More Than Hands

More Than Hands

Down the Rabbit Hole: Structure

Theory of Change, Systems Theory, Jurisdiction, Occupation and Labor

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Corey Rivera's avatar
Healwell and Corey Rivera
Jun 11, 2026
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The other two parts of this series are Massage Therapy Needs Pigs with Wings and Down the Rabbit Hole: Culture. To access the voiceover for this article, scroll down to the section labeled “Systems Theory.”

This article is written to an audience of co-conspirators as opposed to a general group of potentially interested readers.

If you’re reading this article, I’m assuming a few things:

  1. You are deeply invested in fixing what ails the profession of massage therapy.

  2. You’ve realized there are no easy answers, only a lot of hard work.

  3. You’re okay existing in the space between understanding and complete confusion.

This article will provide you with brief introductions to my areas of interest and the questions that plague me (and maybe you, too). After that I leave it to you and your curiosity to decide what to do with the information. The sources I’ve linked are mostly academic literature, not Wikipedia articles or Youtube videos because I trust that you are able to seek alternative sources of information when you feel you need them.

In the first piece, I gave you the short, party-friendly version of my question. Here’s the long version:

Why does a profession that does impactful physical and emotional work with humans and human bodies continue to experience social and economic extraction, knowledge deficits, and fragmented organization— and what keeps that condition in place?

To reiterate: I do not have a graduate degree of any kind. This means that my thought processes are not those of someone with a PhD. My thoughts are not perfectly rational or backed up with solid data. Some of the questions in this article are expressing my opinions, hypotheses, or assumptions.

If you’re cool with that, then away we go!


Theory of Change

A theory of change is an explanation of how and why you think a solution will create the change you want. The trouble with theories of change is all of the variables involved. It is perfectly possible to have a great solution that doesn’t work due to financial needs, lack of optimal timing, shaky or hostile infrastructure, missing skills…the list is long.

There is a model used in activism that says both light (education and knowledge) and heat (pressure and passion) are required to create change. My methods lean toward the light side. I turn up the heat by continuing to ask questions, even and especially when they are uncomfortable.

My theory of change includes these pieces:

  • Mapping the entire system

  • Precision of language

  • Honest discussion of problems

  • Observation without judgement

  • Problem solving without blame

  • Expansion of knowledge and tools

  • Creation of permission structures

  • Deliberate and focused upskilling to support the engagement and contributions of the people affected


Structural Concepts

Systems Theory

Meadows (2008), Finegood (2022), Stroh (2015)

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