Final MTBOK Phase 1 First Draft Content for Public Comment

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Final MTBOK Phase 1 First Draft Content for Public Comment 1 2 Massage Therapy Body of Knowledge 3 (MTBOK) Phase 1 4 First Draft 5 for 6 Review and Comment 7 8 Authored by the MTBOK Task Force 9 Representing a Consensus of the Massage Therapy Profession 10 11 Sponsored under the joint Stewardship of the following organizations: 12 American Massage Therapy Association (AMTA) 13 Associated Bodywork and Massage Professionals (ABMP) 14 AMTA Council of Schools (COS) 15 Federation of State Massage Therapy Boards (FSMTB) 16 Massage Therapy Foundation (MTF) 17 National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) 18 September 15, 2009 19 20 Comments may be submitted (by Section and page number please) via an 21 automated collection tool available 22 by clicking on the URL below. 23 http://www.surveymonkey.com/s.aspx?sm=jF3W8X_2f4JQoWbhCmPfOSpg_3d_3dTable of Contents Page 1 Final MTBOK Phase 1 First Draft Content for Public Comment 24 Table of Contents 25 Section 0 Release Notes and Overview 26 Section 10 First Draft Release Notes 27 Section 20 How to Provide Comments and Suggestions 28 Section 30 MTBOK Vision 29 Section 40 Section Reference Numbers for Non-Section Specific Comments 30 Section 40.1 [Intentionally blank] Use this Section Number as a 31 reference number for General Comments 32 Section 40.2 [Intentionally blank] Use this Section Number as a 33 reference number for MTBOK Organization/layout 34 ...
Published : Saturday, September 24, 2011
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Final MTBOK Phase 1 First Draft Content for Public Comment 
 Massage Therapy Body of Knowledge(MTBOK) Phase 1First DraftforReview and Comment Authored by the MTBOK Task Force Representing a Consensus of the Massage Therapy Profession Sponsored under the joint Stewardship of the following organizations:American Massage Therapy Association (AMTA)Associated Bodywork and Massage Professionals (ABMP)AMTA Council of Schools (COS)Federation of State Massage Therapy Boards (FSMTB)Massage Therapy Foundation (MTF)National Certification Board for Therapeutic Massage and Bodywork (NCBTMB)September 15, 2009 Comments may be submitted (by Section and page number please) via anautomated collection tool availableby clicking on the URL below.http://www.surveymonkey.c px?sm=jF3 _ fOSpg_3d_3dom/s.as W8X 2f4JQoWbhCmP
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Section 0Release Notes and Overview Section 10First Draft Release Notes Section 20How to Provide Comments and Suggestions Section 30MTBOK Vision Section 40 Section Reference Numbers for Non-Section Specific CommentsSection 40.1[Intentionally blank] Use this Section Number as areference number forGeneral Comments Section 40.2[Intentionally blank] Use this Section Number as areference number forMTBOK Organization/layoutCommentsSection 40.3[Intentionally blank] Use this Section Number as areference number forNew Suggestions Section 100Massage Therapy Description and Scope of Practice  Section 110Description of the Massage Therapy Field  Section 120Massage Therapy Scope of Practice Statement  Section 130Whatis Included in the Scope  Section 140Whatis Not Included in the Scope Section 200Competency Requirements for a Massage Therapist inTerms of Knowledge, Skills and Abilities (KSA)  Section 210Entry Level Massage Therapist KSAs Section 210.1Anatomy and Physiology Section 210.2Kinesiology Section 210.3  Pathology  Section 210.4  Massage Techniques, Physiologic and PsychologicalEffects Section 210.5  Therapeutic Modalities Section 210.6  Body Mechanics and Self Care Section 210.7  Assessment, Treatment Planning and Documentation Section 210.8  Research Literacy Section 210.9  Overview of Massage and Bodywork History / Culture  Section 210.10  Business Practices, Laws and Regulations Table of Contents Page 2  
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 Section 210.11  Boundaries, Ethics and the Therapeutic Relationship Section 300Massage Therapy Terminology Section 400 AppendicesSection 410Appendix A Bibliography Section 420Appendix B Explanation of New Science Areas and Research Section 430Appendix C Sample Online Comment Form (Completed) 
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Section 0Release Notes and OverviewSection 10 First Draft Release NotesBackground and Overview: A considerable amount of work has been put into thisdraft document by members of the MTBOK Task Force who represent you, theMassage Therapy and affiliated communities. It’s important to note that this documentis not being developed in seclusion –we have pushed hard to get a document that iscomprehensive and with plenty of substance for the community to take in, think aboutand provide input on.We want your comments, input and suggestions, because it is our goal that the MTBOKbecomes truly representative of the thinking of the community, and we hope you willbecome passionate about it. We hope to achieve a living, learning ‘document’ –that isone that grows with, and in some cases, ahead of our community. It will become living ifyou, the community embrace it, become involved with it over time, and continue to keepit relevant, responsive, growing and strong.The MTBOK has had a good start. Phase 1 is a joint effort sponsored by 6 of the majororganizations in the Massage Therapy field, who each put their individual agendasaside to work for the common good. They did this because they realize the health andvitality of the Massage Therapy profession is in all of our interests, and the creation of aMassage Therapy Body of Knowledge would help achieve that state.To that end, they have established a joint “Stewards” board that providesthe frameworkand resources to begin the project. At the same time, they have stayed out of thedecision making, recognizing that the project needs to be viewed as by and for theprofession and not swayed by individual organizational desires. The StewardOrganizations have not been pre-briefed on the content in this document, and will notreceive it before it goes out for public comment.As of the release of this document, you become an important part of the process, andwe really hope to see you involved. We hope you will participate throughout the project,and want you to understand that this isn’t the only chance you will have to impact thecontent and direction of the MTBOK Phase 1. Our general schedule looks like this: Initiated Task Force work assembling the MTBOK on July 1, 2009 First draft developed and out for public review on September 15, 2009 An event designed to let the profession provide us with thoughts and input will beheld in association with the AMTA National Conference in Orlando Fl onTable of Contents Page 4  
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Final MTBOK Phase 1 First Draft Content for Public Comment September 24, 2009, but you don’t have to be registered for the conference toattend. The formal comment period on the first draft will be open for approximately onemonth. We will continue to leave open the ability to provide comments and willaddress all that are possible between releases. Second draft is scheduled for release shortly after the New Year The final Phase 1 product will be presented to the community and released inearly May, 2010.MTBOK Phase 1 vs the “Final” MTBOK: Phase 1 of the MTBOK will not complete thedevelopment of a full, living Body of Knowledge, but it will have much of the groundwork done, will result in a working process, and will allow for additional work to befocused on the future. Specifically, Phase 1 is charged with producing 4 crucialelements of a Massage Therapy Body of Knowledge: A Description of the Massage Therapy field; A Scope of Practice for Massage Therapy; A description of the competencies of anentry level Massage Therapist in termsof Knowledge, Skills and Abilities; and Terminology as it applies to the Massage Therapy field.Its clear that Phase 1 gets most of the job done, but leaves a lot of interesting work tobe done, and its our hope that a lot of you will participate in upcoming phases, bothformally and informally. In this way you can help guide the destiny of our profession.The Task Force: The Steward organizations solicited applications for volunteerpositions on the task force in hopes that they would achieve a solid, knowledgeablegroup of individuals who brought a full mix of backgrounds and skills into the project.The Task Force members did not work together before nor did they have any significantties to the Steward organizations. They are however, an impressive group (see “WhoWe Are” button on the MTBOK site–http://www.mtbok.org) and include educators,business owners, authors, and have experience with State Massage Therapy Boards,State and local legislation, examination and certification efforts, both eastern andwestern traditions and are also, or have been Massage Therapy practitioners. It’s agroup the profession can be proud of, and even more importantly, one that can beworked with.The Task Force members are all volunteers who serve until July 2010, so there will beopportunity for others to participate on the task force next year.The First Draft Release Notes:
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Final MTBOK Phase 1 First Draft Content for Public Comment
 It’s a first draft, and by definition will change. It’s being put out as early aspossible to provide for substantial input from the community.
 It’s far from being done. Although we are proud of the work so far, it needs morework, and we will be starting on that effort shortly. Over the next few weeks wewill focus on receiving input from you the MTBOK stakeholders (i.e. those whohave some interest in Massage Therapy), establishing the process to deal withthe comments we receive, and working out our strategy for the next release.
 As you review, keep in mind that all the sections in this document relate to the fullMassage Therapy field except Section 200 which is restricted to thecompetencies anentry level Massage Therapist must possess. Although youwon’t see competencies that address what an “advanced”or specialty MassageTherapist should have, keep in mind that Section 200 proposes that thesecompetencies are the minimum that anyone doing Massage Therapy needs topossess.
 Please understand that the MTBOK doesn’t now, and won’t ever (as far as weknow) have any legal authority –the jurisdictions you practice in hold that power.We hope that over time the MTBOK will be a source of information that legislativeand regulatory bodies rely on to obtain the best information for our profession,but nothing in the MTBOK supersedes any rule or regulation that MassageTherapists are subject to.
 We are issuing this draft broadly and hope that it is read and acted upon by boththe Massage Therapy world and for all of those allied health care professionsthat we work with and among. Please note however that we are not attemptingto define other professions –we recognize that there may be overlap in Scope ofPractice and/or Knowledge, Skills and Abilities (KSA) with other professions. Inareas of overlap it is not our intention to take sole ownership –there is a richnessin the diversity of professions and methods and hope that this process helpspromote a more comprehensive array of choices that clients need and deserve.
 We have tried to make it easy to provide us with comments. Our main process isvia an online form. See the next section to get more information on how toprovide us with your comments.
 Future releases of the MTBOK will include additional interlinking to help you fullyfind the information you need. We are also looking at more interactive ways toaccess this information in a way that lets you follow your own path through theinformation rather than that offered by a document. Within a year we would like tosee the MTBOK fully on line in an interactive dynamic state. We would like to
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Final MTBOK Phase 1 First Draft Content for Public Comment have all of the domains of Massage Therapy (Practice, Accreditation, Research,Certification, Education, and Licensure) working with the MTBOK project tocreate interactive links which would help integrate all domains. Finally, we hope that the MTBOK will help achieve a common understanding ofthe profession both within and outside. We expect that a detailed body ofknowledge with have profound impact on the profession and hope that by havinga central repository the work of the related domains such as regulation,education, accreditation, examination, research, practice, etc will not only befacilitated but will provide an environment where the interactions of these willprovide newer and more effective capabilities and “glue” for the profession.Section 20 How to Provide Comments and Suggestions
 Please use the automated form found at: http://www.surveymonkey.com/s.aspx?sm=jF3W8X_2f4JQoWbhCmPfOSpg_3d_3d  to submit your comments whenever possible. Please submit one form for each comment, and submit as many forms as youneed. Specify the line number of the text that begins the part you are commenting on orwhere you wish to add or delete items. Specify the Section number you are commenting on. Please use the Sectionnumbers within Section 40 as the reference for overall or non-specific comments Although providing your email address is optional, it will help us if we need to getin touch with you regarding your submission. Your email address will not beshared outside the MTBOK project. A sample filled out comment submission form may be found asAppendix C.
 Section 30 MTBOK VisionThe Following summary of the vision of the MTBOK is taken from the final MTBOKBusiness Case developed by the MTBOK Steward organizations. The full document isavailable at:http://www.mtbok.org/resources. Vision The vision for a massage therapy body of knowledge initiative is to develop and adoptprofession-wide a common BOK for the profession, defined as1:A living resource of competencies, standards and values that inform and guidethe domains of practice, licensure, certification, education, accreditation andresearch.                                                          1 Report from the Massage Therapy Body of Knowledge Meeting, Kansas City, Missouri, November 5-7, 2008 Table of Contents Page 7  
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Final MTBOK Phase 1 First Draft Content for Public Comment Competencies refer to theKnowledge, Skills and Abilities (KSAs) that enablemassage therapists to perform their work in a safe and effective manner.Knowledge is the technical information, theory and research that support the practice;Skills arethe psychomotor capabilities a massage therapist utilizes; andAbilities aredemonstrable behaviors –both innate and learned –that result in an observableoutcome in the treatment setting.(KSAs will be defined for both the entry level ofpractice, as well as for areas of specialized and advanced practice.) Standards are the established and documented norms or requirements for theprofession. They include such components as a Scope of Practice definition, Codeof Ethics, Standards of Practice, Nomenclature, Taxonomy, Education Standards(including Curriculum Standards, Teacher Qualifications and InstitutionalRequirements), and Workplace Standards(including Ergonomic Factors, FacilityRequirements and Practitioner Capacities). Values are the unique attributes, qualities and principles that are embodied byindividual massage therapists as well as the institutions and organizations thatcomprise the profession.Section 40 Non-Section Specific CommentsSection 40.1 Use this Section Number for when entering GeneralCommentsSection 40.2 Use this Section Number when entering Comments about theMTBOK Organization or LayoutSection 40.3 Use this Section Number when entering New Suggestions  
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Final MTBOK Phase 1 First Draft Content for Public Comment Section 100Massage Therapy Description and Scope of PracticeSection 110 Description of the Massage Therapy Field
Massage therapy is a healthcare andwellness profession. The practice of massageinvolves aclient/patient-centered session, designed to fulfill the requests and needs ofthe client/patient, with the therapist being free of a personal agenda. Massage fulfills thewell researched human need for touch like no other healthcare or wellness profession.Many complementary and integrative practices have components of touch, but massagetherapy is, at its heart, about one human touching another with informed intention,compassion, focused attention, and non-judgment.
During a session a massage therapist may incorporate a wide variety oftechniques andapproaches to address the varied focuses of their client/patient, which may include anyor all of the following:
 Treatment of injury or conditions Relaxation Stress reduction Wellness Enhancing client/patient personal growth Encouraging client/patient awareness of body Facilitating the balance and connection of body, mind, spirit and emotionMassage is performed in a variety of practice settings. A few examples, of the myriad ofpossibilities, include:
 Working with both amateur and professional athletes to lengthen and stretchmuscles and help improve performance; In hospitals doing pre- and post-surgery massage; Doing injury rehabilitation, breaking up scar tissue and increasing flexibility; In multidisciplinary clinics with the like of acupuncturists, medical doctors, physicaltherapists, naturopathic physicians as part of a healthcare team providing integratedhealth care; In oncology clinics, focusing on touch and nurturing care;In a chiropractor’s office doing massage treatment that supports and helpschiropractic adjustments hold; In airports doing seated massage on the tired shoulders of travelers; In day spas or small independent offices offering clients a relaxing, stress reducingtime away from the hectic pace of life to enjoy nurturing caring touch;
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Final MTBOK Phase 1 First Draft Content for Public Comment  With psychotherapists focusing on mind-body connections that help heal pasttrauma; With clients on a self-actualization path, focusing on mind-body awareness, orcreating a meditative state for the whole body; In a stable helping the dressage horse and rider work together with ease addressingthe individual body issues that each may have; In a dog daycare helping an aging dog move with greater ease.
Massage therapy serves all beings through touch regardless of their health or wellnessstatus.
Section 120 Massage Therapy Scope of Practice Statement
Massage therapy is a healthcare and wellness profession performed in a variety ofemployment and practice settings. The practice of massage therapy includesassessment, treatment planning and treatment through the manipulation ofsoft tissue,circulatory fluids andenergy fields, affecting and benefiting all of thebody systems,primarily the musculoskeletal for the following therapeutic purposes including but notlimited to enhancing health and well-being, emotional and physical relaxation, stressreduction, postural improvement, facilitating circulation, balancing energy,remediation,pain relief, injury repair and prevention, and rehabilitation. Massage therapy treatment isperformed and accomplished by use of digits, hands, forearms, elbows, knees, and feetwith or without the use of emollients, liniments, hot and cold, hand held tools or othermechanical or electrical apparatus that mimic the actions of the hands.Section 130 Whatis Included in the ScopeAssuming the required or nationally recognized standard for minimum entry leveltraining in massage therapy, and specific post graduate training where necessary orrequired, the following are included in the Scope of Practice of Massage Therapists: The use of touch through pressure, stroking/gliding (effleurage), kneading(petrissage), percussion (tapotement), compression, holding, vibration, friction, andmovement and stretching (see below) by the digits, hand, forearm, elbow, foot ormechanical appliances which mimic or enhance specific massage therapy handtechniques. Work to enhance wellness and facilitate mind body connections. The use of active/passive range-of-motion, joint movement within the normalphysiologic range-of-motion, active assisted and resistive movement, stretching andrange-of-motion. Energy work which includes the treatment of the electromagnetic or energetic fieldwhich surrounds, infuses and brings the body to life through the use of touch asdescribed in (1) above or through the use of non-contact techniques.Table of Contents Page 10  
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Final MTBOK Phase 1 First Draft Content for Public Comment  Client/patient assessment by health intake form, interview, observation of postureand movement, palpation, range-of-motion assessment,special tests, and withpermission, consultation with the client’s other health care providers. The determination of whether massage therapy is indicated or contraindicated forthe client/patient. The determination of whetherreferral to another health care practitioner isappropriate or necessary when the client’s/patient’s condition is determined by themassage therapist to be beyond his or her scope of practice, skills and training. Formulation of an individualized treatment plan based on client assessment findings. Application of adjunctmodalities which include hot and cold applications (such asheat lamps, compresses, ice or hot packs, stones, etc.), hydrotherapy, topical herbal(non-legend) applications (poultices, muds, packs, etc.), body wraps (for therapeuticmusculoskeletal, constitutional intentions) topical application of salts/sugars, tools,vibrators/thumpers, aromatherapy. Using emollients which include oils, gels, lotions, creams, powder, rubbing alcohol,liniments, antiseptics, ointments and other similar preparations. Documenting a client’s health history, intake interview, assessment findings,treatment and treatment outcomes as necessary. Obtaining at minimum a client’s/patient’s verbalinformed consent prior to initiatingtreatment. Guided Imagery for the intention of facilitating and supporting relaxation. Offering specific suggestions and recommendations of self-care and healthmaintenance activities including but not limited to self-massage, self administeredhydrotherapy applications, stress-reduction and stress-management techniques,effective breathing techniques, progressive relaxation exercises and meditation. Ethical business practices which shall include but not be limited to full disclosure offees and payment policies with the client/patient prior to providing massage therapy. External manipulation of soft tissue except for intraoral and intra nasal work. Withseparate and adequate informed consent. Breast tissue massage. With separate and adequateinformed consent. Animal massage.Section 140 Whatis Not Included in the Scope
The following are NOT included in the Scope of Practice of Massage Therapists:
 Diagnosis (western) of medical conditions or illness. The performing of surgery or invasive therapy. Theprescribing, dispensing, and administering oflegend drugs.
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