The connection of music [sound] and the human body far predates any modern science book or Facebook article. Our ancestors recognized the medical use of music all over the globe throughout history. Some of the most common household names of ancient intellectuals have referenced the mysterious connection between sculpted sound and our body/brain. In this article I will breakdown what music therapy and therapists are striving to achieve and what some job examples are. We will briefly look and learn from the ancients and see what modern science has done and is currently attempting to do. I will leave you with my thoughts on how this may even affect future insurance polices in the foreseeable future.
If you would like to listen to this article - I have it available in audio form below!
Cool, Great, but what is Music Therapy?:
Music Therapy is the clinical practice that uses music as a therapeutic tool in response to cognitive, emotional, physical, psychological, and behavioral concerns.
Music therapists aim to ... "stimulate relaxation, mental/physical rehabilitation, stress management, [improve or develop] coping skills, and [improve or develop] communication skills. Exciting new research tells us that music therapy could potentially help us enhance memory function" (G. Schlaug) . Sourced from an article published by the National Library of Medicine.
A link to the paper can be found here.
Music therapy is often used to promote self wellness, healing, and minor pain management that could help improve quality of life.
Passive & Active Methods:
Music therapy is divided into two forms: active and receptive (passive).
Passive: Also known as receptive, is defined by an individual listening to live or recorded music. Listening to music is considered passive because no music engagement or active participation is involved.
Active: Active music therapy techniques typically engage the client/patient in music composition, singing, and instrument playing. According to the American Music Therapy Association, a majority of the techniques that constitute clinical music therapy fall under an active category.
You can find a link directly to AMTA's official website here.
From a neuroscience perspective, active and passive music therapy methods stimulate different parts of the brain.
Interesting Studies Involving Music Interacting Wth Our Brain:
Based on Functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography Scan (PET scan) studies, active music participation engages more parts of the brain than solely listening to music. In addition to the subcortical and cortical areas of the brain that music listening activates - music participation also engages the cerebellum, basal ganglia, and cortical motor area (Yinger & Gooding, 2013).
Listening to music engages subcortical and cortical areas of the brain, including the amygdala, medial geniculate body in the thalamus, and the left and right primary auditory cortex (Yinger & Gooding, 2013).
Another study demonstrated that the anterior medial frontal cortex, superior temporal sulcus, and temporal poles are engaged when an individual listens to music because he or she could be trying to identify the musician/songwriter's intentions. While listening to music, a patient's preference for musical genre also affects the brain regions that are activated. For example, different parts of the brain are activated when the music is self-selected as opposed to when it is chosen by the researchers (Blood & Zatorre, 2001).
All forms of music have a therapeutic value, and specific types of music may differ in the target neurological stimulation. Professional utilizes music therapy research for its effectiveness in a large range of health care settings, private settings, and educational settings to improve communication, enhance memory, relieve pain and other ways to express feelings and emotions for the well being of all individuals. (Hanson-Abromeit, 2015).
*Disclaimer* There is a lot of missing history here. I am giving an extremely abridged narration of music therapy throughout the ages. I will do a more in depth article in the future for all who are curious or seeking the full unabridged history of music therapy.
The first written historical findings of music therapy are noted in the biblical scriptures of King Saul. (Samuel 16:23)
Sourced from "Therapy With Music". A link to the paper can be found here.
... "The ancient Greek philosophers thought that music could serve a therapeutic purpose. Patients in manic states were often instructed to listen to the calming music of the flute, while those suffering from depression were prescribed listening to dulcimer music." - sourced from Archives of Psychiatry and Psychotherapy (2006)
Plato’s writings shows that he considered music to be “the medicine of the soul” (Gfeller, 2002).
Plato’s theory of correspondence stated that... " musica mundane corresponded with musica humana". In other words, the ... “heavenly harmony of the music of the spheres” could have a positive [or negative] effect on “earthly souls”. Just as music undergoes re-harmonizing, the human body and the human race undergoes re-balancing, and in this way music has therapeutic value (Ansdell, 2004).
Aristotle believed that music had a cathartic effects that could provide relief from negative emotions through catharsis (Dobrzynska, 2006). Aristotle also believed that creating an ideal environment would help to achieve optimal mental and physical well-being. His theory specifically mentions that song, wine, and women, are the three necessary components to create an optimal environment for man (Ansdell, 2004).
Information sourced from Music Art and Therapy. A link to the specific article can be found here.
The Americans and Music Therapy:
The United States of America really began to use music therapy in the early 19th century around the time of World War I.
Massive amounts of soldiers who were wounded in the war needed critical care in hospital wards for psychological and cognitive disorders.
Information provided by AMTA. A link to the specific article regarding WWI can be found here.
The 20th century brought Music Therapy into the professional health care environment.
Therapeutic and rehabilitative services were provided to World War II veterans who were traumatized, wounded, and/or diagnosed with PTSD (Post Traumatic Stress Disorder) along with the services of music based intervention strategies post war. During World War II, Michigan State University became the first academic institution to add a music therapy department in 1944.
Here is a link to their music therapy department which is still around today .
The formation of the National Association for Music Therapy (NAMT) would follow shortly thereafter in 1950. NAMT designed bylaws, standards for education, and provided clinical training for music therapy. Shortly after the establishment of NAMT, the Urban Federation of Music therapists was developed in 1971. They would eventually change their name to American Association for Music Therapy or AAMT. In 1983 the Certification Board for Music Therapists was established, supporting music therapy professionals and incorporating a board exam for certification. The CBMT have encouraged music therapists to be "board certified" since their full accreditation in 1986.
The American Music Therapy Association (AMTA) was founded in 1950 but fully developed in 1998 and continues to operate today. AMTA supports the betterment of health through ethical practices, and clinical based treatment utilizing music therapy. AMTA also provides educational training for music therapists.
... "AMTA's purpose is the progressive development of the therapeutic use of music in rehabilitation, special education, and community settings. Predecessors, unified in 1998, included the National Association for Music Therapy founded in 1950 and the American Association for Music Therapy founded in 1971. AMTA is committed to the advancement of education, training, professional standards, credentials, and research in support of the music therapy profession." - Sourced directly from AMTA. A link can be found to the specific article here.
Music Therapy Job Titles and Work Examples:
1. Where does a music therapist even work?
... "Music therapists work in psychiatric hospitals, rehabilitative facilities, medical hospitals, outpatient clinics, day care treatment centers, agencies serving persons with developmental disabilities, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice." - AMTA
2. Who qualifies someone as a music therapist? It all seems so subjective.
... "Persons who completes one of the approved college music therapy curricula (including an internship) are then eligible to sit for the national examination offered by the Certification Board for Music Therapists. Music therapists who successfully complete the independently administered examination hold the music therapist-board certified credential (MT-BC). The National Music Therapy Registry (NMTR) serves qualified music therapy professionals with the following designations: RMT, CMT, ACMT. These individuals have met accepted educational and clinical training standards and are qualified to practice music therapy." - AMTA
... "MT-BC is the credential required to ethically practice as a music therapist. Once coursework and clinical training are completed, one is eligible to take the national examination administered by the Certification Board for Music Therapists (CBMT), an independent, non-profit certifying agency fully accredited by the National Commission for Certifying Agencies. After successful completion of the examination, graduates are issued the credential necessary for professional practice. To maintain this credential, music therapists must demonstrate continued competence by completing 100 recertification credits or retaking and passing the CBMT examination within each five-year recertification cycle. The MT-BC credential is awarded and administrated by the Certification Board for Music Therapists (CBMT)." - AMTA
3. Biggest misconceptions.
... "[a common misconception is...] That the client or patient has to have some particular musical ability to benefit from music therapy - they do not. [another misconception is] That there is one particular style of music that is more therapeutic than all the rest - this is also not the case. All styles of music can be useful in effecting change in a client or patient's life. The individual's preferences, circumstances, need for treatment, and the client or patient's goals help to determine the types of music a music therapist may use." - AMTA
A link to all of these questions and more can be found here on the official AMTA website.
Let's End By Talking Insurance:
*Disclaimer* I am not a healthcare professional but I do have colleagues that are. I had a few look at the following information to make sure I am correct.
The following information is sourced directly from AMTA. A link to the information can be found here.
Since 1994, music therapy has been identified as a reimbursable service under benefits for Partial Hospitalization Programs (PHP). Falling under the heading of Activity Therapy, interventions cannot be purely recreational or diversionary in nature and must be individualized and based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176.
A link to that specific HCPCS code can be found here.
The music therapy must be considered an active treatment by meeting specific requirements. Some examples of those requirements can be:
1. Prescribed by a physician.
2. Treatment [music therapy] must be goal directed and based on a documented treatment plan.
3. The goal of treatment [music therapy] cannot be to merely maintain current level of functioning; the individual must exhibit some level of improvement.
Active treatment - This is the treatment phase for a clinically diagnosed health condition and is aimed at providing significant, lasting, or progressive improvement.
Medically Necessary - According to Medicare.gov, “medically necessary” is defined as “health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms, and that meet accepted standards of medicine.” For any of those circumstances, if a clinical condition produces debilitating symptoms or side effects, then it is also considered medically necessary to treat them.
Once a treating physician determines that a patient has reached a point of "stability" or has been 'cured', a health insurance plan [typically] would no longer cover additional treatments.
For further information I would advise contacting your healthcare provider.
What is that? This can be considered a heavy definition and could easily warrant it's own article. In quick summary I will let the government tell you their official definition. A link to the full site can be found here.
... "Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments." - Social Security government website
It is important to note that Medicaid is still very relevant in 2018 and helps thousands of Americans every year have access to basic healthcare that the private sector does not provide or make affordable. The following pictures are sourced from the Henry Kaiser Family Foundation. A link to the specific article can be found here.
... "There are currently a few states that allow payment for music therapy services through use of Medicaid Home and Community Based Care waivers with certain client groups. In some situations, although music therapy may not be specifically listed within regulatory language, due to functional outcomes achieved, music therapy interventions qualify for coverage under existing treatment categories such as community support, rehabilitation, or habilitation services." - AMTA
For further information on which states are paving the way please click the link here.
I think this is an exciting time for the music therapy industry - but not the best time to be a music therapist. Right now there is a huge lack of proper studies or monetary backing for research and treatment. In 2013 there was only an estimated five to six thousand working music therapists in the United States according to AMTA. While numbers have gone up since 2013, the job market for music therapists remains relatively small and primarily in the private sector.
Highly Trained and Under Paid:
This profession requires extensive clinical training/schooling and a high level of proficiency on a musical instrument(s). While higher tiered music therapists in the private sector can earn up to $200,000.00 a year, the lower, more common tiers of music therapists are fighting for $40,000.00 - $60,000.00 annual income. I think in order to see aspiring music therapists succeed - insurance polices and schools must incorporate music therapy much, much more. Right now, a primary care physician might not even know about music therapy, let alone prescribe or incorporate it with current treatment. A school (any tier of education) may not even know that music therapists are available or how much money a music therapy department could bring in.
The Saving Grace:
Music therapy is cost - effective and does not rely on "big pharma" drugs. With more research and funding I hope that more insurance polices will recognize music therapy as a viable treatment making it [music therapy] available to the general public. There is mystery and beauty which surrounds our bodies interacting with music. Our ancestors were on to something and I hope that future generations will take it upon themselves to put numbers and facts behind the theories that science is currently publishing. Music saved my life, bringing me back from the darkest clinical abyss. Ever since learning that music therapy was a real subject and topic of interest in the medical community, I have been completely fascinated by music healing our body and mind. Music was played by our ancestors for generations and is embedded into our society. I am extremely curious and excited to see what comes next for the music therapy industry.
About the Author:
Benjamin Jay is a Los Angeles based guitarist, blogger, and content creator. You are reading a blog article from Benjamin's website which he updates frequently. Typically Benjamin writes about gear, social media, the music industry, and interviews artists. To be kept updated with new articles or for information on booking an interview please subscribe down below.
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