Massage Therapy Body of Knowledge

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Comment by Mike Hinkle on October 5, 2009 at 6:34pm

You got me there. When I tested it leaned towards oriental medicine. I think there was a craze at that time to introduce more of it into the Florida schools.

But you about said it right at the end about the civil engineer. If the law says he can.... he can. Heck, look at our last 5 Presidents!

Comment by Carl W. Brown on October 5, 2009 at 6:16pm

Mike I guess that I see massage and bodywork being as diverse a field as engineering. To define a BOK for all of engineering would encompass chemistry, electronic, structural design, building codes etc. I would hope that that BOK would not be use to certify or license. Yes there are lots of jobs that require cross training. One may mix computer engineering and electronic engineering or chemical engineering. The problem with tests like the MBLEx or NCE is that they either take focus on one modality like Swedish or try to span all modalities and not test of competency is any one. What about the civil engineer who can answer enough questions about electronic, chemistry, computer science etc. to compensate for his lack of civil engineering know how.

Comment by Mike Hinkle on October 5, 2009 at 6:11pm

First, I can't "put" anything, anywhere. I am on the fence, watching. Carl, when therapists graduate. They are not modality certified in anything. They are given a piece of paper that says they have completed what the state has set as prerequisite to test. Certification is handled through existing certifying boards specific to modalities.

Yes, KSA's will be set. Competencies will be set and attained. Making the work my own was one of the first things I was taught in Swedish in school.

I don't think we should label or explain modalities because of "dither". Differnt instructors, and, and, and... who will be labeled "The (Reiki, Swedish, Energy....) Guru? I see a lot of "highly nervous, confused, or agitated state" folks if it comes to that. And it really isn't needed.

State Boards that control our regulatory aspects use these processes and there really needs to be a "commom ground" in the profession so we are all on the same page instead of the patchwork system we have now. I think that's a big problem you are trying to solve in CA.

Comment by Carl W. Brown on October 5, 2009 at 5:41pm

Mike, put in the document that this BOK pertains to the domain of knowledge of massage and does not define competencies nor any required minimum subset of KSAs needed to practice a specific modality. This will insure that the developers intentions are not misconstrued.

I will agree that we never master anything but there are sets of competencies that can be certified.

Interesting your word “dithered” “…one of the earliest [applications] of dither came in World War II. Airplane bombers used mechanical computers to perform navigation and bomb trajectory calculations. Curiously, these computers (boxes filled with hundreds of gears and cogs) performed more accurately when flying on board the aircraft, and less well on ground. Engineers realized that the vibration from the aircraft reduced the error from sticky moving parts. Instead of moving in short jerks, they moved more continuously. Small vibrating motors were built into the computers, and their vibration was called dither from the Middle English verb "didderen," meaning "to tremble." Today, when you tap a mechanical meter to increase its accuracy, you are applying dither, and modern dictionaries define dither as a highly nervous, confused, or agitated state. In minute quantities, dither successfully makes a digitization system a little more analog in the good sense of the word.”

You are right that it all blended together. I think that is because we take for different modalities and make the work our own.

What might be useful is a roadmap of modalities what they are how they relate. It was the attidude that it cannot be mixed with other modalities that turned me off to Bowen.

Certification OTHO has its uses as well. It insures that a person has mastered a consistent set of competencies to a minimal level. If I go to a CPA I can presume that he has some understanding of the tax law and not just how to keep books. I would hope that his knowledge of tax law was adequate to presume that he would know to ask an expert when he did not know.

If I go to someone certified to do deep tissue I would hope that they would know more than how to put all there weight in their elbow and not know anything of the anatomy they he was pressing.

A domain of knowledge does not help formulate ways to teach people to avoid harm but if not combined with competency guidelines can actually create harm by introducing people to things that can get them into trouble. If for example I teach people to do hot stone massage without teaching the precautions to prevent burning or cross infection I can be doing harm.

Comment by Mike Hinkle on October 5, 2009 at 4:46pm

Back to hours to confuse the point? Hours are not the way BOK is headed. They are setting KSA's. Even Keith cited this as the way to go. You keep jumping ahead of where the BOK is. There will be levels of certification set in the future. NCB and the Alliance are organizing teachers and the certification aspects in the profession. Will BOKs be written down the road for every modality? We will see.

What you point out about dilution of modalities has always been a concern of mine. That's why I try to get the original creators of modalities to teach at the World Massage Festival. But in the end, as they are dithered so will the knowledge. But almost all of these ideas are centuries old. So no matter how much we are taught, there will always be more. For most therapists, I think it helps them fight burn out. Most therapists never "master" anything and this BOK does not ask them do so.

As this BOK is improved with thoughtful panels through the years ahead, I think it will be used for legislative purposes and I am glad we have input in the system this time.

Comment by Carl W. Brown on October 5, 2009 at 4:18pm

Mike, Am I mistaken but you favor defining the BOK as thouse competences that comprise some sort of massage or bodywork? One can then certify a person as a massage therapist as one who has mastered a specific percentage of this knowledge even if the knowledge is not consistent. It does not sound that the purpose of such an approach leads to helping people practice professionally but rather insure that they spent sufficient money learning “stuff”.

If you truly believe that the BOK will be used for legislative purposes, how do you reconcile the idea that testing on random bits of knowledge dose not insure that the person knows the important facts? As you expand the scope of knowledge, the percentage of knowledge must be lowered. It then dilutes the expertise required. The only thing that stays constant is the cost and hours of education.

If this is the goal then why do the BOK at all? We have the NCE and MBLEx that already do just that.

If you do produce this type of BOK then clearly spell out the fact that it is documenting a range of possible skills and that it is not to be used to certify any specific modalities or competencies. It is like certifying that you a fluent in a language when you know the meaning of a specific number of words. Maybe all you learned was verbs but don’t know any nouns.

Comment by Keith Eric Grant on October 5, 2009 at 4:11pm

In looking around for a good depiction of a competence-based body of knowledge, I ended up back at the late Claude Ostyn's website. He provides a nice picture of the ecosystem of competency management. It basically ties overall goals of accomplishing desired tasks, to management of human KSA's needed for defined tasks, to competencies and accompanying proficiency specifications, to training.

Ostyn also had done a paper that captures a lot of the processes and uses of competency management, which, driven by the defense department's Advanced Distributed Learning initiative and adoption in health care by MedBiquitous is where serious knowledge management is rapidly moving.

I also came across a report by the Human Capital Institute that, particularly in the small yellow boxes, summarizes succinctly some of the key processes. The world of knowledge management has changed greatly in the last 10-15 years, including introduction of new tools an even new ways to elicit out clustering of information that's tacitly present in collections of documents.

I also looked back through my Tweet archive.for a good example of where "the business" side of this is.

Comment by Mike Hinkle on October 5, 2009 at 3:25pm

With eight to nine months to go before BOK publishes their final draft, all these issues will be (and are being) addressed. And there will be other opportunities for therapists to offer their services, skills and knowledge on future BOK Panels.

The MTBOK, Standards of Practice and Model Practice Act will all work together. Everyone needs to look at the BOK Draft (link above) and give their input. Modailities are not being defined, which means they can be applied as they have been taught. Will there be changes? There always are.

Please look at the draft and offer your advice to the panel.

Comment by Carl W. Brown on October 5, 2009 at 2:50pm

Bert, I cannot imagine a BOK that tries to define all bodywork. It is like a course I took where part of the course consisted of high velocity low amplitude spinal manipulations including C1 which cab cause arterial dissections. To pass I had to master the techniques but I will not practice it. While it might be part of bodywork I do not think that we should include it.

My first massage involved freeing a stuck placenta. I was shown how to follow the umbilical cord and locate the detachment point. Use used my native talents to detraumatize the tissue and then coax the placenta to detach and save the poor woman from hemorrhaging to death. Again I do not think that this skill belongs in the BOK.

Likewise I do not believe that a Swedish massage therapist NEEDS to know energy work to do his/her job.

I also think the BOK should not contain things that cannot be demonstrated or that some people cannot learn. An essential part of the way I work is to feel pain in another person. This is something that I do not know if it can be taught or is a talent you are born with.

Does a person in China who studies acupressure study Western anatomy and physiology? Do they teach acupuncturist Swedish massage? If not then I do not think that Swedish massage should be a prerequisite to acupressure either.

Comment by Carl W. Brown on October 5, 2009 at 2:29pm

Mike “There are parameters that affect all therapists.” That is an alternate approach. You can build a BOK that contains only the essentials that all bodyworkers need to know. Thouse things like business practices, ethics and universal precautions.

“They simply want to learn it all, well at least a little of everything. How else will they know if they'll like it?” This is a shopping list not a BOK.

I BOK describes points that the person must master to the specified competency. Fail on any point any you do not qualify. It is like the code of ethics. Conforming to most of the ethics does not work. To be valid each point must be objectively proven to be relevant to a person’s performance. For example, would you certify a person who has great strokes but just does not get draping and constantly inadvertently exposes clients? I think you need this on the must have list. However, if you do Reiki and doesn’t know how to drape does it matter? I think not. Skills do vary by modality and defining a coherent set of skills is what a BOK is all about.

If the schools want to satisfy their function and give people a taste of other modalities that is fine but it does not belong in a BOK. When introducing people to other modalities you have to be careful not to create sorcerer’s apprentices. The point of a BOK is to teach a compete set of knowledge. Teaching massage without contraindications is wrong. Teaching an incomplete modality is also wrong.

Therefore you must limit the scope to a complete and coherent set of teachings. If for example you define massage as both Swedish and acupressure then the person must master both disciplines to qualify as satisfying the BOK. The must be able to drape and read tongues. How many people do you know want to master both? So you have people who satisfy 70% of the BOK. Is part of the 30% important? Is your doctor good but does not know his drugs?

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