Step 1: Know Your State Laws, Regulations, and Requirements

Action Item: Print out the Pass the Test Checklist, found in the Picked Fresh section of this newsletter. Complete additional action items as they are presented.

The first step to passing the test and obtaining your massage credentials is to understand the laws, regulations, and requirements related to the practice of massage in the state where you plan to work. Let’s start with some definitions:

• Laws: Rules that are recognized by a community as binding and enforceable by authority.
• Regulations: Directives that give official guidance about how laws should be followed.
• Requirements: Constraints, demands, necessities, or parameters that must be met or satisfied, usually within a specified time frame.
• Board of massage: A group of people appointed in states that regulate massage to supervise the practice of massage by reviewing practitioner applications for licensure, investigating complaints, and overseeing licensees who work in the state. The goal of a board is to ensure public safety.
• License, registration, or state certification: Official state permission to practice massage and use a protected title after meeting education and other requirements. Most states issue a license but some states use a registration process, certification process, or a combination of methods instead.
• Massage credentials: A general term used here to denote a practitioner who has obtained a license, registration, or state certification to practice massage legally in the state where they reside.

Action Item: View the requirements for your state here and write them in the box on your Pass the Test Checklist.

Obtaining Your Massage Credentials

You might be wondering, “Where do laws and regulations come from, and why do I have to jump through all these hoops?”

If state or local authorities determine that a particular activity can potentially cause harm to the public, they seek to limit the people who can practice that activity. For example, liability insurance data shows that people can be harmed, in significant numbers and to a significant degree, if a practitioner applies massage techniques incorrectly or in the wrong circumstances. As a result, most states have formed a committee to determine what will be required of people who wish to offer massage to the public. This is the means by which the state determines that you can practice safely and competently. In most state or local jurisdictions, some or all of the following requirements must be met to obtain massage credentials and practice legally:

• Complete state education requirements: Most state and local authorities require people to obtain a minimum of 500 hours of education to practice massage (some authorities require more and some require less). Usually an education program must obtain approval from the state board of education (and in some cases from the state board of massage) to offer training. Certain states, such as Connecticut and Maryland, require schools to obtain national accreditation to offer programs.
• Pass the state-approved exam: In regulated areas, people who wish to practice massage must pass a state-accepted test to obtain their credentials. The Massage & Bodywork Licensing Examination (MBLEx) provided by the Federation of State Massage Therapy Boards (FSMTB) is the primary test used for massage credentialing at the state level. All regulated states, with the exception of New York and Hawaii (which have their own exams) use the MBLEx as the state-approved licensing examination. 
• Complete an HIV/AIDS training course: Some states require massage practitioners to participate in HIV/AIDS training. Most often, the training is conducted as part of a school’s program and is a one-time requirement. The goal of this provision is to ensure that people working with the public understand: the causes of HIV/AIDS, guidelines for infection control, legal and ethical issues related to confidentiality, psychosocial issues, and special populations considerations.
• Complete a CPR/first aid course: Many states have a CPR/first aid training requirement. Current training usually includes the use of an automated external defibrillator (AED) device. The first aid section of the course teaches people how to respond to common first aid emergencies such as burns, cuts, or head, neck, and back injuries. Even if your state does not require this training, it is a good idea to take a CPR/first aid course from the Red Cross or local fire station before working with the public.
• Complete a jurisprudence exam: A jurisprudence exam is usually an open-book law exam that ensures knowledge of the laws relating to massage in the particular state, general massage ethics, and continuing education requirements. Many states offer this exam online in an easy-to-use format at no charge to the participant. Check with your school about how this exam is administered in the event that it is required in your state.
• Complete a practical examination: In a practical examination, an applicant performs massage in front of a panel to demonstrate competency in the application of techniques, sanitation and hygienic practices, communication with clients, and overall professionalism. Only Oregon currently requires the completion of a practical examination.
• Obtain a health certificate, physical examination, or tuberculosis (TB) test: In a few places, you may need to obtain documentation that demonstrates you are in good health and do not have any communicable diseases that might cause a health concern for the public.  
• Obtain a background check: A background check ensures you are who you say you are, and that you have no criminal record that would make you unsuitable for a career in massage therapy (e.g., sexual offense). Most states require background checks before issuing any type of health-care related license.

Action Item: Find your state board of massage website here by clicking on your state. Spend five minutes familiarizing yourself with your state board's website and the information it contains.

If you are like most aspiring practitioners, you are probably concerned about preparing for, applying for, and taking the licensing test. Watch for your next enewsletters, where we will address all of these issues more closely. You might also want to check out ABMP Exam Coach, which was specially designed to support students as they prepare to sit for the MBLEx.

MBLEx 101

The Massage and Bodywork Licensing Examination (MBLEx) is the primary test used for massage credentialing at the state level. It was developed by the Federation of State Massage Therapy Boards (FSMTB) to ensure that practitioners entering the massage and bodywork profession possess the knowledge and judgment necessary to prevent undue harm to the public.

The MBLEx is 100 questions in length and contains a security agreement and survey section. Applicants have a total of two hours to complete all sections of the test. Because there is diversity in massage and bodywork training, there are likely a small number of questions that will come up on the test that are outside your training. The number of these questions is unlikely to pose a barrier to passing the examination.

The MBLEx is a computer adaptive test (CAT). To pass, you must answer every question in the order it is presented (you can’t leave a question blank and come back to it later). When you answer a question correctly, the next question is presented at a slightly higher level of difficulty. This difficulty level continues to increase until you answer a question incorrectly. At this point, the difficulty level decreases. Each applicant must answer enough difficult questions to achieve a score that is at, or above, the passing standard.

In upcoming newsletters, we will discuss what type of information you’ll need to know for the test, the format of questions, and methods for testing effectively.