The NCE and Its New Content Areas
A Job Analysis Survey (JAS), conducted about every five years, is an essential element to the certification process by identifying skills and knowledge areas that ultimately define the scope of practice of the profession. More than 1,900 people responded to the survey of over 400 questions, providing definitive data that describes the work performed by massage therapy and bodywork practitioners. This information was then analyzed, grouped into areas of knowledge, and ranked to help determine the content of the National Certification Exam (NCE). This process ensures that the exam reflects the current knowledge required for an entry-level practitioner to practice therapeutic massage and bodywork.

Overview of the New Outline
The content outline is still divided into the following four sections: (a) human anatomy, physiology, and kinesiology; (b) clinical pathology and recognition of various conditions; (c) massage therapy and bodywork theory, assessment, and application; and (d) professional standards, ethics, and business practices.
The outline reflects greater use of non-western techniques such as accupressure and meridian therapies by the inclusion of new sub-sections for traditional Chinese medicine and other energetic systems. The anatomy and physiology section of the outline reflects the holistic nature of bodywork and the unique knowledge someone in this field must acquire.
Emotional states and stress leading to disease, history of abuse and trauma related to disease and recovery, impact of client medical history on disease and recovery, and the effects of life stages on basic health and well being are new areas of emphasis in the client intake and history section.
Additionally, a new sub-category was added for holistic principles, reflecting the importance of using a conceptual and philosophical framework while doing therapeutic massage and bodywork. The emphasis and clarification of the importance of ethics and business practices reflects the greater maturation of the profession.
For the purpose of the survey, a draft job description for practitioners was developed, defining a massage therapy or bodywork practitioner as "one who employs a conceptual and philosophical framework, and uses knowledge of various systems of anatomy, physiology, and contraindications to facilitate the optimal functioning of individual human beings through the manual application of various modalities. The practitioner assesses the client to develop a session strategy, applies relevant techniques to support optimal functioning of the human body, establishes a relationship with the client that is conductive to healing, and adheres to professional standards for practice and a code of ethics."
The new content outline affirms this ambitious job description and helps to move the practice of therapeutic massage and bodywork to the next level of acceptance and professionalism.

Implementing the New Exam
Naturally, with new areas in the content outline, there is a need for new items or questions for the exam. Before any new item is counted toward a candidate’s score, it is pre-tested. The items being pre-tested are integrated with the items on which candidates being scored. During this period of pre-testing these items will appear on the exam; however, they will not count toward the score. This phase of exam development serves many purposes, but primarily assures that the items are of sufficient quality to be counted. Candidates will not be able to tell which questions are pre-test items and which are established items. Therefore, it is imperative for candidates to answer all questions to the best of their ability.
These new items will be pre-tested until enough data supports one of the following actions: 1) the item performs well and will appear on future exams, 2) the item is revised and/or rewritten for future use, or 3) the item is discarded altogether. Quality items will then become an “official” part of the exam and all components of the new content outline will be tested and scored. As with any examination, pre-testing new items and refining current items is a continuous process that occurs throughout the life of the exam. Of course, when a new content outline is developed there are more items to be pre-tested.

What Educators Need to Know
It is important to teach to your program’s philosophy and mission, don’t attempt to teach to the test. The purpose of national certification is to foster high standards of ethical and professional practice in therapeutic massage and bodywork. While schools undoubtedly also adhere to this principle, a national certification exam is more comprehensive in scope than a school’s curriculum; as it should be. The National Certification Examination is developed from the broad scope of the profession, as defined by the Job Analysis Survey, not just one particular school of philosophy. The NCTMB credential provides an assurance to the public, the consumer, and the employer that the certified practitioner possesses the highest professional credential in the field. Individual schools can assist their graduates in attaining this level of recognition by helping them develop the skills they need as independent learners and future practitioners. For years schools have been preparing students well for their future, with over 29,000 certified practitioners as proof. Students should feel comfortable that the knowledge they received will go a long way in the profession. (back to Emerging Standards Contents)

New National Certification Examination Content Outline
Human Anatomy, Physiology, and Kinesiology (27 percent)
Western
    Major systems: location and function
        Integumentary system
        Skeletal system
        Muscular system
        Nervous system
        Endocrine system
        Cardiovascular system
        Lymphatic and immune system
        Respiratory system
        Digestive system
        Urinary system
        Reproductive system
        Craniosacral system

    Biomechanics and kinesiology
        Efficient and safe movement patterns
        Proprioception
        Basic principles of biomechanics and kinesiology

    Basic medical terminology

Non-Western
    Traditional Chinese medicine
        Primary meridians and organ physiology
        Extraordinary meridians – conception and governing               vessels
        Five element theory

    Other energetic systems

Clinical Pathology and Recognition of Various Conditions (20 percent)
History and client intake process
    Emotional states and stress leading to disease
    History of abuse and trauma related to disease and            recovery
    Impact of client medical history on disease and recovery
    Effects of life stages on basic health and well-being
Disease and injury-related conditions
    Signs and symptoms of disease of the major systems of the body:
    indications and contradictions
    Physiological changes and
    healing mechanisms

Massage Therapy and Bodywork Theory, Assessment, and Application (41 percent)
Assessment
    Effects of gravity
    Integration of structure and  function
    Use of palpation for assessment of craniosacral pulses,            energy blockages, and bony landmarks
    Somatic holding patterns in clients
    Using visual cues in assessing clients
    Conventional Western medical approaches to client’s           illness
Structural compensatory patterns
Interview techniques

Application
    Sites to avoid on client’s body
    Proper client draping and
    positional support
    Physiological and emotional effects of touch on client
    Effective and appropriate responses to client’s emotional          needs
    Universal precautions
    Use of appropriate verbal and non-verbal              
        communication skills
    Physiological changes brought about by touch therapy
    Practitioner’s self-awareness during a session
    Using strategies to plan single and multiple client sessions
    Use of manual contact and manipulation to affect soft              tissue,   joints, and the energy system
    Use of joint mobilization techniques
    Use of terms related to quality of movement
    Using and teaching basic principles of posture and
         kinesthetic awareness
    Hydrotherapy
    CPR and first aid

Touch therapy modalities

Holistic principles
    Energetic effects of nutrition
    Stress management/relaxation techniques
    Corrective exercises for clients
    Principles of nutrition and its impact on health
    Principles of holistic practice
    Practitioner kinesthetic awareness

Professional Standards, Ethics, and Business Practices
(12 percent)
NCBTMB Code of Ethics
Confidentiality of client information
Effective inter-professional communication
Use of proper income-reporting procedures
Basic business and accounting practices
Session record-keeping practices
Scope of practice: legal and ethical parameters
(back to Emerging Standards Contents)

Recertification and Approved Provider Corner
The following policies were adopted at the Board of Director’s meeting in New York City, August 23, 1997

Purpose, Philosophy and Guiding Principles
Philosophy
The emphasis for recertification is on professional and personal development because the NCBTMB believes that inspiring the value of responsible, lifelong learning is the most effective means towards continuing competence. The requirements for recertification reflect this vision.

Purpose
The purpose of recertification is to provide massage and bodywork practitioners with an opportunity to demonstrate on-going development and continued commitment to the profession and the National Certification Program.

Guiding Principles
The Guiding Principles of the Recertification System must:
Empower the individual practitioner with the maintenance of his or her own professional development and continuing competence.
Be flexible and multifaceted to accommodate the diverse needs of practitioners.
Be adaptive to the changing nature of our profession in a transformational society.
Have a facilitative rather than a policing, punitive focus.
Incorporate these qualities: fairness, integrity, objectivity, compassion, professionalism, support, and ethics.
Support the mission, policy and procedures of the NCBTMB.

Policy on Category B courses
Any course that does not qualify as Category A but does meet the NCBTMB definition of continuing education shall count toward Category B.
Definition of Continuing Education: Learning experiences which enhance and expand the skills, knowledge, and attitudes of practicing massage therapists and bodyworkers to render competent professional service to clients, the profession, and the public.

Retaking a Course
The NCB has determined that a practitioner may retake a course one time and use those credits toward fulfilling the continuing education requirements for recertification.

Carrying Over of Continuing Education Hours
It is allowable for a certificant to carry over a maximum of 12 continuing education hours from one certification period to another.

Inactive Status
A policy was adopted for an Inactive Status for certificants which will be granted on a case by case basis. This status is designed for a certificant with special circumstances that require more than a 6 month extension. Examples include illness, injury, and military duty. For more specific information and requirements contact the NCBTMB office at 703-610-9015.

University Credits Counting Under Category A
University credits from an accredited college/university may count toward Category A, provided the course meets the NCBTMB definition of continuing education. If you have a question regarding the applicability of a certain university course, please send the information about the course and how you feel it meets the definition of continuing education to the NCBTMB office.
You can obtain a listing of Approved Providers for continuing education from NCBTMB’s website at http://www.ncbtmb.com, on our fax on demand line, or by calling the 800 information line. If you would like to become an approved provider for continuing education please request or download an application through the same options listed above.

Ethics Courses
The Board has adopted a policy that allows the 2 hour ethics requirement to come from within another course. It doesn’t have to be a course completely dedicated to professional ethics. You must still be able to document the course and the ethics section of that course. Note to the provider: Please indicate on the certificate of completion if the course covers at least 2 hours in professional ethics.

Recertification Certificates
Many people have recently been inquiring about when to expect their new certificate. Certificates are not issued until the current certificate has expired. Please expect to receive your new certificate within 30 days of your expiration date.
(back to Emerging Standards Contents)

Preliminary NCBTMB School Survey Results
As of 11/15/97 we have received and totaled 163 surveys. When reviewing the data below please remember that several respondents did not answer some of the questions and some respondents marked multiple answers for any one question. This will account for the seemingly HUGE margin of error!

Question #1 How many hours are in your program(s)?
(0-100 hours) - 10
(101-200 hours) - 6
(201-300 hours) - 8
(301-400 hours) - 6
(401-500 hours) - 25
(501-600 hours) - 61
(601 or more hours) - 72
Some schools have several programs of different length.
188 Responses total

Question #2 How many different programs do you offer?
(1) - 61
(2) - 36
(3) - 27
(4 or more) - 35
159 Responses

Question #3 How many students (on average) graduate from your school per year?
(0-50 students) - 78
(51-100 students) - 37
(101-150 students) - 16
(151-200 students) - 9
(201-250 students) - 3
(251 or more students) - 9
152 Responses

Question #4 How many in class hours of massage/bodywork theory and practice do you provide for your students?
(0-100 hours) - 14
(101-200 hours) - 18
(201-300 hours) - 57
(301-400 hours) - 42
(401 or more hours) - 22
153 Responses

Question #5 How many in class hours of anatomy/physiology/kinesiology do you provide for your students?
(0-50 hours) - 14
(51-100 hours) - 33
(101-150 hours) - 52
(151-200 hours) - 38
(201-250 hours) - 15
(251 or more hours) - 2
154 Responses

Question #6 How many in class hours of clinical pathology and recognition of various conditions do you provide?
(0-25 hours) - 46
(26-50 hours) - 53
(51-75 hours) - 14
(76-100 hours) - 15
(101 or more hours) - 11
139 Responses

Question #7 How many in class hours of business practices and professionalism (including ethics) do you provide?
(0-25 hours) - 71
(26-50 hours) - 58
(51-75 hours) - 14
(76-100 hours) - 6
(101 or more hours) - 5
154 Responses

Question #8 Does your school provide official transcripts to graduates of your program?
(YES) - 135
(NO) - 8
(UPON REQUEST) - 14
157 Responses

Question #9 Would you rather provide an official transcript, or a standard NCBTMB form to prove eligibility to NCBTMB?
(transcript) - 88
(standard form) - 26
(either) - 31
(neither) - 5
150 Responses

Question #10 Does your diploma or certificate of completion show the number of hours in your program?
(YES) - 139
(NO) - 20
159 Responses

Question #11 How does your documentation verifying the education obtained by your students insure against forgery or fraudulent activity?
(embossed seal) - 46
(official signatures) - 10
(sealed envelope) - 5
(a combination of any two above) - 58
(not sure) - 10
(it does not) - 6
(direct mail) - 2
Several people responded YES to this question. Another handful did not understand the question at all and made responses like: “The records are kept in a sealed, fireproof container.” “The records are kept under lock and key off the school premises.” Others just failed to respond at all.
137 Responses

Question #12 How often do you update your curriculum?
(more than once a year) - 63
(as needed) - 44
(once a year) - 28
(every other year) - 5
(every three years) - 1
141 Responses

Question #13 Does your state license massage therapists or bodyworkers?
(YES) - 63
(NO) - 94
157 Responses

Question #14 Would your school be interested in participating in a larger school survey or communication with a NCBTMB focus group?
(YES) - 115
(NO) - 14
(DEPENDS) - 35
164 Responses

Question #15 Would your school support sending a representative from your school to attend a regional education seminar on the NCE?
(YES) - 90
(NO) - 12
(DEPENDS) - 46
Most of the “depends” responses regarded the cost, the time, and the place of the seminar.
148 Responses

Question #16 Do you currently support the NCBTMB or use of the NCE?
(YES) - 135
(NO) - 10
(NOT SURE) - 2
(SOMETIMES) - 4
151 Responses
(back to Emerging Standards Contents)

Test Center Changes
ASI has recently made some modifications to their testing schedule. Please review the following items carefully.

Location	Center Id#	Change Made
Anchorage, AK	2260 2261	Added 5:00 times on Dec. 4, 16, 19, 23 Added 8:00 and 1:00 on Dec. 13 Added 5:00 on Dec. 5, 12, 19
San Jose, CA	0542	Added 5:30 on Dec. 4, 11 and 6:00pm on Dec. 16, 17
Costa Mesa, CA	0541	Added 8:00 and 1:00 on Dec. 13
Sacramento, CA	0540	Added 8:00 and 1:00 on Dec. 5, 12, 19, 29, 30
Rocky Hill, CT	0714	Will test every Saturday
Miami, FL	1061	Monday & Tuesday 8:00, 1:00 & 5:30 Wed, Thur, & Fri. 8:00 and 1:00 Saturday 8:00 only
Savanna, GA	1123	As of Nov 1997 center will test on Tuesdays, Thursdays, and Saturdays at 8:00 and 1:00
Augusta, GA	1124	As of Nov 1997 center will test on Tuesdays, Thursdays, and Saturdays at 8:00 and 1:00
Tifton, GA	1125	As of Nov 1997 center will test on Tuesdays, Thursdays, and Saturdays at 8:00 and 1:00
Boise, ID	1320	Will NOT test on Dec. 16, 17. Also added Dec. 4, 11, 18 at 5:30
Wichita, KS	1706	8:00 and 1:00 on Weds, Thurs, & Sats
Louisville, KY	1828	1:00 on Tues, & Thurs
Midway, KY	1827	8:00 and 1:00 on Weds, Thurs, & Sats
Metairie, LA	1943	8:00 and 1:00 on Tues, Thurs, & Sats in December
Shrevepost, LA	1942	8:00 and 1:00 Tues & Thurs in Dec.
Oklahoma City, OK	3720	December dates are 13 & 20
Arlington, TX	4425	8:00 and 1:00 on Dec.11, 12, & 19
Austin, TX	4421	December dates are 6 & 13
Houston, TX	4422	December dates are 6, 13, 20 at 8:00 and 1:00
Lubbock, TX	4408	8:00 and 1:00 on Dec. 13 & 20
San Antonio, TX	4423	December dates are 13 & 20
Richmond, VA	0020	Will test every Saturday
Yakima, WA	4819	December dates 6 & 13

(back to Emerging Standards Contents)

Incomplete Applications
All incomplete applications will be eligibility. Official school transcripts MUST accompany your application for eligibility. Schools concerned with security problems may issue their transcript to students in a sealed envelope for security. Please also note: sending your application by express mail, federal express or other overnight carriers will not speed your application. All money must be processed at another site first. Therefore, sending applications to the office only slows down your application process. Ensure your application process goes smoothly, check for these commonly missed items:
Completed application form
Payment by credit card, money order, or
certified check (NO personal checks)
Official transcript enclosed
Notarized copy of certificate or diploma

Pertinet Information NCBTMB Looks for on a Transcript
1. School name, address and phone number
2. Official school seal or logo
3. Start and ending/graduation dates
4. Authorized and dated signature of administrator/director
5. Course title, hours and grade

Please send completed applications to:    
NCBTMB, Attention: Eligibility Dept.
c/o First Union Bank
PO Box 85080
Richmond, VA 23285

(back to Emerging Standards Contents)

Correction Note
Since the release of the Spring Issue of Emerging Standards, there has been much discussion regarding the article on "Future Plans for Eligibility Requirements". The NCBTMB would like to correct and clarify the following statement which has created much concern and controversy within the education community: "Understanding that schools cannot modify their curriculums overnight, the NCBTMB will allow a reasonable amount of time for candidates currently enrolled in programs to apply through already established eligibility requirements." The National Certification Board does not believe that schools should teach their curriculum to the national exam or to eligibility requirements. This statement was drafted by staff misinterpreting a Board policy that tied the eligibility requirements to the content outline for the non-traditional (i.e. Portfolio Review) route of demonstrating eligibility. The Board had intended to create an objective process for candidates who are not graduates of an approved 500 hour minimum formal education program that parallels the achievements of program graduates. Until that objective can be accomplished, the Board has put a moratorium on changing the policy and no actions are under consideration at this time. We deeply apologize for any confusion this may have caused.

(back to Emerging Standards Contents)

Eligibility Status Inquires
NCBTMB will no longer answer application status inquires by phone. By redirecting the telephone time previously given to candidates calling, NCB staff can focus its efforts on review of and processing applications. This will allow all applicants to receive notification of eligibility status sooner. If after six weeks you have not received a letter of eligibility notification, you may fax your inquiry to Shayla Newbold at 703-610-9005. We appreciate your understanding and cooperation and hope to provide more efficient service.

(back to Emerging Standards Contents)

Minimum Requirements for Recertification
Recertification is required every four years to maintain NCTMB status/credential

You may do either of the two options:
One (all are required)       
Take NCE                     
200 Hours Hands-on Work Experience    
(hours for teaching is accepted)

Fee:
($195 plus $100)
($295 effective January 1, 1998)

Two (all are required)
50 Hours Continuing Education
200 Hours Hands-on Work Experience
2 Hours Professional Ethics

Fee: $100

See Recertification Packet for appropriate documentation requirements.
All requirements and documentation listed here are condensed for quick viewing. Detailed explanations can be found in the NCTMB Candidate Handbook, Portfolio Review Packet and Requirements for Recertification Booklet.
Thorough review of these publications is recommended before applying.

(back to Emerging Standards Contents)

Policy Regarding Conversion of Credit Hours
Clock Hours
The 50 minute hour is recognized as 50 minutes of instruction followed by 10 minutes break. Unsupervised hours, such as homework, or hours for which the student receives a fee, are not allowed.

(back to Emerging Standards Contents)

Traditional Eligibility Requirements
Course Work
500 (in-class) Clock Hours of Formal Training from a Massage and/or Bodywork school. School must be approved, registered, or licensed by the state or exempt from any state requirements.

Formula
minimum 100 Hours     Anatomy/Physiology
minimum 200 Hours     Massage and/or          Bodywork Theory and      Practice
minimum 200 Hours    Related Education,     includes minimum
2 hours Ethics

Fees
$195.00 effective January 1998

See Candidate Handbook for appropriate documentation requirements

(back to Emerging Standards Contents)

Portfolio Review Process
(an alternative method of applying for eligibility to sit for NCE)

Course Work
Equivalent of 500 hours of education required, allowing varying options for fulfillment. Professional experience may be utilized.

Formula
minimum 100 Hours Anatomy/Physiology
minimum 200 Hours Massage Therapy and/or Bodywork, includes minimum 2 hours Ethics
minimum 200 Hours    Adjunct/related educa-    tion and/or professional     experience        

Fees
$195.00 plus $75.00
effective January 1998

See Portfolio Review application booklet for appropriate documentation requirements

(back to Emerging Standards Contents)

NCBTMB
8201 Greensboro Drive, Suite 300
McLean, VA 22102
703-610-9015 … 703-610-9005
1-800-296-0664 (totally automated line)
e-mail: mswiscoski@ncbtmb.com