I participate in a lot of massage discussion groups on the web, and one thing that constantly comes up is raising the standards for practicing massage in the US. As with any hot topic, some are for, and some are against.
Our Canadian friends across the border in British Columbia require 3000 hours of education, plus a written and a practical exam. Here in the United States, 500 hours of education is still the standard in 26 states. In Montana, Wyoming, Kansas, Oklahoma, Vermont, and Alaska, there’s still no regulation at all, so anybody who wants to call themselves a massage therapist is allowed to do so, whether they have any training or not. New York and Nebraska require 1000 hours of education, and the rest are in between, requiring anywhere from 570-750 hours. A few states require a practical exam; most do not. A couple still have “apprenticeship” options.
Continuing education, both the requirements and the lack thereof, are also another source of contention. 8 of the regulated states have no continuing education requirements. Those that do require it have various cycles ranging from 6 per year to 32 every two years. Some therapists, like me, love continuing education. Others are as thrilled about it as they would be an audit from the IRS.
Should we just keep meeting the minimum, or raise the standards? Would raising the standards give us more credibility? Are we happy to just maintain the status quo? Raising standards would mean a lot of schools would either have to expand their programs, or pack it in. Costs would go up, and that would of course have to be passed along to the student.
I really think it all depends on where we want to see our profession go. For those of us who want to be a respected part of the health care team, there’s only one answer. We need to reach higher. For those who are happy giving a relaxation massage in a salon and who don’t aspire to do anything other than that, it seems a little crazy to force them to do more.
The middle ground is to have tiered licensure. And then there’s there advanced certification that’s forthcoming from the NCBTMB, but we haven’t seen that yet, and don’t know just how advanced it will be. There are a few specialty exams in existence, but at the present time, they create a small ripple in a big pond.
The Massage Therapy Body of Knowledge project is a step in the right direction, but it’s not going to be any kind of instant fix for raising standards. Defining them, maybe, although that remains to be seen.
We’re at a crossroads here, and sooner or later we’re going to have to decide which way we’re going to go. I hope it’s up.
Peace & Prosperity,
Laura Allen
March 11th, 2010 at 7:58 am
Very well stated.
I agree – I would like us to reach higher, but we have to agree on where we are reaching and why. I continually strive to be better trained and educated, but it’s hard trying to explain to PTs, MDs, DCs, and nurses that we can help someone with back pain, headaches, etc when not everyone has the same standard.
On the other hand, our clients don’t care. They hurt, they walk in, they relax for an hour to 90 minutes, they get up, they feel better… That is the extent they are worried about. I have several clients that ask what I learned from my last Continuing Education trip (I tend to take at least one multi-day trip a year, sometimes 2 weeks of intensive classes). For most of them however, I’m still the same massage therapist.
Reach higher – yes. But we need to recognize that our clients don’t know or care how much training it takes for certification in any modality – medical or spa based.
March 11th, 2010 at 8:55 am
The arguement that the profession has to change to be valued by the public bothers me. (The work that we do has been done for a long time. Salvo’s Principles and Practice overviews some history.) I don’t believe this change will occur in this way. In my experience with massage I have to say what you’re talking about has more to do with how men engage with their therapist. How our male consumers view women has more to do with their emotional development than it does with our credentialing.
March 11th, 2010 at 11:40 am
Maryland has a two-tier system. You have to attend massage school and pass two exams, of course, but if you have 60 or more college credits, in any course of study, you are a Licensed Massage Therapist and considered a medical professional. As such, you can practice in a medial setting of doctor’s office, hospital, etc. If you have less than 60 college credits, you are a Registered Massage Practitioner and cannot practice in those medical settings because you are not considered a medical professional. This system doesn’t bother me much, but maybe that’s because I’m an LMT.
What does bother me is the attitude that deep work and relaxation work being somehow so different that they must be separated into “viable heath care” and “only for salons”. I rent a treatment room from a chiropractor and see many of her patients before they receive their adjustment. This is usually a short session of deep, site-specific work. But, I also see patients and my own clients that simply come to relax for an hour with a full-body massage. I treat different these sessions no differently. I’m just as serious about and work just as hard at a relaxation massage as I do site-specific work (which can also be relaxing!).
The reality of it is that are therapists who only want to do the deep, “challenging” work just as there as those who only want to give relaxation massages. And a two-tier system is a good fit for this reality. I just wish is wasn’t so partitioned! Massage is massage is massage. It’s all good.
March 16th, 2010 at 7:55 pm
The “standard” measured as the number of hours a massage therapist goes to school is the wrong core issue. There is no relationship between hours and knowledge, skills and abilities. The quality of the education experienced by our students in classrooms throughout the nation is the metric that creates knowledge, skills and ability in a consistent manner. As an example, a bachelors degree is conferred after a specified number of credit hours are complete yes, but, the course design is fixed, peer reviewed, mostly accredited and basically consistent nationally. So we can pick a number, but until the people teaching students in every school for massage are qualified to teach by virtue of their academic background the number of hours might as well be 10 or 1 million.
When we accomplish this I believe it will solve most of the other problems in our profession.
Standardizing the education experience for massage therapists (and I’m sorry, here I mean, only massage therapists) would then create an agreement across the nation of what one needs to know to enter the profession. Having created that bridge, and then crossing it, will effect the following: help consumers and employers know what a new therapist knows, can do with confidence and safety. It will keep people from being able to practice other professions by using, or hiding behind our title. It will establish an entry level of knowledge, so advanced would be easier to find. It would distinguish what one has to do to become licensed, and then determine if I want to be certified. It probably would create easy conversations for state boards, so that portability could become routine and even simple. It would create a core competency so my specializations would come beyond that start point, again, taught by only those qualified to impart the knowledge. It would hopefully create the interest for accreditation with schools, again, to show a measurable excellence. Thereby weeding out institutions who are not doing the job.
Let us not make the mistake of giving schools the ability to add hours, raise tuition and gather students without a committment to meeting the minimum educational needs of every future practitioner. Interestingly enough the meager opinion our profession held by most in the health care arena, professional athletic settings, high end resort employers etc. is established at the massage school level. It is not enough that some of us have climbed to professional heights in these arenas if the majority of the “profession” can be looked at as barely educated.
March 17th, 2010 at 1:35 am
What is the big deal???? We can have it all. Massage is one of those things that all levels of expertise can survive in. It’s all good. It is the recipient of the work that needs the info that will help determine their needs.
On a personal level, I sometimes want only massage that will soothe and relax, and then sometimes I will want massage that will deliver ranges of motions I have lost.