Date of Award


Document Type

Open Access Dissertation


Health Promotion, Education and Behavior

First Advisor

Ruth P. Saunders


Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 in conjunction with the Massage Therapy Foundation’s Highlighting Massage Therapy in Complementary and Integrative Medicine Research conference in Seattle, Washington. The intended purpose of the symposium was to gather knowledge to inform and aid in the creation of massage therapy best practice guidelines for stress and low back pain. However, upon initial analysis, the committee that arranged the symposium realized they did not have the information needed to create the intended best practices. Analysis detected emergent themes and results yielded a need for clear definitions of massage and massage therapy, contextual elements that influence practice, and a process framework for massage therapy practice. This study is significant because no study to date has used a grounded theory approach to analyze world café style conversations to define and conceptualize clinical practices in massage therapy. Understanding how experts in the field define, describe and understand massage therapy and massage therapy practice could help further the profession with potential implications to practice, education, policy, regulation and research. For example, massage therapists may need further education on areas of documentation, establishing therapeutic relationships, best ways to communicate and offer health promotion messages; additionally incorporating these changes into a practice setting may require massage therapist to reexamine their business and practice procedures. These aforementioned areas (documentation, establishing therapeutic relationships, best ways to communicate and offering health messages) would also need to be incorporated into initial education. Research may be significantly impacted; it will be necessary for scientists to indicate if they are studying massage or massage therapy, for instance. The models and definitions do need to be tested to determine their validity; and the first step would be to study all the constructs (e.g. therapeutic setting, therapeutic relationships, etc.) within the context of massage therapy to see if they do have an impact on outcomes. Then, if the constructs are found to be valid, all constructs within the definition would need to be measured when scientists are investigating massage therapy. Policy at national organizations and regulation may be impacted if is concluded that the best plan for regulation for the profession would be to initiate tiered licensure at the state and national level based on the differences between massage and massage therapy.