resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
August, 2012, Vol. 12, Issue 08
The ELAP Project vs. The Seven Deadly Sins of Massage Education
By Ralph Stephens, BS, LMT, NCTMB
Author's Note: Ralph R. Stephens is a Director of the Alliance For Massage Therapy Education. This article represents his own, personal opinions and not those of the AFMTE.
One of the penalties of not participating in politics is that you will be governed by your inferiors." Plato
Part of political participation is being informed, and if you care at all about the future of our profession, I urge you to read the five page Entry Level Analysis Project (ELAP) description document at: www.abmp.com/downloads/ELAP_2012.pdf. The ELAP stated goal is to standardize educational hours, educational outcomes and improve "portability" – the ability to take licensure credentials from one state to another. All wonderful sounding things; who could be against them? I am not against any of them in principle, however I am extremely concerned about how they might be accomplished.
When you read the document, notice that the project's goal is to determine the minimum educational objectives and Knowledge, Skills and Attitudes (KSA's) needed for an entry-level therapist to pass a licensing exam (MBLEx) and give a "safe, competent" massage. Originally, it was just a safe massage. Competent was begrudgingly added due to the outcry of some concerned stakeholders. Never in the document will you find the term "Massage Therapy" or any other reference to being able to deliver therapeutic or clinical aspects of massage.
A new Job Task Analysis survey (JTA) is being conducted by the Federation of State Massage Therapy Boards (FSMTB) and it contains an add-on section to gather data for the ELAP. The analysis of this data will give more credence to therapists who have been in practice from one to four years and have performed at least 500 hours of massage. (Three years is where the high drop out rate begins.) Doing the math, this is one massage a day for two years or two massages a day for one year. This is what our associations feel is a "functional practice." (From the ELAP Description: "As shown by their persistence for this time, this group has demonstrated perseverance and the skills to develop a functional practice or work productively as an employee.") At two years out, would you define one to two massages a day as a functional practice?
Safety is not a significant problem in massage therapy. The incident rate of actual physical injury caused by massage therapists is miniscule. So, the standards determined necessary to prepare entry level therapists to pass the MBLEx, and give a safe massage, competently are going to be a very lowest common denominator. How is this going to elevate or improve our profession?
It appears the ELAP is a project designed to set another minimal entry-level standard. Why do it again? The data for entry-level KSA's is already on the table and just needs to be recognized and utilized. The danger here is, if this level of training, as defined in the project document, becomes our "standard," the potential exists to reduce/limit our scope of practice. This was tried already by the MTBOK project's scope definition, which fortunately has been mostly ignored. Particularly in states like Florida with a good scope of practice definition in their law, there is a lot to lose. What you might ask? Most likely, the casualty would be the ability to serve the public with the full potential of massage therapy. It could also lead to restrictions in our liability insurance coverage for "therapy," possibly requiring advanced certifications and additional insurance fees and riders to cover therapists doing therapeutic work. As you read the ELAP document, think about this, seriously.
Sadly, the need for the ELAP is based upon a fallacy. Then to begin to argue its minutia becomes an exercise in re-arranging the deck chairs on an adrift ocean liner. We do not need another blue–ribbon panel to set another standard or definition that ignores or papers over the fundamental problems of our profession.
The Real Problem
We have a real problem with substandard, inconsistent entry-level education causing poor quality massage to be delivered to the public. The problem with this low-quality massage training and its resulting low quality of massage practice is the unintended consequence of AMTA's policy of working to get 50 state licensure — no matter what the laws look like, with no attention paid to maintaining, much less expanding, our scope of practice or the regulation of entry-level training programs.
Over the past 15 years, the number of institutions offering entry-level massage training programs has expanded in recently licensed states. Most of these new programs were not traditional start-ups by long-time massage therapists who embodied the lineage of the field. For the first time, we saw the unfettered entry of for-profit career colleges and taxpayer-funded community colleges into our sector. It's simply supply and demand. The passage of new massage laws created new demand for the training required for licensure. These entities were in place with both classrooms and the Federal Student Aid eligibility to quickly add programs. The fact that there was not a population of trained massage therapy educators to teach these programs was not an issue, because the regulations for massage schools and instructors were lax or non-existent.
These institutions are opportunistic: they observe what's happening in the workplace and create or remove training programs according to what's hot and what's not. They have no long-term investment in the profession of massage therapy, as it's just another program to provide revenue. It's solely about the money and not about the lineage of massage therapy or who is being put out onto the street to practice it.
These developments have changed the landscape in ways we could not have imagined. In the rush to "elevate" massage to the status of a profession, AMTA (lately working with ABMP) has actually created a serious decline in the quality of massage services provided to the public (the unintended consequence). This problem is hard to get recognized, because most massage consumers don't know what a decent-quality massage treatment is like.
ABMP's latest massage consumer survey showed that 93% of massage clients were satisfied or very satisfied with the quality of massage they received. Does that mean massage therapists are doing a great job? No, it means most people have never experienced a good massage. To use a fast food analogy: a burger made from greasy, undercooked horsemeat is better than starvation, which is why a billion-dollar-a-year empire was able to be built on low-grade massage. Americans are so touch-starved that they will keep coming back for substandard massage, because it's better than not being touched at all.
How do we get the big players to own up to the respective roles they play in this situation? Neither ABMP nor AMTA have been willing to look at this. Not surprising, since students and graduatess from this sector have ballooned their membership rosters. They're both serving up "happy meals," and taking us on important-sounding trips to exotic lands named MTBOK, MOCC and now ELAP, all of which are distractions from the core problems. Despite their ongoing PR messages, these major organizations are interested fundamentally in their own well-being, and not the profession, much less the public. Actions speak louder than words.
At the very heart of the deterioration of massage quality delivered to the public is the lack of a trained teacher corps to staff all massage schools. To its credit, ABMP has created some basic teacher training seminars. However, they have also rejected as unnecessary and excessive the proposals for teacher education standards that have been developed by professional massage educators in a peer review process, which are based on teacher education standards recognized and used by a variety of other professions. Teaching theory and methodology is the issue here, not just knowledge of the subject(s) being taught.
The Seven Deadly Sins
Colleagues, here comes the real truth of the situation that no one has had the courage to put on the table until now. Standardizing the number of hours or the curriculum content (ELAP) will not improve educational outcomes as long as our massage educational institutions are allowed to:
The (ELAP) is a further diversion from the long and challenging work that will be needed to address these "sins." Two things are needed to "heal" the problem, money and moral conviction. ABMP, AMTA and FSMTB must be persuaded to give substantial and ongoing financial support to COMTA and AFMTE to assist them with their respective missions. COMTA because we need a strong accrediting agency dedicated to the field of massage therapy. That is the natural place for educational standards to live. AFMTE because their Teacher Education Standards Project (TESP) is the trail that the entire education sector must follow if we are to truly "elevate" the profession from the sad state in which it currently exists.
These organizations also need to take a public stand - an unequivocal position - that the operational practices listed in the "Seven Deadly Sins" are no longer acceptable in the massage therapy field; that we expect better from our schools and programs. They may not have the force of law, but such moral courage on the part of community leaders, consistently stated, can and will instigate a change in institutional behavior.
We must take up these challenges for the sake of the massage seeking public and for the lineage of our profession. Want to be part of the solution? Get involved. Thank you for your caring for our profession.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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