New93 role standards, now public
MedTality
Role standards

Therapy and rehabilitation

Massage therapist

What a newly licensed massage therapist must do safely on their own: screen each client for contraindications, deliver massage adapted to what they find, with informed consent and firm professional boundaries, and refer what lies outside massage. Drawn from the MBLEx content outline that most US licensing boards use to make that decision.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
5
Sources
3
Version
1

Built from Federation of State Massage Therapy Boards. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent massage therapist does on day one, dimension by dimension.

Clinical skills

  • Chooses technique, pressure and positioning from the intake and what they find, and adapts or avoids an area when a condition calls for it.
  • Takes and updates a health history that captures what could make massage unsafe or change how it is given.

Workflow and tools

  • Keeps accurate session records that show what was found, what was done and how the client responded, and never records what did not happen.
  • Keeps client information confidential and shares it only with the client's authorisation or as law requires.

Patient communication

  • Makes sure the client knows what the massage will involve and agrees to it, including each sensitive area, and that they can change or stop it at any time.
  • Gives the client predictability, choice and control over touch, and responds calmly if they become distressed, without probing their history.

Compliance and safety

  • Recognises when a finding makes massage, or massage over one area, unsafe, and postpones, adapts or refers.
  • Keeps the therapeutic relationship professional, and ends a session or relationship that cannot stay that way.

Role knowledge

  • Stays within massage scope, and names what belongs to a physician or other clinician without diagnosing or advising on treatment.
  • Knows when a client needs another professional and which one, and how urgently.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Massages a limb with signs of a possible deep vein thrombosis - one-sided swelling, warmth, pain or redness, especially after surgery, immobility, a long flight or pregnancy - instead of avoiding it and advising same-day medical assessment.

    Massage over a clot can dislodge it into the lungs as a pulmonary embolism, which can kill.

  • Would begin or pursue a sexual or romantic relationship with a client, including by ending the therapeutic relationship in order to date them, touch or undrape a client's genitals, or continue a session after a client's behaviour has become sexual.

    Sexual misconduct exploits the trust and vulnerability of the client on the table, causes lasting harm, and is grounds for loss of licence and criminal charges.

  • Would record a session, treatment or duration that did not happen, or alter a record to support an insurance or legal claim.

    False records mislead the client's other clinicians, and billing insurance on them is fraud.

  • Works an area the client has not agreed to, including a sensitive area such as the glutes, inner thigh, abdomen or chest wall, or continues after the client says stop or withdraws consent.

    Touch without consent is assault, and on a sensitive area it is experienced as sexual violation whatever the intent.

  • Tells a client what condition they have, advises them to stop, start or change a medication, or performs a spinal manipulation or thrust.

    A wrong diagnosis delays real care, changed medication can cause serious harm, and manipulation is outside massage training and legal scope.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not diagnose, or tell a client what condition a finding represents.Describes what they noticed, avoids or adapts massage over it, and advises the client to see the appropriate clinician with the right urgency.
  • Does not prescribe or advise on medication, or perform spinal manipulation, high-velocity thrusts or other techniques outside massage law.Refers medication questions to the prescriber and joint manipulation to a chiropractor, osteopathic physician or physical therapist.
  • Does not provide counselling or psychotherapy, even when a client discloses distress or trauma on the table.Listens without probing, stays within the session, and signposts mental health support or crisis services where needed.
  • Does not practise beyond the scope of their state licence: US massage scope, self-care advice and rules on minors vary by state, and differ again outside the US.Works to their own state's practice act and board rules, and checks them when working in a new place.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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