By Les Sweeney, ABMP Executive Vice President

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) has announced that eligibility requirements for candidates wishing to take the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) will change in late 2004/early 2005. A specific date has not yet been announced.

In addition, the board announced it will offer a second credential and exam, the National Certification Examination for Therapeutic Massage (NCETM), which will omit references to bodywork and Asian modalities.

The criteria for qualifying for either of the exams are identical. While not increasing the minimum of 500 hours required to sit for the exam, the changes do stipulate how 65 of those hours must be spent:

• 125 hours of in-class supervised instruction in the body's systems, kinesiology, and anatomy & physiology (increased from 100 hours);
  
• 200 hours of in-class, supervised instruction in massage and bodywork assessment, theory, and application;
  
• 40 hours of in-class, supervised instruction in pathology (increased from no requirement);
  
• 10 hours of in-class instruction in business and ethics with a minimum of six hours in ethics (increased from a minimum of two hours of ethics);
  
• and 125 hours of additional in-class, supervised instruction in an area or related field that theoretically completes your massage program of study.

NCBTMB's content outline was written based on the results of the job analysis of 500 Nationally Certified practitioners. In its press release, no mention was made of whether massage educators were part of any analysis.

According to a recent survey, these new requirements will significantly affect massage and bodywork schools across the nation. ABMP recently conducted its School Operations Survey, which included questions about the school's primary program of instruction. Of the 166 survey responses, 31.9 percent reported having a pathology curriculum that met or exceeded the new NCBTMB requirement. Slightly more than 46 percent reported offering an anatomy & physiology curriculum that met or exceeded the 125-hour requirement NCBTMB plans to introduce.

When considering both requirements, only 15.7 percent of school curriculums currently meet both of the new impending NCBTMB requirements.

This representative sample would indicate that more than 900 massage schools would need to change their curriculum in order for their students to qualify to sit for either National Certification Examination.

Changing a school's curriculum, as many school owners can attest, is not a simple or quick process. In many cases, the changes must be recognized and/or approved by the regulatory authority that oversees post-secondary education in the state in which the school resides. Should the new requirements be adopted in late 2004 or early 2005, it is highly likely that many massage school graduates and enrolled students would be in the midst of a program that would not qualify them for the National Certification Examinations - especially problematic in the regulated states where the NCE has been established as a requirement to practice. ABMP disagrees with the process, specifics, and timeframe of the decision to change requirements for the National Certification Examinations.

An Appropriately Thorough Process?
In developing a job analysis, NCBTMB only received input from 500 NCETMB certificants. It appears they did not communicate with schools or the audience of 120,000 massage practitioners who have chosen not to take the NCETMB. This creates a skewed sample, the result of which potentially engenders disproportionate support for requiring everyone to do groundwork needed to perform medical massage.

Adopting pathology places a medical-massage emphasis on a standard "entry-level" curriculum. This is out of step with the collective judgment of massage school owners/directors - 84 percent of current school curriculums do not meet the proposed standards for anatomy & physiology and pathology.

The adoption of these standards clearly points the National Certification Examination in the direction of "medical massage." While nearly no one disputes the importance of a well-prepared practitioner, the results evidenced by the school survey indicate that pathology does not currently warrant the significance that the new guidelines imply. The inclusion alone of pathology might cause discomfort among a minority of educators and practitioners, but the emphasis (going from 0 to 40 hours required) will likely be a cause of dissent within the profession. It becomes particularly acute when the NCETMB is viewed as it is used - an entry-level examination, in many cases a requirement in order to practice.

Throughout the past two decades many individuals have become successful practitioners without completing 40 hours of pathology. To funnel every future massage therapist through this path begins to eliminate some of the flexibility and diversity that has given such life to the massage field. Further consideration should have been given to the decision, rather than just relying on the views of 500 already-certified therapists. For a segment of the 1,250-plus schools, this won't be a concern - their curriculum already includes 125-plus hours of anatomy & physiology and 40 hours of pathology; for many more, some serious scrambling will be in order.

A school's education director must now struggle with these questions: Do I add hours (and thereby raise tuition)? If not, what in my curriculum should I cut? These are not small questions to answer for the approximately 900 schools affected by this rule change.

Is the NCBTMB Inappropriately Throwing Its Weight Around?
Viewed solely from the perspective of choosing criteria to obtain a voluntary credential, NCBTMB has every right to set the bar wherever they desire.

But NCBTMB has successfully lobbied with 24 states to make passing the NCE a condition of obtaining a massage license. That gives the nine NCBTMB board members potentially huge power over massage training. With that power comes a great responsibility to use the power carefully, to be fair in acknowledging the range of practice objectives different massage therapists select. NCBTMB must not impose its preferences on all entrants to the profession, yet these proposed standard changes would do exactly that.

An Immediate Time Frame
The proposed time frame for implementation of the new requirements takes a controversial change and makes it downright onerous. Simply put, schools are being asked to digest a rather large change in an extremely short amount of time; many of them will simply be unable to adjust their core curriculum in time, through no fault of their own. A likely scenario could be schools having to offer "post-graduate" filler programs of anatomy & physiology and pathology for their newly minted graduates, just to establish them as eligible to sit for one of the NCEs and start their careers. This only adds delay to the process of entering the field, and could further penalize those schools that must adhere to placement standards established by accrediting agencies.

A Missed Opportunity
It's a shame NCBTMB, in introducing its new massage-only credential, didn't avail itself of an opportunity to make a greater distinction between educational requirements for the two credentials. The idea of differing levels of practice within the massage and bodywork community is an idea that has been discussed for many years. NCBTMB has a unique position from which to provide leadership in this area. Instead, it chose to take an easy way out and simply eliminate areas of the existing examination that have been a cause of complaint since the exam's inception.

If the new NCETM credential had more appropriate "entry-level" requirements sufficient to prepare one to perform basic Swedish massage, and the current NCETMB credential had its standards beefed up as currently proposed, the new credentialing process might obtain substantially more support (and significance) within the profession.

What You Can Do
NCBTMB apparently moved to change the nature of massage and bodywork education in the United States without fully considering the implications of such a significant decision. In doing so, the members of the Board have done a disservice to the majority of schools and future candidates for their tests.

The new proposed requirements appear to be already adopted. Unfortunately, no call for comment was issued, which might have helped NCBTMB understand the perspective of the field. However, if you would like to voice your thoughts on the subject, we encourage you to contact NCBTMB's board members and its director of certification, Paul Parker (see "Voice your Thoughts," below). The Board meets again on May 14, 2004.

Voice Your Thoughts
If you have an opinion on the impending NCETMB changes, we encourage you to contact the NCBTMB directly:

National Certification Board for Therapeutic Massage and Bodywork
8201 Greensboro Drive, Suite 300
McLean, VA 22102
(800) 296-0664
(703) 610-9015
Fax: (703) 610-9005

Staff Liaison
Paul F. Parker, Director of Certification
pparker@ncbtmb.com

Board Members
Garnet Adair
NCTMB, Chair

Judy Dean, M.Ed., RN, BC
NCTMB, Chair-Elect

Elaine Calenda
NCTMB, Treasurer

Tree Bright
NCTMB

Pam Laubscher
D.O., Public Member

Elizabeth McIntyre, R.N., M.A.S.
NCTMB

Neal Barry
NCTMB

Bob Lehnberg
NCTMB

William Stoehs
Public Member