| International Journal of Therapeutic Massage and Bodywork (2026) 19(3), 1–6. | https://doi.org/10.3822/ijtmb.v19i3.1611 |
Amanda Baskwill, PhD1*
1Loyalist College, Belleville, ON, Canada
Credibility is fundamental to the continued development and integration of therapeutic massage and bodywork as a health profession. However, credibility does not arise automatically from advances in education, regulation, research, or professional standards. Drawing on literature from massage therapy, professional identity, sociology of professions, and health professional education, this editorial argues that credibility is a social judgment conferred through recognition by patients, colleagues, regulators, and the public. The discussion examines the relationships among professionalization, professional identity, trust, and everyday practice, emphasizing the importance of communication, informed consent, collaboration, accountability, and professional conduct. Credibility is presented not as an achievement but as an ongoing professional responsibility earned through the consistent demonstration of competence, integrity, and trustworthiness across professional contexts.
KEYWORDS: Massage therapy; credibility; professional identity; professionalization; public trust
Massage therapy occupies a complex position within contemporary health care. It is widely utilized, often sought for relief of pain and stress, and increasingly supported by regulation, education, and research. At the same time, it remains inconsistently understood. For some, it is recognized as a form of health care grounded in clinical reasoning and therapeutic relationship. For others, it is associated with relaxation, luxury, or services that exist outside conventional health systems. These divergent interpretations shape how massage therapy is accessed, integrated, and valued within health care contexts.(1,2)
This variability in perception persists despite considerable effort within the profession to articulate its role and strengthen its foundations. Research exploring professional identity among massage therapists demonstrates that practitioners overwhelmingly identify as health-care providers, emphasizing competence, patient-centered care, and therapeutic relationship as core elements of practice.(3) Inconsistent definitions of massage therapy and variability in how the profession is described continue to limit shared understanding across contexts.(4) Together, these findings suggest that the issue is not solely one of professional development but of recognition.
Recent discussions within this journal have examined how professional language contributes to shared understanding and how advocacy extends professional values into coordinated action. These efforts are necessary conditions for professional advancement. They do not, however, ensure that the profession is consistently understood or trusted. As literature on professionalization and regulation suggests, the presence of standards, education, and organizational structures does not automatically translate into legitimacy or credibility if those elements are not recognized and accepted by others.(5,6)
Credibility in therapeutic massage and bodywork, therefore, is not established through assertion, branding, or popularity. It is established when the profession demonstrates, in consistent and observable ways, how it defines its work, prepares its practitioners, and governs professional conduct, and when those demonstrations are recognized by patients, the public, and other health professionals as reliable indicators of safe and effective care.(7,8) In this sense, credibility is not a characteristic that can be claimed but an outcome that is conferred through alignment between professional structures, everyday practice, and external perceptions.
This editorial examines credibility as a relational and ongoing process, shaped not only by what the profession develops internally but also by how those developments are enacted in practice and recognized within broader health and social systems.
Across the health professions, credibility is often treated as a natural consequence of professionalization. Regulation, formal education, research activity, credentialing, and professional standards are frequently viewed as indicators that a profession has achieved legitimacy. The literature surrounding therapeutic massage and bodywork, however, suggests that the relationship is more complex. Professionalization may support credibility, but it does not guarantee that credibility will be recognized or conferred by others.(2,5)
This distinction is particularly important within massage therapy, where the profession has developed many of the organizational features associated with health professional status while continuing to experience variable public and interprofessional recognition. Fournier and Reeves(1) found that massage therapists remained positioned at the margins of collaborative health-care environments despite regulation and increasing evidence supporting their role in care. Participants in their study identified persistent uncertainty regarding massage therapy’s scope of practice, educational preparation, and legitimacy within health systems. Importantly, these tensions were not framed primarily as questions of competence, but rather as questions of understanding, status, and recognition.
Sociological literature on professionalization offers useful context for understanding this tension. Weeden(9) argues that licensing, credentialing, certification, and professional associations function not only as administrative or regulatory mechanisms but also as social signals of competence, accountability, expertise, and trustworthiness. These structures communicate to the public and to other professions that a profession has established recognizable standards for entry, conduct, and oversight. Professionalization is not without complexity. While credentialing, regulation, and professional associations may strengthen accountability and public protection, they may also reinforce professional boundaries and influence which forms of knowledge and expertise are recognized as legitimate within health systems.(9,10) The presence of these structures alone does not ensure credibility. Their meaning must also be understood and accepted within broader social and health-care contexts.
Research examining professional identity among massage therapists reflects a similar complexity. Massage therapists consistently describe themselves as health-care providers and ground that identity in competence, patient-centered care, communication, and therapeutic relationship.(11) However, professional identity is not established through self-definition alone. Mylrea et al.(12) argue that professionalization is not simply the acquisition of skills and competencies but the formation of a professional identity shaped through values, socialization, responsibility, and public trust. In this sense, credibility depends not only on what practitioners know or do but also on whether professional values are enacted in ways that are recognizable and meaningful to others.
Questions of definition further complicate this landscape. Kennedy et al.(4) note that inconsistent terminology and conceptual ambiguity continue to limit shared understanding of massage therapy practice. Without greater clarity regarding what constitutes therapeutic massage and bodywork, distinctions between clinical care, wellness services, and non-therapeutic interpretations become increasingly difficult to sustain. Credibility, therefore, is influenced not only by the existence of standards but also by the profession’s ability to consistently communicate the nature and purpose of its work.
The literature also suggests that credibility is shaped relationally. Professional legitimacy emerges through ongoing interaction among practitioners, regulators, educators, patients, other health professions, and the public.(5,6) Recognition is therefore negotiated rather than assumed. Therapeutic massage and bodywork may continue to strengthen its educational pathways, evidence base, regulatory frameworks, and professional organizations, yet credibility ultimately depends on whether these developments are recognized as coherent, trustworthy, and accountable expressions of professional practice.
Credibility may also be evaluated differently across audiences. Patients, regulators, policy-makers, educators, and other health professionals do not necessarily rely upon the same indicators when assessing professional legitimacy and trustworthiness. While patients may prioritize safety, communication, and therapeutic outcomes, regulators may focus on accountability and public protection, and other health professionals may emphasize competence, evidence, and collaboration. As a result, credibility is not a singular achievement but a multifaceted judgment that is continually negotiated across contexts.
Viewed in this way, credibility functions less as a possession than as a social judgment shaped through the relationship between professional claims and external interpretation. Alignment between how the profession defines its work, prepares its practitioners, governs professional conduct, and demonstrates accountability may contribute to credibility, but credibility itself is ultimately conferred through recognition by patients, colleagues, regulators, and the public.
Recognition alone, however, does not fully explain how credibility is established and sustained within practice. The profession’s claims regarding competence, accountability, and professional responsibility ultimately depend on how these expectations are embodied by practitioners themselves. Questions of credibility therefore extend beyond regulation, education, and professional organization into the formation of professional identity, including how practitioners internalize professional values, responsibilities, and ethical commitments within everyday care.
Professional identity develops through a process of socialization in which practitioners learn not only what they do but also who they are expected to be as members of a profession. Education, mentorship, role modeling, clinical supervision, and professional culture all contribute to shaping how practitioners understand competence, responsibility, ethical conduct, and relationships with patients and colleagues. Mylrea et al.(12) argue that professionalization cannot be reduced to the acquisition of competencies, observable behaviors, or technical skills alone. Rather, it involves a process of identity formation through which professional values become integrated into clinical reasoning, relationships, and decision-making. Professionalism, in this framing, is not simply something practitioners demonstrate intermittently; it is reflected in how practitioners consistently understand and approach their responsibilities to patients, colleagues, and the public. Importantly, the authors connect this process directly to public trust, arguing that professionalism underpins the trust placed in professions by society.
Research examining professional identity among massage therapists provides evidence of how these processes are reflected within therapeutic massage and bodywork. Practitioners strongly associate their work with health care, emphasizing competence, communication, therapeutic relationship, and patient-centeredness as defining characteristics of practice.(3) These findings suggest that massage therapists do not merely perform technical interventions; they understand themselves as participating in a broader professional and ethical commitment to patient care. Professional identity, therefore, functions as more than a personal description of occupational role. It shapes how practitioners interpret professional responsibilities and how professional values are enacted within practice.
Educational standards, credentialing, and regulation may establish minimum expectations for entry into practice, but credibility also depends on how practitioners internalize and enact the ethical and relational dimensions of professional care. The socialization processes embedded within education, mentorship, role modeling, clinical supervision, and professional culture all contribute to shaping what professionalism looks like in practice. In this sense, credibility is reinforced not only through formal structures of accountability but also through repeated demonstrations of judgment, responsibility, communication, and ethical conduct across clinical interactions.
Professional identity also exists within broader sociological processes of professionalization. Weeden(9) notes that professions establish legitimacy through structures such as credentialing, licensing, and professional associations, all of which communicate competence, accountability, and trustworthiness to the public. However, these structures depend upon practitioners consistently embodying the standards and values they represent. A profession may establish formal expectations for conduct, but credibility is weakened when there is a visible disconnect between professional ideals and professional behavior.
Ultimately, credibility and professional identity remain closely interconnected. Public trust is influenced not only by whether professions possess recognizable structures of professionalization but also by whether practitioners consistently enact the values, responsibilities, and ethical commitments those structures are intended to support. Identity, therefore, functions as more than a personal description of occupational role. It shapes how practitioners interpret professional responsibilities and enact professional values within practice.
While credibility is influenced by professional structures, identity formation, and public recognition, it is ultimately experienced through practice. Patients do not encounter regulation, accreditation standards, or professional position statements directly. They encounter practitioners. In this sense, credibility becomes visible through the everyday decisions, behaviors, and relationships that shape practice environments.
This places considerable responsibility on practitioners themselves. Professional credibility is reinforced when clinical practice consistently reflects the values and standards the profession claims to uphold. Communication, informed consent, professional boundaries, documentation, collaboration, and ethical decision-making are not peripheral aspects of care; they are among the primary ways patients and colleagues interpret professionalism, safety, and trustworthiness within practice.
Porcino and Macdougall(8) highlight this clearly in their discussion of informed consent within therapeutic massage and bodywork. The authors argue that consent should not be understood as a singular administrative event but as an ongoing and relational process requiring communication, transparency, responsiveness, and attention to patient autonomy. This distinction is important because it reframes professionalism from procedural compliance to ethical engagement. Patients often interpret credibility through whether they feel informed, respected, safe, and meaningfully involved in decisions regarding their care.
The same principle can be observed in other aspects of clinical practice. Documentation, communication with other health-care providers, explanation of treatment rationale, and appropriate referral practices may appear routine, yet they provide tangible demonstrations of professional judgment and accountability. These activities help make professional standards visible to patients, colleagues, and systems of care.
Questions of credibility become particularly visible within interprofessional practice. Fournier and Reeves(1) found that uncertainty regarding massage therapy’s legitimacy within health-care environments was often connected to limited understanding of professional scope, inconsistent communication, and restricted participation in collaborative care processes. Credibility within health systems is therefore shaped not only by clinical competence but also by how practitioners engage with colleagues, communicate professional reasoning, participate within teams, and contribute to shared patient goals.
Importantly, credibility within collaborative environments is not strengthened through defensiveness or competition. Literature examining interprofessional relationships suggests that trust develops through repeated experiences of reliability, mutual respect, communication, and shared purpose. Therapeutic massage and bodywork practitioners who engage thoughtfully with other providers, communicate clearly regarding clinical reasoning and patient goals, and demonstrate accountability within collaborative care environments contribute not only to individual professional credibility but also to broader perceptions of the profession itself.
This has important implications for therapeutic massage and bodywork education and professional culture. Technical competence alone is insufficient to sustain public trust. Educational preparation must also support the development of communication skills, ethical reasoning, professional judgment, collaboration, and reflective practice. Mentorship, role modeling, and clinical supervision remain particularly important because they shape how emerging practitioners learn to navigate professional responsibility within complex practice environments.
There is also an important collective dimension to credibility in practice. Individual practitioners do not represent only themselves; they contribute, intentionally or unintentionally, to broader public interpretations of the profession. Clinical interactions, public communication, professional conduct, participation within health-care systems, and engagement with evidence-informed practice all contribute to how therapeutic massage and bodywork is understood by patients, colleagues, regulators, and the public.
For this reason, credibility cannot be reduced to branding, marketing, or professional aspiration alone. It is built incrementally through consistent demonstrations of competence, ethical practice, accountability, communication, and collaborative engagement. In many respects, credibility is less often established through exceptional moments than through the accumulation of ordinary professional behaviors that signal reliability, responsibility, and trustworthiness over time.
This alignment is particularly important within professions such as therapeutic massage and bodywork, where public understanding remains variable despite significant advances in professionalization. Educational pathways have expanded, research activity has grown, regulatory structures exist in many jurisdictions, and professional organizations continue to advocate for standards and integration. Yet the literature reviewed throughout this editorial suggests that credibility does not arise automatically from the existence of these developments alone. Rather, credibility depends on whether these structures are consistently enacted in practice and interpreted by others as meaningful indicators of competence, accountability, and professional responsibility.(6,9)
The profession therefore faces a dual responsibility. The first is the continued development of professional structures that support safe, ethical, evidence-informed, and accountable care. This includes education, regulation, credentialing, professional standards, research, and ongoing dialogue regarding scope and professional identity. The second responsibility is ensuring that these structures remain visible through practice itself. Professional values that are not consistently reflected in patient care, interprofessional relationships, communication, and ethical conduct risk becoming disconnected from public experience and professional trust.
Importantly, this work cannot rest solely with regulatory bodies, educators, professional associations, or researchers. Credibility is shaped collectively through the everyday actions of practitioners across clinical, educational, research, and leadership environments. Each interaction contributes to broader understandings of what therapeutic massage and bodywork represents as a profession and how it positions itself within health care and society more broadly.
The literature reviewed in this editorial suggests that credibility is best understood not as an achievement, but as an ongoing professional responsibility. It is shaped through the interaction of professional identity, education, regulation, ethical practice, public trust, and accountability. While these elements are often examined independently, credibility emerges through their alignment and through the consistency with which they are demonstrated across professional contexts.
Ultimately, credibility cannot be awarded by the profession to itself. It is granted by patients, colleagues, regulators, and the public when professional values are experienced as trustworthy, standards are visible in practice, and accountability is consistently demonstrated. The responsibility of therapeutic massage and bodywork, therefore, is not simply to pursue professionalization but to ensure that the knowledge, values, and commitments that define the profession remain evident in the care it provides and the relationships it builds.
Generative AI tools were used in the drafting of this editorial to support brainstorming and refine tone. All content was reviewed, edited, and finalized by the author to ensure accuracy and alignment with the author’s personal and professional values.
The author declares there are no conflicts of interest.
No sources of funding were used in this study.
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Corresponding author: Amanda Baskwill, Executive Editor/Editor-in-Chief, IJTMB, Loyalist College, Belleville, ON, Canada E-mail: ExecEditor@ijtmb.org
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International Journal of Therapeutic Massage and Bodywork, Volume 19, Number 3, September 2026