A few years ago, a national certification program for MTs in the USA was envisioned and developed by Elliot Greene, then National president of the American Massage Therapy Association (AMTA). With great enthusiasm he told fellow AMTA members that he was planning "to make one of the most important contributions to my profession and my career that I have ever done." He was "going to take the National Certification Exam." Acting from his then perspective of an unlicensed MT (in a state without a licensing law, under a cease-and-desist attack from the physical therapy profession), Greene was also able to enlist AMTA's money to start a campaign and legal action toward the passage of a licensing law in his state, Maryland.

According to Greene, the national, all-inclusive program, which would replace AMTA's Registered Massage Therapist professional designation program (AMTA-RMT) and its promotion within the MT profession, was initially financed with a $250,000.00 loan from AMTA. According to AMTA members, that was big, repetitious, effective promotion, like promotion should be. It appears that AMTA money has for years been budgeted on some little understood case-by-case basis for legal expenses associated with state licensing. Unlike the money which was alocated to a nation-wide marketing of the national certification program, to our knowledgeno amount of money was ever allocated to the nation-wide public promotion of a professional licensing program!

Even more puzzling, some of the press releases issued by NCBTMB would have you think that the professional license is frivolous if not in fact counter-productive. Hmm...something like that one can expect to get from the commercial/cosmetic massage organizations. But from the NCBTMB? You wonder...

No doubt, the well-intentioned and very able Greene was instrumental in ushering in a program which is now generating a few million dollars annually for the National Certification of Therapeutic Massage and Bodywork (NCBTMB) (just a minute . . . how much is $150 X 13,000?). No doubt, Greene was the best thing that ever happened to NCBTMB. And he was recently recognized with a well-deserved award by this "unbiased" "independent" organization. The recent passage of the MT law in his state--with the national certification program already in place, mind you--showed mixed results, however, with a less-than-full recognition of MTs as state certified--but not, lo and behold, licensed--MT professionals.

So was the NCBTMB the best thing that ever happened to the MT profession? Do licensed MTs really need another credential before a licensing law has been passed in all states? And is it a fact for all fellow MTs who have taken the NCBTMB exam, as NCBTMB's full page ad (Massage Magazine, Sep '95) suggested, that "over 13000 massage therapists and bodyworkers can't be wrong?" Have you, the reader of MT MATTERS!, benefited from the national certification program? Is there a health profession which has gained legal and public professional status without a professional license? And, in general, is it healthy that the policy-making, money dispensing center of the MT profession in the USA has done very little towards the passage of a licensing law in its own backyard? Can you, for instance, imagine the American Chiropractic Association managing its affairs from a state not under a professional licensing law for DCs? And can the NCBTMB be an independent impartial organization which acts onyourbehalf, the LicMT's behalf, that is?

Or is there a better, more efficient, more logical way toward professional recognition, status and economic viability? Shouldn't, at long last, all professional MT organizations inform their membership about what MT WEB CENTRAL is doing to educate the public and fellow MT professionals about the significance of a professional license?

For the benefit of many MTs who are still confused about the difference between a professional state license and a national certificate which is issued from within the profession as well as for the benefit of hundreds of AMTA-RMTs, those whose professional designation was discontinued as a meaningful credential, MT MATTERS! has invited Greene to reiterate his point of view on this important MT matter.

Hopefully, between Greene's article on Professional Credentials and our ensuing commentary, more discussion and professional enlightenment will follow. You probably don't want to stop reading just yet...

What Are Certification, Licensing, and Accreditation
By Elliote Greene

The term certification is often used as a catch-all term for several different activities that apply to the credentialing of individuals and institutions. This fuzziness of definition has resulted in confusion when it comes to discussing credentials. This article is intended to provide more clarity on the subject.

Certification is essentially the process of publicly attesting that a specified quality or standard has been achieved or exceeded. We see this in an informal way all around us nearly every day. For example, when a product has the Good Housekeeping Seal of Approval, it means that the item has been attested to meet the standard set for it. Whenever we make a recommendation or referral to a colleague or client we are informally certifying the competence of the person or the quality of the item being recommended.

Professional certification uses a formal process to identify and acknowledge individuals who have met a recognized standard. Usually this standard includes education, experience, and an exam of knowledge, skills, and abilities needed to perform the job. When an individual meets the standard, he or she receives certification from a certifying agency. The credibility and integrity of the certifying agency determines whether the agency's certification means anything to the public, and therefore, ultimately, its value. Accordingly, certification agencies may seek out recognition by an outside agency that will, in turn, attest to the certifying agency meeting a standard. Generally, this standard involves the qualification requirements to take the exam, whether the exam meets accepted psychometric standards for exam development, how the exam is given and scored, how the agency is administered, and whether its rules are fair. The National Organization for Competency Assurance operates the National Commission for Certifying Agencies for that purpose.

Professional certification is a voluntary process by which a non-governmental professional organization grants recognition to an individual who has met certain qualifications. It is a credential which attests that the individual has demonstrated a certain level of mastery of a specific body of knowledge and skills within the relevant field of practice. Certification should not be confused with either licensing or accreditation. While each involves some type of evaluation and the awarding of some type of credential, they are quite different from one another and the terms should not be used interchangeably.

Licensure is a non-voluntary process by which an agency of government regulates a profession. It grants permission to an individual to engage in an occupation if it finds that the applicant has attained the degree of competency required to ensure the public health, safety, and welfare will be reasonably protected. Licensing it always based on the action of a legislative body. Once a licensing law has been passed it becomes illegal for anyone to engage in that occupation unless he or she has a license. The health care professions are typically licensed at the state and/or local level, but not usually at the federal level.

Two regulatory variations are state certification (not to be confused with professional certification referred to elsewhere in this article) and registration. These generally are somewhat less restrictive than licensing, but how each is defined exactly can vary from state to state.

Certification differs from licensing in that it is nearly always offered by a private, non-governmental agency. Such agencies are usually outgrowths of professional associations which create certifying agencies to identify and acknowledge those who have met a standard. Another contrast with licensure is that, under a licensing law, practitioners of the licensed occupation must have a license in order to practice. It is involuntary. On the other hand, certification is voluntary. One does not have to be certified in order to practice. An individual takes the certification exam because they want to enjoy the benefits of certification. However, to use the title and initials copyrighted and associated with the professional certification, one must be certified.

Accreditation a non-governmental, voluntary process that evaluates institutions, agencies, and educational programs, (i.e., institutions that grant certificates or diplomas) while certification and licensing involves individual practitioners. Accreditation is defined as the process whereby an agency or association grants public recognition to a school, institute, college, university, or specialized program of study (such as a massage training program) for having met certain established qualifications or standards as determined through initial and periodic evaluations that usually involve submitting a self-evaluation report, site inspection by a team of experts, and evaluation by an independent board or commission.

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