Reflexology education and training provision has continued to improve over the past few years from what was once described as a ‘cottage industry’ (Cant & Sharma 1996), and the reflexology profession is continually seeking to produce skilled practitioners able to operate in a wide ‘practice arena’. Achieving this goal is the primary concern of the Reflexology Forum, currently recognised as the developing regulatory (voluntary) body for reflexology in the UK. Through ongoing work, the Forum has helped the profession to ‘agree a set of common standards for the practice and training of reflexology’ and to ‘develop a core curriculum’ (Reflexology Forum 2005). The Education and Training Working Group, tasked with the production of the core curriculum, identified disparity in accepted standards of training, echoing previously identified ‘disparate provision’ (Mills and Budd, 2000 and Reflexology Forum, 2001). With its development being supported by the Prince’s Foundation for Integrated Health (FIH) and involving representatives from each of the Forum’s professional member organisations, from FIH and Skills for Health, this disparity was addressed through the resulting publication of the ‘Core Curriculum for Reflexology in the United Kingdom’ in July 2006. The core curriculum provides recommendations primarily aimed at complete preparatory education and training of reflexology practitioners, although some guidance for continual professional development (CPD) is also offered. Curriculum content is mapped against National Occupational Standards initially published by Healthwork UK, now Skills for Health (SfH) (2002) and contains SfH assessment guidelines (Reflexology Forum 2006; Box 3.1; Box 3.2).

As training providers conform, delivering courses of sufficient ‘content and depth’ to meet the quality and standards of the core curriculum, this should eventually lead to all reflexology practitioners having a single identity based on the same core clinical skills (Box 3.1). These skills should form the basis of all reflexology training courses, enabling practitioners to adapt treatments safely and effectively, according to the needs of clients with clinical conditions or clients merely seeking relaxation (Reflexology Forum 2006; Box 3.2).

Reflexology practitioners have a responsibility to engage in personal and continuing professional development (Reflexology Forum 2005; Box 3.3). Many UK reflexologists complete vocational training, provided largely by the private sector and further education colleges, which may be approved by one or more of the professional reflexology bodies. These organisations usually have a designated education officer or panel, application process and assessment procedures. Commonly, a fee is required for the approval process and inspection. Additionally, some form of annual review as a means of quality assurance is standard practice.

A variety of progression routes including academic and professional CPD options enable practitioners to build on knowledge and skills acquired through initial therapy training to develop further theoretical and practice-related skills. Academic routes enable development of analytical and research skills and CPD options can help equip practitioners with skills in specialist areas, for example in cancer or pregnancy care (QAA 2008).

Opportunities to access educational courses within complementary medicine are now widely available, but economic and political factors have recently seen a decline in the number of courses available in higher education institutions. However, practitioners may seek further clinical training to secure employment in healthcare settings. To achieve this, they may choose to combine a series of CPD courses, broader academic study and self-directed work experience/placements.

Continual personal and professional development is also important for teachers of reflexology who have a responsibility to maintain and develop their educational and mentoring skills, and, through continuous and current practice, their clinical skills. Relevant bodies within both professions (reflexology and teaching) also require evidence of CPD in order to maintain membership. Teaching and mentoring standards and provision may vary across training providers; however, the core curriculum (Reflexology Forum 2006) provides clear recommendations for sourcing new teachers of reflexology. In addition to teaching and assessor/verifier qualifications, teachers should produce evidence of substantial and current practice experience. Unsupervised course tutors/course leaders should have either 5 years or 1000 hours of continuous and current experience as a reflexology practitioner and supervised course tutors/facilitators should have either 3 years or 600 hours of continuous and current experience as a reflexology practitioner. The curriculum clarifies the importance of practice, stating that ‘current, ongoing experience is as important as a teaching qualification’ (Reflexology Forum 2006:100). It is worth remembering, however, that although years of experience are invaluable, not all experienced practitioners possess the skills required to become good teachers.

FIG. 3.1.

Clinical practice being supervised.

As reflexology is not statutorily regulated, there is no protection of title; therefore, unscrupulous individuals can offer reflexology for monetary gain with little or no training. Some may be self-taught whilst others may have completed an adult education course intended as a ‘taster’ or for non-commercial use with family and friends. Commonly, they are unlikely to have had any external assessment or monitoring of their skills and are equally unlikely to be members of a recognised professional body. Additionally, they are likely to put patients/clients at risk by not obtaining appropriate insurance. Evidence of professional indemnity insurance can reassure the public, as many insurers require evidence of qualification from organisations that they consider to provide a reputable standard of education. Unfortunately, inadequately trained individuals may sometimes obtain insurance based on having been awarded a certificate of qualification, which in the past may have been obtained, for example, after attending a two-day course or completing a correspondence course, and which have been accepted by some insurance companies as sufficient evidence of competence to practice.

To protect and safeguard the public and practitioners the profession is working to help in the move to provide independent information through the establishment of a single national practitioner register. This would help to dispel some of the current confusion amongst the public, providing them with an easily accessible source of appropriately trained practitioners (Reflexology Forum 2005). The use of professional registers within the healthcare professions is also supported by the government, and registers are currently being developed as part of voluntary regulation by the General Regulatory Council for Complementary Therapies supported by the Reflexology Forum, and the Complementary and Natural Healthcare Council (GRCCT –, 2009, CNHC – Complementary and Natural Healthcare Council, 2008 and HMSO, 2007). Although there are two alternative options for membership, a register contributes to meeting the government recommendations of regulating the profession ‘under a single professional body’ (House of Lords, 2000 and Department of Health, 2001). As sufficient evidence of professional status is required to be listed on these registers, reflexologists will seek to maintain and reinforce links with their professional bodies in order to continue their professional development. This will also serve to encourage all prospective and practicing reflexologists to join the many responsible individual practitioners who currently examine their skills and practice to identify any areas requiring attention, which may include consolidating or expanding preparatory education or continuing education and training.