[Research]

Profile of Community Music Therapists in North America: A Survey

By Sandra L. Curtis, Concordia University

Abstract

This study surveyed music therapists (682 respondents from 1,890 survey recipients) to examine their experiences in terms of reported perceptions of their situations, their practices, their approaches, and their personal, work, and family concerns. A first report from this survey (Curtis, 2013) looked at the experiences of present-day music therapists in Canada and the United States. This follow-up report examines the experiences of those survey respondents who self-identify as community music therapists (103 of the 682 survey respondents). Of those respondents, 13.6% were men and 86.4% were women. Canadians accounted for 18.4% and respondents from the US accounted for 81.6%. From among the entire 682 respondents, significantly more Canadians (55.4%) self-identified as community music therapists in comparison with their US counterparts (15.3%; p < .05). Quantitative and qualitative analyses provided information concerning Canadian and US Community Music Therapy respondents in terms of their: demographic information; education and work situations; personal, family, and work concerns; perceptions of discrimination; and theoretical orientations. Emerged themes from the qualitative analysis of respondents’ thoughts on Community Music Therapy included: firm identification; identification with a caveat; community building/belonging; drawing from Community Music Therapy principles; formal track record; reducing stigma; and working with groups. A need for future research (e.g., surveys, interviews, auto-ethnographies, etc.) into the profiles of community music therapists practicing in other parts of the world was highlighted.

Keywords: community music therapists; profiles; professional identity; lives; practices; Canada and the United States of America; survey research

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Introduction

Community music therapy (CoMT) represents a relatively new trend in the field of music therapy (Aigen, 2012; Stige & Aarø, 2012). Stige & Aarø (2012) note that earlier roots of CoMT can be identified in the 1960’s through 1980’s work and writings of such geographically diverse music therapists as Florence Tyson, Edith Boxill, Carolyn Kenny, Even Ruud, and Christoph Schwabe. Other music therapists may have also been incorporating CoMT concepts within their own practice as part of this grassroots movement (Curtis, 2012; Stige, 2015). It was not, however, until the turn of the century that there emerged a cohesive burst of activity in terms of international discourse and writings concerning the theory and practice of CoMT as it is understood today. In 1998, Bruscia included an introduction to CoMT in his Defining Music Therapy, with Ansdell (2002) and Stige (2002) providing some of the first indepth accounts of CoMT practice. Stige (2015) noted that Ansdell’s (2002) Community Music Therapy and the Winds of Change was one of the most influential CoMT publications of the time. Stige followed in 2003 with a detailed description of the development of CoMT theory, practice, and research in his doctoral dissertation. These stimulated considerable interest, animated discourse, and writings internationally in forums such as Voices, the 10th World Congress of Music Therapy in Oxford, and elsewhere (Ansdell & DeNora, 2012; Curtis & Mercado, 2004; Edwards, 2002; McFerran & O’Grady, 2006; Pavlicevic & Ansdell, 2004; Ruud, 2004; Stige, 2004a & b & 2015; Stige, Ansdell, Elefant, & Pavlicevic, 2010; Vaillancourt, 2007 & 2010). Ansdell underscored the importance of the discourse and its underlying grassroots nature:

Circumstances behind the shared invention of the concept of CoMT illustrate the idea that knowledge, authorship and professional development are often better thought of as distributed and plural rather than individual and private. (Ansdell, 2014, p. 42)

While the discourse was international, it was predominantly situated outside of North America. In 2012, Stige & Aarø authored An Invitation to Community Music Therapy—a comprehensive text detailing the theory and practice of CoMT around the world. Stige & Aarø noted that, as European writers, they purposefully chose an American publisher to enhance the book’s global outreach.

With all of these philosophically diverse thoughts and writings on CoMT, it becomes clear that there can be no single definition. Stige and Aarø (2012) contend that defining CoMT is a complex and multifaceted process because of the diversity of contexts and cultures in which it is practiced. Ansdell (2002) adds further that this challenge is a good thing, as it is inherent in the very nature of CoMT, encouraging an understanding in context.

[CoMT] is a different thing for different people in different places. Otherwise it would be self-contradictory. You can’t have something which is context and culture sensitive but which is a one size fits all anywhere model. (Pavlicevic & Ansdell, 2004, p. 17)

Rather than having a single, unified method or theoretical framework, CoMT represents:

an approach to working musically with people in context, acknowledging the social and cultural factors of their health, illness, relationship, and musics. It reflects the essentially communal reality of musicing and is a response both to overly individualized treatment models and to the isolation people often experience within society. (Ansdell, 2002)

Stige (2003) contends that while less succinct, a longer, more elaborate definition is necessary to capture the complexities of CoMT. He provides a three-level definition:

Community Music Therapy as an area of professional practice is situated health musicking in a community, as a planned process of collaboration between client and therapist with a specific focus upon promotion of sociocultural and communal change through a participatory approach where music as ecology of performed relationships is used in non-clinical and inclusive settings.

Community Music Therapy as emerging sub-discipline is the study and learning of relationships between music and health as these develop through interactions between people and the communities they belong to.

Community Music Therapy as emerging professional specialty is a community of scholar-practitioners with a training and competence qualifying them for an active musical and social role in a community, with specific focus upon the promotion of justice, equitable distribution of resources, and inclusive conditions for health-promotion and sociocultural participation. (Stige, 2003, p. 454)

Moving beyond definitions, Ansdell (2002) identifies four distinguishing characteristics unique to CoMT: 1) its aims (e.g., both internal and external/community focus); 2) its mode of intervention (e.g., clinical and non-clinical musicking); 3) its view of the music therapist’s professional role (e.g., predominantly musical rather than therapeutic); and 4) its location and boundaries for the therapeutic process (e.g., on a continuum from the personal to the community). Stige and Aarø (2012) further identify seven qualities they perceive as specific to CoMT. These include CoMT as: participatory, resource-oriented, ecological, performative, activist, reflexive, and ethics driven in terms of clients’ rights as human rights. Stige and Aarø comment that while individually these qualities are not unique to CoMT, in combination they are.

As there is a diversity of definitions of CoMT, so too is there a diversity among its different practices. While reflecting the distinguishing characteristics and qualities outlined by Ansdell, Stige and Aarø, the practice of CoMT reflects a vibrant diversity as it plays out in particular cultures and contexts around the world. Stige and Aarø (2012) honor this diversity in An Invitation to Community Music Therapy by providing a wealth of case stories from CoMT practice in numerous regions, from Europe, to Australia, Asia, Africa, and North and South Americas – each in its own unique fashion attending to unheard voices.

Stige (2014) and Ansdell (2014) provide important historical retrospectives of CoMT, outlining its development through 2014 and identifying its importance, meaning, and contributions in the current context. Ansdell describes the impact of CoMT as a:

Trojan paradigm: smuggling into an increasingly reductionist, individualized and medicalized culture of treatment and care a more flexible ecological understanding of the complex relationships between music, people, health, illness and well-being. (Ansdell, 2014, p. 11)

Stige (2014) adds further that CoMT “has created new possibilities for music therapy to dialogue and debate with medical discourses that dominate contemporary health care services in most societies” (p. 47). In reviewing the development of CoMT over the past 30 years, Ansdell and Stige acknowledge its contributions to increased awareness of the importance of inclusion, collaboration, and social justice and the role CoMT has still to play.

In this light, it is hard to see how CoMT should become redundant anytime soon. To me it seems more probable that it will have a role to play in keeping the doors, discourse, and floors of professional music therapy open. (Stige, 2014, p. 54)

The historical development of CoMT has been documented, along with its definitions, the commonalities and differences among its practitioners, and its contributions to music therapy and allied health disciplines. The increasing international interest in and practice of CoMT point to the contributions that CoMT has to offer the music therapy profession, both now and in the future. Given this, an understanding of the profile of those who practice such a diverse approach could be very beneficial. Before discussing this further, however, it is important to address critical issues around terminology. Just as there has been considerable diversity surrounding understandings of CoMT, there is similar diversity in the naming of those who practice it. The importance of naming should not be underestimated; it reflects and molds our understanding of a phenomenon and our relationship to it. Many speak of their CoMT practice (Stige & Aarǿ, 2012; Stige, 2015). Others speak of a practice which is informed by CoMT or of being music therapists who identify with CoMT values (Curtis & Mercado, 2004). Still others speak of being community music therapists or of being community music therapists in certain contexts. For example, Edgell (2009) noted that, “I am a community music therapist when working with HCBW adult consumers”. The naming is a very personal choice and must ultimately be left to each music therapist to make as it reflects a complex interaction of their understandings of music therapy and CoMT with their changing personal and professional contexts. For the purposes of this research report, the choice was made for “those who practice CoMT” and for “community music therapists”. This choice is in keeping, as will be discussed further in the Methods and Results sections, with survey respondents who identified one of their theoretical orientations as CoMT or who self-identified as community music therapists.

Research Purpose

While much has now been written extensively about CoMT itself, this has not included an examination of those who practice CoMT. The purpose of this study is to take the first step in addressing this gap in the literature. Since the practice of CoMT is so diverse, rooted in individual cultural contexts, it is important to gain an understanding of community music therapists as they are situated in specific countries. An examination of individuals practicing CoMT around the world would be beyond the scope of a single journal article. In light of this, the focus of the current study, as a first step, is limited to North American community music therapists, in particular, those living in Canada and the United States. The rational for this choice is twofold: 1) it is appropriate given the author’s professional experience in those two countries; and 2) while the initial CoMT discourse was situated predominantly outside of North America, there have been both historic roots and a recently-emerging interest documented in Canada and the United States (Baines, 2000/2003; Curtis & Mercado, 2004; Kenny,1982, 1989, & 2006; Stige & Aarø, 2012;Vaillancourt, 2007 & 2010).With this delimitation established, the research question for this study is: What is the profile of community music therapists living in Canada and the United States?

Personal and Professional Context

Prior to moving to the Methods section, I provide here a brief overview of my personal and professional contexts to situate myself for the readers’ benefit. I am a White, middle class, heterosexual, able-bodied woman, born in 1955.My mother tongue is English, but I am also fluent in French and American Sign Language. I am Canadian, and have lived and worked extensively in both Canada and the United States. Within these various contexts I have had experiences of both privilege (e.g., as a White, able-bodied, hearing person in North America) and marginalization (e.g., as a woman in a patriarchal culture). My professional experience as a music therapist has included work with a variety of people of many ages and walks of life. My music therapy practice has been informed by principles of CoMT – at first more intuitively and then later more explicitly as I delved into the CoMT writing and discourse. My practice is also informed by feminist music therapy – again, first more intuitively and then more explicitly with work in the development of a model of feminist music therapy. I would describe myself as a feminist music therapist. My understanding of CoMT and feminist music therapy recognizes the areas of overlap, particularly in their recognition of the importance of sociocultural/political contexts. Both my professional and personal lives have involved an explicit commitment to social justice and activism. This has been primarily, although certainly not exclusively, in terms of my work with women survivors of violence and adults with disabilities. Having explored these various locations that serve to inform my professional and personal life, attention is now turned to details of the current survey research.

Method

Participants

Participants were comprised of the 103 survey respondents who identified themselves as community music therapists (i.e., answering “yes” to the survey question, “Do you consider yourself to be a community music therapist? Why or why not?”). The survey was sent to all professional members of the Canadian Association for Music Therapy (CAMT) and the American Music Therapy Association (AMTA) living in Canada or the United States for a total of 2,040 (1,733 AMTA and 307 CAMT). Of those, 150 were returned because of inactive email accounts, with 682 individuals responding for a 36% return rate. Because of the CAMT policy to not provide member emails, it was not possible to determine if any survey respondents were members of both organizations. As a result, the return rate could be higher depending on how many, if any, held dual membership. Participants were able to withdraw from the survey at any point prior to its submission. It was not possible to determine the drop-out rate since the survey software only collected data from submitted surveys.

Survey

Data analyzed and presented for this report were gathered as part of a larger survey, one component of which compared present-day women and men music therapists and their 1990 counterparts (Curtis, 2013). As a result, the questionnaire retained most of the elements of the 1990 questionnaire for longitudinal comparative purposes, but with some changes. A small number of additional questions was possible, but not for the 1990-comparative portion. The current report analyzes the survey responses of those participants who self-identify in the questionnaire as community music therapists. English and French versions of the questionnaire were pilot tested with a small number of professional music therapists prior to both instances of its administration.

The survey was comprised of 30 items concerning professional music therapists’ lives, work situations, and practice. These included both close-ended and open-ended questions. The first 16 survey items addressed demographic information (e.g., age, sex, ethnicity, geographic location, education, and family and work situations). The remaining survey items included six close-ended and eight open-ended questions. The six close-ended survey items addressed: considerations in career choice; music therapy theoretical orientation; familiarity with community and feminist music therapies; and ranking of personal, family, and work concerns. A 5-point Likert scale was used for ranking concerns. The eight open-ended survey items examined: role models, music therapy career recommendations, the perceived impact of bias or discrimination, self-identification as a community music therapist, and self-identification as a feminist music therapist.

Procedures

Prior to the start of the research, ethics approval was secured from the University Human Research Ethics Committee. An email invitation to participate in the survey was sent to the identified participants with a link provided to the survey available online through Survey Monkey (2014) in either English or French. A follow-up reminder email was sent 3 months later, with the online survey closed after a total of 5 months. For AMTA members, the email invitation was sent directly to all professional members, using individual email addresses provided by the AMTA; for CAMT members, the email invitation was sent by the CAMT national office to all of its professional members. Participation was anonymous, with informed consent obtained though survey participation.

An independent statistical consultant conducted quantitative analysis of the close-ended items of the survey after consultation with the researcher about the project. For the purposes of this report, the focus of the statistical analysis was on: 1) male-female differences in numbers of community music therapists; 2) Canadian-US differences in numbers of community music therapists; and 3) the effect of self-identification as a community music therapist on the perceived impact of discrimination (e.g., sexism, racism, homophobia/heterosexism, etc.). Given the nature of the data, a Chi-squared test was used, with ordinal regression for those ordered categorical variables with greater than two categories. Item response rate was high, with most responding to all items, and a small number omitting some. Individual item non-response rate varied from .1% to 12%.

A second independent consultant completed the qualitative analysis of the survey’s open-ended items making use of the NVivo 10 software (QRS International, 2014). This consultant was responsible, after consultation with the researcher, for use of the software in data collection and analysis, and for the concomitant decision making involved in the process. It was the author’s responsibility to subsequently interpret, synthesize, and make sense of this data analysis.

To start the data analysis process, the qualitative consultant uploaded the raw data into Nvivo and marked the fields to be analyzed along with their descriptions. Nodes were created for each item, as well as for the demographic data (e.g., sex, nationality, etc.). Once coded under their respective nodes, individual items were then examined. Each response was coded individually after all responses to a specific item were read to get an idea of possible nodes. The decision was made to code one answer-one node unless an answer was long or provided information about different issues. With multi-topic answers, parts of the answer were coded under different nodes. As a result, some answers were coded under two or three nodes at the same time. Following this coding, a cluster analysis was used to visualize patterns, grouping nodes that shared similar words in the coded answers. A cluster analysis diagram was generated in NVivo using the Pearson correlation coefficient method, providing a graphical representation of those nodes sharing similar words and those which were far apart in the coded answers. Upon completion of this cluster analysis, all nodes and coded content were reviewed to ensure that the coding still made sense, with appropriate changes made as needed. Because of the anonymous nature of the survey, this qualitative analysis did not and could not include member checking.

Results

Of the 682 respondents, 45% (n = 288) indicated that they were familiar with CoMT and 19% (n = 127) identified themselves as community music therapists (In response to the question, “Do you consider yourself to be a community music therapist? Why or why not?”). It was a purposeful decision not to provide respondents with a definition of CoMT, both because there is no consensus on a single CoMT definition and because the study’s intent was to learn about all those who self-identified as community music therapists regardless of their definition. Of the 127 respondents who self-identified as community music therapists, 103 responded to the specific question in a manner which permitted computer capturing of their information (i.e., included the word “yes”). As a result, this section examines the responses of those 103. In reviewing these survey results, it should be kept in mind that with these 103 respondents, the number responding to individual items occasionally varied by a small amount as not all respondents answered all items.

Demographic Information

Of the 103 respondents self-identifying as community music therapists, 13.6% (n = 14 out of 103) were men and 86.4% (n = 89 out of 103) were women. This does not reflect a statistically significant difference from all of those 682 surveyed regardless of theoretical identification which was 10% and 90% male and female respectively. Both are in line with membership statistics from the AMTA (2012) and the CAMT (2009).

In terms of the CoMT respondents’ nationality, 18.4% were Canadian (n = 19 out of 103) and 81.6% (n = 84 out of 103) were from the US. It is interesting to note that from among the entire 682 respondents, significantly more Canadians self-identified as community music therapists at 55.4% (n = 36) in comparison with 15.3% (n = 91) for their US counterparts (p < .05). This is also in keeping with the finding that of the 682 respondents, Canadians (82.8%) were significantly more familiar with CoMT than their US counterparts (41.2%; p < .05).

The age breakdown of the CoMT respondents included 20.4% (n = 21 out of 103) between 20 and 30, 25.2% (n = 26 out of 103) between 31 and 40, 18.4% (n = 19 out of 103) between 41 and 50, 30.1% (n = 31 out of 103) between 51 and 60, 3.9% (n = 4 out of 103) between 61 and 70, and 1.9% (n = 2) over 70 years of age (See Figure 1).

Of the CoMT respondents, 96.1% (n = 98 out of 102) were Caucasian, 2.9% (n = 3 out of 102) were Asian American/Canadian, 1% (n = 1 out of 102) were multiracial, and 0% were African American/Canadian/Black, Hispanic, Native American/First Nations, Inuit, or Pacific Islander (See Figure 2). One respondent did not respond to this item. This reflects considerable homogeneity but is in keeping with a similar homogeneity in the overall music therapy profession in both Canada (CAMT, 2009) and the United States (AMTA, 2012).

Concerning their marital status, 21.6% (n = 22 out of 102) were single, 66.6% (n = 68 out of 102) were married or co-habitating, 10.8% (n = 11 out of 102) were separated or divorced, and 1% (n = 1 out of 102) was widowed (See Figure 3). Additionally, 49.5% (n = 51 out of 103) had no children, 15.5% (n = 16 out of 103) had one child, 24.3% (n = 25 out of 103) had 2 children, 8.7% had 3 children, and 2% (n = 1 out of 103) had 4 or more children.

Education and Work Situation Information

Survey respondents were asked to indicate all educational degrees they held in any discipline. Of the CoMT respondents, 52.4% (n = 54 out of 103) held a Bachelor’s degree, 49.5% (n = 51 out of 103) a Master’s degree, and 14.6% (n = 15 out of 103) a doctoral degree. Additionally, 4.9% (n = 5 out of 103) indicated they possessed some other form of educational preparation (See Figure 4).

CoMT respondents indicated being in a variety of employment situations (See Figure 5). These included: 65% (n = 67 out of 103) employed full-time, 25.2% (n = 26 out of 103) employed part-time by choice, 1.9% (n = 2 out of 103) employed part-time by necessity, 0% unemployed, and 2.9% (n = 3 out of 103) seeking employment.

The work situations of the CoMT respondents reflected some commonalities and some differences. The majority were working in clinical practice (67.3%, n = 68 out of 101), with a smaller proportion working in academic settings (14.9%, n = 15 out of 101), and a still smaller proportion indicating some other situation entirely. The majority (87.3%, n = 89 out of 102) also indicated working in music therapy, while 8.8% (n = 9 out of 102) worked outside of music therapy by choice, and 4.9% (n = 5 out of 102) worked outside of music therapy by necessity.

Salaries ranged from under $20,000 to over $140,000, with 8.8% (n = 9 out of 102) earning less than $20,000, 22.5% (n = 23 out of 102) earning between $20,000 and $39,000, 36.3% (n = 37 out of 102) earning between $40,000 and $59,000, 9.8 % (n = 10 out of 102) earning between $60,000 and $79,000, 7.8% (n = 8 out of 102) earning between $80,000 and $99,000, 1% (n = 1 out of 102) earning between $100,000 and $119,00, and 2% (n = 2 out of 102) earning more than $140,000. A small number (10.8%, n = 11 out of 102) declined to state their income (See Figure 6).

Concerns

As noted earlier, respondents’ personal, family, and work concerns were ranked on a 5-point Likert scale, with 1 indicating Not a Problem, and 5 indicating a Very Serious Problem. None of the average ranked concerns was higher than a 3 (See Figure 7), with the highest average ranked concerns being lack of time/money for continuing education (2.78), lack of leisure time (2.61), inadequate salary (2.53), and burden of job and family responsibilities (2.33).

Perception of Impact of Discrimination

Survey respondents were provided an opportunity to rank concerns in their own personal lives over discrimination (e.g., sex bias/discrimination, sexual harassment, and homophobia/heterosexism) as well as an opportunity to respond with personal comments to two open-ended questions concerning the perceived impact in peoples’ lives in general of sex bias/discrimination and other forms of discrimination (e.g., racism, homophobia/heterosexism, etc.). The average ranked concerns of CoMT respondents in their personal lives were low at 1.35 for sex bias/discrimination, 1.12 for sexual harassment, and 1.35 for homophobia/heterosexism. In response to the open-ended question about the perceived impact of sex bas/discrimination in general, 68.5% (n = 71 out of 103) indicated that there was sex discrimination, 19.5% (n = 20 out of 103) indicated that there was not, 4% (n = 4 out of 103) indicated something other, and 8 did not respond. In response to the open-ended question about the perceived impact of other forms of discrimination, 74% (n = 76 out of 103) indicated that there was discrimination, 15.5% (n = 16 out of 103) indicated there was not, 2.5% (n = 3 out of 103) indicated something other, and 8 did not respond.

In responding to these two open-ended questions, some answered with a brief Yes or No, while many others (from both sides of the equation) elaborated at length. These included a diversity of thoughts and emotions. Responses to the question, “Do you feel sex-bias or discrimination has an impact in general in our lives?” included:

I am so tired of hearing people going on about their personal agendas. Just get down to doing the best therapy you know how.

Yes, very much so— partly in overt ways, but mostly in surreptitious ways, embedded into the culture's collective values, assumptions, habitual ways of being, etc.

Yes, but as a white male in the U.S., I have the privilege of coming from a cultural position of power.

Responses to the question, “Do you feel other forms of discrimination (e.g., racism, homophobia/heterosexism, etc.) have an impact in general in our lives?” included:

Spending too much time worried about sexual preferences and stuff like that on the work force has truly depleted the quality of work. Stop all the politically correct rhetoric and concentrate on the clients, they are who truly matter.

Yes — again, the landscape is changing, and serious problems with discrimination are aimed at different groups than in past (e.g. Muslims post September 11). Homophobia has decreased in most Canadian communities, but many homosexual people still live in fear and/or with internalized homophobia.

I think that discrimination is often present in our lives in various ways. Religion, race, belief systems, etc., can be possible reasons for discrimination. I think that even though our society accepts more than other societies the differences, we are far from an equal and fair society, where everybody can experience her/his full potential.

It is interesting to note that there was no significant difference concerning perception of discrimination between those respondents who self-identified as community music therapists, and all other respondents. CoMT respondents might have been expected to have a greater perception of the impact of discrimination given that community music therapists work in the community with their clients and given CoMT’s efforts “to relate human needs to a wider perspective on human rights . . . [as a] call for the universal values of social justice, human potential, and mutual care” (Ansdell, 2014, p.43)

Theoretical Orientations

In gathering information about theoretical orientations, survey respondents were provided a list of 14 theoretical orientations from which they could choose any number that applied to them. These included: behavioral/applied behavioral analysis, biomedical, Bonny method of GIM, cognitive, cognitive-behavioral, community music therapy, eclectic, feminist, humanist, neurologic music therapy, Nordoff-Robbins, Orff-Schulwerk, psychodynamic, and other. They were also provided with open-ended questions asking if they were familiar with and if they considered themselves to be a feminist music therapist or a community music therapist. No definitions of any of the different theoretical orientations were provided because the survey purpose was to ascertain how respondents self-identified regardless of definition.

The 103 CoMT survey respondents self-identified with a number of different theoretical orientations in addition to CoMT (See Figure 8). This should not be surprising given that CoMT reflects a recent grassroots movement which many individuals learned of after their formal music therapy training – at least until recently. Of the different theoretical orientations other than CoMT, the most commonly cited were: humanist (50.5%, n = 52 out of 103), eclectic (47.6%, n = 49 out of 103), cognitive behavioral (42.7%, 44 out of 103)), and behavioral/applied behavioral analysis (33%, n = 34 out of 103). It is interesting to note that only 55.3% (n = 57 out of 103) selected CoMT in this survey item, yet, 100% of these responded “Yes” to the open-ended question “Do you consider yourself to be a community music therapist? Why or why not?”. In examining the responses to this open-ended question, a large number included a “yes” along with some caveat (e.g., “Yes, but not at the moment.”). These caveats might explain some respondents’ reluctance to select CoMT from the provided list of theoretical orientations: perhaps they were only willing to self-identify as a community music therapist if they were able to provide some explanations or contexts for their identification. This will be more thoroughly explored in the section which follows entitled CoMT Emerged Themes from Qualitative Analysis – Identification with a Caveat.

CoMT Emerged Themes from Qualitative Analysis

CoMT respondents took time and care to respond at length to the survey’s open-ended questions. Qualitative analysis resulted in a number of emerged themes. These included: firm identification; identification with a caveat; community building/belonging; drawing from CoMT principles; formal track record; reducing stigma; and working with groups.

Firm identification.

Within this theme, CoMT respondents (n = 83) indicated a firm identification with CoMT in their practice, often making specific reference to the CoMT professional literature:

If we are looking at "community music therapy," defined by Gary Ansdell as "an approach to working musically with people in context: acknowledging the social and cultural factors of their health, illness, relationships and musics," then yes, I do consider myself a community music therapist. I work in a children's medical hospital in New York City. With every child, I try to take into consideration the social and cultural realities in which the children and their families find themselves. As much as possible, I attempt to utilize social and cultural dynamics in my work to helping the child and their family deal with illness and hospitalization.

Others spoke of a broader understanding of community and their work without reference to specific literature:

Yes - I see music therapy as a way to increase opportunities for community participation for those with disabilities/illness.

Yes. I believe that music is a culturally situated endeavor that represents an expression of social capital, and that the "client" can be considered a community within which social inequities require redistribution, and where collective community consciousness requires elevation for all of its members to retain value, self-worth, and resources of agency.

Some of the CoMT respondents provided only a clear statement of affirmation – I do consider myself a community music therapist. – while a small number (n = 6) simply gave a firm, but succinct “yes”.

Identification with a caveat

Within this theme, respondents (n = 20) added a number of diverse caveats to their identification as community music therapists. These ranged from their work situation and location to a desire to include more CoMT in their practice, and a sense that they were practicing CoMT, but uncertain if this adhered to a specific CoMT approach.

Philosophically yes. I am, however, primarily in private practice.

Yes, but I would like to be more so. My company currently serves many types of community organizations, particularly parks and recreation and other small groups, but I would like to be doing more. I really believe in community music therapy.

Yes and no - I believe and agree with the concepts, but do not specifically create goals and objectives focused on community music therapy, but create and process music as a community member.

I have thought about and used the term community music therapy for many years, as I believe that the idea of creating community through music is the core of our work. So my vision and ideas about this term are not necessarily quite the same as [the] way in which the term is being used in our field at this time. . . [but for me] building community through shared music is where healing and growth take place.

Not right now, but when working full-time in a large institution, yes, and I would say that most MTs who work in such institutions practice some elements of community MT whether they realize it or not.

It was in being able to provide caveats, include explanations, and detail contexts and constraints that respondents were able to self-identify in greater numbers as community music therapists. This is in sharp contrast, as noted earlier, to their ability to identify their theoretical orientation as CoMT when provided only a list to choose from with no opportunity to elaborate – in that situation, only 55.3% selected CoMT.

Community building/belonging

In writing about their CoMT practice, a common theme of community building or belonging emerged (n = 34), with more specific references to such concepts as: individual in the community, ripple effects, and service in the community. In their words:

I have been raised in the fabulous humanistic tradition, trained extensively through Nordoff-Robbins, and have worked in a community setting for 15 years. I was doing community music therapy before it was called community music therapy. Why? Because I am about building community, drawing from the resources available and crafting a new whole - but mainly because this is the method that best serves the participants I am fortunate to work with.

I remember being at the world congress in Oxford in 2002 and listening to a panel discussion on CMT . . . [which] presented the image of a stone in a pond, and the consequent ripples that go out from there and I almost jumped up and applauded. This has been my image of community music therapy for many years - something happens in the music for an individual in a music experience/group/session, and then that goes with them into the rest of the day, the rest of the their treatment, the rest of their life.

In addressing community building, respondents also spoke of the performative nature of their work. One respondent commented:

I have actively pursued ways to bring my clients together and in community with other agencies and community groups through music performances, song circles, improvisational circles, forums for sharing ideas, etc.

Another respondent added:

Yes: I work with persons with mental health issues in the community and I have carried out music therapy projects with goals that focused on bringing the music, writing, and art of these clients to their community.

Drawing from CoMT principles

In writing further about their work, some CoMT respondents (n = 11) made mention of drawing from CoMT principles and incorporating these into their practice.

I incorporate concepts of community music therapy into my work as I design involvement in music experiences that can help to connect my clients to music experiences in their own lives and community.

Some of these respondents made reference to drawing from the CoMT literature and discourse:

I can say what I have read about community music therapy has informed my work.

Others identified specific values of CoMT that informed their practice:

The socio-cultural underpinnings behind community music therapy resonate with my deepest values as well.

Formal track record

Comments of some of the respondents (n = 17) alluded to issues concerning a more formal track record.

I am a music therapy researcher and believe my research program is informed by values consistent [with] community music therapy and that would inform community music therapy practice.

I consider myself to be a community music therapist because I have a solid track record of having practiced it for many years, with more than one population in more than one setting, and I have also conducted formal research in community music therapy.

These respondents made reference to specific settings within which they could practice CoMT:

Much of my best work has been conducted within community-based facilities.

I work in community settings that promote social thought, acceptance, and tolerance.

These respondents also identified the particular nature of their settings and their clients which contributed to their choice of CoMT practice.

Reducing stigma

A smaller number of CoMT respondents (n = 3) addressed the issue of reducing stigma.

I use music to bring people together, which can be a healing for some through socialization, sharing of experiences, and sharing of music. It may help diminish the stigma associated with therapy as I try to create a relaxed musical environment accessible to all while still maintaining therapeutic benefits.

While small in number, these respondents spoke to their understanding of the powerful role they felt CoMT could play in the important task of reducing stigma for their clients.

Working with groups

In discussing their practice, a number of respondents (n = 14) made specific reference to their group work, as well as to work outside traditional therapy boundaries.

Yes. I worked in a group home for children for several years in which I had to constantly re-create what music therapy was. At the time I had no context for it and questioned whether or not I was really "doing" music therapy. After I read about community music therapy, I realized this was exactly what was needed at my work site! It was a natural integrating music into the community in any way that felt right for the clients: group celebrations, musical check-ins, musical de-escalations, many things that were not and could not be bound by the 50 minute hour behind closed doors. The socio-cultural underpinnings behind community music therapy resonate with my deepest values as well.

Many of these respondents spoke of their groups in terms of being communities in their own right, as well as in terms of their inclusion into the broader community at large. These respondents identified a two-way nature of community interaction, with their groups moving into the community on one hand and community members coming into their groups on the other hand.

Discussion

Having documented the important emergent approach of CoMT, this study took a first step in filling a still existing research gap – namely exploring the profile of music therapists in Canada and the United States who self-identify as community music therapists. Of 682 survey respondents, 127 (19%) self-identified as community music therapists. Of these 127 respondents, 103 completed the answer in a manner which permitted computer-capturing of their data (i.e., included the word “yes” in the response). A wealth of information was obtained from these CoMT respondents, making use of quantitative and qualitative analyses, concerning their: education and work situations; personal, family, and work concerns; perceptions of discrimination; and theoretical orientations.

Interestingly, of those who responded “Yes” to the open-ended question “Do you consider yourself to be a community music therapist? Why or why not?”, only 55.3% selected CoMT from the list of theoretical orientations provided in another survey item. This might be explained in part through the qualitative analysis which indicated that a number of the respondents (20 out of 103) included a caveat with their self-identification as community music therapists (e.g., work situations that made CoMT difficult, a sense of practicing CoMT independently without necessarily adhering to a specific CoMT approach, a desire to incorporate more CoMT in their practice, etc.). More respondents replied in the affirmative about their identity as community music therapists when provided with an opportunity to provide elaborations and to detail contexts and constraints surrounding this identification.

It was also of interest that from among the entire 682 respondents, significantly more Canadians (55.4%) self-identified as community music therapists in comparison with their US counterparts (15.3%). Canadians were also significantly more familiar with CoMT. These findings are in line with those of a previous report which reflected instances of both commonalities and differences within the music therapy professions in Canada and the United States (Curtis, 2015). This previous report, Alike and Different: Canadian and American Music Therapists’ Lives and Work, provided a comparative analysis of the Canadian and US music therapy landscapes, identifying that while both incorporate a diversity of theoretical orientations, there was a greater representation among Canadian music therapists for CoMT, feminist music therapy, humanistic, and Nordoff-Robbins; there was a greater representation among US music therapists for behavioural/applied behavioural analysis, cognitive, cognitive behavioural and Neurologic Music Therapy.

For CoMT respondents, concerns in their personal lives were relatively low (i.e., No average ranked concern higher than a 3 out of 5), with the highest average ranked concerns being lack of time/money for continuing education, lack of leisure time, inadequate salary, and burden of job and family responsibilities. While not ranked high as a personal concern, sex bias/discrimination was perceived by 68.5% as a problem for people in general and other forms of discrimination (e.g., racism, homophobia, etc.) were perceived by 74% as a problem for people in general. There was no significant difference in the perceptions of discrimination (both in their personal lives and in general) between the CoMT respondents and all other survey respondents.

CoMT respondents identified a number of diverse theoretical orientations for their work in addition to CoMT. The most commonly cited of these were: humanist, eclectic, cognitive behavioral and behavioral/applied behavioral analysis. This diversity of orientations is in keeping with CoMT respondents’ thoughts on their identification with CoMT – an identification that included such caveats as including CoMT in their practice only in certain settings or with certain clients.

In writing about CoMT, many of the respondents took great time and care to provide detailed responses to the survey’s open-ended questions. Emerged themes from the qualitative analysis included: identification; community building/belonging; drawing from CoMT principles; formal track record; reducing stigma; and working with groups. CoMT respondents’ identification included firm identification for some, deeply rooted in the current CoMT writings and discourse. For others, it was more of an intuitive identification that arose out of the needs of their own clients and settings. For many, their identification came, as noted earlier, with caveats detailing when and where they would include CoMT in their practice, as well as detailing their own understanding of CoMT. The importance was stressed of building community and of belonging to a community for both client and therapist. While only a small number of CoMT respondents spoke of reducing stigma, they attested to the powerful role they felt CoMT could play. Many identified the importance of groupwork – groupwork that made CoMT possible and that demanded it for the benefit of their clients.

In considering the results of this research, some study limitations should be kept in mind. While one of the quantitative survey questions made it possible to ascertain that 127 of the 682 total respondents self-identified as community music therapists, only 103 of those answered the qualitative question in a manner that permitted computer capturing of that information (i.e., included “yes” in their answer). As well, the total number of CoMT respondents was relatively small at 103.

Ultimately, this survey report provides a rich and detailed look at the profile of those in Canada and the United States who self-identify as community music therapists. It looks at their thoughts on CoMT and its place in their practice. It represents a first step in learning about the experiences of community music therapists around the world. Future research into the particularities of the lives and practices of community music therapists elsewhere in the world could contribute dramatically to our understanding of CoMT practitioners’ profiles. The impact of future research could be enhanced with inclusion of a variety of types including, but not limited to, surveys, interviews, auto-ethnographies, and case studies. An increased understanding of CoMT practitioners’ profiles is particularly important given the diversity of CoMT itself and given its emerging importance. It could serve to enhance our understanding of each other and to further open and engaging dialogues.

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