Critique Essay- Massage Therapy Body of Knowledge
California Intercontinental University
GRC 600: Doctoral Academic Study and Writing
Professor Nigel Basta
March 18, 2018
In this article, we will be discussing the Massage Therapy Body of Knowledge. The authors of the MTBOK Taskforce, includes Bryan Fong, Megan E. Lavery, Kevin Pierce, Susan G. Salvo, Steven Schenkman, Dawn Schmidt, JoEllen Sefton, Michael J. Shea and Chip Hines. It involves members who are volunteers that contributed their time and experience to help create this body of knowledge. The article elaborates why this document was articulated. The major goal is for the BOK to epitomize the massage community as a learning document. Therefore, defined as an essential mastery intelligence of skills and abilities for this practice. Since there is lack of learning in this occupation, it caused issues in areas of wellness and within the healthcare communities. Allied healthcare professionals and representatives partook a series of meetings to address issues and concerns that involved the massage professionals. This material sponsored by the following organizations. American Massage Therapy Association (AMTA), Associated Body Work and Massage Professionals (ABMP), Federation of State Massage Therapy Boards (FSMTB), Massage Therapy Foundation (MTF), and the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The massage therapy MTBOK is a body of expertise that will define the operational elements in this profession.
The training of massage therapy includes a patient session aimed at supporting the therapeutic objective. Since massage therapy is such a diverse field, it has been deficient in formal body knowledge. This deficiency has hindered the advancement, profession, acknowledgment, and recognition within the medical community. The BOK would serve as a system and instructive base to guide future expansion. After a nationwide search, beginning in 2009, five groups came together for this effort and produced a task force from diverse areas of the profession. There were over eighty inquiries received, and sixty-seven applicants considered. A standardized rubric for the BOK was not available. To complete the project development, the principles and processes of the effective project management were established. This work was accomplished by using phone conferencing two to four hours and weekly conference calls. The task force was divided into two teams determined by the subject specialty to facilitate development. The first specialty was the description of the field and the second by the practitioners KSAs. The task force used educational practice to generate a rubric of a taxonomic structure and criteria that would rate the levels of importance for the KSAs founded through experience, data, and research. An evaluation of documents, state laws and guideline, interviews, exam content, and public comment resulted in this elaboration. This type of therapy contains various techniques for the customer, which includes the following: treatment of pain injury, leisure, stress reduction, wellness, improved movement, body awareness, and balance and connection of body, mind, and spirit. Practiced designed settings for these types of therapies encompass hospitals offering massage therapy for patients, massage clinics for injury rehabilitation, and palliative oncology care clinics and multidiscipline clinics with acupuncturists, physical therapists, medical doctors and naturopathic physicians providing unified healthcare. In addition, independent offices, athletic training facilities functioning with professional athletes refining performance, retreat centers spas to help reduce stress, and even in airports while traveling. Massage therapy is a preventative care and wellness occupation that contains manipulation of soft tissue. Which entails of assessment, regimen planning, and recovery of soft tissue, vascular fluids, and energy fields concerning and advancing all of the body systems for therapeutic purposes. This type of treatment requires hands-on components such as hands, forearms, elbows, knees, and feet. It may also include heat and cold, hand-held tools and eternal apparatus. The KSA that is the knowledge, skills, and abilities, elaborates on what is and is not included the scope of practice in both entry level and experience levels. In addition, it includes definitions and terminologies. This provided insight regarding the overall bodywork history and culture and the understanding and overview that it influences. The anatomy and physiology along with relevant medical terminologies that relate to this information.
The purpose of the study was to implement a framework and offered resources because of the limited understanding of the practices and methods used in massage therapy. The criteria included accurate information with statistical data. In 2009, the five organizations wanted to provide an outline along with resources, so they agreed to not be involved nor have approval authority over the content. A yearlong timetable formed choosing eight task force members. The MTBOK first draft was sent to over fourteen massage and health field organizations via press releases and available in Adobe Acrobat form on the website for all stakeholders. In hopes of encouraging, massage professionals to participate in the MTBOK project, announcements there done through email lists to professional associations and school organizations. Over twelve hundred comments received online from the surveymonkey.com. This produced a three hundred and seventy-three-page comment tracking document that used for reviews, debates, and consensus by the task force. Observations were taken in person from September 2009 to December 2010 at six public locations: Florida, Minnesota, Utah, Virginia, and Washington. This system allowed stakeholders to address topics and concern in specific areas. The first draft publicly presented at the first stakeholder session at the 2009 AMTA national convention and the second draft released in January 2010. The final MTBOK version 1.0 was presented on May 15, 2010, and available for download at www.mtbok.org. This version is regularly revised and maintained so that it can serve an innovative profession. This document was suggested to be revised every three to five years. Therefore, there were seven principles used that guided the task force at every stage of the progress process. The first was the inclusion phase which included the stakeholders participating. The second was the transparency which was the communication to be maintained with all the major professional stakeholders and access at all stages of the development. The third is the validity of the document which is to be vetted and continue to advance and ongoing review of the MTBOK. The fourth was that his document would be applicable across the full breadth of massage therapy. The fifth was to have the task force independent from the control or influence of any stakeholder or professional entity and must share the results across the board of profession. The sixth would have flexible conditions and involved as conditions changed. Lastly, the relationship of the stewards would have a collective agreement and ground rules. The clarity of the language delivered was precise in regard to terminology for both entry level and post graduate levels. In section 120, provides definitions with the types of pressures applied and the type of instruments used on clients. In addition, document client’s history intake interview and assessments. Next, the competency requirements were introduced in section 200. Anatomic and physiology 210.2 information was included and elaborated along with the functions, interactions, and relative medical terminology. The anatomic organization expanded on the structures and functions, metabolic functions, homeostasis, body positions and movement, and human development, skills, and abilities. Kinesiology in 210.3 emphasized the abilities of movement and terms of motions along with types of force. Pathology resulting from injury and diseases along with understanding mental health illness in section 210.4. The educational skills and abilities of the assessment process, treatment planning, documentation, procedures and relative terminology. This includes physical assessment and treatment plan in 210.5 section. The qualitative and quantitative research was explained in section 210.6 which included the process of scientific investigation. In section 210.7 business practice laws and regulations were offered regarding the importance of municipal, state, and national laws. This involves the employment overview, insurance for therapy, insurance billing, finance, marketing, and administration. The boundaries of ethics and therapeutic relationship which entails client patient disclosure and confidentiality along with body language. The code of ethics of harassment and discrimination and sexual misconduct in 210.8 section. The sections on 210.9, 210.10 and 210.11 elaborate on body mechanics and self-care, massage techniques, therapeutic modalities. Section 300 offers a comprehensive detailed definition for the terminologies used throughout the body of knowledge.
The MTBOK is about the body of knowledge for massage professionals that addresses the reasons why this document was created. The MTBOK task force attempts to use terminologies and methodologies because of the limited understanding of this type of treatment and the use of indication because it is partially recognized in the healthcare field. I believe that massage therapy professionals have issues with the health care system due to their billing, marketing, and educational requirements. Therefore, after extensive research of other similar careers, I believe the massage therapy body of knowledge is informative but not sufficient enough to be accepted within the health care system. For example, in most cases, one can purchase a gift certificate where you can’t for physical therapy, medical appointment or chiropractor. How could massage therapy be considered “medical procedure” if the price for one-hour full body massage could be $39 – lately a common offer – while a copayment to physical therapy office visit runs $30 average and the reimbursement for physical therapy session averages at $180. (Prilutsky, 2014). There are many benefits of receiving massage therapy such as massage can lower blood pressure, increase circulation, reduce stress, provide pain relief, and much more. That’s why many physicians are now referring patients to massage therapists as part of their overall plan for care. (Massage Therapys Expanding Role in Health Care, n.d.). A lot of the scientific research on massage therapy is preliminary or conflicting, but much of the evidence points toward beneficial effects on pain and other symptoms associated with several different conditions. Much of the evidence suggests that these effects are short term and that people need to keep getting massages for the benefits to continue. (Massage Therapy for Health Purposes, 2017). In a multisite study over three hundred hospice patients with advanced cancer agreed that massage helped relieve pain for these patients. Another study concluded that those with chronic neck pain found that a therapeutic massage was more beneficial in improving and relieving symptoms. (Massage Therapy: Get Facts about Types and Benefits, n.d.). Many would agree that it is relaxing and decreases cortisol levels in the body and it also alleviates tension and reduces stress. Consistent massages assist with lowering the blood pressure which decreases anxiety, hostility, tension, and depression which in turn decreases risks or heart attacks, strokes, and or kidney failures. Muscle relation is promoted by eliminating tense muscles, increasing flexibility, and provides relaxation. The hand pressure used improves circulation by using therapy consistently. Many people experience back, muscle and neck pains and can improve posture. Also, massages can strengthen the body’s immune system. “Studies have indicated that regular massage sessions not only help reduce stress but can also boost the immune system’s cytotoxic capacity (activity level of the body’s natural “killer cells”) and enhances the body’s ability to deliver nourishment. (7 Benefits of Massage Therapy, 2016). However, a massage therapist can enroll and complete a massage therapy program in a short time frame. To complete, the individual must obtain three hundred thirty to one thousand hours. The American massage Therapy Association in New Jersey requires five hundred hours and twenty hours of continuing education units biannually. (Online CE Courses for Massage Therapists | American Massage Therapy Association, n.d.). In contrast from a massage therapist’s education, the physical therapist meets with individuals who are recovering from surgery or who were injured. While physical therapy helps patients to improve and move on, massage therapy works in a holistic way. In addition, most physical therapy wellness sessions last about twelve weeks for an average of sixty-minute sessions. (McMillen, n.d). The methods used are strengthening, flexibility, range of motion and aquatic exercises. The physical therapist must obtain a doctorate degree. The bachelor’s degree must include biology, psychology, chemistry, physics, human anatomy, and physiology. They must pass two major exams, one is from the National Physical Therapy offered by the Federation of State Boards and a law exam as well have a license to practice in the state. Similarly, the occupational therapist requires a master’s degree. In the beginning of this degree, they take courses in behavioral, neuroscience, functional anatomy, and kinesiology. In the latter part of their master’s is spent gaining clinical experiences in different health settings. This allows the professional to choose field work in pediatrics, mental health, geriatric, or physical disabilities. They must be state licensed that is accredited by the American Occupational Therapy associates. Whereas, Chiropractic medicine is to correct alignment problems in the spine and other parts of the body which comforts pain and support the body’s natural ability to heal. One must obtain a Doctor of Chiropractic degree which may take three to four ears to complete. The final phase includes clinical training with students in clinical internships and to practice one must have a license in their state. It can take seven to eight years to complete the necessary education. Finally, the issues with billing is that “According to the Institute for Integrative Health Care, all 50 states allow you to bill insurance companies for massage therapy services related to on-the-job injuries—workers’ compensation—and injuries associated with automobile accidents. Your clients will need doctor referrals.” (How to Get Approved to Accept Insurance for Massage Therapy, n. d). In general massage therapy is not covered by Medicare and Medicaid. Also, some massage therapists do not accept health insurance because of the headaches associate with the process and the substantial amount of paperwork. “Claim forms differ depending on the type of coverage that is paying or reimbursing for the therapy. If the claims are not filled out properly, the medical billing codes aren’t entered correctly, and other proper documentation is done incompletely or incorrectly, the therapist will not get paid for their services, which then results in business losses. This is especially hurtful to the individual therapist with a private practice. For this reason, many massage therapists will not accept insurance.” (Are Massage Therapy Services Covered by Medical Insurance, Medicare, or Medicaid?, 2017). The one main reason is due to the current classification of massage therapy in the broader set of medical services. This kind of treatment falls under a category known as Alternative or Complementary Medicine. This career is not defined under the Affordable Healthcare Act as vital benefits; thus, insurance companies are not required to cover it, so insurance companies tend to not cover massage therapy as it is not under strict regulation and can’t be completely verified as legitimate.
While the body of knowledge is to promote evolution and advancement within the profession, massage therapy will need to incorporate more education and hands on experience to gain recognition within the health care organization. The MTBOK serves as a foundation for growth development and infrastructure for massage therapist professionals. Unfortunately, it is still frowned upon and regardless of the amount of knowledge provided, this career must still prove worthy of recognition to be accepted by the health care community.
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