About Music Therapy

What is music therapy?

Music therapy is a discipline in which credentialed professionals (MTA*) use music purposefully within therapeutic relationships to support development, health, and well-being. Music therapists use music safely and ethically to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains.

*Music Therapist Accredited/Musicothérapeute accrédité

 

Canadian Association of Music Therapists
June 2016

Music Therapy Scope of Practice

The services performed by a certified music therapist (MTA) include the application of music therapy interventions within the context of a therapeutic relationship. This relationship is developed through music-based, verbal, and/or non-verbal communication. Certified MTAs use music to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains. They conduct client assessments, develop treatment plans, implement therapy processes, and evaluate progress. This scope of practice includes a range of procedures, actions, processes, roles, and responsibilities that a certified MTA can safely and effectively perform.

Certified music therapists (MTAs) may also conduct and/or participate in research, educate and supervise students and professionals, facilitate knowledge translation, act as consultants, and provide professional leadership on the use of music to promote health and well-being.

Certified music therapists (MTAs) provide services in a variety of settings including healthcare, educational, community, private practice, institutional, and corporate.  They may work independently or as members of interprofessional teams.  The clinical practice of a certified MTA is guided by evidence-based practice (EBP): the integration of the best available research evidence; the client’s needs, values and preferences; and the expertise of the clinician (Sackett D, L., Straus, S.E., Richardson, W.S., Rosenberg, W., & Haynes, R.B. (2000). Evidence-based medicine: How to practice and teach EBM. (2nd ed.). Edinburgh, UK: Churchill Livingstone.)

MTA Certification is granted from CAMT based on documentation of a successful intern evaluation, passing the board certification exam administered by the Certification Board for Music Therapists, and a signed statement of agreement to adhere to the CAMT Code of Ethics and Standards of Practice.

While CAMT’s scope of practice is being revised, please refer to the joint American Music Therapy Association-Certification Board for Music Therapists scope of practice document here.

Who benefits from Music Therapy?

Music therapy is used with individuals of various ages, abilities, and musical backgrounds in clinical, educational, community and private practice settings. The list below includes examples of medical conditions, living conditions and goal areas that might lead to someone accessing music therapy.
  • Acquired Brain Injury
  • AIDS
  • Autism and other Pervasive Development Disabilities
  • Critical Care
  • Developmental Disabilities
  • Emotional Traumas
  • Geriatric Care
  • Hearing Impairments
  • Mental Health Difficulties
  • Neonatal Care
  • Obstetrics
  • Oncology
  • Pain Control
  • Palliative Care
  • Personal Growth
  • Physical Disabilities
  • Speech and Language Impairments
  • Substance Abuse
  • Teens at Risk
  • Victims of Abuse
  • Visual Impairments

Education and Training

Accredited music therapists, MTA, complete a Bachelor or a Graduate Certificate in music therapy and a 1000-hour supervised clinical internship.

University Education: University coursework consists of supervised clinical fieldwork placements and the academic study in the areas of music therapy research, music, and psychology.

Internship: Following the completion of a university degree in music therapy, the music therapist in training completes a 1000 hour supervised internship. During the internship, the music therapy intern consolidates their knowledge and skills in music therapy, develops competence with one or more clinical populations and gradually assumes the full range of responsibilities of a professional music therapist.  Upon completion of an internship, graduates are eligible to take the CBMT* Exam and after passing this exam, can apply for MTA Certification signifying they are qualified to work in the field and will adhere to the CAMT Standards of Practice and Code of Ethics. *Certification Board of Music Therapists: www.cbmt.org

Continuing Education: The education and development as therapists does not end with the completion of accreditation. MTA must maintain their credential every five years through the CAMT continuing education process. MTA thus are continually seeking to advance the theoretical and practical application of music therapy techniques.

Click here to visit our links page for information about music therapy training programs in Canada

Clinical Process

Clinical work involves preparing, implementing, and evaluating music therapy programmes with individuals and groups. The music therapy process frequently begins with a referral from healthcare professionals, educational professionals, or from individuals who self-refer for music therapy services. The music therapist then completes an assessment through the study of medical or education records, interview of the client and/or family members and, unique to the music therapy assessment procedure, the observation of clients’ responses to music therapy techniques in group and/or individual settings.

Based on this information as well as input from the person, family members and other health care and education professionals, the music therapist formulates goals. These are generally long-term and are achieved in time by the successful completion of smaller and short-term objectives in a group or individual setting. It is these goals and objectives along with intervention procedures and materials that constitute the treatment plan which the music therapist implements.

After implementing the treatment for a reasonable period of time the therapist evaluates the plan to determine whether the methods of treatment are effective and whether the person is making progress in reaching the defined goals and objectives. The treatment plan is modified accordingly. Therapy is terminated when goals have been achieved, the person is discharged from a facility, or when the person can no longer benefit from the services. Throughout the treatment process the music therapist documents assessments, progress, observations, and recommendations regarding the person’s progress. There is ongoing communication between the music therapist and the person who is the recipient of music therapy services, as well as with other members of the interdisciplinary team.

Intervention Techniques

Music therapists use various active and receptive intervention techniques according to the needs and preferences of the individuals with whom they work. These techniques include, but are not limited to the following:

Singing is a therapeutic tool that assists in the development of articulation, rhythm, and breath control. Singing in a group setting can improve social skills and foster a greater awareness of others. For those with dementia, singing can encourage reminiscence and discussions of the past, while reducing anxiety and fear. For individuals with compromised breathing, singing can improve oxygen saturation rates.  For individuals who have difficulty speaking following a stroke, music may stimulate the language centres in the brain promoting the ability to sing.

Playing instruments can improve gross and fine motor coordination in individuals with motor impairments or neurological trauma related to a stroke, head injury or a disease process. Instrumental ensembles can enhance cooperation, attention, and can provide opportunities for practicing various leadership-participant roles.  Playing instruments may assist those with prior musical experience to revisit previously learned skills, thereby allowing the individual to experience a renewed sense of pleasure and enjoyment. It can also develop increased well-being and self-esteem in those who are learning to play an instrument for the first time.

Rhythmic based activities can be used to facilitate and improve an individual’s range of motion, joint mobility/agility/strength, balance, coordination, gait consistency and relaxation. Rhythm and beat are important in “priming” the motor areas of the brain, in regulating autonomic processes such as breathing and heart rate, and maintaining motivation or activity level following the removal of a musical stimulus. The use of rhythmic patterns can likewise assist those with receptive and expressive processing difficulties (i.e. aphasia, tinnitus) to improve their ability to tolerate and successfully process sensory information.

Improvising offers a creative, nonverbal means of expressing thoughts and feelings. Improvisation is non-judgmental, easily approached, and requires no previous musical training. As such, it helps the therapist to establish a three-way relationship between the client, themselves and the music. Where words fail or emotions are too hard to express, music can fill the void. Where trust and interaction with others has been comprised due to abuse or neglect, improvisation provides a safe opportunity for restoration of meaningful interpersonal contact. Where learning ability is limited, the opportunity to try different instruments, musical sounds, timbres and mediums may provide an opportunity for mastery of a new skill and increase life satisfaction.

Composing / Songwriting is utilised to facilitate the sharing of feelings, ideas and experiences. For example, with hospitalized children, writing songs is a means of expressing and understanding fears. For people with a terminal illness, songwriting is a vehicle for examining feelings about the meaning in life and death. It may also provide an opportunity for creating a legacy or a shared experience with a caregiver, child or loved one, prior to death. Finally, lyric discussion and songwriting can help adolescents deal with painful memories, trauma, abuse, and express feelings and thoughts that are normally socially unacceptable, while fostering a sense of identification with a particular group or institution.

Imagery based experiences, such as Guided Imagery and Music (GIM), can provide opportunities to reflect, process, and interact with unconscious or conscious material that may be reflected in an individual’s life. Other expressive modalities, such as artwork and movement, can be used in combination with the music.

Listening to music has many therapeutic applications. It helps to develop cognitive skills such as attention and memory. For example, for those facing surgical procedures, it allows the individual an opportunity to exert a sense of control over their often unpredictable environment. During pregnancy, music listening can provide a connection between the uterine environment and the external environment following delivery. During childbirth music listening can facilitate and support the different stages by promoting relaxation and providing distraction for the labouring mother. In situations where cognitive perceptions are comprised, such as in early to mid stage dementia, listening can provide a sense of the familiar, and increase orientation to reality. For those with mental illnesses such as Schizophrenia or Bipolar Disorder, music listening can facilitate increased openness to discussion and provide motivation for engaging in social activity.

Clinical Settings

Music therapists work in a variety of clinical settings. The following is a sample of where you might find a music therapist:

  • Hospitals
  • Day treatment programs
  • Community programs
  • Correctional Centres
  • Long term care centres
  • Substance abuse and addictions centres
  • Schools
  • Hospices
  • Private Practice

Fees for Music Therapy Services

The salary range for music therapists varies greatly province to province and city to city. Music therapists’ salaries vary based on location, setting, population, experience, training, full time or part time employment or private practice, as well as other factors. As access to professional music therapy services for Canadians increases, it is expected the disparity in salary range will equalize.  Based on the wide variance, CAMT does not currently track the salaries of MTAs. On average, hourly contract fees charged by music therapists range from $35/hour to more than $115/hour.  Average salary ranges are set at the provincial level.