Archive for Massage Politics

Massage Advanced Certification?

October 24, 2010 Julie Onofrio Licensing and Legislation, Massage Politics, News

The NCBTMB (National Certification Board for Therapeutic Massage and Bodywork) is currently in the process of creating an advanced certification massage exam.  I have to say I am skeptical right from the start and always have been since the inception of this organization.  It was created back in 1988 just when I was getting out of massage school. Their history is quite rocky to begin with. I was never a supporter mainly because I saw how it was created.  There was never any research done from what I could see at that time to see if it was needed.  It was supposed to be an entrance exam for the AMTA and it somehow all of a sudden just became a certification exam for the massage profession.  It was funded by AMTA for starters.  They did pay the money back to AMTA and are now independent of AMTA and in fact AMTA has disowned them and does not professionally endorse them any longer and changed their support to the Federation of Massage State Boards exam -the MBLex (AMTA Press Release).

The latest news from the NCB says in their latest news(pdf):

The credential will be the first to enable accomplished practitioners to differentiate themselves in the massage marketplace. It will also make it possible for employers and members of the conventional and integrative healthcare arenas to hire practitioners based on a certified, advanced level of experience and expertise.

Is that what is needed for a massage therapist to differentiate themselves in the marketplace?  What proof is there that an exam will help do that?  What about teaching MT to do just that by learning a specialty and learning to present themselves in a way that differentiates themselves from all of the other massage therapists out there in their neighborhood.  If everyone takes the exam – will they all be differentiated?

Those who earn the advanced credential will be nationally recognized for possessing the critical thinking skills necessary to function in complex situations. In addition, they will be relied upon for their ability to work in a team environment utilizing treatment plans based on research-informed outcomes.

How will they get that training in critical thinking skills and on research when most of the massage therapists out there have little training in research since research is really just in it’s infancy in this profession.

“NCAP practitioners will offer the advanced capabilities increasingly sought out by discerning clients, employers and healthcare providers,” said NCBTMB Chair Neal Delaporta. “The credential will open up new opportunities for therapists in conventional, integrative and clinical healthcare settings. It has the potential to take the entire profession to a new level within the medical community.

Is that what will help us be recognized as a health care profession and be able to work in the medical community billing major medical insurance companies and working with injuries and diseases?  Here in WA State we are already recognized as a health care profession and we are able to work with doctors and insurance companies.  We are able to do that because we had a very savvy insurance commissioner who also had a great massage therapist – Lori Belenski- who is now working for the WA State Chiropractors Association as a lobbyist.  Debra Senn, the insurance commissioner created a law that mandated that insurance companies must pay for massage, Naturopaths and Acupuncturists.  The WA State Legislature adopted the “every category of provider” mandate as part of the 1993, Health Care Reform Act to go into effect in 1996.  The insurance companies fought it and took it into Superior Court and held it up until 2000.  Here is the report done at the time “Issues in Coverage for Complementary and Alternative Medicine Services: Report of the Clinician Workgroup Jan. 2000.  The full report that I have a copy of lists the timeline of events leading to the passing of this law.

Does it take an exam to make massage accepted by insurance companies?  Not based on WA State since we only have the minimum of 500 hours of education required for massage professional licensing.

What will take the profession to a new level is having reciprocal licensing!  Come on already!  That’s a simple one to me anyways.

Chair-Elect Alexa Zaledonis added, “For practitioners with the NCAP credential, it means a potential for increased marketability and heightened earning power. It will help connect advanced therapists of all modalities to rewarding positions with high-level employers.”

How will it do that when the major employer in the massage profession are massage franchises.  There aren’t any higher level jobs or at least very few.  What it takes to find or create higher paying jobs is saying “NO” to low paying jobs and going out there and showing employers just what massage can do and how much you can make for an employer.  It is about having the skills to market yourself and negotiate pay – just like most other careers.  Since most massage therapists are locked in the “Noble Poverty” – “It’s not about the money” – too many Massage Therapists are not standing up for themselves and are looking for what a job can do for them rather than what they can do for a job.

The next step is a job task analysis “that will ask practitioners to determine the knowledge, skills and abilities that an “advanced practitioner” must possess, as well as the level of importance that should be placed on each.”

What makes for an advanced massage therapist?  Is it their skills and training?  Is it the amount of time they last in the field?  With over 250 different kinds of massage and bodywork out there (and that number growing everyday)- how will they come up with skills that all types of massage therapists will be able to acquire?

In 2009, the NCBTMB did a needs assessment survey to ask the profession to help define the criteria for the possible exam.  The survey looked at:

•Defining the Advanced Practitioner
•Identifying the Necessary Characteristics of Advanced Certification
•Identifying the Criteria for Advanced Certification

Personally, I find it interesting that they didn’t ask if they thought an advanced certification was needed.  They just assumed that it was and went on to ask questions about it.   Since I never saw any benefit to the regular certification exam, what will people get out of the massage advanced certification?  I have never in 23 years been asked if I was licensed or certified.  I guess I am lucky to live in an area where massage is accepted more and seems to be ahead of the game in being accepted by health care companies.

What makes for an advanced massage therapist?  Anyone who can last more than 3-5 years would qualify in my book!

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The History of Massage leads to the future

September 6, 2010 Julie Onofrio Massage Politics, Massage Research, News

The history of massage is one of the most popular pages on my website.  Interestingly enough it is also the website that is most plagiarized by others.  Many people are usually interested in the history of massage to show it’s an acceptable method of treatment or they are looking for info for a massage school project.  While the history of massage is not copyrighted – my version of it is.  For the life of me I can’t figure out why people don’t understand that but this isn’t really what I am planning on writing about.

The real story is that most of what is written on my page on the history of massage was taken from bits and pieces from massage school textbooks.  I gathered it a small piece at a time.  Many of the books said similar things on each step in the time line.  Unfortunately for the massage profession – most of it is wrong and I was corrected a long time ago by the historian for the massage profession -Robert Calvert who now has passed away.  I was able to meet Robert in person a few times and talk about the history of massage.  What is intriguing to me is how massage has been handed down through time and how we have gotten to the point of having so many laws and regulations about massage when in fact is was done for so long without.  Also when I study the various types of massage and the history of each of those I often find that most come about out of need to heal the creator’s pain or someone in their family.  They study what is known and spin it around into their own design finding what works and what doesn’t.

Last weekend I spent a whole afternoon perusing the Google Books section on the history of massage and put together an interesting collection of historical massage books on massage and the movement cure as it was once talked about.  The books were written between 1850-1920 and most had a chapter on the history of massage.  Now we don’t actually know if they actually had accurate info or were they all copying each other like we currently have in many current books.   I would love to take the time to read all of those books and also look for other books to compare what they are saying and come up with more details on the history of massage.

The reason for doing such a project would be to learn more about ourselves and where we have come.  The current trends in the profession seem to be headed toward more hours of education and more legislation.  There is talk of degree programs in massage.   Historically from what I read in the old books was that massage was once a 2-3 year training program and it was mostly done by doctors.  It seems that more hours of training is needed to become more a part of the medical profession and to be accepted by the medical profession but we don’t really know if that is true.   Here in WA State we are able to be contracted providers with insurance companies and doctors refer to us all the time.   It came about mainly because of the work of a savvy insurance commissioner, Deborah Senn, who used to get massaged regularly by one of the massage professions political spokespeople, Lori Belenski who currently works for the Chiropractic association.  We didn’t need any more than our 500 hours of training that is required for licensing.  All we needed was a good insurance commissioner who loved massage and knew what it could do.

The old books also have quite a bit of case studies and research being done.  I would love to know more about that early research because there weren’t any big influences like who is paying for them to be done – or maybe there was at that time – I guess I don’t know for sure.

So back to the history of massage and what it can do for our future.  I believe that in studying our history we can get a clearer sense of ourselves and take a better look at just what we want it to become.   How can we help more people with touch and massage?  Could it be in getting back to having massage be a family activity being taught to sons to help their wives during child birth?  As we gain more research and evidence that massage can help people be more healthy, will it be able to become an everyday event covered by insurance for preventative means?  Could we see more programs like Massage for Peace and Touch to TEACH programs to support our communities?  Does that take more education or just more money to start them?  Could we as Robert Calvert spoke about in his book “The History of Massage” be less likely to repeat our past mistakes?

First up is to make sure that everyone knows that Per Ling was not the father of Swedish Massage! (See also Google Books excerpt from the History of Massage” and also this latest article from Judi Calvert on Massage Today)

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Defining Massage Therapy and Bodywork

January 16, 2010 Julie Onofrio Massage Politics

Defining massage therapy is a big challenge for the massage profession.   Each state already defines it for themselves.  I started a list of these definitions of massage a long time ago and I am sure some have now changed and new ones were added by states who just initiated massage licensing.

There is also a group of massage therapists who have joined together to try to create a unified definition of massage called the Body of Knowledge.  Here is the first draft of their definitions of massage.

Here is the AMTA’s Definition of massage from their website..

MASSAGE THERAPY is a profession in which the practitioner applies manual techniques, and may apply adjunctive therapies, with the intention of positively affecting the health and well-being of the client.

MASSAGE is manual soft tissue manipulation, and includes holding, causing movement, and/or applying pressure to the body.

THERAPY is a series of actions aimed at achieving or increasing health and wellness.

MANUAL means by use of hand or body.

The historic definitions of massage as outlined by Robert Calvert in this article on Massage Magazine’s Website continues to show the problems in defining massage.

Then there is the word bodywork that makes the whole situation even more confusing.  There seems to be some groups who represent different techniques who want to be referred to as bodyworkers and not massage therapists, making it even more confusing for the general public to be able to figure out what people are doing when they do massage or bodywork.

I also think one of the biggest things is -do people who are receiving massage really even care what it is called!

When you look at all of the different types of massage and bodywork, it continues to grow even more confusing.  I still have people asking me about the different types of massage and what they do.  I say that it really has little to do with they type of massage as they all can achieve results.  It is more about finding a person that you can work with who understands your situation and has a similar philosophy of healing and health so you can work together to create better situations.

Is cranial sacral work massage or bodywork?  Is Hellerwork massage or bodywork?  Is reflexology massage or bodywork?

As Bevis Nathan points out in his book Touch and Emotion in Manual Therapy
:

From the patient’s point of view, the touch has it’s roots in non-verbal communication or communication.  She does not experience the touch as merely a technique or procedure on her body tissues, it involves her self. She is being held, cradled, stroked, caressed, valued, cared-for, healed.  This patient’s experience is above all a phsychological and existential one.

So how should massage be defined?  How should bodywork be defined?  With keeping in mind what most people can understand or comprehend or make sense of?  What do we need to do to come to a consensus or is it even possible?

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