April, 2006; Paige Robbins Elwafi (Paige.Elwafi@ky.gov)
Response to Hanne Mette Ridder
I read your request for experiences from other countries about developing the profession of music therapy in places that are not knowledgeable of it. I am fairly young and have just a few years of work experience as a music therapist. I have worked in two different countries however, and found similar challenges facing me as a music therapist when defining what we do and spreading the “word” about the profession.
I worked for one year in Doha, Qatar. Being one of the only TWO music therapists in the country (as far as we knew), was very challenging. No one knew about music therapy, so we were educating our co-workers, parents of children we worked with, and lay people constantly. We worked with native Arabic speaking people to translate documents from our American music therapy association into Arabic. We also presented several workshops/lectures at our work and in the community for parents and professionals. At the school we worked at our small music therapy department was combined with psychological services from the very beginning. There was no art therapist there, so we did not have the chance to be “paired” with art therapy. However, I assume that if there was an art therapist there, he/she would have worked under psychological services department, at least until the “arts therapies” department grew enough to become it’s own entity. With that said, I believe that being associated with the psychologists/psychotherapists was very beneficial for us as music therapists starting out, trying to introduce the profession in the most effective manner. Our association to them gave us scientific backing that we needed to get the respect from professionals and parents as something more than just “music”.
Now I am working in Louisville, Kentucky (in the Midwest/southeastern region of the US). I am in a music therapy position at a state psychiatric hospital. My position in technically under rehabilitation services at the hospital. Other services in the rehabilitation department are speech therapy, occupational therapy, physical therapy, art therapy, psychology, behavior analysis, recreation therapy and the chaplain. I attend treatment team/interdisciplinary team meetings that most of the psychologists attend, which is similar to my position in Doha, Qatar. I work with the art therapist most closely, as our methods of treatment compliment each other well. I think we both deal with occasional issues of having to define our discipline as substantial and scientific, but this seems to be at a minimum here. Maybe this is because art therapy and music therapy have been here for about four years, so people are beginning to understand better.
As far as working in the private sector in music therapy in the area of the US, it’s very challenging. Educating the public and government is something we deal with all of the time. I can understand how fighting for a “place” for music therapists to practice is very challenging. From my experience, I think that working from the psychotherapy perspective in finding funding and respect for music therapy in your country may be more advantageous and successful than going with art therapy. If art therapists are struggling like music therapy, maybe going with a psychotherapy backing could help them also. I am not aware of the standing of art therapy in your country. However, uniting with psychotherapists could be limiting for your music therapists, depending upon their philosophies and practices. Uniting with art therapy may be less limiting and allow you the professional freedom of practicing music therapy….these are pros and cons to consider…..
I hope I have been somewhat helpful. Please let me know if there is anything else I can help with. I wish you the best of luck and look forward to seeing music therapy grow in Denmark.
March, 2006; Christian Gold (christian.gold@hisf.no)
A Careful Decision is Important: Response to Hanne Mette Ridder
I think this is a very important question. It is good that Hanne Mette brings it out on an international forum, because it seems relevant in several countries. I know that in Austria there have been negotiations about a music therapy law for several years, without any definite success as of yet. One obvious obstacle is the small number of music therapists. Therefore uniting with other “arts therapies” might be a good pragmatic solution. Precedents in England and Germany also seem to show this direction, as Hanne Mette pointed out. However, I would want to be very cautious with making such a decision. (I am in the blessed situation of speaking only as a music therapist and researcher, not as a front man in any negotiations – and I am taking the liberty of expressing also some unfinished thoughts, meant as an input for the discussion.) I can see several drawbacks:
First, music therapy is, as far as I know, in many countries better established than any other “arts therapy”. Music therapy has more and better research, longer, more established and more integrated training, and is better established in clinical services. Are the other “arts therapies” (whom does that include anyway?) perhaps mainly hoping for a “free ride” with music therapy? That would be good for them – but would it also be good for us?
Second, I do think that there is a better rationale for using music in therapy than for other artistic media. Artistic expression is only one part of this rationale (this one is shared by the other arts). Music also has all these pre-verbal communicative qualities which have been described and researched so extensively both within the discipline and in developmental psychology (e.g. Trevarthen, Holck, etc.). Where is a comparable basis for the other arts therapies?
Hanne Mette also mentions an alternative possibility of going together with psychotherapy. That sounds more fruitful to me, and I would be very curious to hear more about that alternative.
Music Therapy Registration in National Healthcare Systems
December, 2005; Hanne Mette Ridder (hanne@hum.aau.dk)
In Denmark a well recognized music therapy training has existed at Aalborg University for almost 25 years. Every year 8-10 students have completed their studies at master’s level, and many have got working positions in the health care sector. However, when you consult the
The National Board of Health in Denmark music therapy does not exist. Music therapy is not mentioned on their webpage, and on their list of health care professionals music therapists are not mentioned.
It takes time to establish a new profession like music therapy, but the problems seem to come to the foreground in recent time. The National Board of Health has established a registry where all patients in Denmark are registered together with information about all the treatment and care these patients receive. The problem is how music therapists can register their work, when they do not “exist”. The registration has already started in psychiatry, where there now are codes for music therapy (BRFB52) and for music therapy assessment (ZZ4993).
Music therapist Ilse Wolfram has informed our Danish music therapy organization that in Germany the health care system now registers patients in DGRs (Disease Related Groups), and that a considerable effort was made to unite German art therapist associations with other psychosocial organisations. An important part of this work was to collect a huge amount of relevant research material which was done by David Aldridge and Bettina Kunzmann. Julie Sutton has informed us that the way to get the music therapy profession recognized in UK was to relate on a big number of professionals. Thus, the same experience; it was important here as well to unite with art therapists.
In a country like Denmark we are only few music therapists (about 100 in our professional organization) in comparison with the other groups of professionals. So in our organization we discuss if we should take this step and find solutions for uniting with art therapist or with psychotherapists. This arises many political, ethical and not least; practical questions for our organization. I am interested to hear what the experiences are in other countries. Is music therapy a recognized profession in your country? If it is: How did this become possible? If not: Do you find it important to be registered in a national system, and how will you achieve this?