Hire Education: Employing the Right Therapists can Protect your Business from Future Legal Woes

The field of massage therapy and bodywork has grown to include hundreds of schools and several hundred thousand therapists. On average, massage treatments generate 47 percent of a spas revenue, with an additional 15 percent of revenue coming from wet treatments. Treatment rooms take up an average of 39 percent of a spa's indoor space. Because of this incredible growth, the risk of litigation relating to massage therapists is an issue 110 spa can afford to ignore. The best way to avoid legal snafus when it comes to your staff is to set standards for screening and hiring. Whether you run a small or large spa, hiring and retaining quality therapists is vital to your success and survival. Here are some suggestions for the best ways to hire massage therapists who will he successful representatives of your spa.

The Hiring Process
The first step in the hiring process is to define your expectations. Listed below are seven basic areas that should be covered on an application form. Prioritize these areas to determine what type of therapist you want to hire and retain.

Licensure. Familiarize yourself with the laws governing massage therapist licensure in your area. Currently, 36 states plus Washington, D.C., regulate massage therapy at the state level. In the remaining states, individual localities determine their own requirements for licensure. Even in states where massage therapists are state certified, therapists generally must also apply locally for a business license. Applicants for massage therapist positions should submit copies of these documents.

National Certification. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) administers a yearly national exam that certifies that individual therapists have achieved a minimum standard of massage training and education. whether or not your state requires therapists to pass this exam or licensure, yon may choose to include NCBTMB certification as part of your spa's screening process. Massage therapist applicants who are nationally certified should provide you with a copy of their certificate.

Membership in a reputable professional organization. Most massage therapists are members of a national professional organization. The American Massage Therapy Association (AMTA), the Associated Bodywork and Massage Professionals (ABMP), and the American Organization for Bodywork Therapies of Asia (AOBTA) are the largest and best known of these groups. Each group offers various levels of membership, and any therapist applying to be a working professional member must meet certain requirements of training and/or certification. Thus, membership in one of these organizations can corroborate the applicant's qualifications.

Proof of liability insurance. Working professional members of AMTA or ABMP automatically qualify for $2 to $3 million of professional liability insurance. Therapists also have other options for obtaining professional liability coverage and should provide the spa with a copy of their certificate of coverage. In most cases, therapists can obtain an "additional insured endorsement" from their own insurance carrier, further protecting the spa.

School(s) attended. Approximately 1,500 schools in the U.S. teach massage and bodywork. Of course, attendance at an excellent school does not guarantee excellence in the student, and some excellent therapists have attended poor schools. Still, a school's reputation and standards are important to consider. Is the school licensed by the state government? Depending on the state, this usually means that the school has filed a lengthy application and has received official approval for its program. Is the school accredited? If so, that school has taken a further step toward excellence, as the accreditation process is fairly arduous and intellectually rigorous.

Hours of education and experience. Another important criterion is the number of hours of training a therapist has completed. You may choose to require a copy of the applicants graduation certificate, which will state the number of hours included in the training program. However, developing skills as a therapist requires more hours, which may be obtained through continuing education or through maintaining a private practice for a number of years. When evaluating practical experience, consider not only the length of time the therapist has been practicing but also the average number of treatments performed per week. A therapist with five rears of experience who performs only two treatments per week may not have developed the same skill as a therapist with three years of experience performing 20 treatments per week.

Additional timing. Your application form should inquire about the types of additional training the therapist has undertaken and the approximate number of hours of each course of study.

Conducting In-Person Assessments
Once a written application has been used to find candidates who meet the entry criteria for the spa, the interview and hands-on assessment are the next important screening tools. The goal is to identify applicants who not only are licensed and certified therapists, but are also personable, fit the culture of the organization, and demonstrate excellent technique. The personal interview should he done by someone witl1 good interviewing skills. The hands-on assessment should be done by someone who has experience with a variety of massage techniques and who can provide a meaningful evaluation of the therapist's skill. In some cases, both assessments might be done by the same person, hut in many spas, more than one assessor should he involved in the screening process.

The personal interview. The first thing an interviewer will notice is how the applicant is dressed and how well groomed he or she looks. Observe whether the person makes eye contact or avoids it. Notice the quality of the applicant's handshake. A good interviewer also assesses the applicant cognitively and intuitively, with several questions ill mind. Is this a person I like being around? How would I feel about having this person touch my body? Does the person establish an atmosphere of trust and safety with his or her conversational style and presence? Does the person answer my questions directly and honestly? Does the person appear confident and at ease with himself or herself? Does the person appear to understand how to establish professional boundaries?

A number of cues will help the interviewer answer these questions. For example, in describing their qualifications, some applicants may just offer opinions ("I'm really good at that."), while others back up their assertions with evidence ("I am skilled at that by virtue of the 500-hour training program I attended and my two years of experience in the field."). Applicants may demonstrate insight by noting deficiencies in the training program they attended or by offering ideas about what that program could have done better. The interviewer may also gain important information from questions about the applicants' self-care regimens, such as regular massage, exercise, or leisure pursuits.

The interviewer should ask the applicant about each former place of employment listed on his or her application. What did the applicant like and not like about working there? Why did he or she leave? Were there any unusual circumstances regarding the ending of employment? To be even more thorough, the interviewer might ask for the names and phone numbers of several coworkers at the applicant's previous job.

The hands-on assessment. An enormous amount of information not available in an interview can be gleaned from a hands-on assessment. If possible, it's best for the applicant to be evaluated by two different hands-on assessors. The most effective assessor is an experienced massage therapist who has taught massage therapy technique and has many years of experience in receiving and critiquing massage.

The spa should create a form listing each type of information being assessed. Use a rating system, such as Poor, Good, and Excellent, that makes sense for the assessor and for the organization. Design the form in such a way that assessors can document why they felt the applicant met, did not meet, or exceeded the standard the spa is seeking in an employee. Hands-On Hot Buttons
The hands-on assessment evaluates far more than whether the massage feels good. Watch for the following;

Is the therapist applying the appropriate pressure? It should be at the guest's tolerance but not past it.

Is the therapist demonstrating a possibility of aggression? This can be felt in the intent of the applicant's hands.

Does the therapist appear to know the difference between pleasurable hand contact and seductive hand use and demonstrate clarity in draping?

Is the therapist respecting personal boundaries in conversation during a massage, as well as physical boundaries?


Checking References
It is often useful to talk to the references provided by the applicant to see what specific qualities they liked in the therapist. If you ask directly whether there are any areas that the therapist could improve upon, you may also gain some information about the applicant's shortcomings. If a reference from a former employer leaves you with unanswered questions or raises any suspicions, you may want to seek additional references from former coworkers who may not be as hesitant to tell you something. However, there's still a risk that you'll receive an unreliable report, particularly if the individual is the applicant's friend.

At times, even an applicant who appears to be perfectly nice in an interview may have an unsavory past. By performing a Criminal Offender Record Information (CORI) background check, you can determine whether an applicant has a criminal record in any given state. Many government agencies that hire professionals for unsupervised client contact have a CORI check done on all potential employees to safeguard their clients. To order a CORI background check, you must know the states where the applicant has previously worked or lived. let the applicant know that you will be doing a CORI check, and that this is a standard procedure you follow for any hire who has unsupervised client contact. By mentioning this up front, you provide an opportunity for an individual who has a criminal record to explain the circumstances.

- By Ben Benjamin, Ph.D., and Diane Trieste

Ben E. Benjamin, Ph.D., holds a doctorate in education and sports medicine and is senior vice president of strategic development for the Cortiva Institute and founder of the Muscular Therapy Institute. He can be contacted at bbenjamin@cortiva,com. Diane Trieste is vice president of employer and alumni relations for the Cortiva Institute, where she broadens employment opportunities for alumni and helps design curriculum to increase massage therapists' competence to work in spas, resorts, and other wellness industries. She can be contacted at [email protected].

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