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Competency vs. Hours

I have long desired to see the standards for massage therapy education raised in my state and across the nation. Here in North Carolina, the requirement is only 500 hours. That varies in the US, from the unregulated states that have no requirements at all, to the 1000 hours required by New York, Nebraska, and Puerto Rico. The rest fall somewhere in between.

Our neighbors to the north in Canada have a few provinces that are unregulated, but those that are regulated have a much higher hour requirement than the norm here in the US. However, in looking over their documents pertaining to their regulations, I see that it is not really about the number of hours; it is about the basic competencies that they have set forth for an entry-level massage therapist, and I must say that I find it quite impressive. You can read those here.

I imagine that the higher number of hours is merely a by-product of the competencies that are required. It would take a lot more than 500 hours to pack all those competencies in. And I couldn’t find any fault with any of them. It actually bears a lot of similarities to our recent document, the Massage Therapy Body of Knowledge. That’s not a perfect document; it’s just a start on defining what an entry-level therapist should know here. I’ve heard a good many complaints about it. In fairness to the dedicated volunteers who gave of their time and expertise to work on it, they offered a long period for comments from the profession, and I was personally appalled at how few they got. I think they got about 600 or so, and about 50 of them were mine. It was also very telling to me that when our Board sent out a survey to the approximately 40 school owners and program directors recently about raising the standards, only 7 of them bothered to reply. There is a big lack of interest in raising the bar.

The complacency here is staggering, and people just tend to complain after the fact instead of offering input on the front end. It’s the same thing I’ve seen over and over again when it comes to detrimental legislation in our profession; a few dedicated people will contact their legislators before something awful gets passed into law, and the rest will just gripe about it after it happens. That’s another blog, and one that I’ve written several times.

I’ve actually been pushing for our Board to raise educational standards, which like anything a public board is considering gets passed along to a committee for study. It is unfortunate that we could not find any concrete evidence that requiring more hours leads to better test scores. Then again, is that what it’s all about? The ability to pass a test? In our paradigm, yes, it is. We are lacking here in measuring competency in any other way.READ MORE...

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Comment by Scott Dartnall RMT on February 26, 2011 at 11:01am: Great post Laura, thanks for sharing. Be well. Scott

Comment by Laura Allen on February 26, 2011 at 9:13am: Several people on here have mentioned practical exams...most massage schools have student clinics, but I don't know that many who have practical exams. There are only 7 states that require a practical exam for licensing. I never had a practical exam in massage school...they depended on the client evaluations from the clinic to judge how we were doing. Neither the MBLEx nor the NCB exams require any practical on their exams.

I think it does become teacher opinion...and not everyone agrees on what constitutes a "good" massage. One teacher may like a student's massage while another one does not. If it was only about can they correctly do an effleurage stroke, etc, it would be different, but I think people bring their own experiences and prejudices into the mix.

Comment by Daniel Cohen on February 25, 2011 at 6:03pm: Dannie I couldn't agree with you more. A basic course with hands on experience that teaches to feel and read the body with good business orientation is the best background to start. The extras should be advanced study later once special interests are discovered. It seems to me that the greatest advantage in lengthy courses that are expensive benefit the chain schools, colleges and distant learning centers more than MTs that are starting out. Massage Therapy has been a career change for many people, raising entry level hours and schooling requirements while eliminating private schools with CEUs will change all this. Is it for the better? For the better of whom?

Comment by W. Dannie Lane on February 25, 2011 at 1:01pm: I have been in massage school two times, one in 1989 for a 200hr class and one in 2001 for an 800 hr class. I see a 500 hr class as just fine for an “intro” into the massage world. But only if the training they get in that 500hr is good. Like what I got in mine, the 200hr class was just a Swedish type of massage BUT it was ALL focused on how to read the body and the muscles, on how to touch the body. The next class was 750 hrs of Swedish and deep tissue work and 50hr of hands on clinic. This is the thing, it was 750hr if JUST Swedish and DT work, not 8 other things on top of that. Most other therapist I know that have 500 to 1000 hr of training do not have half the training in just these two modalities that I got in my one class. This I feel is what we need to look at in improving the training of new massage therapist. Schools that have a 500hr class and teach Swedish, DT, sports, NMT and more do all of massage a big disservice

Comment by Lisa on February 22, 2011 at 11:43am: It is a combination of education, experience and what you do with both that makes the difference.

This is so true. Because ONLY in the field of massage do we actually TOUCH people's entire body. And to do that, it takes more than just the academic aspect of it, it also takes a connection between therapist and client. You can have someone with 2,200 hours and they can give an awful massage because they aren't simply reading the client's body and communicating with the client. And yet you can get a therapist who's had 500 hours give an amazing massage because they ARE reading the client's body and communicating. That is why I truly believe not every client out there is meant for every therapist. And it's to our individual practice to recognize that and grow within our individualized market.

A 1,000 hours of training doesn't ensure you have the skills necessary to treat the range of conditions that come through your clinic doors.

This also rings true for me. hours alone don't dictate the quality of education. it just dictates the amount of time you spent at the school. The way our schools differ from state to state and even within state, you could easily have someone with 500 hours getting a better quality education than someone with 1,000 who may be receiving a lot of fluff & buff stuff.

what needs to be reviewed is the quality of education and making certain aspects standard, rather than making the hours standard IMO.

Comment by Daniel Cohen on February 22, 2011 at 12:02am: Is it just me or has someone else noticed how different a massage from two people with the same hours of education can be.

How about Doctors? Some have a great reputation and others with the same education are not as often being referred.

It is a combination of education, experience and what you do with both that makes the difference. That is why massage encompasses such variety and gives many career opportunities. I think enough hours should be set as a minimum to provide a marketable skill. Beyond that it is up to the individual.

I believe that any increase to high numbers of hours would only serve to limit the number of practitioners in the hope of raising the fees earned. In fact there does not seem to be a correlation between education and fees. Rather it relates to where can you get a job. In my area, los angeles, the highest fees seem to be among unlicensed outcall massage.

An experienced MT licensed and insured earns around $17/hr massage plus tip at the local chain spas and chiropractic offices. At private small massage establishments it goes to $25-30 plus tips. Independent, unlicensed, uninsured, certification course taken, outcall is $100-120/hour plus tip. This last does include travel time etc. and often goes over an hour. I am sure others will dispute these fees, feel free to offer counter information.

So what is the point of raising required hours? To elevate the profession? To gain greater scope of employment? To raise income? I wish to suggest that a 200 hour certification course plus 120 hour internship with whatever CEs interest a persons quest for knowledge and expertise, already does this while providing an entry level accessible to most.
I am not convinced that the craft requires any higher entry threshold. Now you may correct or educate me to my error.

Comment by Eric Brown on February 21, 2011 at 11:17pm: I barely felt competent after 2,200 hour of basic training here in Ontario, Canada. I don't disagree with you Laura, but I think there is also another side to the story that's been discussed countless times.

If your goal is to simply help people relax, which I think is one of the key benefits and strengths of our service, how much training do you really need? You could probably learn to screen for contraindications and give a very decent relaxation massage with 200 hours. That serves both the practitioners and the public.If therapists are clear on their scope of practice, it's a win-win for everyone.

What drives me crazy and what I find very worrying are therapists who think they have the expertise to deal with issues they clearly don't have training in. A 1,000 hours of training doesn't ensure you have the skills necessary to treat the range of conditions that come through your clinic doors. And I think that false sense that you're qualified because you've been in school longer is a clear danger in increasing required hours of training.

Comment by Mike Hinkle on February 21, 2011 at 2:26pm: Yes, in school, but there are written test as well that are avaeraged in to determine a final grade. Thus not leaving everything just to the teachers decision.

People are saying, many teachers are not qualified today. I agree with Ralph Stephens, before we ratchet up hours or hamper growth with more rules and regs... get teachers corrected first. If teachers could do it before with 250, it doesn't make sense they can't do it with the 500 hour standard.

Practical test were done away with in FL, as a form of licensure and I don't think many, if any, are still doing it that way. Schools will always have practical test to determine ability of application of the knowledge.

Comment by Matthew D. Stewart on February 21, 2011 at 2:04pm: This is a huge reason practical tests have been done away with, it becomes teacher opinion.

Mike,

Do you mean that massage students never have practical tests in their training? If that is so, I find that alarming.

Comment by Mike Hinkle on February 21, 2011 at 1:25pm: On this one, I agree with Daniel. There is room for everyone under the title "Massage Therapist" in America. Different modalities and hours, for specifics, all fall under massage. Let no one aspect or modality, or set number of hours should control the name.

"...competence in touch is so difficult to rank. Is it accurate? I don't believe so." (DC)

On the nose!!!! This is a huge reason practical tests have been done away with, it becomes teacher opinion.