Massage Therapy Body of Knowledge

Comment

Comment by Bert Davich on October 23, 2009 at 1:19pm

Chris,
I owe you an apology for my tone and characterization of your motive. I hope you can accept it. I also want to state that my preference regarding energy work (so far as the BOK is concerned) has been from the beginning that it should not be addressed in the BOK.

Thank you for that Bodhi Haraldsson article. I think it should be read by anyone who is practicing health care of any kind. I often ask follow-up questions in several different ways when I feel a client may be acting the role as described in the article.

I also agree with the final statement about being engendered and enthusiastic about controlled clinical observations. (Where Possible)

The one problem I can see with relying too much on controlled observations of Clinical Therapeutic Massage regards the differences in cause for the same apparent symptoms in different clients. Also different clients respond to different treatment of the same problem due to differences in genetics, lifestyle, length of time since the injury occurred and what mechanism they used to cope with the pain. At that point we are practicing an art learned as a science. That might make controlled studies difficult to rely on without retarding progress. Some kind of balance is needed.

Keith,
Thank you for the links on Canadian massage. I somehow missed that.

Comment by Mike Hinkle on October 23, 2009 at 12:27pm

I think a lot this will be self explanatory once acceptance is in hand. But how will therapist chose those to refer out to? Will it come from an existing list (ie. BC massage competency profile)? Therapists will be doing the referring. This also will need to be addressed in school as well as procedures.

Referring, itself, was only beginning to be addressed when I went to school. So there needs to be additional classes for those who recieved no training concerning this in their schooling. I'm sure it could be handled through CE's.

Comment by Keith Eric Grant on October 23, 2009 at 12:05pm

I keep hearing about wanting to increase credibility as part of the health care system. So bear with me while I discuss what I believe that means. For another health care professional, a credible massage therapist is one that they can refer a patient to as part of treatment or auxiliary to treatment of a specific diagnosed condition. I have, in other places, referred to this as a massage medical application, since those who talk about "medical massage" seem to be referring almost exclusively to orthopedic work. Several years back, I went through the medical literature looking at applications of massage in health care. What came from that effort were three articles: Searching for Medical Massage, Massage Mechanisms, and Interconnecting Science, Massage and Medicine.

So, in considering health care credibility, we should look at what capabilities of practice we want to target competence in as outcomes of core and specialty training. These are essentially job descriptions of massage therapy relevant to application as part of a health care system and relevant to those who would refer patients to us. The goal of training, in this context of health care, is to target competency in a set of knowledge, skills, and abilities that will enable other practitioners to feel confident in referring to us. This, by the way, is to goal of documents such as the British Columbia massage competency profile. The current situation is that other practitioners feel such confidence now only by knowing the capabilities of individual massage practitioners with a known "track record".In the Bayesian sense, we want to improve there estimate of our suitability when they know nothing specific about the indiividual -- i.e. the a-priori estimate of suitability.

How do we accomplish this. We determine the set of competencies that we wish to target, including expected proficiency levels. Then we backtrack from those, to the knowledge, skills, an abilities that would enable such competency. Such a document, because it encapsulates the required knowledge, is a Body of Knowledge.

Having such a BOK, can then serve in a forward direction. It enables educators (of which I am one) to develop curricula and educational materials that will lead to the target competencies in a cost and time effective manner with consistency between schools and individual teachers (i.e. competency management). It enables those involved in competency assurance to develop certifications, tests, and practicals that increase confidence that the targeted competencies and proficiency levels have actually been attained. Ronald Epstein (2007) discusses such assessment as an outgrowth of the Accredation Council for Graduate Medical Education's Outcome Project.. A suitable BOK that links KSAs with specific competencies also, whether directly meant to or not, should provide a means for regulators to discuss what KSAs they need to assure to fulfill their responsibilities of regulating for the public benefit and thus how to frame licensing requirements that are both efficient and effective toward those goals and more uniform than today's hodge-podge.

Credibility is all about specific confidence that a trained practitioner will meet specific needed. So my criteria for evaluating a BOK is quite simple. Do is efficiently and effectively promote the efforts outlined above in a means targeted for acceptance by other health care practitioners and educators? Is it reflecting awareness and inclusion of current methods and standards used by the rest of health care. If yes, well and good. If no, then either we are not, in earnest targeting health care acceptance or we need to go back and rethink our methodology and goals

Comment by Darcy Neibaur on October 23, 2009 at 11:06am

Way to go Micheal. Well said.

Comment by Mike Hinkle on October 23, 2009 at 10:56am

The BOK forces no one to do anything.

Just because some "outside reader" comes up with another conclusion, means nothing. People conclude things wrong everyday, that doesn't make them so.

Will these documents be used to mold future requirements? That is a hope and purpose, to advance the profession. Otherwise, the stakeholders efforts will have been minimal.

Your fear that you won't be able to do your present work, Carl, because you will have to learn something else as well, is baseless. Therapists continue to learn different modalities. Does that mean they forget/suffer in what they already know? It should enhance it. Did your learning engineering hamper your other abilities? Or open your mind to other possibilities? Keith is citing advanced cirriculum (3000 hours) in Canada and you are quibbling about extra ces.

Ce's should be mandatory. All healthcare fields have mandatory continuing ed courses. It should be policed the way it is through CE Broker in Florida. You should not be able to renew your license unless you meet a required amount. I believe this is why people have avoided being NCB certified. I notice you say you are not. NCB is a voluntary program. I rest my case.

NCB has a set amount of CE's that are required prior to recertification. Voluntary CE's will not improve the profession. It is proving true with the voluntary advanced certification being discussed now. Very few will do this if not required.

So far as civility, it is and always has been a two way street. Claiming the BOK dead (after just it's first draft) was anything but.

I am civil to those that are likewise. But, I am tired of an effort to "repudiate" and destroy this effort to organize. And yes, I'm even protective of the position for growth of this profession. Massage will not fall back again into the recesses of time.

There is no representative chosen to do so. Call it self-appointed if you will, but I stand up for this profession and draw the line in the sand. Those attacking or even bemoaning this effort will be challenged for their beliefs as well, as I am being challenged about mine.

This profession is serious about progressing and my civility will to a large point be determined by the opposition as well. I take the stand. This will happen, this time!

Comment by Carl W. Brown on October 23, 2009 at 10:13am

The original department of labor description the job requirements states that a high school education is not necessary but it is recommended. I think things have changed because in thouse days people we trained in-house. Now massage education is part of the postsecondary educational system so there is a de facto requirement for a high school degree or equivalent. This also allows massage educational standards to be set based on postsecondary requirement only.

Comment by Christopher A. Moyer on October 23, 2009 at 10:06am

I just came across this article posted by Bodhi Haraldsson on his facebook page. I think it is very relevant to the current topic, so here it is:

http://www.chiroandosteo.com/content/17/1/10

Comment by Carl W. Brown on October 23, 2009 at 9:56am

Gloria, I have served on standards committees myself and I appreciate that it involves a lot of dedication. But when Mike says “The BOK forces no one to do anything!” and line of the draft says “Competency Requirements for a Massage Therapist in 42 Terms of Knowledge, Skills and Abilities (KSA)” that means to an outside reader that an entry level person must conform to each and every point not that this is a list of skills that entry level MT may possibly posses.

I think that this is the crux of the discussion. Is this a description to the realm of possible things that an MT may do or is it a list of everything and MT must master to be able to practice?

I am concerned the this document may be use to set laws that will make it impossible for people like me to train and practice because it forces you to train in disciplines that make it hard if not impossible to do my kind of work.

As to CEs. I believe that all responsible MTs should continue their education but this is not what CEs were intended to do. They we meant for professions that need to stay current such as CPAs keeping of with the tax law changes or doctors staying current with advances in medicine. I think continuing education should be a part of a voluntary certification program because it shows that the people have the right attitude and are not just doing it because they have to. It helps identify the ones who are committed to the profession that the quality of work they do.

Comment by Christopher A. Moyer on October 23, 2009 at 9:17am

Oh, I almost forgot - about 50 posts ago one of you posted a really interesting article about placebo effects, and how they differ for physical and biochemical parameters. I've since had a chance to read it and would be interested to discuss it further, if the opportunity hasn't entirely passed. And if it has, I'm still grateful to have read the article - it was a very interesting one.

Comment by Christopher A. Moyer on October 23, 2009 at 9:15am

Thanks for the kind words Keith.

I wasn't able to keep up here yesterday, as Thursday is a really busy day for me, but I have been trying to catch up with the dialogue a bit today. I have additional points I'd like to make, or old ones I'd like to reiterate, but I've felt like some of us are talking past each other so I think I'll let these go for a while.

I'll keep what I have to say short and simple: Though there is much enthusiasm for it among those conversing here, it is not universal in the profession that energy work is central to, or even a component of, massage therapy. As I've noted, I think there are numerous problems with treating it as suitable content for a BOK. I'll eventually pass this feedback onto the MTBOK, because I think this is important for the profession, which I have an interest in despite the fact that I am not a massage therapist myself.

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