Why I Believe in ELAP

 

I’ll start my post by revealing my biases: I am President of Associated Bodywork & Massage Professionals (ABMP), a Registered Massage Therapist in the great State of Colorado, and Nationally Certified in Therapeutic Massage. I am also a member of the “Leadership Group,” which consists of representatives of the following organizations: Alliance for Massage Therapy Education (AFMTE, or “the Alliance”), ABMP, American Massage Therapy Association (AMTA), Commission on Massage Therapy Accreditation (COMTA), Federation of State Massage Therapy Boards (FSMTB), Massage Therapy Foundation (MTF) and National Certification Board for Therapeutic Massage & Bodywork (NCBTMB).

 

Much has been written or stated about the Entry-Level Analysis Project (ELAP) already; though many individual comments have been positive, most of the blogs and articles have not been supportive of the project. This post will be. My colleagues Laura Allen, Ralph Stephens, and John Weeks have raised concerns and/or objections, some of which merit discussion.

 

The Entry Level Analysis Project, in its initial form, was the brainchild of Anne Williams, ABMP’s Director of Education. Anne is a restless character; consumed with passion and energy, she embraces the change that seems always to exist in massage therapy and is determined to be an agent for positive change. She continues to devote significant energy to achieving a solid ELAP result and to ensuring opportunities for broad profession input. Already the ELAP design has evolved to incorporate suggestions from the organizations listed above and numerous other key individuals. The ELAP is not an ABMP project; it germinated with Anne, but has been embraced and developed by the organizations listed above.

 

Jean Robinson, ABMP’s Director of Government Relations, and I have long lamented the incongruence of massage therapy regulation; the evolution of statewide regulation of the profession has been marked by pockets of provincialism, resulting in a patchwork quilt of regulations and practice requirements. Our views aren’t unique, or probably that original; since regulation accelerated in the early 1990s, 25 states have adopted state regulatory laws. One of the critical elements of state regulation is the educational requirement. The varied hour requirements among states have been a source of consternation for many of us in the field. Numerous engaged entities, including ABMP, have contributed to the patchwork result. But as a profession, we are where we are. What’s encouraging is that we are now working together using a different angle of attack to try to arrive at an agreed-upon standard with a substantive rationale behind it.

 

The educational foundation of our field is in need of further commitment to consistency and quality; that is why many organizations (ours included) and individuals have committed to improving teacher and student readiness. The ELAP is in a similar vein.

 

FSMTB has embarked on a broadly well-regarded project called The Model Practice Act. It has the full support of ABMP, and, to my understanding, the same from the profession’s other leading organizations. A fundamental challenge with this exercise is selecting a required minimum education component. Every state massage therapy regulation includes a minimum education requirement necessary for licensure/registration. There isn’t today an agreed-upon educational standard upon which FSMTB, the individual states, or the rest of us can rely. The ELAP will potentially—and ideally—help inform a recommended standard. The most commonly utilized “standard” today­—500 hours of education—is recognized by ABMP, AMTA, and NCBTMB for each organization’s membership or certification requirements. The challenge is that standard was at best loosely defined (and weakly justified) sometime in the 1980s. The fact that the origins of the 500-hour standard are subject to debate tells you all you need to know. We are due for an updated process and result.

 

One of the primary benefits from the ELAP will be that recognized training can aid portability of licensure from state to state. Would establishing portability be easy? No. Is it impossible? No. Is it in the best interests of the profession? As one who serves the interests of individual therapists, I can tell you without hesitation that the lack of consistent state regulations creates hardships for many therapists and has for decades. The ELAP is not a panacea, but would be an important step in the right direction. To those who dismiss portability as not important to the profession’s growth—you are wrong, and you are turning your back on your peers. To those who say it will never happen, I say, “Step aside.”

 

Some of the concerns expressed regarding the ELAP focus on prioritization. Critics say this isn’t the most important priority in our field, and major national organizations are wasting time and resources by working on it. I will save space and refer you to three individuals I highly respect who spoke to this perspective in follow-on comments on Laura Allen’s blog: Emmanuel Bistas, Pat Archer, and ABMP Chairman Bob Benson. You can read their comments here. Nothing I could say could improve upon their efforts.

 

The Alliance has made one of its goals establishing appropriate teacher standards for massage therapy training programs. For the last six years, ABMP has emphasized that teachers in the field need more support, training, and preparedness. We have walked the talk by instituting our Instructor on the Front Lines and Instructor 101 programs—to name two of many efforts—and we offer them at no cost to all educators. We believe strongly in the need to establish an appropriate qualification for teachers. But improving teacher quality and the ELAP are complementary undertakings that can’t and shouldn’t be addressed sequentially. We can and should be simultaneously moving forward on both of these worthy initiatives.

 

The development and continuing use of COMTA’s competencies have been mentioned as a reason rendering superfluous the launching of the ELAP. In his Integrator Blog, John Weeks states it would be smart to start with COMTA’s work. Indeed. In fact, COMTA’s competencies are being used as resource material to inform the ELAP, as are numerous other profession developed resources. However, what John doesn’t recognize or mention is that only 6% of U.S. massage therapy training programs have received program accreditation from COMTA, and only 51% of all massage therapy programs are taught at schools that have been institutionally accredited by any U.S. Department of Education-recognized agency. While universal program accreditation may be a worthy goal for the field, we simply aren’t close to that reality. Massage program accreditation today remains a point of differentiation.

 

The ELAP’s intent is to establish a consistent education baseline in the field. Through careful assessment of needed skills, knowledge, and abilities to be ready to begin practice, ELAP seeks to persuade both schools and regulatory bodies to adopt/require a common baseline instructional curriculum. Success will promote consistency and encourage states to support credential portability. The vision isn’t cookie-cutter curriculum templates for all schools. Programs will still be differentiated, reflecting diverse perspectives and consumer desires. ELAP will simply encourage universal adoption of core curricula, which if adequately presented and taught, will create confidence that students completing the core will be ready to begin practice. It will help us better understand what we need to teach, and to what depth, to prepare practitioners to successfully enter our field.

 

By all means, let’s continue to encourage diversity in supplemental coursework as each school imprints its own unique stamp. But let such uniqueness constitute additional enrichment on top of a commonly shared base of knowledge and skills.

 

The massage therapy profession is not perfect—far from it. But there are many things to feel good about.  The collaborative nature of the ELAP project is one of them. For too long, ABMP and AMTA have engaged in activities that ranged from “unsupportive of the other” to “in direct conflict.” One of the many reasons I feel so positively about this project is that our two organizations—competitors for 25 years now­—see eye to eye and understand the importance of working together on ELAP. We’re still going to compete for members, but the profession benefits from our joint leadership, and I for one am optimistic we will continue to find ways to do so. Similarly, the other five participating national organizations—even though they are less directly competitive when compared to ABMP & AMTA—haven’t always been mutually supportive. These meetings, and this project, are true opportunities for our profession. All the organizations, despite having their own DNA, culture, mission, and purposes, seem to hold a common belief that there is room for improvement and that the ELAP is an effort worth trying.

 

The ELAP is important, relevant, and long overdue. It is being tackled by some of the brightest lights in our field. I salute their commitment, and encourage those who believe massage therapy’s brightest days are ahead to become active stewards of our profession and raise our collective knowledge. The first step in supporting the work of the ELAP is to participate in FSMTB’s Job Task Analysis, which also includes an ELAP education survey. To do so, click here. It’s not a short survey—all told it might take up to 45 minutes. But that’s a small investment in our profession’s future. If you are an educator or employer of massage therapists, you soon may also have additional opportunities for input through other surveys.

 

Thanks, in advance, for your commitment. I’m Les Sweeney, and I approve this message.

 

 

Prefer to receive more from Les in small doses? Follow him on Twitter — @abmp_les.

 

18 thoughts on “Why I Believe in ELAP

  1. I graduated from a 250-hour program back in 1994 that I think served me quite well as an entry-level professional. More recently, I returned to Lansing Community College to take their updated, 750-hour, COMTA accredited program, which I completed last year. More education has made me more effective and knowledgeable, but even a basic education was enough to be safe and reasonably effective.

    I wish to caution against the recent trend toward hyper-professionalism. I think it is laudable if a massage therapist wants to obtain advanced skills–and a lot of what is taught as “advanced” lacks scientific validation and a plausible mechanism–but even if it is of value, this higher level of training is not required to practice safely or effectively. Time and again, research substantiates the benefits of plain old humble Swedish massage.

  2. I am always concerned when something comes out of the blue as it appeared that the ELAP project did. I have investigated and followed multiple discussions on the topic and have formed my own oppinions. First, transparency and making sure the project does not have the appearance of bias or self serving to any one organization or special interest. Because of past action the massage community is suspicious. It is necessary for anything that would influence the entire profession be as transparent as possible. There is/was also concern that similar work would not be taken into consideration, ie the MTBOK, COMTA compentencies, NCNTMB job task analysis for example. It is important to realize that this is not an either / or situation but validity will only occur when all are considered and all is in the open. There are research methods that can be used to intigrate all of the data collect from multiple sourses and identify relevance and remove bias. I see the ELAP as another data collection process and in that reqard I am supportive. However, it cannot stand alone and the profession will really only benefit with everything -MTBOK, Line by Line analsysis of MTBOK by the Alliance for Massage Therapy Education, Compentencies,JTA’s etc, along with data from the ELAP are combined together into an Integrated, pofession wide statement on entry level compenties, recommended core currulicum, recommended clock hour requirement and then translated into model legistation. So the problem is not the ELAP, or MTBOK or any of the other data so long as it is valid data. The problem is us–I am so tired of the competition when what we need is unification. There is room for everyone at the table and the Leadership Summits are a start. Now all organization need to come together in a unified statement so the massage profession can move forward. Lets not forget the importance of the Massage Research Foundation. Without evidence to support massage benefit none of the rest makes much difference.

  3. Bravo! This is a great endeavor with sound merit. This is not an easy task to undertake.

    “The ELAP’s intent is to establish a consistent education baseline in the field. Through careful assessment of needed skills, knowledge, and abilities to be ready to begin practice, ELAP seeks to persuade both schools and regulatory bodies to adopt/require a common baseline instructional curriculum.”

    We need to have a common starting point in our schools. I believe it will help administrators and school owners create a sound curriculum base from which to expand their programs. All massage therapists should have the same basic curriculum to include knowledge, skills and abilities to help them become safe and effective practitioners.

    Having completed a yearlong line by line analysis of the MTBOK was a valuable lesson in inconsistencies within current massage curriculum. I am hoping that the ELAP committee members take a close look at what has already been done and utilize the information to assist them in this project.
    I have been working non-stop for 2 years on the Teacher Education Standard Project (TESP) for the Alliance for Massage Therapy Education (AFMTE). In order to teach an entry level or advanced curriculum we have to educate our teachers and have a guide for them to be as effective and consistent as possible. We are all striving to move our profession forward. Our collaboration combining our knowledge and resources will only help to serve our professional community as a source of positive strength and energy to continue to move forward.

    Benny Vaughn’s theme at our recent conference was “Professional Self-Esteem”! I personally believe that ELAP and the TESP is a great start to achieving our “Professional Self-Esteem”.

    A quick note to address a comment by Rich Bartlett – “benefits of plain old humble Swedish Massage” have been proven to very effective in conjunction with psychotherapy to address anxiety and depression (Moyer CA, Rounds J, Hannum J. A meta-analysis of massage therapy research. Psychological Bulletin January 2004;130(1):3-18). In order to work within this type of specialty utilizing swedish massage it takes more knowledge than a 500 hour program can provide. There are way too many myths that lack scientific validation being perpetuated by teachers in the massage profession. However, saying this, a 500 hour program which is standard minimum has been shown to teach therapists how to be safe and effective.

    Rebecca Blessing, DC, MS, CNMT
    Professional Standards Chair
    Alliance for Massage Therapy Education

  4. I don’t approve of ELAP as I understand it. This is all based on an assumption that only Swedish as a foundation is legitimate. I don’t do any Western Massage, I haven’t studied any Western Massage, and few things interest me less than Western Massage, yet I’d have to study that foundation to get to the stuff I’m good at, and stuff my clients want. This would double the training I need just to get started. No thanks.

    • Hello Lauren – I’m not sure where you got the information that the ELAP study is “just on Swedish massage”. That is incorrect. Please click on the link orivuded by Les to take the JTA and Education surveys; that is the best way to not only give your feedback on what your professional experience has shown you, but to also see the kinds of questions being asked. We want to know how YOU address the situations and clients you see as a professional, and whether you think your education adequately prepared you to be successful in the field. And even IF your particular philosophy and methodology for massage end up being in the minority – that doesn’t de-value anything. Simply says that your methodology and level of expertise may be beyond entry-level education.

      • Lauren,

        Interesting response. I too, feel the same way, except that with a different twist. In terms of massage forms, I don’t want to learn Eastern/Asian forms of bodywork, and I don’t believe in forcing students to have to learn this either. I respect the form, I simply don’t believe it should be a factor a “good education”, much like you feel about Western massage education. No disrespect, simply I mirror your view.

  5. The way I understand this, I agree & approve. Would love to see a portability feature for state-to-state. This would also go right along with the CEUs that we all have to have to renew our licenses with. Thanks!!

  6. I think that having massage therapy organizations work together in and of itself is good for the profession. When they form committee’s to try and gather information on improving education and standards for the profession it is always a concern of mine of who is on the committee and what is the intended out come of the project. I like the idea that so many people want to look at core knowledge of massage therapy. I think the more conversation we have on core knowledge and how to improve the massage therapy profession brings more clarity on what massage therapy is. Our profession is evolving every day and self examination is good for the soul of our profession. It is when the project is done and recommendations on what to do with the information are made that things can become quite controversial. I like the more information part.

  7. Go team go! You can never go wrong with improving standards for both practitioners and instructors. Basic or minimum competency is the springboard for further development of advanced skills such as clinical or healthcare massage. The world of healthcare will certainly take us more seriously when there is a greater consensus agreement on knowledge that protects the health and safety of clients/patients. They will also take us more seriously when we can support our claims with high quality evidence based research that supports and validates our assumptions and theories. Anecdotal claims are no longer valid.

    I’m so happy to see our wonderful profession beginning to work together in more in a constructive manner. Perhaps we have come to a tipping point in time for many reasons. We will be taken more seriously too if we agree by consensus rather than with persistent in fighting.

    I want to be on your team!!!

  8. Aligning with COMTA is the right direction for a number of reasons, including the ability to take valuable education into national defense. Our service members are interested in what we do, respond well to treatment of the various stresses they endure, and will have the right to train in this capacity in the future. COMTA assists this process and bridges expectations.

    The direction of advanced studies has plenty of research basis when focused on both the soft skills of business, and the direct response of soft tissue manipulations performed in therapeutic rehabilitation.

    I applaud these efforts and thank you all for the compassionate and thoughtful discussions!

  9. We are much closer to consenses that it appears. The data collected by the MTBOK and the line by line Analysis by the Alliance for Massage Therapy Education matches up really well with the COMTA compentencies. As presented in the line by line analysis done by the Alliance the MTBOK entry level content could be presented in a program of 500 to 600 hours as determined by the educators who worked very hard for a year to produce the analysis. The data collected by the Federation with the current job task analysis plus additional data on that survey targeting ELAP information when OBJECTIVELY compared to the MTBOK and COMTA will pretty much seal the deal. The massage community is not functioning on the fringe anymore and the public and employeers are expecting standards. The organizations must get it together and develop a joint unification statment about education and practice standards. COMTA has determined that it takes 600 clock hours to meet the REALLY GOOD COMPENTENCIES they have . I think the ELAP data will be close to this so long as they do not attempt to make the data fit the Federal Financial Aid mandates of 900 clock hours for maximun elegibility for financial aid. A model curriculium for entry level massage training could created if you would just lock some of in a room and not let us out until it was done. And then schools could use it how ever they wanted.

    I do not think that the elegibility educational standards are high enough for the new and true Board Certification Exam in progress with NCB. Right now they are at 750 hours which is 250 contact hours over the current standard of 500 hours. I would be fine with the 250 contact hours of education if it were stated as post graduation and licensure regardless of how long the entry level massage program is. I also thing that the continuing education should be within catagories such as assessment, pathology, ethics, sciences.

    The massage profession needs to get over itself, the leaders need to as well. It is time to get this done.

  10. I agree that this work is valuable for the future of this great work, and I also agree on the caution of being too hyper professional. What I am seeing — is this focus will, can and is detracting for some important issues that we are facing politically, expecially here in florida – where we – massage threapists, and A.P.’s and some of D.C.’s work has been blocked by laws just passed prohibiting LMT’s, A.P.’ and some of D.C.’s to bill for PIP auto insurance cases, limiting the auto accident victum to the options of hospitals/walk-in clinics – surgery and pain pills. This should never happen in the world of health and healing care — but if this is a trend — so much for our “professionalism” — as the options get taken away for anyone to properly be taken care of from injury.

    We must be vigilant in all areas of our work. Having a structure to better define the therapist — so people have a better idea of whom to choose would be helpful. But allowing our legislators to wipe away the choices for our clients and ourselves is very dangerous, and must be addressed!

    I would like to propose that we create a forum around this — Florida could use all the help we can get to stop this craziness.

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