we cannot assure that at least 90% of entry-level program graduates can give a massage of satisfactory scope and quality. What we need are curricula with academic integrity, not just some arbitrary number of hours and a few learning objectives.

Further, clock hours are an unsound way to specify an educational program. We need to move to an academic credit-hour system, like every other healthcare profession. We must move to an educational system based on competencies, which includes assessment of student performance at each level of their training. COMTA has had a competency-based curriculum standard for more than a decade, yet our major stakeholders are off to re-invent the wheel. Why not use COMTA's existing program, updated with the MTBOK, now with its re-mapped KSAs? (More brilliant work done by the Alliance.)

Besides, job task analyses (JTA's) (the ELAP is to be based on a new JTA being done for the MBLEx), while psychometrically valid and legally defensible, measure what people who are not necessarily successful and who do not know what they do not know, think others should know to be successful. They primarily serve to dumb a profession down, especially as its level of competency decreases. New JTA's only lower the floor. It is time our profession comes up to a competency standard developed by successful experts, not down to a price or worse, to a continually lower common denominator.

The "license portability" promised by this ELAP project will likely not happen, as there are many other factors besides hours in laws and rules that affect portability. Supporting model legislation by the Federation of State Massage Therapy Boards (FSMTB) is the best way to achieve portability. Besides, portability is not the burning issue nor essential for the development and improvement of a profession.

A "Kneaded" Idea

Come-on stakeholder leaders, don't waste our dues dollars on another ivory tower task force whose report will be thrown on the pile with all the others. It is time to support:

  • The establishment of meaningful teacher standards (TESP).
  • Realistic competencies for entry-level massage education (COMTA + MTBOK).
  • Beneficial model legislation, which includes teacher standards and competency-based curriculum standards with the academic hours to impart them (FSMTB).

If you really want to do something constructive, help us dramatically modify or put the ineffective modular program format out to pasture for good. And for extra credit, how about developing and implementing reasonable admissions standards instituted in every school that offers a massage program? We should not be throwing our doors open to the academically inept, and/or ethically challenged (like felons) guaranteeing failures, loan defaults, and future ethics complaints.

This approach is the most efficient way for massage therapy to achieve its potential with both the public and the arising integrative medicine-healthcare community – both of whom are waiting for us to elevate ourselves to a true alternative healthcare profession. Will we step-up and meet their expectations? More importantly, will we decide to live up to the potential our profession has to offer the public?

Think about it. If you care, get involved.

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


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