Understanding Certification & Credentialing Terminology

Hello, Everyone.

While exploring on the internet, I came across an excellent article  on credentialing  terminology written by Georgia Patrick of The Communicators, Inc.  I’m going to do my own ‘take’ on her article, incorporating some items that are specific to credentialing in the massage therapy industry. 

First off, I think many people are often confused by these terms.  Credentialing terminology can be convoluted and easily misused.  The word ‘credential’ itself is often misunderstood.  Dictionary.com defines ‘credential’ as evidence of authority or anything that provides the basis for confidence, belief, credit, etc.  ‘Credentialing’, then, is the act of conferring those credentials.  The credentials used by NCBTMB are those of certification.  The word ‘certify’ means, among other things, “to give assurance; testify; vouch for the validity of something.”  NCBTMB gives assurance and vouches for the validity of a person having the knowledge, skills and abilities to practice entry-level massage therapy in a safe and effective manner. 

In a wider since, credentialing is both a process (the act of conferring credentials) and an industry (institutions relied upon to provide independent verification and certification of individuals or processes).  Even among the multitude of people in the credentialing industry, credentialing terms are often misused.  Those who work in credentialing interact with people in many fields: education, regulation, assessment, etc.  Below are some of the terms you may encounter which relate to credentialing. 

Competency-Based Certification

This is a voluntary process through which an organization (like NCBTMB) grants recognition to those who have met specified qualifications and demonstrated sufficient knowledge, skills and/or abilities.  NCBTMB certificants have earned the NCTM or the NCTMB through the documented completion of NCBTMB’s eligibility criteria (including education), passage of an NCBTMB exam, and a commitment to adhere to the NCBTMB Code of Ethics and Standards of Practice.

Usage: Voluntary certification is evidence that the articulated standards have been met, but certifications themselves are not the same as licenses to work in a particular field. In massage therapy, it is usually the state regulatory bodies that issue licenses. In some cases, certification programs fulfill some requirements for state licensure.  The NCBTMB exams are utilized by 37 states towards their licensure requirements.  You will find that in fields where little or no regulation is present, certification programs are created by individuals in their field to provide some sort of competency measurement.  Certifying bodies in other fields (such as real estate, law, appraisal, and nursing) recognize competence in advanced or specialized areas not covered by state licensure.  

The credential conferred by these certifying bodies is frequently generic, at the foundation or entry-level, and broad, since it can encompass an entire profession.  Entry-level certifications require minimum knowledge, skills and abilities to competently practice the profession.  Once established, many broad-based programs expand their offerings by creating advanced, specialty or added qualification programs to satisfy the needs of all who seek certification through the same professional organization.  NCBTMB’s creation of the Advanced Certification is an example of this.

Curriculum-Based Certificate   

This is a certificate issued upon completion of a set curriculum.  The educational institution that offers the training also provides the certificate.  The certificate awarded may be broad (encompassing several dimensions of a profession) or narrow (focusing on a specific area).  In massage therapy, many different techniques or modalities off curriculum-based certificate programs.

Usage: Individuals receive this certificate when they complete a course or series of courses and an assessment process.  The assessment is limited to course content. As Ms. Patrick stated “The linkage to specific course content differentiates the curriculum-based certificate from the certificate of knowledge and professional certification.”

Portfolio-Based Certification

There are a few certification bodies who issue certification based upon documentation of predetermined prerequisites, without any sort of assessment.  The recognition is awarded based upon the submission of documentation showing an individual’s experience, expertise and education in a given area.

Certificant 

The individual who has achieved certification is called a certificant.  During the process of earning their certification, they are referred to as a candidate.  

Certificates of Completion

These can be given to an individual upon the completion of a specific learning program, with or without an assessment mechanism.  For example, Certificates of Completion are sometimes given at the conclusion of continuing education courses.  These are sometimes referred to as Certificates of Attendance or Certificates of Participation and are relatively narrow in scope.

Usage: These certificates do not attest to learning achieved ( as opposed to endured – someone can sit through a class and learn very little) and, therefore, are generally considered of little value.  They do serve a purpose for NCBTMB by affording a way for certificants to document their continuing education.  These are not considered true credentials because its recipients are not required to meet specified standards.

Licensure

This is the mandatory credentialing process handled by regulatory bodies.  In massage therapy, it is usually the State Boards who oversee licensure.  Licensure is the legal granting of permission to individuals so that they may engage in a given occupation or profession.  To earn a license, individuals must usually prove that they have attained a minimum degree of knowledge and skills required to protect the health, safety and welfare of the public.

Usage:  A credentialing program that is also used in some part of the licensure process is expensive and complex on national and international levels.  Licensure protects the public from incompetent practice, and sometimes chooses to do so by recognizing components of a certification program as part of their requirements.  NCBTMB is pleased to assist 37 states towards their licensure process by providing exams or certifications that are recognized towards their requirements.      

Comments

[K.Lee]

I am all for more education, but at some point, when do we stop? Do you know it costs more in CEU's and fees to maintain our licenses than most other healthcare?
I figured it was based on the fact that we have freedom to work on our own in a way that cannot be easily governed, like nursing which must be overseen by a physician. We are not medicare providers. So everyone wants more from us and I do think we should learn more, but in many ways, massage is becoming very grey area, like: Life Coaching...is it psychology or personal training, and if so where is the line?
In the era of new "Medical massage", where nothing is really new, just revisited, I'm not in favor of throwing money at it, just to brag that I have the new and improved, same 'ol, same 'ol.

[Dennis M. Nelson]

I think if certification leads us to be able to be reimbursed for insurance, then I can see the value. A couple of years ago, reimbursement for manual therapy was well received. Then, it all dried up. I was surprised to hear other massage therapist being against insurance covering massage. But, there were a lot of people that would not have gotten massage had it not been covered by their insurance. As I predicted, once it went away, many people that needed medical massage no longer got it and a lot of massage therapists were put out of work or displaced to lower paying jobs.
The problem was that too many therapists did not know how to do neuromuscular work and were only giving "relaxation" massages and not properly writing SOAP notes. There is a big difference in the codes and what the insurance company would pay for. I think if we had a certification specifically for medical massage practitioners, then we could convince the insurance companies to revisit our benefit to the medical community. True, the doctors I have worked with care more about my skills than my certification. But at least an advanced certification can get our foot into other doors. Without a seperate certification, I see no need to recertify and have the same credentials as someone who performs the entertainment massage.

[Kiva]

What K.Lee says is true...certification, CEU's and yearly licensing fees are MUCH higher for massage therapists than other healthcare professionals. I speak specifically to nursing as I am an RN.
A couple of years ago I moved out of state and it was much much easier to reactivate my RN license than to keep my Massage License. I actually just let the massage part go which is really a shame.

I feel there needs to be less be beaurocracy not more.
Not only are the fees too high but as entrepreneurs, LMT's also have
to pay for their own healthcare, quarterly taxes and business expenses. I do not see how NCBTMB benefited my career in any way.
I'm an excellent bodyworker who has experienced MANY crappy massages from licensed certified therapists. Advanced Certification just seems like another way to get more money from hard working LMT's.

[K.Lee]

"Without a seperate certification, I see no need to recertify and have the same credentials as someone who performs the entertainment massage."

Posted by: Dennis M. Nelson | 07/26/2010 at 01:46 PM

With all due respect, I'm shocked you would say that.
Ethics violations exist in every profession, massage is no different.
Why should anyone with their self respect intact even worry about the bottom dwellers of the profession? They do not truly harm us anymore than the doctors and nurses with drug addictions harm their professions.
I have cartons of certifications, plaques, titles and tags and one thing is certain; I work for my re certifications and I am fed up with it. Earning levels of skill and achievement and licenses only serves to pin one down when now one of the states I license in have added a "hands on" clause to the 24 renewal in an off year to the National. This means that where I live, I must travel to another city, rent a hotel for a two day event, then pay for both the event, time, travel and the other 12 I need for that state - which then means get ready for my home state the next year. Ridiculous. For those of us that live in radius to two or three states, does anyone at NCB not realize this is going to be the exodus for me?
I am in school for RN and the good news is that through that, I will get my lymphatic cert and still do massage - then I can save money and let all the licensing go, because I have served and served and served and received nothing from my profession in return.
If our leadership was as aggressive as the COTA's and PTA's have, we would have more access to the medical field without new hat tricks needed. I'm not a quitter, so it pains me to have to say, I cannot afford to keep throwing money at this unrequited profession: I quit.

Fact: the massage schools are usually owned, operated or directed by a member of a .... board.

[Laura Allen]

I'm distressed by the distress! And I am not rich by any means, but I don't view keeping my license, renewing my certification, and abiding by the CE requirements as a burden, either financially or time-wise.

I have made a great living in the massage profession, and I have been able to employee others who are thriving as well.It has been to the benefit of my business for courting doctor and dentist referrals. And the public in general is impressed when they walk in the door and see the wall full of our credentials displayed. I think there is a perceived value for the public and a real value for me as well. I have been NCTMB and licensed since 2000, and I can't imagine letting that go until I get too old to keep it up. I'm also looking very forward to taking the Advanced Exam. That kind of thing impresses physicians--just like board-certification is a hallmark of a well-trained and experienced doctor, so will it be for us as massage therapists.

[veronica kerr]

My biggest question would be how would be prepare for this test. When we are in school they prepare us for what will be on the exam so we know what to study. There are also several study guides that help you take the national exam. People that have been in the field for 10 plus years are doing there CE's but they are focusing on practical use in your business not on how to pass an exam. Being in the industry for over 10 years what we have to study for the exam and what we encounter each in everyday is very different. I have worked in different states and setting. I have worked with doctors, chiropractors, spas, gyms, myself and at a horse race track doing massage for the jockeys. I am duel licensed as a massage therapist and esthetician. I have also been a yoga instructor. I feel like a test could not possibly express more that what my experience already is. How will people prepare for this type of testing? I am not totally against it but anyone that has good experience they already have an advantage. I don't know what a test will do for me if my clients already see me because of my experience.

[amy]

I also have the question of how does one prepare for the test? Is there any plan in place to add a study guide to the website?

[Michaele]

Let me ask the same question a different way. Is there any plan to release a study guide for this exam. If so how soon before the initial exam?

Also Who is being invited to these meetings/planning groups that can go back to individual states and up date chapter associations and individuals who don't have them. The step by step page is frustrating. There is still a whole lot to be done. The first exam time frame is set but, I don't see alot of progress along the pyramid.

[Rachel McGraw]

I have to acknowlege the complaints from the previous postings in that the overhead of continuing ed and recertification can be a great challenge, but the choice of what to take and how it will affect an advanced exam is also a concern. I am up for recert in 2012 and wonder if I should keep this exam in mind as I select CEU courses? I usually choose these classes based on the health trends of my clientel (I have several long-term geriatric clients)and courses based on my five year business plan. How should someone in my position proceed?

[COB]

Doctors, Doctors that's not what this is about, it is about massage therapist's. We spend hours and hours of hands on touch and recommendations of human body and mind education, giving referrals to doctors and are clients walk away feeling as if they had "stepped away from reality" for a moment nothing more, nothing less.
I have obtained my certification process and it was not easy, however, I obtained it in the State where it's not regulated and when the Advanced Certification test is finalized I will take it as well. Because with that I feel successful, advancement and my clients can view my potential as a professional. We must obtain our position in this world there is so much to gain.

[Igor Shafhid]

Hello,

I think it is great that the massage field is expanding to recognize the need to integrate massage with the healthcare arena as a whole. I am a Russian doctor/Russian LMT/massage instructor/US LMT/massage instructor, and when I practiced in Russia as a doctor and massage therapist, massage was always practiced in the hospital settings as an important tool of therapy for numerous diseases and disorders. When I arrived in the US in 1993, I was surprised to see that the US western medical field had not yet recognized the importance and totality of all what advanced massage could do for treating the more serious types of injuries and diseases. I currently teach an advanced medical massage program which I developed in Russia that was utilized in hospitals in Russia and the Baltic regions with clinical results.
With all this said, I do hope that the task force will recognize the foreign massage therapists who might not be certified here in the US, but are licensed, and well qualified to be part of the advanced certfied therapists. When I arrived into the US, WA State licensed me as a massage therapist due to my Russian credentials, and thus the reason I am not certified, as I was not required to take the national test. I do hope the task force will not make certification for advanced massage based only for those current certified therapists, but that they will consider those like me.

Thanks for letting me share!

Igor

[Christina M. Gibbons]

I am very much interested in taking the new advanced exam, but I also would like to know how to obtain study materials for the new test. I would also like to know how this new test will really help me more than my certification I have now. I currently have to move around with my husband because he travels from project to project. This is very costly for me as a massage therapist. I believe the regulations for massage licensing should be encompassed nationally and recognized by all states especially if we take the new exam and pass it. Moving around so much I am constantly having to pay fees to get new licensing along with renewing my NCBTMB. When I pass the new test will I have to pay separate renewals for my NCBTMB I have now and the new certification as well? Will the new exam, since it is voluntary, be recognied by all states?

[Stephanie Shindler]

I agree with a few others that the National Certification should be based on a requirement of at least 1000-1500 hours of education, rather than having separate tests for basic (500 hour) certification and then advanced (1000 hours). At some point, more acronyms become confusing and dilute the intended meaning/message. It would be great if "National Certification" stood for one level of training.