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The Path to Music Therapy and Why It Matters

Isabelle Spence, MT-BC

In this article, Isabelle Spence offers a compelling introduction to music therapy – what it is, why it matters, and how it empowers patients like “E.” This piece is especially valuable for students, clinicians, and patients who want to understand how to incorporate supportive therapies like music therapy into holistic, patient-centered care.

From the Editors

To many patients, alternative therapies such as recreational therapy, music therapy, art therapy, and equine-assisted therapy not only promote healing, skill development, and mental well-being, but they can also be empowering and provide opportunities to express autonomy ina medical system that often leaves them without. Supportive therapies can contribute a plethora of benefits to a patient’s treatment plan and as the future of the medical profession, it is imperative to know how to utilize and refer to these options effectively and with intention.

Music therapy is a clinical and evidence-based practice facilitated by a board-certified music therapist that utilizes music as the medium to affect change and improve the patient’s overall well-being through addressing need areas in cognitive, emotional, physical, social, motor, sensory, communication, and other domains. This can look vastly different depending on the patient’s needs and settings. Music therapists serve a multitude of settings including but not limited to, home health, hospitals (in-patient and out-patient), private practice, assisted-living facilities, hospice/palliative care facilities, schools, incarceration centers, day programs, and more. In order to become a music therapist, one must hold a bachelor’s degree (or higher) in music therapy from an accredited and approved college or university program. After the 4-year coursework program, all student music therapists must complete 1200 hours of clinical training including a supervised internship before degree completion. Upon completion of a bachelor’s degree or higher, music therapists must sit for the national board certification exam to obtain the credential MT-BC (Music Therapist – Board Certified) which is necessary to professional and ethical practice (American Music Therapy Association, 2025). The profession has two main regulatory organizations, American Music Therapy Association (AMTA) and Certification Board for Music Therapists (CBMT) which ensure quality services and ethical practice. In addition to the national board certification, some states also have title protections, state recognition requirements, and/or state licensure requirements. Just like any other healthcare profession, there is potential for harm by an unlicensed, non-certified practitioner, so referring to a board-certified therapist is essential.

Music therapy is a valuable and cost-effective service for patients in healthcare facilities with all cultural backgrounds, ability levels, and settings. Research shows that music therapy positively impacts length of stay, pain perception, medication administration, and reducing repeat admissions, which increases facilities’ profit retention from common reimbursement sources.

Another critical area that music therapy benefits the healthcare system is in patient satisfaction. Patients who receive music therapy rate their satisfaction an average of 3.4 points higher than patients who don’t receive music therapy (Gooding, 2014). For more specific information on cost-benefits, treatments, and outcomes in more settings with multiple populations, music therapy research articles can be accessed through PubMED, Journal of Music Therapy, Music Therapy Perspectives, and other peer-reviewed journals.

Throughout my career thus far, I have worked in outpatient hospitals, home health, and schools, though most of my time is spent in patients’ homes. Due to the nature of home health, I develop long-term relationships, strong rapport, and collaboration with all my patients and their families, as well as other members on their treatment team. My services serve as a constant in their lives and a safe space for them to express their autonomy while also furthering their goals and improving their quality of life. Most of my personal caseload comes from a disability waiver through Medicaid and thus I work with disabled and neurodivergent patients in all stages of life.

Many of my clients have been on my caseload for years, some even since I first started in January 2022. One such patient, pseudonym “E”, was referred to me through the CLASS waiver and eventually stayed on my caseload through private pay after leaving the waiver program. “E” has GLASS syndrome, a rare genetic disorder that results in various levels of cognitive, speech, motor, behavioral, and emotional needs. She has also been diagnosed with secondary conditions such as aphasia, autism, cerebellar initiation interference, and generalized anxiety disorder. In addition to music therapy, she previously received recreation therapy and speech therapy, and she currently receives occupational therapy, equine-assisted therapy, medication therapy, and case management with a social worker. We have addressed a plethora of skills together, including fine motor isolation and control, acquiring new and strengthening pre-existing communication systems (such as American Sign Language, ProloQuo, verbal speech, and typing), autobiographical recollection, pattern recognition and recall, identifying emotions and perspective taking, increasing self-confidence, holding reciprocal conversations, orienting to time and place, making phone calls, and many other goals to improve her overall quality of life and mental health. One of her favorite interventions in our sessions is the news song, where we take turns showing a picture from our week, asking and answering questions about when, where, who, what, and why, describing the image using at least four adjectives, and finally identifying one emotion and engaging in a perspective-taking exercise involving making inferences and abstract reasoning.

Throughout our time together, she has progressed immensely and is extremely motivated by music therapy. When “E” and I first started working together, we focused on verbalizing “hello” and “goodbye,” using people’s names, and typing “yes” or “no.” Now after three years, “E” is writing and speaking full sentences with minimal support, advocating for herself in her treatment plan, and expressing her autonomy over session activities. “E” has also worked with and taught six music therapy students about the art of therapy and effective implementation that empowers and respects patients and their autonomy. For her and many other patients, music therapy has been a safe place for her to work on goals that are important to her, establish a non-family trusted adult to advocate with her, and most importantly, a place for her to feel unconditional positive regard and respect as she is.

It is an honor and a privilege to serve patients, and we have the power to affect positive change in our patients’ lives! It is our duty to acknowledge the power imbalances within the healthcare system, intentionally amplify patient voices, and collaborate with our referral networks to provide the best possible treatment when they are in our direct care and beyond. “Interdisciplinary involvement is vital for the introduction of music therapy into a health care system” (Gooding, 2014). As current and future healthcare workers, we must work together and use all of our collective resources to improve patient outcomes, patient satisfaction, and overall quality of life for all the patients we serve. Music therapists are an excellent addition to your referral list and treatment teams to meet your patients’ needs in and out of healthcare facilities.

References

  1. American Music Therapy Association. Who Are Music Therapists? | Who are Music Therapists? | American Music Therapy Association (AMTA). (n.d.). https://www.musictherapy.org/about/therapists/
  2. Gooding, L. F. (2014). Medical music therapy: Building a comprehensive program. American Music Therapy Association.

Isabelle Spence, MT-BC

 

Isabelle Spence, MT-BC, graduated from the University of Alabama with a bachelor’s degree in music therapy and a minor in psychology in 12/2021. Isabelle is passionate about performing on her flute, and she has performed as an ensemble member and a soloist across the country. Isabelle completed her internship with Heart and Harmony Music Therapy in the fall of 2021. Isabelle’s clinical experience includes premature infants in the neonatal intensive care unit (NICU), adults with traumatic brain injuries (TBI), and more, including adolescent and adult populations. She also teaches adaptive music lessons, and serves as a practicum and internship supervisor to teach future music therapists. She currently lives and works in Arlington, Texas.