Ep. 2 – Standards in Oncology Massage Education: Why They Matter with Mary Aguilera-Titus
[00:00:00] Ericka Clinton: Welcome to Collaborative Connections, I’m Erica Clinton and I’ll be your host for today’s podcast. And our guest is Mary Aguilera Titus. Since In this episode of the Collaborative Connections podcast, host Erica Clinton interviews Mary Aguilera-Titus, a licensed massage therapist and instructor who teaches oncology massage therapy to other therapists. Mary is also a charter member of the Society for Oncology Massage and currently serves as the head of the Education Committee.
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[00:01:27] In this captivating conversation, Mary and Ericka discuss the foundational courses of S4OM.They also delve into the various opportunities students have after completing these courses, emphasizing the significance of continuing education. Mary shares her experience teaching virtual courses and how they have increased accessibility to education, as well as discussing the instructor standards and the clear set of education standards that have been built in. Don’t miss this insightful episode where Mary and Ericka uncover the exciting new initiatives S4OM is taking on in the world of oncology massage educationEp. 2: Standards in Oncology Massage Education: Why They Matter with Mary Aguilera-Titus 2002, Mary has been a licensed massage therapist in both Maryland and the District of Columbia, and nationally certified by N C B T M B.
[00:02:20] Mary’s been an instructor with an oncology massage Education Associates from 2015 to 2022, where she taught oncology massage therapy to other therapists. Mary is a charter member of the Society for Oncology Massage and currently serves as the chair of the education committee. Welcome, Mary. How are you?
[00:02:46] Mary Aguilera-Titus: Thanks. It’s great to be here. I’m doing great.
[00:02:48] Ericka Clinton: Thank you so much for being with us today. I’d love to spend most of our time talking about education but I’d love to connect the dots for our listeners. So can you just tell us a little bit about how you got involved with the Society for Oncology Massage?
[00:03:06] Mary Aguilera-Titus: Sure. Yeah. If I can remember what, what brought me here many moons ago. So I, I started the journey with oncology massage, learning about oncology massage therapy in 2004. Took a lot of classes actually with Tracy Walton and then Gail McDonald, and then other educators that were active at the time who are no longer teaching.
[00:03:28] But that there was a cohort here in the DC area, you know, district of Columbia, Maryland, Virginia. There were many massage therapists who were really focused on this. And they many included me in, oh, did you hear about this? Did you hear about that? And that’s how I came to be connected really with Society for Oncology Massage.
[00:03:50] I missed the first gathering in 2007. Part of the experience that brought me to oncology massage therapy was my sisters. And their journey with breast cancer. So I took about a year off after they passed and then kind of leaped back into it in around 2000, 2007, 2008 which is when I got involved with S four oh m.
[00:04:16] 2008 was when I, someone tapped me, I can’t remember who now, to be part of the education committee. And we were in the very beginning stages. Very beginning stages of trying to figure out. How do we get our arms around what education looks like for oncology, massage therapy? And we leaned heavily on N C B but we also gathered a lot of knowledge from all of the pioneers that are in the field who were all part of this very, at that point, very small tribe, trying to just, like I said, figure this out.
[00:04:51] Get our hands around what does it look like to have standards around oncology massage therapy but. That’s really where it was born from a, a group of massage therapists and kind of connecting the dots, listening to people being invited. So you never know where something might lead. And that Right, that was true for me in terms of getting connected to D four Ohm.
[00:05:17] Ericka Clinton: Wow. So you connect to S four Om like in 2009, after having obviously a very impactful personal experience with cancer. And was that also what led you to becoming an educator?
[00:05:32] Mary Aguilera-Titus: It took a while to say yes to being an educator. Just part of my personality probably. But no, I didn’t become an educator until 2015, so several years when I was just part of the, part of the team trying to I was very much in favor of having some strong educational standards.
[00:05:58] You know, I had, during those years of becoming a massage therapist and developing my career I, I also had care for my sisters, but I also had three school-aged children. So the education piece was a thread throughout Prior to becoming involved with S four M? Absolutely. And and that just Karen, I was a skillset, I think, and a, and a viewpoint that I carried through and was able to offer support in the education arena.
[00:06:32] Ericka Clinton: Mm-hmm. Yeah. Okay. So I think when people think about education or continuing education, they don’t realize that standards kind of exist. Can you give us a little bit of an understanding of why educational standards are important?
[00:06:46] Mary Aguilera-Titus: Sure. I mean, it’s it really allows for an even playing field of when we say a course or a field of instruction hel has its students Achieve X, Y, or Z you know, competencies.
[00:07:03] It gives a framework and that’s really what I consider it as. You know, these standards create a framework, so it allows us to talk about the same thing. What do we mean when we say oncology massage therapy? What aspects are we considering important and the, and what? We focused on right from the beginning within S four OM was the foundational courses.
[00:07:26] Mm-hmm. And we’re, we’re really clear that we’re just looking at that beginning course. You know, you know, 24 hours is our minimum for the foundational course. And honestly, it, it feels like it just scratches the surface. I know I felt that way. I took my first class 24 hours and I was like, whoa. Mm-hmm.
[00:07:45] They so much more to learn here late. And I spent the next several years, you know, taking many more courses from a different education providers. So the standards help us. As both students but also as educators have a common language and a common knowledge about what is it we’re trying to support our learners in accomplishing?
[00:08:11] What do we want them to leave this space having feeling more confident with in terms of, and in massage therapy, obviously it’s both the knowledge, but also the hands-on skills.
[00:08:24] Ericka Clinton: So I love that concept of an even playing field, kind of. It’s like, yes, everything has to be very clearly equitable across all of those dynamics and competencies, so that again, everyone who achieves this level of education or credential is.
[00:08:44] At the same level of ability and clinical reasoning. And I think that’s really, truly important when you work with people who have or had, have had cancer. So S four oh, Has these foundational courses, but can you tell our listeners a little bit or just talk to our listeners about what are the actual educational standards that s r Om has written?
[00:09:10] They’re on our website and that all of our recognized education provider organizations follow.
[00:09:17] Mary Aguilera-Titus: Yes. So, yes, exactly. I’d definitely say, as you just suggested, go to the website. I am not gonna go through the whole details of them and during our conversation, but essentially they have been revamped a few times.
[00:09:33] This last iteration that we are using was revamped in 2021 June of 2021, so two years ago. They’re divided. It’s divided into two aspects. The first is instructor, instructor standard. So we mainly, we want, we want people to be a preferred practitioner because with the preferred practitioner, there are certain aspects of, obviously people have had a course, but they are committed to what, you know, S four Ohm is about.
[00:10:03] But more important, we want people to have being well grounded in their practice of massage therapy. So we talk about five years being a massage therapist, and we also talk about 500 hours. Practicing oncology massage therapy so that if you’re teaching other people, the belief was it would be smart to have people who are well-placed in their practice of oncology massage therapy.
[00:10:30] They’ve been around the block a few times in terms of seeing things and knowing things and experiencing different situations. As well as having a teaching background now, teaching golly. Teaching. It doesn’t need to be a degree in teaching, but it needs to be an experience in providing instruction in helping your student and your learner, you know, learn the skills.
[00:10:53] So that can come in a variety of ways and we’re, we really like to be open about that, but we just wanna kind of put a pin mark in. It’s important to know how to. Hold a class, whether it’s virtual or in person. So those are the elements of the instructor standards, the curriculum standards, it’s a pretty clear list of what we think are the.
[00:11:17] Very minimal pieces of what’s important to know about cancer, about what that looks like the different types the different treatments. And then we move into how do, how do those treatments impact massage therapy, right? That’s the crux of it. How do we adapt, given our knowledge about cancer and our knowledge about treatments?
[00:11:42] So that’s a. That’s kind of the gist of the foundational course. We like to make sure that there is clinical learning activity, so what’s happening to help develop the learner in understanding when to do what. When to employ different skills, how to develop an intake. That’s kind of an art form that takes a while to, to develop, but we’ll, we’ll start and make sure that’s introduced in a foundational course.
[00:12:11] And there’s the comprehensive, practical, which is designed in different ways at all of our rep orgs, and we use the acronym rep. To, you know, distinguish recognized educational provider organization. So it’s just a a shortcut rep org. All of our rep orgs are those educational entities that offer a foundational course.
[00:12:33] Foundational course. Yes. It, it has this list that you’ll see on the website at the basics about cancer, the treatments, and then how to adapt from there. Included in that needs to be a comprehensive, practical, which means delivering a massage therapy session to either a person who has had an experience with cancer or a simulated client.
[00:12:56] So there’s a very clear history that has devised and the student. You know, goes through the intake and goes through delivering the session with all of that in mind and the instructor kind of guides. Right. That’s our, that’s the role of an instructor is to guide, to, to help with the knowledge, but also to guide in that.
[00:13:18] So those are all components of the foundational
[00:13:20] Ericka Clinton: course. Wonderful. So it makes it seem, or it seems, and it is that that foundational course is pretty comprehensive, as you said. As the basics, the foundation for training for an oncology massage therapist. Now you said the foundational course has to be at least 24 hours, right?
[00:13:41] Mary Aguilera-Titus: It does, that’s the minimum. But we have many of the courses that are more than that. Some are 32, 30, 32, 48 there, you know, 100 hours in Beaumont, right? Yes. So there, there’s, there’s a variety out there. Honestly, 24 hours is a lot. There’s a lot of material to cram into 24 hours. No, it’s at times. I am pretty sure that when I teach, it’s more than 24 hours than people, than my students spend on on with the homework and everything else.
[00:14:14] But it’s because there is a lot of information that’s important to try and convey. A person isn’t gonna walk out the door with all of that in place, but. Here’s where to get, here’s where to practice that. So yes, number of hours varies. Minimum is
[00:14:30] Ericka Clinton: 24. Okay. And in terms of getting all of that information as well as the hands-on experience, are the foundational courses a hundred percent in person?
[00:14:43] Do you have some that are hybrid? I, I don’t even. In my mind, I don’t think our virtual course would make a lot of sense, but I also understand the times that we’re living in where the technology is supporting our access to education. But what has S four M said? That is
[00:15:00] Mary Aguilera-Titus: a great question. Oh, man. We went around the block on that one during Covid.
[00:15:06] So yes, prior to Covid, all of our, all of the foundational courses were in person for sure. It was hard to even conceive of Anything else besides that? It’s massage therapy. We’re hands on people. Right? Covid happened. Everything shut down. And there was this, okay, how, how do we come back into the educating field?
[00:15:30] We saw people do it. We saw grade schools, high school. We saw there was this amazing attempt and execution. I mean, people, it made it happen and it was successful in many ways. And it has a drawback, right? Mm-hmm. We convened what we called the think tank in the middle of Covid because this was being wrestled with.
[00:15:53] There was a team that was like the education committee was being asked to consider this. I will say I was one of the people that was like, I how it, we can’t do this. Okay, so we, we developed this think tank and there were four different small groups from professionals across different spectrums.
[00:16:13] Not just massage therapists, people in education, people in nursing, people in. We formed these small little pods to really, we could totally get behind the knowledge piece being communicated. On via Zoom. Right. That made sense. How do you assess clinical skills, hands-on skills via a camera that felt like, you know, it felt like a hard no from some of us, and it felt like for others it was like, Don’t, don’t be so sure. So this group, you know, we, we worked over a period of a couple of months people met, entertained questions, and then ultimately came back together. And the ultimate decision was, you know, it is possible, it is happening in the fields that require a hands-on presence. And so S four, oh, you know, it was brought to the board and it was, you know, agreed upon, we will.
[00:17:12] Agree to offer virtual training if those trainings still respect the clinical learning activities, the CRAs that are present in the in-person. So we try to really focus on the, on the Cs. And how do you assess, how do you assess your students for these things? Mm-hmm. And if you can be able to describe how you assess in both an in-person format, you know, as well as a virtual format, then we have more momentum.
[00:17:50] So, yes. Amazing. We have, I would say we have, we definitely have in-person classes that are back up and virtual. We have some that have been a hundred percent virtual. I’ve taught a hundred percent virtual courses, which is just kind of funny because I was one of those ones that was like, can’t happen, right?
[00:18:09] and Then we have hybrid, right? We have people that are teaching part of their classes online and part of their classes in person.
[00:18:15] Ericka Clinton: Okay. So adopting all of the covid opportunities, as I like to call them, right to make sure that we can continue to provide top-notch education. What I,
[00:18:28] Mary Aguilera-Titus: what I saw, what I.
[00:18:29] Absolutely 100% was kind of blown away by, but also not surprised when you think when you step back and look, before I would teach 24 hours, that it’s eight hours a day over a weekend, and people walked out with skillsets. But doing it over, we now, I do courses that meet either once a week or twice a week on Zoom and with, that’s with six hours at as home study as a precursor to our 24 hour on Zoom people’s knowledge base.
[00:19:01] Is much deeper and they’re able to retain more information just because we have a length of time to review it. We have a length of time to assess there’s quizzes and et cetera, that we just don’t have the time in an eight hour day that, you know, people walk out of there just fried. it was, it’s a definite pros and cons Right. To each type of approach.
[00:19:23] Ericka Clinton: But I, I really love that perspective when you can step back and say, okay, this gave us something we didn’t have before. Right. But it also allows for I think, more people to access education than ever before.
[00:19:36] Oh. Because now you can teach to someone who lives hundreds of miles away and they still get quality education. That
[00:19:44] Mary Aguilera-Titus: is, we’ve had people from Hong Kong in our class, people from Israel people from all over the United States. And that means different time zones. But. It, it is, it’s pretty amazing, parents who are trying to juggle both work and childcare and can carve out a few hours for a zoom.
[00:20:07] It, it has increased accessibility to educate. That’s,
[00:20:12] Ericka Clinton: That’s wonderful. there are various options for people, however they want to take them, and obviously if somebody still wants to. Travel and have a little vacation as continuing education, they can still go to a location and take a class.
[00:20:27] And I, we talked about how you kind of have built in instructor standards with the education standards, so there’s a clear. Set up of competency from the instructor to the course itself. Can you tell us how many recognized education provider organizations S four currently has?
[00:20:49] Mary Aguilera-Titus: I had to go back on the website.
[00:20:51] I, there are 16 listed, but to be very honest, there is several in the pipeline. Okay. So that will increase that, that is a higher number, but we just haven’t gotten the webs page updated with some of those. So I would, I think we’re hovering around 20 rep orgs. And some of them are international.
[00:21:08] We have people in Australia when we have a current person in Argentina who’s applied. They’re in their final their final, you know, kind of pathway of, of approval. So I would say 20 is, it might be even higher than 20,
[00:21:26] Ericka Clinton: That’s amazing. And in terms of the application process or how to become a recognized education provider, obviously reviewing the standards so that you know, your instructors and the curriculum that you’ve developed will basically pass muster.
[00:21:42] And can you just give us a little idea of what kind of the steps are in application? Is there the ability to get advisement on how to do and complete your. Your application and get approved by S 4
[00:21:56] Mary Aguilera-Titus: 0 1. A hundred percent. There’s the education committee, the and then part of the education committee is the, what I, what we call the art group.
[00:22:06] It’s the application review team. There are four of us on that. So the. The four of us review each application. So there is a main application that a person needs to fill out. Having a contact person who is responsible for the application, for what’s in the application, who knows it. And it’s a fairly, it’s lengthy in the sense that, you know, you need to.
[00:22:28] Put down what your resources are. How did you develop the course? What are your learning objectives? What are your clin clinical learning activities? How do you assess for those activities? That requires time and thought, but it’s not any different really than what’s required from N C B when you submit a course for review and approval.
[00:22:48] so you, you walk through, if there are questions, there’s someone you know reaching out [email protected]. We’ll get back with you on that. We’ll, I’ve talked with many people on the phone had Zoom calls with people in different countries in order to help them through that process. Absolutely we want people to succeed in this.
[00:23:10] Of course, we don’t want it to be so terrible and onerous that, you know, we want people to succeed. We also wanna be Kind of consistent with applying the standards. We want it to be transparent. We want it to be the same for every person who’s applying. So in that sense, we are kind of like name blind.
[00:23:30] We just kind of go through in each section and does this make sense? And if there are questions on an application, the art team. Replies back to the contact person to say, okay, section one looks great. Section two looks great. Section three, we had a question on 3.2 and section four we had a question about 4.2 so that the contact person, the applicant can see exactly which areas and we’re wondering about, we need clarification on.
[00:24:00] There’s always an opportunity to come back. And that, so that’s a pending notice. And then people will resubmit their application with those things clarified and on we go.
[00:24:11] Ericka Clinton: Wonderful, wonderful. So very supportive process. So you have your recognized education provider organizations. They provide these foundational courses of various.
[00:24:23] Styles, lengths and so forth. Now, once a person takes a foundational course, how do they then become a preferred practitioner?
[00:24:33] Mary Aguilera-Titus: Yeah, another great question. It’s a fairly straightforward and easy process. If you’ve taken an S four Ohm rep org, you know, foundational course, and you are a massage therapist, especially if you’ve been a massage therapist for a year, it’s a very straightforward application.
[00:24:52] I think that we even have it like within our website, our webpage, right, where you can just kind of. Fill it out, attach the as necessary documents and submit. And really that’s about, you know, your entry level massage training. Is that clear? Do you have insurance, attach that form, attach the certificate of completion or achievement from your foundational course.
[00:25:17] So it’s filling out all those things, attaching those copies and sending it in. It’s a very easy. Process from what I’ve observed and seen.
[00:25:27] Ericka Clinton: Wonderful. Now, what if you’re a person who say, has not taken a foundational course, but has a lot of. Background in training, working with cancer patients taking other courses that may be relevant in oncology massage.
[00:25:44] Is there a different pathway Yes. Than taking the foundational
[00:25:49] Mary Aguilera-Titus: course? Okay. Yeah. I think one, one of the things I like about S four O M is we really try to expand the areas. So with that specific question, we have what’s called the preferred practitioner alternate application. To make it as, again, you know, equitable across the board.
[00:26:09] We’ve basically taken the standards, the education standards, and we’ve taken them and put them into an application form. So it’s lengthy. It’s lengthy. We’ll say that it, it, it, you know, but you, the applicant would need to basically complete the questions as they relate to the standards. And submit that.
[00:26:33] You know, I’ve looked at it and it’s, it, it almost feels like an exam from our foundational course, right? Mm-hmm. Knowing all of this information, but it’s one way of saying, okay, these students that are, you know, graduating or leaving or completing a foundational course, that that course needs to have these standards included.
[00:26:55] So those who are applying, having had experience in other places, it makes sense. They would need to know the same level of information and be able to show that, demonstrate
[00:27:08] Ericka Clinton: that. Right. Equitable education and competency. No judgment on how you got there. No. No. Right. Just, just that you have it. And I think that Really allows people to understand that becoming a preferred practitioner is not just a label.
[00:27:25] It’s not like a certificate that you paid for. It really is a designation that says you are educated and qualified to work with this very special and potentially vulnerable population. I, I love that. And then I would say your preferred practitioners I know are listed on your website. So people can locate a practitioner if they’re looking for someone trained in oncology massage.
[00:27:49] And I think that’s a helpful resource for potential clients, caregivers, physicians, oncologists, whoever who might be seeking out the services of a massage therapist who’s qualified to work with a cancer patient.
[00:28:05] Mary Aguilera-Titus: 100%. I, I know for me personally, I have I have referred people who have inquired of me.
[00:28:13] You know, how can I find a massage therapist? I live in Florida, I’ll send them to the preferred practitioner directory. Mm-hmm. To, you know, you can type in your zip code and you can look, you can find someone in your area. I’ll also say that, People have found me. Mm-hmm. You know, my, my investment in, in being a preferred practitioner has paid for itself many times because, because clients family have found me on that on the practitioner listing because they’re looking for someone for their mom or their sister, or, you know, whoever.
[00:28:48] Mm-hmm. So, you know, it’s, it’s not as a marketing thing that that’s not the. In my mind, the goal it is an, I think it’s an investment in your level of education and knowledge. And with that comes an opportunity to be more For the public to know more about finding you.
[00:29:13] Ericka Clinton: Yes. And obviously within that they understand that you’ve gone through training and education because you’ve been approved by the Society for Oncology
[00:29:21] Mary Aguilera-Titus: massage.
[00:29:22] Exactly. You’ve had your foundational training and you know, I consistently tell. Students that I have the opportunity to work with go for more classes. Yes. Go experience. There’s, there are so many ways to take this training. This is, this is your beginning step and maybe people wanna go into more end of life care or maybe people wanna go into working with people to help manage their lymphedema.
[00:29:45] There’s all kinds of ways to take this, but it, it’s a, it’s a wonderful beginning step and out of the gate. When you leave your class, you have tools that you can absolutely use to begin to work more confidently and competently work with people who have a history of cancer.
[00:30:05] Ericka Clinton: Wonderful. Wow. Thank you so much, Mary.
[00:30:09] That was so helpful, and thank you for sharing all of that information. I think a lot of people will be happy to get an understanding as they approach. Maybe becoming an educator or a preferred practitioner or just finding a great resource for oncology massage education. So before we get going, is there anything you would like to leave us with or finish with today?
[00:30:35] I
[00:30:35] Mary Aguilera-Titus: mean, I think that for anyone who’s interested in becoming a recognized education provider, we welcome you. We would love to have you apply. Take a look at the standards, take a look at the process, and if it’s at all confusing or you’re unsure about something, reach out. There are people that are willing to help.
[00:30:56] You know, you have to do the heavy lifting of having a class that you know will pass muster and your instructors. But it’s, we hope that it’s clarified and if it’s not, reach
[00:31:08] Ericka Clinton: out. Yeah. Wonderful. Thank you so much, Mary, for your time. You’re welcome. And this was just amazing and hopefully we’ll get to talk to you more about some other education related things that S four M is embarking on but more podcasts later on.
[00:31:26] Mary Aguilera-Titus: thank you so much for having me. I really appreciate it. Yeah, you’re
[00:31:28] Ericka Clinton: welcome. Standards in Oncology Massage Education: Why They MatterEp. 2: Standards in Oncology Massage Education: Why They Matter with Mary Aguilera-Titus