by Erik Dalton, Ph.D.

What’s the big deal about scope of practice for bodyworkers? As long as I do what I learned in school, I should be fine–right? In fact, there are many critical factors involved in operating an ethical (and legal) manual therapy business. Sadly, many therapists fall into the trap of thinking they can meet all client therapeutic needs, especially those who’ve just started a practice and need the income. But intentionally refusing to refer certain clients to more qualified practitioners in our own field may be as much an ethical violation as to not refer out to other medical practitioners, i.e.. chiropractors, orthopods, osteopaths, etc. 

For example, your certification is as a massage therapist. One of your clients comes in and says her chiropractor suggested she try Rolfing®. You might be tempted to say, “I can do that,” and maybe you have experienced structural integration as a client, maybe you are interested in the structure of the body, maybe you had a teacher at massage school who was a Rolfer, or maybe you think if you just dig your elbow in that’s Rolfing. None of that matters in the least. Rolfing, like many types of bodywork, has its own certification program and is protected by a registered service mark. Unless you are a graduate and member of the Rolf Institute, you cannot ethically say you do Rolfing. And in fact, if you have not completed the training, how could you really know what it is?

Again, professional competence comes in. The smorgasbord approach of many massage schools is to teach you a little of many things as your preliminary entry into the field. That may be an appropriate level of training for certain settings; for example, spas or a start in private practice. To really develop as a practitioner, choose what you like best and hone those skills; otherwise, you will be a “jack of all trades, master of none.” Just as you would be suspicious of a lawyer who did the full gamut of law—divorce, patent, estate, personal injury, real estate and tax law, as examples—an educated client will be suspicious of a practitioner who claims to be able to do everything well. If you want to say you do Rolfing, craniosacral work, shiatsu or any other specific modality, take time to complete the appropriate amount of training and any required certification in that field, so you can, in good conscience, put it on your business card and offer it to your clientele.

The same is true with cash clients who come for a specific issue or a specific type of massage. If it is not your area of expertise and there are other more qualified manual therapists available to help them, you may show a lack of integrity in taking their money for services you are not fully qualified to render.

The remedy for this is continuing education (CE). The human body is fascinating and complex, and one of the joys of our profession is there is always more to learn. Due to the great demand for quality home-study courses, the Freedom From Pain Institute® has created a best-selling program titled “Professional Ethics for the Modern Manual Therapist.” This NCBTMB-approved, six-CE course includes a “Roles and Boundaries” chapter to satisfy state and National requirements.

Erik Dalton, MASSAGE MagazineErik Dalton, Ph.D., has dedicated 30 years to the study of massage, Rolfing® and osteopathy while maintaining a full-time practice. Developer of Myoskeletal Alignment Techniques® and founder of the Freedom From Pain Institute®, Dalton is dedicated to research and treatment of chronic pain conditions. Myoskeletal workshops and home-study courses are approved by NCBTMB, Florida Board of Health and most state certifying agencies. Visit to read published articles and subscribe to the free monthly “Technique” e-newsletter. Review all home-study options at Online testing available for all courses.