Scope of Practice

The practice of Massage Therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain (Massage Therapy Act, 1991).

What are Standards of Practice?

The College of Massage Therapists of Ontario (CMTO) has published Standards of Practice for registrants which establish the expectations for all Massage Therapists regardless of their role, job description or area of practice. These Standards guide your practice in order to protect the public. Contravening or failing to maintain either published Standards of the College or unpublished Standards of Practice of the Profession is an act of Professional Misconduct under the CMTO’s Professional Misconduct Regulation.

The Standards of Practice form a live and dynamic document that will evolve as changes in practice occur. It is an MTs obligation to ensure they are complying with the Standards of Practice of the profession and the published Standards of the College that are in force at the time.

The Standards of Practice outline key expectations and describe the minimum requirement for performance.  Within each standard you will find items which outline behaviours that may or may not apply to every situation (client population, environment, etc.).  It is up to the MT to use their clinical judgement and decision-making skills to determine if an item applies within the current context, considering all factors.  However, even if an item does not apply in a situation, the MT is still expected to be able to demonstrate all items should he / she be requested or required. In situations where the MT uses their clinical judgement and determines an item is not applicable, the MT must be able to provide a reasonable rationale for the variation from the Standard.

Why are Standards of Practice Necessary?

These published Standards of Practice are also used in the following ways:

• Massage Therapists are able to understand what is expected of them;
• Educators are able to address the Standards as objectives in curriculum design;
• Registration (admission to the College);
• Investigations into professional conduct;
• Discipline Hearings;
• Fitness to Practise Hearings;
• Quality Assurance;
• Client Relations; and
• The public is able to assess the quality of treatment through written Standards.

Relevant Legislation

In addition to being accountable to meet the published Standards of Practice of the College, Massage Therapists are accountable under the legislation that includes the following:

• Regulated Health Professions Act, 1991 (RHPA);
• Massage Therapy Act, 1991;
• Regulations under the Massage Therapy Act;
• Health Care Consent Act, 1996 (HCCA); and
• Personal Health Information Protection Act, 2004 (PHIPA);
• In some situations the Personal Information Protection and Electronic Documents Act, 2000 (PIPEDA) may also apply.

• Acupuncture Standard of Practice
• Standard for Maintaining Professional Boundaries and Preventing Sexual Abuse
• Standard 1: Prepare the Treatment Area
• Standard 2: Inform the Client of the Fees and Obtain His/Her Agreement to a Fee Schedule
• Standard 3: Wash Your Hands and Any Skin Surface that Will/Has Come in Contact with the Client
• Standard 4: Interview the Client to Obtain His/Her Treatment Goals
• Standard 5: Risk Identification and Management for an Outbreak of Infectious Diseases
• Standard 6: Obtain, Update and Record the Client’s Health History
• Standard 7: Consent
• Standard 8: Determine the Client’s Condition by Conducting Assessment/Re-Assessment
• Standard 9: Determine if Massage Therapy Treatment is Indicated
• Standard 10: Treatment and Treatment Plans
• Standard 11: Pre / Post Treatment Protocol
• Standard 12: Draping
• Standard 13: Recommend Self-Care
• Standard 14: Client Health Record
• Standard 15: Use of Personal Protective Equipment During a Treatment
• Standard 16: Discharge of a Client

• Standard 1: Introduction to the Standards for Specific Massage Therapy Techniques
• Standard 2: Perform a Stroking Technique
• Standard 3: Perform a Rocking or Shaking Technique
• Standard 4: Perform an Effleurage Technique
• Standard 5: Perform a Petrissage Technique
• Standard 6: Perform a Friction Technique
• Standard 7: Perform a Vibration Technique
• Standard 8: Perform a Tapotement Technique
• Standard 9: Apply Deep Fascial Techniques
• Standard 10: Myo-Fascial Trigger Points
• Standard 11: Apply Low-Grade Joint Mobilization (Sustained Grade I or II or Grade I or II Oscillations)
• Standard 12: Apply High-Grade Joint Mobilization (Sustained Grade II and or Oscillations III and IV Joint Mobilization)
• Standard 13: Perform a Stretch Technique
• Standard 14: Perform an Intra-Oral Treatment
• Standard 15: Perform Breast Massage
• Standard 16: Perform Massage to the Chest Wall
• Standard 17: Apply Hydrotherapy