The authors of this article are Jacqueline Tibbett, PhD, LMT; Natalie Lorick, LMT; Mk Brennan MS, RN, MT

What does it mean to be a massage therapist? By Massage Therapy Foundation are massage therapist’s health care practitioners or service providers? As the massage field continues to evolve, how massage therapists answer these questions may be key to long-lasting, fulfilling careers. The Massage Therapy Foundation is reporting on an important new research study, published in the Journal of Complementary and Integrative Medicine, that explored massage therapists professional identity. You probably have experienced a variety of ways that massage therapists act in a professional capacity. Not only do therapists have differing beliefs about what it means to be a massage therapist, but the public and other health care professionals also have differing beliefs about the massage profession. The authors of this study note that a unified set of professional values and beliefs may have benefits, especially as the profession shifts to meet public needs. Research demonstrates that when a person’s individual identity aligns with their professional identity, resilience and career longevity are the results. It can also impact clinical decision-making and ethical challenges. Misalignment can lead to ethical distress and burnout.

The Study

The study team, led by Canadian researcher and massage therapists Amanda Baskwill, set out to answer the question: “How do massage therapists in Ontario describe their professional identity?” Professional identity was defined in this study as “the values and beliefs held by [a professional] that guide her/his thinking, actions, and interactions with the patient.”(In this study, the massage clients were referred to as patients.) This study used a qualitative description design. Qualitative studies seek in-depth understanding of a topic and are useful for generating hypotheses and developing concepts. This study design aims to minimize interpretative interference by the researchers. For this study, registered massage therapists in Ontario were contacted via email and interested therapists were selected for interviews. The interviews were recorded and transcribed. Two researchers independently analyzed the interviews to categorize the themes that emerged.

The study team stopped conducting interviews when no new

concepts came forth from participants. In total, 33 massage therapists with diverse characteristics and primary practice settings were interviewed. Six themes emerged from the interviews that portrayed the values and beliefs that influence the way massage therapists see themselves and interact with others.

Theme 1: Passion as Professional Motivation

The study participants described being committed to massage therapy and the patient. Patients were valued over money, and apathetic massage therapists were not acceptable to the participants. One participant noted: “Nobody wants massage therapist who is there for a pay cheque.”

Theme 2: Confidence and Competence

Participants described confidence that stems from professional knowledge and skill, which builds trust with the patient. Staying curious, current, and providing good information were regarded highly, whereas providingmisinformation or information out of a therapist’s scope of practice reflected poorly on the profession. Knowing when to admit you don’t know the answer was valued as part of professional competence.

Theme 3: The Therapeutic Relationship

Participants described their profession as generally having excellent communication skills and being friendly and non-judgmental. Listening allowed therapists to provide empathy for and acceptance of patients while maintaining ethical boundaries.

Theme 4: Individualized Care

Participants valued personalizing all aspects of treatment in order to achieve outcomes together with each patient. Some described a tension between providing what patients wanted and what they thought was best, including with the amount of pressure that patients wanted. One participant stated: “I look for a crossing point between what [the] person wants and what I feel is appropriate. My goal is to always find where those two things come together. So that [you] feel like you got the care that you wanted … but that I provided you with care that was safe and effective at the same time.”

Theme 5: Patient Empowerment

Empowerment was described as supporting patients to take responsibility for their health by educating them about their options. “I want people to notice what’s happening in their own body and take charge.” Participants noted that patient empowerment improved compliance and health outcomes.

Theme 6: Role Recognition

Most participants recognized themselves to be health care professionals rather than service providers, and desired to be regarded as such by others. Though

some noted that recognition of massage therapists’ contribution to health care has improved over time, it should be greater. Some participants noted that a wide range in massage therapy treatments contribute to lack of role recognition by others.

Importance of The Study and Limitations:

Th is paper provides in-depth insight into massage therapists’ professional values and beliefs and may be useful information to meet the needs of massage therapists as the profession continues to evolve. Generally, participants believed that passion guides professional behavior. They expressed a reverence for personalized, evidence-based practice, and a general agreement on being a health care provider. Areas of tension were noted, including navigating financial incentive vs. the intention to heal, patient priorities vs. therapist expertise, and professional identity vs. public perception. This study could be useful for an individual massage therapist to identify why he or she may be feeling signs of burnout. Th e authors note that feeling aligned to a professional identity has been demonstrated in other health fields to protect against burnout. Could changing practice settings help therapists bring their professional identity in line with their personal identity? Is educational programming designed to unify massage therapy professional identity needed? This study has some limitations: It may not reflect the views of massage therapists in locations outside of Ontario, because differences in practice setting, government regulation, and culture influence professional identity. Also, the lead author is a massage therapist with her own beliefs about the profession. The authors addressed this by using non-massage therapist co-authors, an oversight committee, and study methodology designed to minimize interference. What does the future hold for our professional role and identity? The study team used their study results to create a questionnaire for upcoming research. They note that more research is needed on several topics, including whether lack of massage therapists’ role recognition affects their practice.