Issue link: https://www.massageandbodyworkdigital.com/i/1451559
THE CURRENT STATE OF LICENSURE AND CREDENTIALING A credential is an external indicator that someone has mastered a pre-determined set of knowledge, skills, and abilities (KSAs) in a designated content area. Upon graduation from school, a massage therapy student receives a diploma or completion certificate from a school. Next, if the state requires it, they pass a state licensure test. Presently, 44 states require a license to practice massage therapy. Licensure is the main recognized credential for massage therapists at this time. Its primary purpose is to protect the public. However, massage therapy licensing has not solved some of our biggest challenges around questions of credentialing. The profession has dozens of specialties, but these can mostly be placed into two broad massage categories. The first includes those whose work is primarily general relaxation, often called "personal- care service." We can all agree that this type of work has health benefits, so please do not assume I am suggesting this first model is not beneficial for enhancing health and well- being. The second category specifically focuses on using massage to address compromised health conditions; this will be referred to as massage as a "health-care service." This model could involve treating pain or injury conditions, massage provided in a hospital with cancer patients, care of geriatric patients, or any number of other practice environments. The key distinguishing factor for this second category is that a greater understanding of working with compromised health conditions is necessary for effective and safe practice. One of the challenges facing the profession today is how to appropriately credential practitioners for each of these two categories. Initial licensure does a pretty good job of covering the primary KSAs when massage is used as a personal- care service. However, the scope of KSAs required to address compromised health conditions is far more complex. Practitioners work with much more complex client cases when using massage specifically as a health-care approach. As a result, there is a greater potential for adverse outcomes. One of the more critical lessons learned over the decades is that massage is not benign—it has profound physiological effects. It is important to verify that practitioners are adequately trained to work with clients needing specialized care. Some argue that for massage to be taken seriously by other health-care professionals, additional credentialing above and beyond entry-level licensure is necessary. Practitioners, educators, and other stakeholders, such as insurance companies, have recognized it would be helpful if there were some type of advanced credential for this second category of massage as a health-care practice. THREE MODELS OF CREDENTIALING Advanced credentialing is implemented in several ways. However, three models attract the most attention: tiered licensure, college degrees, and alternative credentialing. Admittedly, a move toward advanced credentialing will be an incremental process taking years to unfold fully. Let's look at each of these models and some of the pros and cons of each. TIERED LICENSURE There is only one level of licensure in states that regulate massage. In a tiered licensure model, there would be an advanced license level administered by each state in addition to the basic license. Practitioners who want to work with clients seeking massage to treat compromised health conditions would need to acquire additional licensure. Let's take a look at some of the benefits first. 52 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 2