3 Things About Being A Music Therapist That Others Don’t Tell You About
1) It takes a lot of hard work and effort to become a board-certified music therapist.
“The education of a music therapist is unique among college degree programs because it not only allows a thorough study of music, but encourages examination of one’s self as well as others.” -American Music Therapy Association (AMTA).
Although the required coursework vary from school to school, completing my music therapy requirements at Berklee College of Music was challenging. Every semester I had an average of 8 courses/semester (Berklee goes by semesters, not years) and each class consisted of 1-2 credits, at most 3. These classes included music theory, arranging, conducting, ear training, music technology, psychology, private lessons, ensemble, music therapy, development seminars, electives, and general studies. Courses specific to music therapy included 5 levels of supervised practicum fieldwork in facilities that served individuals with disabilities in the community. I was assigned to work at a school setting with children diagnosed with cerebral palsy for my first practicum, and this was my first direct hands-on client experience with music therapy. I was then placed at a nursing home for my second practicum that focused on geriatrics in which I served groups of elderly who were diagnosed with depression and Alzheimer’s disease. Then I got to work with homeless women in my next practicum, adults with developmental disabilities in the one after that, and children and babies in intensive care units during my final practicum at Boston Children’s Hospital. Courses in addition to each practicum focused on specific areas, such as P1 (practicum 1) in Special Education, P2 in Geriatrics, P3 in Research, P4 in Psychiatry, and P5 in Medicine. Although you’re required to work for about 7-8 weeks at your chosen facility (1-2hrs once a week) and that may not seem like much, having to balance studying, completing research, doing homework assignments, practicing instruments, preparing for concert recitals, recording music, attending meetings, memorizing songs, and overall figuring out my life as both a musician and a music therapist was very challenging. Although my main focus was music therapy, I still needed to focus on vocal performance as I was graded for my musical skills, not just for my clinical work. There are numerous amounts of documentation and clinical writing involved as well, and each practicum is paired with courses related to what you’re learning and dealing with in that specific practicum. Music therapy courses at Berklee require not only sitting at your desk listening to lectures, finishing up tasks and passing exams, but they require active participation such as public speaking, group work, role playing, advocating, and playing instruments. In other words, it’s about practicing and developing skill through action than just having mere knowledge about each course. Meditation and self-care practices are also taken place inside classrooms where you get to be in an open and vulnerable space with others, tap into your own personal thoughts, emotions and feelings, and focus on self-awareness and awareness of others. There is a lot of individual attention that you get from professors who have high expectations of their students (Berklee’s student-teacher ratio- 11:1), and because I got to learn in such small, inclusive classroom environments with direct patient contact at fieldwork, I grew massively in my musical and clinical knowledge and abilities. Because I was pushed to actively participate and throw myself into uncomfortable situations, I’ve grown immensely through my learning. It’s great that we get to apply what we learned in class directly into practice at our practicum sites and receive feedback from our supervisors on site who are also professional music therapists. Classrooms feel like workshops, and practicums feel like small unpaid internships. It’s challenging to be seen and trained as a musician, professional, and therapist inside classrooms when we’re still students and sometimes don’t feel mature enough to handle the ups and downs of social and emotional experiences throughout the whole process. But real growth happens when you’re out of your comfort zone and that’s how Berklee was like for me and for many others who are currently music therapy students. We are constantly pushed to feel uncomfortable in our learning.
Then after you’ve completed all of your training at school which usually takes about 4.5-5 years, you graduate (hurray!) and then go search for an AMTA-approved internship to receive your degree. This is the last step you need to complete before receiving your official diploma and becoming a professional music therapist. My internship took place at Children’s Hospital of Orange County (CHOC) in which I worked 40 hours/week, unpaid, for 6 months. Although there are some paid music therapy internships, most are not and require you to work 6-9 months depending on the site. Then once you complete your internship, you are finally eligible to sit in for the certification exam. Once you pass the exam, you are finally acquired the credential Music Therapist-Board Certified (MT-BC).
I say music therapy is 70% therapy and 30% music. We are using music as a tool to reach non-musical goals. So it’s not just about performing and entertaining patients/clients and wowing them through your musical skills, it’s about using music purposefully and intentionally through the connection and relationship you build with your patients/clients to help them reach their goals. We do music WITH the patient, not just TO the patient. It doesn’t mean you have them to follow you, you adapt yourself to follow them. This is also the main difference between music education and music therapy- while music education focuses on musical knowledge and skills that follows a standard, rigid curriculum with no adaptations to meet the patient’s specific needs, music therapy adapts the music to meet each patient’s specific goals and needs. Music therapists are trained to see the needs of patients with disabilities and special needs on a deeper level, and therefore know how to use effective strategies to target those specific needs through music. Here is an example I can provide from my internship- I’ve worked with several cancer patients at CHOC and at the time, many were experiencing stem cell transplants and chemotherapy. Going through treatment can be extremely stressful and scary for kids, especially when their family isn’t around to keep them company through challenging times. Kids need to be in supportive environments where there is structure, autonomy/independence, and relationship support. In order to target these three elements, my main goals for music therapy were to provide structured and predictable environments, increase their autonomy and control, and build rapport. To provide structure, I used familiar music for predictability and songwriting scripts; for autonomy support, I allowed patients to make their own choices about lyrics, melody, how they wanted the song to sound like; and for relationship support, I focused on building rapport through discussing about the content of the song, brainstorming ideas together, and interacting throughout the overall songwriting process. Providing specific music interventions that are tailored to their experiences helps create a safe space and allows them to drive benefit from music and be successful in therapy. So music therapy isn’t just focusing on the musical elements- rhythm, melody, harmony, timbre, pitch, dynamics- but it’s focusing on the musical elements to be used clinically in purposeful ways. It’s more about the interaction, the connection with the patient/client rather than the music itself. Because our main focus is therapy, music therapists utilize a variety of methods and don’t necessarily have a traditional, fixed way of doing things when providing music and playing instruments. I’ve used the back of my guitar as a drum once, the side of my guitar as a slide for stuffed animals, boomwhackers to slide eggs through the tube rather than whacking them on hard surfaces to make sounds (which is how you would “normally” play it), the back of a floor drum as a pot to make soup with kids, xylophone blocks as cake for dessert, a drum mallet to strum the guitar, and I can name other ways where I’ve used music creatively, thinking outside the box for patients. You have to think what are the GOALS you’re trying to reach, and how are you using music as a TOOL to reach those goals? Music therapists use music both traditionally and non-traditionally to reach non-musical goals. Unlike a traditional music educator who plays guitar to teach students how to strum and has everyone to follow, music therapists could use a guitar to teach how to strum, use it for play using toys, move it around in different positions and be flexible with the overall use of the instrument that follows the patient and their response to music. Music therapists are aware of how to utilize music to engage and target specific needs of individuals from the moment-to-moment experience.
3) You never know what to expect as a music therapist.
There are no fixed answers to anything. We need to let go of expectations and assumptions about various situations and circumstances, especially during sessions. I remember my supervisor who is a board-certified music therapist with almost 20 years of experience with music therapy, telling me he still gets nervous to this day walking into patient rooms, because it is a new experience for him each time. It is crucial that we remain open to whatever happens, to lean onto discomfort, to let go of the need to control and to simply go with the flow. I had one patient at CHOC where, when I went to check-in to ask if he was in the mood for some music, he responded with an enthusiastic “yes!” and gave me a huge smile. He seemed to be feeling a lot better than the last time I saw him when he was undergoing chemotherapy, so I got excited and started thinking to myself what songs would be good for him and which instruments I could use for those songs. I told him I’d be right back with my instruments (which only took about 5 minutes) and walked right back to his room, only to see he was now crying after his mom refused to feed him chicken nuggets. He was not allowed to eat before his procedure, and he looked at me and shook his head. I had no choice but to put aside the session plan I had for him and adjust myself fully to that moment. I decided to pull out an ocean drum and strum relaxing chords on my guitar to provide relaxation and calm his emotions, and matched my humming to my guitar. I had no idea how the session was going to go after that and what to expect out of it, but I trusted my gut in that moment and decided that that was what was best him. Then the next day, I walked into his room again to see he was feeling a lot better and was bursting with energy throughout the session so I matched myself to his energy level and provided that high stim he needed. Being a music therapist means you’re constantly having to deal with fluctuations (fluctuating referral calls, fluctuating moods of patients and families, fluctuating health conditions) and overall spontaneity- so it’s crucial that music therapists are flexible, open-minded, and adaptable to various circumstances. The only things to expect as music therapists are expect the unexpected, expect discomfort, and expect the unknown.
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