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What is music therapy?
Music Therapy is the clinical and evidence-based use of music
interventions to accomplish individualized goals within a therapeutic
relationship by a credentialed professional who has completed
an approved music therapy program. (American Music Therapy Association
definition, 2005)
What do music therapists do?
Music therapists assess emotional well-being, physical health,
social functioning, communication abilities, and cognitive skills
through musical responses; design music sessions for individuals
and groups based on client needs using music improvisation, receptive
music listening, song writing, lyric discussion, music and imagery,
music performance, and learning through music; participate in
interdisciplinary treatment planning, ongoing evaluation, and
follow up.
Who can benefit from music therapy?
Children, adolescents, adults, and the elderly with mental health
needs, developmental and learning disabilities, Alzheimer's disease
and other aging related conditions, substance abuse problems,
brain injuries, physical disabilities, and acute and chronic pain,
including mothers in labor.
Where do music therapists work?
Music therapists work in psychiatric hospitals, rehabilitative
facilities, medical hospitals, outpatient clinics, day care treatment
centers, agencies serving developmentally disabled persons, community
mental health centers, drug and alcohol programs, senior centers,
nursing homes, hospice programs, correctional facilities, halfway
houses, schools, and private practice.
What is the history of music therapy as a health care profession?
The idea of music as a healing influence which could affect health
and behavior is as least as old as the writings of Aristotle and
Plato. The 20th century discipline began after World War I and
World War II when community musicians of all types, both amateur
and professional, went to Veterans hospitals around the country
to play for the thousands of veterans suffering both physical
and emotional trauma from the wars. The patients' notable physical
and emotional responses to music led the doctors and nurses to
request the hiring of musicians by the hospitals. It was soon
evident that the hospital musicians needed some prior training
before entering the facility and so the demand grew for a college
curriculum. The first music therapy degree program in the world,
founded at Michigan State University in 1944, celebrated its 50th
anniversary in 1994. The American Music Therapy Association was
founded in 1998 as a union of the National Association for Music
Therapy and the American Association for Music therapy.
Who is qualified to practice music therapy?
Persons who complete 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.
Is there research to support music therapy?
AMTA promotes a vast amount of research exploring the benefits
of music as therapy through publication of the Journal of Music
Therapy, Music Therapy Perspectives and other sources. A substantial
body of literature exists to support the effectiveness of music
therapy.
What are some misconceptions about music therapy?
That the client or patient has to have some particular music ability
to benefit from music therapy -- they do not. That there is one
particular style of music that is more therapeutic than all the
rest -- this is 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 and need for treatment, and the client
or patient's goals help to determine the types of music a music
therapist may use.
How can music therapy techniques be applied by healthy individuals?
Healthy individuals can use music for stress reduction via active
music making, such as drumming, as well as passive listening for
relaxation. Music is often a vital support for physical exercise.
Music therapy assisted labor and delivery may also be included
in this category since pregnancy is regarded as a normal part
of women's life cycles.
How is music therapy utilized in hospitals?
Music is used in general hospitals to: alleviate pain in conjunction
with anesthesia or pain medication: elevate patients' mood and
counteract depression; promote movement for physical rehabilitation;
calm or sedate, often to induce sleep; counteract apprehension
or fear; and lesson muscle tension for the purpose of relaxation,
including the autonomic nervous system.
How is music therapy utilized in nursing homes?
Music is used with elderly persons to increase or maintain their
level of physical, mental, and social/emotional functioning. The
sensory and intellectual stimulation of music can help maintain
a person's quality of life.
How is music therapy utilized in schools?
Music therapists are often hired in schools to provide music therapy
services listed on the Individualized Education Plan for mainstreamed
special learners. Music learning is used to strengthen nonmusical
areas such as communication skills and physical coordination skills
which are important for daily life.
How is music therapy utilized in psychiatric facilities?
Music therapy allows persons with mental health needs to: explore
personal feelings, make positive changes in mood and emotional
states, have a sense of control over life through successful experiences,
practice problem solving, and resolve conflicts leading to stronger
family and peer relationships.
Is music therapy a reimbursable service?
Medicare
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, the 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.
The music therapy must be considered an active treatment by meeting
the following criteria:
Be prescribed by a physician;
Be reasonable and necessary for the treatment of the individual’s
illness or injury;
Be goal directed and based on a documented treatment plan;
The goal of treatment cannot be to merely maintain current level
of functioning; the individual must exhibit some level of improvement.
Medicaid
As Medicaid programs vary from state-to-state, so do the Medicaid
coverage avenues for music therapy services. Some private practice
music therapists have successfully applied for Medicaid provider
numbers within their states. Some states offer waiver programs
in which music therapy can be covered. In some situations, although
music therapy is not specifically listed as a covered service,
due to functional outcomes achieved, music therapy interventions
can fall under an existing treatment category such as community
support, rehabilitation, or habilitation. Examples:
Arizona
Medicaid coverage for music therapy provided to individuals with
developmental disabilities; originally recognized as a habilitation
service but also considered as a socialization service.
Minnesota
Individual music therapist received provider number to service
clients with mental illness and developmental disabilities. Waiver
program for children with developmental disabilities provides
coverage for music therapy.
Pennsylvania
Department of Aging Waiver program allows Medicaid payment for
music therapy provided in a community based setting. Music therapy
is listed under health and mental health related counseling services.
North Carolina
Medicaid reimbursement is available for music therapy services
through the Community Alternatives Program (CAP) for clients with
developmental disabilities.
Indiana
Waiver program for children with developmental disabilities offers
coverage for music therapy.
Michigan
Music therapy is a covered service under the state’s Medicaid
Children’s Waiver Program.
Private Insurance
The number of success stories involving third party reimbursement
for the provision of music therapy services continues to grow.
Over the past twelve years a growing public demand for music therapy
services has been accompanied by a demand for third party reimbursement.
In response to the increasing demand the music therapy profession
has worked to facilitate the reimbursement process for clients
of music therapy services.
The American Music Therapy Association now estimates that at least
20% of music therapists receive third party reimbursement for
the services they provide. This number is expected to increase
exponentially as music therapy occupies a strong position in the
health care industry.
Insurance companies are recognizing the advantages of including
music therapy as a benefit as they respond to the increasing market
demand for greater patient choice of health care services. Companies
like, Blue Cross/Blue Shield, Humana, Great West Life, Aetna,
Metropolitan, and Provident have reimbursed for music therapy
services on a case-by-case basis, based on medical necessity.
Music therapy is comparable to other health professions like occupational
therapy and physical therapy in that individual assessments are
provided for each client, service must be found reasonable and
necessary for the individual’s illness or injury and interventions
include a goal-directed documented treatment plan.
Like other therapies, music therapy is typically pre-approved
for coverage or reimbursement, and is found to be reimbursable
when deemed medically necessary to reach the treatment goals of
the individual patient. Therefore, reimbursement for services
is determined on a case-by-case basis and is available in a large
variety of health care settings, with patients with varying diagnoses.
Other Sources
Additional sources for reimbursement and financing of music therapy
services include: many state departments of mental health, state
departments of mental retardation/developmental disabilities,
state adoption subsidy programs, private auto insurance, employee
worker’s compensation, county boards of mental retardation/developmental
disabilities, IDEA Part B related services funds, foundations,
grants, and private pay.
What is the American Music Therapy Association?
The American Music Therapy Association is the largest professional
association which represents over 5,000 music therapists, corporate
members and related associations worldwide. Founded in 1998, its
mission is the progressive development of the therapeutic use
of music in rehabilitation, special education, and community settings.
AMTA sets the education and clinical training standards for music
therapists. Predecessors to the American Music Therapy Association
included the National Association for Music Therapy founded in
1950 and the American Association for Music Therapy founded in
1971.
What is a typical music therapy session like?
Since music therapists serve a wide variety of persons with many
different types of needs there is no such thing as an overall
typical session. Sessions are designed and music selected based
on the individual client's treatment plan.
What is the future of music therapy?
The future of music therapy is promising because state of the
art music therapy research in physical rehabilitation, Alzheimer's
disease, and psychoneuroimmunology is documenting the effectiveness
of music therapy in terms that are important in the context of
a biological medical model.
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