CONNED - Critique of New NCBTMB Eligibility Determinants

CONNED — Critique of New NCBTMB Eligibility Determinants

Keith Eric Grant

Fairly recently, the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) revised their eligibility determinants. It's worth a look to see where massage training is going and what it means to practice.

Eligibility Determinants

From the January 2006 NCBTMB Candidates Handbook
<http://www.ncbtmb.com/forms/exam_handbook_jan06.pdf>

If enrolled in a program prior to June 1, 2005

a. A minimum of 500 hours of in-class, supervised instruction, broken down as follows:

100 of in-class clock hours in Anatomy/Physiology
200 in-class clock hours in Massage and/or Bodywork Theory and Application. This must include at least (2) in-class hours in Ethics
The remainder of your in-class clock hours must be in a related field — something that completes your program of study.

b. Graduated from an established school that is approved as a state-licensed training institute to provide massage therapy and/or bodywork in the state in which it is located and meets NCBTMB’s criteria to receive a school code. If not licensed, the school must be able to show that it is exempt from licensing status.

If enrolled in a program after June 1, 2005

a. A minimum of 500 hours of in-class, supervised instruction, broken down as follows:

125 hours of in-class, supervised instruction in the body’s systems and anatomy, physiology and kinesiology
200 hours of in-class, supervised instruction in massage and bodywork assessment, theory, and application
40 hours of in-class, supervised instruction in pathology
10 hours of in-class instruction in business and ethics (a minimum of 6 hours in ethics)
125 hours of additional in-class, supervised instruction in an area or related field that theoretically completes your massage program of study.

Critique of Determinants

Both the new and old eligibility determinants require 500 hours of supervised, in-class instruction. The practical effect is that this is a body count (or gluteus in seat) requirement for students to commute and burn gas.It also is likely a an attempt to stiff the increasing competitive advantage of career and community college's use of distance education. It does not specify that students can't be instructed by remote broadcast, be shown pre-recorded material, or be assigned to computerized lessons, only that this has to occur in a classroom with a faculty warm-body present. The determination of what material is didactic, and could be well-handled by distance education, and what part is kinesthetic training is not considered.

The revised determinants change 100 hours of anatomy and physiology to 125 hours of anatomy, physiology, and kinesiology. In a separate determinant, 40 hours of pathology is added. To my knowledge, no specific needs have been determined or outcomes to practice (i.e. the graduate will be able to answer or demonstrate …) documented for either of these changes. Ten hours of instruction in business practices including a minimum of six hours of ethics have now been set as a separate determinant. Previously, a a specification for two hours of ethics was folded into another determinant. Two-hundred hours of bodywork theory and application have been changed to 200 hours of massage and bodywork assessment, theory, and application. A final segment of time must only be related to the practice of massage and bodywork, giving the impression that this determinant serves no specified need other than to pad the hours. All determinants repeat the “body-count” specification for in-class, supervised hours.

The only determinant that is specifically not didactic is the “application” in the 200 hours of assessment, theory, and application. I would assume that, like ingredients on a can of soup, those considered to be most important come first and occurring in the smallest amounts come last. Even here, much of the applications could be taken as a didactic exercise in assessment and theory; i.e. completion of case studies. Given that licensing requirements for practice are generally specified only in hours at an approved school and passage of a certification exam, and given the vague yet largely didactic eligibility determinants set by the NCBTMB, one would conclude that the successful practice of massage, and thus the training, is overwhelmingly based on didactic knowledge.

The massge profession has essentially defined an orchestra whose members are music historians and theorists. If the massage profession is going to bemoan the loss of kinesthetic skills, the situation can be seen as a self-inflicted, unintended collateral damage from NCBTMB and AMTA certification elegibility and licensing goals. The problem is not a matter of how schools implement our values, but in what our explicit values have become.

The insistence of the NCBTMB on exclusively in-class hours is arbitrary. The vast majority of the required coursework is of a didactic nature well-handled by distance education methods that are well-developed. Moreover, such an insistence seems yet another action by the NCBTMB designed to open them to an anti-trust action. This observation is somewhat strengthened by the tendency of the NCBTMB, in paragraph (b) of both the old and new determinants, to second-guess the states in the definition of an approved school.

In closing, I'll note that states generally specify that one must pass the NCE, not be certified by the NCBTMB. My understanding is that there is a first amendment freedom of association issue here¹. As it turns out, the NCBTMB has made accommodations to such language. In the application form it states:

If a candidate does not wish to become nationally certified, but is still required to take and pass the National Certification Examinations in order to practice in a particular jurisdiction, then he or she may select, NCBTMB National Examination for States Licensing (NESL) option.The NESL option is available to any candidate who is denied eligibility for certification through NCBTMB, either by the traditional application or portfolio review process. In addition, the NESL option is available to candidates who do not wish to become nationally certified or do not meet the eligibility criteria that are outlined in this the National Certification Examination Candidate Handbook. Candidates who select the NESL option are not required to submit notarized copies of diplomas and/or official transcripts. However, candidates are still required to adhere to all policies and procedures associated with the examinations, as they are outlined in the National Certification Examination Candidate Handbook."

In short, if a person otherwise meets licensing requirements except for passing the NCE, the NCBTMB provides the test. This makes the in-class, supervised, as well as other specific requirements moot, as long as one can pass the test and is interested only on becoming licensed, not on become certified by the NCBTMB. Note also that the wording applies to any jurisdiction requiring passage of the NCE, not just to licensing states.

¹eg. Supreme Court Petition 2004-0446. The First Amendment protects the right to refrain from speaking and the right to refrain from association. See, e.g., Wooley, 430 U.S. at 714, 97 S. Ct. 1428. Moreover, the government may not compel individuals to fund speech or expressive associations with which they disagree. See United Foods, 533 U.S. at 411, 121 S. Ct. 2334.

Conceivably, such decisions could affect even a state's ability to require use of the NCE, to the extent that NCBTMB has clearly become not just a provider of exams but an advocate for its perspectives and funds such promotional activities from proceeds from mandatory exams.

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Last modified: 21 May 2006