The Need for CE and Advanced Credentialing

I have been having some interesting conversations with industry leaders in the last couple of weeks about continuing education and advanced credentialing. I’ve also participated in some lively social media discussions around these same subjects. There are certainly some strong feelings and opinions about continuing education requirements in our field.

More than once I have heard comments referring to our existing continuing education process as a racket. Some say it is ineffective and only serves to be a moneymaker for certain individuals and organizations. I’ll be the first to admit that our current system has its fair share of problems. For example, there are a huge number of courses which have been approved for continuing education credit that really shouldn’t be. I think most people are in agreement that this is the case, so now we have the challenging process of undoing and cleaning up this situation.

Why Continuing Education

So I also hear many people ask—“What is the reason there are continuing education requirements”? Continuing education course work is required in many professions, and especially in the healthcare field. The primary idea is that it helps individuals stay current with recent changes in the field. It also helps them grow as professionals. Those are clearly important factors that stand as a good reason for continuing education. However, there is a very important and underlying issue rarely mentioned in these discussions.

In our field continuing education fills a completely different role as well. Our profession really has a split personality. We are preparing individuals for work environments where massage is primarily used as a personal care service (spas, cruise ships, etc.). Yet, the greatest number of massage therapists work in environments where clients seek their help for some type of compromised medical condition or pain complaint.

This division of massage as healthcare profession vs. personal care has plagued us for decades. The primary problem is that state credentialing and massage school curricula only have one set of criteria for massage therapists and don’t make a distinction between these two divisions. As a result, we have one set of training standards attempting to prepare massage therapists to work in two very different work environments. Our current set of training standards do a pretty good job of preparing massage therapists to work as professionals in the personal care service sector (although we could always improve). However, we are far from producing training for entry-level massage therapists that prepares them to work in healthcare environments as a competent health care professional. AND THAT IS WHY CONTINUING EDUCATION CONTINUES TO BE IMPERATIVE FOR OUR PROFESSION!

Our Future and Tiered Credentialing

Massage therapists who work in healthcare environments are predominantly gaining their advanced clinical skills through continuing education courses. There are many who argue that we need a dramatically greater number of hours for entry-level training of massage therapists in order to address this deficit. However, many of those massage therapists who have no desire to work in the traditional healthcare dimension of massage argue there is no reason for them to go through this level of extensive training if they aren’t going to work in a healthcare environment. (And let’s please not get sidetracked by the statements that there are health benefits to personal-care massage and that this approach is also therapeutic. Of course there are and of course it is! However, what we’re talking about here is a work situation where the primary intent of the practitioner is to address compromised health care conditions, as opposed to massage that is offered primarily for a sense of relaxation and well-being).

So if we have this division and we do not have adequate training for healthcare professionals in our entry-level training, then continuing education plays a dramatically more important role in preparing individuals to work in healthcare environments. But that brings us to another problem. There is no  standard or credentialing within our field that says what additional training is needed.

There has been a great deal of discussion about tiered credentialing in our field for some time and this seems like the most reasonable way to address this issue. However, if we are using continuing education courses for this additional training, how do we standardize them? There is another inherent problem here in that so many continuing education courses are built around personal philosophies of the guru individual who supposedly invented or created some new technique. Note that the vast majority of continuing education courses are about learning techniques and not about many different facets of rehabilitation science. See Paul Ingraham’s great discussion of this in his article on Modality Empires.

I have taken part in a number of efforts to address this credentialing issue, and each one of them succumbed to logistical challenges or other problems that prevented them from coming to fruition. Up until this time there did not seem to be a way to standardize a large quantity of the training that was predominantly about rehabilitation science and not necessarily focused on a particular technique.

Attempting to solve this problem is the primary motivation behind the development of our new Clinical Rehabilitative Massage Specialty Certificate program in partnership with the NCBTMB. This program includes hands on training that can be acquired from a number of partner instructors, along with a comprehensive online hybrid training program that emphasizes key facets of rehabilitation science. You can learn more about the CRM Specialty Certificate here.

I hope this program becomes a first stepping stone in the direction of us having reasonable tiered credentialing that can address this primary problem in our field. In the meantime, I think it is crucial that we continue to recognize the great additional load that we have placed on continuing education within our field to make up for training deficiencies at entry-level for healthcare-oriented massage. This is one of the main reasons that it is important to closely examine the curriculum and content in these continuing education courses in even greater detail.


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