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I gave the keynote address at the conference of the Southeastern Region of the American Music Therapy Association in March, 2003, in Chapel Hill, NC. I was very pleased and honored to be asked to give this address, helping to open the conference which focused on interdisciplinary approaches in music therapy. Although I had not thought a great deal about this topic prior to preparing this talk, I found developing it to be very interesting, and I realized as I worked that I and all music therapists are very involved in being interdisciplinary music therapists.

This led me to call my talk "The Interdisciplinary Music Therapist." I hope some of what I developed might be interesting and useful to the readers of Voices, and have decided to share this information in this Fortnightly Column. This column is therefore adapted from the presentation that I did at the conference.

Models of Interdisciplinary Work

There are three models that might be considered to be variations of interdisciplinary approaches. They are the interdisciplinary model, the multidisciplinary model, and the transdisciplinary model. The definitions that I am using are from Faith Johnson's chapter, "Models of Service Delivery and their Relation to the IEP," in Models of Music Therapy Interventions in School Settings, edited by Brian Wilson (2002). Other definitions are also available. I know that these models may have different meanings in various countries, and suspect that this is likely. Some of them seem to be used interchangeably in the United States.¹ In spite of this lack of clarity, I will share these as a starting point.

The interdisciplinary model comes from the dictionary definition of interdisciplinary, "involving two or more academic, scientific, or artistic disciplines" (Webster's New Collegiate Dictionary, 1975, p. 602). In this model, professionals provide services in a variety of disciplinary areas; team members share goals and implementation plans with one other; and team members implement their own sections of the plan, with no crossing of professional boundaries. It is the second area, team members share goals and implementation plans with one other, that distinguishes this model from the next one, the multidisciplinary team. The interdisciplinary model is the most commonly used model in music therapy, from my experience. I believe that most music therapists prefer working within this model. Certainly some of my best experiences in music therapy have been using this model.

The second model is the multidisciplinary model. In this model, professionals provide services in a variety of disciplinary areas; each team member develops a separate plan to meet client needs; and team members implement their own sections of the plan. The way that this is different from the interdisciplinary model is in the second area, each team member develops a separate plan to meet client needs. The goals in this model are coordinated among members of the team, although they are not necessarily the same from discipline to discipline. In Europe, I believe that "multidisciplinary" may be used to mean what is referred to in the U.S. as "interdisciplinary." The topic of the 1995 European Music Therapy Conference, held in Aalborg, Denmark, was "Music Therapy Within Multi-Disciplinary Teams" (Pedersen & Bonde, 1996) and, as far as I can tell, this conference focused on the same type of cooperation that is (also) labeled "interdisciplinary." Practically, even in the U.S., people often use "multidisciplinary" interchangeably with "interdisciplinary."

In the third model, the transdisciplinary model, the work of the team surpasses individual professional identities; all team members are responsible for implementing plan; and goals are met in many settings, with team members working together throughout the process. The name for this model comes from "trans," which means "across," so this model is across disciplines. This model is used primarily in special education, perhaps mostly in working with children with severe and profound disabilities. It seems that the reasoning for using it with children with severe and profound disabilities is that these children have so many needs and need so much support that they can get these best in a setting where everyone is involved in the treatment, as with the transdisciplinary approach. I believe that it is also used in some rehabilitation settings. My experience with this approach was in a rehabilitation setting. When I was doing part-time music therapy work at Frazier Institute in Louisville, KY, many of the sessions were co-treatments. In addition to music therapy being a co-treatment with speech or physical therapy were many instances where an occupational therapist and a physical therapist, for instance, would work together in treating a patient. I believe that some of these, where they each used elements of the others' approach, would have been considered to be within a transdisciplinary model. (I think that some of the co-treatments also used an interdisciplinary model, where both therapists used their own techniques with the patient, although in the same session.) From some communication that I have had with music therapists in the U.S., I believe that the transdisciplinary approach is sometimes used without labeling it as such.

Music Therapy Compared With Other Disciplines

Music therapy has some distinct features that make it unique in the way in which it fits into an interdisciplinary or related model. Some disciplines may focus on method, some on outcome, and some on population.²

For those with a focus on method, the boundaries are defined by the method that is used. This includes music therapy and other arts therapies. The primary reason that we consider music therapy to be music therapy is that, as music therapists, we use music as our main tool, thus the boundaries of music therapy are defined by the focus on music. Similarly, the boundaries of art therapy are defined by the use of art, movement therapy by the use of movement, and so forth.

The boundaries of those with a focus on outcome are defined by the outcome or behavior that is the focus. In physical therapy, for instance, the focus is on changing physical behaviors. In speech therapy, the focus is on speech and communication, and in psychology, the focus is on changes in psychological behaviors. Thus, we see that the boundaries of these disciplines are defined by a focus on the outcome.

For disciplines whose boundaries are defined by a focus on population, the boundaries defined by the population served. The boundaries of special education are defined by the fact that special educators serve children in special education. The boundaries of the discipline of geriatrics are defined by the work of people in this discipline with geriatric clients, and the boundaries of the discipline of pediatrics are defined by the work with pediatrics patients.

Features of the Interdisciplinary Nature of Music Therapy

This interdisciplinary nature of music therapy presents some opportunities and some challenges. These opportunities and challenges could also be labeled as positive and negative aspects, or as satisfactions and frustrations of interdisciplinary work. I have divided these into three areas - that music therapists draw from other disciplines, that we train in other disciplines, and that we communicate with other disciplines - and will discuss these below.

Draw from other disciplines. On the positive side of the fact that music therapists draw from other disciplines, we have the opportunity to learn material from many disciplines. On the negative side, this can be overwhelming and we may have difficulty achieving a balance. Related to this, and on the positive side, we incorporate clinical material from many disciplines. The negative side of this is that it may be difficult to integrate material from so many areas. Personally, I have never been focused on one specialty area so have had to learn material from many disciplines. I have learned primarily through reading and occasional seminars and workshops and chose to pursue my PhD in the related discipline of educational psychology. And I have usually done clinical work in addition to my teaching. I am now in Louisville, KY, and my primary clinical work is exploring some aspects of medical music therapy. Learning material from other disciplines and incorporating material from many disciplines has had both positive and negative aspects for me. It is exciting to include material from so many other disciplines along with music. It has probably helped me a great deal in my teaching, as I can speak of music therapy with a variety of populations with some personal experience. In addition, it is stimulating and keeps me thinking and growing. On the negative side, I never feel that I come close to learning what I plan to learn and am always very busy. I also believe that it can be very difficult to integrate material from so many disciplines.

Train in other disciplines. Another feature is that music therapists often train in other disciplines. Of course, sometimes people come to music therapy after having already been trained in another discipline. In the U.S., this is not necessary although in some other countries, it is required that the person be trained in another discipline prior to becoming a music therapist. An advantage of this is that music therapists very often benefit from training in other disciplines. On the negative side, though, such training may detract from growth in music therapy because the person's energy then goes toward growing in the new discipline, or a music therapist who has been trained in another discipline may leave music therapy for the other profession. There are often questions when music therapists want to get additional training as to whether it is better to get a master's or doctorate in music therapy or a related field. Advanced training in music therapy can help to deepen music therapy skills, including clinical, research, and theoretical skills. My experience is that people who are able to keep growing in their music therapy skills stay energized and want to continue in music therapy, while those who focus on other areas to the exclusion of growth in music therapy often leave music therapy. This is obviously an advantage for people who choose to receive advanced training in music therapy.

My understanding of the reason that there were no PhD programs in music therapy in the U.S. for many years was that the knowledge base in music therapy could not support PhD study. So the recent beginning of a PhD in music therapy (at Temple University) is encouraging and, I think, reflects the advancement of our knowledge base and growth of our discipline. This is in addition to PhDs in Music Education with emphases in music therapy that have been offered in the U.S. for many years and through which many PhD music therapists have trained. It is also, of course, in addition to the PhD program at Aalborg and the program at Witten-Herdecke, both of which offer this level of training on the international level. On the other hand, advanced degrees in other professions also provide skills in those areas and can be useful and applicable to music therapy.

When I decided to get my doctorate, I chose to get my PhD in Educational Psychology. I wanted to get a degree that would give me a credential in addition to my music therapy credentials and the program that I attended (Fordham University in New York City) made me eligible for licensure as a psychologist in New York state. In addition, there were many things that I wanted to learn that I felt I could learn through a psychology program. This was an excellent decision for me at the time. I learned a great deal about (quantitative) research and became very excited about the possibilities for research and applications to music therapy research. I deepened my understanding of learning, motivation, development, and other areas that are foundational to music therapy. I also learned material and earned a degree that eventually did allow me to become a licensed psychologist. I found nearly every aspect of my PhD study to be stimulating and positive. At the time that I got this degree, I could not have made a better choice. But I did not deepen my understanding of music therapy through my study for this degree. Everything that I gained was related to music therapy but it was not music therapy. I suppose that, for the period of time in which I was deeply involved in my PhD study and the work related to it, my energy was on something other than music therapy although I did have applications to music therapy in mind. For me, this all worked out and deepened my commitment to music therapy and knowledge on which I base my understanding of music therapy. During this time, I had a lot of questions about whether I wanted to work in psychology, as a psychologist or researcher. There were appealing things to me about the possibility of a change of professions. I eventually decided to stay with music therapy. A primary experience that helped me make the decision to remain in music therapy occurred when I was working as a psychologist (part-time) at Daytop, a therapeutic community for people with drug addiction. I worked with a number of people who did not express themselves easily through words. Although the conditions of my employment made it inappropriate for me to incorporate music therapy techniques, I often wished that I were hired as a music therapist so that I could help some of the people who could not express themselves verbally to express themselves through nonverbal, musical means. This helped me to I realize that I really did want to remain in music therapy where we have such a powerful medium to help people who cannot communicate adequately through verbal means.

Communicate with other disciplines. Music therapists also communicate with people from other disciplines. On the positive side, we are enriched by our interactions with these people. This need and desire to communicate with others, though, can be problematic when we cannot interact as we would wish. In an ideal situation, whether we are members of an interdisciplinary team or one of the other models, we get to communicate with other team members - telling them about music therapy and learning what we need to from them. This can be very enriching. But there are times when we don't get to interact, either because of time or exclusions due to lack of understanding. This can be very frustrating. I have been in several clinical situations in which decisions about clients were made without my input (including decisions about discharge) or where I couldn't get access to the people that I needed in order to get the information that I needed to work. These have been very frustrating experiences. These situations, though, also present opportunities as all offer opportunities to educate others as to benefits of music therapy. In addition, dealing successfully with the challenges can enrich us personally and can also enrich our practices.

Interdisciplinary Work with Other Creative Arts Therapies

Another aspect of interdisciplinary cooperation is with our creative arts therapy colleagues, including art, dance/movement, drama, and related arts therapists. This working together can be through collaborating on clinical work, or it can be through joint projects such as research and writing. We may also incorporate techniques that we learn from other creative arts therapists into our sessions. I have not had as many of these opportunities as I wish that I had had, although recently Cathy Malchiodi, a well-known art therapist, joined the faculty of the University of Louisville where I teach, and has brought energy and enthusiasm about the possibilities of collaborating on various projects. I have had a wonderful time in our initial contacts, and they have made me aware of how stimulating our relationships with other creative arts therapists can be.

Conclusion

In conclusion, the interdisciplinary nature of music therapy challenges us to work effectively as team members, contributing to the team and educating others. We have the opportunity of growing and learning from the balance of positive and negative aspects. I hope that this column may stimulate some of the readers of Voices to consider the opportunities and challenges that their work as interdisciplinary music therapists presents.

References

Bruscia, K. (2002), The boundaries of Guided Imagery and Music (GIM) and the Bonny Method. In Bruscia, K. E., & Grocke, D. E., Guided Imagery and Music: The Bonny Method and Beyond. Gilsum, NH: Barcelona Publishers (pp. 37-61).

Johnson, F. (2002). Models of service delivery and their relation to the IEP. In Wilson, B. L. Models of Music Therapy Interventions in School Settings, Ed. 2. Silver Spring, MD: American Music Therapy Association (pp.83-107).

Pedersen, I. N., & Bonde, L. O. (1996). Reflections on the 3rd European Music Therapy Conference, Aalborg 1995. In Pedersen, I. N., & Bonde, L. O. Music Therapy within Multi-Disciplinary Teams: Proceedings of the 3rd European Music Therapy Conference, Aalborg June 1995. Aalborg, Denmark: Department of Music and Music Therapy.

Webster's New Collegiate Dictionary. (1975). Springfield, MA: G. & C. Merriam Co.

Notes

1 Some of my impressions of how music therapists use these approaches and terms comes from input that I received from participants on the Music Therapy Listserv. A number of participants in this Listserv responded to my query as to how they work with other disciplines. Their answers were varied and helped me to formulate the thoughts that I am sharing.

2 Some of my thoughts about the focuses of various disciplines are from Bruscia, K. (2002), The Boundaries of Guided Imagery and Music (GIM) and the Bonny Method. In Bruscia, K. E., & Grocke, D. E., Guided Imagery and Music: The Bonny Method and Beyond. Gilsum, NH: Barcelona Publishers (pp. 37-61).

How to cite this page

Wheeler, Barbara (2003) The Interdisciplinary Music Therapist. Voices Resources. Retrieved January 09, 2015, from http://testvoices.uib.no/community/?q=fortnightly-columns/2003-interdisciplinary-music-therapist