In the present study we conducted a first of its kind online survey of music therapists (MTs) in Israel. Though this field has been growing rapidly and to date includes about 700 MTs, there was not yet a survey conducted to adress their fields of interest, and their clinical and theoretical orientations. A total of 107 MTs, 48 of which had more than 8 years of experience (MEMT) and 57 of which had less than 8 years of experience (LEMT), answered an internet survey examining: (a) the instruments and the techniques they use, (b) the populations they work with, and (c) their theoretical orientation. Results indicated significant differences between MEMTs and LEMTs in almost all fields of inquiry. Generally, most of the younger generation is open to more techniques, proficient with more instruments, and uses more music in their work. In a continuously globalizing world, the results of this study are relevant to not only Israeli music therapists, but others as well since the local situation captured in this study can be compared and related to the situations in other countries. Recommendations are provided for places where such studies and surveys have not yet been conducted.
Surveys conducted to research the music therapy profession have been a widespread and
effective tool in past decades, especially in the United States (
Several surveys have addressed the preferences of MTs within a specific client
population. Jackson (
Other surveys were not limited to a particular clinical population but rather focused on
the attitudes of MTs, music therapy students included, towards different issues. Cohen,
Hadsell & Williams' (
Clark and Kranz's (
Curtis (
Despite the fact that nation-wide surveys can be effective, they have not yet been
conducted in many countries, including in Israel. Music therapy in Israel began
sporadically in the 1970s and was formalized in the early 1980s, when three training
programs were founded: (1) The music therapy program at David Yellin College of
Education, founded by Dr. Chava Sekeles; (2) the music therapy program at Bar-Ilan
University, founded by Prof. Dorit Amir; and (3) the music and dance therapy program at Levinsky founded by
Dalia Razin College (
During the past decade some very important changes occurred. First, all programs
developed from granting a post-bachaloriate diploma to granting a full master's degree.
Second, a fourth music therapy program was founded at Haifa University headed by Dr.
Cochavit Elefant
In the present study we examined, as broadly as possible, the Israeli milieu of MTs. We wanted to know what techniques they use, what populations they attend to, and how they define their theoretical orientation. We were also interested to see the breakdown of these questions with regard to the level of MTs’ experience: Do less experienced MTs give different answers than more experienced ones? Such a perspective could help to assess whether developments in training courses may be helpful or not for MTs working in the field. As MTs who have influence on decisions made in our milieu, such information provided an updated picture regarding the current state of the profession, and ideas regarding possible changes that may be required.
To achieve these goals, we initiated an online survey that was sent to MTs on alumni lists of all of the training programs in Israel.
The survey included questions that reflect: (a) the instruments and music therapy techniques that MTs use; (b) the populations and age groups that MTs work with and the population(s) they prefer to work with; (c) the MTs’ theoretical orientation (e.g., music as therapy vs. music in therapy, verbally vs. musically oriented music therapy, and psychological theoretical framework). The research questions were:
What are the instruments and techniques, the clinical populations, and the theoretical orientations of MTs in Israel?
Are there any differences between less experienced and more experienced MTs in regard to these factors?
Because of the preliminary nature of this study, no hypotheses were made.
One hundred and seven (107) MTs that live and work in Israel participated in the study, all of whom were trained as MTs in Israel. There were 85 women and 22 men and a balanced distribution of training programs from which they graduated: 41 graduated from the Levinsky program, 23 graduated from the David Yellin program, 35 graduated from the Bar-Ilan program (including the Haredi College), and 8 graduated from the newly established Haifa University program. The age distribution was as follows: 8 MTs were between 25 and 30; 32 between 31 and 35; 16 between 36 and 40; 15 between 41 and 45; 12 between 46 and 50; 24 aged 51 and older. The median age was 38. Experience wise, participants were distributed as follows: 24 MTs had 1 to 3 years of experience; 34 had 4 to 8 years of experience; 23 had 9 to 15 years of experience; 13 had 16 to 20 years of experience; 13 had 21 years of experience and more. The median of this variable was 8 years of experience.
An online survey was devised for the purpose of this study. Items in the survey
included demographic questions (e.g., age, gender, seniority, training program,
etc.); questions regarding the instruments and techniques MTs used and felt most
proficient with (e.g., "What do you consider your primary instrument? What is your
secondary instrument?", "What techniques do you feel most comfortable with?");
questions regarding preferred populations (e.g., "What population group do you feel
most comfortable working with?"; “What age group do you feel most comfortable working with?"
The survey, a Google Doc, was sent electronically to 396 MTs whom we found a way to contact
Participants were divided according to the median of seniority (Median = 8 years of experience), which resulted in a group of 58 less-experienced MTs (LEMT) and 49 more-experienced MTs (MEMT).
Participants were asked to indicate the two instruments (primary and secondary) that they felt most proficient with. Results are presented in Table 1, separately for MEMTs and LEMTs. For the MEMTs, the piano was highly dominant (65.3% of the MEMTs reported it as their primary instrument), and the other instruments were more marginal. For the LEMTs, in contrast, both the piano and the guitar were reported as their primary instrument (75.8% of the LEMTs reported one or the other as their primary instrument), and other instruments were marginal. Regarding the secondary instrument, the MEMTs and LEMTs had different profiles here, as well. While 56.3% of the MEMTs reported the guitar as their secondary instrument, LEMTs reported both guitar and piano as their secondary instrument (67.2%). MEMTs and LEMTs were similar, however, in that the piano and the guitar, taken together, were the most dominant instruments.
Reports of MEMTs and LEMTs regarding their primary and secondary instruments (in percentages)
Piano | Guitar | Drums | Voice | String instrument | Wind instrument | Total | |
---|---|---|---|---|---|---|---|
Primary instrument | |||||||
MEMT | 65.3 | 10.2 | 2.0 | 8.2 | 0.0 | 14.3 | 100.0 |
LEMT | 53.4 | 22.4 | 5.2 | 8.6 | 5.2 | 5.2 | 100.0 |
Average | 58.9 | 16.8 | 3.7 | 8.4 | 2.8 | 9.3 | 99.9 |
Secondary instrument | |||||||
MEMT | 18.8 | 56.3 | 6.3 | 10.4 | 4.2 | 4.2 | 100.2 |
LEMT | 24.1 | 43.1 | 13.8 | 12.1 | 0.0 | 6.9 | 100.0 |
Average | 21.7 | 49.1 | 10.4 | 11.3 | 1.9 | 5.7 | 100.1 |
Independent
Participants were asked what techniques they used and to what extent. Figure 1 shows this information, comparing MEMTs and LEMTs.
Music therapy techniques used by MEMTs and LEMTs
A two-way repeated measure analysis of variance with musical technique as a within
subject factor, and seniority as a between subject factor showed that there was a
significant difference between the extent to which different techniques were used
(
MTs were asked to indicate which clinical population they preferred to work with. Table 2 shows the results, comparing MEMTs and LEMTs.
Distribution of Respondents According The Population They Prefer to Work with and Their Seniority (In Percentages).
Autism | Intellectual Disability | Youth at risk | Older Adults | Learning disabilities | Emotional disabilities | Mental disabilities | Physical disabilities | Total | |
---|---|---|---|---|---|---|---|---|---|
MEMT | 6.5 | 2.2 | 2.2 | 8.7 | 13.0 | 50.0 | 15.2 | 2.2 | 100.0 |
LEMT | 29.3 | 10.3 | 8.6 | 3.4 | 5.2 | 29.3 | 8.6 | 5.2 | 99.9 |
Overall | 19.2 | 6.7 | 5.8 | 5.8 | 8.7 | 38.5 | 11.5 | 3.8 | 100.0 |
Overall, the population the participants most preferred to work with were clients
with emotional disabilities (38.5%), and the least preferred clients were those with
physical disabilities (3.8%), youth at risk (5.8%), and older adults (5.8%). A
breakdown into MEMTs and LEMTs shows, however, different fields of preference. While
the MEMTs indicated clients with emotional disabilities as their foremost preferred
population (50.0%), and clients with physical disabilities (2.2%), clients with
intellectual disability (2.2%), and youth at risk (2.2%) as their least preferred
population, LEMTs indicated both clients with emotional disabilities (29.3%) and
clients with autism (29.3%) as their preferred populations, and older adults (3.4%)
and clients with physical (5.2%) and learning (5.2%) disabilities as their least
preferred populations. A chi-square analysis showed that the differences between the
preferences of MEMTs and LEMTs were significant (
MTs were asked to indicate which age group they prefer to work with. Table 3 shows the results, comparing MEMTs and LEMTs.
Distribution of Respondents According to the Age Group They Prefer to Work with and Their Seniority (in percentages)
Toddlers | Children | Adolescents | Adults | Elderly people | Total | |
---|---|---|---|---|---|---|
MEMT | 6.3 | 52.1 | 14.6 | 20.8 | 6.3 | 100.1 |
LEMT | 33.3 | 26.3 | 22.8 | 12.3 | 5.3 | 100.0 |
Overall | 21.0 | 38.1 | 19.0 | 16.2 | 5.7 | 100.0 |
Overall, the MTs preferred to work with children (38.1%) and they least preferred to
work with older adults (5.7%). When referring separately to MEMTs and LEMTs,
significant differences were found. While MEMTs preferred working with children
(52.1%) and adults (20.8%), LEMTs preferred to work with toddlers (33.3%), children
(26.3%), and adolescents (22.8%). A chi-square analysis showed that the differences
between the preferences of MEMTs and LEMTs were significant (
MTs were asked to what extent they define their theoretical orientation as "music as
therapy", and to what extent they define it as "music in therapy" on 1 (
Music therapy approach (music as therapy vs. music in therapy), comparing MEMTs and LEMTs
MTs were asked to refer to the verbal vs. musical orientation of their work, that is,
to what extent their work is musically oriented, and to what extent they were
verbally oriented. To examine their responses, a repeated measures analysis of
variance was conducted with verbal vs. musical orientation in treatment as a within
subject factor and with seniority (MEMT vs. LEMT) as a between subject factor.
Results (see Figure 3) show that in general, MTs report a more musical (
Music therapy orientation (musical vs. verbal), comparing MEMTs and LEMTs
MTs were asked to indicate what their general theoretical framework was. They could indicate any one of the theoretical frameworks that appear in Table 4 or any combination of the frameworks.
Psychological Theoretical Framework of MEMTs and LEMTs (in percentages out of the total number of participants in each group)
Humanistic | Psychodynamic | Intersubjective | Developmental | Educational | Cognitive | |
---|---|---|---|---|---|---|
MEMT | 37.5 | 45.8 | 31.3 | 2.1 | 8.3 | 16.7 |
LEMT | 38.6 | 52.6 | 43.9 | 1.8 | 14.0 | 1.8 |
Overall, MEMTs and LEMTs were quite similar in defining their theoretical framework with humanistic, psychodynamic, and intersubjective frameworks being most frequently mentioned.
The purpose of this study was to examine, as broadly as possible, current Israeli MT practice with reference to MT techniques, client populations, and theoretical orientation. The comparisons we made between experienced and less experienced MTs enabled us to see whether the current situation is static or dynamic and changing, and if so – in what direction. We find such information important because it enables the practice to situate itself in the changing contexts and to respond to different needs. We will discuss each of the main findings in the context of music therapy training in Israel and in comparison to studies conducted in other countries, whenever available.
The piano was, by far, the most prevalent instrument among music therapists in this
study. Although the guitar was also dominant, especially among the LEMTs, the piano
still seems to be the most frequently used musical instrument by MTs in Israel. Other
instruments, such as drums and voice, were reported to be used to much lesser
extents. Studies conducted in North America have shown a more heterogeneous scene.
Goodman (
The reason why the piano is so dominant amongst Israeli music therapists could be
explained by the focus that it has been given throughout the years (since the early 1980s) in the Israeli music
therapy training programs. First of all, according to the entrance requirements
stated in guidelines for registering students
The results showed that Israeli music therapists use a variety of music therapy techniques, the leading ones being instrumental improvisation, work with existing songs, vocal improvisation, and songwriting. This is not a surprise because these techniques are the four most basic "tools" of many music therapists. GIM, in contrast to the others, was rarely used among the respondents in this study. This is probably connected to the fact that no music therapy program in Israel provides GIM training. In this respect it is significant that more than a third of the respondents that expressed a need to develop professionally, mentioned their need for GIM training. If policy makers in Israeli music therapy are to consider this clinical expertise as important for potential music therapy clients, there should be a systematic implementation of GIM training in at least one of the training programs or perhaps as a post-masters diploma or continuing professional development for graduates seeking this path of clinical development. We believe that enabling more paths for music therapists will eventually make music therapy available to more potential clients.
Regarding the clinical populations that were most preferred by the respondents, there was a significant difference between the LEMTs and the MEMTs. While the MEMTs mostly preferred the age group of children and people emotional disabilities as their preferred clientele, the LEMTs were more flexible as to their preferred age groups (toddlers, children, and adolescents) and regarding their preferred clientele groups (emotional disabilities and autism). Respondents, both MEMTs and LEMTs, were less enthusiastic about working with older adults or clientele with intellectual disability, learning disabilities, mental disabilities, physical disabilities, or , youth at risk.
Studies have shown that there are several factors influencing which clientele MTs
prefer. Blachman (
It is unclear which of these factors influence MEMTs to prefer a specific and narrow clientele, or what affects LEMTs to have broader preferences. Has something in the perspective of music therapists changed so that they feel it is possible to work in a wider variety of working environments? Or has something changed in the field so that new client possibilities such as kindergartens and high-schools opened their gates to MTs? The answers to these questions are still unclear and further research is required to understand the inter-relationships between the field, the MTs, and how the MTs perceive the field in regard to their personal and professional developmental aspirations.
One of our main concerns in this survey is that older adults were not a popular
choice among the respondents, despite the growing numbers and needs of potential
clients in this age group and the growing developments in the field of gerontology in
Israel (
Measuring the theoretical orientation of MTs is quite difficult and it was therefore approached in several different ways in our survey. One way was to see how music and words were intertwined in music therapy. In general, the respondents of this survey combined music and words, music in therapy, and music as therapy. Interestingly, however, the MEMTs did this in different proportions than the LEMTs. While the MEMTs combined more evenly the verbal and the musical in their sessions, the LEMTs gave more emphasis to the musical. While the MEMTs gave more weight to music in therapy, the LEMTs gave equal weight to music in therapy and music as therapy. Assuming that music as therapy applies more music making than music in therapy, it seems that the younger generation of music therapists is drifting towards making more music in sessions and talking about it to a lesser extent. On the other hand, it could be that the more experience MTs feel more accomplished using both words and music while the less experienced MTs did not gain enough experience using words in therapy. Yet other possibilities to understand the difference between MEMTs and LEMTs is that MEMTs are less comfortable using music or that different client groups require different emphases altogether. Further research might show which of these possibilities is more probable.
A second way to evaluate theoretical orientation is to ask what framework MTs rely on
in their work. Here we found that Israeli MTs, both more and less experienced ones,
rely on psychodynamic, humanistic, and intersubjective approaches and less on
educational, developmental, and cognitive approaches. It seems that the respondents
in this survey were geared to psychotherapeutic work, despite the fact that most of
the music therapists in the country work with children in schools. It could be argued
that developmental, educational, and cognitive approaches would be more suitable for
them. This incongruence between what MTs bring to work (i.e., music psychotherapy –
perhaps because this is what they were trained to do) and what they ought to be doing
(music therapy in educational settings) was brought up in two separate masters theses
that examined music therapy in education (
It is interesting to contrast the orientation of MTs in Israel to clinical
orientations reported in other countries. Undoubtedly, the theoretical orientation of
MTs stems from the framework of the training programs and contexts in which
practitioners work in that country. It is expected, therefore, that in Denmark where
the Aalborg University program is dominant, MTs will abide to the tradition and the
concepts of humanism as well as psychodynamic ideas of this school (
Summing up the findings of this survey makes it possible to obtain a broad picture of the music therapy profession in Israel. This picture can be a helpful tool for music therapy policy makers in deciding how to further develop this field; what are the field’s strengths and weaknesses; what should be preserved and maintained and what should be developed and promoted. The main practical points for training programs we came up with in this study are: (1) Enable/encourage instruments other than the piano and the guitar. This is especially important considering Israel’s multicultural nature, implying the importance of encouraging the promotion of non-Western MTs and instruments; (2) connected to the first point, embrace a more specific, well-educated, client-appropriate theoretical approach rather than focus on one direction all-encompassing framework, in order to expose the students to a variety of approaches. Especially see how the approaches taught in the programs serve future MTs in the educational field; expose students to new developments in the field of music therapy, such as community music therapy and neurological music therapy; and create opportunities for post graduate studies to learn models such as GIM; (3) Promote opportunities to work with less popular populations such as older adults and clients with physical disabilities. Exposure should begin in the training programs. Although students in the Israeli training programs are typically exposed to a variety of clinical populations (e.g., autistic spectrum disorders, learning disabilities, physical disabilities, mental disabilities, youth at risk) and work in varied places (e.g., parent-child centers, hospitals, rehabilitation centers, psychiatric hospitals, schools, special education schools) there is still a need to identify those populations and locations that are not receiving proper attention.
Despite the fact that this study is a local one, seemingly applicable to Israel only, we
believe that it has global implications. Policy makers in different countries can see
how the music therapy situation in one country reflects on their own situation. Policy
makers can also induce what points in the present survey apply to their country and
therefore, call for similar actions as recommended here, and what points are different
and thus call for a separate survey. One point, however, should stand out in any case:
the mere act of surveying music therapists and trying to sketch a picture of our
profession is invaluable. We, therefore, highly recommend that researchers in other
countries perform similar surveys. A loftier idea, perhaps one that should come after
several countries have published their "local" findings, would be to conduct an
international survey, in which as many countries as possible are represented, and
comparisons and categorizations are made.
Replaced by Dr. Dikla Kerem in 2015
Recently replaced by Dr. Ayelet Dassa
Note that participants were not asked what population they actually worked with because this would result in answers affected by various constraints such as funding, legislation, etc. The present question, therefore, points at the MTs would wish to work with if they had the choice.
Note that not all of the 700 MTs that graduated in Israel actually work as MTs and that not all of them are affiliated to an organization or a training program. Therefore, it was not possible to access all 700 Israeli MTs.
In 'music as therapy' music is served as the primary
stimulus medium and emphasis is given to the client-therapist relationship through
music whereas 'music in therapy' put the music as adjacent and not necessarily the
primary modality (
Where these could not be found, we manually went through acceptance regulations that were published annually and / or made contact with former heads of music therapy programs and asked them.
The World Federation of Music Therapy (WFMT) has conducted such a survey but it has not yet been published.