Re: Legalising "Massage"

[5O1]

The difference? Well, in the State of Ohio, were I am living, massage therapy is a regulated profession. So regulated that the examinations and the qualifications are under the supervision of the equivalent of the General Medical Council - so yes, it is deemed a medical profession. And because it is a regulated profession, I cannot use the title "Massage Therapist".

Only therapists trained by approved schools are permitted to sit the state's qualifying examinations. Ohio does not accept the National Certification Examinations run by a board called the National Certification Board for Therapeutic Massage and Bodywork, which a lot of states accept. Ohio requires a minimum 600 hours training, which the National Certification only requires 500 hours.

Having said all that, the state of Ohio does not regulate "relaxation massage." So if the purpose of the massage was merely relaxation, feel-good etc spa-based, then you do not fall within under the supervision of the Medical Board.

However, this is the USA, and I was not going to give massaages to friends without insurance, so I had to negotiate with the ABMP, one of the main professional bodies here, to accept me on the basis of the ITEC. The LOWEST grade of membership they have is that of "Massage Practitioner" - someone who has had 100 hours of massage training. They had to think about it because ITEC's old APM syllabus specified "minimum number of hours" which was 60 for A&P, and 40 for Massage. However, a bit of sweet-talking, and I managed to get in. And then discovered what a great outfit the ABMP were compared to what IGPP... (sorry - that's another thread!!)

The practical side for me is that I am not required by the ABMP to undertake CPD/Continuing Education. Lowly massage technicians like me are deemed not to need any such training as we are not going anywhere any way... ;-)

And yes, I do like the title "Massage Practitioner". Better than the more commonly used term "bodyworker" which has connotations of dented cars and car paints...

 

[jtease]

In one of the American Massage magazines (I forget which one - will dig it out for peoples reference) recently there was a very interesting letter. A MT moved from one states where she wasn't regulated to another where she was. She had been practicing for a long time and was a highly respected therapist, however had to go through 500 hours of training. She felt that the 500 hours weren't really of any use as a professional. It taught the movements but spent most of the time talking about A&P and what you can't do and why you can't do it.

Sounded like when you qualified you would be too scared to touch a client!

I much prefer the Eastern methods of teaching - hands on practical teaching with theory to back it up and the understanding. Not the otherway round.

Foz xxx

 

[SmokeLine]

So where does that leave you exactly? Sorry if being thick or having a blonde moment!

ie. What service can you offer exactly and what are you not allowed to do or advertise etc?

If I was in the USA and wanting a massage....would I therefore be put off from coming to see a 'practitioner' and and what grounds? (depending on State laws etc).

[&:]

Ps I think you're lovely and would come and see you anway.

 

[Zach Will]

Well... if I were to advertise, I can only advertise "relaxation massage" and emphasise the de-stress effect of the massage. I cannot use the word "therapy" or "therapist" at all.

Which also means that I cannot be seen taking a full medical history, or maintain detailed records that I used to keep. Too much like massage therapy!

If you were in the US and wanted a massage, then you are right - it all depends on which State you're in. In regulated States, you would want a massage therapist, in unregulated states, you would want either a licensed massage therapist, or a certified massage therapist, although the latter is used for anyone with any type of certification (like my ITEC...) Most therapists would try to take the exams of the National Certification Board of Therapeutic Massageand Bodywork - if they do have that, they will have NCBTMB after their name. This means they have had a minimum 500 hours of training, and have passed the independently assessed NCBTMB.

However, there are many great massage practitioners who do not have the NCBTMB, and many with NCBTMB who can't do a classical effleurage to save their lives. So ... it's a hit or miss...

And ... awww shucks you're making me blush!

 

[HELP!]

Just for those who are interested, here is the syllabus for the NCBTMB examination:

125 hours of in-class supervised instruction in the body’s systems and anatomy,
physiology and kinesiology (increased from 100 hours);
200 hours of in-class, supervised instruction in massage and bodywork assessment, theory and application
40 hours of in-class, supervised instruction in pathology (increased from no
requirement);
10 hours of in-class instruction in business and ethics with a minimum of six hours in ethics (increase from a minimum of two hours of ethics); and
125 hours of additional in-class, supervised instruction in an area or related field
that theoretically completes your massage program of study.

As you will see, the A&P requirement already has more hours than the ITEC Holistic Massage Diploma!

There is however, a groundswell of protest because the main massage therapist body (AMTA) who has a strong influence on the NCBTMB exams, is perceived as conciously taking massage down the "medical massage" route - i.e. massage purely from a Western, allopathic view. There is a complaint that this ignores the other parts of massage - the "holistic" approach that encompasses energy etc..

 

[Ron Jay]

That seems to be very much inline with the letter to which i was referring. The letter is published in Oct / Nov Massage & Bodywork Magazine. The writer talks about her original 100hour intensive course in California she did 13years ago, it was 100hours of pure touch. She then moved to Oregan and had to spend time adding 620hours of eductation to her 13years experience. Its interesting how she describes in this course "Most of the massage hours were spent in learning fear-based techniques that boiled down to how not to touch."

I think A&P is incredibly important an aspect of Massage training, but the sciences aren't the end of it. We may be able to talk like doctors, but that is the last thing we are. We need to understand the body and how it works, but we need to learn the wonderful power and energy and healing ability of touch. I loved my training courses (London College of Massage Diploma so neither ITEC or VTCT), massaging my fellow students, them massaging me and then discussing it and learning from that joint experience. The A&P gave me an understanding of what I was massaging and how I was affecting the body but aren't clients paying for the quality of my massage ... not how many muscles, origins and insertions I can remember? Which incidently is now very few.

Foz )

 

[ergrqfla]

fozz, i agree. in RL, yes we need to know about the body and its systems and certainly health related issues but we are not training to be medical physicians and when i think how much i learnt, what is now being taught and how much nursing staff are taught... well, from what i gather, we know more than nurses!

i think far too much A & P is taught. i dunno... am i wrong? is cell reproduction that important for me to know? is it so important for me to know the names of veins and arteries, all the nerves?

i observed my line manager on saturday as part of my teacher training course. it was a 5 hour... 5 HOUR... A & P class for ITEC. blinking heck! i was only there for half of it and she covered muscles, how they move and how they are on the body. absolutely brilliant lesson... we sang a song (the muscle okey cokey... extend your right arm up, flex your hand... etc!), laid jigsaw cutouts of muscle groups on a cardboard torso... now muscles and bones i do see as important to know.

its like driving a car though... learn to pass the test, then become a driver...

 

[Cloe B]

That is how I would love to learn A&P - the fun and enjoyable way where I will actually remember it. Nice analogy of learning to drive, very accurate.

Foz xxx

 

[Lady Cece]

I agree with all you say, A and P is important, but actually being able to 'feel' what is going on and help people is more important.

Rosie. I think the problem is this: Where to start and where to finish? We were taught the ins and outs of a ducks arse and yes, I have forgotton most of it. I don't regret it though and really enjoyed it.

I think the best experience is gained through working on people and the more you do the more you learn, obviously.

I also did a great class called 'learn those muscles' which involved felt tip pens and getting your kit off and being drawn on, it was really helpful.

dazzakoh, how on earth do you draw the line? I haven't been trained in 'remedial massage' which I suppose is what you are talking about, but it is really pretty much what I do and I treat a lot of people with bad backs and necks quite successfully. I didn't learn any of it on my courses, I learned from other therapists and Andrew (my business partner who is an osteopath - thanks Chuck!) and do my own thing really. I wouldn't be able to stick to Swedish, I just can't! So I would probably be struck off in the States.[:'(]

By the way, dazzakoh, I have a terrible reputation for asking men to marry me and I am an awful flirt.

 

[one girl]

How on earth do I draw the line? With great difficulty. Just make sure you don't say the word therapy, and you are only there to relax, and ease the pains of stress.

It's worse in some States where it is completely regulated.

I think if you were to branch into medical/remedial massage, and work closely with doctors, then yes, you would need to know and remember all those muscles and other funny words. Bearing in mind that many people in the US get their medical massage bills covered by insurance, which are reviewd by medical people, the therapists needs to know all the details for (i) filing the payment claim; (ii) their client care records, in case of lawsuits.

If you didn't have to communicate in that language, we won't remember it at all. I'm willing to bet most of us have forgotten a lot of the detailed A&P we knew just before the exam...

Even with A&P, I have to say, I don't just want A&P, I want relevant A&P. To paraphrase Rosie, I am not going to be massaging a cell. Having said that, knowledge of cell histology, is helpful in understanding how the body works, and deepens an understanding of what I am trying to achieve.

Take one example of a course having A&P for no purpose other than to make it respectable. Knowledge of the lymphatic system is very relevant when I am doing a lymphatic drainage. The problem with ITEC Lymph Drainage, is that despite being a Level 3 course, the A&P content barely explains anything about the system, and concentrates on the routine. Yes, there is more detail about the lymphatic system than in the general A&P course, but not much more. That therefore results in training a "technician" or "practitioner", who can do the job, but doesn't have to understand the how's and why's - the knowledge wasn't made relevant.

We all can be great drivers, but not all of us know the theory of how a gearbox works. If we did, and understood what a synchromesh was, we would know we needed to be gentle when changing gears, not just force the gear-stick into place. However, even if I knew how a synchromesh worked, and therefore appreciated why I should just slide a gear-stick into place, I do not need to know exactly how it works, and the nuts and bolts of the whole contraption.

Ditto with us. We may know how to relax a stressed muscle. It would be great if we understood what the stroke did to the muscle, and that will enable us to adapt to new situations. But do we really need to know about the nuts and bolts of the quadriceps/triceps in order to do a great job? Don't think so. Helpful..but I'm not going to perform surgery: I do not need to know that much!

Okay... That's my piece...

And candie... aw shucks.... but I play for the other team...

 

[Patel]

i was bored and just did that online ITEC quiz... omg! i did so badly! thing is, as candie says, i learnt it at the time, passed with credit so must have known it. yes we get a greater understanding of how the body works but, as i said over there, do i really need to know the latin/ proper name for skin? do i need to know how long mitosis takes? if a bone has been broken, do i need to know its complicated? i bet it hurt and thank god i didnt have to fix it! do these things make me a better therapist? no.

more time should be spent discussing actual treatments, actual ailments one in likely to come across in practise. yes of course know the muscles in deoth, the bones and systems, but some of what is expected is learning for learning sakes... particularly ins and outs of ducks arses!!!

 

[Meklar]

Don't you just hate it when that happens!

Even more reason to like you then.

 

[loudyhowdy]

Okay... the main question is, if this is what we the people on the outside are saying, how do we get the examining bodies to respond? What forum exists for us to inform the powers that be in all the myriad of bodies as to what we really need??

 

[edie]

I don't think they will listen.[]

All I can imagine is that with time we will get a bit of power behind us. Then maybe they won't be able to do just what THEY like.

 

[Ellie Hello]

through contacts? That nice little building to your right you mean? [sm=cool-smiley-021.gif]

the belgian girl x

 

[Latina Bonita]

I was looking at the American [link=http://www.ncbtmb.com/]National Certification Board for Therapeutic Massage and Bodywork[/link] today to find out a bit more about it. For those who aren't aware what certification involves here is a very brief summary:
[ul][*] You must attend a registered college to complete 500 hours of clinical study[*] At least 100 classroom hours for A&P[*] At least 200 classroom hours for bodywork theory and practice[*] Theory and practice to include at least 2 classroom hours on Ethics[*] Remainder of time to be in a related field of study[*] Examination fee of $225 (approximately £115) - non refundable on failure of exam[*] Exam will consist of 160 multiple choice questions (four possible answers)
[/ul]
Well, I think the first thing is that I am not aware of any massage course in the UK that would comply with this requirement. My own course at the London College of Massage consists of 82 classroom hours of massage theory and practice, 48 classroom hours of A&P. Then a suggested 140hours of A&P homestudy and at a very minimum 50hours out of massage practice. Bringing the total to 130 hours of classroom time and at least 190 hours hours of home study.

Is this enough? I'm not sure, its certainly a lot. Now several years on I wish I could remember more of my A&P, but that doesn't mean I didn't do enough - just that I forgot it all. Am considering taking another course in it to refresh the mind. By simply doubling the hours of the course I'm not sure that there is much more that I could have learnt, it was a very thorough and practical course.

Personally I would love to see some sort of UK Standard for Massage. However I am not sure in what form that should come. If it was to take place it would have to be an independent body that represents all interested parties. However part of the problem is that for massage we don't really have such a body. There was the British Massage Therapy Council but that ceased operation in Feb last year. Now there is the [link=http://www.gcmt.org.uk/]General Council for Massage Therapy[/link], and looking through the committee membership well appointed - Wendy Kavanagh, Gill Whitworth, Clare Maxwell- Hudson, Darien Pritchard all names I recognise of people I respect straight away. However I'm not sure how active they are now, their latest news was April 2004 for a therapist register.

I think this is part of the problem, we don't have a body adequately representing Massage as its own therapy adequately.

Mat xxx

 

[emale address]

Matt

I think the question we have to ask ourselves is, what do we want the body for? As representation or as registration? In the USA, the slow march of the legalisation of massage proceeds apace, despite what many practitioners want. The idea is primarily to divorce massage from prostitution, and to "dignify" the massage profession by having national qualifications. However, as you pointed out, the National Certification Exams here only require hours per course. In other words, it doesn't matter how crap your technique is, what the board wants to know if whether or not you have those hours. The actual examination is within reach of someone who has just done ITEC, and then does a bit more detailed work - I actually used a NCE prep book to help me prepare for the ITEC examinations, and therefore know the difference. And yes, ITEC will never get recognised under the US requirements as it is not detailed enough.

I will go further and stick my neck out to say that the ITEC Diploma is actually inadequate for training proper therapists. All of us have had to learn and adapt what we learned to different situations. However, how many of us were actually made to plan a course of therapy in class? Where in the ITEC exams are we taught to release a siezed muscle, or matters such as trigger points, or carpal tunnel? As for injury to the therapist due to overwork, that certainly wasn't taught in class. It was a good basic start, but that really is what it was, a start.

So far, there has been no one body in the UK to unite the massage profession. Again, too may vested interests in competing bodies. Aromatherapy and Reflexology has seen a convergence - reluctant - see departure of ICM from the old AOC. However, we are far from reaching a concensus as to what is the basic education required of a therapist for massage - again probably because there are too many strands in there, and too many competing interests.

GMTC has gone silent. I suspect it's again because of competing interests. Who knows Matt - maybe one day we will see a united massage profession. Even then, look at the USA. The American Massage Therapy Association grew up as a uniting voice, and still represents at a National Level, a major voice in the USA, but it is now seen as being too much towards medical massage, and not representing the holistic therapists... However, it is still a uniting voice, and what it decides, all schools follow...

Anyway. My two cents - which I gather is only worth a pence now...

 

[Alex M]

Hi dazzakoh

ITEC was never designed to produce medical massage therapists it was designed for therapeutic massage, the sort you receive in a health spare environment and in reality the training goes into far to much detail for what is required for that.

There are other more specialised courses for those who wish to treat muscular/skeletal dysfunctions.

At the end of the day this is all about control and making money by the teaching institutions and governing bodies who are usually an intricate part of each other, more hours in the classroom and continued education equates to more money for them and higher treatment bills for our patients because we have to pass on our training expenses.

What is missing in this equation is the natural intuitive approach which is often required to produce results, this requires us to move beyond our training and do what feels right in any given situation, sadly that is often frowned upon as quackery because it cannot be taught.

Do we need a national register or governing body, yes like we need a boil on our backsides, I'll get of my soap box now

 

[door]

Hi there,

I am not sure that the US model of licensing is the best as each State has varying guidelines.

In Canada the largest provices are licensed as well as some of the smaller ones and we are working towards National Governance. Each person must complete a course that has a minimum of 2200 hours of education including massage theory, anatomy, physiology, treatments etc. It ends up being the equivalent to the first 2 years of med school. In my opinion this is crucial to the profession being seen as credible. It is too easy to refer to a Massage Clinic as a parlour and have sexual conotations attached to it.

Though the exams are difficult and nerve racking I feel that we have a responsibility to our clients/patient to "Do No Harm!" In my opinion the only way we can fulfill this obligation is to educate ourselves and be regulated. Held accountable!

What do others think?

If you could upgrade with anatomy and physiology, assessment, etc, courses that were independent internet courses would people use them? They would obviously have to be recognized by an association or governing body.

Thoughts?

 

[Fran]

Hi Susan

In Canada the massage therapists seem to be a part of the general health care system and though I can see some therapists wanting to go down that road in the UK we do already have the state registered physiotherapists who fulfil that role.

They where a part of the massage body but split of at the beginning of the last century and went with the Drs to work with machinery and electrotherapy, the rest stayed with the traditional hands on approach to massage therapy.

Now the doctors might well see us as pore relatives in the therapy arena but a lot of us do not want to be a part of the orthodox medical brigade and are quite happy to offer an alternative or a complimentary therapy in a more natural and therapeutic way.

There is room for both approaches but more hours in the classroom unfortunately does not always equate to better therapists.

It is in my experience often the diversity of approaches to treatments given by the individual therapists with years of hands on experience outside of the classroom environment which pays dividends to the patients and keeps them coming back