Core Issues

The Massage therapy Profession is at a pivotal moment. Beneath the surface of our profession lies a web of complex challenges that affect every therapist, educator, and organization. From the lack of educational standards and low pay to infighting among associations and the absence of a professional framework, these issues are shaping the future of massage therapy—often in ways we might not realize.

After 38 years in the profession and the last 20 or so watching the many aspects of the profession, I will dive into the core issues holding back progress, unpack their impact on the profession, and explore what it will take to create meaningful change. Whether you’re a seasoned therapist, an educator, or just passionate about the field, understanding these challenges is the first step toward building a stronger, more respected profession.

  1. Practice Framework – Most professions have what is called a Practice Framework that directs many of the other things like licensing, legislation, and include a vision, mission, definitions of terms, scope of practice (Model Practice Act), Education Standards, curriculum (ELAP), licensing, career progression (Massage school, Board Certification, Specialty Certifications, Degrees) that is updated regularly. The Massage Profession has pieces of it but they are not implemented which often leads to fighting fires in the massage profession (DoE ruling, license portability, Illicit businesses, etc).
    Learn more about Practice Frameworks.
    Learn more about Competencies
    See also: Defining the Massage therapy profession
  2. Licensing and legislation reform.
    • Update the Body of Knowledge and use it to define the scope of practice and implement similar scope of practice in each state. Use the BOK to inform boards and massage schools about the required knowledge, skills and abilities.
    • Our educational requirements vary state to state and many are unaware of the Entry Level Analysis Project’s (ELAP www.elapmassage.org) recommened hours and competencies.
      Learn more about Competencies
    • Continuing Education.
      Move CE requirements in licensing language to Continuing Competence. What is it?
      See the CE Conundrum. State boards require Continuing Education that varies greatly and does not provide continuing competence (CC). CC is different than CE and different from Professional Development. CE and PD should be the responsibility of our professional associations.
      See also the preliminary research on the effectiveness of CE vs CC and PD.
      Learn about the history of CE in the massage therapy profession to understand more on this important issue.
    • Update if needed Model Practice Act (PDF) created by the Federation of State Massage Boards and implement in every state.
    • Figure out Stronger Language to help untangle massage therapy from sex work. Look into city/county ordinances and things like the landlord engagement project by the Network Team (www.thenetworkteam.org)
  3. Licensing portability.
    • Consistent licensing requirements, education requirements, ce requirements, draping requirements, ethics requirements, unlicensed practice laws will improve the image of the massage profession and allow massage therapists to work in other states more easily.
    • IMpact – Interstate Massage Compact is in progress. It shows us where the gaps are in our consistency in licensing and legislation issues. See a line by line analysis of the IMpact. to better understand it.
  4. Combating illicit massage businesses.
    • Untangling Massage from sex work
    • Hands Off Our Name: Massage is Therapy
    • Study Establishment Licensing Laws to see if they are working to untangle massage from sex work and is law enforcement more able to shut these places down.
    • Create Model Ordiances for cities/counties
  5. Integrating massage therapy into healthcare systems.
    • Massage is Healthcare no matter where massage is given – in spas, resorts or clinical settings. Learn more about the history of massage therapy in healthcare.
      2000-2024 – Timeline History of Massage therapy in healthcare.
      1700-2018 – Timeline History of Massage therapy in healthcare.
    • Learn about the history of the word Medical Massage part One and Part Two 2000-2024.
    • Remove the term Medical Massage and replace with Clinical Massage. See the Medical Massage Conundrum and the problem with so called Medical Massage Certifications.
    • Create Clinical Massage Competencies and Implement.
    • Create Clinical Massage CERTIFICATION. Learn about the use of the terms Certification vs Certificate
    • Get Massage Therapy covered by Health Insurance, Medicare, Medicaid and provide support for working with insurance in the form of advocating for fair pay, fair benefits and adequate networks.
  6. The Massage Therapy Workplace
    – Educate employers and employees on misclassification of employees as independent contractors.
    – Support Unionization of Massage Therapists and/or better working environments. (What other profession is paid only when they have clients?)
  7. Preserve and Protect History of the Massage Therapy Profession.
  8. The Call for Clinical Supervision
    Clinical supervision is a relatively new concept in the massage profession, offering therapists a supportive environment to process client interactions, set clear boundaries, and prevent burnout. Engaging with a more experienced therapist through supervision helps practitioners understand their motivations, establish effective client relationships, and attract ideal clients who value massage. This process is essential for personal and professional growth, ensuring therapists meet their own needs while providing client-centered care. Look into making it a requirement for licensed massage therapists.

Scroll to Top