Orthopedic Massage Education & Research Institute

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15 Responses to “The Time Has Arrived for Advanced Credentialing”

I agree with you Whitney–we need to move forward now. Rather than spending oodles of money fighting with states to maintain the NCB licensing test, we should all be encouraging the NCBTMB to do what they were organized to do in the first place–certification. If they had meaningful certifications they wouldn’t have to make all their money in licensing because people would happily re-certify.

OK, moving on now, it is amazing to me that the mention of massage therapy is left out of the conversation at functions involving the CAM professions (ACCAHC), even when there are massage therapists at the table, because our training is not deemed sufficient or consistent on a national level. It is very frustrating for those of us at the table, but at the same time, I understand why we are being left out.

A final comment: we need to embrace accreditation as the entry level bar, and that is a minimum of 600 hours. The alternative is to stop calling it massage therapy education and start calling it massage therapy training. And, maybe we need that difference as you mentioned, as long as the personal care people can identify when they should not be attending to someone and make an appropriate referral.

- Jan Schwartz, May 18th, 2009 at 7:56 AM

You are preaching to the choir Whitney. Thank You, this is well written and clearly communicated. I would love to be in the larger conversation about “competencies opposed to hours”.

- Xerlan Deery, May 18th, 2009 at 8:01 AM

Jan:
Very good points here and you bring up another interesting issue. I think many people don’t realize the numerous ways in which we are being left out of this conversation. I still think many people who have never spent significant time exposed to health care education in other fields don’t realize what we really don’t know and why we can’t be taken seriously at this point.

- Whitney Lowe, May 18th, 2009 at 9:30 AM

I can only agree with both of you-in my area of specialty-massage for elders and those in later life stages, we are always interfacing with the health care community. Advanced credentialing standards-that are reciprocal across the US and beyond would be a huge benefit to those trying to implement massage programs in those settings! Please count me in on any ongoing conversations-I did immediately respond to the request for support in this area from NCB-but have not heard anything from their side of the table as of yet..

- Lisa Curran Parenteau, May 18th, 2009 at 9:37 AM

I am curious to hear more about your ideas for more education for massage therapists to what your training would include. I would like to see more training in psychology and the use of relaxation massage for conditions such as depression and anxiety and such. Getting regular massage can also work to help work through self esteem issues that come from early attachment issues. Also what about stress and how it creates the various conditions we see in people so often.

I work with these kinds of conditions extensively and we do need more research on this but I think that most of our other health issues are caused by stress and taking relaxation massage out of the picture would be a disservice to the profession. Relaxation massage therapists can show improvement which is all the insurance companies seem to be really asking for.

Julie Onofrio

- Julie, May 18th, 2009 at 11:48 AM

Jan said it first: it’s time for the NCB to stop their ridiculous campaign of interference in state governance and get on with the task of offering advanced certifications. Almost every month, some entity appears before our board (NC) and asks us to accept this exam or that exam as proof of advanced credentialing, and as a state board, it’s not our place to do that. If the NCB would get with the program, they could be enhancing the credibility of our profession and our status as members of the health care team, instead of wasting time trying to destroy the unity of the 30+ state boards that have joined the FSMTB.

- Laura Allen, May 18th, 2009 at 2:32 PM

There is no question that relaxation massage has health benefits and the effort to establish an advanced credential would not take relaxation massage out of the picture in terms of making that kind of contribution. There are clearly a number of stress-related ailments afflicting our society and relaxation-oriented massage can do a great deal to decrease the impact of those stress-induced ailments.

However, there is the whole different arena of working specifically as a health care provider who may be working with post-surgical conditions, rheumatological disorders, acute injuries, and numerous other conditions where the intent of the massage intervention is more of a medical treatment. It is for this type of situation where the advanced credential is needed.

Again, just because this credential would exist and focus on medical conditions doesn’t mean that relaxation-oriented massage would not be used for improving health. There is a substantial difference in any modality/approach/etc. used for health enhancement and something used as a medical intervention.

- Whitney Lowe, May 18th, 2009 at 2:57 PM

It doesn’t amaze me, Jan, though I agree with you about the purpose of national certification and what you see as its necessary aim.
Whether for relaxation or for clinical application, I believe that the consortium and similar academic bodies will take massage seriously only when its practice meets a universal standard nationwide. At present they – and heck, most practitioners – really don’t know what they’re saying when they say ‘massage’.
Advanced certification in 50 states would go a long way to remedying that communication gap.
I remember my first public Government Relations meeting as a massage therapist 21 years ago, when the Sheriff’s Lt. said to the OC Board of Supervisors, “These people don’t even agree with each other – how can I work with them?” And our meeting was pretty much over for the evening. We resolved to create a unified voice and work out all our differences before appearing before a govt. body again, and things have improved. I believe that the same approach would help when dealing with those who hold the keys to massage’s credibility and acceptance.
Mark

- Mark W. Dixon, May 18th, 2009 at 3:43 PM

Whitney,

I think you are correct that the time for this has come. There may be some downside to doing it [I know there are some legit counter-arguments], but at this point I believe it is far outweighed by the positive aspects.

I do believe that it would be a huge mistake however to simply pile more hours onto existing programs without carefully thinking through what the additional training/education will entail. I agree that the general concept of looking at competencies is one important way to go – others have written extensively on this, and there are examples/models for it [British Columbia for instance].

There are some other tracks [for a start] that could be followed after the initial [500 hour] basic education:

1] Clinical experience in schools following a case study model. Most schools have clinics, but I am not sure how they are used pedagogically in all cases. They can be used to great advantage if in addition to an opportunity to learn and refine professionalism and client interpersonal skills [important!] they are also used as shared clinical problem solving experiences [along the lines of what I experienced in your online orthopedic massage course]. This will bring alive what students learn in the science and hands on courses, esp. since I many massage students tend to be kinesthetic learners.

2] Experience in the form of hospital/clinic/institution rotations/affiliations. This kind of transitional experience is almost always included in other health care education -MD’s DO’s, RN’s, LPN’s, PT’s, PTA’s, PA’s etc etc. They serve many educational purposes but they would also provide an opportunity for massage therapists to gain insight into how other practitioners work “in situ” and for other health care practitioners to “see us in action” – to see what we do and how we deal with patients, and the immediate results of our work. That would help us integrate [both into those settings and in the sense of others referring patients to us with confidence]- I think even more so than simply informing people that we have upped our education requirements. They don’t really know what we are learning in the first place, so many not be impressed that we are now learning more of it. This will take a big effort on the part of schools to set up and structure these experiences, but as you say, there is no time like the present to get started on that.

3] Research literacy. It is important for all massage therapists to be at least aware that massage therapy research is underway, and to be familiar with how the research results have influenced practice [our attitude about massage and cancer is a great example]. There are resources available now that should be included in massage education [regular columns in the massage professional publications, workshops at AMTA conferences for instance]. Above and beyond that, if interested, students can learn skills to locate and effectively read and understand peer reviewed articles, and maybe even participate in writing clinical case studies and assisting in research projects — this will do a great deal to improve our credibility in a health care system that strives to be evidence based.

I believe there are many ways in which advanced credentialing could be done that would not simply be the piling on of more hours in a way that might shut out “entry level” or personal care oriented therapists – but it could also devolve into that if we are not careful. Thanks Whitney for being such an informed and reasoned voice in the discussion.

Jennifer Barrett

- Jennifer Barrett, May 19th, 2009 at 9:47 AM

Great to see so much participation on what is clearly an important issue for the profession.

In NZ we’ve had two standardised levels of education & registration for a number of years now. One relates to the practice of relaxation massage & one remedial massage (or what seems to be called orthopedic massage in the states). Hours requirements are roughly the same as yours for the first level, with the hours requirement for the second set currently at 1200 with a (pencilled in) plan to expand this to 1800 over the next couple of years. It’s a system that works fairly well, although we have no legal requirement of accreditation prior to massage practice in NZ at present – clearly necessary to achieve any kind of parity/respect in the wider health field.

The remedial massage standards set a fairly good standard for practice, however from where I stand now, it seems that it’s really not enough. Our training has been very focussed on the technical skills of massage, and while I feel that this is covered fairly well in most diploma-level courses, our gaps are in the area mentioned by Julie – psychology, as well as ethics & cultural awareness. These subjects are covered to some degree in most massage curriculums, but if I compare the weighting with other healthcare professions, and the legal requirements of other professions who are registered under our version of your accreditation process, I believe we are a little light in these areas. To my mind, there’s also more scope for expansion into the area of somatic education, and research, although both of these are also covered to some extent in most massage curriculums.

I should mention that we haven’t yet gone down the pathway of registration/accreditation. It’s quite possible that our legislators might not be happy with a two-tiered level of registration, especially when the baseline for most healthcare professions in NZ is at least degree level education, and often significantly higher. We’ll see….

- David McQuillan, May 19th, 2009 at 2:15 PM

This issue is timely and crucial and has generated so much discussion that we’ve started a social network on Ning that is exclusively devoted to addressing it. Please join us there to further this discussion. Here’s how:

Go to: http://advancedmassage.ning.com/
Click on “My Page” and fill out your contact information and join us!

- Whitney Lowe, May 20th, 2009 at 7:35 AM

Massage practice will not be considered “therapy” by the allopathic community until practitioners have college degrees and significant standards of training in advanced anatomy and medical applications of massage. Addressing these issues will separate those of us who wish to work as health professionals on a parallel with physical/occupational therapists from spa practitioners. Until we establish a minimum of 4 year college degrees and advanced credentialing standards, doctors will not take us seriously. In future years I hope that “Muscular Therapy” will be offered in colleges as a masters degree program. Working with people who have life threatening diseases is a serious professional route that should require serious education. Those who protest are probably unwilling to invest that much time and money in training.

- Aleta Heir, September 8th, 2009 at 8:49 AM

Australia is in the exact same situation. Couldn’t be any more similar.
Our biggest hurdles are:
– Associations don’t have the staff to persue such endeavours. They focus too much on member numbers rather than future directions for both parts of the industry. Financially driven unfortunately.
– The less qualified fight tooth and nail to keep the standards and expectations of professionalism to a minimum. They don’t see the benefit, just the work involved
– We don’t have entry levels into the industry, hence we attract many who are educationally challenged.
– Too many associations with no one vision, no one lobby group, no direction to the 17,000 members. Hence the members take it upon themselves to promote and advertise. You can only imagine the diversity in their opinions. Moreover the confusion to consumers and authorities within the health system.
– Self regulation is useless. It only regulates the good people. The less than ethical within our ranks only see opportunities to pillage the educational nightmare we have. Creating short courses that attract those that want quick education. Down grading our skill set, down grading our professionalism, our reputation and inevitably our future.

Time for someone to make a stand. Wish i was powerful enough to be that person.

- Brad Hiskins, September 9th, 2009 at 6:04 PM

Oh yeh, we have degrees. Unfortunately they are private degrees, run by private colleges with only financial gain in mind. The degrees have not been ratified by the industry or anyone else for that matter. Only their own committee over a cup of coffee. They do not meet our national competency standards and have no real place within our industry. And to make it worse they have called them yet another name – “musculoskeletal therapists” – just to confuse us and the consumers even more.
I love living in a capitalist society, but sometimes some regulation is needed to keep the wicked in hand.

- Brad Hiskins, September 9th, 2009 at 6:09 PM

One last post. Our school in Canberra Australia is 2000 hours of face to face education. We have no problems with the competency based edcuation when colleges follow it. The students are very employable and well versed in musculoskeletal health.
Just with they were the norm rather than the exception.

- Brad Hiskins, September 9th, 2009 at 6:11 PM

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