Minimal requirements strawman

Replies to This Discussion

Permalink Reply by The Rev on October 29, 2009 at 3:18pm

That is your loss... I googled you and see you are in Florida? I am so sorry you were brought up under that yoke. Viva la difference... I am a Boston moved to Berkeley kinda guy. Liberal NE to progressive Berkeley. You can tell when you have been in Berkeley too long when you see a sign that reads 'Free Firewood' and ask who is Firewood? I have not been here that long, yet

Darcy Neibaur BS LMT NCTMB said:

I have never been in an unlicensed environment.

Permalink Reply by Mike Hinkle on October 29, 2009 at 3:26pm

Carl,

People are licensed to protect the public. Harm comes in many more ways than just physical harm caused because of the massage. Insurance covers those aspects and probably about the right amount.

An energy worker is making outreagous promises; how do you stop it? A therapist hurts someone and disappears; how are you going to find him? An establishment is collecting for gift certificates and rips people off; how you going to find him?

With licensure, you know where to go, who to talk to and what they are legally allowed to do. Then you can get these people out of the system. Otherwise the public is always subjected to these unlicensed therapists.

Carl W. Brown said:

Mike, according to the ABMP I pay $67 of my dues for professional liability for $2,000,00 of coverage with just 100 hours of training. This tells me the experts know this to be a safe profession and they are willing to bet money on it.

When I was a computer programmer I could not afford the professional liability insurance and the general liability (slip & fall) insurance cost me $500 for $500,000.

If someone will build a standard based on proven harm I will buy into it. But I don’t see that the BOK addresses the issue of harm at all. 99% of the KSAs have nothing to do with harm and the rest have no standards. How much education is need to make sure that you wash your hands and disinfect your stones?



Mike Hinkle said:

Rev, I understand. You were able to go years with minimal standards and those were glorious days, I'm sure . But those standards today are not enough to protect the public and the states. But because of state rights and responsibilities, they have to organize. As my Dad tells me everyday, "Mike, nothing stays the same forever. Don't fear the future, embrace it!"

The Rev said:

Mike Hinkle said:

No wonder CA is a mess guys, this is not scientific. I am thinking, I also think, do they need to know the muscles? States need to set rules and therapists need to meet them. I have never heard of a professions guidelines being organized in this manner.

I am beginning to think we may not have much in common... Did you ever work in an environment with no state licensing? Most no longer can have that experience.

Permalink Reply by Laura Allen on October 30, 2009 at 4:50am

I don't know anyone who considers Reiki to be massage. There's no manipulation of soft tissue involved. The fact that many MTs do it doesn't make it massage.

Carl W. Brown said:

Keith, I am thinking that we cannot expect a person to master all modalities before they get started and that modalities that need an absolute minimum of the KSAs such as Reiki are not considered by some people to be massage.

If we then look at one job description we will get a better idea of how to build a more realistic picture of massage in general.

I also think that this type of model makes it easier to set competencies for each KSA because it is a limited list. For example there are a limited number of muscle that one needs to know for 512 and 513. They need to know the major muscles of the back, neck shoulders arms and hands but since they don’t take notes or communicate with others do they need to know the names of the muscles?

Permalink Reply by Laura Allen on October 30, 2009 at 5:17am

I have worked in an unlicensed environment. Licensure was not yet in our state when I started. I was the administrator of a massage school when it came in, and had to prepare the application for board approval of the school. Bringing licensure into a state is usually, although not always, directed at ensuring schools meet minimum standards, as well as ensuring MTs meet minimum standards.

I thought then, and continue to think, that ensuring that a school meets minimum standards for educating students was a good thing. The standards in our state include requiring proof that the teachers are qualified to teach; that there are viable lesson plans with measurable learning objectives; that there is adequate room for each student; that there is a good student/teacher ratio; that the school is adequately equipped, etc., not to mention that the therapist has been trained in A&P, physiology, kinesiology, massage contraindications, and professional ethics.

When licensure became the law here, there was of course a grandfather period. In our state, the requirements for that were 400 documented massages and at least 4 years of practice. I was appalled at the number of former students who called and said "Documented? What do they mean?" These are people who were taught to do intakes, conduct interviews, and maintain SOAP notes on every client when they attended the school---but until it was the law, they didn't do it. Many people just quit practicing because they hadn't been conducting their practice in a professional manner.

Do I want the government telling me how to run my life? NO. But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it.



The Rev said:

If you can say you started a practice with 100 hours of training and have experienced fully the gamut of work from the days of non imposition of requirements to receiving work in the present you cannot understand. Just for your info, standards, for me, is not the problem. Argue for high standards, but (it's too late) keep the state and other governing agencies off my back. You and yours left the table and went to the government a long time ago.

Now THAT is scary... There is the ol' harm to the public argument. I thought that fell by the wayside, but apparently not.
Now there is something we have in common. The only constant is change. The change in the field appears good to you. To me it is bad.

Let me ask again.. Have you ever worked in an unlicensed environment? Do you have a practice or are you just in it for the marketing of educational workshops/conferences, etc? (hat is not a bad thing).

Permalink Reply by Stephen Jeffrey on October 30, 2009 at 7:52am

Hi Laura, you put your case very well for licenceing and highlight energy work, do you think it should be in a massage BOK? I practice both diciplines but dont think it should come under massage as I feel it would cause to much complication and arguement as is evident in the discussions on here.

Laura Allen said:

I have worked in an unlicensed environment. Licensure was not yet in our state when I started. I was the administrator of a massage school when it came in, and had to prepare the application for board approval of the school. Bringing licensure into a state is usually, although not always, directed at ensuring schools meet minimum standards, as well as ensuring MTs meet minimum standards.

I thought then, and continue to think, that ensuring that a school meets minimum standards for educating students was a good thing. The standards in our state include requiring proof that the teachers are qualified to teach; that there are viable lesson plans with measurable learning objectives; that there is adequate room for each student; that there is a good student/teacher ratio; that the school is adequately equipped, etc., not to mention that the therapist has been trained in A&P, physiology, kinesiology, massage contraindications, and professional ethics.

When licensure became the law here, there was of course a grandfather period. In our state, the requirements for that were 400 documented massages and at least 4 years of practice. I was appalled at the number of former students who called and said "Documented? What do they mean?" These are people who were taught to do intakes, conduct interviews, and maintain SOAP notes on every client when they attended the school---but until it was the law, they didn't do it. Many people just quit practicing because they hadn't been conducting their practice in a professional manner.

Do I want the government telling me how to run my life? NO. But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it.



The Rev said:

If you can say you started a practice with 100 hours of training and have experienced fully the gamut of work from the days of non imposition of requirements to receiving work in the present you cannot understand. Just for your info, standards, for me, is not the problem. Argue for high standards, but (it's too late) keep the state and other governing agencies off my back. You and yours left the table and went to the government a long time ago.

Now THAT is scary... There is the ol' harm to the public argument. I thought that fell by the wayside, but apparently not.
Now there is something we have in common. The only constant is change. The change in the field appears good to you. To me it is bad.

Let me ask again.. Have you ever worked in an unlicensed environment? Do you have a practice or are you just in it for the marketing of educational workshops/conferences, etc? (hat is not a bad thing).

Permalink Reply by Carl W. Brown on October 30, 2009 at 9:43am

I may only have had 140 hours of massage school but I have had hundreds of hours of other training that does not qualify. I do not work on naked people. But I am still forced to comply with the massage laws even though I don’t do what most people consider massage,

How many resorts use SOAP notes? I started to use them but I found that they actually hurt my practice because the put me in a frame of mind that I intellectually knew how to fix the problem from my limited knowledge or previous experience and it got in the way of my intuitive work. I have to deliberately purge my mind of any preconceptions of what it wrong or how to fix it to let my “muscle whispering” work.

Professional standards vary by what you do. In CA the law requires that anyone not licensed provide a disclosure describing what they do, the principles behind their work, their education and the fact that they are not licensed. My guess is that 95% of MTs ignore the law. I even offer free classes to practitioners on how to develop disclosures that conform to the legal requirements but I get few takers. I think this is unprofessional but I would guess that our current title licensing board will not enforce the law.


Laura Allen said:

But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it..

Permalink Reply by Mike Hinkle on October 30, 2009 at 10:21am

Carl,

What good are standards? You have a "reason" everytime, why they don't work for you. And since you "guess 95% of your fellow MTs aren't complying" with a standard, you won't either. So again, what good are standards in CA? Nobody forces you to do anything. There is no massage enforcement in CA and every rule you have, has a way around it, ending with the self rule of, "it doesn't apply/work for me" or "they aren't doing it, so I won't either." This is professionalism? This puts you in a position to address KSAs or competency?

If you went to school more than 140 hours, you may learn a lot in thouse classes, you deem, not needed for entry students. Now that was a swipe. But based in fact! CA has little room to consider itself a "model" for a national plan, or any plan. It should serve as an example to states still not licensed, "take a look at what can happen to your profession, in your state, without licensure". Noel just wrote another thread saying how your scope and practice are being carved out by Chiros and PTs. You did not take steps to protect your profession. Just one more reason for licensure.

It is with much continued effort that, massage is allowed to be practiced in CA. If I were there, I would encourage therapists to get involved with the regulating agency and give them every assistance I could, because without them, you will have little to nothing...
Carl W. Brown said:

I may only have had 140 hours of massage school but I have had hundreds of hours of other training that does not qualify. I do not work on naked people. But I am still forced to comply with the massage laws even though I don’t do what most people consider massage,

How many resorts use SOAP notes? I started to use them but I found that they actually hurt my practice because the put me in a frame of mind that I intellectually knew how to fix the problem from my limited knowledge or previous experience and it got in the way of my intuitive work. I have to deliberately purge my mind of any preconceptions of what it wrong or how to fix it to let my “muscle whispering” work.

Professional standards vary by what you do. In CA the law requires that anyone not licensed provide a disclosure describing what they do, the principles behind their work, their education and the fact that they are not licensed. My guess is that 95% of MTs ignore the law. I even offer free classes to practitioners on how to develop disclosures that conform to the legal requirements but I get few takers. I think this is unprofessional but I would guess that our current title licensing board will not enforce the law.


Laura Allen said:

But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it..

Permalink Reply by Darcy Neibaur on October 30, 2009 at 11:32am

Carl I always use soap notes on new clients and returning clients and those I do out calls on.

Carl W. Brown said:

I may only have had 140 hours of massage school but I have had hundreds of hours of other training that does not qualify. I do not work on naked people. But I am still forced to comply with the massage laws even though I don’t do what most people consider massage,

How many resorts use SOAP notes? I started to use them but I found that they actually hurt my practice because the put me in a frame of mind that I intellectually knew how to fix the problem from my limited knowledge or previous experience and it got in the way of my intuitive work. I have to deliberately purge my mind of any preconceptions of what it wrong or how to fix it to let my “muscle whispering” work.

Professional standards vary by what you do. In CA the law requires that anyone not licensed provide a disclosure describing what they do, the principles behind their work, their education and the fact that they are not licensed. My guess is that 95% of MTs ignore the law. I even offer free classes to practitioners on how to develop disclosures that conform to the legal requirements but I get few takers. I think this is unprofessional but I would guess that our current title licensing board will not enforce the law.


Laura Allen said:

But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it..

Permalink Reply by Laura Allen on October 30, 2009 at 11:50am

No, Stephen, I don't think Reiki belongs in the BOK for massage. It belongs in a BOK for energy work. I started attending classes in energy work 5 years before I started attending massage school. I also attended a school that was heavy on woo-woo, shall we say, but I still remember being shocked when I was sitting for the NCTMB and had questions about chakras on my test. I was glad I knew them....and until the NCB came out with their NCTM a few years ago, the burden was on people to try and learn that for themselves if their school didn't cover it. Massage is massage and energy work is energy work, and though they often meet and marry, they're two different things. It will be interesting to see what the BOK ends up looking like, and like any first attempt, it's not going to be perfect, but at least it's a start.

Stephen Jeffrey said:

Hi Laura, you put your case very well for licenceing and highlight energy work, do you think it should be in a massage BOK? I practice both diciplines but dont think it should come under massage as I feel it would cause to much complication and arguement as is evident in the discussions on here.

Laura Allen said:

I have worked in an unlicensed environment. Licensure was not yet in our state when I started. I was the administrator of a massage school when it came in, and had to prepare the application for board approval of the school. Bringing licensure into a state is usually, although not always, directed at ensuring schools meet minimum standards, as well as ensuring MTs meet minimum standards.

I thought then, and continue to think, that ensuring that a school meets minimum standards for educating students was a good thing. The standards in our state include requiring proof that the teachers are qualified to teach; that there are viable lesson plans with measurable learning objectives; that there is adequate room for each student; that there is a good student/teacher ratio; that the school is adequately equipped, etc., not to mention that the therapist has been trained in A&P, physiology, kinesiology, massage contraindications, and professional ethics.

When licensure became the law here, there was of course a grandfather period. In our state, the requirements for that were 400 documented massages and at least 4 years of practice. I was appalled at the number of former students who called and said "Documented? What do they mean?" These are people who were taught to do intakes, conduct interviews, and maintain SOAP notes on every client when they attended the school---but until it was the law, they didn't do it. Many people just quit practicing because they hadn't been conducting their practice in a professional manner.

Do I want the government telling me how to run my life? NO. But do I want standards for a profession that involves making a living by placing your hands on naked people? Yes. We are virtually the only ones other than physicians who work with unclothed and otherwise vulnerable people. I think a certain level of proof of competence is in order. I don't resent having to be licensed. I'm glad of it.



The Rev said:

If you can say you started a practice with 100 hours of training and have experienced fully the gamut of work from the days of non imposition of requirements to receiving work in the present you cannot understand. Just for your info, standards, for me, is not the problem. Argue for high standards, but (it's too late) keep the state and other governing agencies off my back. You and yours left the table and went to the government a long time ago.

Now THAT is scary... There is the ol' harm to the public argument. I thought that fell by the wayside, but apparently not.
Now there is something we have in common. The only constant is change. The change in the field appears good to you. To me it is bad.

Let me ask again.. Have you ever worked in an unlicensed environment? Do you have a practice or are you just in it for the marketing of educational workshops/conferences, etc? (hat is not a bad thing).

Permalink Reply by The Rev on November 4, 2009 at 9:33pm

"Bringing licensure into a state is usually, although not always, directed at ensuring schools meet minimum standards, as well as ensuring MTs meet minimum standards."

Minimum requirements... Laws create requirements. It becomes a requirement one does this this this and this to be able to do something.

Increasing the requirements benefits those who get to charge those needing to meet those requirements.

Standards really are a different matter.

I am a high standard kinda guy that may be forced into complying with a requirement way below my personal standards. I am insulted I would have to go to the CAMTC in order to use the title cMT when that was on my certificate in 1988.

The Rev

Permalink Reply by Mike Hinkle on November 4, 2009 at 9:44pm

Rev by joining, you will raise the standard. And others will look to you to keep raising it. You can help set them, if you are on the inside.

The Rev said:

"Bringing licensure into a state is usually, although not always, directed at ensuring schools meet minimum standards, as well as ensuring MTs meet minimum standards."

Minimum requirements... Laws create requirements. It becomes a requirement one does this this this and this to be able to do something.

Increasing the requirements benefits those who get to charge those needing to meet those requirements.

Standards really are a different matter.

I am a high standard kinda guy that may be forced into complying with a requirement way below my personal standards. I am insulted I would have to go to the CAMTC in order to use the title cMT when that was on my certificate in 1988.

The Rev

Permalink Reply by Carl W. Brown on November 7, 2009 at 12:20pm

Basic Swedish BOK. The KSAs and competencies needed for basic Swedish competency. This does not include Swedish based therapeutic modalities nor advanced relaxation and spa modalities.

This BOK presumes that the person has a high school or equivalent education and will only address postsecondary training.

The KSA reference numbers are based if the first draft.

000 Know oils and lubricants and shelf life of each. Know the difference in feel of different lubricants and when to use each.

410 Know bones but not necessarily the individual bones of the skull nor identify individual carpal bones.

411 Identify the muscles or muscle groups that will be worked on individually in a standard Swedish relaxation session. Know origin, insertion and fiber direction. Be able to palpate muscles. Identify in relation to other muscles.

412 Know major blood vessels and general blood flow direction

412 Brain spinal cord, sciatic & perennial nerves. Voluntary, autonomic, sympathetic and parasympathetic.

455 Identify pressure sensitive areas such as carotid arteries, back of knee etc,

415 Function of lymphatic system, muscle pumping action, lymph nodes, and general lymphatic flow.

420 Male/Female anatomy

476 Body mechanics is a very important part of Swedish work. It is essential that the person feel comfortable and that the training instill a sense of balance and movement that feels natural to the client.

522, 532, 551 Know normal ROM for all joints and be able to determine if a person has restricted ROM and know their limitations. Know special limitation such and not crossing the mid line for people with hip replacements.

583 Know contraindications. Know about wounds, ports, pacemakers, identify drugs taken to prevent clotting.

586, 620, 631 Universal precautions

652 Be able to drape without exposing a client and turn client in different positions. Use of bolsters, wedges, pillows and supporting clients in side laying positions. Face cradle positioning. Client should feel that the practitioner is comfortable with draping techniques.

700, 702 704, 706, 711 714, 716, 718, 720 721 723, 729, 731, 737, 738, 740, 741 743, 746 752.

811 Must demonstrate knowledge and comfort with body mechanics. But know the signs of burnout and how to avoid injury to self and others. 859 is not necessary.

846 Must know privacy parts of HIPAA and know the difference between electronic and non-electronic regulations. Must know penalties for privacy violations.

898 Must complete First Aid and CPR training to Red Cross standards.

975 Know how differences setting influence the client’s session.

976 Know the cultural differences in body image and acceptance of massage. Know that the therapeutic relationship and gender differences also have different perceptions in different cultures. Be able to indetify when a client may consent to something that they are not comfortable with because they feel that they are expected to consent.

990 1029 1034 1036 1051

1053, 1054 1055 while necessary are not KSAs.

1071 This is probably the most important part of the standards.

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