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NCBTMB and the Soul of Bodywork

By David Lauterstein

Originally published in the June/July 2004 issue of Massage & Bodywork magazine. Copyright 2004. All rights reserved.

Am I going crazy? Or has the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) lost its way? You decide.

Recently the NCBTMB launched a "National Massage Safety Week." The dubious and self-serving implication was that anyone who was not nationally certified was not "safe." I can scarcely imagine a more ill thought-out campaign.

I recall when former American Massage Therapy Association (AMTA) President Elliot Greene began talking to me many years ago about national certification. He had, as many of us did, a desire that the standards in our profession have some consistency from state to state. Now, however, the NCBTMB is actually promoting certified people over non-certified as more likely to be safe - we have the makings of a self-promoting bureaucracy advancing its agenda to the exclusion and detriment of the field.

In early April, my co-director and I learned from one of our students that the NCBTMB also plans to change its curriculum requirements to take the National Certification Exam. Even though we are school owners, we did not receive any type of advance notification. Unpleasantly surprised, I immediately went to the NCBTMB website, which says the plan is to change the requirements in late 2004, or in 2005.

The new requirements supposedly will be that, of the 500 hours national certification requires as a minimum (with 100 anatomy and physiology hours currently required), schools must now add an additional 40 hours of pathology and 25 additional hours of anatomy, physiology, and kinesiology than are currently required. This means that schools with 500-hour programs will have to replace massage training hours with pathology and A&P hours or raise their hours and likely the tuition of their programs.

This decision, which I hope is overturned or at least modified, encapsulates the misguidance of so many trying to steer our profession these days. This editorial is an appeal to all school owners, teachers, and therapists who feel as we do to contact the NCBTMB with a request to cease and desist from tunnel vision and poor timing.

Following are some of the realms of concern in connection with this decision.

Over-medicalization. The NCBTMB, the Commission on Massage Therapy Accreditation (COMTA), and AMTA all claim to be holistic in their orientation. Unfortunately, this assertion has increasingly become mere lip service. There is no mention of any increase in training hours or emphasis of subjects pertaining to the art of massage. By adding pathology and A&P requirements exclusively, these organizations are contributing to the medicalization of our field. Recent history gives no basis, other than sheer defensiveness, to these groups' claims to holism.

The holistic emphasis of massage includes scientific competence, but goes beyond it, into the development of creativity, sensitivity, and the evolution of massage/bodywork as a true healthcare modality. Massage is not primarily a medical treatment. Most state laws explicitly state so. Nonetheless, the NCBTMB, COMTA, and AMTA persist in the medical orientation and are selling out our most precious birthright - massage as a unique healthcare modality. Although there has been quite a bit of emphasis these days on the clinical, I have yet to teach a group of students who, when presented with a holistic vision, didn't heave an enormous sigh of relief. It's like waking from a spell. Virtually everyone in massage, when presented with a clear vision of holistic practice, prefers its scope and heart to the exclusively medical model of massage.

To be perfectly clear, I have nothing particularly against pathology and anatomy hours being required - only that hours in those subject areas be appropriately balanced by hours pertaining to the realm of health and the refinement of the therapist's sensitivity. This approach might include important subjects such as what is health; what is care; quality of touch; energetic as well as physical assessment skills; creative session design; looking more deeply at issues of pressure, rhythm; what to leave in or out for whom; how to combine modalities appropriately to address the individuality of the client; and deeper exploration of the inspirational and aesthetic dimensions of massage.

Reduction of the diversity of educational approaches. The current requirements allow for 100 hours of anatomy/physiology, a minimum of 200 hours of massage and/or bodywork and the remaining hours in whatever the school chooses to complete your massage and/or bodywork study. The new requirement will, if programs remain at 500 hours, reduce the discretionary hours by nearly one-third. Currently, these hours clearly allow for a variety of approaches and diversity of education. That is not progress; this is a step backwards.

Ethics and poor judgement. I was told by the NCBTMB that this decision was announced to the profession in January. I immediately checked with three other leaders in our field and not one of them knew about it. I had received an elaborate NCBTMB orientation box in February - the change was not mentioned. So how was this announced? It was on their website. This would be like billing my students for a new tuition while telling them it had been announced somewhere on our website.

I have also been told that schools don't have to adopt these new requirements.

However, when the National Certification Exam is required by 23 states, can the NCBTMB be so naïve as to say we're free not to comply?

Timing. Our students alerted me to this decision. Reading the website, they were panicking at the published timing for the new requirements going into effect. Many schools have students enrolled in programs that do not finish until 2005. And most well-run schools plan their overall curricula and schedules at least a year in advance. This timing and the confusing language of the announcement is flabbergastingly insensitive with respect toward schools, students, and therapists. It is ironically in line with the lack of heart in the new requirements.

I issue a call to the massage and bodywork profession:

• Our profession must rise up and refuse the top-down micromanagement by the NCBTMB, COMTA, and AMTA and any other organization that threatens the precious diversity within our profession.



• The NCBTMB must withdraw its decision to add pathology and A&P hours without a corresponding strengthening of the health-promoting, right brain, imaginative, and heartful side of massage. It is time our profession begins to walk again on two feet, honoring art and science, instead of just hopping on one, increasingly to the tune of insurance companies. It is time to walk the walk, not just talk it.



• I recommend the formation of a task force to explore how the profession can proceed on both feet - emphasizing the art and the science of massage and bodywork. I call upon the NCBTMB to declare a moratorium on curriculum changes mandated until this task force has been convened to explore how the profession as a whole can proceed and with the precious legacy of holism intact.

It certainly can be more difficult to test people on their sensitivity than on their knowledge of anatomy. This difficulty is perhaps our greatest challenge as a profession. Without the resolution to develop both the art and science of massage and bodywork, we will develop only the science. And, shortly, we would be little different in philosophy or practice from the allopathic healthcare fields.

This is our birthright - to facilitate a higher level of health in the body, mind, and spirit. Massage and bodywork do go beyond the medical. That is largely why people seek it out as an alternative, and why we need to further develop and protect it in every way we can. We hold the future of our profession in our hands.

As a professional therapist and educator with more than 25 years of experience, blood, sweat, tears, and joy in this profession, I urge you to stop the NCBTMB from attaching the shackles of the medico-industrial-academic complex on our profession. Returning to the issue of National Massage Safety - it may be critical at this time that the profession as a whole works together to keep itself safe from the current tendencies dominating the NCBTMB.

Massage is a freedom-loving profession. To keep it that way, let your opinion be known. Let's keep our freedom in our hands. And, by every means possible and necessary, let us keep the beautiful dream of healing through the science and art of touch alive in our hearts.

You can contact the National Certification Board for Therapeutic Massage and Bodywork at 800/296-0664 or visit www.ncbtmb.com.

David Lauterstein is co-founder of The Lauterstein-Conway Massage School in Austin, Texas. He is the former editor of the Massage Therapy Journal, author of Putting the Soul Back in the Body, and an international teacher of Deep Massage and Zero Balancing. He can be reached at dltlc@io.com.

Viewpoint is an open forum for issues of concern to massage therapy practitioners. It does not necessarily represent the opinions of Massage & Bodywork magazine, its staff, or its publisher, Associated Bodywork & Massage Professionals.