resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
April, 2014, Vol. 14, Issue 04
Finding a Bridge to Somewhere
By Ralph Stephens, BS, LMT, NCTMB
In this, the third column in what I am calling the Policy Wonk Trilogy, we will look at the best solution on the block to uplift our profession, elevate our educational system and improve the quality of massage delivered to the public.If you have not read the two previous columns, they are in the November 2013 and February 2014 issues of Massage Today. And please note the therapy tip at the end of this column.
It's time to get out the shovels and dig deep enough to find a real solution to the primary problem plaguing the profession of massage therapy. First, high-profile projects like the MTBOK or the ELAP can have no real impact because there is no way to compel implementation of their recommendations. That is probably a good thing considering their recommendations miss the mark. However, if we go down to the foundational structure, it becomes apparent to the careful observer that the real problem is how we regulate our massage schools. Most state departments of education and boards of massage do little to regulate free-standing massage schools and massage programs in other institutions. Some basic forms are filed, maybe a bond posted and that's it. In most jurisdictions, it is just a business tax and permit.
When we started passing licensing laws for massage therapists, there needed to be qualifications to obtain a massage license. Since at that time there was no accreditation agency functioning in our profession, most state licensing laws specified education hours and curriculum, and gave the Massage Board some authority to oversee massage schools. This pattern has continued over the past 15 years. However, almost universally, these boards are understaffed, have little inspection ability and neither board members nor professional staff have the requisite experience with educational administration.
No other profession tries to define and enforce its educational standards through licensing statues and state board rules. Ours does because we did not understand the proper structure of professional regulation as we passed our patchwork of lousy massage regulations, with a few good ones here and there. By contrast, licensure in most professions requires that an applicant has graduated from a school accredited by the accrediting agency that is dedicated to that profession. Done. You won't find specifics on the number of clock hours of classroom training in other profession's licensing laws, or any mention of the required courses in the training curriculum. THAT IS ALL HANDLED AT THE ACCREDITATION LEVEL. The system of state occupational licensing boards was created to regulate practitioners – not educational institutions. This is a fundamental flaw that must be changed. Until it is, this "achilles heel" will maintain the current inconsistencies and inefficiencies of educational regulation and will prevent massage therapy from becoming a true profession.
It is time we change our statues to require institutional or programmatic accreditation for all massage schools from one specialized accrediting agency. It's a simple solution with ample precedent in other professions. However, the path to getting there is complex and fraught with obstacles. First of all, there are seven different agencies recognized by the U.S. Department of Education (DOE) that accredit massage schools and programs. On top of that, only about half of all massage programs are offered in an accredited institution. And only four states that license massage therapy require accreditation of massage schools.
The Commission on Massage Therapy Accreditation (COMTA) is the only one of the seven accrediting agencies that is considered by the DOE to be a specialized accreditor for massage therapy and it is the only one that has developed and implemented competency-based curriculum standards. They're the home team here, but they've been under supported by the major organizations in our field and are struggling to attract and keep enough schools under their wing to remain viable.
We already have the vehicle to bring about the needed improvements in massage education – and DOE has given COMTA the blessing to do so. As the common accrediting agency for all massage institutions, COMTA could implement the teacher education standards developed by the Alliance for Massage Therapy Education. As well, its competency-based curriculum standards would create greater consistency in entry-level training programs; something that the MTBOK and ELAP are incapable of doing on their own.
As the FSMTB develops its Model Practice Act as a guide for state massage regulation, it should specify that an applicant for licensure has graduated from a COMTA-accredited institution. State massage boards do not have the expertise, the staff or the authority to bring about the educational changes we need to deliver competent professional massage to the public. Trying to integrate the findings of the ELAP and MTBOK projects into our laws will be an expensive and time-consuming effort. Even if that were to be accomplished, it would still have little effect as licensing boards cannot effectively enforce standards on massage schools.
Needless to say, this will require a huge paradigm shift, which is seldom easy and often painful. Several obstacles must be worked out and it will take time, maybe a decade. Schools that have institutional accreditation from one of the six general vocational accrediting agencies must have a way to add programmatic accreditation from COMTA in addition to their existing status. These schools cannot and will not leave their existing accrediting agency that provides the gateway for students in all of their various programs to receive Federal Student Aid.
Then there is the issue of the other half of all massage schools that are not currently accredited. Most have stayed away from this process because they do not want the headaches of administering Federal Student Aid – or simply lack the financial resources to be able to meet the DOE's eligibility requirements. For these schools, COMTA must be able to create (again with the DOE's permission), a kind of "lite" accreditation process that is not a gateway to financial aid. For those who may remember, the original acronym for this agency in the early 1990's was COMTAA, which stood for the Commission on Massage Therapy Accreditation and Approval. It's time to bring back an approval-level function to be able to bring all massage educational institutions under one regulatory roof.
I am asking for a lot here, but massage therapy has emerged in a very different way than other regulated professions. While we desperately need to move the oversight of schools to COMTA, we must do it in a way that does not unduly punish schools or cause them to perish. Instead of funding more "Bridges to Nowhere" projects like MTBOK and ELAP, our stakeholders should be funding COMTA and the lobbying necessary to accommodate our profession's transition to a properly regulated entry-level education industry.
Stimulus - Response
While some believe that we "relax" muscles by physical pressure and stretch forces applied by the common massage techniques, there is another possibility. Maybe all we are doing is some form of stimulus response. Are we merely providing a stimulus to the nervous system and that stimulus causes the nervous system to "relax" a muscle and/or vasodilate blood vessels? Do you know how the nervous system "perceives" the touch you apply? Do you know how the stimulus of a particular massage stroke is perceived by the nervous system? If not, you are working blind. Each massage stroke is perceived by the nervous system as a specific stimulus and it elicits a specific response. To get the desired response you better be applying the correct stimulus.
Might it be that we are stimulating mechanoreceptors which elicit a relaxation or inhibition response? Might there a better way to manually elicit an inhibition response than the tried and true method of sustained pressure and deep stripping effleurage causing at least discomfort to the patient and over time injury to most therapist? Stay tuned for the answer. You will be surprised.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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