Massage Therapy Journal Spring 2025

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Spring 2025

CE Orthopedic Massage Techniques for the Upper Body

JOURNAL

Sustainability within the Massage Therapy Industry Massage therapists and massage product manufacturers work together to make the industry more sustainable Plus Understanding Medicare Advantage

Self-Care for Sustaining a Career

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Massage Therapy Journal Vol. 64 No. 1 Contents

FEATURES

68 SUSTAINABILITY

14 SELF-CARE FOR SUSTAINING A CAREER Your well-being is important. Nurture yourself for a more balanced work life. By Noel L. Poff,

22 WHEN IT’S TIME TO HIRE YOUR FIRST EMPLOYEE Hiring can be a form of self-care, allowing you time for both yourself and your practice. But, being smart about the hiring process is key.

30 ORTHOPEDIC MASSAGE

WITHIN THE MASSAGE THERAPY PROFESSION Massage therapists and massage product manufacturers work together to make the industry more sustainable. By David Malone

TECHNIQUES FOR THE UPPER BODY CE Learn more about orthopedic techniques and review the anatomy of the joints, muscles and nerves that make this work effective. By Rob Kelly

Certified Advanced Rolfer, C-IAYT, CPT, LMT, RYT-500

Lysenko Andrii / shutterstock.com

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JOURNAL

DEPARTMENTS

Massage Therapy Journal® | Official Publication of the American Massage Therapy Association® Spring 2025 Vol. 64 No. 1 ISSN: 0895-0814 USPS 0010-218 Cover credit: KanokpolTokumhnerd / lemono / Olga_C / Shutterstock.com Michelle Vallet Senior Publications Manager AMTA BOARD OF DIRECTORS (effective March 1, 2025) Cindy E. Farrar President Kimberly Kane Santos Immediate Past President

LETTER FROM THE PRESIDENT I Am Because We Are

SHAREABLE RESEARCH Self-Care As A Cornerstone to Career Longevity

Jaime Bernardo, Jr. Director Heber J. Blackner Director Matthew Fecteau Director Donald Goodale Director Rick Greely Director Robert C. Jantsch Director Jane Horton Johnson Director Debbie Kilty Director Cheryl L. Siniakin, Ph.D. Director Lee Stang Director

EDITORIAL REVIEW OPERATIONAL COMMITTEE Jacqueline Herbach, LMSW, LMT President, Momentum Massage, Jane Neumann, BS, LMT, NCTMB Private Practice

Fitness, & Mind New York City Steve Jurch, MA, ATC, LMT Director of Allied Health Training at the Community College of Baltimore County

AMTA Illinois Chapter Communication Chair

Jessica Libero, LMT, NCTMB Connecticut and New York Licensed Reiki Practitioner Martha Brown Menard, Ph.D., CMT

Photo courtesty of Wellness Stock Shop

ADVOCACY Learn More About Medicare Advantage Plans and Massage Therapy Benefits

Publication Management SPARK Publications sparkpublications.com

Project Manager: Jaclyn Yepsen Creative Director: Larry Preslar

SOOTHE Energizing Morning Routine for Massage Therapists

Massage Therapy Journal is published quarterly by the American Massage Therapy Association (address below). Periodicals postage paid at Evanston, Illinois, and additional mailing offices. POSTMASTER: Send address changes to Massage Therapy Journal , 500 Davis St., Suite 900, Evanston, IL 60201-4695. SUBSCRIPTIONS: All subscription matters and notice of change of address should be sent to: Massage Therapy Journal Subscriptions, AMTA, 500 Davis St., Suite 900, Evanston, IL 60201-4695 (877-905-2700). Subscription rates: U.S. and Canada, $25 for one year (four issues); $45 for two years (eight issues). Foreign, $70 for one year; $120 for two years; available on a limited basis. Contact AMTA Member Experience, 500 Davis St., Suite 900, Evanston, IL 60201-4695. Phone: 847-864-0123 info@amtamassage.org EDITORIAL COPY: Queries should be sent to Michelle Vallet via email: mtj@amtamassage.org . Visit amtamassage.org/mtj for writer guidelines. Information contained in Massage Therapy Journal does not necessarily reflect the opinions or beliefs of AMTA and/or the staff of Massage Therapy Journal . ADVERTISING: Contact the AMTA sales team at Smithbucklin to learn more about advertising and exhibitor opportunities: (301) 215-6710 Ext.130 or hbrown@smithbucklin.com. Copyright © 2025 American Massage Therapy Association MTJ-024

78 TOOLS OF THE TRADE Take 5: Using Social Media and Referral Programs to Your Advantage

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FACILITATING HEALING: IMPROVING CLIENT OUTCOMES

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6 • Massage Therapy Journal

Letter from the

President

I Am Because We Are Greetings Friends! I must admit this is somewhat of a surreal

represented by the Masai warriors of Kenya. When greeting each other, they always ask: “And how are the children?” The traditional answer is: “All the children are well.” This response communicates that all is well only when the needs of all, especially the most vulnerable, are well tended. AMTA’s commitment to our members and community at large is a manifestation of our mission statement “To serve our members ...” and core values “We are a diverse, inclusive and nurturing community working with integrity, respect and dignity.” A litmus test I use for life decisions is the phrase “timing and purpose.” Both aspects have to be aligned with each other, in relation to current life conditions, my greater purpose and the prospect at hand. Time and again AMTA has met or exceeded the tests. The significance, responsibility and honor to serve as the 2025/2026 AMTA National President is in no way lost on me. Thank you for this tremendous opportunity. “A litmus test I use for life decisions is the phrase ‘timing and purpose.’ Both aspects have to be aligned with each other, in relation to current life conditions, my greater purpose and the prospect at hand. Time and again AMTA has met or exceeded the tests.”

ENGAGE WITH AMTA AMTA’S local chapters are a great place to start getting involved. Find yours at amtamassage.org/ chapters.

experience for me, writing this letter, as well as my new role as AMTA’s National President. Even though I’ve had a year as President-Elect to prepare and get used to the idea, I still get giddy at the realization. So much so, that on at least one occasion, I was dubbed the “Giddy-one.” At the start of my massage journey 28 years ago, I couldn’t have imagined my path would lead me here. Yet, as the poet Rumi once said: “As you walk out on the way, the way appears.” While unexpected, each turn on my AMTA path has brought great opportunities— opportunities for personal and professional growth, making strong connections and lifelong friends, and, most of all, leadership service. A Commitment to Excellence In January 2015, as the AMTA-Georgia Chapter President, I attended a Chapter Presidents meeting. During the meeting, Chapter Presidents took another oath in addition to that of our oath of office. It was an oath of excellence. A commitment to the AMTA community and to what became our AMTA Culture Initiative. In recognition of that oath, we received a special “commitment to excellence” pin. In the nine years since, I have had both my 20th and 25th AMTA membership anniversaries, served as AMTA National Director (three terms!), AMTA President-Elect and now AMTA President. Each milestone has come with commemorative pins. As appropriate, I wear them when attending AMTA events or otherwise representing AMTA. Among them, still worn and in many ways most meaningful, is the commitment to excellence pin. For me, the idea of committing to excellence brings to mind a cultural perspective

Cindy E. Farrar AMTA President

I am because we are.

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Spring 2025 • 9

Shareable Research

Self-Care As A Cornerstone to Career Longevity When you’re committed to taking care of your clients, your own self-care may be compromised. Whether it’s overloading your schedule, not prioritizing your physical care, or ignoring signs of injury or burnout, not being thoughtful about taking your own well-being seriously can shorten your career in the massage profession.

Photo courtesty of Wellness Stock Shop

Share this research with clients and colleagues by visiting amtamassage.org/mtj.

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10 • Massage Therapy Journal

Self-care has been trending these last few years for a very good reason: It’s necessary.

Self-Care for Stress

Transcendental Meditation + Self-Care This 2024 qualitative study explored the influence of transcendental meditation (TM) on the well-being of clinical nurses to better understand the experiences of clinical nurses who practiced TM, specifically through assessments that include Watson’s holistic unitary caring science theory. The study. This qualitative study involved a thematic analysis of the written descriptions provided by clinical nurses following the completion of a TM program during the COVID-19 pandemic. The results. Nurses described their experience with the practice of TM as creating present-moment focus leading to enhanced self-care and development of true authentic presence with others. The overall theme uncovered in the analysis is that authentic presence is truth in knowing, being, doing and becoming. “The findings were congruent with Watson’s unitary caring science theory and provided illumination of the holistic value of transcendental meditation as a self-care strategy for supporting nurses’s well-being with the goal of retaining nurses in practice,” researchers concluded. “When nurses care for themselves, they are more likely and able to care for others, thus helping them to enjoy their nursing careers.”

Researchers wanted to assess the effectiveness of a 12-week online, guided, self-paced intervention of mindfulness and self-care practices on self-compassion, attentiveness and perceived stress for university health care students and faculty. The study. Participants in this 2024 study received seven different mindful and self-care activity options every week for 12 weeks. Outcome measures were assessed using a pre-survey, weekly surveys and a one-month post-survey, including the Perceived Stress Scale 4, Self-Compassion Scale-SF, Mindful Attention Awareness Scale, health behaviors and feasibility. The results. A total of 232 participants indicated one or more outcome measures, and 68 participants completed all 14 measures. “Students and faculty demonstrated significantly increased mindful attention awareness, days of mindfulness practice, self-compassion and trended toward more physical activity,” researchers noted. “They reported significantly lower stress and that mindful practice altered the way they dealt with stress.” Results indicated that most participants chose shorter meditation, yoga and self-care options during the study.

References 1. Slota M, Healy H, Hagen B, Brasher P, Fay L, Crowell N. “Impact of mindfulness and self-care intervention on stress, self-compassion, and attentiveness in university healthcare students and faculty. ” J Am Coll Health . 2024 Jun;7:1–10. 2. Aquino-Russell C, Bonaire J, Hartranft S, Gutach M, Johnson A. “Transcendental meditation enriches nurses’ authentic presence through caring for self and others.” J Holist Nurs. 2024 Dec;42(4):361–373.

WANT MORE INFORMATION? For more information on some of the research being done on the benefits of massage therapy, browse the Research section of AMTA’s website at amtamassage.org/research.

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12 • Massage Therapy Journal

Advocacy Advancing the Massage Therapy Profession

Learn More About Medicare Advantage Plans and Massage Therapy Benefits Overview of Medicare Advantage M edicare Advantage, also called Medicare Part C, is a private insurance option approved by Medicare that serves as an alternative to

Massage Therapy and Medicare Advantage

While original Medicare does not cover massage therapy, some Medicare Advantage plans may offer it as part of their expanded benefits. This coverage is typically included under wellness or complementary therapy options, recognizing the role of massage therapy in managing chronic and acute pain, reducing stress, and improving overall health. Coverage details, such as the conditions eligible for massage therapy, the number of sessions allowed and reimbursement policies, vary by plan. Massage therapy clients should check with their specific Medicare Advantage provider to understand the scope of their benefits, including any referral or pre-authorization requirements. Licensed massage therapists interested in working with Medicare Advantage clients must familiarize themselves with billing codes, documentation

FREE WEBINAR Watch AMTA’s free Medicare Advantage 101 Webinar to delve into how to effectively navigate and engage with Medicare Advantage plans.

original Medicare. These plans provide all the benefits of Part A (hospital insurance) and Part B (medical insurance) and often include additional coverage for services like vision, dental and wellness programs. Most Medicare Advantage plans also offer prescription drug coverage (Part D). With a focus on a more holistic approach to healthcare, these plans frequently tailor their benefits to meet the diverse needs of their members, which can include support for pain management and wellness services. Medicare Advantage plans operate through networks of healthcare providers, and enrollees typically need to follow specific rules regarding where and how they receive care.

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standards and network participation criteria to ensure compliance and streamline reimbursement processes. Does Medicare Advantage cover massage therapy, and if so, what should clients and therapists know? Yes, Medicare Advantage plans can cover massage therapy under certain conditions. Since 2020, Medicare Advantage plans have been able to offer non-medical benefits that meet member’s health and social needs, including therapeutic massage. For 2025, over 250 Medicare Advantage plans nationwide are offering the therapeutic massage benefit. Coverage details vary by plan and may include limitations on eligible conditions, the number of sessions allowed and reimbursement rules. Clients should contact their specific Medicare Advantage provider for details on coverage, referral requirements and pre-authorization processes. Licensed massage therapists should understand the billing codes, documentation standards and network participation requirements to ensure compliance when working with these plans. How can massage therapists participate in Medicare Advantage networks and manage billing for clients? To work with Medicare Advantage clients, licensed or certified massage therapists must: • Join the network of providers for the specific Medicare Advantage plan. • Learn the required billing codes and reimbursement policies for therapeutic massage. • Follow documentation standards and pre authorization procedures required by the plan. Being proactive in understanding the individual plan’s requirements ensures a smoother process for reimbursement and compliance. By doing so, massage therapists can effectively expand their services to clients covered by Medicare Advantage plans.

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14 • Massage Therapy Journal

Self-Care for Sustaining a Career By Noel L. Poff, Certified Advanced Rolfer, C-IAYT, CPT, LMT, RYT-500 Your well-being is important. Nurture yourself for a more balanced work life.

Genko Mono / tanyaaleshevich / Shutterstock.com

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Spring 2025 • 15

T he holidays were only a couple of weeks away and they were one of the few motivators left for me after working a solid month of seven-day work weeks. Despite it being a festive and fruitful time, I didn’t feel that way. My wife and I argued one day when I came home in the evening and plopped on the couch. My knees ached, still recovering from a torn meniscus, and my spine fell back into its preferred twist. My hands hurt any time I tried to grab anything.

“Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it.” —RUMI

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16 • Massage Therapy Journal

When my wife asked me to help with the dishes, I remained silent and immobile. She got irritated. Then I got irritated at her irritation and we spiraled into a loop of ongoing frustration. After I had some time to reflect, I realized that from the time I get up in the morning to the time I go to bed at night, I’m catering to the needs of others. Ultimately, I understood I wasn’t being real about my own limitations. Self-Care Requires Self-Love As a massage therapist with a background in training and a previous interest in physical therapy, I consider myself keen on the topic of self-care, and that is knowledge I share with my clients. For example, part of my regular intake involves asking clients what they do for self-care. Here, I’m usually referring to activities such as hot/cold therapy, stretching, going to the gym, yoga or meditation.

Massage instructors I’ve had throughout the years have helped me fall in love with the massage therapy profession more and more. Observing their work and listening to their wisdom gave me hope for a lifelong career facilitating healthy changes in my clients through hands-on support. What I learned and continue to learn from my teachers is that self-care is much deeper than simply stretching between sessions or making sure to take time off from demanding work schedules, though these things are important. Instead, self-care is an ongoing process of self-love that inevitably weaves itself into our work. To be effective, self-care needs to be integrated into other aspects of ourselves, including our emotional and spiritual health. When we equate self-care with self-love, we instantly recognize that there is more to caring for ourselves than staying healthy enough to sustain a long career as a massage therapist—our physical bodies will continue to age regardless of our recovery methods. Self-Care: Understanding What’s at Stake Massage therapy is a demanding profession, both physically and mentally, as we know from the number of massage therapists who are forced to leave the profession—either temporarily or permanently—because of injury or burnout. I myself have felt like I was close to the end of my own run on occasion. I continually draw inspiration, however, from the stories of practitioners with 20, 30, 40 years or more in the industry and practices that are as vibrant as I felt on my first day of class. When you spend time with such people, you realize that it’s not just their physical endurance that sustains them, nor some magical energy. Their bodies age and ache just as much as anyone else’s. In most cases, the difference is their holistic approach to self-care, which includes not just managing physical health, but also managing energy, taking ownership of stress, continually finding inspiration, seeing the bigger picture, having the right motivation, weathering the storms of loss and facing the fears of change.

These activities are all on my own list of things I use to help restore myself. Even so, I still sometimes feel like my work as a massage therapist isn’t sustainable, and that worries me because massage is the only career I’ve ever really trained for or known.

lemono / Shutterstock.com

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Spring 2025 • 17

All of these qualities are hard to teach as part of a curriculum because they are unique to every person. What is common is that they are all part of being a human being—and we can’t separate our being human from our work. The more we can synthesize our work with our humanity, the better able we’ll be to transform the way we work into a way of caring for ourselves. We’ll dive into this by looking at a few practices that may be easily woven into your current self-care regimen, including: taking time to discharge, developing a positive relationship with stress, maintaining a beginner’s mind, cultivating neutrality, knowing your worth, taking ownership of your awareness and having patience in your practice. “The whole world can be explained in just one sentence. ‘What is being discharged is old and what is being charged is new.’” —DADA BHAGWAN Understanding How Discharge/ Recharge Can Help You Maintain Your Energy We are in a state of continual charge, and much like batteries we need to recharge ourselves. If we go too long without a power source, we run out of juice. What’s more is that our charges are shifting positively and/or negatively per our interactions with sources of energy that possess their own charges, including other people. When energies mix and mingle in as intimate a setting as a massage, it’s prudent to pay attention to how your own energy feels afterward. You may feel the need to recharge from the expense of energy or you may even feel the need to discharge an accumulation of extra energy. Either way, there is an energetic imbalance that you would do well to correct before your next session or before you go home.

You may not have any real opportunities to fully rebalance your energy until the end of your day. There are quick ways to restabilize yourself between sessions, however: 1. Taking a minute of mindful breaths 2. Step outside and stand in the grass, if it’s warm enough, or just stay quiet for a minute and listen to what’s going on in nature 3. Brew a quick cup of herbal tea and take time to enjoy, noticing the flavors and warmth on your tongue These little respites can help you maintain your energy throughout your workday. Still, you should plan for a full discharge session at the end of your day that is ideally long enough to create a sufficient buffer between the workspace and your home whenever possible. This self-care may look like stopping by the gym to exercise on your way home, taking some time to lay down before moving onto the next thing, or even talking with colleagues. Work has a way of coming home with us and even more so nowadays with text, emails and social media. Resist the urge to dive right back into work mode at home through such mediums and do your best to give those things their own space to be addressed.

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18 • Massage Therapy Journal

“Adopting the right attitude can convert a negative stress into a positive one.” —HANS SELYE Stress Is Not the Enemy: Using Challenges to Your Advantage In the 1990s, researchers explored how to create contained ecosystems and assess their viability for purposes such as building colonies on other planets. Within these biospheres, they noticed something interesting about tree growth: trees grew much faster than they would in normal conditions but started to fall over after reaching a certain size. What they found was that the trees’ weakness was largely caused by a lack of stress wood, which in natural conditions is developed in response to wind. One of the oldest trees in the world, a 5,000 year old bristlecone pine named Methuselah, is just an eight-hour drive east from San Francisco. I

think of this idea of strength born from challenge when I see the contortions of the trunk, the adjustments this tree has been forced to make while enduring varying wind speeds over the millenia. Then I ask myself: Have the unique stressors I’ve encountered in my life made me stronger and more aware? In many ways, the answer is “yes.” When you’re feeling stressed or overwhelmed, consider the following: 1. When you think about the challenges you’ve faced, both personally and professionally, what stands out to you most? Have you, like Methuselah, been able to adjust? What have the challenges you’ve faced taught you about your own resilience? How can those lessons be used to endure—perhaps even welcome!—future challenges? 2. Be conscious of how you’re thinking about stress and try to remember the notion of healthy stress or “eustress,” where stressors are viewed as positive opportunities for growth rather than adversities to be avoided. When we take an active role in stress, we take responsibility for it. When we take ownership of our stress, we also take control of its effect on us. Consequently, we can both protect and enrich ourselves at the same time.

“In the beginner’s mind there are many possibilities, but in the expert’s mind

there are few.” —SHUNRYU SUZUKI

The Beginner’s Mindset: How to Stay Inspired

Burnout is common in most professions, but may be particularly prevalent in hands-on practices like massage therapy, where the work is often physically and emotionally demanding. Think back to when you first went to massage school

lemono / Shutterstock.com

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Spring 2025 • 19

and recall the excitement of learning so many new skills, techniques and modalities. Remember how excited you were to begin your career and start working with clients? When I graduated from massage school, I felt like a whole new world opened up for me—and I was ready to explore. After some years in practice, however, that world began to feel smaller, and I found that the energy I once focused on developing and pursuing my passion for massage was now reserved for just getting through my workday. Soon, I went back to school, thinking that pursuing a graduate degree was the key to reigniting my passion. I started applying to schools, believing the academic route would open up more fields for exploration. What I found, however, was that all I really wanted to learn is how to better help my massage clients. I didn’t want to stop doing massage; I wanted to deepen my knowledge and understanding of the work I love. The real lesson? I realized I learned more about the body attending weeklong workshops in massage than I did in any biology course in college. What was even better was that I could apply just about everything I learned through the experiential nature of massage continuing education immediately to my work. Part of self-care is finding ways to stay inspired and connected to your work to help you keep your passion for massage alive. If you feel like you’re getting stuck, you might try some of the following ideas: 1. Connect with experienced massage practitioners. What I consistently noticed was experienced practitioners are willing to attend more training and are open to learning, not just from their peers with as many years in the profession as they have, but also from their students. 2. Stay curious, stay in that same frame of mind that you had when you first started school, and be open to the possibilities of utilizing different principles and methods. Read an article on a technique you’ve been wondering about, or

register for that class you’ve been considering. Even just chatting with a colleague about how they approach a particular issue can open up possibilities you hadn’t thought of before and rekindle the excitement. The lesson learned from this is timeless yet simple: Stay in the beginner’s mindset and you’ll protect yourself against getting bogged down in a rut. “Don’t just do something, stand there.” —THE WHITE RABBIT, ALICE IN WONDERLAND Slowing Down Is Self-Care There have been numerous times I’ve felt overwhelmed trying to meet the needs of a client. There are days when nothing I do seems to work and the muscle doesn’t get any less tense. The harder I work, the worse things feel in my own body. In my first years as a massage therapist, I could power through those periods of stagnation and still feel satisfied in knowing

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I began to connect with my work on an entirely different level that leaves me feeling more fulfilled than drained. I left sessions feeling as though I’d just spent an hour in meditation rather than in a workout. Admittedly, I often fall back to working more with muscle than with intention, but the more I am reminded of how things land when I allow myself to slow down, the more I begin to see more clearly that we can have the same, if not better, results with less effort. “This is the real secret of life— to be completely engaged with what you are doing in the here and now— and instead of calling it work, realize it is play.” —ALAN WATTS Self-care is a topic of great interest for those working in health professions because peoples’ understanding of the quality of care comes first from the quality of their providers’ health. Like climbers rappelling down to rescue our comrades, we have to ensure our lines are secure first. “Lines” can represent a lot more than just physical health and stamina. What we need to feel healthy and whole can include a larger circle of care that serves to support us, like our own personal external and internal support systems. Here, we’ve reviewed some of the internal support systems that can be continually enriched through self-awareness. Your internal support systems are as much a part of you as your thoughts and beliefs. They are inseparable from you and, as such, are woven into your work. Developing a life with self-care doesn’t have to be something you need to make extra time for and balance between meeting the demands of the day. It can be something you playfully invite into how you work with others that is both energizing and sustainable for a long and rich life as a massage therapist.

that I tried my best. Unfortunately, I learned fast that “powering through” is not a sustainable way of practicing and quickly led to my injuring myself in various ways. Then, I began watching practitioners who have been in the massage profession for several years, and I noticed something very different about their approach. After performing a technique on a client they would just stop, sit down and take a breath. Without cue, the client would stop and take a breath as well. The session would then continue with another intervention followed by another moment of pause. Seeing this give-and-take had a profound impact on me because I previously felt the need to keep moving for the entire hour in session. I equated the value of the session with how much time my hands were on the client. In this alternative way of working, the value became the level of presence I maintained with the client and how well I could hold a healing space.

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Spring 2025 • 23

When It’s Time to Hire Your First Employee Hiring can be a form of self-care,

allowing you time for both yourself and your practice. But, being smart about the hiring process is key.

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24 • Massage Therapy Journal

T he time has come. The signs are everywhere. Maybe you don’t have time to take on new clients. Maybe you haven’t had time off in months. Or maybe your practice is growing and you need to be able to delegate some of your workload.

you supply the needed information to an automated EIN Assistant.” What will payroll look like? Anyone looking to hire an employee will also need to think about payroll. There are myriad payroll options available for small businesses, such as Gusto, Quickbooks Payroll and Square Payroll. Massage therapists should do a little research on the various options to find the best payroll software for their practice. Employee paperwork. As you think about payroll, remember that any employee you hire will need to fill out a W-4 to withhold the correct amount of federal tax from each paycheck. Remember, a W-4 is for employees, while a W-9 is for an independent contractor. Most of the payroll software available can help you navigate payroll taxes and expenses. “Payroll expenses are the sum you pay to employees for their labor, as well as associated expenses, such as employee benefits and payroll taxes,” Benson explains. “This is an important definition to note because you should consider your overall payroll expense when hiring a new employee.” New hires must also fill out an I-9 form to prove they are legally eligible to be employed in the United States. “You, as the employer, are charged with verifying the information your employee has supplied by examining one or a combination of documents (U.S. Passport, driver’s license, birth certificate),” Benson says. “So you, too, will complete and sign your portion of the I-9 and keep it on file.” Reconciliation Act mandates employers report any new hires to the directory maintained by their states within 20 days of the hire date. What to Look for When Hiring: Additionally, since 1996, the Personal Responsibility and Work Opportunity

No matter the reason, the voice in the back of your head is saying the same thing: It’s time to hire. Hiring seems simple enough on the surface, but the process of bringing another person into your practice should be thoughtful and deliberate. Without careful planning, hiring can quickly turn something that is meant to help you and your practice into a massive headache instead. Between filing the proper paperwork, preparing for your new employer tax responsibilities, making sure you choose an employee that fits with your goals, and onboarding the employee, there are a lot of details to keep track of in the hiring process. Below are a few of the most important things to remember before, during and after hiring your first employee.

Tax Considerations Mean Paperwork, Paperwork and More Paperwork One of the first and most

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important things to come to grips with when considering hiring is the paperwork you’re going to need to file. Apply for an EIN number. Before hiring, you need to apply for an Employer Identification Number (EIN). “The IRS and state agencies will require this number for tax filings and other paperwork,” says Brittany Benson, Lead Tax Research Analyst at H&R Block’s Tax Institute. “The fastest, easiest way to get yours is to apply online ,” she says”. You’ll be issued an EIN immediately after

Getting the Right Fit Hiring a first employee is a big decision, and deciding

who among the applicants best fits your needs and culture of your practice is an even bigger

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decision. But, there are ways to streamline the process and make sure that hiring goes smoothly, not only for you, but also the person you’re hoping to bring into your practice. For example, be up front and transparent about the pay you can offer (and any benefits) so that those considering applying know before they even send you their information. “Deciding how much a new employee is paid can be one of your tougher challenges as a small business owner,” says Benson. “You want the best candidate you can find. You’ll need to find the sweet spot—the salary that will appeal to someone with your desired qualifications yet leaves some room for negotiation.” Again, it is important to note that the salary is just one component of the overall payroll expense to consider. Things like taxes and commissions also play into the total sum. Solid preparation is also key. You’ll have a better chance of attracting the kind of talent you want for your practice if you are very clear about what you want and need out of your employee. Are you looking for someone who specializes in a certain area or technique, such as Swedish, deep tissue or myofascial release? Do you want someone who combines a traditional technique with a more niche expertise, such as pregnancy massage or IASTM (instrument-assisted soft tissue mobilization)? What kind of hours are you looking for this person to work? What personality type will work best with your own? These are just some of the questions you should have clear answers to before beginning the hiring process. Another thing to consider that will help you focus on hiring the best possible fit is the goals you have for your massage practice. Be up front about what they are with any candidates to make sure they align with what the candidate is looking for in an employer. This can save a lot of trouble down the line if it quickly becomes apparent your goals don’t align. Finally, discuss and assess the non-massage specific qualities you want in an employee during the interview process. How a person

You’ll need to find the sweet spot— the salary that will appeal to someone with your desired qualifications yet leaves some room for negotiation.

interacts with you is likely how they’ll interact with your clients, so take note of how prepared people are for the interview and share basic expectations around client interaction, dress policy, punctuality and hygiene—anything that is important to maintaining the standards that you and your clients have come to expect.

Onboarding: Getting Off on the Right Foot Once you’ve found your perfect employee, made an offer and they accepted, the

WHAT WORKED FOR YOU?

Do you remember the first employee you hired? Tell us about the experience and what you found most surprising and rewarding

onboarding process begins. Hiring websites like Indeed.com will sometimes have onboarding tips that might help you remember all the details that will make getting your new employee up to speed less difficult for you both. Beyond the things that need to be done (like any W-4 or I-9 paperwork), orienting the employee to how your practice runs is important. For massage therapy practices, this work might include: • Showing the new employee the space where he will be working

about the process at communications@ amtamassage.org!

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26 • Massage Therapy Journal

What’s important to remember when onboarding is that this is the time to answer any questions the new hire may have.

make sure they are comfortable in their new role and to make the transition for your practice as seamless as possible. The purpose of hiring an employee is to make your business more efficient, and the onboarding phase can help ensure you both get off on the right foot as you adjust to one another. “Effective onboarding helps your newest employees feel like a part of the team and the company culture from the beginning,” says Benson. “This warm welcome makes them more likely to feel engaged, which can improve performance and encourage them to stay with the practice longer.”

• Giving the new hire a tour of the office space and where they can find basic necessities like towels and sheets and anything else you intend to supply that would be used during a massage session • Providing your new hire with any necessary sign-in information for items such as scheduling software or email • Providing an employee handbook or any documents that outline important policies, guidelines or rules for your practice What’s important to remember when onboarding is that this is the time to answer any questions the new hire may have, both to

DISCLAIMER This article is not meant to provide employment, hiring or legal advice. Please consult with professionals to make sure you’re operating within your state’s guidelines, laws and regulations.

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