Friday, November 7, 2014




I have read numerous posts (including mine) about issues with massage education and school approval.  I have a suggestion. Maybe it could work.

The concern is the quality and continuity of massage education.  This blog is going to focus on entry level education which is the point of entry into the practice of massage therapy. In the U.S. the point of entry is determined by state statute—licensing. The Federation of State Massage Boards has developed a Model Practice Act MPA.

There has been quite a bit of controversy about the Federation’s agenda, but I am going to put that aside just now.  Yes it is true that the Federation cannot mandate anything.  It is also logical that burdened state government agencies will pay attention to the Model Practice Act because it is there and easy to use. Therefore, in this Blog I am going to respond as if the MPA is how the legislation will play out.

The MPA defines entry level practice for massage therapy.  OK- what does that mean?

The Entry Level Analysis Project-ELAP-, determined the curriculum content and hours both of which the MPA include.  The hours are 625. You will have to read the curriculum content yourself. It is logical to expect that the MBLEX ( the only state licensing exam not since the agreement with between the Federation and the NCB-yes I know there are a couple states that still have own exam) will reflect the  ELAP content.  So if a curriculum does not cover ELAP curriculum content, in the future students may not be prepared to pass the licensing exam.

While not perfect-I can live with the ELAP recommendations :curriculum and hours.  So in my mission possible process the profession has entry level education defined.

There is also an outcome measure for curriculum effectiveness- Pass rate on the MBLEX.  Now be careful about getting your fascia in a twist. We all know that being able to pass a test does not measure how well a graduate can perform a massage.   Our goals as educators are:

·        Prepare the student to be able to pass the licensing exam

·        Prepare the student for success as a massage therapist

Program approval would evaluate these two points.  The first point is easy- exam pass rates.  I suggest 70% pass rate as measurement.   There will always be students that struggle with exams regardless of education and as educators we can to work to help them get over test taking difficulties. I do not support multiple choice exams as a valid measurement OK. However, that is what we have; the model is deeply ingrained in occupational licensing so it is not a battle worth fighting right now.   The 70% pass rate does not penalize schools for the test taking issue.

 ·        Prepare the student for success as a massage therapist

Evaluating this is much harder and very subjective.  Currently accreditation uses enrollment compared to graduation rates and then job placement rates for graduates.  I am not a fan of this but don’t have a better idea either.  If a person pays for an education then they should be able to at least be average in skill levels and at least be able to obtain an entry level job. They many not keep it or be successful in the long run, but they should be able to at least get a job.  I again suggest 70% placement rate of graduates who declare that the intention for learning massage is to get a paying job or be self-employed and earn money.   There may be a few individuals in massage classes that are not vocationally focused but want to learn how to help family members etc. A school should not be held responsible for these student’s graduation and placement rates. However, a school should be held accountable for the students they enroll, the ability for these students to reasonably complete the education and get a job.  This means NOT enrolling individuals that will not be able to meet these minimal requirements.  I suggest a 70% completion rate.  This means if 10 students enroll then 7 should finish the program and 5 of the graduates should get a job or become self-employed.

 OK—here is the baseline. 






All this points are able to be objectified.    A programmatic approval process would revolve around these points. 

Actually most of this is already imbedded in current state licensing for massage.  However the MPA wants ( taken from the Model Practice Act document)

“In addition to the recognition of the

ELAP recommendations, it is intended

that eventually all those who enter

the profession shall have received an

accredited education. Accreditation

enables State Boards to approve

massage schools through a nationally

established standard of accreditation

and would promote educational

quality and increase portability by

eliminating the need for individual

states to devise their own standards.


However, during a transitional

period before accreditation is

accepted as a standard of education,

as the profession evolves, it is

recommended that all educational

institutions adopt a curriculum that reflects the ELAP recommendations

and that is acceptable to an

accrediting body recognized by the

U.S. Department of Education.”



What is accreditation?  Accreditation -a process of formal recognition of a school or institution attesting to the required ability and performance in an area of education, training, or practice.

Here is COMTA’s definition: Accreditation is a voluntary peer review process that identifies and acknowledges educational institutions and programs for achieving and maintaining a level of quality, performance and integrity based on educational and professional standards. - See more at:

 This is from the Accreditation Standards

A. The programs under consideration for COMTA accreditation have current approval(s) as required by law and regulation in their jurisdictions, including state education agencies, state private postsecondary regulators, or massage or esthetics licensing boards.  P.2

What does that mean? Does it mean that the school facilities are legal? Does it mean that the facilities are safe? Don’t the zoning and building codes do that? Maybe it means that the school is in compliance with state regulation related to licensing of the actual school? If the state does this then accreditation does not have too as well.

What about administration procedures?  I can understand that a STATE would want to defer this obligation to an accreditation organization.  However, validating that the school is functioning administratively does not mean that the finances must be audited, or that school uses a specific filing process, etc.   I point this out because the accreditation process gets bogged down in this kind of stuff. 


I propose that COMTA develop a curriculum approval process that  states can defer to providing an external source of validation to determine that the school meets the recommendations and requirements of the Model Practice Act : ELAP compliant curriculum and 625 hours. Since the MPA does not define teacher criteria it is logical for programmatic approval to include a base line for teacher standards and ongoing teacher development.  I also suggest that educational quality be measured by “so called student success measures” of 70% GRADUATION RATE- 70% PASS RATE ON LICENSING EXAM - 70% PLACEMENT RATE FOR GRADUATES- at least until a better idea can be implemented.  I also suggest that if during the program approval process any issues indicating financial instability, fraud, illegal operations that COMTA report these concerns to the state for investigation.

I believe that the on-site visit process has become a burden both to the school and accrediting body and a more efficient and cost effective process can be use such as an independent neutral local individual whose job it is to provide a virtual tour of the school and synchronize communication between the school personal, students and accreditation personal - something like SKYPE.  It is the on-site visit costs that really increase the fee structure.

I also suggest that sustaining fees for yearly reporting are paid on a per enrolled student basis.  This would help small schools budget for the process.

I also suggest that ALL massage education is programmatically approved.  If a school wants institutional accreditation for financial aid or other reasons, then the massage education should still be programmatically approved.  Right now, only COMTA can do this. Other organizations may become able but not right now. 

To sum up:

·        ALL massage educational programs would be program approved using the criteria I described.

·        This approval process would need to reflect MPA content.

·        The process would be cost effective and my educated guess is that $3000 should be enough.

·        The initial approval would be based on this flat rate that does not mandate a costly on-site visit. 

·        Ongoing yearly monitoring would use a sliding scale based on enrollment. I suggest no more than $100 per student.

·        A school does not have to be institutionally accredited.

·        However, all institutionally accredited schools must also have massage program approval.

·        A school does not have to meet any financial bench marks, or standardized administration policies. However indications of illegal, unethical and fraudulent activity identified by the programmatic approval body (COMTA) will report to the state massage board for investigation.  

·        I suggest a 7 years phase in period to allow sufficient time for schools to adapt and implement to programmatic approval.