Massage therapy and bodywork are used by a wide array of people seeking the benefits of massage, which include physical relaxation, reduced anxiety, increased circulation, and pain relief. Specific indications for massage include treatment of acute low-back pain and lymphatic massage for patients with lymphedema from conditions such as postmastectomy extremity edema. Massage is used by various practitioners, including physicians, physical therapists, osteopathic physicians, chiropractors, acupuncturists, nurses, and massage therapists.
Massage should not be used in the presence of bleeding disorders, phlebitis and thrombophlebitis, edema that is caused by heart or kidney failure, fever or infections that can be spread by blood or lymph circulation, and leukemia or lymphoma. Massage should not be performed on or near malignant tumors and bone metastases; over bruises, unhealed scars, or open wounds; on or near recent fracture sites; or over joints or other tissues that are acutely inﬂamed.
There is no national licensure in massage therapy, but licensure is offered in 40 states. One-fourth of the massage training schools are accredited by the American Massage Therapy Association (AMTA). The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) administers a certification examination, and 35 states use it for licensure. The NCBTMB is an independent, private, nonprofit organization, founded in 1992, that fosters high standards for therapeutic massage and bodywork professionals. There are more than 90,000 nationally certified massage therapists and bodyworkers in the United States. Certification by NCBTMB requires successful completion of the examination and the completion of a minimum of 500 in-class hours of formal education and training (13).
Hypnosis involves the induction of trance states and the use of therapeutic suggestions. Hypnosis has documented value for a variety of psychological conditions and pain control and recovery from surgery.
Hypnotized persons occasionally report unanticipated negative effects during and after hypnosis. The spectrum of reported effects encompassed minor transient symptoms such as headaches, dizziness, or nausea in experimental situations to less frequent symptoms of anxiety or panic, unexpected reactions to an inadvertently given suggestion, and difficulties in awakening from hypnosis. More serious reactions following hypnosis are attributed to the misapplication of hypnotic techniques, failure to prepare the participant, and preexisting psychopathology or personality factors. There are no known deaths attributed to the use of hypnosis.
False memories of suggested events that did not occur in reality, particularly when legal and interpersonal battles are involved, can be viewed as an untoward reaction to psychotherapeutic procedures. In hypnotic and nonhypnotic situations, leading and suggestive overtures can produce false memories. Because hypnosis involves direct and indirect suggestions, some of which may be leading in nature, and because hypnosis can increase confidence of recalled events with little or no change in the level of accuracy, therapists must be attentive to the problem of creating false memories.
There is no national or state licensure for hypnotherapists. The International Medical and Dental Hypnotherapy Association will certify hypnotherapists if they meet the minimum eligibility requirements and will provide referrals.