Guest Post: Focusing on our Field, our Profession, and our Clients

I am excited and pleased to introduce you to Meredith Pizzi, a Boston-based music therapist and business owner. As you may remember from my post a couple weeks ago, our profession is considering a move to becoming a Masters-level entry field. I had heard through the grapevine that Meredith had some insightful thoughts on this topic, so I invited her to share some of them here on the blog. Sure enough…she does!

I greatly respect and appreciate the work of the ETAB Board, however, I strongly disagree with a number of the arguments made in the documents and fundamentally believe that starting to make a move at this time to a master’s level degree would not move our field forward in the right direction.

I come to this conversation as a Board Certified Music Therapist, a practicing clinician since 2004, and also as an employer of music therapists. As the Owner and Executive Director of Roman Music Therapy Services, LLC in Massachusetts, I employ a team of music therapists providing contracted music therapy services from birth to older adults in over 35 locations. I believe strongly in the value of services we provide and the need to provide the best possible care and treatment for our clients. I participated in the Town Hall Meetings at both the Mid Atlantic and New England Regions’ Conferences, and I am really glad to see, hear, and read the discourse regarding our field among professionals and students of music therapy.

I believe that focusing on changing the entry level program to a master’s degree will distract us from the really important issues at stake for our field today.

I believe we need to…

1) Increase our workforce of both trained entry level music therapists and advanced level practitioners

I completely agree with the references in ETAB’s recommendations that we need to increase our work force of technicians, music therapists who are trained and qualified to provide excellent music therapy services to meet the increasing and expected increase in demands in our communities. As an employer, I strongly believe that we need more technicians, and more advanced level practitioners. There is an increasing need for music therapy professionals who are able to provide great services. A strong undergraduate training and in-depth internship experience, with continued ongoing professional development and supervision, has prepared many great music therapists to work in a variety of settings, including those served in my agency. We need more music therapists to provide services and I believe changing the entry level to a master’s degree would limit the number of new clinicians coming into the field and delay the amount of time before new professionals can begin to provide services.

We also need increasing numbers of advanced practice music therapy clinicians who can address the increasingly complex needs of our communities and supervision of music therapists. I believe that focusing on growing both bodies in our workforce is more important than changing the requirements for entry level clinicians.

I would much rather see an emphasis placed on finding ways to train more entry level music therapists and concurrently, more advanced practice music therapists who have experience and graduate training.

2) Focus on state recognition and access to services at the state level

The presentation at the regional meetings suggested that we should “envision a time.”  Envision a time with increased access to service, and I believe that will come by putting our time and energy into state recognition and occupational regulations. Success stories have been frequent in the last few years, and most states do not care if we are practicing at a bachelor’s or master’s degree level. We need to advocate for our field and define who we are clinicians, and changing the structure of our field at this time will not increase the chances for us to be recognized at the state level. In fact, I believe it will probably make things harder, as now we would need to go back to our advocates at the state level and say, “By the way, we’ve changed our minds. We think our music therapists need more training.” We are not a large enough field to make that argument at this time!  I fear this would limit access to services and backfire on many of the state grassroots advocacy efforts.

3) Better understand the economics of our field and economic implications of changes to educational requirements

I come to the question of economics as a business owner and an employer of music therapists. The economic assumptions made by ETAB in terms of financial costs and benefits to the field do not provide a complete picture of our field or the financial needs of college students today.

First, let’s look at our students. Additional costs for a required graduate education would be prohibitive for many students and the documents state that students may choose not pursue music therapy if it requires a graduate degree. The increased costs would limit the pool of students, and increasing the workforce is a top priority! It also overlooks the cost of music therapy education and how graduates will pay back their student loans. There would be increasing student debt when students graduate and earn their MT-BC credential.

The assumption that professionals would benefit from “salary advancement” is not at all in line with our current economy or the reality that many music therapists are already currently billing for services at the same level as other related service providers, even though our professionals are able to work with a bachelor’s degree.  I currently bill for services at the same level as other related service professionals already, and us changing our entry level requirements will not allow me to bill any more, or pay my therapists any more. From my view as a business owner and employer, higher salaries will not come from a move to master’s level. Higher salaries may come from tiered levels of practice in which an advanced level clinician is able to provide different services to a facility, however, an entry level clinician at the master’s level could not bill more than an entry level bachelor’s music therapist is currently billing. An entry level music therapist is still an entry level music therapist! And in these economic times there is a question of how much the market can bear. We need to be cautious and not promise dollars falling from the sky as a payoff down the road.

About reimbursement, many music therapists are already successfully reimbursed for music therapy services at a bachelor’s level. Having a master’s level entry requirement will not change our need to advocate at the state level, nor will it provide a band-aid that will suddenly make us eligible for other avenues reimbursement. State recognition will have more significant effect on our ability to be included in legislation, not the type of degree we hold.  Kimberly has already shared her thoughts on this. You can read more Here.

4) Study our workforce retention issues to better understand our current field and prepare for our future

I believe the discussion about workforce issues in the ETAB documents brought up more questions than it answered. There were assumptions made about the retention of music therapists in our field and the effect of graduate degrees, however, we need to recognize that currently, most music therapists who have a master’s degree are music therapy clinicians trained at the bachelor’s level or through an equivalency program who choose to stay in the field and continue their studies. I would encourage more studies to look at this, as well as answer some of these other questions.

• Why do trained professionals leave the field?
• If it is primarily for raising families, do they come back?
• What makes professionals stay in the field?
• Do music therapists who have done master’s programs as their entry level program hold job titles of music therapist? Are they primarily providing music therapy services or are they using other parts of their degree programs to provide more mental health/counseling services?
• How many music therapists are currently practicing with bachelor’s only? Equivalency? Master’s only? Bachelors and Masters in Music Therapy?
• What are the amount of student loans owed by music therapy graduates currently, both at a graduate and undergraduate level? How is this trending over time? And how likely are students to be able to pay back their student debt?

5) Clarify the Scope of Practice of an entry-level music therapist (Professional Level of Practice) versus Advanced Practice Music Therapist

I believe the greatest work of the ETAB Committee was the Advisory on Levels of Practice in Music Therapy. The definition of levels of practice is something that needs to be addressed further within our field. We need to find ways to clarify, strengthen and distinguish levels of practice to gain recognition in particular settings and to limit the scope of practice for entry level music therapists to a more practical number of requirements. Further clarification on Scope of Practice for Entry Level Professional music therapists would take some of the pressure off of academic institutions and undergraduate students who feel there is just too much information to tackle. We need to look across the entire field of practice and define what level of education, training and experience is required at the professional and advanced level of practice. This type of approach will ensure that advanced level clinicians are actually advanced level clinicians, which a master’s level entry does not guarantee.

Conclusion

I am so grateful to AMTA and to ETAB for putting this conversation front and center. I believe that it is an important discussion and consideration, and I also think that we have other work to do.  We need to recruit exceptional high school students to our programs, develop our experienced clinicians into great advanced level clinicians who are able to do increasingly complex work and supervise other music therapists, promote state recognition of the MT-BC credential, and advocate for increased access to high-quality music therapy services.  Further debate about the recommendations will not move our field forward at this time. Let’s look at where we are as a profession, not other related services, and continue to develop the field of music therapy with tiered levels of practice as that will benefit our clients most significantly.

About the Author: Meredith Pizzi is the Founder and Executive Director of Roman Music Therapy Services, a Boston-based music therapy agency which focuses on serving young children, children and adults with social, emotional, cognitive, behavioral, physical, and educational needs, and older adults.

Tagged as: education, guest author, Guest Posts, masters-level entry, training