What Music Therapists Do, How to Become One
What do music therapists do?
Music therapists do many things. I personally work with a variety of clients through a music contracting company. I work with children with severe emotional disturbance and also some with developmental handicaps. I also work in a nursing home. Outside of the contract work, I do a kindermusic program - an early childhood music program.
Tell me what you do with the children.
I work with them in their own homes once a week. Some of these kids have been abused, some have bipolar disorder, some have schizophrenia, quite a few have ADHD, some are autistic, cerebral palsy - all different kinds.
The approach that I take is very improvisational. For example, a couple weeks ago I went to see one of my clients, he's a 12-year old boy with mental retardation and schizophrenia. I actually see him in his school. This particular day he had had a very frustrating day in school. We started by singing the "hello" song we always sing, in which I kind of ask him how he's doing. He said that he was very upset.
We had a piano in the room so we moved to that. I just provided rhythmic support in my part for his melodic improvisation. He doesn't have any piano background, but he was just expressing himself. Then he asked for my drum - I always have a bag of instruments with me - and he played the drum while I played piano. He was very angry, so he was playing hard, fast, and in erratic rhythms. I supported that style, but slowly brought him away from that by playing a little more calmly and softly than he was. Gradually, his drumming calmed, and became a steady, controlled rhythm. At that point, he began to smile for the first time since I'd arrived. Then, we talked a little bit. He said that he liked the drum, and that he had been very angry, but that he was feeling better.
Is that the goal of music therapy - to bring about a more positive emotional state through the communication of music?
With him, it is. I have other clients who have different goals. For example, I have autistic kids that are very set in their routines. If you interrupt their routines, they go into a tantrum. So with them, I work on gently altering the routine. I do different music each week.
What about the nursing home?
Well, often for older folks that have trouble breathing, we do a lot of singing to help their respiration. We do that a lot especially with pneumonia patients, because it helps keep the infection out of their lungs. If it settles to their lungs, it can kill them.
That's physical therapy as well as emotional.
Absolutely. Also, with my kids, we'll do a lot of singing to work on their speech abilities. So speech development is important. This is true of Alzheimer's patients, too. Many of them can't talk, but they will sing. So I work on helping those people express themselves and communicate by singing. Or, at the very least, they can hum a melody.
Where training is required in order to be a music therapist?
We are allowed to practice with a Bachelor's degree in music therapy plus professional certification. There are 70 or 80 schools that provide the Bachelor's program in the U.S., and that list can be obtained from the American Music Therapy Association at MusicTherapy.org. In order to get certified, we have to complete a clinical internship - clinical training period - for a minimum of six months. After that, you take a certification exam to become a Board Certified Music Therapist, abbreviated MT-BC.
Now, there are certain positions which are only available to music therapists that have gone a step further and completed a Masters degree in the field. Masters programs are available, and I believe a Ph.D. program was just begun, as well.
There is also an equivilancy program for professional musicians or psychologists who are interested in a career shift to music therapy, so there is an alternative to the full four-year degree. They also have to complete the clinical internship, of course.
What's the most difficult thing about being a music therapist?
The most difficult thing about the career is justifying it to other people. Most us love what we do and know it does good, but people are often skeptical.
The most diffcult thing about the work itself is burn out. It's a very real problem. I have to struggle to balance work, and home, and my clients, and my time.
What causes this burn out?
It's a combination of the emotional load, the struggle for recognition, many things. A lot of what we do is care work. We build relationships with our clients. It's a very emotional thing, not just with the clients, but also because it's music, and as musicians, that's very important to us emotionally. Most of us are very emotionally involved in our work. We invest alot in the music that we make and the relationships with our clients.
It's particularly difficult when you work with end-stage patients that are near death. You can imagine how difficult it is to build these relationships only to lose your client.
What's the best thing about being a music therapist?
It's incredibly rewarding. It's rewarding to know that you are offering something to the client, and the music is offering something to the client, that may not have been available to them before. I have clients that respond to music in ways that exceed their reponses to everything else. I have a client who is severly, profoundly retarded. You could go in her room and talk to her and touch her and it will have no effect at all. But once you start playing the music she'll start smiling and shaking her head to the beat of the music. Just having that connection - bringing her out of herself - is amazing.
