Document Type


Date of Degree

Fall 2012

Degree Name

PhD (Doctor of Philosophy)

Degree In

Community and Behavioral Health

First Advisor

Campo, Michelle L

Second Advisor

Lowe, John B

First Committee Member

Glanville, Jennifer

Second Committee Member

Snetselaar, Linda

Third Committee Member

Yang, Jingzhen


Massage therapy is often used to treat musculoskeletal symptoms and to promote wellness. While evidence regarding its effectiveness is increasing, research related to actual practice and studies seeking to understand the mechanisms of massage therapy are needed. The purpose of this research was to describe the characteristics of massage therapists and their clients and to understand the role of communication in massage therapy outcomes. The first study examined the outcome expectations, expectancies, and behaviors of a random sample of massage therapists in Iowa (n=151) using a cross-sectional survey. The second study used a practice-based research design incorporating two samples of massage therapy clients (n=320 and n=321) to develop and validate a measure of client expectations of massage, the Client Expectations of Massage Scale (CEMS). The third study examined the influence of client expectations and massage therapists' interpersonal attractiveness on pain and satisfaction following massage. Social Cognitive Theory and Expectancy Violation Theory were used as frameworks to demonstrate how health behavior and communication theories can provide insight to massage therapy research. Results indicated that massage therapists had high expectations regarding the benefits of massage therapy and engaged in a variety of behaviors that reflect the clinical, educational, and interpersonal nature of massage therapy. In addition to using a variety of manual therapies, the massage therapists educated their clients in areas such as diet, stress management, and exercise to improve client health. Similarly, clients had positive expectations as measured by the outcome, clinical, educational, and interpersonal subscales of the CEMS. Positive outcome expectations predicted significant improvements in pain and serenity. High interpersonal expectations were related to negative changes in serenity. The third study revealed that high satisfaction was influenced by positive interpersonal attractiveness but more research is needed to understand the influence of client expectations being met on satisfaction. Initially high educational expectations, exceeded educational expectations, violated interpersonal expectations, and positive interpersonal attractiveness were related to less pain following massage. In conclusion, this research demonstrated that client expectations and massage therapist interpersonal attractiveness are important constructs to consider when evaluating the effects of massage therapy.


Expectancy Violations Theory, expectations, massage therapists, Social Cognitive Theory


x, 122 pages


Includes bibliographical references (pages 109-122).


Copyright 2012 Karen Therese Boulanger