A Study of Industry Professionalization

Luann D. Fortune

Charles Seashore – Faculty Assessor

School of Human and Organization Development

Fielding Graduate University

March 19, 2009

As a massage therapist for over fifteen years, as well as an instructor to those aspiring to the profession, I believe in the potential impact of massage as a practice and intervention. In recent years, I have furthermore witnessed a shift in the way that massage is practiced, purchased, and perceived by related service providers. Whether in response to a changing marketplace, or under the impetus of various stakeholders in and near the massage therapy field, the industry is growing and going mainstream. Parallel to that growth runs a trend to professionalize the profession, for myriad predictable reasons. However, this move to professionalism carries inherent, and possibly unforeseen, implications for the practitioner and ultimately for the consumer.

This paper describes this movement to professionalism in massage through the perspective of the environmental factors and stakeholders that are orchestrating and implementing it. Specifically, the paper focuses on associations that support massage therapy and how their visions and actions are directing industry change. In the spirit of hermeneutic inquiry, particular groups are analyzed with progressively deeper layers of consideration. The more intimate insights were collected through individual, private interviews with association directors and key administrators. Embedded in this presentation are repeated revisits to the published data and an ongoing search for substantiation from non self-referential sources. The discussion portion considers various perspectives for understanding the data and the professionalization movement through organizational theory and parallels in other industries. Finally, alternative outcomes are considered, with speculations on possible impacts.

Professionalization of Massage

Massage is gaining increasing prominence in North America as an intervention to promote wellness as well as rehabilitation. Massage was previously more accepted in the spas of Europe (Cherkin, 1998), the protocols of Chinese medicine (Carlson, 2006, p. 5), and the procedures of Ayurvedic medicine (Johari, 1996). Massage recently became more popular in the U.S. Frequently cited surveys (Eisenberg, et. al, 1993; Barnes, Bloom & Nahin, 2008) estimate that over a third of the U.S. population purchases alternative treatments for wellness, including massage therapy. Other estimates claim that 24 percent of adult Americans get a massage at least once a year (AMTA, 2007). Massage is now commonly employed to address a wide range of needs and symptoms, across populations that vary from the very aged to the very young (Field, 2001, p. 131). There is not just one channel for this impact, and in fact, there are many ways to practice this skill and art. There are estimated to be over 250 types and modalities of massage from which to chose (ABMP, 2008), and equally as many reasons for people to purchase the various types of treatments.

In the US, most professional massage is purchased by adults who self pay for the service (Field, 2001, p. 91) outside conventional health care channels (AMTA, 2006; Field, 2001, p. 91) at an average of $60 per session (AMTA, 2007). In 2004, massage therapy was projected to be a $6 to $11 billion a year industry (Barnes, Powell-Griner, McFann, Nahin, 2004). In 2008, estimates increased to $11 to 16 billion per year (ABMP, 2008). Some argue that the service might be recession proof (McGinn & Sterling, 2008) as increasingly stressed, debilitated, dysfunctional, and otherwise needy people seek out the service for the various remedies it offers (Kent, 2008, p.18).

Massage therapy as a profession is growing beyond the national average, at an estimated 20 percent per year (Bureau of Labor, 2007).  Currently, there are an estimated 265,000 to 300,000 massage therapists and massage school students in the United States (AMTA, 2007). The number of state approved schools increased from 637 to 1,529 between 1998 and 2007 (ABMP, 2008).

With wider public acceptance and consumption of alternative wellness methods, (AMTA, 2006; Field, 2001, p. 91) massage delivery channels are changing. Surveys of one national association membership (ABMP, 2008) claim that the therapist’s private office is the most common venue in which to purchase massage. The percentage of massage therapists who work in spa settings is dropping, from 41.8 percent in 2003 to 28.9 percentage in 2007 (ABMP). Perhaps this shift to a more therapy-based setting is demonstrated in the increased presence of licensing. In 1980, nine states regulated massage (AMTA, 2009a). Today, 42 states and DC regulate the practice of massage therapy (Crownfield, et. al, 2008, p. 1; AMTA, 2009). With increased regulation comes a focus on tighter standards and other measures of professional conduct.

An in-depth investigation of organizations that support professional massage therapy offers insight into the development of the market and the profession. In the past ten years a formal movement has developed amongst industry stakeholders to “professionalize” (Kahn, 2002, p. 2) the business of massage. One strategy of the movement involves standardizing the cornerstones of regulation and examination, certification, research, and education. At the forefront of that movement are a handful of professional associations.

An important aspect of the movement involves expanding research and introducing “evidence based practice” (Kahn, 2002; Bondurant, 2008, p. 1) into the process of massage. There is a new focus to fund and develop research that provides evidence of efficacy for various massage indications, protocols, and conditions (Bondurant, p. 3). The studies are primarily situated in the context of empirical research, similar to that found in medical science (Kahn, 2002a, p. xv-xvi). Research topics vary from examining efficacy of specific techniques for particular structural rehabilitation, to protocols for supporting systemic disorders such as cancer or ADHD (Field, 2001, p. 134-136), to more generalized explanations as to why massage helps relieve stress (Field, 2001, p. 87-89). A related project is presently being launched to prescribe “body of knowledge” (MTBOK, 2009) standards for training and practice. Underlying the call for evidence is the suggestion that proof will not only validate the field of massage but also direct individual treatments, as practice protocols based on the evidence become the standard.

In most practices, I think the application and interpretation of massage therapy is highly individual, variable with the therapist as well as the client, and can be considered through many coexisting metaphors (Morgan, 1997). Medical science’s empirical research offers only one such metaphor. Are the demands for evidence-based practice coming from the market, the therapists, or some other force? In depth consideration of the market perspective is beyond the scope of this paper. The impact of the movement to professionalize massage is a likely topic for my own dissertation. But the role of the associations could prove to be key. This investigation focuses on who are the stakeholders driving this movement to professionalize, what is the place of evidence-based practice in their vision, and where do their marching papers come from.

Professional Massage Associations

This study is not an expose. It does not purport to reveal what the associations actually do with their constituency, but rather what the associations report that they do. Therefore, it assumes that vision and perception guide the evolution of the associations, and potentially of the industry. Working hermeneutically (Bentz & Shapiro, 1998, p. 40) based on published text and interviews, the following sections present in successive layers: first the material details and the vision of the association, and next the underlying arguments and philosophies that propel the foremost associations.

In selecting which associations are most influential, membership size was first considered.  Also, longevity and scope of presence among therapists as well as consumers is considered.  A balance of purposes, ranging from educational to regulatory, is embodied in the complement of associations discussed. Some of these organizations are relatively young but serve an important role or function, especially in how they interact with the changing industry climate.

This paper identifies several national associations that are influential in North America, particularly in the US. Almost all practicing massage therapists are directly impacted by at least one of these organizations, either through training, licensure, certification, or association membership that also provides professional insurance. There are several professional support groups, the larger two being the Associated Bodywork and Massage Professionals (ABMP), and the American Massage Therapy Association (AMTA), which includes various influential committees such as the Council of Schools. Two smaller groups, the International Massage Association (IMA), and the American Organization of Bodywork Therapies of Asia (AOBTA) are mentioned superficially, as they are more limited in their membership and scope of influence.

There is an independent research foundation dedicated to massage, the Massage Therapy Foundation (MTF). The specialty certifier of massage schools is the Commission on Massage Therapy Accreditation (COMTA). The national certifying group is the National Certification Board of Therapeutic Massage and Bodywork (NCBTMB), which was initially the sole examining organization.  However, the Federation of State Therapeutic Massage Boards (FSTMB) has recently introduced its own proprietary exam and is replacing NCBTMB in that role.

Professional Support Association Profiles

Approximately 40 percent of practicing massage therapists subscribe to one of two professional associations (ABMP, 2009a), the ABMP or the AMTA. There is no prohibition against dual membership, though this is seldom done. The primary objective of membership, insurance coverage, is satisfied with a single subscription. Although insurance coverage is a concern for practitioners, I can find no malpractice legal cases filed against a massage therapist. Yet, the National Practitioner Databank, a tracking mechanism for complaints, lists six medical malpractice reports regarding massage therapists in the US from 1990 to 2004 (NPDB, 1992-2004, as cited in “Massage Therapy”, nd). Nonetheless, the threat of malpractice, both on behalf of consumers and as a precaution for therapists, is one motivator for professionalization tactics.

Associated Bodywork and Massage Professionals

The privately owned ABMP reports approximately 71,000 members (ABMP, 2009; England, 2007), the largest professional membership of the associations. ABMP was founded in 1987, and has steadily increased its domestic membership each year (ABMP). A foundational tenet of the organization, which continues today, is to accept a wide range of practitioners with “diverse practice choices” (ABMP, 2009a), most of who work at massage part-time (ABMP, 2009).

ABMP offers a range of membership options, according to varying educational and practice-related standards. Approximately 22 percent of their membership (Massage Today, 2005) subscribe to the highest professional category, Certified, although other options do not require continuing education or local licensing. Annual fees range from $199 to $229 per year (ABMP, 2009). Membership benefits vary with membership level, and include professional and liability insurance, subscription to ABMP publications, and marketing support. In the past two years, ABMP has also expanded its offerings of educational programs (Bondurant, 2007), including its Massage Schools Alliance geared to massage educators (ABMP). Although 31.6 percent of members have taken the National Certification exam and remain certified, as explained below, another 64.2 percent have never taken the exam (ABMP).

ABMP conducts regular membership surveys.  In 2007, ABMP sent out 4,962 electronic invitations to its then 67,432 membership (ABMP, 2009).  They received 976 responses, or 19.7 percent, which were used to construct the bi-annual membership profile data (ABMP, 2008). It is not clear from the published findings how respondents were selected, although “invitation” (ABMP, 2008) connotes less than random selection. Survey results represent 1.4 percent of their member population, and thus, the statistical significance and viability is not clear.

Based on this 2007 data, ABMP suggests a profile for their typical ABMP member. She works part-time in massage, supplements her income with another job for at least 25 hours per week, and is an independent practitioner motivated by “genuine desire to improve the well-being and healthfulness of their clients” (ABMP, 2009a). Some 83 percent of these therapists are women, the majority of whom are married, with a median age of 45 (ABMP). She has a college degree 56.5 percent of the time. She reports working in various settings, although primarily in her own private office (ABMP). She is less likely to work in a medical office now than in 2005, down from an incidence of 32.9 percent to 24.3 percent (AMBP). She uses a variety of techniques and modalities, primarily deep tissue massage some 33.1 percent of the time, but also Swedish, reflexology, and “energy” work  (ABMP). Her client contact hours are dropping, averaging 14.4 per week, down from 15.4 in 2005 (ABMP). Most of her clients result from personal referrals, and she wishes that she had more of them (ABMP). The top five reasons listed for seeking massage were “stress management, relaxation, relief from acute pain, management of chronic pain, and rehabilitation from injury” (ABMP).

American Massage Therapy Association

The AMTA is a non-profit organization, and operates under a complex set of governance bylaws and chapter-supported volunteerism. It was founded in 1943 and claims approximately 56,000 members in the US and 27 other countries (ABMP, 2009; AMTA, 2009). Until several years ago, when it was overtaken by ABMP, it led in membership numbers. It offers similar benefits as the ABMP: professional and liability insurance, publications, and marketing support.  Fees are similar; annual membership fees are approximately $255, varying slightly according to local chapter supplemental dues. However, professional membership is not offered in different levels: all members are required to meet a single set of criteria similar to ABMP’s strictest standards, including accredited training, certification, and licensing. AMTA members are required to hold valid licenses in states that regulate massage. Although not identical measurements, this demonstrates a difference in the ABMP membership where only 31.6 percent have taken the exam required for licensure. In contrast, AMTA’s vision is integral to promoting higher standards of practice.

AMTA last published their membership demographics in 2006 (AMTA, 2006), They annually publish an industry Fact Sheet based on data compilations from various sources (AMTA, 2009) that appear quite similar to the ABMP data (ABMP, 2008). The demographic profile suggested by the 2006 data is almost an exact parallel to the ABMP’s members: 85 percent are women, has a median age of 44, and works part-time as a massage therapist, spending a median of 12 hours per week massaging. The AMTA average prototype is slightly less likely, about 15 percent, to have a college degree than the ABMP member.  As with the ABMP data, the method and sources are not clearly explained or transparent.

AMTA is also dedicated to industry development, as stated in its mission: “…to serve AMTA members while advancing the art, science and practice of massage therapy” (AMTA, 2009). AMTA authored its first code of ethics in 1960 (AMTA, 2009), changed its publication name in 1986 from Massage Journal to Massage Therapy Journal, and employs a large professional staff to provide regulatory advocacy and lobbying, encourage education principles, develop practice standards, create demand for massage in the public sector, and more recently, promote massage therapy research (AMTA, 2009). AMTA’s strategic plan includes proactive pursuit of licensure in every state, and promoting brand name consumer preference for AMTA members (AMTA, n.d.a).

In 1982, AMTA established a branch, the Council of Schools, to take a leadership role in support and development of massage training institutes. Member schools must adhere to curriculum standards and meet legal requirements in their jurisdiction. In 2008, there were about 300 member schools (AMTA, 2008), down from 350 in 2001 (Barrett, 2006). AMTA’s interest in elevating industry standards is manifest in the formation of separate entities to accredit, certify, and examine. Offshoots of the AMTA, which now operate as stand-along organizations, are discussed below.

International Massage Association

The IMA is a proprietary organization based near Washington, DC. Annual fees are $199, also offered for $149 without insurance coverage. Established in 1984 as an alternative to the large associations for providing affiliation and insurance, it claims that its membership numbers are in the tens of thousands (IMA, n.d.). But industry experts (Sweeney, 2008) estimate that IMA membership is a small fraction of the ABMP or AMTA. The actual counts remain proprietary information.

American Organization of Bodywork Therapies of Asia

Founded in 1989, the AOBTA has approximately 1,500 members (Spuller, 2008). Members practice some form of oriental bodywork, such as Japanese Shiatsu or Chinese Tuina. The practice paradigms foundational to AOBTA are different from western massage, and the role of the association is to protect their membership’s scope of practice and right to work. AOBTA has been effective in getting non-western techniques included in national exams. AOBTA provides insurance and marketing support to its membership.

Accreditation Agency: Commission on Massage Therapy Accreditation

In 1989, AMTA established the Commission on Massage Therapy Accreditation Approval (COMTAA) (Barrett, 2006) in order to “improve the quality of education through an accreditation process “ (Osendorf, 2006, p. 7). COMTAA eventually transitioned to independence as COMTA and is the only accrediting agency dedicated to massage therapy education (COMTA, 2008). In 2002, the US Department of Education granted COMTA federal authority to accredit massage programs including those offered in conjunction with associate degrees (OEDb, n.d.). COMTA employs a small staff, and is governed by a twelve member volunteer Board of Commissioners (COMTA, n.d.). Competency standards that were adopted in 2003 (Ostendorf, 2006, p. 1) direct the examiners; they are based on a grass roots orientation of  “what do these people need to know and what do they need to be able to do to be successful” (Ostendorf, 2006, p. 6).

COMTA’s role is to ensure that schools meet industry “competency-based standards” (Hymel, 2003) for basic training. COMTA includes in its curriculum standards a research competency component (Hymel, 2005) in order to “call the profession to a potentially heightened level of credibility” (Hymel, 2003, p. 194). Of approximately 1,300 domestic schools or programs in massage (PubMed, 2009), COMTA has accredited only a small fraction, approximately 100. This proportion is in part due to the rapid increase in massage training programs in non-dedicated schools, such as those now part of college offerings.

National Certification Board of Therapeutic Massage and Bodywork

In 1992, AMTA created the NCBTMB in order to promote national standards and certification, specifically through licensing. Over 91,000 massage therapists are now certified through NCBTMB (NCBTMB, 2007). NCBTMB, a non-profit organization, separated from AMTA and established its own charter in 2007 (NCBTMB, 2007a). It is currently recognized by the National Commission of Certifying Agencies (NCCA) (Barrett, 2006; NCBTMB, 2007).

NCBTMB promotes higher standards of “ethical and professional practice through national certification” (NCBTMB, 2008). They advertise a pledge with four tenets: safe conduct, confidentiality, professionalism, and ethics and accountability  (NCBTMB, 2008), and claim an important role in setting standards “to protect consumers, employers, and the profession” (NCBTMB, 2007). They promote this role as enabling increased national mobility for the professional massage therapist. They also provide a grievance process for investigating complaints.

In order to take NCBTMB’s exam, applicants must complete a minimum 500-hour accredited massage training program. After passing the initial exam, credentials must be renewed every four years.  Criteria for certification renewal include an annual minimum of 200 hours of massage therapy contact (Bureau of Labor, 2007) and 48 hours of continuing education over a four year period (NCBTMB, 2007).

Until last year, NCBTMB’s examination was the standard requirement for licensure in most states.  However, an examination recently introduced by the FSTMB is quickly being adopted as the preferred vehicle for licensure. In seeking to retain some segment of the business, NCBTMB is positioning itself as the certifying body. According to one local massage licensing board member (Casperson, 2009), NCBTMB’s future could include certifying in advanced techniques or modalities, but at the moment the situation presents a quandary. Since NCBTMB is currently the only certifying option, any massage therapists wishing to be certified must first take the NCBTMB exam. Yet many states are now asking for the new FSTMB exam in order to license.

Regulation: Federation of State Therapeutic Massage Boards

In 2005, a handful of state regulators initiated the formation of the FSTMB to support member massage therapy licensing bodies. Their intention was to establish compatible requirements and cooperative procedures between jurisdictions, and also share data, such as that related to disciplinary history (FSMTB, n.d.). Of the 43 states that regulate massage today, 39 and the District of Columbia and Puerto Rico are members.

Consistent with other regulated professions, states require that applicants have passed a recognized examination in order to be licensed as massage therapists. In 2008, FSTMB introduced its own examination of entry-level competence, the Massage & Bodywork Licensing Examination (MBLEx). It has already been adopted by 17 states.  The MLBEx, is likely to become the national standard for the industry.

Research: Massage Therapy Foundation

In 1990, the AMTA established a separate research arm, the MTF that transitioned to a separate 501c3 non-profit corporation. Today, it has an annual operating budge of about $250K, four dedicated staff, and is governed by a volunteer board of 11 trustees.  Despite fiduciary independence, MTF still shares its executive director with AMTA, being allotted about ten percent of the director’s time (Thompson, 2008).

MTF raises independent funds, and distributes grants to massage therapy dedicated research, education, and community outreach. The AMTA is still their largest contributor (Thompson, 2008). Since 1993, MTF has granted $245,000 for community service projects, and $441,000 in research grants (MTF, 2008). MTF recently introduced a program to teach massage educators to incorporate research literacy into their curriculum (AMTA, 2009c). In addition, MTF provides a massage therapy research database with over 5,000 entries (World Massage Forum, 2007), and last year launched a quarterly peer review journal, the International Journal of Therapeutic Massage & Bodywork (IJTMB), which is offered free from an online platform.  IJTMB is only one of two scholarly journals to focus on massage and bodywork, the other being the Journal of Bodywork and Movement Therapies.

MTF funds projects based on an established research agenda that has evolved since 1999 (Cassidy, 1998/1999) and is further articulated in the Massage Research Agenda (Kahn, 2002).  Fundable research is based in the empirical medical science paradigm, and focuses primarily on disease or dysfunction (Thompson, 2008). MTF plans a symposium in May of 2010 to update the agenda.

Spiraling deeper into the professional stakeholders

In keeping with the hermeneutic method employed for this study, a review of the published information identified threads for deeper inquiry. This resulted in a series of interviews with principals of key stakeholder organizations. Since AMTA is seminal to most of the entities, a pivotal interviewee was AMTA Executive Director Liz Lucas. Related threads of investigation lead to interviews with Diane Thompson, MTF President, Glenn Hymel, IJTMB Editor, John Gosse, Acting Director of COMTA, and Les Sweeney, Executive Director of ABMP. Interviews were tape recorded when possible, and are transcribed in Appendix 1. Gosse also provided additional COMTA reports documenting interviews conducted in 2006 with prior commissions and directors. These appear in citations in the text and the reference section. Finally, a locally assembled group of massage therapists shared their insights as to how they see their work. Notes from the discussion (2009) appear in Appendix 2.

AMTA’s Agenda: Four Cornerstones of Professionalism

Based on their mission and formational role in advancing a fellowship of support organizations, the AMTA is an orchestrator of the movement to professionalism (Lucas, 2006). A personal interview with Executive Director Liz Lucas (October, 2008) confirmed and elaborated this position. Lucas considers the domestic pool of currently practicing massage therapists to be roughly 260,000. AMTA represents about a quarter of the practitioners, but Lucas implies that her organization interprets to and promotes with the entire marketplace (Lucas, 2008).

According to Lucas, AMTA is not simply driving the movement but reacting to changes in the environment. The information age has fed maturation of the marketplace; demand for massage, which is mostly urban, increases as it is better appreciated and understood (Lucas, 2008). As demand proliferates, employment opportunities increase creating the potential for slipping standards as a byproduct of rapid growth. Subsequently, there is a “cry from regulators” (Lucas) for consistency in entry-level education. Lucas suggests a model for incorporating the key industry stakeholders into Four Cornerstones of Professionalism: licensure, certification, accreditation, and research.

Licensure

AMTA’s goal is for licensure in all states, an objective supported by 90 percent of AMTA members (Lucas, 2006). Forty-two states and DC are now regulated. However, in other jurisdictions right to work remains an issue for therapists concerned with practice restrictions. In some venues, regulated practice now allows protection for massage therapists to practice their trade legally where affiliated professions previously challenged their legality (Greene, 1997, p. 87). Those turf battles are now maturing within regulated systems, although levels of professional recognition through license requirements remain contested (Eisenberg, Cohen, et al., 2002, p. 965).  AMTA is positioned to play a role in shaping how regulation is executed, and supports FSMTB as a partner in this function.

FOUR CORNERSTONES OF MASSAGE INDUSTRY PROFESSIONALISM

On the lobbying side, AMTA and its regulatory advocacy program and support staff continue to play a key role in attaining uniform and domestic licensure in every state. Although the FSMTB has an intrinsic interest in regulatory penetration, it is not a lobbying group. Instead, it fulfills a regulatory coordination role, exerting influence to impose consistence standards. It supports national mobility for practitioners, now more able to move from state to state and become licensed. One exam will lend consistency, and though “NCBTMB has temporarily filled a gap, we need to look at other regulated professions as models” (Lucas, 2008). FSTMB does not support the use of dual exams: “having a choice becomes a moot point because the MBLEx is clearly the only appropriate exam” (FSTMB, n.d.).

Although superficially this argument is practical, endorsement of a single exam by the examiner smacks of commercial or political self-interest. Also, the organic need of the proposed mobility is questionable based on the demographic data.  Since the majority of massage therapists practice as a part-time pursuit, most are not jeopardizing livelihood in moving to another jurisdiction since for most therapists, another job is their major income source. This point does not diminish the value of professional mobility, but raises the question of whether the concern is actual or projected based on stakeholder’s visions.

Certification

As the FSTMB becomes the examiner of choice, the viability of the NCBTMB arises. Lucas’ cornerstone model endorses a distinction between licensure and certification. Licensure should be the minimum standard for competency (Lucas, 2008). Advanced credentials and continuing education are certifying issues. NCBTMB is currently filling that role, but Lucas points out that this function could also be assumed through the FSMTB. In fact, the introduction of the new FSMTB exam creates a paradox for newly examined therapists who want to establish certification. They would have to take another exam, the one offered by NCBTMB, in order to obtain renewal certification. This situation is the result of stress between stakeholders, and likely to spark further debate.

NCBTMB has a history of controversy in its management, operations, and dealings with fellow associations (Razzo, 2005; NCBTMB, 2007b; Bondurant, 2009). Besides having a reputation for mismanagement and internal chaos, its contentious relations with fellow associations were apparent to the public by 2005 (Razzo). NCBTMB initially opposed the formation of the independent Federation in 2005. Its reported unresponsiveness to FSMTB’s requested changes to NCBTMB’s examination prompted FSMTB to introduce its own exam, the MBLEx. This subsequently removed NCBTMB’s virtual monopoly on this market. Currently, both AMTA and ABMP have endorsed the MBLEx as the preferred and sole professional exam (Bondurant, 2009). Hawaii and New York continue to offer their own proprietary exams.

A pre-requisite for taking any of the state exams is completion of an accredited program in massage therapy. Recent trends in providing this adult education are changing these offerings with consequences that affect the key stakeholders (Lucas, 2008; Sweeney, 2008; Gosse, 2008).

Accreditation

Massage education that consistently conveys standards is a critical cornerstone. While schools and programs have increased, including those accredited by COMTA, AMTAs Council of Schools membership decreased approx 18 percent (AMTA, 2008; Barrett, 2006). This is attributed to two factors. First, there is a move towards corporate ownership of schools (Lucas, 2008), e.g., the ten-location chain owned by Cortiva (Schwartz, 2006, p. 2). “what you’re seeing…is this consolidation with these big companies such as Cortiva” (Freeman, 2006, p. 8). Thus, multiple locations now count as one school. Second, many massage training programs are now contained in colleges or broader based vocational schools (Gosse, 2008). In these cases, many of the programs are accredited by a generic agency and less foundationally intertwined with the AMTA and its agenda for uniform, higher standards.

A goal of the AMTA is to have all massage therapy schools and programs accredited by a “USDE recognized agency specializing in massage therapy education standards” (AMTA, n.d.). At present, COMTA is the only such agency. COMTA is still young in its own standardization process, having adopted detailed procedures only in the past five years. Establishing a clear and consistent internal process has itself been a struggle (Gosse, 2008; Thomas, 2006). It took years to move into being a “proper accreditation agency” (Gosse, 2008).

Despite the recent focus on evidence-based practice, COMTA’s intial standards were practitioner driven. “What accreditation should really be concerned with is what can the people do on the way out, not how many people they’ve been associated with who have Ph.D.’s or how many books there are” (Freeman, 2006, p.11).  But in addition, standards lay the ground work for evidence-based practice: “coordinating the various curricular, instructional, organizational, and resource areas (is) essential to advancing massage therapy research competencies” (Hymel, 2003).

A former COMTA commissioner argues that standards are important for the employer: “…the massage industry was growing so rapidly without standards that it was important for us (COMTA) to make a stance to show employers that, hey, if your applicant has graduated from a COMTA accredited school, then you know they have X,Y, and Z competencies…. we constantly have employee retention issues, so you have to really be wise how you interview people and we need to look to the resources that are providing the right education to the therapists.” (Trieste, 2006, p. 2). This interest might not be meaningful to most massage therapists, who as noted above, are largely self-employed (AMTA, 2005; ABMP, 2009).

Greater uniformity is a likely by-product of massage school ownership consolidation. “… The extent to which more schools are owned by a smaller group of owners there’s going to be a tendency toward standardization within those institutions” (Freeman, 2006, p 8). Uniform standards also appeal to corporate reframing of massage product offerings. Larger concerns are likely to have the financial resources required to influence developments (Schwartz, 2006, p. 5).

Even if standardization is successful, there are downsides. “standardizing high quality gives you high quality.  But it does lessen the opportunity to try new things…so to the extent that creativity and diversity was a value in developing the profession’s educational processes that could be lost” (p. 8). But accreditation standards help to improve credibility outside the massage community.  Massage therapy is “far more acceptable in the healthcare profession even than it was 10 years ago. I know absolutely COMTA played a part in that” (Schwartz, 2006, p. 6).

The intertwined relationship between COMTA and AMTA continues to influence vision and practice e.g., “AMTA was HUGE in…ongoing financial support” (Ostendorf, 2006). Financial support is also linked to competitive considerations. One former commissioner claimed that COMTA’s evolution from AMTA committee to nationally recognized accrediting body was a result of AMTAs concern for competitive advantage over ABMP. “We were faced with a competitor that was an outgrowth of ABMP—I don’t know what that acronym stands for I’m sorry to say…so the commission made a decision to move forward.” (Ostendorf).

COMTA faces many challenges, including competition from the primary accrediting agencies Academy of Clinical Close Encounter Therapies (ACCET) and Accrediting Commission of Career Schools and Colleges of Technology (ACCSCT) (Trieste, 2006, p.2) . In addition, there are concerns related to evaluating the teaching of fundamentally kinesthetic skills in increasingly techno-centric learning environments. “It’s really going to be a challenge for COMTA to find the appropriate response to Distance Education….(but) just think of the ramifications if you don’t have control of the actual environment of learning” (Ostendorf, 2006, p. 7). That the COMTA commissioners are considering such complexities speaks to its inherent industry-based perspective. Accordingly, COMTA has potential to consider training elements from a more meaningful position than educators with little understanding of the massage process. However, the question remains as to whether COMTA can exert influence quickly enough to command critical mass of the massage program market. (Schwartz, 2006, p. 5).

Research

Through certification and accreditation, “nationally uniform credentialing are necessary to ensure…more generalizable clinical research” (Eisenberg, Cohen, et. al., 2002). As massage use increases, and is increasingly positioned as a complimentary and alternative medicine (CAM) practice, allied health care professionals are calling for “accessible high-quality evidence from clinical trials to show which CAM therapies work best and for which conditions” (Manheimer & Berman, 2004, p. 268). Research is a keystone to professionalization as an adjunct medical service, although it begs the question of the overall impact of that positioning.

The MTF’s entry into the research arena is only one of recent developments. Until about 15 years ago, scientific research of massage was rare.  One early proponent of touch research, T. Field, gained national attention and funding due to her early work with premature infants (Field, 2001). Field went on to form a dedicated organization, the Touch Research Institute (TRI). Today, TRI has conducted over 100 studies on massage and touch, many focusing on infants (Field, 1999). The National Institutes of Health established their National Center for Complimentary and Alternative Medicine (NCCAM) in 1998 (NCCAM, 2009a).  In 2008, NCCAM’s total appropriation was $121,577,000. Although only a fraction of that amount was allotted to massage dedicated studies, “the scientific evidence base for integrative medicine will rest on data from both clinical trials and basic research that elucidates biological mechanism” (Briggs & Turman, 2008).

One indication of how CAM is gaining wider acceptance is that a conventional medical professional suggested it in 33 percent of the cases (PubMed, 2009). But lack of empirical research makes some allied health care professionals nervous (Cherkin, et. al, 2002, p. 378). Research, specifically that situated in the medical science paradigm, “gives credibility to massage, because Western medicine wants research-based evidence.  Massage is moving in that direction” (Schwartz, 2006, p. 7). Some scholars have acknowledged that the medical model is limited in its ability to capture the full range of benefits from massage, suggesting that a psychotherapy perspective of efficacy would be more meaningful (Moyer, Rounds & Hannum, 2004). However, critics from the more conventional perspective continue to label some modalities or techniques embedded with massage therapy as “quackery” (Barrett, 2006).

In addition to benefiting allied providers, massage research will help “all our stakeholders: insurance companies, referring care givers, pharmaceutical industry, researchers, the educators” (Thompson, 2006). Research will also force a standardization of language. Thompson asserts that currently the terms used differ amongst therapists, as well as between massage and other health care providers. Primarily, the consumer will benefit. Research will help better answer consumer questions: “should I be getting massage, how will it make me feel differently, how does this work with my medication, how does this work with my relationship with my health care provider” (Thompson). Ultimately, it will inform the therapist as to how to work more effectively, i.e. “how we can give the best care possible” (Thompson).

Thompson expresses another underlying agenda more relevant to individual practitioners: insurance reimbursement such as that provided in Washington State (2008). Research, as well as minimum professional standards, will support insurance reimbursement (Cohen, et al, 2005). “It is perfectly understandable—even just and laudable—that massage therapists of high caliber would desire professional recognition for what they are able to do, and that they would want their practices to have enhanced access to insurance payment plans that fund the vast majority of healthcare costs in this country” (Juhan, 2007, p.5). However, numerous debates now active in the health care industry dispute whether insurance reimbursement is an advantage, given the move to health care cost containment (Ziegenfus & Bentley, 2003, p. 232). “Our system has developed a technological and pharmacological expertise that is truly remarkable. And these developments in turn have made our healthcare by far the most expensive in the world “ (Juhan, 2007, p. 1-2).

In summary, research is intended to bestow legitimacy to the profession, and solidify the right of massage therapists to practice their trade. This aspect intersects with scope of practice, and is further addressed in regulatory activities. But it might have unintended and possibly uncontrollable consequences. “The result of more uniform licensure and credentialing may be excessive standardization and a decrease in individualization of services. Thus, increased standardization of credentialing for CAM practitioners may alter CAM practice substantially.” (Eisenberg, 2002) In this professionalization process, the character of massage therapy could be permanently altered. “What we could lose is the very basis of open-ended inquiry and exploration that have made us “alternatives” in the first place” (Juhan, 2007, p. 7).

ABMP: the Counterweight

ABMP often appears as a contributor and supporter to research projects (Health News, 2007) and alliances to establish industry standards (MTBOK, 2009). A personal interview with ABMP Executive Director, L. Sweeney (2008) provided further insight on ABMP’s view of the market and movement, which contrasts with the views held by AMTA.

Sweeney is “not sure” about AMTA’s push for professionalization (Sweeney, 2008). Pursuit of massage therapy as adjunct health care has “not turned out to be as viable a path as some expected” (Sweeney). He predicts a “third party pay backlash” that will make insurance reimbursement a stumbling block for massage therapists already stressed financially. Sweeney further suggests that accreditation is not necessarily the “panacea”, as massage providers compete for increasingly limited disposable income. Instead, marketing is the key, which must be supported by consistent and reliable practices in massage education. Sweeney thinks that ABMP’s commitment to supply members improved marketing tools, supporting a broader array of massage opportunities, is one of their cornerstones.

From the metaphor of recognizing the political aspects of association interaction, Sweeney states “ABMP and AMTA have differences in constituencies, but still have more in common than not” (2008). From a practical standpoint, Sweeney suggests that the professional gestalt will be enhanced by medical community acceptance and that even spa-based massage could benefit from research. However, “not every school needs to embrace research and research literacy” (Sweeney, 2008).  According to Sweeney, the massage therapist “wants to be defended against the skeptics” (Sweeney), and personal experience is the critical factor. But there is room for evidence informed awareness in the variety of massage settings: even spas appreciate research (Sweeney). Whether ABMP’s partnership in some efforts is motivated by collaboration or strategic self-defense, their presence will influence the ultimate direction of professionalization developments.

Massage therapist perspective

Survey data that claims to represent how massage therapists view their work appears self-referential.  The AMTA and the ABMP quote each other’s proprietary data, and furthermore claim that other data sources, including the U.S. Department of Labor have questionable data (Sweeney, 2008).  Both associations agree that there is not, to their knowledge, any studies that investigate how massage therapists experience their work, how they decide to work on any given client, or how their choices are influenced by their work setting (Lucas, 2008; Sweeney, 2008).

In February 2009, at a small assembly of local AMTA massage therapists, I asked for metaphors for how they viewed their work with clients (Appendix 2). They suggested a breadth of possibilities, from their role as a “provider of safe touch” to that of a “re-embodier”, or one who “put(s) body together, put(s) body with mind and spirit” (Appendix 2). One metaphoric role was that of “body mechanic” (Appendix 2). They were further asked, based on their familiarity with the current movement towards evidence-based practice, how their insights related. All agreed that the move to evidence-based practice only recognized the “body mechanic” function.

Medicalization of massage could adversely affect massage therapists’ freedom to integrate various techniques and modalities. “Legitimate practice of massage therapy…can help people relax, relieve aching muscles, and temporarily lift a person’s mood. However, many therapists make claims that go far beyond what massage can accomplish” (Barrett, 2006). Barrett (2006) goes on to name various techniques that are not medically based as “quackery”, and warns consumers and regulators that such practices should be abolished. “It is very likely that conservative medical experts will have the power to say what it is, who can practice it, and exactly how it is to be practiced” (Juhan, 2007, p. 7).

Discussion

The move to professionalize massage has both risen from changes in the environment and constructed its own environmental changes. Positions of the stakeholders can be examined from separate metaphorical perspectives of how organizations and entire industries operate. Although more conventional paradigms of organizational theory, based on the analogy of a machine (Morgan, 1997), are not considered here, one summarizing comment from a former COMTA commissioner invokes a mechanistic perspective.

“Massage is a sort of free-wheeling occupation.  A lot of them did not like what they were seeing in the AMTA in terms of moving toward more standardization, that sort of thing.  They thought it would be imposed on them against their will.  And that’s happened in some ways” (Thomas, 2006, p. 4).

Organizational Theory: Organization As Organism

The metaphor of the organization as an organism relies on the organic nature of human groupings, especially in context of their environment (Morgan, 1997, p. 34). This perspective tends to focus on how interactive forces shape development. A set of constructs called Population Ecology (Morgan, 1997, p. 61-64) is grounded in Darwinian principles. Survival depends on an organization’s ability to control adequate resource supplies (Morgan, p. 61) as the population progresses through phases of variation, selection, retention, and modification. From this perspective, the organization is a discrete entity interacting with the environment (Morgan, p. 64) in an ongoing, open-ended process. The organization is highly opportunistic, and monitors environmental conditions.

This paradigm particularly reflects how the ABMP sees the evolving massage industry, as well as its own role (Sweeney, 2006). One aspect of this view, developmental openness, allows increased options for innovation (Morgan, 1997, p. 65-66). ABMP’s advanced marketing efforts seek to exploit such opportunities. But the perspective also allows for reciprocal change, since not just single entities but whole eco-systems evolve (Morgan, 1997, p. 64). Assumption of scarcity indicates that evolution will occur competitively. But if the assumption becomes that resources can be self-generating, entities can collaborate (Morgan, p. 65), e.g., as ABMP’s position on alliances for accreditation and research. ABMP acts as an “agent operating with others” (Morgan, p. 69) both in its interaction with and its construction of the massage industry. Neglected aspects of the population ecology, such as consumers who still need to be introduced to massage, can be cultivated. Thus, ABMP supports the national chain, Massage Envy, in spite of a lack of commitment to higher standards. Potentially, new patterns of inter-organizational and inter-environmental relations can shape future development in a proactive way. Organizational theorists argue “social and economic resources, especially in a knowledge economy, are inherently self-generating” (Morgan, p. 63-64). Through environmental interaction, innovators can create value niches that did not previously exist (Morgan, p. 63).

Another example illuminated by the organic viewpoint concerns the language of massage therapy. As a byproduct to create evidence for practice, standardized definitions of massage terms (Thompson, 2006) are evolving out of necessity. Terms that were individual and personalized are channeled into organizational missions and process. Various outlets, such as accreditation procedures, examination protocols, and research parameters, spread the usage and application of uniform definitions. Eventually, these become homogenous and universal.

Understanding evolution in the massage industry solely through organismic perspective has limitations. Organizations are not materialistic entities (Morgan, 1997, p. 64) but rather social constructions of their members (Morgan, p. 69). The potential for self-directed organizational transformation (Morgan, 1997, p. 63) is better appreciated through another metaphor, that of organizations as agents of flux and transformation (Morgan, 1997, p. 251-300).

Organizational Theory: Organization As Agents of Flux and Transformation

Some organizations encounter problems by failing to recognize how they interact with their environment (Morgan, 1997, p. 258). Characteristic of so-called “egocentric organizations” is a self-centered perspective dominated by a narrow domain (p. 260). Subsequently, they advance the agenda of the minority, mistaking it for a force of critical mass. In the massage industry, different perspectives can claim that the proponents of professionalization are either leading the pack or being chased by it.

An alternative is for organizations to see themselves as agents of change. Astute organizations appreciate that they do not exist separately from their environments (Morgan, 1997, p. 298). Instead, they continually influence the processes that construct the atmosphere and are furthermore inseparable from it. The AMTA, along with its offshoots, explicitly embraces this metaphor. Advancing along this line of thought, they can engage the change process mindfully through collective and individual self-reflection and behavior. “The way we see and manage change is ultimately a product of how we see and think about ourselves” (Morgan, p. 298).

Change agency carries inherent risks, especially if generative efforts operate in a closed system of relations. In such cases, entities misguidedly strive to clone their goals in various incarnations, as “their own organization and identity is the most important product” (Morgan, 197, p. 253). They do this by engaging in “circular patterns of interaction that are self-referential” (p. 253). Under these criteria, the AMTA cornerstone model is vulnerable to inbreeding.

Successful change management tends to allow for value consideration, reflection, synthesis, and process integration (Hatch, 2006, p. 319-320) at all levels of ownership and influence. Open-ended collection and transfer of information can strengthen mutual learning, and help avoid common pitfalls of growth. One potential pitfall, labeled the “competency trap” (Hatch, 2006, p. 320) is when organizations fail to recognize that directed changes result in little or no competitive advantage. In this application, the change refers to the reorientation of the industry towards the medical model. If successful, this could result in bifurcation of massage therapy into either medical practice or spa setting. Where the non-medical, non-spa massage would then reside is questionable. The benefits of such an outcome are unclear.

Organizational Theory: Chaos Theory

Examining the organizations and their principals surfaced multiple incidences of inconsistencies and mis-matches. For instance, revisiting the challenge of incongruent language that MTF’s Thompson raises (2008) it is critical to note that many in the healthcare community do not equate “therapeutic” with “medical” (Juhan, 2006, p. 5). Some constructs in massage practices are clearly outside of evidence-based practice. But in defense of some “quackery” techniques (Barrett, 2006), “energy medicine”, as it is known in other circles, is practiced by many (ABMP, 2009) and purports to be foundationally supported by theoretical advancements in physics. “Undreamed of discoveries about how human beings function and heal are appearing at a rapid rate, as many researchers are breaking ground by learning to ask new kinds of questions that specifically challenge conventional scientific wisdom” (Juhan, p. 7). Some argue that forces towards professionalism, especially evidence-based practice, could be edging us toward a “trip switch that could have major unintended consequences” (Juhan, 2006, p. 5).

Invoking precepts from Chaos Theory (Morgan, 1997, p. 299), organizations and their environments are part of an “attractor pattern” (p. 265) that holds together until pushed to the edge of chaos, and then flip into new patterns that are always coherent.  Allowing for the butterfly effect, the challenge is to introduce small, manageable changes that can morph into major impacts (Morgan, p. 299). In the process, insight can be gained by examining “paradoxes and tensions that are created whenever elements of a system try to push in a particular direction” (Morgan, p. 299).

Final Thoughts from Organizational Theory

Organizational theory suggests that best the chances of transforming along with the environment is through “open-ended” evolution (Morgan, 1997, p. 261). Empirical science makes many claims, but open-endedness is not one of them. In its goals, the AMTA states two points: “Massage therapy practice will be evidence-based” and, that “People recognize the power of touch to affect the mind/body/spirit continuum” (AMTA, n.d.). Yet, AMTA offers no tactic to reconcile the incongruity between pursuing evidence situated in empirical medical science and the mind/body/spirit continuum. MTF further recognizes the value of finding another model to apply to wellness questions (Thompson, 2006). For MTF’s upcoming conference to revise its research agenda, it plans to convene a group of massage therapy experts “put them in a room and close the door” to create strategies (Thompson, 2008). Applicable organization theory suggests that they will be most effective if they remember to take practice realities into the room with them.

Conclusions

“I don’t know. But it’s different, and whenever the world changes, you wonder how it’s going to be.  Clearly the world is changing. (Freeman, 2006, p. 9)

Organizational theorists (Morgan, 1997, p. 63) claim that entities become extinct as a result of change that results in a less effective environmental fit. As the association stakeholders continue to respond to, as well as construct industry change, extinction could apply to any of the associations, the cornerstones, or even the craft of massage therapy as it was once practiced.

Massage therapy industry stakeholders should be mindful of the idea that change has a mind of its own. Like other developmental phenomenon, it is an “emergent phenomenon” (Morgan, 1997, p. 299) that eludes predetermination and evades control. Attempts to elevate professional standards will be effective as they match the needs and desires of the massage consumer and practitioners. But attempts to manipulate the culture in pursuit of vision that lacks consensus is ladened with unpredictability.  Stakeholders can benefit from systematic reflection and planning directly related to industry developments. Unfortunately, “order becomes apparent only with hindsight” (Morgan, 1997, p. 300).  In the case of evidence-based practice, this could be an idea that is generative.  Or it could be a residue from a prior paradigm, based in empirical medical science and practice, whose potential application has already diminished.

Acknowledgements

The author wishes to acknowledge the cooperation, candidness, and assistance of Diane Thompson, Director of MTF, Glenn Hymel, Editior of Journal of Bodywork and Movement Therapies, Liz Lucas, Executive Director of the AMTA, John Gosse, Interim Director of COMTA, Les Sweeney, Director of the ABMP, and members of the D.C. Chapter of the AMTA for providing personal, individual interviews and sharing non-proprietary industry and association information.
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What Massage Therapy Research Means to You:And what you can do about it

With Luann Fortune, LMT, NCTMB, MA, Doctoral Candidate
An interactive workshop and discussion

For AMTA DC Chapter
November 6, 2011
In the past decade, medical science has taken an increased interest in massage therapy.  Seems like we read about a new clinical study or finding about every week in the popular press.  But other than serve as a useful marketing tool to generate new business, what application does this research have for the seasoned massage therapist?
In this hour presentation, Luann Fortune will describe how the growing body of scientific research is already impacting your everyday practice.  Find out how it is likely to continue to have an impact, how you can stay on top of the latest findings (before your clients tell you about it), and what you can do to be part of the movement to research (or not to research).
Luann has been practicing and teaching massage therapy in D.C. for over 20 years.  She has published numerous papers and articles, including a study on the impact of licensing on massage therapists (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091437/).  She is currently completing her doctoral dissertation in Human Development at Fielding Graduate University; her research examines how massage therapists conduct their work.  Luann can be contacted at lfortune@email.fielding.edu.

]]> http://lufortune.wordpress.com/2011/10/06/research-for-massage-therapy/feed/ 0 lufortune http://lufortune.wordpress.com/2011/10/06/paper-presentation-at-sphs-2011/ http://lufortune.wordpress.com/2011/10/06/paper-presentation-at-sphs-2011/#comments Thu, 06 Oct 2011 14:51:14 +0000 Luann http://lufortune.wordpress.com/?p=108 Continue reading →]]> At the Annual Meetings of the Society for Phenomenology and Human Sciences, I will be presenting on my application of ethnomethodology to my dissertation research that focuses on how massage therapists construct a whole work session.  It will be held in Philadelphia, October 23-24, 2011.  My paper is called: Capturing Silent Voices:  Ethnomethodology for Translational Research on Complementary and Alternative Practice (on the SPHS program as How Do Massage Therapists Accomplish A Whole Treatment Session: An Ethnomethodological Study).

]]> http://lufortune.wordpress.com/2011/10/06/paper-presentation-at-sphs-2011/feed/ 0 lufortune http://lufortune.wordpress.com/2011/10/06/infant-massage-workshop-autumn-2011/ http://lufortune.wordpress.com/2011/10/06/infant-massage-workshop-autumn-2011/#comments Thu, 06 Oct 2011 14:46:27 +0000 Luann http://lufortune.wordpress.com/?p=105 ]]> I will be teaching infant massage for new babies and their parents/caretakers/loved ones on Saturday, November 5 from 12:30pm to 2:30pm at Circle Yoga, in NW DC.  Please contact Circle Yoga to register at 202 686-1104

A Reflective Paper

HOD753A – Epistemologies of Scholar-Practitioner Approaches

Marie Farrell, Faculty Assessor

Luann D. Fortune

Submitted January 24, 2008

Fielding Graduate University
TABLE OF CONTENTS

Introduction

SITUATING MYSELF

COURSE OVERVIEW & MATERIALS

MY SCHOLARLY CONTEXT

THE INTENSIVE

IRB

The Process

CULTURES:

Positivism

Interpretive Social Science (ISS)

Constructionism

Radicalized Discourses:

Critical Race Theory

Ethnic Studies

Feminism

Queer Theory

Post-Modernism

CULTURE AS METHOD

Ethnography

Participatory Action Research (PAR)

Case Study, Interviewing & Participant Observation

CONCLUSION: MY MOMENT

 INTRODUCTION

In an early scene in the film, Sliding Doors (Pollack, 1998), Gwyneth Paltrow narrowly slips through closing subway car doors, and rides into a life full of change, strife, and meaning. In a technique permitted by the medium, at the same instance she misses the door opening by seconds and plays out a different life story. Thus begins the parallel plots of this romance, where the viewer is allowed to experience two versions of the character’s life as it develops in increasingly divergent projectiles.

I can relate to the Sliding Doors metaphor at this moment in my academic career. But unlike Paltrow’s oblivious character, I appreciate that the doorway I cross will inform my scholarly journey. I am a new doctoral student examining my epistemological positioning in my work. I recently completed the course work for Epistemologies of Scholar-Practitioner Approaches (753A) and participated in the intensive workshop with Marie Farrell at the 2007 Fall Research and Practice (RaP) Session. The course examines how social science scholars establish their investigations, both conceptually and methodologically. This excellent intensive helped me consider how my story could play out different ways.

How I align my intellectual sensibilities at this critical moment is a broad question. My selection of a program, my mentors, teachers, and course work reflect those choices. They are important, and will influence how others, and most importantly, how I view my work. Also, my philosophy, or epistemology, will impact my selection of what is important to know, my ontology, and the research questions that follow. My foundational worldview will ideally direct my research methods, and my ability to influence thinking and create relevant knowledge.

The process has already begun despite the weightiness of these considerations. I have selected a program, a topic that preceded it, a mentor, and I have commenced my work. These elements are each intrinsically linked to a leading Culture of Inquiry (Bentz & Sharpiro, 1998). The opportune placement of my 753A course, early in my Fielding adventure, allows me to understand the underlying basis for different perspectives and considering the ways they can influence my expression. The purpose of this paper is to reflect on the course material and consider my choices.

This paper is arranged, consistent with Dr. Farrell’s presentation framework (Farrell, 2007, Table of Contents), to consider my context as well as the course content. I first provide an overview of the process and materials and situate myself in the examination. I then take a closer look at the specific cultures and methods. Here, I expand on a technique used most effectively in the workshop: the use of film to demonstrate the use of perspectives. I found this vehicle enhanced my understanding of both theory and application. I conclude with a brief discussion of how I can situate my future work.

SITUATING MYSELF

The timing of this course was well placed synergistically. After my New Student Orientation (NSO) and Learning Plan (LP) work in September, I immediately began an online Doctoral Competencies Seminar (DOCS). This valuable course touched on various elements of scholarly practice, and addressed the periphery of underlying epistemologies. Advantageously, 753A picked up where some of that course work left off. I launched into an online Human Development and Consciousness (HOD702) course in late September. One reading was an overview by Goldhaber (2002) who suggests a paradigm for considering schools that study human development. This contributed to my fluency in epistemological language, and introduced some of the approaches that 753A covers in greater depth.

COURSE OVERVIEW & MATERIALS

I began receiving emails and access to a Felix forum for 753A postings after completing my contract with Dr. Farrell in early September. I needed every bit of the six weeks allotted for preparation. The final forum count yielded 35 postings. Additional articles were accessible online. I went through three printer ink jets and over a ream of paper creating a binder of the hardcopies. Dr. Farrell also provided templates for making flash cards that I assembled and studied for the promised Jeopardy-like quiz. I obtained and read the required texts, which provided different approaches to the topic. All of these materials continue to be useful reference sources.

Social Research Methods: Qualitative and Quantitative Approaches (Neuman, 2006) is useful for its predictable format and completeness. Neuman tends to lump approaches into either quantitative or qualitative, and focuses more on execution than underlying paradigms. The chapters on quantitative measurement and analysis are helpful for general reference. This text spoke in language and constructs I recalled from my undergraduate days. It is a good foundational textbook.

The Landscape of Qualitative Research: Theories and Issues (Denizen & Lincoln, 1998) is a collection of essays on interpretive approaches to social science. These consider underlying philosophies and methods in historical, ethical, and political context as different “moments” (ibid, p. 407). This book portrays a discipline with many rooms, all still under development.

Mindful Inquiry in Social Science Research (Bentz & Shapiro, 1998) presents discussions, rather than explanations. The authors identify nine principal “Cultures of Inquiry” (ibid, p. 9) as Phenomenology, Hermeneutics, Critical Social Science and Critical Theory, Ethnography, Quantitative and Behavioral science, Historical Research, Theoretical Research, Action Research, and Evaluation Research (ibid, p. 93). They reach beyond method execution and consider underlying meaning in the adoption of different approaches. They also provide practical suggestions on matching method with the topic and researcher sensibilities.

In addition to books and articles, Dr. Farrell provided her own notes and a bound Power point presentation. These have been especially useful in stimulating recall for the preparation of this paper.

Finally, before the three-day intensive session, I prepared for several experiential assignments. I viewed the film Capote (Barron, et. al, 2005), listened to a segment of the Jefferson Hour (2007), and assembled memorabilia from a particular Culture of Inquiry. I chose to represent “The Other” (Denizen, 1998) of the American Plains Indian, specifically the Blackfeet Tribe. I know several of the course participants, so I was able to share thoughts and insights ahead of time, as well as the ride to and from Baltimore.

MY SCHOLARLY CONTEXT

It is a bit of an exaggeration to claim that I have a personal scholarly context. I am just starting in this doctoral program. I undertook the program because I felt compelled to pursue academic investigation about the massage therapy clinical work I have done for the past 15 years. My vocational sphere’s conversations usually involve experiential knowledge. Although there is a current movement to seek evidence to support massage therapy, that work is happening primarily through research in medical or psychotherapy models. Yet, I am convinced that a human development interdisciplinary approach will best serve my desire to better understand what I do, observe, and teach.

I took up massage after an earlier career in for-profit business. My massage therapy training was in a vocational training program where I later joined the faculty. Although demanding in many ways, massage school is not scholarly. My last scholarly program was as an undergraduate about 30 years ago. I finished my B.A. work at SFSU with a degree in Interdisciplinary Social Science. I had excellent teachers there and completed some rewarding fieldwork for my undergraduate thesis.

My first two college years were at the University of Chicago, in the School of Human Development. I collected qualitative data for an up and coming associate professor while completing my traditional common core requirements. For many weeks, I scanned children’s picture books, line by line, counting the number of incidences of active and passive verbs according to whether the subject was male or female. I received very little training for this task and no supervision, and quickly came to suspect my own accuracies. I expressed this to my professor, and he admonished me for inappropriately challenging his authority. Thus, I returned to my task. The data was eventually compiled, analyzed, and published. The professor is well known today and regarded in his field.

I recollected this experience as I prepared for the Intensive. I realized that I harbor an unexplored suspicion towards data collection and manipulation. I intellectually appreciate the value of empirical research. Practically, I acknowledge that the prevailing Western perspective considers it necessary to call it a pursuit of science. But a part of me remains convinced that quantitative data carries a shadow of an inexperienced collegiate guessing if Spot is a boy or a girl.

THE INTENSIVE

Overall, this Intensive experience helped me grow academically in subject and in perspective. Dr. Farrell’s knowledge, energy, and talent as an instructor and facilitator are largely responsible. Her multi-dimensional approaches harnessed all of my different learning styles, and triangulated with both sides of my brain and limbic system. Through her Intensive, I learned in several days what would have taken me months on my own. However, overcoming my first learning hurdle was a matter of scheduling chance. It occurred when Katrina Rogers spoke on the first day about the Institutional Review Board.

The Institutional Review Board (IRB)

My pre-intensive questionable associations with data charting stirred up some ethical reflections on the research process. Ironically, one of our first segments focused on research ethics and the IRB process. I realized during Dr. Rogers’ presentation that Social Science had come a long way in 30 years. This presentation re-oriented my prejudices concerning data collection and imparted important practical information.

In 1974, when I was counting boys, girls, and their action verbs, the National Research Act created the National Commission on Protection of Human Subjects. Back then, one of my other research assistant tasks involved administering IQ tests to day care attendees. Again, I felt ill trained and poorly equipped, and regretted the loosely structured involvement of very young children. Thanks to IRB, that should not happen today. It is still possible to do shoddy research. However, it is more likely that someone is watching.

The Intensive Process

The course reading materials and preparations were rich and dense, and I found myself befuddled by the time I commenced the Intensive workshop. However, Dr. Farrell’s stimulating approach and clear style quickly helped to clear my mental fog and establish confidence. As an ice breaker, we gathered in a circle and together sang I can’t say goodbye to you (Hobbs, 1978) to an old Helen Reddy recording. I was invited to fall in love, presumably with some epistemology in the room. I wanted to counter sing, I’m not at all in love (Adler & Ross, 1954). But I noticed that my brain fog had cleared.

Over the three days, I became increasingly clear and conversant in the subject matter. I learned and laughed my way through our Quiz Show enactment, participated in an Imagery Study as both subject and researcher, and re-made the film Capote (Barron, 2005) in the image of another epistemology. We worked in small groups experientially, and collectively through Dr. Farrell’s comprehensive presentations. I made a mini-presentation from the view of “The Other” as an American Indian, as we followed along the historical “moments” (Denizen & Lincoln, 1998) of research cultures. I tried to understand the content and meaning of each approach, wondering all the time how it applied to me.

In the group presentation, we traced scholarly thinking in Western history beginning in the Middle Ages. We observed acceleration in evolution and diversity in approaches as we progressed to today. Some of my confusion resulted from the readings, where definitions and categories varied depending on the source (Farrell, 2007). The essence of each began to solidify as we discussed major thinkers of each moment and its schools.

Writing about the cultures brings me further along in understanding their nature and applications. Also, I returned to a technique we used during the Intensive. Modern academia is experiencing a cross-over between the social sciences and the arts, where techniques in one discipline are migrating into the other to expand perspectives. I found this apparent in our dissection of the film Capote (Barron, 2005). I sought out representative films for each culture to gain further clarity for this paper. Allowing myself to dwell in the film, I attempted to capture the lived experience projected in the approach.

CULTURES

Positivism

Positivism, also known as Empiricism, Behavioralism, and Naturalism is based on a philosophy that truth can be revealed, that causation renders effect, and that all things can be measured (Goldhaber, 2000). This culture is the foundation of most natural science, and until recently, most social science. Its purpose is to discover and document the universal natural laws (Farrell, 2007f). It demands exact, objective procedures, usually steeped in quantitative method.

Since the parlance of Positivism is entrenched in modern Western culture, I found philosophical examples prolific in the motion picture world: from stories of conflict, where the truth is revealed in the final act; to love stories, where the real meaning is illuminated to the lovers; to sagas that convey a cultural value or message. One especially long and masterful epic is the Lord of the Rings (Jackson, 2001, 2002, 2003) trilogy. It tells the story of the fantastic Hobbit characters who, with the help of a cast of heroes, elves, and a wizard, thwart the Lord of Evil and his ring of power. Their saga portrays discovering the truth that the ring is the cause of the uprising of evil, forging the path to its destruction, and drumming up the requisite courage and determination for salvation. When I noted Frodo’s lament to Sam, “What’s the use?” and the latter replies, “That there’s some good in this world and it’s worth fighting for!”, I realized I might be co-mingling Positivism with its ancestral roots in The Enlightenment (Farrell, 2007f).

I looked for a film that would feature quantitative research, and cause and effect, pursuant to the plot resolution. I came across an unlikely candidate in the comedy, My Cousin Vinnie (Launer, 1992), the story of two hapless young men on a road trip who are wrongly accused of a small town murder. During a pivotal courtroom scene, the bumbling lawyer Vinnie tries to vindicate his cousin. The key defense witness reduces the crime scene evidence to a series of automobile specifications and measurements. The truth is revealed, proving that the accused is innocent. It also demonstrates that Positivism can be funny.

Interpretive Social Science (ISS)

Although Neuman (2000) lumps together all qualitative methodology, Bentz and Shapiro (1998) provide a more unique treatment of each category. There are differences and debates among researchers on key assumptions (Agger-Gupta, 2007). I admit that the distinctions got blurry for me, and the film analysis helped clarify different viewpoints.

Phenomenology

At the core of Phenomenology is a desire to holistically describe an aspect of human experience (Wojnar, D. M., Swanson, K. M., 2007). These researchers are more concerned with investigating the essence of a thing or experience, than predicting or controlling an event. They look for meaning in the individual as well as the collective and historical context by describing lived experience of the subjects and the observers.

The film Sophie’s Choice (Barish, 1982) tells the life story of the main character, a Polish immigrant, through the eyes of a young would-be writer, Stingo. Sophie’s past is revealed through progressively more intimate conversations and interactions. History is intertwined with the contemporary story of Sophie and her obsessive lover, Nathan. As the plot unfolds and penetrates into the depth of Sophie’s secret, Stingo moves from observer to participant in the tragic conclusion.

The role of Stingo as ethnographer also illustrates how the culture of Phenomenology can accommodate various methods. This introduces a practical distinction between a Culture of Inquiry and a Method of Inquiry. Although a Positivist Culture demands conformation with empirical method, the cultures of ISS accommodate crossovers and mixtures of research methods. For some Phenomenologists, this prompted a development into its cousin Phenomenography, a methodology that employs a more analytic perspective to researching human experience (Richardson, 1999).

Hermeneutics

Another culture of ISS is Hermeneutics. As an epistemology, it strives not only to unfold meaning through progressively deeper investigation, but also to articulate and understand the conditions and context that surround the studied experience. Hermeneutics is also a methodology, which can be employed separately. The method originated in the humanities in the study of biblical text. It examines written words, conversations, or pictures to arrive at embedded meaning. In the earlier example of Lord of the Ring (Jackson, 2001), the ring’s power is revealed in the words inscribed on its inner surface and explained in the ancient texts found in the wizard’s library.

A film that combines both Hermeneutic philosophy and method is Possession (Weinstein, 2002). It spirals deeper into meaning and researcher involvement through formal examination of written text. The story follows two competing scholars as they investigate letters of two 19^th Century poets. The scholars fall into a parallel spiral of romance and intrigue as they unveil a clandestine affair between their subjects.

Social Constructionism/CMM

Social Constructionism is founded on the antithesis of Positivism. Instead of reality being external, waiting to be discovered, it supposes that reality is constructed through social interaction (Denizin & Lincoln, 1998). Research focuses on the collective construction of meaning, through language and social structures. An epistemological relation, Constructivism, focuses on individual meaning making through thought (ibid) that is revealed through interpretation.

One film so perfectly captures the subjectivity of truth and the individual construction of reality that is has become an adjective for the phenomenon. Rashomon (Minoura, 1950) portrays the same brutal act, a rape and subsequent murder, through four separate narrations. Hence, the viewer receives four different interpretations, and is left to construct their own truth about the facts of the event.

A type of Social Constructionism, the Coordinated Management of Meaning, (CMM) includes the work of Fielding’s own Dr. Barnett Pearce. It focuses on communication with the understanding that individuals construct their social reality based on their interaction and their language. We listened to an audio interview (Farrell, 2007b) with Dr. Pearce on his topic in our Intensive workshop. Intrigued, but not satisfied that I had obtained sufficient grasp of his concepts, I took a subsequent seminar co-hosted by Dr. Pearce at Winter Session. He summarized foundational elements in his philosophy by two tenets: 1) Each person has their own individual story, and 2) Meaning is created by the reflexivity between people. It is the tension that occurs in the process of reconciling the former through the latter that defines our humanism (Pearce, 2008).

I found this approach portrayed in the film Being There (Braunsberg, et. al, 1979). The simple-minded gardener, Chance, is put out on the street after the death of his benefactor. He proceeds to become famous for his insight and wisdom as people construct their own meaning from his simple words. Chance, now Chauncie, says “If the roots are deep, there will be growth in the spring”. Instead of gardening advice, his financial and political maven audiences hear predictions about domestic economic cycles. The story unfolds poignantly and humorously to demonstrate an extreme disconnect between one man’s story and how it receives and resonates amongst others in their own context.

Critical Social Science (CSS)

With a Positivist slant, CSS believes that social reality is external, waiting to be discovered (Farrell, 2007a, p. 2). However, individuals are constricted:  by their social, historical and cultural context, and, the material content of their daily lives. These cultures investigate with an activist orientation and from perspectives of marginalized populations. Its intention is to reveal underlying structures and conflict to enable individual empowerment. It is the home for Critical Race Theory (CRT), Ethnicity Studies, Feminist Studies, and Queer Theory. Other versions of this construct are Dialectical Materialism, Class analysis, Structuralism, and Realism. All versions argue that race, gender, ethnicity, and sexual categorizations are social constructions.

Critical Race Theory (CRT)

In 1903, W. E. B. Dubois introduced the concept of “double consciousness” (Farrell, 2007) to describe the life experience of the African American. In the 1970s, CRT emerged as a scholarly response to perceived stagnant racial reform in the U.S. Proposing that racism is inherent in American culture, the purpose is to expose racism in all of its manifestations (Farrell, 2007c). Some aligned scholars assert that their approach is not just about racism but the very nature of reality.

I considered films that projected this approach and thought of the work of director Spike Lee, such as his biographical account of Malcolm X. Then, one evening while discussing my new film hobby around my dinner table, my middle school daughter suggested I see the “classic” Guess who’s coming to dinner (Kramer, 1967). So I did (again). This film is almost an historic document by today’s standards. It occurs in a not-so distant time when racial prejudices ran closer to the surface, and norms of behavior were more rigid. It is today recognized as a landmark work in revealing deep-seated injustices held by reasonable, even “liberal” (ibid) people. Over the 108 minutes while I dwelled in this film, I came to appreciate that the design elements of CSS are dictated by its context. So is the effectiveness of the work as a change medium. When John (Sidney Poitier) tells his father “You think of yourself as a colored man. I think of myself as a man. Only when you and your generation are dead and gone will you be off our backs!” (ibid), I marveled on the progress of the past 40 years, the distance still remaining, and the likelihood that this film helped bridge the gap. It inspired a respect for all those who work for change, and a deeper appreciation of CRT and its potential as a change agent.

Radicalized Discourses & Ethnic Studies

This approach intends to challenge Western-centric prevailing structures that are fundamentally skewed to inequality and injustice. This is broader in subject scope than CRT. Populations addressed here include American-Asian, Hispanic, and Native American. Although I found films that portrayed these groups, most neglected the radical criticism inherent in this scholarly approach. Through more of a Phenomenological view, I played mah-jongg with Chinese Americans in the Joy Luck Club (Stone, 1993), sang with New York Hispanics in West Side story (Wise, 1961), and listened to the Lakota language in Dances with wolves (Costner, 1990). The exercise revealed to me that CSS is more than research with minorities.

Feminism

Feminist Studies grew out of the 1960’s woman’s movement that claimed Positivist research was conducted exclusively from a male point of view (Farrell, 2007d). The Feminist Studies culture says that gender dictates a fundamentally different life experience. It reaches beyond simply studying a female population. This culture is flexible in choosing research techniques and advocates a feminist criticism (ibid). Inversely, expansion of the culture parallels increased research from other perspectives with female populations, such as quantitative medical research. Feminist Studies and research on female subjects is not identical.

In applying this distinction to films, I found the movie A League of their own (Abbott, 2003), to be a Positivist oriented worldview of women engaged in the traditionally male job of playing professional baseball. It did not demonstrate social construction of reality as defined by gender roles. This message I found in Meshkini’s The day I became a woman (2000). This Iranian film describes oppression through three consecutive stories of women at different life stages: childhood (Hava), youth (Ahoo), and old age (Hoora). In these three narratives, Hava is forced to take the veil on her ninth birthday, Ahoo’s husband divorces her and her tribe punishes her when she refuses to give up a bicycle race, and Hoora literally sails off into the sea with newly acquired household appliances she never enjoyed in her life. Hoora’s story reflects the Feminist Studies value of emancipating its subjects and “making their voices heard” (Farrell, 2007d).

Queer Theory

Queer Theory and Queer Studies focus on “sexual categorization processes and their deconstruction” (Farrell, 2007e). Like Feminist Studies, this culture evolved from the 1960’s social liberation movement, but reaches beyond simply studying homosexual populations or behavior. Practitioners make the distinction between studying homosexuality (a biological phenomenon), studying gays (a personal experience), studying queers (social deviations), and studying society from a queer perspective (Farrell, 2007e). The last of these involves examining the nature of deviation, particularly from a Social Constructionist standpoint.

In searching for films that engaged these different perspectives, I found a separate section in my local video store that brokered films portraying homosexual erotica (mostly male) and psychological perspective. A more mainstream popular version of the personal male experience is depicted in Brokeback Mountain (Ossana, 2005). This tells the tragic story of two closeted gay cowboys and their life-long repressed and socially unacceptable relationship. In Capote (Barron, 2005) the viewer sees the creative power of a peculiar viewpoint through the title character’s investigation and writing of his masterpiece, In Cold Blood. Intrinsic to his insightful genius is Capote’s deviant perspective on society.

Post-Modernism

Most Western scholarly thought assumes that knowledge is accumulated over history, and that what is known can be foundational to what is to be learned. Many approaches further assume that patterns or relationships are inherent and can be discovered. Post-modernists disagree, and instead assume that existing research perspectives and methods are invalid. Post-Modern Research rejects conventional documentation as well, preferring expression in alternate forms, such as art or theatre.

Francis Ford Coppola’s 1983 film, Koyaanisqatsi, is titled after a Hopi word meaning “life out of balance” (Reggio, 1983). It also means:  “crazy life”, “life in turmoil”, “life disintegrating”, and “a state of life that calls for another way of living” (ibid). The film is wordless except for the intermittent chanting of the single word of its title. It is visually a collage of video clips choreographed into increasingly frantic and disturbing rhythms. The double-time footage conveys, through images of industrial de-humanization and ultimate destruction, a message of a planet out of control. The film culminates in slow-motion images that invoke intimate humanism, reminiscent of realized despair. It closes with several Hopi prophecies, including “if we dig precious things from the ground, we will invite disaster” (ibid). The creators’ intention seems to be to shock and evoke the viewer into a paradigm shift, presumably before it is too late.

CULTURE AS METHOD

In considering more Social Science epistemologies, I found several defined by the methods they employed. Ethnography, epitomized by early anthropologists, requires the researcher to imbed himself in his subject’s foreign setting in order to better understand how groups function. Focus can be on behavior or beliefs, but the initial research model asked the observer to remain objective, detached from “The Other” (Farrell, 2007). Evolving from the Traditional Period of ISS research (ibid), and stemming from a Positivist approach to anthropology, the researcher spends many hours in participant observation and direct contact fieldwork to determine how specific populations live. This approach is demonstrated in many contemporary documentary films, such as the BCC’s Planet Earth series (Allen, et. al., 2007). In Field Research, the extensive observation notes are coded and analyzed, in various ways. Other direct contact methods include Case Study and Interviewing, although they can be used to a more subjective end.

Grounded Theory is similarly rooted in field research and interviewing. The goal is to determine a core central theme (Trochim, 2006) by asking a complex series of generative questions and pursuing emerging links. This approach is presented in the work of Mike Moore’s Fahrenheit 911 (2004), the critical film about the attacks of September 11, 2001.

Taking field research one further step is Participatory Action Research (PAR). The practitioners of this method find relevance only when it is concurrently applied to solve a practical problem during the research project. One such example in film is Super Size Me (Spurlock, 2004), where the filmmaker not only interviews experts but also makes himself the subject of a dietary experiment. By feeding only on McDonald’s take out food for 30 days, it is questionable whether he primarily solves an existing problem or creates one for himself (a diet related medical emergency). In either case, Spurlock brings critical attention to the problem of American nutritional deficit related to fast food eating.

Finally, two other self-explanatory methods covered in this course are Historical Research, or Historiography, and Theoretical Research. Dr. Farrell used Historiography by systematically presenting the various Cultures of Inquiry evolving through periods of Western Civilization. Theoretical Research evaluates the logical structure of existing theories and text towards the development of new theory (Bentz & Shapiro, 1998, p. 144). It often crosses over into Historical Research and Hermeneutic method.

CONCLUSION: MY MOMENT

My 753A experience demonstrated the valuable place in my learning plan for intensives. I see how much more I can gain from a structured engagement in a group setting, especially with faculty well matched to my interests and learning style. As a result, I intend to include intensives in executing my Learning Plan whenever possible.

What has this course and this paper taught me about my personal epistemology? I pondered this for weeks now. Disappointed that I did not fall in love as Dr. Farrell beckoned (Hobbs, 1978), I also hear the clock ticking. I am afraid of commitment to one worldview, fearing it will block out insights and valuable conclusions best accessible through another perspective. But I need to consider my productivity. Although the choices do not always demand monogamy, they almost always preclude some options. So, I need to give it my best shot and make a pick.

I am interpretive, as demonstrated in this paper. I find the greatest meaning in my world through the stories, not the facts. That makes me well matched to phenomenology. My expansion of meaning through the text of films demonstrates an affinity to hermeneutic method. Because I believe that language constructs personal reality and I admire the role a change agent, Social Constructionism and CMM might be my venue. But with my topic in the area of somatics, studying body based experience through text or language poses some interesting challenges. I need to evaluate the potential value of empirical data since my topic partially resides in the scientific community. Thus, I see that selecting a culture and a method needs to match the question and the audience as much as the researcher.

At the risk of being an opportunist, I plan to be a Mixer. It makes sense to use a variety of approaches in order to generate the greatest impact with my research. I will likely include an element of empirical research, and work to achieve triangulation through observation and interpretation. This is hardly radical, often used in research, and can carry generative potential, in life as in art.

Like Paltrow, my train has left the station, but it is still traveling. The doors I select will define how my story unfolds. However, I am left to wonder if the route might dictate the plot, but as in Sliding Doors, all will be reconciled in the end.

References:

Abbott, E. (Producer), Marshall, P. (Director) (2003). A League of their own (Motion Picture). USA: Parkway Productions.

Adler, R. & Ross, J. (1954). I’m not at all in love. First performed in the Pajama Game. New York: Alfred Publishing Co.

Agger-Gupta, D. (2007). Debates and differences in scholar-practitioner inquiry: Hermeneutics, Phenomenology, Grounded Theory, and Phenomenography. Santa Barbara, CA: Fielding University.

Allen, P., Berlowitz, V., Brownlow, M., Byatt, A., Cordey, H., Keeling, J., Linfield, M. (Producers) (2007). Planet Earth (Film). UK: BCC Productions.

Barish, K. (Producer), Pakula, P. (Director) (1982). Sophie’s choice (Motion Picture). USA: Universal Pictures.

Barron, C., W. Vince & M. Ohoven (Producer) & Miller, B (Director) (2005). Capote (Motion Picture). USA: Sony Pictures Classics.

Bentz, V. M., & Shapiro, J. J. (1998). Mindful inquiry in social research. Thousand Oaks, CA.: Sage.

Braunsberg, A. (Producer), Ashby, H. (Director), & Kosinski, J. (Writer) (1979). Being There. (Motion Picture). USA: Warner Brothers Pictures.

Costner, K. (Producer/Director) & Wilson, J. (Producer). Dances with wolves (Motion Picture). USA: Orion Pictures.

Denzin, N. K., & Lincoln, Y. S. (1998). The landscape of qualitative research : theories and issues. Thousand Oaks, CA.: Sage Publications.

Farrell, M. (2007). Cultures of Inquiry: Point point presentations. Santa Barbara, CA.: Fielding University.

Farrell, M. (2007a). Cultures of Inquiry: Marie Farrell’s notes on Critical Social Science (CSS). Santa Barbara, CA.: Fielding University.

Farrell, M. (2007b). Social Constructionism Research 753A, An Interview with Dr. Barnett Pearce. Santa Barbara, CA: Fielding University.

Farrell, M. (2007c). Cultures of Inquiry: Marie Farrell’s notes on Radicalized discourses and ethnic epistemologies. Santa Barbara, CA.: Fielding University.

Farrell, M. (2007d). Cultures of Inquiry: Feminist Research. Marie’s notes. Santa Barbara, CA.: Fielding University.

Farrell, M. (2007e). Cultures of Inquiry: Sexualities, Queer Theory. Marie’s notes. Santa Barbara, CA.: Fielding University.

Farrell, M. (2007f). Cultures of Inquiry: Marie Farrell’s notes on Positivist Social Science. Santa Barbara, CA.: Fielding University.

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Jackson, P. (Producer/Director) (2001). The Fellowship of the ring (Motion Picture). USA: New Line Cinema.

Jackson, P. (Producer/Director) (2002). The Two towers (Motion Picture). USA: New Line Cinema.

Jackson, P. (Producer/Director) (2003). The Return of the king (Motion Picture). USA: New Line Cinema.

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Moore, M. (Producer/Director) (2004). Fahrenheit 911 (Motion Picture). USA: Miramax Studios.

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Ossana, D. (Producer), Lee, A. (Director). (2005). Brokeback Mountain (Motion Picture). USA: Universal Studios.

Pollack, S., P. Braithwait & W. Horbert (Producers) (1998). Sliding Doors (Motion Picture). USA: Miramax and Sony Pictures.

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This is an important move forward for qualitative research in massage, and integrating the voice of the therapist into established knowledge.  My thanks go out to the many who made this accomplishment possible.