Silverman Article Re: Master's Requirement - 1 views
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Graduate Entry Status for Music Therapists February 15, 2012
Preface
The author of this document commends ETAB for their dedicated work on this consequential and complicated issue. The amount of work that has gone into their decision-making and recommendations is astounding and the author acknowledges - and shares - their desire to provide greater access to quality music therapy services.
The purpose of this document is to highlight a number of potential concerns associated with the proposed Masters (MA) Entry Level Status in music therapy (MT).
This below document is not intended to be an attack on ETAB's recommendation; rather, the purpose of this document is to play "devil's advocate" and facilitate thought, dialogue, and problem solving concerning the profession we esteem. It is the author's intent to stimulate critical thought and constructive dialogue concerning the proposal. In Good to great, Collins (2001) noted the importance of thoughtful dialogue concerning what he termed "scary squiggly things" (p. 72) in making large-scale decisions. Thus, this document is intended to highlight scary squiggly things relating to ETAB's proposal. In the spirit of congeniality, the author of the current document is not taking sides or drawing a proverbial line in the sand; rather, the author is proposing issues to be addressed by the ETAB in their proposal and items that can be discussed during Town Hall meetings at regional AMTA conferences this spring. Finally, regardless of one's position in the debate concerning the proposed Masters Level Entry issue, the author of the current document reminds readers of our shared vision: To provide greater access to quality music therapy services.
Respectfully,
Michael J. Silverman, PhD, MT-BC Director, Music Therapy Program University of Minnesota silvermj@umn.edu
GRADUATE ENTRY LEVEL CONCERNS2
I. Educational Issues Influencing AMTA & CBMT Membership
A. Recruiting. Schools with an undergraduate MT program are currently able to offer a degree after approximately 4.5 years (four years of coursework and six month clinical internship). Being able to earn an income after 4.5 years is extremely attractive to prospective students and their parents.
B. Secondary admissions. Secondary admissions are a controversial issue in higher education. Secondary admissions to a MA level MT program might discourage prospective students. If there is a chance that prospective students might not be accepted to a MA program after 4 years of undergraduate work, they might be discouraged by the profession and choose to pursue another degree or career choice.
C. Length to degree. It will likely be more difficult to recruit prospective students for a six year MA degree. Maintaining adequate numbers of students - and graduating students in a timely manner - in both undergraduate and graduate programs is important for academic programs.
D. Compression of the number of professional MTs. Moving to MA entry would make the profession more exclusive. Thus, the number of professional music therapists and student music therapists would likely decrease (the number of music therapy programs would likely also decrease if universities and colleges are not able to hire two full time faculty members). Making the program more exclusive by requiring a MA to practice will likely decrease enrollments. This could make the MT field more similar to other smaller creative arts therapies. One factor that makes MT stronger than the other creative arts therapies is our larger membership (and number of schools with MT programs) and membership would likely diminish if we move to MA entry level.
E. Ability to fill current jobs. We already cannot fill all the prospective MT jobs. The ideal time for moving to an MA degree would be when there is a surplus of MTs, not when there is a current shortage of MTs, with many needed in the future (Groene, 2003).
F. MTs with advanced degrees remain in the field longer. The Vega (2010) study is interesting and the author should be commended for her significant and consequential contribution to the literature base. However, it might be considered unwise to base a large part of the rationale for the MA level entry upon results of a single paper. More importantly, we need additional MTs as indicated by Groene (2003). Although Vega found MA level MTs tend to work in the field longer, it does not necessarily mean we will be able to serve more clients. What the profession also needs is greater numbers of MTs working for longer periods, not solely MTs working longer. All professionals are at risk of changing jobs or professions. This is the natural progression of promotions and opportunities.
G. AMTA promoting additional academic programs. AMTA has been advocating for additional schools to offer MT. Thus, there is concern that universities and colleges without a music therapy program will find it much harder to hire two full time academics (for the MA level entry) than one academic in order to start a program. There is a financial dis-incentive and this will likely make AMTA's task of initiating additional MT programs more challenging.
H. Consultation with other professionals and research. We might consider whether other professions that require MA degrees currently have shortages in the number of qualified graduates entering the profession, and how this may have been influenced by the move to
requiring a master's degree (i.e., OT, PT).
I.Surplus of physical therapists during their move to MA. The move to a master's level entry requirement for physical therapists came at a time during which there was a surplus of physical therapists (Plack, 2002). There is now a shortage of physical therapists (Weiss, 2009). Music therapists number fewer than physical therapists and are already in short supply.
J. Greater numbers of clinicians can influence legislation for licensure. For many states, the cost of establishing a state licensure board is supported by the dues of licensees, making it more feasible to have a licensure board if there are more practicing music therapists in the state (Oliver, 2003). A decrease in the number of practicing music therapists could make it more difficult and more cost-prohibitive to obtain state recognition and licensure for music therapists.
K. Less experienced therapists. Approximately 26% of respondents to AMTA's annual membership survey had been music therapists for 1 to 5 years from 1998-2009 (Silverman & Furman, 2010). This group had the largest variation and tended to decline from 1998-2009. Additionally, 20% of music therapists had been practicing from 6 to 10 years with little variation over time. Review of the standard deviations in age groups 26 to 30 (SD = 3.09) and more than 30 years (SD = 3.54) indicate variation (in these cases, increases) in the percentage of music therapists who have been in the profession for these lengths of time. In general, it seems that the number of less experienced music therapists is declining. This could potentially be a result of a number of factors, such as music therapists potentially changing fields or retiring from the profession. Although Decuir and Vega (2010) investigated more experienced music therapists who had at least 10 years of clinical experience, future research concerning less experienced music therapists is certainly warranted and results may lead to finding innovative methods for retaining these clinicians. If AMTA moves to MA entry level, it may deter people from the field and the number of inexperienced therapists will continue to decline (Figure 1). Moreover, when older MTs retire, who will fill their positions? A large - and increasing - percentage of MTs are older and may be approaching retirement (Figure 2; Silverman & Furman, 2010). AMTA needs to carefully consider who will fill these jobs, especially with a decrease in less experienced and younger MTs. Moving toward MA entry status will likely deter many high school students from entering the field as working after attaining a four year degree (plus internship and board certification) is attractive to prospective undergraduate students.
GRADUATE ENTRY LEVEL CONCERNS4
40 30 20 10
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
1-5 years6-10 years 16-20 years21-25 years more than 30 years
11-15 years 26-30 years
Figure 1: Percentages of AMTA members - years in profession
35 30 25 20 15 10
5 0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Under 2020-2930-3940-49
50-5960-6970 & over Figure 2: Percentages of AMTA members by age group
II. Committee Concerns
A. Educational pedigree make-up of ETAB. It seems as though all ETAB committee members have at least a MA degree (and often a PhD). While the author of this document recognizes ETAB did not choose its members, would BM level MTs have a concern about their lack of representation on this committee?
B. Educational background of ETAB. In observing the educational pedigree of committee members, it does not appear to be a well-rounded committee. Again, the author of this document recognizes ETAB did not choose its members. However, many of them studied at the same institutions, often concurrently. For a consequential decision such as MA entry level, we need a well-rounded and diverse committee with differing opinions to stimulate critical thought, dialogue, and inquiry. Please understand that this concern is neither the fault nor the responsibility of ETAB.
C. Leading with answers and not questions. When presenting the decision to move to MA level entry to the Assembly of Delegates, ETAB seemed to have made their decision without consultation or Assembly input. Collins (2001) noted the importance of leading with questions rather than leading with a decision already made. According to Safire (2004), groupthink is the type of thinking that occurs when a group attempts to minimize conflict, improve cohesiveness, and reach a consensus without testing, analyzing, and evaluating ideas. Henningsen and colleagues (2006) noted that groups should take time to examine the positive and negative consequences of decisions. Moreover, when anticipating potential positive and negative consequences is not done, the quality of the decision may suffer. Thus, more time and debate should occur on this consequential issue in order to anticipate potential advantages and disadvantages associated with the proposed change. Perhaps AMTA could conduct a survey of the membership - and related professions - to further understand how and if BM level therapists are not being considered for clinical positions because they do not have a master's degree. Perhaps an outside consultant (who has experience with higher education music programs) would be able to provide an unbiased, professional, and data based approach to stimulate discussion and decision-making. Perhaps ETAB might consider surveying AMTA membership (including undergraduate students), university administrators, clinical training directors, and MT faculty. These data seem vital for such a consequential decision.
III. Faculty Load Concerns
A. Professional MA degrees. It seems as though the ETAB's rationale for MA entry level was due to clinical and not research reasons. Thus, if a professional MA (versus a research MA) degree is sought, who will teach these classes? Faculty members receive load credit for teaching actual classes, but load credit is sometimes not associated with thesis writing or advising. Thus, professional MA degrees might cost universities more funds than a research based MA degree because schools will have to hire extra faculty to teach professional MA classes.
B. ETAB's lack of discussion concerning faculty load. There was no mention of load at all and, unfortunately, load tends to drive many decisions in higher education. Moreover, load issues are not something to be dealt with after the change to MA entry-level status has been made. This consequential issue warrants attention before any decisions are made. We will certainly need the support of administrators and NASM to implement these changes and we should consult with them and utilize their input to make the transition as smooth as possible.
C. Research MA Degrees. Directing a MA level thesis is a considerable amount of work and takes an experienced faculty member (as well as other experienced faculty members who make up the thesis defense committee). Do we have enough of these people in our field? If the ETAB's rationale concerns MT clinical practice, should a clinician be forced to study research and take additional research courses rather than clinically based courses?
D. Hours in MA degree. If additional MA level courses are required (more than the 30 required hours), schools may have to hire additional faculty members to cover this additional load.
E. Practica instructors and MTs in the community. How might this potential change affect practica instructors? Will practica instructors have to supervise greater numbers of students as students are in school longer? Many practica instructors are not paid to supervise university students. Practica instructors typically volunteer their time and already have many clinical and facility responsibilities. Is it fair to place an additional burden and workload on practica instructors?
F.MTs with a professional MA degree would be at a disadvantage concerning teaching in higher education. If persons obtain clinically focused MA MT degrees, then degree holders will not necessarily be ready for teaching positions in higher education (i.e., higher education issues, research, teaching, recruiting, administration). How might we separate these degrees and prepare MTs for clinical practice, research, and teaching?
IV. Fiscal Concerns
A. De-emphasis on graduate education in state universities. Many (but not all) state universities are decreasing the sizes of their graduate programs as graduate programs are often more expensive and have smaller numbers of students. Graduate programs are typically smaller than undergraduate programs and thus cost additional resources.
B. Emphasis on undergraduate education in state universities. There is a movement toward increasing undergraduate enrollment at land grant and state institutions. Some universities make more money on undergraduate students (i.e., the University of Minnesota), providing a financial incentive for higher undergraduate enrollments.
C.Hiring an additional faculty member as mandated by AMTA. Due to the unfortunate economic times, many universities are looking to cut program in an attempt to save money during an unprecedented time of economic hardship. If AMTA mandates MA entry status, universities may not be able to hire the additional and necessary faculty. At the University of Minnesota (MT program started in 1972), it took 36 years (and an interim director who had nothing to lose) to hire a 2nd full time MT faculty member.
D. Undergraduate and graduate MT programs currently approved by AMTA. There are 71 schools in US and Canada with an undergraduate MT program; 36 have a MA program (AMTA, 2010). The 35 schools without a MA program (Appendix A) could be forced to hire another full-time faculty member that would result in additional costs to the university. Who is going to pay for this? In the current economic climate, universities are looking to cut programs and thus save money. Thus, the 35 schools without a MA program could be at risk of losing their programs and not being able to start a MA program.
E. Emphasis on completely funding all graduate students. Many universities want to completely fund graduate education. Thus, graduate students would not have to pay for education.While this funding may seem initially attractive, these students need to be
GRADUATE ENTRY LEVEL CONCERNS7
able to offer the university something in return for their assistantship (such as teaching Introduction to MT). This represents a potential problem for MTs at graduate level entry as these graduate students would be "un-fundable" - they have no skills for research, clinical practice, would not be able to supervise, and have no teaching or clinical experience. How might schools justify paying for graduate MT students' educations?
F. Graduate admission caps. Many schools have a cap on graduate admissions. At the University of Minnesota, Silverman is allowed two to three graduate students per year. (Three graduate students in 2010 and two in 2011.) Can we keep expanding the number of professionals with these kinds of graduate matriculation caps in place at some schools?
G. High school music programs. High school music programs are also diminishing and many are moving to an after-school model. Will these students be able to successfully audition for an MA degree? Will they have the necessary music skills to compete against other MA students (including MA and DMA performance students) for instructors' studios? Studio space in higher education music program remains at a premium and music therapy majors often compete against DMA and MA performance level applicants.
H. Employers might not be able to increase MTs salaries. Employers will not necessarily pay MTs more if AMTA moves to MA entry status. Employers have also been hurt by the economic downturn and are looking to save money wherever they can. Asking employers to pay MTs more for the same job MTs had been doing with an undergraduate degree seems counterintuitive. Moreover, we cannot expect employers to change what they ask MTs to do in clinical practice. MT might already be at a disadvantage as other practitioners who utilize music (i.e., music thantatologists and harp therapists) may not require as high a salary as MTs. Hospitals would thus be able to pay less for one of these practitioners than they would for a MT.
I.The impact of the economic downturn on higher education. Due to the current economic situation, universities are rethinking how they fiscally operate. This is a dangerous and uncertain time to be advocating for the hiring of additional faculty members to run a MA program. Moreover, the shift in fiscal thinking at the university level will likely be permanent. Many scholars and economists have noted this recent recession is a different type of recession and the cuts universities have endured will likely be permanent (Figure 3; source: http://www.crgraphs.com/).
Figure 3: Job losses in recent recessions
J.More students in fewer classes. There is an emphasis in universities on filling classes - separating BM and MA MT majors will not help this issue, resulting in additional classes and thus higher costs to universities. Class sizes will be smaller and universities may cancel those classes that do not "make" (i.e., have a certain number of students in the class or it is cancelled).
K. Increasing tuitions. Tuitions are rising due to previously allocated state funds being diverted from higher education. Higher education is becoming increasingly expensive and - for fiscal reasons only - the less time a student remains in school, the better. Will a MT be able to pay off their student loans based from her or his salary as a MT?
L.Music therapists with the "expressive arts therapist" title have lower salaries than any other job tile. In a recent paper studying music therapists' salaries from 1998-2010, the authors found that music therapists who had the "expressive arts therapist" tended to have the lowest salary (Table 1, Silverman, Furman, Leonard, Stephanz, & McKee, 2011). Art and Dance/Movement therapists, who practice at the MA level, are considered expressive arts therapists. Therefore, having a MA degree may not necessarily increase income.
Table 1
Descriptive Data - Salary by Job Title
Job Title
Activity Coordinator/Director Activity Therapist Case Manager Clinical Therapist
Creative Art Therapist Director/Administrator/Supervisor
Faculty Music Educator Music Specialist Other Recreation Therapist Rehabilitation Therapist Self Employed Special Educator
V. Implementation Concerns
MeanSD
38064.00 34788.08 41932.44 50633.33 46348.62 48526.08
52429.08 42100.31 47880.38 38913.00 38876.46 41278.69 45556.77 43070.80
6006.94 4460.20 9410.25 9968.58 7185.11 6103.68
5654.40 5953.69 6083.94 7450.09 7101.44 7370.17 5496.89 8415.79
1998
29629 28486 25167 39000 32885 38318
45378 33929 37875 31045 28300 32192 41286
2010
45063 38370 49250 55600 55136 56276
61570 50259 56714 43542 49167 54677 44892 34000
Expressive Arts Therapist
33887.89
5196.63
28857
43800
A. Little plan of how to implement change. ETAB seemed to be focused on passing the change, then dealing with how to change. This approach seems problematic - complications and issues will certainly arise that would benefit from a priori discussion. As a larger group, we need to anticipate potential problems and identify potential solutions before we make the decision. There needs to be significant dialogue and problem solving concerning these consequential pedagogical and fiscal ramifications.
B. Current BM level MT practitioners. Would the profession "Grandfather" BM level people in so they could continue to practice? How might employers view this transition if they already have a BM level MT? We cannot make these decisions after we approve the change - these decisions are far too consequential. Additionally, MTs with a BM degree may be at a disadvantage if they try to change jobs as employers may choose to hire MA level practitioners instead of experienced BM practitioners.
C.Affiliate MT programs; Transferring/Graduating from a BM in MT at one university to a MA in MT at another university. University programs often do not align well (MT programs have considerable autonomy) and the ETAB's affiliated institutions idea could be problematic - students might miss certain material or receive duplicate material if they change programs. Affiliations between university programs are complicated and can be problematic (i.e., admission criteria, tuitions, loads, prerequisites).
D. Current NASM program requirements. There are no MA entry-level music degrees. The MT field does not want to be an exception - administrators typically do not like exceptions. Has NASM been consulted concerning ETAB's proposal?
E. Time to degree. How long would attaining a MA degree take? MA equivalency (EQ) programs at the University of Minnesota are typically 2 years, plus internship, plus thesis. This program seems to work well and Silverman is able to recruit more students than he can admit (14 prospective students in 2011 for two or three spots). But if attaining a MA degree takes longer, we will likely lose recruits.
F. Why is ETAB making this change? What is it that we want? Why are we making this change? Do we want more respect? Do we want reimbursement? Art and dance therapists (MA) do not seem to have additional respect or reimbursement even though they practice at the MA level - licensure and state recognition may be an answer, not changing our entry status. Physical therapists (who have a greater membership and earn more income than MTs) have changed their entry level from bachelors to masters and then from masters to doctoral in an effort to achieve recognition from the medical field. Can MT afford to follow in PTs footsteps, especially with a much smaller membership and fewer financial resources?
G. Consultation with other professions that have moved to MA entry level. ETAB might consider studying timelines that other professions have followed in moving ahead with implementation of master's degree entry level.
H. Concerns stemming from PT. The American Physical Therapy Association (APTA) debated the move to master's level entry for 20 years before implementation (Plack, 2002). An examination of factors that necessitate a lengthy transition in degree requirements should be conducted when developing a realistic timeline for implementation.
I.Approval process. How will AMTA and NASM handle approving new MA programs? If this change is made, there may be a large number of schools applying for new MA programs. As this could result in a tremendous amount of work that needs to be completed in a very short time. How does ETAB propose dealing with this challenge?
J.MAs teaching instead of PhDs. If the change to MA entry-level status is made, universities may be forced to hire MA level instructors due to time constraints and lack of qualified applicants. MA professors may be at a disadvantage in higher education as they may not be able to teach the necessary research courses or supervise MA level theses. Moreover, at some institutions, MA professors may not be able to work toward tenure as only PhD level professors are able to be considered tenured or tenure-track faculty.
VI. Pedagogy Concerns
A. Musical development specific to music therapy. If we move to a two-year MA EQ (academic coursework) type program, this will likely limit the amount to time for students to develop musically. Currently, MT students have four years to prepare and become more musically mature. A two-year program could hurry musical maturation and we cannot expect other BM or BA programs to give students the music skills they need (due to the emphasis on classical training in most universities). Other music departments, schools, or colleges without a MT program will not necessarily change their curricula to accommodate music therapy. If ETAB contends that a 4 year BM in MT degree has too much material to adequately cover, how will we teach this material - in addition to MA research courses, graduate electives, and other graduate level requirements - in a shorter time period?
B. Expansion of the field and profession. The ETAB noted that the MT field has expanded. However, all other fields have expanded as well - this is the nature of professions and research.
C. Comparison to teaching and nursing professions. Perhaps ETAB could consider comparing MT to nursing and teaching (as both fields practice at the Bachelor level). These practitioners are respected due to the size of their membership, state recognition (often a license), and their ability to do their jobs competently. We do not "look down upon" these professionals due their four-year degrees.
D. Pedagogical advantages of a traditional four-year degree program. A four-year degree program has pedagogical advantages, especially for undergraduate students who may not be as emotionally mature. Ideally, students have time to first learn about, then observe, then co-lead, then lead MT sessions. Unfortunately, MA EQ students are typically not afforded this luxury. They are "thrown to the wolves" in their first semester - they are often expected to learn to play the guitar and lead sessions within their first week of school. While not ideal, it is the reality of these degree programs.
E.What is being taught in graduate MT programs? Will a graduate education strengthen the clinical skills of a MT? Yes - but graduate degrees tend to be more focused on research, scholarship, and teaching. Clinical practice will undoubtedly improve, but likely not by a noticeable difference, especially without bachelor level work experience.
F. Experience versus education. Experience is often the great equalizer, not education. We all know excellent BM level MT practitioners. Many undergraduate students even surpass the clinical skills of their academic mentors. We should celebrate this accomplishment and recognize the importance of clinical experience.
G. MT-BC Examination. ETAB noted that higher percentages of students failing MT-BC exams may be associated with BM level entry. Perhaps it is their instructors' faults for not providing them the knowledge they require to pass the exam. Undergraduate MTs from the University of Minnesota have been consistently passing their exams on their first attempts. Before assuming that the number of examinees who do not pass the CBMT exam on their first attempts is representative of the quality of undergraduate training programs, an analysis of the variation in the pass-rate between degree levels (BM vs. MA) needs to be conducted.
H. Do many MTs really need a MA degree? The greatest percentage of MTs work in geriatric settings (Silverman & Furman, 2010). These are often large group settings - not intensive individual psychotherapy. Do these clinicians really need advanced degrees for group-based work with older adults?
I.Private practice and university business classes. As private practice has been (AMTA, 2010; Silverman & Furman, 2010; Silverman & Hairston, 2005; Wilhelm, 2004) and continues to be a large area of clinical practice, undergraduate business courses constitute an important learning objective for music therapy students. Often, MA students do not receive credit for undergraduate courses. Would MA MT students be allowed to take undergraduate business courses? Would they receive credit or be allowed to utilize financial aid for courses outside of their degree programs?
J.Work experience. Many people work before they go back to school for a graduate degree. These students tend to "get more out of" their graduate work as they can relate their work experience to the course material. If we move to MA entry status, students will not be able to reap the benefits of relating and generalizing course material to work experience.
VII. Physical Therapy Comparison Concerns
A. Salaries of physical therapists. The median salary for physical therapists with less than three years' experience is $60,000. It rises to $70,000 with four to six years' experience and $86,000 at more than 16 years (Weiss, 2009). Thus, PTs have considerably higher salaries than MTs and ETAB's comparison of MT to PT may not be justified.
B. Comparing MTs to PTs. Music therapists do not earn as much money as PTs or OTs (Silverman, Furman, Leonard, Stephanz, & McKee, 2011). It is unrealistic to believe that employers will pay MTs more with MA entry level. As tuitions continue to escalate, how will students pay off their debts associated with attaining an MA degree? Without the promise of a high salary, will we be able to recruit students to MA MT programs?
C. Problems with entry level degree shifts. As a result of changes in PT, there are numerous entry level degrees, including: BA, BS, MA, MS, MPT, and DPT (Weiss, 2009). This results in confusion for employers and, if MT chooses the MA entry-level option, could possibly detract from the MT-BC we have worked so hard to establish and recognize.
D. Reduction in physical therapy programs due to higher entry level requirements. Elevating the requirements for PT will reduce proliferation of programs (Weiss, 2009). This could also affect minority recruitment - both of these consequential issues are concerns for AMTA.
E. Facilities hiring 1 PT and many exercise specialists. Currently, many hospitals hire 1 PT and then many exercise specialists or physical therapy assistants (as they are less expensive than a PT). PTs only assess and write treatment plans and are not actually treating patients. This could happen to MT - hospitals could potentially hire 1 MT to assess and write treatment plans, using volunteers or lower paid music people (i.e., the Society for Arts in Healthcare's new training program) to provide "treatment" to patients.
F. Decrease in Canadian PTs due to move to MA level. Since the move to the MA level in Canada, there are fewer PT graduates (Landry, Ricketts, & Verrier, 2007).
VIII. Reasons for Change to MA Entry Status Concerns
A. Access to Medicare and Medicaid funding. Having a MA may not necessarily increase MT access to Medicare and Medicaid funding. As individual states control how these funds are allocated, perhaps licensure (licensure is done by state) would increase MTs ability to serve populations who may receive these benefits.
a.Medicare funding: Reimbursement seems directly linked to demonstrating and defining medically necessary. Licensure of Board-Certified Music Therapists would help with both defining and regulating our scope of practice. Through licensure, states would be able to acknowledge that MT-BCs provide services that are proper and needed for diagnosis or treatment of medical conditions, are provided for the diagnosis, direct care, and treatment of a medical condition and meet the standards of good medical practice in the local area (Simpson & Burns, 2004).
b. Medicaid funding: Simpson and Burns (2004) recommend that MT-BCs review any and all state regulations that could affect the ability of a music therapist to provide services, including determining requirements that all providers be recognized by the state. This statement seems to direct one towards licensure, not necessarily MA entry. State licensure defines and regulates an occupations scope of practice, while acknowledging their title (i.e. MT-BC). Individual state licensure, not entry-level MA, may allow for this.
B. Respect. There has been an argument that hospitals do not respect BM level MTs. This argument is unsubstantiated as there are no data supporting this argument. Anecdotally, Silverman worked in a variety of hospitals (with a variety of degrees) and has noted staff tend to judge people based from the job a person accomplishes (i.e. behaviors), not by one's education. We all know people with undergraduate MT degrees that are absolutely amazing clinicians. These clinicians should be celebrated and their mentors should be commended.
C. Growth versus arrival. Therapists never "arrive," even if they attain a higher degree. Therapists are in a continual state of growth. Moving toward MA entry status will not ensure that therapists "arrive" at a higher competency.
D. Comparisons to PT, OT, and ST. ETAB contended that MT would be similar to PT, OT, and ST. The author of this document disagrees; MTs will be compared to Art and Dance Therapists, who practice at the MA level and have considerably smaller organizations (likely due in part to MA entry level).
E. Nursing and teaching. What would happen if teaching and nursing (both four year degree programs) moved to MA entry status? Would these professions lose recruits and contract due to a more exclusive entry status? These are questions ETAB might consider.
F. Advanced competencies. MA entry may take attention and recognition away from advanced competencies we have worked so diligently to create.
G. MT-BC. MA entry may take attention away from the MT-BC credential. Potential employers may focus on the degree and not the certification. Employers might consider a person with a non-MT master's degree to be a competent MT.
H. How long before a PhD in MT is considered the entry-level degree? If MT moves to an entry level MA, what is next? An eventual move to PhD? (This is what has happened in PT - the profession moved to a MA entry in 1999 and is now moving toward a PhD entry level [Plack, 2002]).
I.Licensure. Perhaps we need to investigate whether other professions required state licensure at the time of the move to master's entry level and consider whether requiring a MA to practice music therapy will influence the ability of states to move toward licensure. It might be helpful to consider whether a potential shortage of music therapists could increase the practice of hiring of non-music therapists. Arts in healthcare volunteers, music thantatologists, harp therapists, and others could potentially step in to fill the potential shortage in music therapists. Thus, a focus on increasing recognition and regulation of Board-Certified Music Therapists, before pursuing MA entry, may be the preferred path. The lack of recognition of the MT-BC credential and/or lack of licensure in many states makes this an important consideration.
J.MA versus licensure in PT, OT, and Speech Language Pathologists. Other related health- care professions, including physical therapy, occupational therapy, and speech-language pathology, have waited until after establishing practice acts and licensure in the majority
GRADUATE ENTRY LEVEL CONCERNS14
of states before moving to a master's entry level requirement. All of these professions have established assistant-level positions that do not require a master's degree to practice. This was done in recognition of the fact that requiring a master's degree to practice would decrease the number of certified therapists. These professions have a greater number of practicing professionals and approved graduate programs than the creative arts therapies, although a shortage of PTs, OTs, and SLPs remains a problem nationwide.
K. Licensure before MA entry level. Other professions (PT, OT, SLP) that have greater recognition, larger workforces, and higher salaries had state practice acts and licensure for at least twenty years before requiring a master's degree to practice. Rushing to require a master's degree before our profession is more widely recognized at the state level might be a mistake that could potentially cost the MT profession in terms of numbers/population. With a smaller workforce, creating state licensing boards will be much less feasible and more expensive for practicing music therapists, since the cost of setting up a licensing board is often spread out among the membership of licensed professionals within the state.
L. Music therapy clients. How might MA level entry effect MT recipients? There is concern regarding the lack of emphasis concerning music therapy recipients in ETAB's report/recommendation. It might be helpful to include "music therapy clients" in the analyses of potential costs and benefits to stakeholders. Careful consideration of whether the proposed move to MA entry status will really increase access to quality music therapy services is warranted. The impact of potential shortages of music therapists on clients should be considered.
M. The need for additional data. Has any researcher conducted a survey of prospective MT students or current MT undergraduate students asking whether they would choose/would still have chosen music therapy as a profession if they knew they would need a master's degree to practice? Has any researcher conducted a survey of whether facilities employing bachelor's level music therapists would pay more if their employees had attained master's degrees? The move to a master's level entry requirement might appear to be a knee-jerk reaction based on what other professions have done, without careful analyses of how the decision has affected other professions or analyzing how our profession is different from other professions that have made this move.
N. Music therapy in every state. There are currently 10 states that have a music therapy program within the state but do not have an MA program in the state (Alabama, Kentucky, Mississippi, North Dakota, Oklahoma, Oregon, South Carolina, Utah, Washington, and Wisconsin). We could potentially lose education and training in these states if these schools are not able to hire a second full time faculty member or initiate a MA program. Additionally, attaining licensure bills in these states would be difficult without academic training programs.
O. MTs taking administrative or non-music therapy positions. It is natural for people to be promoted when they demonstrate competency in their current jobs. As such, many music therapists are promoted to administrative positions wherein they earn more money and have greater responsibilities. While this decreases the numbers of MTs, it might be perceived as a testament to the current training MTs receive: Employers feel that MTs are competent and ready for additional responsibilities. This is an organic type of progression all competent professionals might encounter.
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P.MT is not broken. There are so many things in our profession (and in the educational training of music therapists) that work exceptionally well. What exactly is "broken" about what we are doing that we think we can "fix" by moving to a master's level entry requirement? Have we thoroughly assessed other possible solutions before deciding to make such an enormous change? If, after a thorough analysis, it appears moving to a master's entry level will be the most beneficial option, the timing of such a decision should be carefully considered and not rushed.
IX. Student Debt Concerns
A. Student debts. We cannot pass the burden of this enlargement/increase in education to students when they will likely not make more money by attaining an MA. Students graduate with too much debt already and higher education is becoming increasingly more expensive.
B. MT Employers will likely not pay MTs more. We cannot assume that MT employers will pay MTs more with MA entry-level status. How will students pay off six or more years of higher education debt on a MT salary? This could potentially hurt AMTA membership.
C. Working as an MT-BC before finishing the MA. Currently, MA students can take their MT-BC exams and begin working without actually finishing their degree (typically a thesis). However, a move to MA entry level would prohibit students from working until after they complete the entire degree plan. Thus, it could take longer before students are able to work. MTs might lose jobs as a result as other therapists could fill these MT positions.
X. Timing Concerns
A. MA entry level someday. Perhaps there will be a day for MA entry-level status. But perhaps it would be preferable for MTs to follow the lead of nursing and teaching professions, not art and dance therapists. This is hardly the time for these arguments; arguments that will cost a lot of money and could dramatically reduce the number of MTs (and thus reduce the number of MT recipients). We need to ask the question: "Who will pay for this?" These changes are not free and come at great cost during an unprecedented time of economic hardship and uncertainty. MA entry level will undoubtedly cost universities and students additional financial resources.
B. Licensure. Would it be better to work on issues related to registry and licensure? These seem to be the keys to funding and AMTA/CBMT are currently "on a roll." If the end goal is respect, then perhaps licensure is the key (as it is in education).
C. Time to degree. "Time to degree" is a current "buzz word" in higher education. Universities are seeking ways to reduce the number of courses and credit hours required for graduation. MTs in higher education need to be careful about how they approach this issue of making the MT degree "bigger" - lengthening degrees could result in programs being cut.
D. Shortage of MTs and need for additional MTs. There is currently a shortage of MTs and this shortage will likely grow (Groene, 2003). When PT made the move to MA entry in
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1999, there was a surplus of PTs (Plack, 2002). The time for a move to MA entry is not when there is a shortage; it should be when there is a surplus.
XI. Undergraduate MT Programs Concerns
A. All MT programs would seem to be MA Equivalency (EQ) programs. With proposed changes, it seems as though all programs might appear as MA EQ programs. Would the Introduction to MT class be eliminated as it is not needed in graduate level education? This course often functions as a "money maker" for many schools (at UMN, we offer it both semesters and allow non-MT students to enroll [i.e., 30 students each semester = FTE!]). With proposed changes, Silverman would remove this course from the MT curriculum at UMN. Moreover, Introduction to MT is a great recruitment tool (at UMN, we tend to recruit 3-5 students per semester from the Introduction to MT class); Losing the Introduction class could potentially hurt advocacy and recruitment.
B.Fiscal concerns from Introductory MT courses. If Introduction to MT courses are decreased or eliminated, this could potentially affect AMTA's earnings on Davis, Gfeller, and Thaut's (2008) Intro to MT text.
Thank you for your careful consideration of these issues.
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References American Music Therapy Association. (2010). Member sourcebook. Silver Spring, MD: Author.
APTA (2011). Physical therapist (PT) education overview. Retrieved from www.apta.org/PTEducation/Overview/.
Collins, J. (2001). Good to great: Why some companies make the leap...and others don't. New York: Harper Collins.
Davis, W. B., Gfeller, K. E., & Thaut, M. H. (2008). An introduction to music therapy: Theory and practice (3rd ed.). Silver Spring, MD: American Music Therapy Association.
Decuir, A. A., & Vega, V. P. (2010). Career longevity: A survey of experienced professional music therapists. Arts in Psychotherapy, 37, 135-142.
Groene, R. (2003). Wanted: Music therapists: A study of the need for music therapists in the coming decade. Music Therapy Perspectives, 21, 4-14.
Henningsen, D. D., Henningsen, M. L. M., Eden, J., & Cruz, M. G. (2006). Examining the symptoms of groupthink and retrospective sense making. Small Group Research, 37, 36- 64.
Landry, M. D., Ricketts, T. C., & Verrier, M. C. (2007). The precarious supply of physical therapists across Canada: Exploring national trends in health human resources (1991 to 2005). Human Resources for Health. Retrieved from http://www.biomedcentral.com/content/pdf/1478-4491-5-23.pdf.
Oliver, S. (2003). Certification vs. licensure: What are the differences? BC Status. Downington, PA: Certification Board for Music Therapists.
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Plack, M. (2002). The evolution of the Doctorate of Physical Therapy: Moving beyond the controversy. Journal of Physical Therapy. Retrieved from http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/69169.
Safire, W. (2004). The way we live now: On language-groupthink. Retrieved from http://www.nytimes.com/2004/08/08/magazine/the-way-we-live-now-8-8-04-on- language-groupthink.html?ref=onlanguage
Silverman, M. J., & Furman, A. G. (2010, November). Employment trends in the American Music Therapy Association, 1998-2009. Poster session presented at the 12th annual meeting of the American Music Therapy Association, Cleveland, OH.
Silverman, M. J., Furman, A. G., Leonard, J., Stephanz, E., & McKee, R. (2011, November). Music therapy salaries from 1998 - 2010: A descriptive and comparative study. Poster session presented at the 13th annual meeting of the American Music Therapy Association, Atlanta, GA.
Silverman, M. J., & Hairston, M. J. (2005). A descriptive study of private practice in music therapy. Journal of Music Therapy, 42, 262-271.
Simpson, J. & Burns, D. S. (2004). Music therapy reimbursement: Best practices and procedures. Silver Spring, MD: American Music Therapy Association.
Vega, V. P. (2010). Personality, burnout, and longevity among professional music therapists. Journal of Music Therapy, 47, 155-179.
Weiss, T. (2009). Where the jobs are: Physical therapist. Retrieved from http://www.forbes.com/2009/06/04/jobs-physical-therapy-leadership-careers- employment.html.
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Wilhelm, K. (2004). Music therapy and private practice: Recommendations on financial viability and marketing. Music Therapy Perspectives, 22, 68-83.
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Appendix A AMTA Approved Colleges and Universities without a MA Program (AMTA, 2010)
1.University of Alabama 2.Cal State Northridge 3.University of Georgia 4.Western Illinois University 5.Indiana-Purdue University Fort Wayne 6.University of Evansville
7.Wartburg College 8.University of Louisville 9.Anna Maria College 10. Berklee College of Music 11. Eastern Michigan University 12. Augsburg College 13. Mississippi University for Women 14. William Carey University 15. Molloy College 16. SUNY - Fredonia 17. East Carolina University 18. Queens University of Charlotte 19. University of North Dakota 20. Cleveland State University 21. SW Oklahoma State University 22. Marylhurst University 23. Duquesne University 24. Elizabethtown College 25. Seton Hill University 26. Slippery Rock University 27. Charleston Southern University 28. Converse College 29. Southern Methodist University 30. University of the Incarnate Word 31. West Texas A&M University 32. Utah State University 33. Seattle Pacific University 34. Alverno College 35. University of Windsor