Massage is a method of manipulating soft tissue using compression and traction for therapeutic, palliative, and self-care or wellness purposes. Massage practitioners cannot provide services or apply techniques that would require a separate state license to practice, such as psychotherapy, chiropractic or osteopathic procedures, acupuncture, physical or occupational therapy, or any other branch of health care, unless they have the appropriate state license. Bear in mind massage practitioners who are dually licensed should refrain from wearing “two hats” simultaneously.

For example, when operating in the capacity of a massage practitioner, provide only those services within that scope of practice. When operating as a different professional, provide only those services within that particular scope of practice. Additionally, all professions have their own professional standards and codes of ethics (e.g., codes of ethics for licensed mental health counselors are different from codes of ethics for massage practitioners); the profession with the strictest code of ethics prevails and becomes the standard of conduct for all professional activities for the dually licensed massage practitioner.

Delegation is the assignment of a task or task completion from one authorized person to another authorized person. The delegated task must be within the capabilities, job duties, and scope of practice identified by state laws. For example, a health care provider cannot delegate tasks such as topical application of prescription drugs unless this task is part of the delegatee’s scope of practice. For massage practitioners, this restriction includes not only facilities that offer massage but also care provided in the therapist’s home office or client residence. In protection of your license and current position, it may be imperative to clearly communicate to staff the scope of practice for massage practitioners if asked to provide a service or application outside the scope.

The following is a list of what is commonly outside of a massage practitioner’s scope of practice. Check your state law for an accurate list of scope of practice inclusions and exclusions.

• Acupuncture

• High-velocity/low-amplitude manual thrusts at the end of available passive range of motion as performed in chiropractic or osteopathic procedures

• Ultrasound, electrotherapy, laser and microwave therapy, injection therapy, diathermy, and transdermal electronic nerve stimulation

• Dietary and nutritional counseling

• Cosmetology or specific procedures to beautify the skin

• Depilation, waxing, hair extractions, and electrolysis

• Colonic irrigation and other methods of internal hydrotherapy

• Ear candling

• Herbalism

• Homeopathy

• Naturopathy

• Diagnosis of diseases or injuries

• Psychotherapy, hypnotherapy, counseling, or related mental health care practices or procedures

• Recommending, prescribing, dispensing, administering, applying, or modifying prescription and over-the-counter drugs

• Intentional use of techniques to evoke an emotional response in the client

• Genital, intraanal, or intravaginal contact or manipulation

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View More: Susan Salvo is a massage therapist, author, educator, researcher, explorer, and perpetual student. To learn more, check out the “About Susan” tab. You can contact Susan at