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graduationI love nurses. I’m related to some great nurses. I’ve had a local nurse practitioner refer her patients to me for massage. I have a friend who has a master’s degree in nursing. I know LPNs, RNs, BSNs, MSNs. The only thing that’s missing from my list is someone with a Ph.D. in nursing. I need to get on that.

Nurses come in all flavors. Nurses are the people in your family doctor’s office who chat with you on the phone, weigh you (and never makes you feel bad if you’ve gained a few since your last visit), and who know all the details of your life and your family. Nurses are the people who supervise all of the technicians in a surgical suite, making sure all the equipment is in place, making sure the patient is prepped and making sure everything runs smoothly. Nurses are the people who sit in an intensive care room charting every med, every reading, every change, and every observation while keeping the family updated on how the patient is doing. There are nurse practitioners who are allowed to prescribe meds, there are nursing researchers who study how to make nursing more effective for the patient.

Nursing programs run from short programs of study at community colleges all the way up to doctoral level degrees. If you want to study nursing, it’s up to you to decide how far to go.

Massage therapy doesn’t have that

Recently, on Facebook, a massage therapist asked if there was any college that offered a bachelor’s degree in massage. Sadly, the answer was no. If this MT wants to continue her education, she’ll have to study another subject; perhaps physical therapy or kinesiology or biology, but not massage.

And that makes me very sad

You became a massage therapist because you love massage, not because you love physical therapy. But if you have a hankering to go back to school and get a degree, you don’t get to study what you love. You’re stuck compromising and studying something kinda closely related.

What if there was a university level study of massage therapy?

That’s the question that was discussed this week in Seattle. Ravensara Travillian Ph.D. LMP, Christoper Moyer Ph.D., and Laura Allen LMT spent the evening of December 9th discussing what advanced education would look like and what it would do for the profession and our communities.

Ravensara is a Licensed Massage Practitioner (we don’t get to use the word therapist in WA; it’s a thing) since 1992 and has recently been working closely with underserved populations, particularly refugees and military veterans. We have a huge military base here with multiple deployments to Iraq and Afghanistan, so this is a group of people that are near and dear to our hearts.

Christopher is a psychological scientist who studies when, for whom, and by what mechanisms massage therapy, the manual manipulation of soft tissue intended to promote health, wellness, and performance, can be beneficial. He has published several papers on the effects of massage and a textbook on integrating massage research into your practice.

Laura is a massage therapist, clinic owner, author and massage educator. She blogs extensively on the state of the profession, the organizations in the profession, and laws affecting the profession.

An Advanced Certificate, NOT a new Requirement

All 3 speakers emphasized that they are discussing an advanced certificate, not new regulations or requirements for initial licensing. This education is not a replacement for our current massage curriculum but is an add-on for those who have already completed basic massage education.

In the state of Washington, Licensed Massage Practitioners (LMP) are allowed to bill insurance and more than half of the LMPs in this state do bill insurance of some sort. In other states, this isn’t the case, but I would predict that more and more therapists will bill insurance after the Affordable Care Act is fully implemented. No one at the event suggested that all massage therapists should be required to bill insurance, but for those that do, the advanced certificate could prove beneficial.

What can we gain from an advanced certificate program?

Christopher Moyer started the evening off by discussing the 3 benefits to be gained by an advanced certificate program.

1 – Research

In particular, studying the mechanisms of massage and the outcomes. How does massage work? When does it work? What works?

2 – Education

As in most fields of study, advanced education and research trickles down throughout the profession. Everyone gets to benefit. We should also see an increase in critical thinking skills (yes, it’s a skill, not a talent) as this will be part of the curriculum. We’ll also be able to leverage the tools and technology available in a university setting. Access to laboratories, libraries, and equipment is incredibly valuable.

3 – Service to the Community

We don’t live or work in a vacuum and the advanced certificate program will help deliver massage to populations in need, such as veterans, refugees, and caregivers.

What the advanced certificate program WON’T do

Each of the speakers emphasized the following and I want to make sure it gets adequate space here:

  • It won’t dehumanize massage. “We appreciate the connection and humanity”
  • It won’t enforce any belief systems on the massage profession
  • It won’t quash individual freedoms
  • It isn’t trying to create ‘group-think’

The speakers and the program all respect the unique benefits of massage that aren’t in any other profession.

What are other countries doing?

We were fortunate to have Bodhi Haraldsson attend. Bodhi is the Research Director at the Massage Therapists Association of British Columbia and provided a lot of insight into the state of the profession in British Columbia and Ontario. He was also interested in whether this program would be offering a Master’s level degree. Currently, the massage program in British columbia is far greater than that required by any state in the US. New Zealand currently has a Bachelors program available for massage. So there is an interest, at least internationally, in an advanced degree program for massage therapy.

When asked if she would be pursuing an advanced degree program, Ravensara felt that it would be too large a step at this point. The logistics and overhead associated with a degree program in an accredited university are beyond the scope of the project, at this time. In the future, it is certainly a possibility. At the moment, an advanced certificate is more realistic and acheivable.

The state of the industry in the US

There are currently about 250,00-300,000 massage therapists in the US. Interesting fact: Ohio was the first state to license massage therapy and did so in 1916! There are still 6 states which don’t license massage therapy, but this is still a huge improvement since I started practice in 2006. Of those 44 states that license massage, not all of them license it as a health care provider.

The FSMTB did a survey of MTs and the results are jawdropping:

61% don’t earn enough money to support their family and have to take a second job

Salaries are depressing:

  • 11% earn less than $10k/year
  • 18% earn less than $15k/year
  • 19% earn between $20k-$30k/year
  • 6% earn between $40k-$50k/year
  • 2% earn more than $60k/year

By contrast, Bodhi reported that more than 50% MTs in BC and Ontario earn more than $40k after taxes, versus our 8%. That’s right, Canadian MTs actually make a good living. He attributes this to the heavy dependence on insurance income.

Are we really a profession that dislikes higher education?

If you read any of the flame wars on Facebook, you would come away with the impression that the majority of massage therapists aren’t interested in higher education. The numbers, however, tell a different story.

34% of MTs have had some college

  • 19% have Associate degree
  • 27% have Bachelor’s degree
  • 9% have Master’s degree
  • 2% have Ph.D.

Opinions & Conclusions

Well, that’s over 1200 words of some of my notes from the meeting. The video recording will be online and I’ll post a link to it here when it’s available so you can see the whole thing. I took 6 pages of notes and this blog post, at nearly 2000 words, is only scratching the surface of what we discussed.

What follows below are my opinions.

This is worth further study.

There are a lot of details to attend to, but there seems like plenty of upside and I’d like to see Ravensara continue her work here.

Concerns from the educators, Jill Berkana founder of Berkana Institute for Massage Therapy and Annie LaCroix the founder of Columbia River Institute of Massage, and myself (I teach at Bodymechanics School of Myotherapy and Massage) all asked questions regarding teaching teachers to prepare students for an advanced certification. The other concern is that there is a big discrepancy in educational requirements from state to state, not just in the number of hours but in how those hours are apportioned between subjects. This means there might have to be some remedial courses made available to make sure all students coming into the program are properly prepared.

This is not as big a deal as it seems. Most universities and colleges have this problem with their incoming students and provide classes to backfill knowledge gaps. No one discussed changing the curriculums of massage programs being taught, so don’t freak out. We’re talking about making courses available in the program that would fill in those gaps.

There is a desire for an advanced study program

I see people ask this on social media and I get asked on a regular basis. There are always people who are infinitely curious about a subject and want to explore it in greater and greater depth. Their study benefits all of us as they uncover new information, techniques, and methods. That does not obligate any or all of us to follow them on that journey. I’ve worked with a lot of Ph.D. and I’ve never felt the urge to attempt that level of study.  Until we create a program of advanced study within massage, we are forcing those people into fields of study that are close, but no cigar, as they say.

This could expand employment opportunities

Not all massage therapists want to be entrepreneurs. Many of them want to work for someone else. If this is you, your employment choices really boil down to: working for a chiropractor, working for a spa, working for a chain, or working in a small clinic. Yes, there are a statistically small number of jobs outside of those 4 buckets, but they are very few and very far between.

Advanced certification could open up doors for us to work in other health care venues, where massage therapists are the exception, rather than the rule. Hospice, hospitals, long term care facilities, substance abuse programs, mental health facilities, health care cooperatives, veterans hospitals, and many many more. Massage research shows how beneficial our work is to so many people who cannot access it either because they cannot travel to massage or because it would cause a financial hardship.

The advanced certification plus the research that will be done and published by the program could make employment opportunities in these venues more available to massage therapists. More jobs plus more people being treated can only be a good thing.

I expect to get a lot of blowback

Given the tone of ‘discussions’ on social media, I expect a pretty fair amount of hatred to head my way. There seems to be a number of people in the profession who actively resist any new research information, any further education, any call for honest and open discussion about what we do and why/how it works. That makes me incredibly sad. Massage is a profound form of therapy and I want to see the profession grow and reach more people. That’s why I support this effort into investigating an advanced certificate program in a university setting.

I would like to open this up for discussion. Ravensara has been very transparent in the information she is gathering and the work she is doing. What questions do you think need to be answered? What is your opinion? There’s the comment section below, so please use it.

* photo by Rennet Stowe

38 Responses to University level massage therapy studies

  1. Brilliantly reported, thank you! I’m excited to see where this goes. I really think having the option for further education in massage can only help the profession. I’m baffled why anyone would oppose such a thing. But I guess I’ll learn more as debate begins 🙂

    I’ve long been enchanted with Ravensara’s work, Chris’s research, and Laura’s wit and insight. I’m sad I wasn’t there.

  2. I have been teaching in New York community colleges for 15 years, and currently building my 3rd program. I taught in a small private college, a large public college in the City University of NY system, and now I’m teaching and building a new program in a medium-sized public community college in the State University of NY system. These are Middle States accredited colleges with nursing programs and other allied health programs.

    I have hoped to build, explored, and wished for a bachelors degree program for years, but it’s been extremely challenging creating sustainable community college programs — 3 of the SUNY programs have closed in the past few years.

    However, graduates from these community colleges often go on to senior colleges for bachelors degrees and some go on for advanced degrees. One went to Hunter College’s Interdisciplinary Studies program where she designed her own major; one went to Naropa University to complete a masters degree in somatic psychology. SUNY Empire has offered the opportunity to create a massage therapy major. Goddard College offers a BA in Health Arts and Sciences and an Individualized Study program where a student could conceivably work with massage therapy.

    I think the reality is that our profession does need to start with community college degree programs. Some CCs offer massage as a certificate program.

    Some CC faculty and administrators have said that massage therapy is not academic and should not be in community college. I’ve had administrators laugh in my face for suggesting a bachelor’s program in massage therapy.

    Advanced certification would be helpful. Associate degrees would put us in the same bracket as PT Assistants — who are under the supervision of PTs — and AAS Nurses — Nurses are now required to get Bachelors degrees. If we want to compare ourselves to other healthcare professionals, we have a long way to go. In most states, MTs have less education than cosmetologists (usually 1200hrs) and WAY less education than any other healthcare profession.

    • Lisa – Thanks for the background and your thoughts. I don’t understand why massage isn’t considered to be academic, so it looks like we have a long way to go to educate educators as well.

  3. Thanks for sharing Kelli! One of the things I love most about being a massage therapist is learning about the human body. I think advanced educational opportunities in the field would increase the research being done on massage, which would then benefit the entire profession.

  4. I would love to be able to higher my education in massage therapy. I take so many CEU’s to learn. This is a wonderful insight, how the massage therapy community can expand.

    • Anne – thanks for you comments! This sounds like something you would enjoy and I hope you continue to stay updated and provide input as the program develops.

  5. Absolutely higher education, but with serious curriculum reworking (i.e., very few freshman level requirements outside of the field). We have to go in a realistic, more educated direction, a direction that could make clearer the distinction between therapeutic and palliative massage. The PT world went from bachelor’s to master’s to PhD in the last few years, and we aren’t even on the train (I’m not sure if the handful of junior colleges in New England still offer massage therapy).

    The mere fact of college education for MTs might not make a difference at this point, but more robust programs in massage therapy would certainly turn out therapists with more tools and, possibly, better communication skills in science. The massage education world has systems of education all over the map, now; it’s difficult to distinguish, for example, CEU programs that are legitimate from the fly by nighters.

    There are colleges out there that specialize in areas that didn’t even exist 30 years ago, like outdoor education, sustainability, and whole systems design, to name a few. I would bet that there are experimental yet legitimate schools that would welcome us (Oberlin, Antioch, even Evergreen up by you).

    My feeling is that higher education for us is inevitable, and we have the opportunity to do it right, having developed courses of study all over the country. It’s quite a challenge and would require a significant transition, but my two cents is that it is a good idea. Thanks

    • Dave – good points all around. Thanks for your thoughts.

      Yes, the massage education world is all over the map right now. There are no standards of teaching and I think much of that has to do with instructors being subject matter experts with no formal teacher training. I include myself in that group. And the state of CEs is abysmal. There are some CE instructors that have no experience teaching and no business teaching. Not to mention some of the classes offered.

      We have the opportunity to do it right, but we need to build it up right from the start or we’ll forever be trying to fix it.

  6. I have two problems with putting massage, even “advanced” massage into the formal education system of universities and community colleges.

    The first is that, once they get their fingers into massage, it will quickly become a “degree required” field. That, I believe will be bad for the field in a couple of ways. And the content of that degree may contain totally unrelated material

    The second is that, once in the system, students will be burdened with extra costs and what I call “faculty full employment” classes – that unrelated material I mentioned.

    Rather than let the education system swallow us, I think our energies would be better spent creating a massage version of ASE certification. The ASE model allows the massage world to define standards and required education. Then, forces schools – massage schools or state education systems to train students to our standards. This agency will also fund research by qualified MTs.

    Some will say we already have that. No, we don’t. What we have now is a collection of agencies which, no matter their founding good intent, currently seem to exist primarily for self-preservation. Have you looked at the COMTA Accreditation standards?

    And since I’m on a rant, how about some legitimate instructor qualifications? As near as I can tell, those that require any instructor training require about 20 hours on-line. I don’t think you can do a good job of teaching course development in 20 hours let alone prepare someone for the classroom.

    • Mark – thanks for the comments. It’s good to see someone talk about what they disagree with.

      “once they get their fingers into massage, it will quickly become a “degree required” field.” I hear your concern and it is something that Ravensara and Christopher were very aware of. They seem to want to avoid this scenario and have the higher education be totally voluntary. Given the fractured nature of educational requirements between states, I think we are still a very long way from this ever happening. And, if we’re aware of it from the outset, we can work to avoid the need for a degree through careful lobbying and watching legislation as it works its way through the various state governments.

      I’m not sure we could get the massage school industry to accept an ASE model; they are very reluctant to changing their curriculum now. However, if we were to get more teacher training into the schools, we might find that education starts to even out amongst schools.

      And rant away on the instructor qualifications. I take as many teacher training courses as I can, but when I started, I was handed a slide set and a syllabus. Not really the best of starts.

      • We already have our foot in the ASE model door. COMTA is already the “standard.” We just need to get a few consecutive cauptans on the ship to set course towards real standards for accreditation.

        It can even be used to create specialties as the ASA does with their different certification tests for mechanics.

  7. I’m curious as to how MTs are worried that a higher level of education might enforce any belief systems on the massage profession. I’ve been verbally thrashed for telling people that massage is not a cure, and I’m insensitive for saying as much. I’ve all but said, “Science doesn’t care what we believe,” which isn’t a very diplomatic way to go about it. The facts of the matter don’t carry much weight if people are turned off to the idea of research, so getting people on board is a fun balancing act.

    • I think most of those people are energy and other alternative practitioners. They’re afraid taking massage into science will leave them out, exempt the “magical processes.”

      They are shortsighted. EX: We know Reiki does something (Bias here – Reiki Master) but the claimed way it works violates the rules that govern the universe. Studying Reiki to see how it really works won’t exclude practicing Reiki. It may give us insight into how it actually works and how we can give client better results.

      • I couldn’t have said it better, Mark.

        I think change is hard regardless of what is changing. The massage industry, like almost every other industry, is changing and some fear they will be left out.

  8. Love to hear this being talked about. I am a supporter of an advanced certificate and would love to participate in the discussion. Keep up the good work and this will become a reality.

  9. I am one of the 9% with a Masters degree and I really do support education and critical thinking skills, particularly in this age of Obamacare with more potential clients with complicated medical issues. But if we want massage therapists to pursue advanced education we need to look at reimbursement rates. I have billed insurance for the past 8 years and have seen reimbursement rates in WA state plummet dramatically in the past 3 years. As massage therapists we can only treat one person at a time. The reimbursement rate needs to be commensurate with the additional time and expense required to obtain advanced training otherwise it is simply not a fiscally feasible pursuit at this time.

    • MJ – I heard this being discussed around the tables before the presentations started. Our reimbursement rates have dropped and it’s becoming less viable as an income stream. Perhaps the advanced certification will help with that, but it is something we need to be aware of.

  10. This is an Excellent Report on their first efforts! Nice Job Kelli! I had the privileged of being there in person and this really covers most of it.

    There are many concerns though as to how will it help get more jobs in hospitals or do anything they were saying really.

    I just couldn’t get over their unorganized efforts and some of the mis-information like we already have access to research papers through http://www.heal-wa.org here in WA. As someone else mentioned, we already are a part of health care here in WA and the pay rate has decreased significantly and I would guess it will continue to decrease, so how will having to pay more for an advanced course when you can’t get paid more and will probably be paid less if you take insurance. Most of our therapists here in WA do accept health insurance and clients have almost come to expect it.

    I also was very concerned about the whole presentation as I was expecting a more detailed outline of the program and their plan on how they expect to raise money. I also thought it was somewhat deceptive when they asked for $5 Million when I had only previously read that they were talking about 50K for starters. That sounds more doable. It was just more general info that we already know.

    I was expecting that there would be 65 people there as mentioned by Ravensara on Friday before when I spoke with here. How can someone be organizing a dinner and not know that 45 people who signed up were not going to show up. The room was set up for 65 and there was enough food for that number. It just makes me nervous giving this group any more money until they really have a plan and are more open about what they are doing/planning. I would like to know what the money that was just raised did for them. I know that it is just at least a start and that they were together doing some more planning or whatever. But it makes me leary to think of others giving more until they are more organized. I think the whole event was done too early in their planning but maybe it is just a good way to practice.

    There were some major players I would have invited that are local leaders in the profession and they were left out.

    There are also many more important things that the profession needs such as a true national license and more standards in basic massage school and things like this before an advanced training will do much really.

    There are many many questions to be answered before this goes any farther. We need more research on what the profession needs.

    • Julie – excellent comments!

      We in WA are rather spoiled with our access to research papers and our ability to bill insurance, etc. The rest of the US is, sadly, not as lucky. So, keeping that in mind, do you think that this type of program might bring other MTs in other states the resources we have here? I’m hoping so.

      And for the turnout – I can’t answer this as I’m not on the organizing committee. But many of the major players were in FL in a coalition meeting and so were unavailable. I don’t think Ravensara was aware of their schedule when she scheduled the dinner.

      Yes, this is very early in the process and there are a lot of questions to be answered. Without some level of support from people in the profession, they can’t even begin to start getting more detail. I will disagree with you about needing more research on what the profession needs. I think enough has been done to begin studying whether or not we can create an advanced certificate program.

      I know you know how to get in touch with Ravensara and I trust you are addressing her directly with your questions and concerns. I’m sure she welcomes them because, if you’re thinking it, others are too and they need to be addressed.

  11. Totally in agreement regarding having an opportunity for higher levels of education beyond the current market place of proprietary ceu’s.
    On an entirely different note I wish there were a type of massage therapist emeritus designation. There are MT’s like myself who have been in the business for over 25 years. My practice and what I provide is fairly well established and at age 64 not going to change much. I enjoy ceu’s and yet at times honestly feel I have “paid my dues” if that makes any sense. Peace to you all.

    • Garry – thanks for your comments.

      You are not the only person to mention the ce requirements for long time practitioners. It is a topic big enough for another blog post, if not a few meetings. I’m not sure what the answer is; I’ve seen MTs with a lot of experience with varying amounts of expertise. Perhaps it is a reflection of their initial education, perhaps it’s a reflection of experience and continued education. But it is a topic for further discussion.

  12. Great post! I feel that higher education is key for the progression of our industry.

    In Michigan there are two community colleges that offer a two year degree https://www.oaklandcc.edu/health/massagetherapy/ & Schoolcraft College. Then you have Oakland University located in Michigan as well that offers The School of Health Sciences which massage would fit nicely into a program such as this https://www.oakland.edu/Default.aspx?id=11303&sid=305&CWFriendlyUrl=true.

    I plan on going back to school to seek a higher degree and hope to see a University adopt a 4 year program within the next 10 years.

    • Mika – thanks for the links. I’m glad to see you want to go back to school and wish you the very best in your education. Stop back and let me know how it’s going, when you get there.

  13. I would love to see a tired system of training. I have met many therapists with no desire to learn anymore. They hate CEU requirements and only do them because they must. They took the shortest cheapest program they could find in order to practice.

    Then there are those of us who actually want to learn as much as possible. We spend fortunes on CEU classes and books. We read medical journals. We would love a degree program.

    I think both groups have a right to exist. My concern is that a degree will become a requirement and we will become like PT. I know many DPTs ( I teach them) who got a great education to give exercises and hot packs. The 4 year degree was just fine but now they get an education that is not really needed in the field – except to stroke egos.

    I would love to see a 4 year program. I attempted to create one myself. It is not hard to do the academic portion. The difficulty is getting a school to actually take a program. We need to prove a need and that graduates could make a living. They would probably need to make a better living than those meeting current standards.

    I am all into helping design a program. Its all that preliminary work that makes the job difficult. That and paying off a 4 year education.

    • Richard – I agree that both groups have a right to exist. I’m a life-long learner, myself, so having an advanced program appeals to me. When the video comes out, you’ll hear Ravensara talk a bit about the burden of creating a degree program, which includes having dedicated faculty and the like. So she’s taken a stepped approach to this starting with an advanced certificate. I encourage you to keep in touch with this as it sounds like you have some valuable inputs and experience.

  14. I originally studied massage therapy in WA. I was fortunate that the school that I attended appreciated serious study of the human body. I took a cadaver class at Bastyr University. I would think that if such a place (Bastyr) was interested in teaching Master’s level education in Massage Therapy then we’re golden? It may be worth talking to a few board members, or stock holders? Just an idea.
    I’ve been a practicing LMP/CMT for close to 20 years, and there is still so much that I would like to learn about how our work affects the people with whom we work, and always how to improve!

  15. I have a degree in Sports Medicine, focused on a curriculum to meet the requirements to become a Certified Athletic Trainer, another field that has had to “push from behind” to become recognized by those in the medical field. It was only a few years ago that states began to allow ATC’s to do third party billing. (sound familiar?) I believe that setting a national standard for curriculum within a program for massage therapy would “legitimize” the profession and raise it to a level that would benefit all parties involved; practitioners, clients, even insurance providers. That being said, it was only a few years ago that the state of Massachusetts was without any sort of regulation other than town by town. There is some HEAVY lifting ahead…

    • Jason – It is heavy lifting. In the few years I’ve been in practice, we’ve added 10 more states to the side of regulating massage, so we’re down to only 6 that don’t. Good to hear that ATCs are finally able to do third party billing. You’re another part of the wellness community that can really help people and I look forward to seeing more of you in the future.

"Dream large, laddie!" - Local Hero, 1983