Thursday, May 27, 2010

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!


  1. Thanks for posting so openly about this! I believe that music therapy and "supportive music" can co-exist as long as the clear distinction is made. In fact, there is a non-profit here in San Diego called Resounding Joy that trains "joy givers" to provide "supportive music" to shut-ins and people in need. The trainers are board-certified music therapists, so it works well because in the volunteer training program, a clear distinction is made between clinical music therapy and supportive music... There must be other good examples out there.

    I also believe that Health Rhythms does a good job of making a distinction - They do NOT call their program "therapy," yet many HR facilitators oftentimes are other types of therapists or clinicians who use drumming to compliment their current practice (without calling it music therapy).

    I see how a music therapy partnership would fit in well at the U of F...

  2. Thanks, Kat! Resounding Joy is a great example of music therapists and other musicians working together!

  3. I am wondering how to get insurance to pay for music or art therapy? Do you know the billing codes?

  4. Hi Traveller,

    Thank you for asking an important question. I am sure there are many people who would also like to find this information. I have not talked much about the topic of reimbursement and do not consider myself an expert on the issue. My first suggestion would be to find a music therapist who is willing to work with you directly. Every state and insurance company is different, so even if one person is able to get reimbursement it does not mean that you can. A music therapist will be able to obtain valuable information from the American Music Therapy Association in the form of a Reimbursement book and packet that will aid them in getting the process started. You will most likely have to have a doctor's order and then work with the insurance company on using an appropriate code. The common codes for music therapy are listed in the reimbursement sourcebook that the music therapist will be able to access. There are people out there who have been able to obtain reimbursement for music therapy, but it there is no standard way to proceed and every insurance company and even plans within the company are different. Good luck and please let me know if you are successful!

    Here is a link that has some helpful resources:


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