Massage Therapy Body of Knowledge

Comment

Comment by Carl W. Brown on November 13, 2009 at 12:58pm

Keith, “Organizations, whether news or professional, no longer can control the discussion.” This is what happened to the data processing industry. However if that had been able to get a programmer licensing bill to pass in the 70’s making personal programming illegal the world would be a different place. Unfortunately this industry has been controlled by organizations though manipulative laws that hamper the free enterprise system that allows democratic voices to have their effect like in the computer industry.

The problem is that most people in this industry were trained in the system and do not know that there are alternatives. It is like the difference between China and Russia. In china the people were always merchants at heart and never culturally accepted communism but is Russia people grew up not being able to associate the effort of working to the rewards of pay. I think that the current crop of MTs have been brainwashed into think that there are no alternative approaches.

I guess now that organizations like CAMBS are gone and the CAMTC is not in the business of setting standards, schools must teach to the test.


I bothers me that the powers to be are willing to sacrifice quality for status quo knowing that if realistic standards are developed based on objective testing that the 500 hour myth dies. I suspect that they want to 500+ hours to show the world that it takes effort to do massage. I think that can have this dream by title acts where you need to do far more than just be able to do massage if you want the title of “massage therapist”

It could be a win-win situation but instead of organizing I see most going underground and just ignoring the law rather than trying to change it. I hope your vision is right but I am a bit of a pessimist.

I hope that Mike is right and the second draft will be better.

Comment by Bert Davich on November 13, 2009 at 12:41pm

Carl, I do have a comment about that.

Although I haven's had time to isolate the BOK line #'s you stated should be used, I don't think the BOK should be about 'Swedish' or any other 'modality' defined concept.

What I do believe is that a good starting point stems from a research article originally posted by Keith... http://www.biomedcentral.com/1472-6882/6/24
"Development of a taxonomy to describe massage treatments for musculoskeletal pain"

This study crosses the 'Modality Barrier' and does not pigeon hole a therapist regardless of modality. At the same time it allows for a specific definition of KSA's for a graduating therapist.

I see 2 adjustments required:
1) Level of Mastery required for entry level qualification
2) Some missing elements of actual practice are absent, including Proscribed (omitted) treatments by protocol. These would need to be addressed.

Here are the basic components for a start. Note that Meridian work was proscribed as well as some other elements.

Table 2

Components of treatment protocol in study of massage for neck pain
1. Styles or techniques allowed with no restrictions
1. Application of cold
2. Application of heat
3. Compression – pumping or static
4. Craniosacral
5. Friction or direct pressure
6. Cross-fiber friction
7. Gliding (effluerage) – Swedish
8. Gliding – deep (effluerage, stripping) – clinical
9. Holding
10. Kneading (petrissage)
11. Lymphatic drainage
12. Percussion (tapotement)
13. Rocking, jostling, shaking, vibration
14. ROM – active or resistive (also active assisted and/or resisted stretching, MET, PNF – consisting of three types of resistive stretching: lengthening, contracting the agonist; lengthening the agonist, contracting the antagonist; and lengthening the agonist, contracting agonist and antagonist)
15. ROM – passive (passive stretching, positional release)
16. Skin rolling
17. Stretching (manual)
18. Traction
19. Trigger point therapy

2. Principal treatment goals LIMITED by protocol (i.e., allowed only if represent less than 20% of an individual session)
Energy Work (e.g., Reiki, Polarity, Therapeutic touch, Zero Balancing)
Movement Education (Active Exercise Styles) (e.g., Alexander Technique, Feldenkrais Method, Aston Patterning)

3. Treatments proscribed by protocol
Aromatherapy
Asian bodywork (shiatsu or other meridian based massage)
Dietary supplements
Recipe techniques – although components of those may be acceptable

Sherman et al. BMC Complementary and Alternative Medicine 2006 6:24 doi:10.1186/1472-6882-6-24

Comment by Carl W. Brown on November 13, 2009 at 12:04pm

Bert, can’t agree with you more. I pared the BOK down in my strawman to just that (basic Swedish) and started filling in some of the expected standards and was thinking of suggesting this to them. Do you have any comments on that proposal?

I agree that we need to start with something that is easy to get your hands around and then expand it later to encompass more.

I can’t imagine that the MTBOK expects that the minimum requirements are that one has to master each and every KSA. If you can pick and choose then it is not a standard. To do Swedish for example you need draping skills and body mechanics that other forms of bodywork do not.

Comment by Bert Davich on November 13, 2009 at 12:33am

Keith and Carl,
I see the point on networking to create a set of standards through consensus as to what is useful.

However, it is necessary to first define what the standards are for.

The MTBOK seems to be attempting to define minimum standards for initial licensing (graduation if you will), yet it contains KSA's that are clearly beyond what a newly graduated therapist can rationally be expected to have.

It appears that we should concentrate on influencing the BOK members to create the initial BOK to address that issue and unequivocally state that is the purpose of the initial BOK. This will allow the BOK to happen sooner rather than later, without a divisive internal fight, and will allow time for consensus driven sets of standards to be created that go beyond what a new graduate can be expected to have for any set of KSA's there is a consensus to create.

I also advocate it should not be stated as a minimum KSA for a specific modality (such as Swedish). Modalities are limiting in and of themselves. Carl, would you have wanted your initial work to be limited to effleurage, petrissage, friction & tapotement?

This BOK will happen, too many heavyweights want it so. So lets work to get it right.

Comment by Mike Hinkle on November 12, 2009 at 4:40pm

Carl,

You agreed about 50 comments back the "Master" issue was mute. Back again?

So glad you agree we need standards. Your second paragraph explains all the reasons for improving schools through standards... good job!

Carl, I don't want to go to Medical School. The hours we are talking about are for attaining enough training to graduate from Massage School.

Comment by Mike Hinkle on November 12, 2009 at 4:32pm

Keith,

I see the real world. This discussion, on this site, will affect the MTBOK minimally at most. I see, there were outstanding members picked by the major stakeholders of the profession, not a single source. I see, you, Carl nor me were chosen to be on the MTBOK. I did not apply.

So I see, this is our opinions and that's about all. I have seen no organizations, whether news or professional, trying to control this discussion. I see just the opposite. ABMP has given us this chance to say as we will.

And I agree about "time". It's all about the hours... there never seems to be enough.

Comment by Keith Eric Grant on November 12, 2009 at 4:05pm

Mike says:

We won't know the standards until we see what comes out in May.

Mike, this is exactly part of the problem. You see the world as single source, much as large news conglomerates tend to do. But, the future of business and, I believe, knowledge management, is in ecosystems. Organizations, whether news or professional, no longer can control the discussion. What will emerge will be an interesting process. In truth, we won't know the standards until we reach a point that a consensus emerges as to what's useful in practice. But, I'm going to stop talking about that at this point, and simply see what I and others can network and create. Better use of time.

Comment by Carl W. Brown on November 12, 2009 at 3:59pm

Mike “Anyone wanting to use line item veto to shorten anything can.” Are you saying that one has to master each and every KSA in the BOK? If so to what competency? If I can pick and choose the KSAs and the degree that I am competent then where is the standard?

“Few people will enter any program not knowing when they will finish.” What do you do with the people who after the hours are done still don’t know the material? Pass them anyway? Without standards you have to. This is why many MTs are such poor performers. If I go to college I can expect to get a BA in four years but it might takes me longer because I have to repeat classes, change majors or just can’t get the needed classes, or wait to take classes with better teachers.

If I want to get into a good medical school hours alone won’t hack it.

Comment by Carl W. Brown on November 12, 2009 at 3:43pm

Rudy, I agree but I also think that thouse without the kinesthetic skills either acquire them or drop out of massage. With some people they come naturally and others never learn them (four left feet).

It is interesting that to develop my kinesthetic skills I had to suppress my medical intuitive skills. After completing massage school I switched back to improving my medical intuitive skills at the expense of my kinesthetic skills. Today I don’t do Swedish and instead refer people to other who do. Hours are not an indicator because it depends on what you learn. The hours I spent learning Swedish are totally wasted and the time I spent on other bodywork did not help me do better massage in fact they made me worse.

My choice at the fork in the road was to do OK massage or follow my natural talent and help people in a different way. Clients have different issues and need the variety. Too often schools will spend the hours teaching a little of this and a little of that and nothing well. I believe that we desperately need a standard to teach to that will give people a cohesive point to start. Then they can branch out.

I also think that if we understand massage training better it will help us understand what is massage and what is other bodywork that has different and sometimes contradictory training requirements.

Asking how many hours does it take to learn massage is like asking know many hours does it take to learn partial differential equations? It depends on how well does the person have to know it, what mach background do they have, how good is the teacher, and the ability of the student to think in ways that are different from previous forms of math.

Comment by Mike Hinkle on November 12, 2009 at 3:28pm

The training depends on the teacher. So can we please set some standards for these massage school teachers?

The division of (knowledge)hours can be set by standards.

We won't know the standards until we see what comes out in May.

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