According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students. As of 2011, there were more than 300 accredited massage schools and programs in the United States. Most states have licensing requirements that must be met before a practitioner can use the title "massage therapist", and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school. There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.
Reflexology in Thailand is abundantly offered even at spas, centres, markets, and chair beside the street because it is widely known as one of the most relaxing therapies. Colorado School of Thai Massage offers a short course of reflexology about the fundamental practice of Thai Foot Reflexology. For those who are interested, no bodywork experience required to join this course.
The price of a couples massage depends on the spa, the amount of time, and the amenities. Generally, it is the cost of a regular massage, times two. Sometimes you can add on private time. For instance, Aspira the Spa at The Osthoff Resort in Wisconsin offers couples massage at $135 per person for 50-minutes. Couples can enjoy an additional hour of time alone together in the spacious suite, equipped with a master shower, whirlpool bath, stone fireplace, and sofa, for $50 per person. At some spas, the package might include private time and amenities like Champagne, which sends the price higher.