Standards of Practice
Standard I: Professionalism
The Certificant must provide optimal levels of professional therapeutic massage and bodywork services and demonstrate excellence in practice by promoting healing and well-being through responsible, compassionate and respectful touch. In his/her professional role, the Certificant shall:
Standard I(a): adhere to the NCBTMB Code of Ethics, Standards of Practice, and Policies and Procedures;
Standard I(b): comply with the peer review process conducted by the NCBTMB Ethics and Standards Committee regarding any alleged violations of the NCBTMB Code of Ethics and these Standards of Practice;
Standard I(c): treat each client with respect, dignity and worth;
Standard I(d): use professional verbal, nonverbal and written communications;
Standard I(e): provide an environment that is safe and comfortable for the client and which, at a minimum, meets all legal requirements for health and safety;
Standard I(f): use standard precautions to insure professional hygienic practices and maintain a level of personal hygiene appropriate for practitioners in the therapeutic setting;
Standard I(g): wear clothing that is clean, modest, and professional;
Standard I(h): obtain voluntary and informed consent from the client prior to initiating the session;
Standard I(i): if applicable, conduct an accurate needs assessment, develop a plan of care with the client, and update the plan as needed;
Standard I(j): use appropriate draping to protect the client's physical and emotional privacy;
Standard I(k): be knowledgeable of his/her scope of practice and practice only within these limitations;
Standard I(l): refer to other professionals when in the best interest of the client and practitioner;
Standard I(m): seek other professional advice when needed;
Standard I (n): respect the traditions and practices of other professionals and foster collegial relationships;
Standard I(o): not falsely impugn the reputation of any colleague;
Standard I(p): use the initials BCTMB only to designate his/her professional ability and competency to practice therapeutic massage and bodywork;
Standard I(q): remain in good standing with NCBTMB;
Standard I(r): understand that the NCBTMB certificate may be displayed prominently in the Certificant’s principal place of practice;
Standard I(s): use the NCBTMB logo and certification number on business cards, brochures, advertisements, and stationery only in a manner that is within established NCBTMB guidelines;
Standard I(t): not duplicate the NCBTMB certificate for purposes other than verification of the practitioner’s credentials;
Standard I(u): immediately return the certificate to NCBTMB if certification is revoked; and
Standard I(v): inform NCBTMB of any changes or additions to information included in his/her application for NCBTMB certification or renewal within sixty (60) days of such changes or additions.
Standard II: Legal and Ethical Requirements
The Certificant must comply with all the legal requirements in applicable jurisdictions regulating the profession of therapeutic massage and bodywork. In his/her professional role, the Certificant shall:
Standard II(a): obey all local, state, and federal laws;
Standard II(b): refrain from any behavior that results in illegal, discriminatory, or unethical actions;
Standard II(c): accept responsibility for his/her own actions;
Standard II(d): report to the proper massage therapy regulatory body within thirty (30) days of discovery of, any evidence, such as first-hand knowledge, indicating any unethical, incompetent or illegal act committed by other Certificants;
Standard II(e): maintain accurate and truthful records;
Standard II(f): report to NCBTMB, within thirty (30) days of discovery of, any evidence, such as first-hand knowledge, of violations of the NCBTMB Code of Ethics and these Standards of Practice by himself/herself or by other Certificants;
Standard II(g): report to NCBTMB, within thirty (30) days of discovery of, any criminal conviction of, or plea of guilty, nolo contendere, or no contest to, a crime in any jurisdiction (other than a minor traffic offense) by himself/herself or by other Certificants;
Standard II(h): report to NCBTMB, within thirty (30) days of discovery of, any pending civil litigation and the resulting resolution related to the professional practice of the Certificant and the professional practice of other Certificants;
Standard II(i): report to NCBTMB, within thirty (30) days of discovery of, any pending complaints in any state or local government or quasi-government board or agency against his/her professional conduct or competence, or that of another Certificant, and the resulting resolution of such complaint; and
Standard II(j): respect existing publishing rights and obey copyright and trademark laws, including, but not limited to, those that apply to NCBTMB’s copyright-protected examination.
Standard III: Confidentiality
The Certificant shall respect the confidentiality of client information and safeguard all records. In his/her professional role, the Certificant shall:
Standard III(a): protect the confidentiality of the client’s identity and information in all conversations, advertisements, and any and all other matters unless disclosure of identifiable information is requested by the client in writing, is medically necessary, or is required by law;
Standard III(b): protect the interests of clients who are minors or clients who are unable to give voluntary and informed consent by obtaining prior written permission from a legal guardian;
Standard III(c): solicit only information that is relevant to the professional client/therapist relationship;
Standard III(d): securely retain client files for a minimum period of four (4) years from the termination of the therapeutic relationship; and
Standard III(e): dispose of client files in a secure manner.
Standard IV: Business Practices
The Certificant shall practice with honesty, integrity, and lawfulness in the business of therapeutic massage and bodywork. In his/her professional role the Certificant shall:
Standard IV(a): provide a physical setting that is safe and meets all applicable legal requirements for health and safety;
Standard IV(b): maintain adequate and customary liability insurance;
Standard IV(c): maintain adequate progress notes for each client session, if applicable;
Standard IV(d): accurately and truthfully inform the public of services provided;
Standard IV(e): honestly represent all professional qualifications and affiliations;
Standard IV(f): promote his/her business with integrity and avoid potential and actual conflicts of interest;
Standard IV(g): advertise in a manner that is honest, dignified, accurate and representative of services provided and remains consistent with the NCBTMB Code of Ethics and these Standards of Practice;
Standard IV(h): advertise in a manner that is not misleading to the public and shall never use sensational, sexual or provocative language and/or pictures to promote his/her business;
Standard IV(i): comply with all laws regarding sexual harassment;
Standard IV(j): not exploit the trust and dependency of others, including clients and employees/co-workers;
Standard IV(k): disclose a schedule of fees in advance of the session;
Standard IV(l): make financial arrangements in advance which are clearly understood by, and safeguard the best interests of, the client or consumer;
Standard IV(m): follow Generally Accepted Accounting Principles;
Standard IV(n): file all applicable municipal, state and federal taxes; and
Standard IV(o): maintain accurate financial records, contracts and legal obligations, appointment records, tax reports and receipts for the most recent three (3) fiscal years.
Standard V: Roles and Boundaries
The Certificant shall adhere to ethical boundaries and perform the professional roles designed to protect both the client and the practitioner, and safeguard the therapeutic value of the relationship. In his/her professional role, the Certificant shall:
Standard V(a): recognize his/her personal limitations and practice only within these limitations;
Standard V(b): recognize his/her influential position with the client and not exploit the relationship for personal or other gain;
Standard V(c): recognize and limit the impact of transference and counter-transference between the client and the Certificant;
Standard V(d): avoid dual or multidimensional relationships that could impair professional judgment or result in exploitation of a client, student, employee, supervisee, mentee, trainee, or anyone else with whom a power differential exists;
Standard V(e): acknowledge and respect the client's freedom of choice in the therapeutic session;
Standard V(f): respect the client’s right to refuse the therapeutic session or any part of the therapeutic session;
Standard V(g): refrain from practicing under the influence of alcohol, drugs, or any illegal substances (with the exception of a prescribed dosage of prescription medication which does not impair the Certificant);
Standard V(h): have the right to refuse and/or terminate the service to a client who is abusive or under the influence of alcohol, drugs, or any illegal substance; and
Standard V(i): have the right to refuse and/or terminate the service to a client who exhibits language or behavior which the therapist deems as an immediate or potential risk to the safety of the: (i) client;( ii) Certificant; or (iii) therapeutic relationship.
Standard VI: Prevention of Sexual Misconduct and Inappropriate Touch
The Certificant shall refrain from any behavior that sexualizes, or appears to sexualize, the client/therapist relationship. The Certificant recognizes the intimacy of the therapeutic relationship may activate practitioner and/or client needs and/or desires that weaken boundaries which may lead to sexualizing the therapeutic relationship. In his/her professional role, the Certificant shall:
Standard VI(a): refrain from participating in a sexual relationship or sexual conduct with the client, whether consensual or otherwise, from the beginning of the client/therapist relationship and for a minimum of six (6) months after the termination of the client/therapist relationship, unless an ongoing current sexual relationship existed prior to the date the therapeutic relationship began. In the case of a pre-existing ongoing sexual relationship, providing therapeutic massage and bodywork on such a person is discouraged, but may be done with informed consent which acknowledges the power differential in a therapeutic relationship and the complexities of dual relationships;
Standard VI(b): in the event the client initiates sexual behavior, interrupt therapy to clarify the purpose of the therapeutic session. Provided that the client’s initial sexual behavior ceases, the Certificant may, at his or her discretion, take action to terminate or continue the session. The Certificant shall terminate the session if the sexual conduct continues;
Standard VI(c): with the exception of a pre-existing ongoing sexual relationship, as set forth in Standard VI(a), recognize that sexual activity with clients, students, employees, supervisees, mentees, trainees, or anyone else with whom a power differential exists, is prohibited even if consensual;
Standard VI(d): not touch the genitalia;
Standard VI(e): only perform therapeutic treatments beyond the normal narrowing of the ear canal and normal narrowing of the nasal passages: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law;
Standard VI(f): only perform therapeutic treatments in the oral cavity: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law;
Standard VI(g): only perform therapeutic treatments into the anal canal: i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is expressly authorized to perform colonic irrigation under state law; and
Standard VI(h): only provide therapeutic breast massage: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law.
Standard I: Professionalism
The Certificant must provide optimal levels of professional therapeutic massage and bodywork services and demonstrate excellence in practice by promoting healing and well-being through responsible, compassionate and respectful touch. In his/her professional role, the Certificant shall:
Standard I(a): adhere to the NCBTMB Code of Ethics, Standards of Practice, and Policies and Procedures;
Standard I(b): comply with the peer review process conducted by the NCBTMB Ethics and Standards Committee regarding any alleged violations of the NCBTMB Code of Ethics and these Standards of Practice;
Standard I(c): treat each client with respect, dignity and worth;
Standard I(d): use professional verbal, nonverbal and written communications;
Standard I(e): provide an environment that is safe and comfortable for the client and which, at a minimum, meets all legal requirements for health and safety;
Standard I(f): use standard precautions to insure professional hygienic practices and maintain a level of personal hygiene appropriate for practitioners in the therapeutic setting;
Standard I(g): wear clothing that is clean, modest, and professional;
Standard I(h): obtain voluntary and informed consent from the client prior to initiating the session;
Standard I(i): if applicable, conduct an accurate needs assessment, develop a plan of care with the client, and update the plan as needed;
Standard I(j): use appropriate draping to protect the client's physical and emotional privacy;
Standard I(k): be knowledgeable of his/her scope of practice and practice only within these limitations;
Standard I(l): refer to other professionals when in the best interest of the client and practitioner;
Standard I(m): seek other professional advice when needed;
Standard I (n): respect the traditions and practices of other professionals and foster collegial relationships;
Standard I(o): not falsely impugn the reputation of any colleague;
Standard I(p): use the initials BCTMB only to designate his/her professional ability and competency to practice therapeutic massage and bodywork;
Standard I(q): remain in good standing with NCBTMB;
Standard I(r): understand that the NCBTMB certificate may be displayed prominently in the Certificant’s principal place of practice;
Standard I(s): use the NCBTMB logo and certification number on business cards, brochures, advertisements, and stationery only in a manner that is within established NCBTMB guidelines;
Standard I(t): not duplicate the NCBTMB certificate for purposes other than verification of the practitioner’s credentials;
Standard I(u): immediately return the certificate to NCBTMB if certification is revoked; and
Standard I(v): inform NCBTMB of any changes or additions to information included in his/her application for NCBTMB certification or renewal within sixty (60) days of such changes or additions.
Standard II: Legal and Ethical Requirements
The Certificant must comply with all the legal requirements in applicable jurisdictions regulating the profession of therapeutic massage and bodywork. In his/her professional role, the Certificant shall:
Standard II(a): obey all local, state, and federal laws;
Standard II(b): refrain from any behavior that results in illegal, discriminatory, or unethical actions;
Standard II(c): accept responsibility for his/her own actions;
Standard II(d): report to the proper massage therapy regulatory body within thirty (30) days of discovery of, any evidence, such as first-hand knowledge, indicating any unethical, incompetent or illegal act committed by other Certificants;
Standard II(e): maintain accurate and truthful records;
Standard II(f): report to NCBTMB, within thirty (30) days of discovery of, any evidence, such as first-hand knowledge, of violations of the NCBTMB Code of Ethics and these Standards of Practice by himself/herself or by other Certificants;
Standard II(g): report to NCBTMB, within thirty (30) days of discovery of, any criminal conviction of, or plea of guilty, nolo contendere, or no contest to, a crime in any jurisdiction (other than a minor traffic offense) by himself/herself or by other Certificants;
Standard II(h): report to NCBTMB, within thirty (30) days of discovery of, any pending civil litigation and the resulting resolution related to the professional practice of the Certificant and the professional practice of other Certificants;
Standard II(i): report to NCBTMB, within thirty (30) days of discovery of, any pending complaints in any state or local government or quasi-government board or agency against his/her professional conduct or competence, or that of another Certificant, and the resulting resolution of such complaint; and
Standard II(j): respect existing publishing rights and obey copyright and trademark laws, including, but not limited to, those that apply to NCBTMB’s copyright-protected examination.
Standard III: Confidentiality
The Certificant shall respect the confidentiality of client information and safeguard all records. In his/her professional role, the Certificant shall:
Standard III(a): protect the confidentiality of the client’s identity and information in all conversations, advertisements, and any and all other matters unless disclosure of identifiable information is requested by the client in writing, is medically necessary, or is required by law;
Standard III(b): protect the interests of clients who are minors or clients who are unable to give voluntary and informed consent by obtaining prior written permission from a legal guardian;
Standard III(c): solicit only information that is relevant to the professional client/therapist relationship;
Standard III(d): securely retain client files for a minimum period of four (4) years from the termination of the therapeutic relationship; and
Standard III(e): dispose of client files in a secure manner.
Standard IV: Business Practices
The Certificant shall practice with honesty, integrity, and lawfulness in the business of therapeutic massage and bodywork. In his/her professional role the Certificant shall:
Standard IV(a): provide a physical setting that is safe and meets all applicable legal requirements for health and safety;
Standard IV(b): maintain adequate and customary liability insurance;
Standard IV(c): maintain adequate progress notes for each client session, if applicable;
Standard IV(d): accurately and truthfully inform the public of services provided;
Standard IV(e): honestly represent all professional qualifications and affiliations;
Standard IV(f): promote his/her business with integrity and avoid potential and actual conflicts of interest;
Standard IV(g): advertise in a manner that is honest, dignified, accurate and representative of services provided and remains consistent with the NCBTMB Code of Ethics and these Standards of Practice;
Standard IV(h): advertise in a manner that is not misleading to the public and shall never use sensational, sexual or provocative language and/or pictures to promote his/her business;
Standard IV(i): comply with all laws regarding sexual harassment;
Standard IV(j): not exploit the trust and dependency of others, including clients and employees/co-workers;
Standard IV(k): disclose a schedule of fees in advance of the session;
Standard IV(l): make financial arrangements in advance which are clearly understood by, and safeguard the best interests of, the client or consumer;
Standard IV(m): follow Generally Accepted Accounting Principles;
Standard IV(n): file all applicable municipal, state and federal taxes; and
Standard IV(o): maintain accurate financial records, contracts and legal obligations, appointment records, tax reports and receipts for the most recent three (3) fiscal years.
Standard V: Roles and Boundaries
The Certificant shall adhere to ethical boundaries and perform the professional roles designed to protect both the client and the practitioner, and safeguard the therapeutic value of the relationship. In his/her professional role, the Certificant shall:
Standard V(a): recognize his/her personal limitations and practice only within these limitations;
Standard V(b): recognize his/her influential position with the client and not exploit the relationship for personal or other gain;
Standard V(c): recognize and limit the impact of transference and counter-transference between the client and the Certificant;
Standard V(d): avoid dual or multidimensional relationships that could impair professional judgment or result in exploitation of a client, student, employee, supervisee, mentee, trainee, or anyone else with whom a power differential exists;
Standard V(e): acknowledge and respect the client's freedom of choice in the therapeutic session;
Standard V(f): respect the client’s right to refuse the therapeutic session or any part of the therapeutic session;
Standard V(g): refrain from practicing under the influence of alcohol, drugs, or any illegal substances (with the exception of a prescribed dosage of prescription medication which does not impair the Certificant);
Standard V(h): have the right to refuse and/or terminate the service to a client who is abusive or under the influence of alcohol, drugs, or any illegal substance; and
Standard V(i): have the right to refuse and/or terminate the service to a client who exhibits language or behavior which the therapist deems as an immediate or potential risk to the safety of the: (i) client;( ii) Certificant; or (iii) therapeutic relationship.
Standard VI: Prevention of Sexual Misconduct and Inappropriate Touch
The Certificant shall refrain from any behavior that sexualizes, or appears to sexualize, the client/therapist relationship. The Certificant recognizes the intimacy of the therapeutic relationship may activate practitioner and/or client needs and/or desires that weaken boundaries which may lead to sexualizing the therapeutic relationship. In his/her professional role, the Certificant shall:
Standard VI(a): refrain from participating in a sexual relationship or sexual conduct with the client, whether consensual or otherwise, from the beginning of the client/therapist relationship and for a minimum of six (6) months after the termination of the client/therapist relationship, unless an ongoing current sexual relationship existed prior to the date the therapeutic relationship began. In the case of a pre-existing ongoing sexual relationship, providing therapeutic massage and bodywork on such a person is discouraged, but may be done with informed consent which acknowledges the power differential in a therapeutic relationship and the complexities of dual relationships;
Standard VI(b): in the event the client initiates sexual behavior, interrupt therapy to clarify the purpose of the therapeutic session. Provided that the client’s initial sexual behavior ceases, the Certificant may, at his or her discretion, take action to terminate or continue the session. The Certificant shall terminate the session if the sexual conduct continues;
Standard VI(c): with the exception of a pre-existing ongoing sexual relationship, as set forth in Standard VI(a), recognize that sexual activity with clients, students, employees, supervisees, mentees, trainees, or anyone else with whom a power differential exists, is prohibited even if consensual;
Standard VI(d): not touch the genitalia;
Standard VI(e): only perform therapeutic treatments beyond the normal narrowing of the ear canal and normal narrowing of the nasal passages: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law;
Standard VI(f): only perform therapeutic treatments in the oral cavity: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law;
Standard VI(g): only perform therapeutic treatments into the anal canal: i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is expressly authorized to perform colonic irrigation under state law; and
Standard VI(h): only provide therapeutic breast massage: (i) as indicated in the plan of care; (ii) after receiving informed voluntary written consent; and (iii) only if the Certificant is permitted to do so under state law.