Scope of Practice is a terminology used by state licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each state has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice.  http://en.wikipedia.org/wiki/Scope_of_practice

No matter what type of treatment you are going to receive, it really does pay to know what to expect...

The Most Common Violation woulf be If you go to the nail salon and receive more than a superficial foot/hand Massage; It is not legal, and it could be dangerous. A short shoulder “rub” is illegal and could be damaging unless the person is licensed.

To become a licensecd Massage Therapist in New York, over 1000 (one thousand) class room hours is required and then passsing a state administered exam is required. This typically a 2 year period costing between $20,000 to $30,000 for the education. 

Hot Topics of Scope in Massage Therapy

1. Draping

Draping refers to the professional ways of covering the client. There are various techniques, but the main focuses are client comfort and privacy. We drape to ensure that no genitalia is exposed, so the client’s body is in a restful state and has reached a comfortable temperature. Even if a client asks to be Massaged nude, as a professional, I must of course say “no”. It is illegal in NY State to do and I would NEVER risk my license. If a therapist abides, well I would certainly question their intentions.

FYI- It is absolutely typical for a therapist to Massage the glutes (buttocks). In fact, Massaging the region is incredibly beneficial (especially for those with back pain or tight hamstrings). However, the therapist should drape in such a way that the middle of your glutes is not exposed.

Common materials used in draping: sheets, towels, blankets.

2. Breast Massage

Catchy isn’t it? Sounds sexy and intriguing perhaps. It’s very important to address this because I know of quite a few people who have been touched in inappropriate manners during their treatment. So allow me to clarify…Breast Massage is legal in NY only if there is written consent BEFORE treatment. Some therapists are trained in this area and it can be very therapeutic. Please understand though, that it is NOT part of a typical treatment. If a therapist tries to perform Breast Massage without your written consent, tell them you know better. If you feel truly uncomfortable leave the treatment immediately. Even if you end up staying, let their higher-up know what happened, because you can be sure that you aren’t the first, nor the last…Take down their full name and license number and report if necessary.tp:/http://www.massagetoday.com/archives/2004/01/03.html

3. Underage Massage

Everyone needs or deserves Massage. If under the age of 18 written consent from the legal guardian must be provided on the intake form. In some cases the guardian may be required to be present during the treatment.

For more info about NY State laws on Massage Therapy (although not very detailed) go to:http://www.op.nysed.gov/mtguide.htm

4. And now back to Scope

5. Traveling

Since Massage Therapy is not a Nationally regulated practice, each state can vary greatly. It was only a month ago that PA decided to change their laws. Before November 2008, Joe Shmo off the street could give you a full treatment. They offered certifications, but they were not mandated. So I really do mean it when I say do a little research. This includes other countries. I can guarantee that a Massage in NY is QUITE different from a “Massage” in Europe. Want to be naked? Go there!

This will tie nicely into…

6. Communication

Before enjoying a treatment you should be asked to fill out a Health History form. This intake is again, part of the law in NY. However, many Spas do not include this in their practice. Instead they put their therapists’ licenses at risk in order to keep up with the flow of the ‘spa atmosphere.” Perhaps they feel it’s an imposition to the client, or perhaps they just don’t want to keep the paper work. Whichever the reason, the facts do not change. (Even for short treatments, such as Chair Massage, I at least have an acknowledgement form to sign.) After a client fills out my intake form, I still have a few questions to ask them. Many times (in fact more often than not) they leave out medical history that is important for me to know. Usually even after questions there will still be more for me to discover when they’re on the table. (Headaches, sleep problems, anxiety, old sprains, removed moles etc. are all important…even your bowel movements. Yeah, now I dare you to say that Massage isn’t medical.)

If anything causes you to feel uncomfortable during a treatment you should alert your therapist right away. This could range from pressure preference to conversation. Even if you requested a Deep Tissue Massage and the deep is too deep, I advise you not to “get through the pain.” Ask you therapist to lighten up a little and wait for your body to allow for that pressure. Nine times out of ten, if they warm up the area really well, they can return to it, causing much less pain (if any).

Asking how this ties into “scope”? Well during communication, many times important things come up, such as psychological issues, marital problems, health issues…understand that while we are very educated, it is a fine line of what is within our scope. My intake form clearly states that I do NOT diagnose. So I really try to give life advice and not specific opinions about a situation. If I see a mole that looks suspicious I calmly ask my client if they are aware of it, and if they have had it checked by a doctor. I am allowed to give recommendations. Tell my clients what has worked for me and show stretches to alleviate pain.

Now here’s the test folks…if you feel uncomfortable during a treatment what do you? Let’s see if I’ve taught you anything yet. (drum roll please) Ah yes, communicate with your therapist and in the worst case…REPORT.