Date received by Delegate: 12/13/10
Name of Originator: Ann Blair Kennedy
AMTA ID#: 91404
Phone: 864-923-4456
Email: abkamta@thekennedys.us
Name of Delegate: Debra Gallup
Phone: 803-318-1664
Email: debrabgallup@earthlink.net
BACKGROUND INFORMATION:
The psychiatric definition of depression can be found in the dictionary as "a condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason."1
Not all people with depressive illnesses will have the same symptoms. The National Institute of Mental Health states, "The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness."3
Symptoms include:
- Persistent sad, anxious or "empty" feelings
- Feelings of hopelessness and/or pessimism
- Feelings of guilt, worthlessness and/or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details and making decisions
- Insomnia, early–morning wakefulness, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment3
Depression can be an expensive and devastating condition. According to the Centers for Disease Control,"Depression can adversely affect the course and outcome of common chronic conditions, such as arthritis, asthma, cardiovascular disease, cancer, diabetes, and obesity. Depression also can result in increased work absenteeism, short-term disability, and decreased productivity."2
The CDC has found that depression affects 1 in 10 adults in the US.2 Those that are most affected are: "persons 45-64 years of age, women, blacks, Hispanics, non-Hispanic persons of other races or multiple races, persons with less than a high school education, those previously married, individuals unable to work or unemployed, and persons without health insurance coverage."2
The CDC also recommends "collaborative care, an approach that involves the collaboration of primary care providers, mental health specialists and other providers to improve disease management for adults with major depression on the basis of strong evidence of effectiveness in improving short-term depression outcomes."2
Research indicates massage can :
- Improve mood4
-
Reduce depression4:
- in those with chronic pain6
- in those with chronic pain over time6
- in hospice patients7, 18
- in children with cancer8
- in children with HIV9
- in pregnant women10, 25
- associated with lower back pain11,12
- in those with tension-type headaches13
- in children and adolescent psychiatric patients15
- in women with breast cancer16, 17
- in people with chronic disease18
- in adolescent mothers19
- in those with chronic fatigue syndrome20
- in those with high blood pressure21
- in those with fibromyalgia22
- in adults with multiple sclerosis23
- in women with premenstrual dysphoric disorder25
- in women in labor26
- Reduce trait anxiety and depression with a course of treatment providing benefits similar in magnitude to those of psychotherapy14
RATIONALE:
Research shows that in a variety of populations, instances, and age groups, depression symptoms can be reduced by incorporating massage into treatment and care. Therefore, individuals who seek relief from depression symptoms can benefit from massage therapy given by professional massage therapists working within their scope of practice.
The position statement supports most of the AMTA Core Values as follows:
- We are a diverse and nurturing community working with integrity, respect and dignity.
- We embrace consistency in education.
- We endorse professional standards.
- We believe in the benefits of massage.
The position statement supports portions of the AMTA Vision Statement:
- AMTA members are devoted to professionalism and excellence in massage therapy practice.
- Quality research is the foundation for evidence-informed massage therapy education and practice.
- AMTA supports its members in expanding their knowledge through quality education.
- AMTA promotes its members as the highest quality professionals in massage therapy.
- Massage therapy is easily accessible.
- Massage therapy is a vital component of health care and wellness.
The Position statement supports much of the Strategic Plans Goals and Objectives:
PROFESSIONAL COMPETENCY
Goal: Support high standards in massage therapy education.
Objective: Expand massage therapy education that elevates the professional competency of our members.
ADVOCACY AND INFLUENCE
Goal: The health care and wellness industry accepts the value of massage therapy
Objective: Increase understanding of the benefits of massage therapy through education of the health care and wellness industry.
INDUSTRY RELATIONSHIPS
Goal: AMTA is a respected leader within the health care and wellness industry.
Objective: Increase collaboration between AMTA, its members and other health care and wellness industry leaders.
RESEARCH
Goal: AMTA members are aware of the importance of scientific research to the massage therapy industry.
Objective: Increase the opportunities for members to access massage therapy scientific research through AMTA sources.
POSITION STATEMENT:
It is the position of the American Massage Therapy Association (AMTA) that massage therapy can be effective in reducing the symptoms of depression.
REFERENCES:
1. Depression. 2009. In Dictionary.com on-line dictionary. Retrieved March 23, 2011, from http://dictionary.reference.com/browse/depression.
2. Depression affects 1 in 10 Adults. (2011). Retrieved March 23, 2011, from Centers for Disease Control website: http://www.cdc.gov/Features/dsDepression.
3. What are the Signs and Symptoms of Depression. (2009). Retrieved April 30, 2011, from the National Institute of Mental Health website: http://www.nimh.nih.gov/health/publications/depression/what-are-the-signs-and-symptoms-of-depression.shtml.
4. Hou, W.H., Chiang, P.T., Hsu, T.Y., Chiu, S.Y., Yen, Y.C. (2010). Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry. 71(7):894-901.
OBJECTIVE: To systematically investigate the treatment effects of massage therapy in depressed people by incorporating data from recent studies.
DATA SOURCES: A meta-analysis of randomized controlled trials (RCTs) of massage therapy in depressed people was conducted using published studies from PubMed, EMBASE, PsycINFO, and CINAHL electronic database from inception until July 2008. The terms used for the search were derived from medical subheading term (MeSH) massage combined with MeSH depression. Hand searching was also checked for bibliographies of relevant articles. Retrieval articles were constrained to RCTs/clinical trials and human subjects. No language restrictions were imposed.
STUDY SELECTION: We included 17 studies containing 786 persons from 246 retrieved references. Trials with other intervention, combined therapy, and massage on infants or pregnant women were excluded.
DATA EXTRACTION: Two reviewers independently performed initial screen and assessed quality indicators by Jadad scale. Data were extracted on publication year, participant characteristics, and outcomes by another single reviewer.
DATA SYNTHESIS: All trials showed positive effect of massage therapy on depressed people. Seventeen RCTs were of moderate quality, with a mean quality score of 6.4 (SD = 0.85). The pooled standardized mean difference in fixed- and random-effects models were 0.76 (95% CI, 0.61-0.91) and 0.73 (95% CI, 0.52-0.93), respectively. Both indicated significant effectiveness in the treatment group compared with the control group. The variance between these studies revealed possible heterogeneity (tau(2) = 0.06, Cochran chi(2)(16) = 25.77, P = .06).
CONCLUSIONS: Massage therapy is significantly associated with alleviated depressive symptoms. However, standardized protocols of massage therapy, various depression rating scales, and target populations in further studies are suggested.
5. Hatayama, T., Kitamura, S., Tamura, C., Nagano, M., Ohnuki, K. (2008). The facial massage reduced anxiety and negative mood status, and increased sympathetic nervous activity. Biomed Res, 29(6):317-20.
The aim of this study was to clarify the effects of 45 min of facial massage on the activity of autonomic nervous system, anxiety and mood in 32 healthy women. Autonomic nervous activity was assessed by heart rate variability (HRV) with spectral analysis. In the spectral analysis of HRV, we evaluated the high-frequency components (HF) and the low- to high-frequency ratio (LF/HF ratio), reflecting parasympathetic nervous activity and sympathetic nervous activity, respectively. The State Trait Anxiety Inventory (STAI) and the Profile of Mood Status (POMS) were administered to evaluate psychological status. The score of STAI and negative scale of POMS were significantly reduced following the massage, and only the LF/HF ratio was significantly enhanced after the massage. It was concluded that the facial massage might refresh the subjects by reducing their psychological distress and activating the sympathetic nervous system.
6. Walach, H., Güthlin, C., König, M. (2003). Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. J Altern Complement Med, 9(6):837-46.
BACKGROUND: Although classic massage is used widely in Germany and elsewhere for treating chronic pain conditions, there are no randomized controlled trials (RCT).
DESIGN: Pragmatic RCT of classic massage compared to standard medical care (SMC) in chronic pain conditions of back, neck, shoulders, head and limbs.
OUTCOME MEASURE: Pain rating (nine-point Likert-scale; predefined main outcome criterion) at pretreatment, post-treatment, and 3 month follow-up, as well as pain adjective list, depression, anxiety, mood, and body concept.
RESULTS: Because of political and organizational problems, only 29 patients were randomized, 19 to receive massage, 10 to SMC. Pain improved significantly in both groups, but only in the massage group was it still significantly improved at follow-up. Depression and anxiety were improved significantly by both treatments, yet only in the massage group maintained at follow-up.
CONCLUSION: Despite its limitation resulting from problems with numbers and randomization this study shows that massage can be at least as effective as SMC in chronic pain syndromes. Relative changes are equal, but tend to last longer and to generalize more into psychologic domains. Because this is a pilot study, the results need replication, but our experiences might be useful for other researchers.
7. Chang, S.Y. (2008). Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. Taehan Kanho Hakhoe Chi, 38(4):493-502.
PURPOSE: The purpose of this study was to examine the effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer.
METHODS: This study was a nonequivalent control group pretest-posttest design. The subjects were 58 hospice patients with terminal cancer who were hospitalized. Twenty eight hospice patients with terminal cancer were assigned to the experimental group (aroma hand massage), and 30 hospice patients with terminal cancer were assigned to the control group (general oil hand massage). As for the experimental treatment, the experimental group went through aroma hand massage on each hand for 5 min for 7 days with blended oil-a mixture of Bergamot, Lavender, and Frankincense in the ratio of 1:1:1, which was diluted 1.5% with sweet almond carrier oil 50 ml. The control group went through general oil hand massage by only sweet almond carrier oil-on each hand for 5 min for 7 days.
RESULTS: The aroma hand massage experimental group showed more significant differences in the changes of pain score (t=-3.52, p=.001) and depression (t=-8.99, p=.000) than the control group.
CONCLUSION: Aroma hand massage had a positive effect on pain and depression in hospice patients with terminal cancer.
8. Hughes, D., Ladas, E., Rooney, D., Kelly, K. (2008). Massage therapy as a supportive care intervention for children with cancer. Oncol Nurs Forum, 35(3):431-42.
PURPOSE/OBJECTIVES: To review relevant literature about massage therapy to assess the feasibility of integrating the body-based complementary and alternative medicine (CAM) practice as a supportive care intervention for children with cancer.
DATA SOURCES: PubMed, online references, published government reports, and the bibliographies of retrieved articles, reviews, and books on massage and massage and cancer. More than 70 citations were reviewed.
DATA SYNTHESIS: Massage therapy may help mitigate pain, anxiety, depression, constipation, and high blood pressure and may be beneficial during periods of profound immune suppression. Massage techniques light to medium in pressure are appropriate in the pediatric oncology setting.
CONCLUSIONS: Massage is an applicable, noninvasive, therapeutic modality that can be integrated safely as an adjunct intervention for managing side effects and psychological conditions associated with anticancer treatment in children. Massage may support immune function during periods of immunosuppression.
IMPLICATIONS FOR NURSING: Pediatric oncology nurses are vital in helping patients safely integrate CAM into conventional treatment. Pediatric oncology nurses can help maximize patient outcomes by assessing, advocating, and coordinating massage therapy services as a supportive care intervention.
9. Hernandez-Reif, M., Shor-Posner, G., Baez, J., Soto, S., Mendoza, R., Castillo, R., Quintero, N., Perez, E., Zhang, G. (2008). Dominican Children with HIV not Receiving Antiretrovirals: Massage Therapy Influences their Behavior and Development. Evid Based Complement Alternat Med, 5(3):345-354
Forty-eight children (M age = 4.8 years) infected with HIV/AIDS and living in the Dominican Republic were randomly assigned to a massage therapy or a play session control group. The children in the massage therapy group received two weekly 20-min massages for 12 weeks; the children in the control group participated in a play session (coloring, playing with blocks) for the same duration and length as the massage therapy group. Overall, the children in the massage therapy group improved in self-help abilities and communication, suggesting that massage therapy may enhance daily functioning for children with HIV/AIDS. Moreover, the HIV infected children who were six or older also showed a decrease in internalizing behaviors; specifically depressive/anxious behaviors and negative thoughts were reduced. Additionally, baseline assessments revealed IQ equivalence below normal functioning for 70% of the HIV infected children and very high incidences of mood problems (depression, withdrawn) for 40% of the children and anxiety problems for 20% of the children, suggesting the need for better monitoring and alternative interventions in countries with limited resources to improve cognition and the mental health status of children infected with HIV/AIDS.
10. Field, T., Figueiredo, B., Hernandez-Reif, M., Diego, M., Deeds, O., Ascencio, A. (2008). Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships. J Bodyw Mov Ther, 12(2):146-50.
Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.
11. Hernandez-Reif, M., Field, T., Krasnegor, J., Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy. Int J Neurosci, 106(3-4):131-45.
STUDY DESIGN: A randomized between-groups design evaluated massage therapy versus relaxation for chronic low back pain.
OBJECTIVES: Treatment effects were evaluated for reducing pain, depression, anxiety and stress hormones, and sleeplessness and for improving trunk range of motion associated with chronic low back pain.
SUMMARY of BACKGROUND DATA: Twenty-four adults (M age=39.6 years) with low back pain of nociceptive origin with a duration of at least 6 months participated in the study. The groups did not differ on age, socioeconomic status, ethnicity or gender.
METHODS: Twenty-four adults (12 women) with lower back pain were randomly assigned to a massage therapy or a progressive muscle relaxation group. Sessions were 30 minutes long twice a week for five weeks. On the first and last day of the 5-week study participants completed questionnaires, provided a urine sample and were assessed for range of motion.
RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher.
CONCLUSIONS: Massage therapy is effective in reducing pain, stress hormones and symptoms associated with chronic low back pain.
PRECIS: Adults (M age=39.6 years) with low back pain with a duration of at least 6 months received two 30-min massage or relaxation therapy sessions per week for 5 weeks. Participants receiving massage therapy reported experiencing less pain, depression, anxiety and their sleep had improved. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher.
12. Field, T., Hernandes-Reif, M., Diego, M., Fraser, M. (2007). Lower back pain and sleep disturbance are reduced following massage therapy. Journal of Bodywork and Movement Therapies, 11(2) 141-145.
Summary: A randomized between-groups design was used to evaluate massage therapy versus relaxation therapy effects on chronic low back pain. Treatment effects were evaluated for reducing pain, depression, anxiety and sleep disturbances, for improving trunk range of motion (ROM) and for reducing job absenteeism and increasing job productivity. Thirty adults (M age=41 years) with low back pain with a duration of at least 6 months participated in the study. The groups did not differ on age, socioeconomic status, ethnicity or gender. Sessions were 30 min long twice a week for 5 weeks. On the first and last day of the 5-week study participants completed questionnaires and were assessed for ROM. By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and sleep disturbance. They also showed improved trunk and pain flexion performance.
13. Moraska, A., Chandler, C. (2009). Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study. J Man Manip Ther. 17(2):86-94.
Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks. A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH.
14. Moyer, C.A., Rounds, J., Hannum, J.W. (2004). A Meta-Analysis of Massage Therapy Research. APA Psychological Bulletin. 130(1): 3–18.
Massage therapy (MT) is an ancient form of treatment that is now gaining popularity as part of the complementary and alternative medical therapy movement. A meta-analysis was conducted of studies that used random assignment to test the effectiveness of MT. Mean effect sizes were calculated from 37 studies for 9 dependent variables. Single applications of MT reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level. Multiple applications reduced delayed assessment of pain. Reductions of trait anxiety and depression were MT’s largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy. No moderators were statistically significant, though continued testing is needed. The limitations of a medical model of MT are discussed, and it is proposed that new MT theories and research use a psychotherapy perspective.
15. Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., Schanberg, S.(1992). Massage reduces anxiety in child and adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry. 31(1):125-31.
A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased overperiod. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.
16. Listing, M., Krohn, M., Liezmann, C., Kim, I., Reisshauer, A., Peters, E., Klapp, B.F., Rauchfuss, M. (2010). The efficacy of classical massage on stress perception and cortisol following primary treatment of breast cancer. Arch Womens Ment Health. 13(2):165-73.
To investigate the efficacy of classical massage on stress perception and mood disturbances, 34 women diagnosed with primary breast cancer were randomized into an intervention or control group. For a period of 5 weeks, the intervention group (n = 17) received biweekly 30-min classical massages. The control group (n = 17) received no additional treatment to their routine health care. The Perceived Stress Questionnaire (PSQ) and the Berlin Mood Questionnaire (BSF) were used and the patients' blood was collected at baseline (T1), at the end of the intervention period (T2), and 6 weeks after T2 (T3). Compared with control group, women in the intervention group reported significantly lower mood disturbances, especially for anger (p = 0.048), anxious depression (p = 0.03) at T2, and tiredness at T3 (p = 0.01). No group differences were found in PSQ scales, cortisol and serotonin concentrations at T2 and T3. However, perceived stress and cortisol serum levels (p = 0.03) were significantly reduced after massage therapy (T2) compared with baseline in the intervention group. Further research is needed to validate our findings
17. Imanishi, J., Kuriyama, H., Shigemori, I., Watanabe, S., Aihara, Y., Kita, M., Sawai, K., Nakajima, H., Yoshida, N., Kunisawa, M., Kawase, M., Fukui, K. (2007). Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer. Evid Based Complement Alternat Med. 6(1):123-8.
We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients.
18. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H. (2007). Rhythmical massage therapy in chronic disease: a 4-year prospective cohort study. J Altern Complement Med. 13(6):635-42.
OBJECTIVE: Rhythmical massage therapy is used in 24 countries but has not yet been studied in outpatient settings. The objective was to study clinical outcomes in patients receiving rhythmical massage therapy for chronic diseases.
DESIGN: Prospective 4-year cohort study.
SETTING: Thirty-six (36) medical practices in Germany.
PARTICIPANTS: Eighty-five (85) outpatients referred to rhythmical massage therapy.
OUTCOME MEASURES: Disease and Symptom Scores (physicians' and patients' assessment, respectively, 0-10) and SF-36. Disease Score was measured after 6 and 12 months, and other outcomes after 3, 6, 12, 18, 24, and 48 months.
RESULTS: Most common indications were musculoskeletal diseases (45% of patients; primarily back and neck pain) and mental disorders (18%, primarily depression and fatigue). Median disease duration at baseline was 2.0 years (interquartile range 0.5-6.0). Median number of rhythmical massage therapy sessions was 12 (interquartile range 9-12), and median therapy duration was 84 (49-119) days. All outcomes improved significantly between baseline and all subsequent follow-ups. From baseline to 12 months, Disease Score improved from (mean +/- standard deviation) 6.30 +/- 2.01 to 2.77 +/- 1.97 (p < 0.001), Symptom Score improved from 5.76 +/- 1.81 to 3.13 +/- 2.20 (p < 0.001), SF-36 Physical Component score improved from 39.55 +/- 9.91 to 45.17 +/- 9.88 (p < 0.001), and SF-36 Mental Component score improved from 39.27 +/- 13.61 to 43.78 +/- 12.32 (p = 0.028). All these improvements were maintained until the last follow-up. Adverse reactions to rhythmical massage therapy occurred in 4 (5%) patients; 2 patients stopped therapy because of adverse reactions.
CONCLUSIONS: Patients receiving rhythmical massage therapy had long-term reduction of chronic disease symptoms and improvement of quality of life.
19. Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies' effects on depressed adolescent mothers. Adolescence, 31(124):903-11.
Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.
20. Field, T.M., Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. (1997). Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome. 3, 43-51.
Twenty subjects with chronic fatigue immunodeficiency syndrome were randomly assigned either to a massage therapy or an attention control group. Although depression and anxiety scores were initially as high as clinically depressed patients, analyses of the before versus after therapy session measures on the first and last day of treatment revealed that immediately following massage therapy depression scores, pain, and cortisol levels decreased more in the massage versus control group.
21. Hernandez-Reif, M., Field, T., Krasnegor, J. & Theakston, H.(2000). High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywork and Movement Therapies. 4, 31-38.
High blood pressure is associated with elevated anxiety, stress and stress hormones, hostility, depression and catecholamines. Massage therapy and progressive muscle relaxation were evaluated as treatments for reducing blood pressure and these associated symptoms. Adults who had been diagnosed as hypertensive received ten 30 min massage sessions over five weeks or they were given progressive muscle relaxation instructions (control group). Sitting diastolic blood pressure decreased after the first and last massage therapy sessions and reclining diastolic blood pressure decreased from the first to the last day of the study. Although both groups reported less anxiety, only the massage therapy group reported less depression and hostility and showed decreased cortisol.
22. Sunshine, W., Field, T.M., Quintino, O., Fierro, K., Kuhn, C., Burman, I. & Schanberg, S. (1996). Fibromyalgia benefits from massage therapy and transcutaneous electrical stimulation. Journal of Clinical Rheumatology. 2(1):18-22.
Adult fibromyalgia syndrome subjects were randomly assigned to a massage therapy, a transcutaneous electrical stimulation (TENS), or a transcutaneous electrical stimulation no-current group for 30-minute treatment sessions two times per week for 5 weeks. The massage therapy subjects reported lower anxiety and depression, and their cortisol levels were lower immediately after the therapy sessions on the first and last days of the study. The TENS group showed similar changes, but only after therapy on the last day of the study.
23. Hernandez-Reif, M., Field, T., Field, T., & Theakston, H. (1998). Multiple sclerosis patients benefit from massage therapy. Journal of Bodywork and Movement Therapies. 2, 168-174.
Twenty-four adults with multiple sclerosis were randomly assigned to a standard medical treatment control group or a massage therapy group that received 45-minute massages twice a week for 5 weeks. The massage group had lower anxiety and less depressed mood immediately following the massage sessions and, by the end of the study, they had improved self-esteem, better body image and image of disease progression and enhanced social functional status.
24. Field, T., Deed, O., Diego, M., Gualer, A., Sullivan, S., Wilson, D. & Nearing, G. (2009). Benefits of combining massage therapy with group interpersonal psychotherapy in prenatally depressed women. Journal of Bodywork and Movement Therapies. 13(4):297-303.
One hundred and twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater percentage of that group completed the 6-week program. The group who received both therapies also showed a greater decrease in depression, depressed affect and somatic-vegetative symptom scores on the Center for Epidemiological Studies-Depression Scale, a greater decrease in anxiety scale scores and a greater decrease in cortisol levels. The group therapy process appeared to be effective for both groups as suggested by the increased expression of both positive and negative affect and relatedness during the group therapy sessions.
25. Hernandez-Reif, M, Martinez, A., Field, T., Quintino, O., Hart, S., & Burman, I. (2000). Premenstrual syndrome symptoms are relieved by massage therapy. Journal of Psychosomatic Obstetrics & Gynecology. 21(1):9-15.
Twenty-four women with premenstrual dysphoric disorder were randomly assigned to a massage therapy or a relaxation therapy group. The massage group showed decreased anxiety, depressed mood and pain immediately after the first and last massage sessions. The longer term effects of massage therapy included a reduction in pain and water retention and overall menstrual distress.
26. Field, T., Hernandez-Reif, M., Taylor, S., Quintino, O., & Burman, I. (1997). Labor pain is reduced by massage therapy. Journal of Psychosomatic Obstetrics and Gynecology, 18(4):286-91.
Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing from their partners during labor, or to receive coaching in breathing alone. The massaged mothers reported a decrease in depressed mood, anxiety and pain, and showed less agitated activity and anxiety and more positive affect following the first massage during labor. In addition the massaged mothers had shorter labors, a shorter hospital stay and less postpartum depression.
SEND US YOUR COMMENTS
No offense, but this seems like a pointless waste of time and money. Who is your target audience? Medical professionals already know about depression, “regular folks” aren’t going to read this amount of text (and where would they even see it? Most people have never heard of AMTA and aren’t likely to visit your site), and even AMTA members won’t bother to plow through long, boring position statements, based on this example. If you’re trying to convince the general public of our legitimacy, this doesn’t seem like an effective approach. And statements like these
- We are a diverse and nurturing community working with integrity, respect and dignity.
- We embrace consistency in education.
- We endorse professional standards.
- We believe in the benefits of massage.
These are, at best, simplistic and obvious (that last bullet point; I mean, we’re massage therapists!) and, at worst, meaningless (how do you cite the first bullet point?). I couldn’t make it through this first statement and have no desire to click on all of the other links to check those out, too.
If you insist on this approach, however, you should at least start with a short, easy-to-view summary, then let the readers delve deeper if they feel the need to check out a substantive background. (In fact, that is standard practice in most business writing.) Starting your statement with the symptoms of depression is a sure-fire way to lose most of your audience, since they’ll be expecting an actual Position Statement and not a refresher course on the topic of depression. Apologies if this seems harsh, but it’s so disappointing to find this is how our representatives spend their time.
Richard P. Bennett, LMT
Chicago, IL
AMTA Clarification: Position statements are a way AMTA uses to express its positions on “professional or public policy issues that relate to the mission and goals of the association.” The association posts approved position statements and their supporting research on the AMTA website and uses them regularly in communications with the media, governmental bodies and health care organizations. Position statements are a common process for other health care-related non-profit associations to put forward their organizational views for many audiences.
It is important to keep in mind that proposals include rationale and information meant to convey to delegates why the association should approve a proposed position statement. This often includes restatements of the association’s goals, objectives and/or values to express why it is right for the association to support the proposed position. Most of this information is not used in conveying an approved position statement to our primary audiences. AMTA usually uses just the statement and the research to support it.
I think the document is too long. It should be shortened and simplified. If I were the general public I would not have even read the whole thing. Its sounds pretentious. I would put it like this:
POSITION STATEMENT:
It is the position of the American Massage Therapy Association (AMTA) that massage therapy can be effective in reducing the symptoms of depression.
Research indicates massage can :
Improve mood4
Reduce depression4:
1. in those with chronic pain6
2. in those with chronic pain over time6
3. in hospice patients7, 18
4. in children with cancer8
5. in children with HIV9
6. in pregnant women10, 25
7. associated with lower back pain11,12
8. in those with tension-type headaches13
9. in children and adolescent psychiatric patients15
10. in women with breast cancer16, 17
11. in people with chronic disease19
12. in adolescent mothers20
13. in those with chronic fatigue syndrome21
14. in those with high blood pressure22
15. in those with fibromyalgia23
16. in adults with multiple sclerosis24
17. in women with premenstrual dysphoric disorder26
18. in women in labor27
Reduce trait anxiety and depression with a course of treatment providing benefits similar in magnitude to those of psychotherapy14
Then include the research links for those who want to read it, which I personally enjoy when I get the time but others just prefer to take the word of someone they trust.
I do believe that we as an organization should state that massage does help with depression. We owe it to the world.
Arthur Brodie, member #5894