Manualization was initially developed for the creation
of standardized treatment protocols for psychotherapy,
both to help provide methodologic rigor for
evaluation, and as a means to provide specificity and
guidelines regarding individualized treatment [31].
Massage therapy, as an intervention in clinical trials
has similar needs for methodologic rigor to standardize
patient-customized treatments and practitioner variation
[32,33]. In 2002, Schnyer and Allen published
their methodology on developing treatment manuals
for acupuncture interventions used in NIH-funded
trials. These manuals served as a means to facilitate
the training process, enable evaluation of conformity
and competence, and increase the ability to identify
the active therapeutic ingredients in clinical trials of
acupuncture [34]. The Institute of Medicine has noted
that manualization is an integral component for rigorous
research on CAM therapies.