Features Education Regulations
Massage Therapy In Canada

As a distinct health care profession in Canada, massage therapy was organized in the early part of the 20th Century, and regulated in Ontario in 1919 and B.C. in 1946.

In 2002, Newfoundland and Labrador became Canada’s newest province to establish regulation in the health care field of massage therapy. All other provinces are voluntarily self-regulating and practitioners in these jurisdictions are affiliated with professional groups (professional associations) who, in effect, provide structure and services necessary for administering qualifying exams, disciplinary standards and continuing education.

In the 21st Century, there are over 10,000 practicing therapists in Canada, with the vast majority of these residing in Ontario.

The standard for massage therapy education and training in Canada varies according to differing provincial requirements.

In legislated provinces, minimum educational requirements are set for massage therapy schools or programs in massage therapy.

In British Columbia, the requirement is 3,000 hours, while in Ontario and Newfoundland and Labrador, the requirements are posed in terms of competencies articulated in the Competency Document created by the College of Massage Therapists of Ontario.

The Agreement on Internal Trade (AIT), in effect, the federal government’s mandate to eliminate artificial barriers and establish labour mobility, provided the impetus for legislated provinces to establish a mechanism to compare training requirements. The mechanism used to evaluate training requirements utilized a competencies template that is outcome based and assesses training requirements in terms of learner outcomes as opposed to number of hours of instruction.

As a result of AIT, massage therapists presently relocating within legislated provinces must only seek additional training in those competencies not required in their originating province.

The Agreement on Internal Trade (AIT), in effect, the federal government’s mandate to eliminate artificial barriers and establish labour mobility, provided the impetus for legislated provinces to establish a mechanism to compare training requirements.

The mechanism used to evaluate training requirements utilized a competencies template that is outcome-based and assesses training requirements in terms of learner outcomes as opposed to number of hours of instruction. As a result of AIT, therapists presently relocating within legislated provinces must only seek additional training in those competencies not required in their originating province.

Training requirements within non-legislated provinces vary from 400 to 2,200 hours. The Department of Education in these provinces performs the institutional and administrative evaluation, typically by assessing the submission of the school against the provincial legislation affecting their sector of the education industry. 

In some provinces, massage therapy programs will undertake a review by an industry specialist in order to ascertain if the program meets employment skills requirements. In non-legislated provinces, professional associations evaluate course curriculum to ascertain graduate eligibility for membership with their organization. No mechanism presently exists for therapists’ mobility within non-legislated provinces.

Therapists leaving non-legislated provinces and relocating to legislated provinces must have their qualifications evaluated by the regulatory body in the given province.

Additionally, therapists needing to fulfill upgrade requirements must approach educational institutions within those provinces on an individual basis and participate in their prior learning assessment process.

Except for the province of British Columbia, massage therapy schools are not required to participate in a school or program evaluation process. In B.C., however, the regulatory body for the profession of massage therapy, the College of Massage Therapists of British Columbia provides a regulatory process, which includes accreditation of educational programs. 

The accreditation committee of the CMTBC has been accrediting programs in massage therapy in British Columbia since 1996. Massage colleges in British Columbia are also accredited, similarly to all private post-secondary institutions in the province, by the Private Post Secondary Education Commission of B.C.

Some progressive, forward-looking private colleges appreciating the value and importance of accreditation in providing a guarantee of quality to the public have sought accreditation with the Commission on Massage Therapy Accreditation. The Commission on Massage Therapy Accreditation is an American accrediting agency which to date has proved an expensive but accessible option to fill the relative vacuum of massage therapy accreditation in Canada.

Why do we need a national accreditation organization?
Presently, the massage therapy profession in Canada does not possess a nationally recognized body or organization, which evaluates and assures the quality and integrity of massage therapy in Canada.

Although we perceive our education as significant and comprehensive, at least in comparison to our American counterparts, this analysis remains our opinion, which lacks objective verification.

Non-accredited institutions and programs may well have high quality and standards. However, they cannot provide a reliable third party assurance that they meet or exceed these standards. Accreditation provides that assurance. A viable accreditation process involves a rigorous self-evaluation by the institution or program, and appraisal by competent professionals and a subsequent review and decision by the central governing body. Periodically, examinations are required in order to ensure the standards are being maintained. 

Areas for improvement are identified, and plans are developed for addressing these improvements. The accrediting body usually publishes lists of institutions and programs that continue to achieve an acceptable level of quality based on the standards established.

The accreditation process is formative in raising the standards of institutions and the process not only provides significant benefits to the institutions, but to individual practitioners in the professional field. Ultimately, the public, the community and anyone concerned, benefits from highly trained practitioners.

The reality of life within the Canadian health care and educational systems necessitates that we seek recognition, outside our industry and credibility within a larger system (Canadian health care system, education system).

We must demonstrate empirically that our belief is grounded in fact, and is borne out in an objective body and system whose job and function is to demonstrate the quality of the education we practise, and the level of accountability we afford the government, other health care professionals and the public.

What is Accreditation?
Essentially, accreditation is a status of public recognition that an accreditor gives to an educational institution or program that meets the accreditor’s evaluation criteria. Accreditation indicates that an accreditor has evaluated and will continue to evaluate an educational institution or program and has determined its quality and integrity warrant the confidence of the educational community, government agencies, other agencies and organizations and the public.

Are there different types of accreditation processes?
The two basic types of accreditation are institutional and programmatic.  Institutional accreditation applies to an entire educational institution, while programmatic applies to specialized or professional programs or departments that are parts of the total institution. Programmatic accrediting agencies are often called “specialized accreditors” or, if they accredit programs in one of the professions, “professional accreditors.”

History Of The Profession’s Efforts To Create A National Accreditation Organization
The interest in creating a national accreditation body for the profession of massage therapy in Canada represents a long-sought goal.

Since approximately the mid-90s, stakeholders in B.C. and Ontario have aspired to create a national accreditation structure for massage therapy.

The CMTA has had an interest in this venture and its accreditation sub-committee has been pursuing this goal for several years. The rationale for creating a national accreditation system includes facilitating the effort to expand regulation in non-regulated provinces, supporting mobility of therapists within Canada and promoting excellence in our schools.

The committee proceeded to explore the possibility of creating a national accreditation structure by addressing the question: “Is it feasible for the Canadian Massage Therapy profession to establish its own accreditation organization and system, and if not, are there other existing systems which we could participate in?”

The CMTA determined that creating a Canadian accrediting body for the profession of massage therapy was not financially feasible, and sought instead to affiliate itself with an existing accreditation system.

Therefore, the CMTA explored two models of accreditation systems, these being the Canadian Medical Association (CMA) and the American Commission on Massage Therapy Accreditation (ACMTA).

Although the CMTA identified the CMA system as more desirable than the Commission on Massage Therapy Accreditation (COMTA) model, the onerous nature of the CMA requirements made pursuing this model unrealistic. Consequently, the CMTA elected to pursue COMTA as an interim accreditation process.

However, COMTA, at the time, was preoccupied with the pursuit of U.S. Department of Education recognition, and required a six- to 12-week breathing period before being available to begin negotiations on a COMTA system for Canada.

In the interim, the CMA Committee on Conjoint Accreditation modified their expectations of emerging health professions, and this once again raised the committee’s hopes that adopting a CMA accreditation model might be a possibility after all. Pursuant to this, the CMTA hired a consultant to work with the Education Sub-Committee.

The initial funding provided was essentially seed money and necessitated the acquisition of additional funds to pursue the project further.

A grant proposal submitted by the CMTA was forwarded to Human Resources Development Canada, and unfortunately rejected, given government’s priorities at that time.

Most recently, the Canadian Council of Massage Therapy Schools (CCMTS) identified the creation of an independent, autonomous, national accreditation organization and system as its primary focus in its strategic plan for the growth of Canada’s massage therapy colleges and the profession. The executive was charged with creating an action plan for the creation of an independent, autonomous, national accreditation organization and system.

As a preliminary step, the CCMTS undertook a feasibility study, which included the preparation of an environmental trend analysis, examining the trends, reality, challenges and opportunities shaping the future landscape of massage therapy. Then the council participated in a review and analysis of accreditation organizations and systems available in traditional and complementary health care today.

These efforts culminated in the creation of a proposal and template for national accreditation.

The CCMTS invited the national stakeholders in the massage therapy industry, the regulatory bodies (British Columbia, Ontario and Newfoundland and Labrador), the Canadian Massage Therapy Alliance and the Association of Massage Therapists and Holistic Practitioners (to represent the interests of those provinces that are presently unregulated in Canada) to attend a presentation and discussion forum on May 10, 2003 in New Westminster, British Columbia. This CCMTS-hosted forum created the energy and momentum necessary to make national accreditation a priority in the collective agenda of the profession in Canada.

All stakeholders present acknowledged the significant foundational work of the Council of Schools as a beginning place for building a collective process to facilitate the profession’s efforts to realize this important and highly desired goal.