Modality Specific Testing:

An Heretical Approach


Just Common Sense?


By Gary Lescak


     The word massage is a broad umbrella term that is both useful and unwieldy. It is broad in that it encompasses: modalities that are thousands of years old and modalities that have been assembled very recently; modalities that have their origins from every corner of the globe; modalities that represent opposite extremes in theories and philosophies; and individual practitioners that run the gamut of human character and motivation. The same could be said of the word religion.

     Both of these terms are useful to us because they allow us to subsume and re-present vast quantities of knowledge, opinion, history, ideas, beliefs, culture, feelings / emotions, and experience under one heading when appropriate.

     Both of these terms become unwieldy and inappropriate when applied to legislation / laws that apply to all individuals subsumed under either category when that categorization requires one single definition that fits everyone.

     That is the nature of the beast; there is no fault or blame to be placed on any individual or organization. This is

simply how the creature has evolved over time. The

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problem stems from the desire to fit this square peg into a round hole. That is, the desire to critically, objectively evaluate, dissect, define, quantify, and

categorize all aspects of the human experience to fit the Western scientific model so loved by allopathic medicine is the theoretical basis for massage legislation; and the beast just does not fit.

     There is no room in legislation for: the intuitive aspects of massage; some individuals’ natural healing abilities; widely disparate and sometimes diametrically opposed techniques, theories, and philosophies; cultural and spiritual beliefs; widely differing knowledge bases; or individual styles and preferences. There is no room because these items are anathema to the allopathic tradition.


Now To The Problem

     The crux of the problem is that the American Massage Therapy Association (AMTA) wants to grow up to be the American Medical Association (AMA) of massage with all the financial rewards included therein. Their idea is to either define that square peg out of existence or shave that square peg until it fits the round hole of their one-true-way ideal, and the tool they are using is the National Certification Exam (NCE).

     The NCE is not evil in and of itself; it is a modality (Swedish) specific test. The evil lies in the fact that it is the only modality specific test used for most state licensing.

     Obviously, there are many administrative, methodological, and legal problems associated with the

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NCE; the current literature abounds in articles on this topic. However, the NCE and its associated problems are not my focus here; I take them as a given, as do 90% of the

therapists in this country. The problem is that the AMTA, by way of big dollar lobbying, has jammed this farcical instrument down the throats of every massage therapy practitioner, student, and member of the general public in almost every state that has adopted licensing. And let’s face it, the bottom line is the bottom line. This testing game is worth millions; especially if there is only one player…and it is obvious that the AMTA wants the whole pie.

     Again, there is plenty of information out there, thanks to the web, that explains how this test was formulated, accredited, and “sold” as a supreme standard; and none of it paints a very favorable picture of the AMTA, the NCE, or the host of other corporations they have formed or employed to buy and manipulate their way to credibility. This has been an on-going, almost 20 year campaign, to monopolize and control the industry.

     The victimization of therapists, students, and the general public by this AMTA control of testing and most board recognized schools in almost every state that has adopted licensing has finally been recognized, almost always after the fact, by the overwhelming majority of therapists in this country; and they are tired of it. They do not want to be shaved down to fit in that round hole.


The Answer is Not…

     The answer is not the Federation of State Massage Therapy Boards (FSMTB) with their current orientation

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which is to grow up to be a better AMA of massage than

the AMTA by spawning a better round hole test; wrong direction. The FSMTB could be an answer if they endorsed the following alternative.


Where To Look For The Answer

     Let me begin by saying that any answer to this problem of testing should meet the standard of fairness to all legitimate practitioners; legitimate should be defined broadly and fair should mean testing a person on the content of their program of study to determine a minimum standard of competence that should be defined by the state in which they live.

     The question at hand is one of fair, critical evaluation. The answer to the question is in front of everyone regardless of style: look to history. No matter what style or combination of styles a person has studied and practiced, who knows the individual’s competency better than the source of that knowledge?

     Translation: there are hundreds of recognized, legitimate modalities subsumed under the broad umbrella of massage with their own teaching, testing, and certifying programs. The individual state licensing boards, or better, an organized group of them like the FSMTB, needs to recognize and approve modalities, programs, and testing from groups / organizations they authorize based on the groups meeting criteria established by the boards.


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Reasons Why There Should Be More Than One Test For Massage Licensing In Every State


1. The law provides for it. No private corporation that does not answer to our duly elected representatives and

government should be allowed to control and monopolize any industry. The legislators in a number of states, in their wisdom, purposely wrote provisions in the law allowing for multiple tests.


2. Fairness under the law to all legitimate applicants / practitioners. The broad umbrella term “massage” encompasses many different modalities. It is only fair to test an applicant on his/her course of study. One of the main purposes of Massage Licensing Boards is to protect the general health and welfare of the citizens of their respective states by establishing and verifying a minimum standard of competence; not to force all practitioners to study and practice the same modality. Modality specific tests will allow for a fair and impartial application of the law to all legitimate practitioners.


3. To eliminate the appearance of special interest favoritism and deny a small special interest group representing less than 10% of the estimated therapists in America from controlling all present practitioners and schools regardless

of modality, all future students, and subjecting every citizen

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of this country to the results of one highly disputed test, that to the best of my knowledge, has never been submitted to any state official for examination. 


4. To lessen the liability exposure of the Massage Licensing Boards / States from charges of restraint of trade, violation of the public trust, collusion, conspiracy, conflict

of interest, etc. These are topics associated with the NCE;

see #5.


5. There are problems with any test. There are many problems, both administrative and methodological, with the NCE; there are many authors describing / discussing many of the problems with the NCE. These authors include the International Massage Association (IMA) whose over 70,000 members practice over 200 massage modalities, the Federation of State Massage Therapy Boards (FSMTB), the Associated Bodywork and Massage Professionals (ABMP), the American Medical Massage Association (AMMA), incorporated massage businesses, massage school owners, physicians, individual massage therapists, and even members of the NCBTMB Board.


6. Healthy competition benefits everyone. Our entire system works on competition, capital, and the free

enterprise system. There is no explanation from any source that would explain why one exam is better for the profession than multiple exams. Why would anyone disenfranchise other organization’s attempts to develop

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alternatives to the NCE that might actually do the job better or, at the very least, offer a fair alternative? Why would

anyone be against multiple, fair, credible tests except for personal gain?


The Answer

       Yes, modality specific testing is the answer. This has been the case for everyone prior to licensing; meaning that everyone who has learned massage and has met a certain


level of competence defined by their teacher(s) has received some sort of recognition / certification by that teacher(s) or their representatives. The state licensing boards need to establish criteria, recognize, and approve the sources of knowledge, their legitimacy, programs of study, and testing, and let them certify that minimum level of competence.

     There are numerous benefits of this approach; here are a few: (1) fairness to all; (2) a return of power to the state licensing boards where it belongs; (3) it is a method that respects and recognizes the history, individuality, and diversity of the many modalities subsumed under the heading of massage; (4) properly applied, it can provide better, more complete and valid testing.

     This last point deserves special attention. It was beyond the scope of this article to delve into the methodological problems associated with testing. However, suffice it to say that many people recognize the faulty epistemological premise and the resulting lack of validity of any testing of competency in massage from any test that does not have a

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practical, hands-on component. Modality specific testing by

the providers of instruction will allow this component to be present; meaning no state can afford to fund an in-depth practical exam, but it is a realistic possibility for the individual providers.



     Multiple, modality specific testing is a step toward inclusiveness of all legitimate modalities and all competent therapists, and is a statement of policy that applauds and

supports diversity. A single exam is a means to exclusiveness, and is a policy that leads to a narrow, one-true-way mind.

     Some people will call this approach a step backward. Perhaps we need a step backward to a time before we were in the grip of an ever-tightening monopoly intended to crush diversity in order to take a step forward.

     Please do not conclude that there are no problems to be resolved with this approach; there is much work to be done and many issues to be resolved… but the results are worth the effort.









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About The Author


     Gary Lescak has studied, practiced and taught massage since 1967. He is a certified instructor in Okazaki restoration therapy (Seifhukujitsu). He is co-owner of the Power of Touch Massage clinic in Metter, Georgia; owner / Director of the Martial Arts Academy, School of Massage; and serves as the Executive Director of the Hawaiian Jiu-Jitsu System, a national organization with a massage certification program that is dedicated to preserving the legacy of Henry Seishiro Okazaki. For more information:





Kill or Cure: The Martial Art / Healing Art Connection; in Massage and Bodywork magazine, April, 2004.

Produced and directed “The Kodenkan – Dan Zan Ryu Jujitsu” video series.

Other works are in progress.



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