Becoming a Massage Therapist: what you need to know

Massage instuctor teaching two students

image courtesy of Jessica Williams on Flickr

So you’ve decided to start a career in massage therapy: congratulations! You’re about to embark on an incredibly rewarding journey. Still, it’s a tough place to be in; you know that there are things you should learn before you begin, but you don’t even know what you don’t know yet. How are you supposed to find the information you need in order to get started on the right track?

Luckily, you’re here. While the information you’ll learn in massage school will by far overshadow anything you could read in a single article, here’s what you need before you get started.

Licensing: what does it take?

The first thing that you absolutely must know about becoming a massage therapist is what the requirements for practicing are where you live and work. It may come as a surprise that this isn’t consistent across the country (and this is a thorn in the sides of veteran massage therapists too), but states, and even some cities currently manage their own requirements for practicing massage.


Most states have a minimum number of hours that a massage therapy student must spend in class in order to be considered qualified. This ranges from 500 hours in some states (such as Texas, for example) to 1,000 hours (as in New York). There may also be specific requirements about how those hours are spent, such as a minimum number of hours spent practicing hands-on techniques, certain curriculum criteria that must be met, or limitations on the number of hours that can be completed online versus in a face-to-face setting.


exam form

Image courtesy of Alberto G. on Flickr

In the majority of states, graduating from a massage school with the correct number of classroom hours isn’t enough. After graduation, you’ll be required to take an exam. There are currently two examinations that are widely accepted by a number of states as being acceptable.

The Massage and Bodywork Licensing Examination (MBLEx), developed by the Federation of State Massage Therapy Boards, is currently accepted by 38 states. The exam is taken on a computer at a Pearson testing center after you graduate, and covers what you might expect: anatomy and physiology, pathology, assessing and treating clients, the benefits of massage, ethics, and professional business practices.


The NCBTMB offers two exams for massage licensure: the National Certification Exam for Therapeutic Massage (NCETM), and the National Certification Exam for Therapeutic Massage and Bodywork (NCETMB). 38 states accept one or both of these exams for licensure. The content of both exams overlaps quite a bit, but the NCETMB includes questions on types of bodywork that lie outside of traditional Western massage therapy, while the NCETM does not.

State Exams

Some states, such as New York and Hawaii, choose not to use either of the larger exams, and instead administer their own. Massage schools in states such as these will have information available on how and when these exams take place, and what you need to study in order to prepare. If you’ve attended school in another state but still meet all the educational requirements, you may still be permitted to take a state exam to become licensed. The Boards regulating massage in those states have all the information you need about moving in from out of state.

Additional Exams

A handful of states accept either the MBLEx or on of the NCB exams, but require a state-administered exam in addition. In some cases (like Oregon), this is a hands-on examination where you demonstrate your skills in person. In other states, there is a jurisprudence exam, a written test covering the specific laws that regulate massage therapy in that state.

Background Check

Given that massage therapists work closely with people, most states require a background check before granting a person a license to practice massage. This isn’t to say that if you have any sort of criminal record that you won’t be able to become a massage therapist. Things that might raise red flags include theft, sexual assault, or using controlled substances. Having been stripped of a former medical license due to misconduct would also be a major issue. However, in many situations, you can argue your case before the state Board in question. Someone who has successfully undergone treatment for substance abuse and remained clean for a number of years would be one good example of a case where a meeting with the state Board could be fruitful.

Choosing a School

Obviously, you’ll want to choose a school that will allow you to become licensed in your state. If you live near the state border or plan on moving in the next few years, it might be worth it to fulfill the requirements for that state as well. For example, if you live in Covington, KY where you need 600 hours to practice, it’s worth considering attending a school with a 750 hour program so that you can hop across the river and work as a massage therapist in Cincinnati, OH too.

Beyond meeting basic requirements for licensure, you’ll be judging massage schools based on your own priorities.

  • What kinds of massage does the school specialize in?
  • Does the school offer extras, such as internships, tutoring, or exam prep classes?
  • Does the school schedule fit with your work and family commitments?
  • What kind of reputation does the school have in the massage therapy community?
  • Can credits earned be transferred to a two- or four-year degree program?

For more specific questions to ask when thinking about massage schools, check out Considerations When Choosing a Massage School.

Paying for School

piggy bank sittin on coins

image courtesy of 401(K) on Flickr

Becoming a massage therapist has some significant costs. Annoying to think about? Absolutely. But it’s better to consider how you plan on paying for massage school BEFORE you sign up for your first term, rather than after. Massage school can vary widely in price, from $6,000 in some places to more than $20,000. Naturally, part of this has to do with the duration of the program; it makes sense to spend twice as much for 1,000 hours of classes than for 500 hours. But more expensive doesn’t always mean better: some schools spend a lot of money on advertising and attractive decor, while a less pricy school might skimp on the extras and spend more of your tuition on world-class teaching faculty. You never know until you investigate.

Given that, no matter what school you attend, there will be a hefty chunk of cash involved, how will you pay for school?

  • Do you have money saved that can cover your tuition? How long would it take you to save up enough? What if you added an extra contribution to your savings each month?
  • If you plan to work while in school, how many hours can you manage and still keep on top of your classwork and other responsibilities? What would your household budget look like?
  • Does your school qualify for financial aid? If so, have you filled out the FAFSA? You may be eligible for grants or loans.
  • Does your school offer different payment plans? You may be able to save money in the long term by paying more upfront.

Other Expenses

Budgeting for massage therapy school is important, but there are other expenses that may surprise students. Some of these include:

  • Textbooks
  • Equipment, such as a massage table and linens
  • Massage products like oil or lotion
  • Uniform, if your school requires one
  • Gas money for commuting to and from school
  • Professional organization membership fees
  • Licensing and exam fees
  • Business startup costs

There are absolutely ways that you can save on these kinds of expenses. Buying secondhand is often a great option, especially for textbooks and large equipment (you can always buy a fancier massage table after you graduate). Carpooling is a great option for those who live a significant distance from school, and gives you time to get to know your classmates better too. Some costs offer no wiggle room (like licensing fees) so you’ll just have to add them to your budget. But knowing about them now means that you have the time to save so that you won’t be blindsided by them later.

Your Career Path

massage therapist stretching client

image courtesy of Brian Cribb on Flickr

Sure, you know you want to be a massage therapist, but have you thought about where you’d like massage therapy to take you? Do you know how much you would like to earn?

  • Do you like the idea of helping clients feel special and pampered? A spa or salon environment might be just what you’re looking for, where you can use top-notch products to create a truly luxurious experience.
  • Do you see yourself working as part of a healthcare team? Hospitals, outpatient clinics, physical therapy offices, and chiropractic clinics all hire massage therapists. These settings may not offer the zen environment of a spa, but can be very rewarding for people who are excited by the challenge of working with people who are injured or ill.
  • Not ready to think about being tied down to one business location? In-home massage can be a great way to reach out to people who can’t make the trip out to see you.
  • Wish you could do something for the folks you left behind in the corporate world? On-site chair massage is a growing industry. Take your chair and meet your clients where they’re feeling the stress: at work.

Not sure yet? Don’t worry. You’ll get more of a feel for things after a few terms in school. Even those with a really clear idea of their career goals often have a change of heart midway through their education. Getting exposure to as many different kinds of massage therapy jobs as possible can help you discover where your passion lies. Volunteer with different organizations. Shadow a massage therapist. Go get a massage in different settings. Eventually something will sing to you, and you’ll know where you want to focus.

One Last Thing: YOU

man leaping from water

image courtesy of R'eyes on Flickr

Knowing about the massage world is important, but even more important is knowing yourself. What frightens you? What makes you happy? What study methods work best for you when you have to prepare for an exam? Are you detail-oriented or more focused on the big picture? Do you procrastinate?

Knowing why you want to be a massage therapist is just as important as knowing how to get there. If it’s because you think it’ll be easy money, you’ll probably be disappointed, but you’ll be equally disappointed if you expect that you can focus exclusively on helping people and never worry about marketing or getting paid.

Knowing your strengths will help you build on them and make yourself stand out from others who have more experience than you. Knowing your weaknesses means you won’t be blindsided when those areas get put to the test. It also means that you know when to ask for help, which is no small feat.

Knowing what kind of environment you flourish in can give you the drive to find the job of your dreams, and the strength to turn down those that would make you unhappy. It can also give you a framework around which to build your own business, if that’s the path you choose.

The better you know yourself, the better you can give your very best to your clients. And that doesn’t just make a strong massage student, it makes a massage therapist who is prepared to get out there in the world and truly shine.