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The future of the massage profession??

I sometimes wonder about the future of the massage profession and where it might be in another 20 years. I know when I first started in 1987 with my little 250 hours of training, I would have never thought I'd last this long. Back then there was no such thing as getting a job in massage - a real employee job. Any job back then was an independent contractor. My rent was $100 in my first office space in a gym and that was split between 2 people!

I think the biggest change was in having more jobs be available and the growth of massage franchises.
With more jobs available and the many massage franchises popping up looking for workers and more massage schools than ever trying to stay in business what will be in our future? (See other thread on that.!)

I also wonder about the so called 'medical massage therapist'. I know being in WA I am 'lucky' to be able to be a contracted provider and be able to bill for my massage services. I don't have to be trained in anything specific to do so. I do have a bunch of extra training but don't even really feel like I use it anymore. I just do massage. Other massage therapists always think that they want this in their states. Here it has been a mixed blessing. Ins. companies are constantly reducing what they will pay us and the allowable benefits making it harder to work with clients and make a living.

I have a website on becoming a massage therapist - www.massage-career-guides.com and I get more questions from people right out of high school asking if they have to take math or wanting to know what jobs are like that I had to start a section for high school students. ( I actually have mixed feelings about people right out of high school going into massage. The average age for massage therapists has been around 45 for many years. I wonder how that affects classes and how things are taught.)

I know we are working on things like the BOK which I still don't really know what it is doing or how it will be used to influence our future. I know that more research is being done and the Massage Therapy Foundation is holding their first conference. I still don't really get research. How can you measure touch? If one person does the exact same thing to 10 different people it will feel different to everyone!

I used to be totally against licensing and having more rules and regulations mainly because I was able to be so successful on just 250 hours. I have also heard horror stories of people going through 1000 hour programs and being so afraid to touch anyone that they never went into massage even after getting through school. I tend to hear more stories of MT struggling to make a living even after longer classes so I don't know what the answer is. I am a big fan of Keith Grant's White paper on licensing (www.ramblemuse.com/articles/masg_governance_rev.pdf) but now adays I am even starting to think that a 4 year program is needed if more high schools students are wanting in.

Where is our future headed? Where do we want to go as a profession?

Julie
http://www.massage-career-guides.com/future-of-massage.html (this link has a few links to other articles on the future of massage and more of my thoughts on it.!)

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Comment by Kim Goral on April 1, 2010 at 6:40pm
Julie, from a practical perspective, if I am a practitioner and I tell my client that massage is going to help them, I should be able to substantiate why it can help them. Otherwise, it sounds like I am making things up and it undermines my credibility and the credibility of the profession.

As clients become more educated about massage therapy, they want to know more. The way to answer their questions is by making claims that can be backed up by facts. Research is the way to get to the facts. For that reason alone I think research is a good thing and a definite part of the future in massage therapy.


Excellent response. Learning about research and then reading it should be part of our work and definitely in the schools. Emmanuel is absolutely correct- what good is it to tell your clients "massage is great for X" when you don't have anything to back it up with other than maybe a myth someone told you or some anecdotal "evidence"? I saw your new blog post and responded there to the questions you have here, of which many are the same.
Comment by Emmanuel Bistas on April 1, 2010 at 12:41pm
How will it help me in my practice?

Julie, from a practical perspective, if I am a practitioner and I tell my client that massage is going to help them, I should be able to substantiate why it can help them. Otherwise, it sounds like I am making things up and it undermines my credibility and the credibility of the profession.

As clients become more educated about massage therapy, they want to know more. The way to answer their questions is by making claims that can be backed up by facts. Research is the way to get to the facts. For that reason alone I think research is a good thing and a definite part of the future in massage therapy.
Comment by Vlad on April 1, 2010 at 11:06am
You're asking WHY research is important?

WHY should we know about it? To me it's obvious, but maybe you should listen to Werner an Thompson talk about it.

I first want to know why I should even study it or be interested in it. I don't want to read those books until I have enough reason to spend my time doing so.

You say you don't "get it" over and over. Well, I don't get anyone who doesn't say to themselves "I don't know about this, I better go read about it"

What's the point in hammering on about how you you "don't get it" if you don't do anything about educating yourself about it?
Comment by Susan G. Salvo on April 1, 2010 at 10:32am
A little history helps when pondering the 500 hour question.

The American Massage Therapy Association was previous called the American Massage AND Therapy Association. Curricula approved by the AMTA were a minimum of 1000 hours.

Either in 1983 or in 1987, the AMTA shortened their name to American Massage Therapy Association. Curriculum requirements were reduced to 500 hours to focus more on massage therapy.

The AMTA has had other names, such as the American Association of Masseurs and Masseuses (1943-1958).

The AMTA also had a tiered system of Certified (CMTs) and Registered Massage Therapists (RMTs). It reminded of the nursing profession that have LPNs and RNs.

I took and passed the RMT exam in Seattle in 1987. The AMTA abolished the tiered the following year.

I think Robert King was AMTA president back then. He might be able to offer more perspective.
Comment by Julie Onofrio on April 1, 2010 at 9:58am
I am not asking Chris to teach me about research. I first want to know why I should even study it or be interested in it. I don't want to read those books until I have enough reason to spend my time doing so.

All of the research we have on cancer and we still don't have a cure for it. I have also heard too many horror stories from a friend of mine who does work in research. She is always after her researchers because they throw out results to prove their theory. They are of course paid by big drug companies and need the grant money. What will research do for us? Why do we need research? How can it help someone get massage clients? Why should we even study research? That will be the other thread but this thread seems to be turning into research... Yes I am going to the research conference here in Sea only because it is a block away from my office. I am only going one day because I don't even have a clue what they are talking about in the class listings. What is translational research? How will it help me in my practice? I am guessing I am not the only one who doesn't get it...
Comment by Vlad on April 1, 2010 at 9:28am
"not anything to do with becoming a good massage therapist who could be successful!"
Emmanuel's question on number of hours is interesting and you pointed out something there too. A good massage therapist and a successful one don't always go hand in hand. A therapist can have a thousand hours, be very competent in their manual work, be a lousy businessperson and fail, but if they went into medical massage in a hospital setting then they could possible do very well. Plus a spa worker could do very well with much less training than someone in a medical setting.

So having such a survey to find out correlation between # of hours and whether they're successful would need to keep into account the different streams that people take and also defining success isn't that easy.

It would be interesting though.
Comment by Vlad on April 1, 2010 at 8:45am
Menard's book is a very easy read that breaks research down into meaningful terms and then she also goes into ciritical evalutaion.
It's not a long book.
Also, there are a lot of articles written by Menard that are available off the MTF site that are also easy reads. It won't make it so that people can go in immediately and understand stats, but most people should be able to understand everything other than the stats (type of study, what is meant by conforms, bias etc) after reading that book and reading the articles. Also the somatic articles, like this one by Diana Thompson is a great intro. There is also a ton of other info on the MTF site, including this good overview which is a very easy read, discusses wholism vs reductionism and covers a LOT of info in one document.

There is another book called Doing Case Study Research which is not specific to massage therapy, but it's also an easy read and goes into things like "what is meant by scientific inquiry", differences between quasi-experimental and experimental design etc. It's not even 100 pages long - you could read it in an hour and although it's about case studies, it would be good for anyone starting out also.

If anyone then uses them as a base and goes on to read Hymels book, they'd then be well on the road.

To be honest, Julie, it would be too much to ask of anyone to teach the basics of research on a thread (plus Chris has already written about many examples of possible tests on different threads as a method of trying teach already and it's obvious from some of the responses that people aren't taking time to read about it on their own). It would much more productive for people to read a couple of books and then ask about specifics of research or some aspect aspect of it that they don't understand or questions on articles in particular. Robin and I have been trying to get people to do that. If everyone realized that looking at an article and just asking questions on that can be beneficial to everyone else, maybe that would be more productive.

Although if Chris suggested the thread, then it means that he's all on for it - I just wish people would be a bit more proactive and use his time up better rather than forcing him to teach a class on basics of research online.
If people picked up a book or two from a library it would be a start!
Comment by Julie Onofrio on March 31, 2010 at 9:48pm
Yes I'd like to see more research done on how much training we do need. Everyone just arbitrarily came up with this number 500 hours. I saw the change over to this and as Keith said in his White paper it was mainly do to getting pell grants and financial aid - not anything to do with becoming a good massage therapist who could be successful!

And yes Chris - I will start another thread on research...it intrigues me but at the same time baffles me. It needs to be broken down into something meaningful that everyone can understand and also put into terms to show doctors what it can do as they really go more by research. Thanks for the update on it being the 2nd conference!

Julie
Comment by Emmanuel Bistas on March 31, 2010 at 10:56am
Good question Julie.

I think the future will be great, but I guess the specifics will depend on who has access to the lobbyists and how public opinion is shaped.

I like Keith Eric Grant’s article on massage governance. It was written in 2002 but a lot of it is still applicable today. He makes many good points, and there are even more good points on his website. I think that those who push for increased hours, school accreditation, and increased regulation as means of improving standards of practice should read it.

You mentioned franchises, research, bachelors degrees and the MTBOK.

I think that franchises can be good for our profession. They get the mainstream exposed to massage and increase people’s interest in it and, therefore, increased demand follows (this is covered somewhere else on this site, I agree with Rick Morgan’s take on this).

Regarding research, the one type of research that I would like to see is one related to the hours of entry-level training. Is there a statistically significant difference between those graduates of 500-hour programs, 750-hour programs, or even 1,000 hour programs? And what about a research about what type of program content best prepares students for a career in massage therapy? It would be good to have that info, not just peoples’ opinions. About massage research, that is always good, but I wonder if whole systems research (that Robin Byler Thomas discusses elsewhere here) can be what we need in our profession instead of a Randomly Clinical Trial approach. It feels to me that taking apart massage therapy to see how it works is like when I took apart my first quartz watch to see how it worked. It didn't.

Regarding Bachelors’ degrees, many MTs already have those - and even advanced degrees – but not in massage therapy. I think that is something that is unique to our profession, that many of us studied something else in college and ended up in massage therapy simply because we didn’t have to go to school for another 4 years. We must (as we should) continue our education for the rest of our lives, but the initial training was fairly short compared to a college degree. I don’t know how I would ask someone with a master’s degree to get a bachelor’s degree in massage therapy. I would think articulation agreements with colleges and universities would be good to have, so if someone wants to get a bachelors’ degree they can do it, but I don’t think that the bachelors’ degree should be a requirement for entering the profession.

I think the MTBOK will be an OK point to start talking about what we do as massage therapists. The profession has grown a lot in recent years and sometimes it reminds me of aspects of the Tower of Babel story. We have created something so big but now we are all stating to speak different languages and do not understand each other. Emotions on this forum about energy and evidence-based massage point to that. We all need to approach our Body of Knowledge from an angle that our understanding of our profession will keep evolving and we must be open to re-examining what we do and who we are. I hope that the BOK will be revisited and revisited and revisited over and over again.

Finally, with respect to the future, I think that the passage of the healthcare bill, to the extent that provides a safety net for self-employed people, has the potential to be of great help for massage therapists who would normally leave the profession for a full-time job that gives them health insurance.
Comment by Christopher A. Moyer on March 30, 2010 at 1:56pm
Hi Julie.

For the record, this year's research conference will be the MTF's second one, not the first. The first one was in Albuquerque, in 2005.

As for not getting research - thank you for being bold enough to state this plainly. You are probably expressing what many other people think, or wonder, related to this topic. And you are correct that something like touch, along with many other aspects of massage therapy, vary from person to person.

I'll try to be brief so as not to take your post way off topic (we could start another thread on this subtopic if you like), but let me note that this is true for many of the things that researchers study. Each individual responds to drug therapies in different ways depending on their genetic makeup, overall health, age, nutrition, etc. Individual variability may make research more difficult, but it doesn't make it impossible.

Some may object that my example is too concrete - if so, consider a different one. Wine tasting is known to be quite subjective, but it is not purely subjective - even blinded, expert wine tasters can reach some consensus on what they are tasting. If they could not do that, we would have to reject that there even is such a thing as objective wine tasting (indeed, that may be true for those of us who have not dedicated any time to developing expertise in wine tasting). But the fact that they can reach consensus, even though it is imperfect, tells us that there are common factors in what they are experiencing. I think receiving massage therapy is probably a lot like this - our individual experiences will vary, but they are undergirded by certain common factors that we should be able to measure reliably.

And, the differences among individuals are also interesting to measure - why do two people have a different experience to the same treatment? Can we take advantage of that, or control it? (Maybe, maybe not.)

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