Massage Therapy Body of Knowledge

Comment

Comment by Christopher A. Moyer on October 20, 2009 at 8:05am

Keith - well said.

Mike - You say that "many aspects of energy work can not be "scientifically" understood..." but I think the truth is much closer to the fact that they are actually very well understood. The precepts of energy work are almost certainly invalid, and the resultant phenomena, which are subjective, are the result of psychological mechanisms that are relatively well understood.

You go on to say "we can line up hundreds of clients that have been helped by energy work." This is not exactly true. One could line up hundreds, or thousands, or millions - the number is irrelevant - of people who believe they have experienced energy work. That is not the same thing.

Put another way - all of the phenomena associated with energy work practices can be explained by theories that are more plausible than the ones the practices is founded on.

Comment by Christopher A. Moyer on October 20, 2009 at 7:59am

Hi Bert.

Thanks for responding. I completely agree with you that "if something cannot be objectively quantified, it is not possible to predict or expect consistent results" and that "anything written in a BOK must be objectively quantifiable and evidence based to be accepted in the scientific and political universe."

As for objectively quantifying energy work, it is my opinion that isn't even that difficult, scientifically. This is illustrated by the Rosa et al. study on therapeutic touch that appeared in JAMA, for example. What do you think?

http://jama.ama-assn.org/cgi/content/full/279/13/1005

Comment by Mike Hinkle on October 19, 2009 at 10:18pm

I am not the one describing energy , in any direction. I said Carl is using different modalities against each other, including energy. It seems there is an effort afoot to get a modality pigeon-holed, thwen tear apart the BOK accordingly. You yourself said it,our basic scientific understanding of forces and energy . Many aspects of energy work can not be "scientifically" understood (yet) and some here, even challenge it's existence. Yet we can line up hundreds of clients that have been helped by energy work. We know there is much that yet has to be discovered in massage research. That does not mean we will not continue to help those with these modalities. Research has not kept up. But science (even evidence based) will not stop these modalities or stop therapists using them.

Challeged legally or scientifically, it may fall shory of your present BOK standards. This will not stop it from being presented to the public May 13-15, 2010 in Seattle. So because the initial BOK and research used won't hold up to these criteria it should stop until it does? Good luck with that opinion. I don't think that will stop it.

So far as critique, I am not stopping it am I? I seem to be still responding. It does matter that this was the first draft and is open for comments and course corrections are taking place.

As far as multiple parties, bring them on. Where are they so far with their input? Seems they too are waiting to see that second draft. They sure are quiet so far.

Comment by Keith Eric Grant on October 19, 2009 at 9:47pm

Mike,

This can be considered to be input. It is a foretaste of the type of review and critique that something that claims to be a body of knowledge within the domains of health care will be subjected to by multiple parties in terms of scientific basis, supporting research, quantifiability, ... Something that violates our basic scientific understanding of forces and energy isn't going to cut it. If you want to speak of energy, then you are going to have to identify it as a known, measurable, energy under current scientific understanding of the term. It also helps if you have a physically reasonable model for the use of such energy by a practitioner. As to the critiques this will face from outside, I recommend the free registration to Pulse so you can look at Edzard Ernst's Blog and taking a look at the blog Science-based medicine. Raising a BOK will be considered as a declaration of knowledge according to scientific and medical standards. If one doesn't want this, then it should be called a Body of Current Practices, or a Body of Practitioner Myths. [By the way, Mirka Knaster (Discovering the Body's Wisdom) and Thomas Clair (Bodywork) have both previously cataloged a number of massage and bodywork practices.]

One also, by the way, also has to consider how any U.S. created BOK will stand (i.e. hold-together scientifically) in terms of international efforts and, notably, Canadian efforts to look at evidence-based massage and creation of a massage ontology.

The number of the draft is irrelevant. It is a draft issued for public comment and thus should be considered as open to all relevant comment as being a health profession's body of knowledge. It is better to receive a level critique and review near the beginning of a project than to progress far before finding that course corrections are required. In short, expect a scientific critique from multiple parties rather than an episode of cheer-leading. And yes, my physicist credentials are showing more than they normally do, but that also is a foretaste.

Comment by Bert Davich on October 19, 2009 at 8:30pm

Christopher,
My statement that energy work could not be quantified assumed "objective" quantification. I agree with your assertion that detection of the effect is quantification with the stipulation that every form of "detection" you mentioned is subjective. And that is the problem. If something cannot be objectively quantified, it is not possible to predict or expect consistent results. My personal subjective experience is that some clients are very aware of energy work and others are completely oblivious to it.

Anything written in a BOK must be objectively quantifiable and evidence based to be accepted in the scientific and political universe. If you can come up with a way to objectively quantify energy work I would like to hear it.

Comment by Mike Hinkle on October 19, 2009 at 6:36pm

Carl,

It is the 1st (FIRST) draft! They wanted our input. I don't make the case, because I don't agree with that part and will wait to see if it is in the next draft!

You are trying to play energy versus medical versus swedish, to try and separate each side. There are ways to appease all. Patience....... the major problem with the first draft was that they tried to be all inclusive and they did that to get feedback in each direction.

Now we will get a trimmed down 2nd draft around New Years and still get input. I know changes are being worked on. I wish I were directly involved in this one, but it is in good hands. Keep watching.

Comment by Carl W. Brown on October 19, 2009 at 5:15pm

Mike my point is that the document does not either state how much you need to know about atoms and why or provide clues as to how someone reading the document can determine it.

We do have a common ground the act of touch, Beyond that we have some disciplines that overlap, build on each other and teach mutually exclusive skills.

Entry level skills are thouse that are absolutely essential to practice what you do and without any of them you fail to be qualified. To build such a list you need to not only select thouse skills but a minimal level for each skill. You cannot include skills that are person may or may not need nor can you leave it up to the imagination as to what competency is required to meet the entry level requirements.

Since you also want to include non-essential skills that may only be needed by certain modalities that is OK as long as they are clearly designated as so and separated form the minimal entry level subset. Since they are optional you don’t need to specific explicit competencies.

I think you also want this document to include optional skills because it can be used by schools to give people a more rounded perspective on where they may want to go with bodywork. But the document should make it clear that if you want to do medical massage that you can safely do so with absolutely no energy work and conversely if you are going to do Reiki that you don’t need anatomy or physiology.

I suggested quantum physics as a bit of tongue and cheek humor. But I was just trying to illustrate that they is a wide spectrum of interpretation between that and not even requiring that you know that atoms are composed of electrons, protons and neutrons.

You don’t make any case for why an MT need to know about atoms.

Comment by Christopher A. Moyer on October 19, 2009 at 1:50pm

Hi folks. It looks like I'm a little late to this discussion. But, I did just read all 100 posts in an attempt to prevent myself from bringing up things this discussion might have already settled.

I've read the MTBOK draft and plan on assembling and posting my remarks via their webpage.

In my opinion, the most serious problem with the document in its current form - and I do believe it is quite a serious problem - is the many references to energy medicine and related concepts. This is because there is no objective evidence whatsoever that these things exist. It seems to me that there is quite a bit about massage that is known and that can be objectively demonstrated and verified, and that this is what belongs in a BOK. I agree with something Keith said several posts back, i.e., that it may be permissible to "demote" information about unproven theories or traditions to that status, if they are being used in the profession to the degree that familiarity with them is useful. Personally, I think even this level is problematic when it comes to "energy medicine" and massage therapy.

Another poster (Bert, I believe) has asserted that energy medicine practices cannot be quantified. I'd like to point out that this is not true, if they actually exist. If there really is some kind of energy that is being manipulated, and/or if it is actually having an effect, detection of that effect is a form of quantification. There is nothing at all to prevent us from testing the assertions of energy medicine practitioners - can they detect what they claim to detect? Can recipients distinguish when they are being worked on, and when they are not? That may be a rough form of quantification - zero or one, if you like - but it is quantification nonetheless.

-CM

Comment by Mike Hinkle on October 19, 2009 at 12:58pm

Carl, first you said school should take a month. Now you say Quantum Physics is needed. You use your own argument to throw this out with:

KSAs without standards are like a shopping list with no quantities. Unlike the shopping list you don’t have the opportunity to buy 1 gram of flour for the cake. But if that is all you buy you might as well buy none and just cross it off your list. However, buying a 50 pound sack of flour makes no sense either, it is over kill. You might as well add quantum physics to your study of the atom.

We will find a common ground. Otherwise the profession will never get organized. As you said, doctors don't "recall" it all either. We will set "entry-level" qualifications and we will adapt.

We are massage therapists. Laws were used to accomplish that. Parameters and standards will be set, and as always will come back to the teacher's discretion, as to whether the standards are met for graduation. Mastery is not the subject. Meeting the standard is. Even with our instructors "few" are Masters! We still recognize them, learn from them and grow.

Will this be a perfect document? Hardly. But it is a "living document" and will be changed accordingly as needed. Certain knowledge, skills and assesments will be set and graded accordingly. You even said, less education is needed. So when are you going to drop this "mastery" joke?

Comment by Keith Eric Grant on October 18, 2009 at 7:28pm

Carl,

The late Claude Ostyn, former head of the IEEE working group on competence data standards, did a nice job of addressing this issue (and others) in a white paper. It succinctly captures the concepts of collecting the KSAs and performance levels (at the level of a competence map) as they would be applied to ability to perform specified collections of tasks. They provide one of the clearest statements I have seen for creating and managing such a collection.From multiple indications I've seen (AICC, MobileMind, Aaron Silvers), Ostyn was very highly regarded in the learning technology community. His opinions are thus a likely indicator of both how he helped shape the learning future as well as where competency management is headed.

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