THE MASSAGE WORLD ACCORDING TO SANDY

 

Now that the comment period for the Federation of State Massage Board’s Model Practice Act draft is over we will all have to wait and see what happens next. Those that commented – good for you! Those that did not and knew about it, I have my funky face on.  Sometimes we think that if we agree with something we do not have to provide input. Not so. Feedback is important!  Those that did not comment and did not know—well no excuse. Professional behavior involves being informed. Enough said. 

I am going to use this waiting time to create a list of how I would organize and manage the massage world. I hope it is thought provoking.

In no specific order—just as the thoughts manifest in my brain----

ü  Educators in the massage world would attend the Educational Congress

http://www.afmte.org/afmte-conference/

The Educational Congress intention is to gather a critical mass of educators and facilitate co-location of meeting space for various organizations to gather and collaborate. Organizations are encouraged to hold board meetings, offer content for Congress participants, report to the Congress on the current status of that organization, and receive public comment and feedback. The 2015 Educational Congress meetings will take place over 8 days July 21-28 with the main portion of the conference with exhibition hall will only be July 23, 24, and 25. The event will be held at The Commons Hotel in Minneapolis, MN located on the University of Minnesota Campus.

ü  I want AMTA to stop holding the school summit and put support behind the Educational Congress and the Alliance in general. . ABMP is supporting the Educational Congress at least this year.

ü  Massage Educators would support The Alliance For Massage Therapy Education (AFMTE)

AFMTE was formed in 2009 to work with and strengthen the skills of massage therapy educators. The main focus of AFMTE is to create and implement teaching standards and to support educators in delivering exceptional education.  Our focus is teacher education and continued professional development for therapists and teachers. Currently, there is no mechanism in our field to train, evaluate, and certify teachers at any level.  So the AFMTE has undertaken a long-range project to identify the National Teacher Education Standard Project (NTESP).  The overall goal of this project is to create a culture of teaching excellence and eventually offer an instructor certification upon completion of the course. I WANT THE ALLIANCE AND THE NATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK TO COLLABORATE ON THE INSTRUCTOR CERTIFICATION PROCESS. THE AFMTE IS INVOLVED WITH THE TRAINING AND NCB DOES THE EXAM.  Check out the following  links.

 http://www.afmte.org/  

http://www.afmte.org/education/tesp-core-competencies/ 

 

ü  The Entry Level Analysis Project-

ELAP.  elapmassage.org is valid for standardizing the entry level content for massage education.  It is not perfect-but close enough.  It is very comprehensive and I wish referred back to competencies but COMTA (The Commission on Massage Therapy Accreditation) has good competencies that could be matched to the ELAP content.  We have the Massage Therapy Body of Knowledge, MTBOK- ELAP – and COMTA competencies.  They primarily agree so on with it. All curriculums for massage education should contain the elements identified by these documents. Period. If you are an educator it is your responsibility to study the content in these documents. There are no excuses.

ü  I want massage education to be taught in small highly focused massage schools with owners and teachers who are personally and professional vested in quality education. 

My definition of small is 40 students or less per year in classes of 6-14 students.  And I want these dedicated massage educators to fill available spaces and make a reasonable profit.  I want the tuition to be able to be paid out of pocket which means between $7000 and $ 8,000 for a 625 hour program (about $12 a class hour). I want these school to teach the ELAP content but I want them to differentiate themselves as unique and worthy of student attendance by their innovation and dedication to excellence in education and service to the student.  I want teachers in these schools to be highly qualified and when available to be certified to teach massage therapy.  I want these teachers to be fairly paid for their time at $20-$25 per hour.

ü  I want The Commission on Massage Therapy Accreditation COMTA www.comta.org to develop a  MASSAGE PROGRAM APPROVAL PROCESS INDEPENDENT OF INSTITUTIONAL ACCREDITATION FOR THOSE MASSAGE SCHOOLS WHO DO NOT ACCEPT FINANCIAL AID.

The program approval process can be modeled after the current programmatic approval with some modifications.  Here are my suggestions:

Massage Program Approval

The program must be clearly identified as a professional massage therapy. The program must provide an organized plan of study of at least 600 clock hours. ELAP FOLLOWED.

The program must offer a certificate, diploma massage therapy to a body of students enrolled for the purpose of receiving such a credential.

Then using the document link I identified the current standards that are applicable.  Interested readers can look of the specifics.  THE FOCUS IN ON EDUCATION- not administration, finance or management. Standards 1-4  5.4   7.1 7.2   In my opinion all of the other standards are monitored by the State and COMTA can certainly report a school to the state department of education if they identify violations and concerns.

file:///C:/Users/Sandy%20Fritz/Downloads/COMTA%20Self-Study%20Report%20(November%202011)%20changes%20accepted%20-%20FINAL.pdf

Fees for the approval need to be fair and affordable.  COMTA really does a good job at this.  Program approval can be for a set period— with annual reporting of any changes.  Curriculums need to be updated frequently so I would support a 3 year comprehensive review without onsite visit and an onsite visit with renewal every 7 years.

COMTA can continue to offer the current programmatic and institutional accreditation for those programs that are part of a larger institution such as community colleges and for those schools wanting financial aid.

ü  I support and encourage Board Certification from the National Certification Board for Therapeutic Massage and Bodywork. http://www.ncbtmb.org/

Let go of the past and support NCB in the now and in the future.  No one has to be Board Certified but professional behavior should support a desire to verify advanced learning and experience. It is not perfect but is a solid point of differentiation between entry level and experience.

!!!And Board Certification as opened a pathway for academic degrees in massage therapy. I especially support Sienna Heights University for their forward thinking and commitment to the massage profession.  There is a minor available in health care administration for those who are business focused and a minor in psychology for those with teaching as a goal. By the way the university also has an associate’s degree. 

http://www.ncbtmb.org/board-certification/college-credit-awarded-board-certification

ü  We need to come to grips with the EVIDENCE BASED AND EVIDENCE INFORMED practice issue in massage therapy. 

It is dividing the massage community. It really is quite simple: Most of what we do as massage therapist is hypothesis - not fact.  LEARN TO THINK for goodness sake. Critical thinking skills are essential.  There is little high quality research data about massage. However, there are a number of logical extrapolations that can be made to justify the benefits of massage.  The massage world cannot claim to be evidence based.  Ongoing research is very important. There will always be levels of experience that cannot be logically explained. That is OK.  But please, let’s just stop making claims that are not justifiable based on known physiological functions. 

ü  I support the Massage Therapy Foundation and want all to support them as well.    

 

ü  I want the massage world to embrace massage therapy as complete in and of itself and stop diluting it with adjunct methods that are not massage.  

 

ü  I REALLY want the Coalition of Massage Leadership Organizations to fund an independent ergonomics and bio mechanical analysis of massage therapy practice so we stop hurting ourselves.

 

ü  I want massage therapy to embrace the value of being an occupation based on service, ethical behavior, and valid education in the vocational sector with pathways to academic degrees for those who desire to achieve them.

ü  I want massage therapists classified in the occupational category with multiple career pathways.  We can be professionals in a wellness, spa, medical, sport, and rehabilitative realm. 

 

ü  I want continuing education providers to stop making up new names for the same stuff and to only teach material which with they are experience and only if they know how to teach.

 

ü  I want massage therapy to be less gimmicky.  I really get tired of and embarrassed about all the stuff out there that is the newest greatest thing.

 

ü  I want massage therapist to do massage and not infringe on other professionals scope of practice.  We are not nutritionists, athletic trainers, strength and conditioning coaches, aroma therapists, chiropractors, psychologists, spiritual advisors , doctors, or any other of the multitude of methods and professions out there.  WE PROVIDE THERAPEUTIC MASSAGE.  If you combine methodology then disclose in marketing materials. When I want a massage I want a really good massage.

AND

 

ü  I want massage therapists to make a sustainable living

ü  I want people to be able to afford massage without reliance on health insurance.

These go together. As an occupation and based on educational requirements, a yearly income of  $30,000 -$35,000 (full time- 40 hours per week- income taxes yet to be paid)  is reasonable regardless of self-employed or employee.   This is approximately $15 per hour.  I think it is OK in the first year after graduation for the hourly average to be $12 and at 5 years full time experience to be $17 per hour and at 10 years of full time experience to be $20 per hour.  If gratuities are factored into the wage then $ 12 per hour may be fair.  Notice this is per hour and not per massage.  It is based off of an 8 hour day 5 days a week and providing 5 massage session in the 8 hours. The massage fee for the client would need to be between $40 and $50 per 50 min session.  If employed the employee can cover overhead and make a reasonable profit.  If self-employed these suggestions cover overhead and management hours.

These are some of the things I would do if I could-
Together we can.  

MASSAGE THERAPY EDUCATION-A WINDOW OF OPPORTUNITY

A few facts and background information.

For profit education has been around for centuries.  The concept is not new.  There has been one change however that has made a huge impact on profit based education. That change is a shift from student self-pay to some sort of government assistance to pay for education.  In 1944, Congress produced the Servicemen’s Readjustment Act – better known as the GI bill.  Enter the for -profit school first to fill the gap from an influx of veteran students and then exploitation of those very same students with what is called predatory recruitment.   November 8, 1965, the United States Congress passed Public Law 89-329, 79 STAT 1219, which provided financial assistance to students in postsecondary and higher education. Prior to 1965 federal financial aid did not exist.  In 1992 for-profit colleges and universities became eligible for federal financial aid.  WOOT WOOT for the for-profit schools- First the GI bill for money and now government financial aid.

Generally, non-profit schools include state universities and community colleges.  They receive a significant portion of their funding from the government. Most private universities are also non-profit institutions. The community college system has been in existence since the 1900s but really took off in the 1960 when most of the community colleges moved from the private to public sector. Since 1965 these educational institutions have been subsidized by the state and federal government and students can receive financial aid grants and loans.  The community college system moved away from the vocational and technical roots and began providing primarily academic education preparing students to move on to a bachelor’s  degree at a university.

Well guess what—the for-profit school sector identified the need-vocational training and then filled it.  This is what the for-profit school sector is really good at and should be able to provide this type of education in an ethical and quality way. I support for-profit education.  I think for-profit schools are the best answer to vocational and technical training. It isn’t the profit that is the problem. It is the access to easy money better known as financial aid. The problem is also the student that is removed from the pay out of pocket reality process of education and instead gets caught in the hidden process of debt.  This is so so so sad.

For-profit schools teaching all sorts of skills grew at amazing rate after 1992.  However- tuition costs at a for-profit is generally twice as much as tuition at a community college. There are a few reasons for this but three big ones are: cost of advertising, cost of accreditation and administration of financial aid programs and the need to make a profit for owners.   

Although for-profits enroll only about 10-15 percent of all students, their students make up about 47 percent of all three-year loan defaults. Part- not all- but part of the reason for this is that the for-profit educational sector has traditionally served the complex student such as young single mothers and individuals that have struggled in the traditional academic setting-including community colleges.

 By 2015, new federal regulations will cut off student aid dollars to for-profit programs whose graduates struggle to pay back their loans.  Nonprofit public sector schools such as community colleges also have high default rates on student loans.  I have no clue what ramification the community colleges will have regarding default rates.

NOW:

I am going to make a case for financial aid access being a major contributor to problems with massage therapy education.   I am also going to make a case for financial aid being the main problem with the current downfall of the for-profit school sector.  Specific to massage therapy education are the major problems related to Corinthian College particularly for massage education offered in the Everest division.

 It is not the profit part ----but the financial aid part.

Back in the day –pre 1980 most all massage therapy schools were small independently owned for -profit educational schools.  There were a few exceptions, but not many.  Schools were state licensed as for- profit proprietary schools.  MASSAGE THERAPY EDUCATION IS ROOTED IN THE FOR-PROFIT EDUCATION SECTOR.  Most massage schools were not accredited. There was no access to financial aid.  Read the brief history of Commission of Massage Training and Accreditation COMTA.  Notice my added commentary in CAPS

COMTA: a brief history Copied from COMTA WEBSITE.

In 1982, the American Massage Therapy Association (AMTA) Council of Schools (COS) was established, in recognition of a shared concern among educators and school executive directors for the quality of massage therapy education. Early Council work focused on the need to develop and maintain educational standards. I WAS AROUND FOR THIS DEVELOPMENT-THE CONCEPT WAS GOOD.

 In 1989, (BEFORE FINANCIAL AID ACCESS) the Commission on Massage Training Approval/Accreditation (COMTAA) was established. In the following two years, with the assistance of AMTA’s Program Approval Review Committee, COS and additional AMTA volunteers and staff, COMTAA created and implemented standards, policies and procedures that would meet the rigorous standards of the U.S. Department of Education (USDE) for accrediting agencies. Recognition by the Council on Post-Secondary Accreditation was pursued as a developmental stage toward the ultimate goal of USDE recognition.  OK. ALSO GOOD.

 In 1992,(OH NO ---RIGHT WHEN FOR PROFIT SCHOOLS COULD GET FINANCIAL  AID FUNDS) in an effort to combat widespread fraud, waste and abuse in the federal Title IV financial aid programs, Congress passed the Higher Education Amendments. This law requires USDE recognized accrediting agencies to act as “gatekeeper” of federal funds. The responsibility for oversight of student loan programs for years had been shared by states, accrediting agencies and the USDE. Congress determined in 1992 that this triad was not able to guarantee program integrity and financial accountability in higher education institutions. The Amendments created a new triad in which the states (which have a new enforcement capability) and the accrediting agencies (which have new requirements to meet) each have responsibility for monitoring and reporting to each other and to the USDE.

IN 1992 FOR-PROFIT COLLEGES AND UNIVERSITIES BECAME ELIGIBLE FOR FEDERAL FINANCIAL AID. ACCREDITATION BECAME A MAJOR PLAYER IN THE FINANCIAL AID GAME.  NOT GOOD!

 While waiting for the USDE regulations to be issued, COMTAA continued to accredit and approve programs, as well as refine its policies and procedures to be ready to come into compliance with those regulations. In October 1996, an elected COMTAA Commission was seated. The members were elected by the then current COMTAA approved and accredited programs. The initial representation on the Commission included two massage school administrators, two massage school educators, two public members, and one each of professional academic, massage therapist employer and massage therapist practitioner.

THE ABILITY FOR COMTA TO APPROVE SCHOOLS INDEPENDENT OF ACCREDITATION WAS A VERY GOOD THING.

 In 1997 the decision was made to end the approval status on March 31, 1999, and change the name to the Commission on Massage Therapy Accreditation (COMTA). In 2004 COMTA became a completely independent organization. OH NO-END OF ANY TYPE OF APPROVAL STATUS. NOW ALL SCHOOLS WOULD HAVE TO BE INSTITUTIONALLY ACCREDITED AND COMPLY WITH ALL REQUIREMENTS BASED ON FINANCIAL AID.  WHAT A SHAME.

 USDE recognition was granted July 10, 2002. On November 8, 2004 COMTA’s USDE recognition was continued for five years and the scope of practice was expanded to include accreditation of academic associate degree programs. As part of the renewal of recognition process in 2010, COMTA requested an expansion into occupational associate degrees and aesthetics/esthetics and skin care. The body which determines agency recognition (NACIQI) met in December 2010 to evaluate this renewal and expansion. Both areas of expansion were approved and the COMTA recognition was renewed for one year to allow for certain COMTA procedures and policies to be updated. http://www.comta.org/main/about-comta/

ACTUALLY ALL OF WHAT COMTA DID WAS GOOD.  THE PROBLEM WAS THE OVERLAP WITH ACCREDITATION MOVING AWAY FROM A PROCESS TO DETERMINE EXCELLENCE AND BECAME A HURDLE TO JUMP TO ACCESS THE CASH COW OF FINANCIAL AID.

THIS IS WHAT ACCREDITATION SHOULD BE:

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. THIS IS GOOD

Benefits of accreditation

•Helps educators increase the quality and performance of massage and bodywork programs.

•Offers external measure of credibility, which assists in attracting quality students, faculty and staff.

•Increases program quality as faculty, staff and students participate in the self-study process and clarify the important role each plays.

•Produces a sense of pride knowing that an impartial assessment attests to the quality of the school/program.

•Provides universal recognition of program quality, often by professional organizations, which may increase recruitment potential.

•Enhances the reputation of the program/school in its local community.

•Provides valuable feedback from many stakeholders, including employers and graduates, to help improve the quality of the school/program. http://www.comta.org/main/accreditation/

ALL OF THE ABOVE BULLETS ARE EXCELLENT REASONS TO BE ACCREDITED. COMTA, IN MY OPINION, TRULY HAS THE BEST INTERESTS OF MASSAGE EDUCATION AT THE ORGANIZATIONAL CORE----

HOWEVER- IN ABOUT 2005 LARGE MULTI PROGRAM, CORPORATION BASED SCHOOLS BEGAN TO ADD MASSAGE TRAINING-WITH FINANCIAL AID ACCESS AND NOT ACCREDITED WITH COMTA.  THE MAIN PURPOSE FOR ACCREDITATION NOW IS ACCESS TO FINANCIAL AID.  ALSO, LARGE CORPORATIONS BOUGHT INDEPENDENT MASSAGE SCHOOLS-CORTIVA AND STEINER WERE THE BIG PLAYERS.  RECENTLY STEINER EDUCATION GROUP BOUGHT CORTIVA. ORIGINALLY MANY OF THE SCHOOLS UNDER THE STEINER UMBRELLA WERE COMTA ACCREDITED.  SOME SCHOOLS REMAIN WITH COMTA BUT OTHERS HAVE MOVED AWAY FROM COMTA ACCREDITATION USING OTHER ACCREDITING BODIES. THE PRIMARY SOURCE OF INCOME FOR THESE SCHOOLS IS FINANCIAL AID.

PROFIT IS NOT BAD. PROFIT IS GOOD. FINANCIAL ASSISTANCE FOR EDUCATION CAN BE A GOOD THING BUT INSTEAD FOR YEARS IT HAS BEEN A BAD THING.

Let me stop the CAPS now.

Generally, non-profit schools include state universities and community colleges.  They receive a significant portion of their funding from the government and can offer lower tuition. Most private universities are also non-profit institutions.

For-profit schools, on the other hand, are subsidiaries of big public companies. In addition to educating students, the company’s owner or shareholders expect the school to make money.

For example, Steiner Education Group operates schools at 32 campuses in 14 states that train close to 5000 massage and spa professionals each year. Steiner Leisure Limited is a family of companies including Steiner Transocean Limited and is a publicly traded company. Steiner began acquiring schools in 1999.

Corinthian Colleges Inc. is also a family of companies that includes Everest, Heald and WyoTech campuses. The company operates 105 schools in 25 states and 17 schools in Canada. The company was founded in 1995 and we completed an initial public offering in 1999.

My massage therapy school-Health Enrichment Center School of Therapeutic Massage was licensed in the early 1980’s and became accredited with ACCSC to support an articulation agreement with Sienna Heights University. I never participated in financial aid.  Through the 1990’s I maintained accreditation but eventually the cost and regulations, primarily because of financial aid requirements (which I did not use), forced me to withdraw in 2010.  My dream of a pathway to a bachelors degree for massage therapy was reinvented when the National Certification Board and Sienna Heights University partnered for Board Certification to transfer for college credit.  I lived the accreditation experience for years and saw the original intention of excellence dwindle based on gatekeeping for access to financial aid.  

OK-all that being said what is the point of this blog? Well there may be a window of opportunity for the small independently owned for -profit  massage therapy schools that have struggle so hard for the past 10 years.  Our massage community has lost many of these schools but there are some of us that have persevered. Some of us have had to use personal resources to keep the doors open. All of us have worked harder than you can imagine unless you have been in the same situation.   Most of us have less than 50 students per year. Some do participate in financial aid and many offer their own in-house payment plans.  Tuition need to be reasonable so students can self- pay. Some reading may snark at my recommendations but here they are anyway. 

The average yearly income for massage therapists is between $22,000 and $30,000. We may not like it but that’s what the statistic from multiple resources show. When and if the financial aid mess straightens out the amount of financial aid allow in loans and grants will be significantly limited. Relating to debt load to potential income aid will likely be limited to between $5000 and $8000 (my educated guess).  If the school participates in financial aid the educational program will need to be about 750 -900 contact hours and a typical tuition cost would be $ 12,000-$16,000.  The student will still need to pay out of pocket $7000 -$8000.   

 Are you ready-----drop access to financial aid. 

ELAP is recommending an entry level program length of 625 hours.   At $12 a classroom hour a 625 hour program would have tuition of $7500.  I know I am an author- and I want you to buy my textbooks- but remember entry level students do not need 10 books to learn massage and books are expensive.  

Let's go back to our roots and realize this may be a huge step forward. At the same time all small for-profit schools need to work together. We won’t make it if we continue to stand all alone. The Alliance for Massage Therapy Education  www.afmte.org  can be our common bond.

Community college based massage programs have not increased like I thought. These educational institutions can also respond to this opportunity. I hope massage educators in these systems stick it out and strive for quality vocational education.  There are some really quality programs out there in the community college sector.  The Alliance for Massage Therapy Education  www.afmte.org   can be our common bond.

Finally, support COMTA to make a potentially radical move to stop institutional accreditation and stop being a financial aid gatekeeper.  Instead revert back to an approval only program that we can afford and support.  This may not be possible and if not I sad. Those of us who operate excellent massage schools want to be validated by our peers. We want to be part of accreditation’s original intention of external validation of excellence but that is not what accreditation is about anymore.   We need something else.

Here are the links I used for background.  Check them out

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended December 31, 2013 http://www.steinerleisure.com/files/SLL/SteinerLeisureLimited2013AnnualReport.pdf

http://www.cci.edu/about/history

http://www.bloombergview.com/articles/2012-10-25/the-long-and-controversial-history-of-for-profit-colleges

http://www.newsday.com/opinion/oped/the-long-controversial-history-of-for-profit-colleges-caitlin-rosenthal-1.4157154

 http://www.educationnews.org/articles/community-colleges-a-brief-history.html#sthash.tesmQvq5.dpuf

http://en.wikipedia.org/wiki/List_of_for-profit_universities_and_colleges

Moody’s outlooks for the US Higher Education and Not-for-Profit sectors are negative. http://facilities.georgetown.edu/document/1242807545994/11-25-2013_Higher+Education+Not+for+Profit+Outlook+2014.pdf

http://www.theatlantic.com/business/archive/2011/09/how-for-profit-colleges-can-save-themselves-and-higher-education/244595/

Legacy

Definition of Legacy

Anything handed down from the past as from an ancestor or predecessor. Something inherited from a predecessor a heritage from a previous time that has influence now.  Left behind old or no longer in active use.

"Legacy." Definitions.net. STANDS4 LLC, 2014. Web. 14 Jul 2014. <http://www.definitions.net/definition/Legacy>.

 

I am working on textbook revisions.  I am always working on textbook revisions.  At the same time there are students to teach, clients to see, calls and emails to answer and the forever ongoing list. On the person side there is laundry to do, weeds to pull, beans to pick and kitty litter to clean among a ton of other tasks.  On the family side there are people to see, gatherings to attend, birthdays to celebrate, kids to hug, people to call and well, you get the idea.  However, I am taking the time to write this Blog post.

I saw the term Legacy used to describe a type of massage schools.  My assumption when reading was that Legacy schools were those created back in the day by committed massage therapists and sometimes called Mom and Pop schools.  I liked the term legacy.  The school I have owned and do a majority of the teaching is 29 years old this fall and falls into my assumed definition of legacy schools.  Made me proud.  Then I looked up the definitions of the word.

Anything handed down from the past as from an ancestor or predecessor.

Can I claim that my school was handed down to me? No, I opened the school many years ago. My daughter now manages the school ( and me) and my youngest son who is a practicing massage therapist has been being groomed for years to take over  more of the teaching and eventually writing for me as I get older( much older).  For these two the school is a legacy.  The various textbooks I have written could also be considered legacy. Most of all, the teachers and clients I have had over the many years  have been a legacy for me. 

 Something inherited from a predecessor a heritage from a previous time that has influence now.

What have I inherited that I can describe as a legacy?  Certainly all the information I have accumulated comes from those that precede me.   I have been blessed with teachers and mentors that molded me in my younger days and continue to influence me. Those experiences were not always pleasant but I will never be able to be thankful enough for their time and expertise.

The crazy professional development pathway of the massage profession has left a legacy that influences now.  There has been real progress in the massage community in the past 5 years.  It has been bumpy, frustrating, messy, silly, expensive, BUT the end results to this point indicate maybe the fragmented past is moving to a more cohesive future.  I sure hope so. 

 

 Our past as a professional community with all the in fighting and unnecessary competition is nothing to be extraordinary proud of.  There have been bright spots for sure.  The Massage Therapy Foundation is certainly a star.  The Alliance for Massage Therapy Education is an important bright spot that should be supported by all massage therapy organizations.  The  American Massage Therapy Association AMTA in particular should suspend the competing meetings and activites and put full support behind the  Alliance.  

There are individuals who I am proud to know. They have stuck it out just like I have and often been much more tactful in there guidance than I have. While we all have to admit that what we do is always somewhat self-serving, the individuals I am thinking of  soften this by being dedicated to serving the massage profession as a whole.     

 Left behind, old or no longer in active use

This was the part of the definition of legacy that was the wakeup call.  All the warm fuzziness of my original perception of legacy now had some prickles.  There are things that I think the massage community has left behind and has made or is making a huge mistake.

We need to move forward and overcome the unproductive massage organization behavior legacy from the past.

 

I think we have minimized and are leaving behind the importance of the goals massage can achieve related to relaxation and stress management.  The relaxation massage is degraded by being called “fluff and buff” massage. Make me frustrated, among other emotions best not expressed in a public forum.  Where is the legacy of a really good massage with nothing else added such as all the acronyms and abbreviations: ARTS, MATS, NMT, TRp. MFR , SRT, CST, MLD, SER, PI, SI – you know what I am talking about.  It seems that as a legacy we are embarrassed about the word massage.  So instead we call massage: manual therapy, bodywork, soft tissue work and so forth.  It can’t just be massage, it has to be sports massage, pregnancy massage, deep tissue massage,  so and so’s name massage.  So end of that rant.

There are other things we should leave behind.  Out dated information about how massage works, outdated opinions about ergonomics and body mechanics, and old resistance to change in the profession. 

One thing we need to leave behind is outdated information, opinions and emotions about the National Certification Board for Therapeutic Massage and Bodywork.  I never fully supported the old certification process.  I have never supported certification be used as licensing.  Licensing is a measure of minimal baseline practice at entry level to protect the public.  Certification was degraded when it became intertwined with licensing.  This is all now in the past and not a legacy we want to embrace and take into the future.

BUT ----

Board Certification through the National Certification Board for Therapeutic Massage and Bodywork represents the first steps in true validation of expertise beyond licensing.  It is not perfect.  What is? 

AND -----

Board Certification is important, needed and needs to be supported by the massage community. Board Certification is a major step forward in professional development and the past is just that—the past.   Attitudes no long valid should follow this definition of legacy.  

 Left behind, old or no longer in active use. Enough said.

 

 

Who Made That Rule?

 

This blog is prompted by some discussions on Facebook and some discussion I have had with my graduates who are working a various spas and franchises.  The perpetuating issue of myths related to massage affects is challenging many of our beliefs about massage therapy. There are other rules out there as   well.  For example:

·        Never break contact with your client once the massage has begun

·        You have to use long strokes to make the massage experience relaxing

·        You have to put your table low to get more pressure

·        Massage strokes must go toward the heart

·        The client is disturbed if you move them around during the massage

And well I am sure you have some to mention as well.

This reminds me of a story: A person always cut a ham in half before putting in the pan to bake.  One day someone asked them why they did that? The reply was-because my mother always did it that way. Later when asking mother why she cut the ham in half before putting it in the pan she said,” had to cut it in half or it would not fit in the pan I used.”

The rules that I want to challenge in this blog are related to how massage therapists are hurting themselves attempting to comply with the rules. I also hold us mature educators out there accountable for perpetuating these out of date and potentially harmful rules.  I challenge all of us to take inventory of what we do during massage and then answer these questions:

Why am I doing this?

Does this increase the likelihood that the client’s goals will be met?

Where did I learn this?

I this approach making me bend over, reach, twist, bend my knees to far or in other words hurting me to do it?

What is this method supposed to do?

What physiologic function does this method mimic?

Am I just mindlessly rubbing?

Listen everyone: just because someone taught you something does not mean it is correct.  Long standing rules about how to do massage need to be challenged.  Just because something has been done a certain way for a long time does not mean it is the best way to accomplish the goal.

 The long sweeping strokes for example are very hard on the low back and shoulders. So why do them.  Good question right? I expect some are thinking about connection and flow and whatever.  If the client’s outcome is relaxation then the physiology for that is parasympathetic dominance.  The characteristics of the massage to mimic and support the parasympathetic autonomic nervous system are:

·        Feeling safe

·        Feeling connect to another

·        Nothing abrupt, surprising or startling

·        Slow rhythms, i.e. music if enjoyed, slow massage (not so slow you need time lapsed photography to see it)

·        Nothing painful

·        Being warm

·        Being quiet

·        Being rocked

·        Moderate pressure- not light and not deep and no poking or tickling

·        Smooth transitions from one part of the body to another

·        Pleasure

·        Time –about 45 minutes

·        Full body approach- for goodness sake only spend about 15 minutes on the back if even that much.

You get the idea. And where do these elements require long sweeping strokes that make the massage therapist bend over and reach.

I expect some reading this have their fascia in a twist.  If that is the case then meditate on the picture of my garden and then we need to get over ourselves and take responsibility to prepare the next generation of massage therapist using our wisdom and experience and not our outdated rules.

STOP IT!

 

Most that follow my blog are aware that I work with professional athletes.  One of the golfers I work with scheduled a massage yesterday after being on the road for a while playing in multiple tournaments.  He will often get a massage while on the road.  Since this was a long trip he had received multiple massage sessions from a variety of people. I always ask what type of massage he received while on the road so I can factor that into my treatment plan.  What follows is a summary of what he told me about his experiences with massage on this particular trip.

He received 6 sessions. The best massage was at a Massage Envy. The reason he felt it was the best is because it was the only massage where someone did not try and fix him.  He said it was basic and the pressure could have been better modulated.  Sometimes it was too deep and poking and others too light. The massage therapist spent too much time on his back and not enough time on his legs but overall he was relaxed and slept better that night.

The session he complained about the most was with a “sports massage specialist” with 15 years of experience who spent quite a bit of time telling my client just how good she was and how much she knew and how she was going to get him right. The client asked if she knew who I was and she said no. The concern he had is that I write one of the top selling books on massage for athletes.  If she was an expert it seemed to him she would be well versed on the various books and experts in the field.   This was the most expensive session at $150 for 90 min.  The whole time she was giving the session she talked and called out things she was doing like NMT, MAT, MET, trigger points, myofascial release and so on. He couldn’t remember the list but he had no idea what she was talking about.  The worst of it was when she started digging on some scar tissue from a couple of prior surgeries.  By this time I was angry. I told him it was absolutely wrong for a massage therapist who is only going to see a client once to attempt to reverse any specific condition and she could have hurt him.  He said he was sore the next day and felt sluggish.  He did not play well.

The next couple of sessions were not as bad but the massage personnel did not work on his goals and jumped right into the “deep tissue” stuff.  He said, “They just love to dig around the shoulder blade Sandy like it is the most important spot. Nothing was wrong with my shoulders and I told them so but they kept right on till I demanded they stop.  My legs were sore from walking up and down hills and one girl hardly touched them.” Grief. He said the massages were a waste of money.  In addition he said one of the girls was dressed so skimpy and revealing that he was embarrassed for her.

One session was from a male massage therapist that was set up at the tournament.  The massage was OK but the guy kept name dropping the whole time about other golfers he worked with.  My client wished he would have just shut up.

The finial massage was not very good. The massage therapist was new having just graduated from school.  She was nervous and that is understandable.  The massage was at the spa associated with one of the hotels. My client tried to assure her but she just would not settle down and the massage was choppy and ineffective. At least she disclosed to my client that she was new and nervous and she did not try and fix him and she did not hurt him. She used way to much lubricant that smelled weird and he was greasy after the session. That massage was $90.   

Fortunately he dosed off  and I got into my massage zone because after this conversation I was angry, embarrassed for my profession, frustrated, concerned and disappointed.  He had spent around $500 and he was hurt, could have been hurt worse, put in a position where he had to try and calm down a massage therapist and listen to others brag and name drop. Wasn’t worth it he said.  

What is unfortunate is that I have heard these types of stories way way too often.  I have had clients hurt by massage therapists, usually by trying to fix something that should have been left alone.  I often will tell clients to be cautious about what they let a massage therapist do to them.  The so called “sports massage therapists” are often the worst.  I have had clients so sore after a massage that their performance was affected. Clients have been over stretched, dug on, and been told wrong information and hype.   I am concerned about confidentiality and really hate name dropping.  I also find it appalling what some massage therapist wear while giving a massage. How are we going to claim to be professionals when we won’t even dress like professionals?  

So now that I think I have settled down, my concerns and questions are:

What is lacking in education and professional development that these issues occur much too often?

What public education is necessary so massage clients can recognize potentially harmful methods and what to expect for professional behavior?

What are the professional organizations, especially the AMTA and ABMP, doing to continue to reinforce safe and professional massage practice of their members?

Are there any improvements that could be made in textbooks and other educational materials that would prevent these things from happening?

Where are the mentors and teachers and employers who will confront and then will work one on one with individual massage therapist who are inappropriate?

I am concerned that these issues keep occurring over and over and over. The problems are not isolated and the data collection for the ELAP identified may of the same issues my client experienced.   I know that there will always be a few people that are truly bad massage therapists and these individuals should not be tolerated. I know that there will always be a few massage therapists who are so insecure that they have to brag and make unjustifiable claims. There are always some bad apples in all professions and occupations however----This should be the exception and not common occurrence.  

My client did tell the massage therapists who insisted on doing the deep tissue stuff to stop. He did tell the one who had all the so called experience to read my books.  He is good at feedback so he does his part.

 I wonder what would happen if the CLIENTS took a stand and would not accept poor performance by a massage therapist.   Maybe a promotional campaign and a grass roots effort with massage therapists educating clients about proper professional behavior and how to protect themselves from the “egocentric fixers” out there. 

Ideas welcome.  And if you recognize anything that you do that my client described STOP IT. Also take the risk for the massage community and tell others massage therapist who are harmful and otherwise unprofessional to STOP IT.   Stuff like this cannot continue if we are going to be respected as massage therapists.  It just has to STOP!

 

 



LETTING THIS CONTINUE IS GARBAGE AND CRAP.



 

 

MUSINGS

 

I meditate in my own way every day.  It might not be what is considered traditional meditation practice but it works for me.   The sequence more or less goes like this:

Wake up about 30 minutes before alarm and dose a bit with the cats purring in bed each it their own spot: Gary nuzzled in my neck, Poe at my side and Smokey by my feet sucking on the blanket with the associated slurpy sucking sound.  This lasts about 15 minutes and then the bladder becomes insistent enough that I have to get up.

As I sit up I wiggle and stretch a bit while also reflecting on what day it is since I don’t always remember.

Once up the real meditation begins.

Morning medication and put the tea kettle on.

Feed Cats-Ha the cats. I feed them and they sit on me (or sleep with me) and purr.  It is worth all the cat hair.

In spring, summer and fall go outside and wander around picking mint for tea

Make tea and let it steep.

Feed water and clean parakeets named Chirp and Tweet.  Play them YouTube of chirping parakeets to keep them entertained.

Clean kitty litter.

Sweep floor.

Drink tea while wandering around in garden (spring, summer, fall) or wandering around house (winter).

Feed and clean Bunny Rabbit who just hopped into my house about a year ago.  This includes wandering around the yard for greens for Bunny and collecting bunny poo for fertilizer.

Feed outdoor birds: orioles grape jelly, humming birds sugar syrup, suet for wood peckers, chickadees, finches and the rest.

Wander around the garden and collect greens and other veggies for breakfast omelet. Eat.

 Get ready for the day.  

This whole process takes about an hour.  It includes lots of feeding and cleaning of me and critters and lots of wandering around.  This morning as I was wandering I got to thinking about a concern I have for the massage profession. I am wondering about the future of massage practice.  A lot has happened in the past few years resulting in a consolidation of a pathway for professional development.  Because of the Massage Therapy Body of Knowledge (MTBOK) and Entry Level Analysis Project (ELAP) we now have a workable entry level education point for massage with curriculum recommendations that should begin the process of standardizing entry level skills and knowledge for massage therapy licensing. The Federation of State Massage Boards released the Model Practice Act for massage licensing and while it will take time for it to be implemented by individual states finally after over 20 years on my wish list we have it. Advanced practice and a gateway to specialty certification are in place with the Board Certification provided by the National Certification Board for Therapeutic Massage and Bodywork.  Board Certification also can be used to obtain degrees both associates degrees and a Bachelor’s degree in Massage Therapy.

The organizations representing massage are working together finally.   We need all of them but they need to speak with one voice while each doing their individual role.  AMTA is the membership organization, ABMP, while a for profit organization, offers insurance alternatives and support for the massage therapists and educators.  I am pleading with both of these organizations to put all of the resources they currently allocate to massage education into backing the Alliance for Massage Therapy Education (AFMTE). I ask others to contact the AMTA and ABMP and encourage them to endorse the Alliance as the organization representing education and educators. COMTA  (Commission on Massage Training and Accreditation) service a necessary roll in the massage profession.  Unfortunately accreditation costs are often beyond what small independent schools can absorb. I wish for a process that can be used by small independent schools that do not want to participate in financial aid.  I know those at COMTA are trying to work out something but they are held to requirements by the Federal Government.   The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB)  is an organization that the profession must have for recognition of advanced and specialty training. It is necessary for a respected profession to have a certification process beyond entry level licensing.  

And we have the Massage Therapy Foundation which is the research arm of the massage profession.  Thank goodness.

So what does all this have to do with my morning meditation sequence?     This is the time when thoughts move randomly and this morning I realized that for the first time in my professional massage career of over 30 years all the pieces are in place for true professional development.  WOW.

There are some very important issues to deal with for sure:

A realistic but sustainable income for massage therapist based on level of education and experience.

The professional desperately needs an independent ergonomics study to determine the best way to do massage without hurting ourselves.

There are unethical practices at schools and by the leadership organization that continue to confuse what is charged for massage and how that actually translates into a hourly income.  This creates unrealistic expectations in massage therapists especially those just graduating.

The individual massage therapist does not make enough money to afford to go to tons of meetings so I suggest that conferences and convention be web cast somehow. I know it can be done.

The education for entry level and continuing education for massage is in desperate need to oversight and professional educator training and certification.

And there is more however I can see the potential.  As I do my morning meditation there is a lot of care and feeding of my critters and me. The massage profession needs a lot of care and feeding right now as well.  I also clean up lots of crap and the massage profession certainly has crap to deal with.  However my Bunny Poo is really good fertilizer for growth.  I can hope that the years of quagmire that the massage therapy organizations have been in have produced the fertilizer needed for growth now.   We need to acknowledge what day it is and the time is now for those of us who love the massage profession to commit to developing the next generation of leaders, educators and massage therapists.

I have to fold laundry and get ready to see massage clients.