In the last few years myomassology has been increasing in popularity, as a result in recent months I have been asked by several of my clients and the public what are the differences between these two therapies. I honestly did not know, so I decided to do some research to clear that up for my clients/public and myself.
While both therapies are aimed at improving the well-being of their clients, there are several differences between the two. Knowing the differences will allow you to make an informed decision about the care you receive and determine which therapy and treatment approach is right for you. This blog will illustrate and highlight the similarities and differences of massage therapy and myomassology by providing a comparison chart and further explanations of the following: 1) the definition of each, 2) titles used, 3) education, 4) registration process, 5) quality assurance, 6) professional conduct, and 7) insurance coverage for both therapies.
“Massage therapy consists primarily of hands-on manipulation of the soft tissues of the body, specifically, the muscles, connective tissue, tendons, ligaments and joints for the purpose of optimizing health.
Massage therapy treatment has a therapeutic effect on the body and optimizes health and well being by acting on the muscular, nervous and circulatory systems.
Physical function can be developed, maintained and improved; and physical dysfunction and pain and the effects of stress can be relieved or prevented through the use of Massage Therapy.”
(College of Massage Therapists of Ontario, CMTO)
“Myomassology teaches the integration of massage, chair massage, lymphatic drainage, reflexology, acupressure, and energy work.”
(Natural Health Practioners of Canada, NHPC)
The title Registered Massage Therapist (RMT), and Massage Therapist (MT) and their abbreviations are protected titles under the Federal Trade-marks Act.
Only individuals that are registrants of the CMTO may use this title, or claim to provide “massage therapy”.
You can check the CMTO website to view a list of practitioners illegally using this protected title.
The title Certified Myomassologist Practitioner (CMP) is a legal title held under the Canadian Examining Board of Health Practitioners (CEBHP).
There are variations of this title used including Licensed Myomassologist Practitioner (LMP), or Registered Myomassologist Practioner (RMP)
For the purpose of this article the title CMP will used.
Education/Training for an RMT is 2-3years depending on the school
Education/Training for a CMP is 6 months (3 weeks of home study each month, one week in class each month
Develop experience in a clinical setting by providing treatments/assessments to clients (members of the public) under the supervision of an experienced clinic supervisor for the duration of the massage program
Do not work in a clinical setting or work on the public during their schooling
Participate in specialized outreaches such as cancer, prenatal/infant, sports, geriatrics, etc. and provide treatments to these unique groups
Do not participate in specialized outreaches
Anatomy & Physiology: 16 months/visit to cadaver lab (252 hours)
Pathology: 12 months
4 months (42 hours)
Palpation: 4 months
24 months (504 hours)
4 months (42 hours)
Clinical Practice: 24 months (210 hours)
Nutrition: 4 months
Kinesiology: 4 months
12 months (126 hours)
Business: 4 months
Anatomy & Physiology: 3 weeks of home study through DVD & work book
Tuina Chinese Massage
Must receive a diploma from an approved massage therapy program and
MUST pass government board exams consisting of a written test of 150 multiple choice questions, and a practical examination
In addition pay a registration fee is due in order to become an RMT and obtain the right to practice massage therapy.
Must receive a diploma in myomassology by an approved school and pay a fee to the Canadian Examining Board of Health Practitioners (CEBHP) to become a CMP
REGULATED HEALTH PROFESSION
Massage therapy is a regulated health profession under the Regulated Health Professions Act (RHPA). The RHPA provides regulation for the scope of practice of 21 health professions in Ontario, under their respective Colleges.
These colleges were created by the Ontario Government to protect the public by ensuring safe, effective and ethical care by health care professionals.
Not a regulated health profession
As mandated by government legislation, RMT’s must participate in a
Mandatory Quality Assurance Program to maintain their RMT designation. There are three parts to this program, 1) Obtain Continuing Education Units, 2) Self Assessment, 3) Peer Assessment
Not mandatory to participate in Continued Competency Program, only if the CMP chooses to belong to the National Health Practitioners of Canada (NHPC)
Mandatory to obtain 30 Continuing Education Units (CEU’s) every 3 years as part of the Quality Assurance Program
Not mandatory, unless the CMP chooses to belong to the NHPC, they must obtain 20 Continued Competency Credits every 2 years
Peer assessed at random, or if RMT does not comply with the Quality Assurance Program. This is to ensure the RMT demonstrates knowledge, skill, as well as the health and safety of the clinic environment.
The peer assessor then reports to the Quality Assurance Committee (QAC) and they can chose to enforce the following if the RMT is not up to par with the CMTO standards.
1) Make recommendations regarding practice improvement, 2) Direct the RMT to complete specific remedial & refresher courses, 3) Give the RMT the opportunity to correct deficiencies.
Not Peer assessed
Must send proof of completion of CEU activity through receipts, certificates, and logs every 3 years to the CMTO
Members of the NHPC are selected at random draw to send in documentation of proof of completion of continued education
RMT’s must complete a self-assessment every 3 years to help identify current level of knowledge/skill as well as areas that need further development. This helps RMT’s choose what CEU’s to focus on
After completion of a continued education activity CMP’s (only members of the NHPC) fill out a form to explain what they learned and how they were able to incorporate the new knowledge/skill into their practice
Failure to comply with the Quality Assurance Program results in the RMT being referred to the Quality Assurance Committee, which has discretionary authority to enforce suitable consequences
If the CMP is a member of the NHPC and fails to comply with their Continued Competency Program, it results in possible discontinued NHPC membership and loss of any insurance, if there is a policy in effect
ENSURING PROFESSIONAL CONDUCT
RMT's are required to keep all client information confidential except as required or allowed by law or to facilitate diagnosis or treatment of a client. Failure to comply is considered professional misconduct
If you have a complaint regarding the care you have received from an RMT, you may file a complaint with the CMTO.
If the complaint cannot be resolved between the two parties an investigation will be initiated.
If an RMT is found guilty of professional misconduct as a result of negligence, malpractice, incompetence, or abuse they may receive the following consequences depending on the severity of the offence.
1) Suspension, or removal of their right to practice, 2) mandatory remediation program, 3) complete specific continuing education, 4) Limitations, terms, or conditions are set upon the registrant 5) verbal warning
All results of discipline hearings become a matter of public record.
There was no information posted on the CEBHP, or the NHPC websites indicating their policy on client confidentiality
If the CMP is a member of the NHPC or CEBHP, then this organization will review the complaint.
If the complaint cannot be resolved between the two parties an investigation will be initiated.
If the CMP is a member of the NHPC and is found guilty of professional misconduct by this organization the consequences for the CMP include the following:
2) Suspending registration of a member for a specified amount of time until certain conditions are met, limiting practice, 3) requiring a member to waive, reduce or repay a fee for service, 4) cancel the registration of the member
There are 3 reasons why members of the CEBHP, CMP’s, would fail to qualify for renewal, and thereby have their number suspended.
The 3 reasons are if 1) The CMP is charged and convicted under their local by-law, 2) is criminally convicted (pertaining to morality offence), or 3) fails to pay their annual dues to the CEBHP
CMTO has a ZERO tolerance policy for client/patient abuse (verbal, physical, sexual, or emotional). All complaints thoroughly are investigated.
The CMTO is committed to preventing abuse of clients in any form by educating their registrants, the public, and the clients.
There is no policy addressing this issue on either the CEBHP, or the NHPC websites.
Fitness to practice: This addresses situations where an RMT may be compromising client care as a result of incapacity due to a physical or mental condition/disorder.
As a result to protect the public the RMT’s practice may be subject to terms, conditions, limitations, or are no longer permitted to practice.
The CMTO imposes a rehabilitative, rather than punitive measures in cases of incapacity
There was no information on the CEBHP, or NHPC websites to indicate whether CMP’s are monitored or policed in regards as to whether they are fit to practice.
Mandatory Reporting: This refers to the obligation under the RHPA & Health Professional Procedural Code for RMT’s to file reports to the CMTO in a few instances.
1) Self Reporting: if you have any offence(s) against you, if you have had a finding of professional negligence or malpractice
2) Reporting of others:
· Suspected sexual abuse of a client by another RMT or health care professional
· Child abuse/neglect of a client
· Suspected elder abuse of a client
CMP’s are not required to report offences against themselves, or report sexual abuse, or child/elder abuse by another holistic Practioner.
SCOPE OF PRACTICE
Has a Scope of Practice, outlined by their regulatory college the CMTO
Scope of Practice
The practice of Massage Therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.
(Massage Therapy Act 1991)
Does not have a Scope of Practice
Swedish massage, Non-Swedish techniques like frictions, fascial work, joint mobilizations, remedial exercise, hydrotherapy, and client education
(See note below on other modalities)
Swedish massage, Reflexology, CranioSacral Therapy, Chair Massage, Acupressure, Chinese Cupping, Body Mechanics, Paraffin Therapy, Tuina Chinese Massage, Pregnancy Massage
RMT’s must carry a Mandatory $2 million liability policy
Liability insurance is recommended but not mandatory for CMP’s
Massage therapy is covered by extended health care insurance
Myomassology is currently not covered by extended health care insurance by most companies
2) To become a Registered Massage Therapist, individuals not only have to receive a diploma in massage therapy but also have to pass a government regulated board exam. This extra level of testing serves as a quality control measure by ensuring only competent therapists will be practicing massage therapy. This provides safety for the public by only allowing individuals that meet the standards of the CMTO to practice. Upon receiving a myomassology diploma, to become a CMP, there is no further testing such as a government regulated examination to become certified.
3) When receiving treatment from a health care provider that is a member of a regulated health profession, you can feel secure knowing you are receiving safe and ethical treatment provided by your therapist. The governing body for RMT's, the CMTO, number one priority is the protection of the public. Through legislation, regulations, standards and policies that have been set by the CMTO and other Colleges, regulated health care professionals are accountable to their regulatory College for the quality of care they provide.
Seeking care from a regulated profession protects the public in the following ways:
- Professional Conduct: by its members (RMT’s)
- Registration: A mandatory examining process is completed to ensure educational and college standards are met before registration designation is provided.
- Mandatory Quality Assurance Program: Promotes continued competence and advancement in skill/knowledge.
- Client Relations: each college under the RHPA has a zero tolerance policy for mistreatment or abuse of any client/patient.
- Discipline: A member can be suspended or stripped of their designation if they are reprimanded for professional misconduct, fallen beneath the standards of practice, or abused any member of the public.
4) By having to participate in a MANDATORY Quality Assurance Program to maintain designation as an RMT, it ensures therapists' keeps up to date on their skills, latest research in their field, and deliver safe treatment to their clients. In addition, by having to send in proof of completion rather than random selection, it holds the RMT accountable. Further, the peer assessment helps to ensure RMT’s are upholding professional standards by having a colleague physically check in to observe the practice of the RMT. Finally, the self-assessment component allows the RMT to self reflect on their strengths and weaknesses and identify areas for self improvement. As mentioned above, only CMP’s that are NHPC members are required to participate in continued learning.
5) Since the education and training for RMT’s is very intensive in anatomy & physiology, treatment/assessment, and mastering the hands on applications of Swedish/Non-Swedish techniques, the other modalities listed below (similar to what the CMP’s learn) are offered as continued education courses. RMT’s may take courses in these other modalities once they have demonstrated their knowledge/skill and have become registered with the CMTO. These other modalities are not taught as part of the regular massage therapy curriculum as there must be a strong understanding of anatomy & physiology before these courses can be taught safely and thoroughly understood.
Modalities in the Scope of Practice of Massage Therapy for continued education for RMT’s include, but are not limited to: (This is not a complete list, but most common modalities)
Active release, Acupressure, Acupuncture, Cranial sacral therapy, Deep connective tissue, Hot stone therapy, Labour support, Manual lymph drainage, Neuromuscular therapy, Reflexology, Rolfing, Shiatsu, Thai massage.
6) The importance of MANDATORY liability insurance speaks for itself. This protects you as a client in case an injury may occur as a result of treatment or accident in the clinic. Not all CMP’s may carry liability insurance.
7) The CMTO governs which courses/modalities are within RMT's scope of practice. The importance of having a scope of practice protects the public by outlining what modalities are within the limits of an RMT’s capabilities and knowledge, thus keeping the public safe. This ensures that RMT's will not be practicing a technique that is out of the realm of their qualifications, which could produce harm to their clients. CMP’s do not have a defined scope of practice that guides which modalities are safe for them to employ into their practice.
8) The importance of the massage therapy being covered by extended health care is important if you have this coverage. As mentioned above most insurance companies currently do not cover myomassology. Before receiving a treatment from a CMP check with your insurance company to see if this type of therapy is covered under your plan.