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

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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….

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

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.