Which one of you is the Music Therapist?

Reconciling Music Therapy and Arts in Medicine Programs

Music therapists have long sought to establish music therapy as a recognized therapeutic practice alongside physical therapy, occupational therapy and speech therapy. We have seen success in accomplishing this through much research and the establishment of clinically proven protocols. Music therapists are generally happy to see other people use music to aid in health and learning because most people already have a sense that music can aid in these processes. So more people providing music in a variety of settings is a good thing in my mind, but this situation has caused some small angst for music therapists over the years. Although music therapy, as an official profession in the United States, is now sixty years old, there are still many people who would see us as the "traveling minstrel" of the hospital or school.

Arts in Medicine programs have the benefit of providing access to the arts for patients who are forced to stay in hospitals for any length of time. They typically involve all art forms, including dance, art, music, poetry, and even gardening. One possible drawback, however, is the potential confusion about the roles of volunteers and trained music therapists in using music in the hospital setting. I honestly had not realized that Arts in Medicine (AIM) programs have been flourishing so well around the country. In a brief survey around the web, I found programs at the Cleveland Clinic, Texas Children's Cancer Center, and the University of New Mexico. We also have a large program at Tallahassee Memorial Hospital through Florida State University and there is another flagship program called the Shands Arts in Medicine program through the University of Florida in Gainesville.

The AIMS (Arts in Medicine Service) program here in Tallahassee does a very good job of differentiating music therapy from the volunteers and students that bring the art and performing art into the hospital. The AIM program for Tallahassee Memorial Hospital (TMH) is designed to, "Improve the aesthetic environment" of the hospital. There is no attempt by members of the AIM program to implement goals and objectives to directly influence health or treatment outcomes. Since TMH has two full-time music therapists and generally two music therapy interns, all direct patient care involving music is handled by the music therapy department. AIMS participants are supervised by Florida State University and receive college credit for their work. They do not use music in one to one contact with patients, but are regularly scheduled to perform concerts in the hospital atrium. In this way, the line between music therapy and AIMS personnel are clearly defined and easy to understand by patients and staff.

The University of Florida employs a completely different model of providing the arts to the hospital setting. The Shands Arts in Music program actually employs full-time "artists in residence" who work at the hospital and supervise the other AIM participants. The "artists in residence" who provide music are not necessarily music therapists, and music therapy is not provided at the hospital. The Shands program is a robust endeavor with more than one hundred volunteers participating throughout the year alongside the "artists in residence." The program at Shands was specifically designed to apply the arts to patient care and not simply improve the aesthetic environment through exposure to the arts. As seen in the picture above, the environment at Shands hospital has been dramatically impacted by the AIM program, but the "artists in residence" are also specifically tasked with developing arts interventions to aid in patient care. I find this idea troublesome since art, dance and music therapists go through much specialized training in psychology, counseling, anatomy, etc. in addition to training in their medium in order to meet the needs of clients.

I think I prefer the AIMS model at TMH because of the well defined boundaries between people doing music therapy and other people doing music to increase the aesthetics of the environment. I admire the University of Florida program for its creativity and dedication to the arts, but it would be nice for them to also recognize the use of music by musicians who have been trained in applying it therapeutically using research-based protocols. I would like to know how other music therapists feel about this situation. I also wonder what it looks like from the outside looking in, from non-music therapists approaching a hospital with one or both programs. Maybe I am over-sensitive to the development of AIM programs or do you think that it might be confusing for a patient to distinguish music therapy from AIMS program members?

Please feel free to share you story of an encounter with music therapy or AIMS when you went to the hospital!