“A qualified music therapist must have graduated with a bachelor’s degree (or its equivalent) or higher from a music therapy degree program approved by the American Music Therapy Association (AMTA), and must have successfully completed a minimum of 1,200 hours of supervised clinical work through pre-internship training at the AMTA-approved degree program, and internship training through AMTA–approved National Roster or University Affiliated internship programs, or an equivalent. Upon successful completion of the AMTA academic and clinical training requirements or its international equivalent, an individual is eligible to sit for the national board certification exam administered by the Certification Board for Music Therapists (CBMT).”
Music therapy in America is governed by two separate organizations: the American Music Therapy Association (AMTA) and the Certification Board for Music Therapists (CBMT).
AMTA is our professional association responsible for establishing education and clinical training standards, supporting music therapy research, upholding ethical standards, educating the public about music therapy, and increasing access to quality music therapy services. Among many other initiatives to advance music therapy and support music therapists, AMTA organizes annual conferences and publishes the Journal of Music Therapy and Music Therapy Perspectives.
CBMT is an “Independent, non-profit, certifying agency fully accredited by the National Commission for Certifying Agencies (NCCA).” “The purpose of board certification in music therapy is to provide an objective national standard that can be used as a measure of professionalism and competence by interested agencies, groups, and individuals. The MT-BC credential may also be required to meet state laws and regulations.” CBMT is responsible for assessing the knowledge required for safe and competent practice, for issuing the music therapist credentials of Music Therapist – Board Certified (MT-BC), and for maintaining high standards of continuing education or recertification.
Music therapists are uniquely trained to implement evidence-based treatments that will serve and not harm their clients. Although the possibility of harm through music seems counterintuitive to some individuals, well-intending musicians without the required knowledge, skills, training, and experience may pose risks to vulnerable populations, such as premature infants, children with special needs, veterans of war with post-traumatic stress, or family members in hospice. “Music therapists, therefore, participate in continued education to remain competent, know their limitations in professional practice, and recognize when it is appropriate to seek assistance, advice, or consultation, or refer the client to another therapist or professional… To protect the public from threats of harm in clinical practice, music therapists comply with safety standards and competencies such as, but not limited to: Recognize and respond to situations in which there are clear and present dangers to a client and/or others; Recognize the potential harm of music experiences and use them with care; Recognize the potential harm of verbal and physical interventions during music experiences and use them with care; Observe infection control protocols (e.g., universal precautions, disinfecting instruments); Recognize the client populations and health conditions for which music experiences are contraindicated; and Comply with safety protocols with regard to transport and physical support of clients.”
Music therapists maintain a vision of the bigger picture in order to best serve an individual client. This not only means engaging the whole person across all domains rather than just a diagnosis or limitation; it means more than holding the patient’s history and potential future in mind while guiding their present therapy, but indeed minding their total environment. We must minimize any barriers to ensure they receive service in the least restrictive environment (LRE). We collaborate not only with other healthcare professionals, but with the family, caregivers, or any other appropriate persons in the total social environment. We educate them on which objectives music therapy is working on, how we’re working on them, and what more can be done outside of the session to best generalize and maximize outcomes.
It is important to evaluate a client’s response to their individualized music therapy treatment plan by documenting change and progress. Modifications can be designed as appropriate. When objectives are met, new objectives may be projected to continue progress towards larger goals. Additionally, priorities may altogether change throughout the treatment process. Finally, it is also important to develop a plan for when music therapy services will end. What is the end goal? When have we reached it? How do we maintain such accomplishment? What happens next?
“Music therapy interventions may include music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music. Music therapy clinical practice may be in developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational areas.” “Music therapists are members of an interdisciplinary team of healthcare, education, and other professionals who work collaboratively to address the needs of clients while protecting client confidentiality and privacy. Music therapists function as independent clinicians within the context of the interdisciplinary team, supporting the treatment goals and co-treating with physicians, nurses, rehabilitative specialists, neurologists, psychologists, psychiatrists, social workers, counselors, behavioral health specialists, physical therapists, occupational therapists, speech-language pathologists, audiologists, educators, clinical case managers, patients, caregivers, and more.”
Music therapy referrals are based on non-musical needs, such as mental health, behavior modification, academic learning, reality orientation, neurological rehabilitation, or daily living skills. These and many other goals, along with more specific objectives and music therapy strategies, are developed as part of an individualized treatment plan after “systematic, comprehensive, and accurate information” has been collected as part of a thorough music therapy assessment. The individualized treatment plan determines the “appropriateness and type of music therapy services to provide,” and is based on clinical assessment, as well as the best available research, the music therapist’s clinical expertise, and the client’s input. “A music therapist is respectful of, and responsive to the needs, values, and preferences of the client and the family.” Music therapists may collaborate with the primary care provider (PCP) and other professionals to provide integrated care, and will make referrals to other professionals if “faced with issues or situations beyond the original clinician’s own practice competence, or where greater competence or specialty care is determined as necessary or helpful to the client’s condition.”
Music therapists are trained to competently, safely, and ethically apply evidence-based music interventions in “developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational areas.” Music therapists cannot provide service beyond our Scope of Music Therapy Practice, unless we have earned the additional knowledge, skills, and certification to do so. Similarly, “We acknowledge that other professionals may use music, as appropriate, as long as they are working within their scope.” MT-BCs recognize that there will be overlap in services between different healthcare providers; we encourage mutual respect and collaboration to best serve the client. Treatment should integrate those services each clinician is uniquely trained to provide.
“The Scope Of Music Therapy Practice (SOP) is based on the values of non-maleficence [doing no harm], beneficence [acting for the benefit of others], ethical practice; professional integrity, respect, excellence; and diversity.” The SOP assumes Music Therapy practice which is: safe, ethical, and within one’s skill set; based on the best available research, client-centered care, and clinical expertise; and engaged with interdisciplinary collaboration.
“Music therapy is defined as the clinical and evidence-based use of music interventions to accomplish individualized goals for people of all ages and ability levels within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” A music therapist is defined as, “an individual who has completed the education and clinical training requirements established by the American Music Therapy Association (AMTA) and who holds current board certification from The Certification Board for Music Therapists (CBMT).”