Issue link: https://www.massageandbodyworkdigital.com/i/640605
C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 43 PATHOLOGY PERSPECTIVES to surgical procedures, caring for terminally ill loved ones, chronic pain, burn scars, and many other circumstances shows that symptoms are often reduced and quality of life improves with massage therapy. Some evidence also suggests that the more massage a person receives, the longer lasting the benefits are. But we don't know the mechanism of these effects, and they do not appear to be universally generalizable. Further, we don't know that massage therapy is substantially more effective than other interventions like yoga or exercise. What does that mean for our profession? I see three main questions to begin this discussion: Are Massage Therapists Mental Health-Care Providers? The temptation is to answer that question with a resounding no, but it's not that simple. If the evidence shows that massage therapy is effective for many clients with anxiety and depression, then it is not unreasonable to claim that benefit. Whether that makes our work mental- health therapy is another question. What Does Doing Therapy Even Mean? It is interesting to note that doing therapy is not a well-defined term, even within psychotherapeutic circles. Therapy can refer to any treatment intended to reduce illness or improve health. We call ourselves massage therapists, because we engage in an active intervention designed to lead to a positive outcome. But so do yoga teachers. And people who lead Pilates classes. And belly dance instructors. Dance, exercise, yoga—all of these have demonstrated value for mental health. Does that make the people who offer them mental-health therapists? Or is it more accurate to say that the mental-health benefits in these activities are simply a positive side effect of healthy activity? What Would a Mental-Health Specialty for Massage Therapy Look Like? At this time, it is possible to obtain advanced training in massage therapy to work with athletes, cancer patients, children, people with orthopedic injuries, pregnant women, and many other specialties. It doesn't seem farfetched to suggest that a specialty in working with mood disorders might also be possible. Indeed, in relaying the clearly and consistently positive findings about massage therapy in this context, Christopher A. Moyer, PhD, suggests the following: "Building on what is already known about the effects of massage therapy on anxiety and depression, everything possible should now be done to better understand and optimize the ways that massage therapy influences affect, the observable components of an individual's feelings, moods, and emotions." 1 To my knowledge, no advanced education program for massage therapists to work with this specific population exists at this time. If such a specialty were developed, here are some of the components it would need for it to be safe, ethical, client-centered, and within established scope of practice: • MTs need a well-developed team of other health professionals, specifically medical doctors, psychiatrists, psychologists, or other counselors who are available for consultation and referrals. • Clients need to be fully informed of the limitations of the massage therapy scope of practice and encouraged to include other professionals as their mental health- care providers; this includes giving permission for their provider team to discuss their case whenever necessary. • MTs need instruction in how to use validated anxiety and depression scales so they have a method of tracking progress for their clients; these scales should be consistent with the ones used by other members of the team. • MTs should be familiar with the principles of CBT in order to use communication practices that are consistent with the rest of the client's health-care team. • MTs must be able to recognize signs of mental-health emergencies and have the resources to take appropriate action for clients who are at risk of causing harm to themselves or others. • MTs must have access to their own support system of colleagues—a peer supervision group—with whom they can appropriately explore their emotional and professional challenges in working with this population. These suggestions are by no means comprehensive; this is simply a list of some of the skills and abilities that a massage therapist who wants to specialize in working with clients with mood disorders might need. The best role for massage therapy in the context of anxiety disorders is something of a moving target right now. But, if practitioners feel called to pursue this specialty, I hope they do so with the best possible support system for themselves and their clients. And, then, I hope they report back to the profession. Note 1. Christopher A. Moyer, "Affective Massage Therapy," International Journal of Therapeutic Massage and Bodywork 1, no. 2 (2008): 3–5. Ruth Werner, BCTMB, is a former massage therapist, a writer, and an NCBTMB-approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2016), now in its sixth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com.