Licensing and certification are important for any profession. They indicate levels of education, knowledge, and experience that the public can trust. We license drivers for safety. Your architect is licensed. So is your doctor. Your contractor is too. These licenses give us a little peace of mind that the practitioner actually knows what they are doing and, at minimum, has demonstrated that knowledge. Many times, that demonstration of knowledge comes in the form of an exam. It’s the same for massage therapy.
In massage therapy, a professional exam is now required in many states (but not all) in order to become a “Certified Massage Therapist” (CMT) and to get a license to work or do business. The nationwide professional exam is called the MBLEx, an acronym for Massage and Body Licensing Examination. It’s a challenging, well constructed evaluation tool created with input from many medical and wellness professionals (including experienced massage therapists) and governed by the Federation of State Massage Therapy Boards (FSMTB).
What does the MBLEx exam cover?
The MBLEx checks knowledge, comprehension, and application focused on eight areas:
- Anatomy & Physiology: Requires a deep understanding of body systems, their functions, along with concepts dealing with tissue injury and repair.
- Kinesiology: Tests components and characteristics of muscled, including location, attachment, actions, fiber directions; as well as joint types and structures, and range of motion.
- Pathology, contraindications and special populations: Tests knowledge of common pathologies and skills in identifying pathology-related, site specific contraindications. It also covers common medications and special populations.
- Benefits and Physiological effects of massage techniques: Evaluates knowledge about the effects of massage on the body, psychological aspects and benefits to touch, benefits of massage for specific client populations, massage strokes and sequences, and using hot/cold therapy with clients.
- Client assessment, reassessment & treatment planning: Checks the ability of the therapist to understand medical and health information and use that information to plan a massage session. It covers how to assess posture, range of motion, and muscle issues through palpation (touch). It tests the ability to evaluate client information and formulate a session strategy.
- Massage & bodywork history, culture, modalities: Checks general knowledge of the origins and development of the practice of massage and checks skills used in contemporary massage. It also evaluates knowledge of a broad spectrum of massage modalities.
- Ethics, boundaries, laws, regulations: Evaluates knowledge of ethics and scope of practice, as well as professional boundaries, maintaining confidentiality, and keeping a professional relationship. There are also questions about communication and massage-related laws and regulations.
- Guidelines for Professional Practice: Tests everything from safety issues (both for the client and therapist), to proper draping techniques (maintaining safety, comfort & modesty), to business practices, forms, taxes, marketing, and record-keeping.
It’s not an easy exam. It covers a LOT of territory.
While requirements to become a massage therapist vary from state to state, and also by cities/counties within each state, the MBLEx is a nationwide examination recognized by almost every state. It is NOT an automatic nationwide license in and of itself. To actually get paid for doing massage requires a license and obtaining that license usually involves proof of completion of a minimum number of hours of education in an accredited massage school program, a full and complete background check and proper local permits and business licenses. The MBLEx is quickly becoming an important additional component on the list of requirements a CMT must have in every state to get a license and work.
The test doesn’t tell the whole story
While passing a test of basic knowledge and understanding about massage is important, it doesn’t tell the whole story about the massage therapist. An exam only sets a baseline of knowledge which every therapist should know. It does not indicate if a therapist is technically competent and effective when doing hands-on work as a therapist.
Luckily, any massage therapist from an accredited massage therapy school will have hundreds of hours of hands-on experience actually conducting massage sessions, typically under the watchful eye of a coach, mentor or teacher. As part of their education, students typically work in student clinics, where they can practice on “real people” in a safe and controlled environment. Most schools also require many hours of externship, where students work in real-world spas, massage clinics, and other locations to see what it’s like to work in the profession. During those apprenticeships, therapists typically work only on staff (not the public), so they can get good feedback from working therapists about their quality of touch, flow, technical skill, communication skills and overall ability to massage.
Most massage therapists will also tell you that another key to success is learning to ground, be present, and sense the energetic connections going on during a massage session. Therapeutic touch is a powerful tool that can go well beyond physiological benefits for a client (and therapist) and have a significant positive impact on mind, body and spirit. It’s pretty impossible to test these intangibles, but you’ll know when your therapist is energetically in sync with you. It’s a wonderful feeling. It makes you want to go back for more massage, too.
So does a therapist have to pass a nationwide exam to be a “good” therapist?
Massage has been around since 3000BCE and the exam is relatively new, so there are tens of thousands of extremely competent therapists out there who have not passed a written exam like the MBLEx. As many state and local governments further hone requirements for professional licensing, they’re adding the MBLEx as an essential component. Therefore, even seasoned therapists are considering taking the exam, even if they aren’t required to do so.
Successful completion of a rigorous content-area exam is a statement of professionalism that the public can understand. The MBLEx exam also tests many elements that help ensure the safety of the public, and the therapist. And that helps everyone feel better.
The more therapists pass the exam, the more the public will also realize how much work we’ve gone through to become a therapist and that builds confidence and trust among clients. Since the knowledge required to take the test comes from hundreds of hours of classroom time, supervised practice and plain old hard work, it’s an affirmation for the therapist, too.
The presence of a professional exam, like the MBLEX or the alternative NCMTMB Board Exam, will continue to drive the profession forward. Those therapists who are excellent bodyworkers and who make it a habit to stay up to date in their learning will likely opt to take the test to demonstrate their own knowledge and differentiate themselves from those with less knowledge and training. Over time, everyone in the profession will likely be called to demonstrated knowledge through an exam to remain licensed, and that’s icing on the cake combined with their ability to give a great massage.
So, while licensing and testing requirements continue to evolve, you can still feel good as you continue to visit qualified & well-educated therapists and get terrific bodywork, whether or not they’ve passed the MBLEx. A little encouragement from their favorite client for them to take the test won’t hurt, though, and it’ll likely help the therapist out as another confirmation of their awesomeness. Looks great on a resume, too
Bard Williams, Ed.D., CMT
Owner & Therapist at Silicon Valley Massage Therapy Group, LLC, San Jose, California
Principal author of most of the articles you see in the WELLNESS FOCUS blog and several study guides to help therapists pass the MBLEX..
And yes, I passed the MBLEx, too!