There is much debate in the U.S. about the purpose of the correctional system that is based in part on ideological differences related to opinions of crime causation (Sims, 2003). The traditionally conservative view (often associated with the Republican party in the U.S.) is that individuals who commit crimes are acting on the basis of free will and lack self-control or moral values, whereas the traditionally liberal view (frequently held by members of the Democratic party in the U.S.) is that crime results from external forces like inequality and discrimination (Sims, 2003). Although not always the case, proponents of the conservative view tend to believe that the purpose of the correctional system is to punish and keep society safe from dangerous people, whereas proponents of the liberal view tend to advocate for rehabilitating offenders and reforming a system that is unjust (Sims, 2003). In spite of these relationships between political affiliation, political ideology, and correctional ideology, there is evidence that support for rehabilitation and alternatives to incarceration has increased in recent years even in deeply conservative, Republican regions of the U.S. (Thielo et al., 2015).

Religious beliefs also influence views on criminal punishment, sometimes to a greater degree than political affiliations (Thomson & Froese, 2017). People who believe in a punitive God tend to favor harsher punishments for criminals, whereas people whose religious beliefs include a greater focus on forgiveness tend to support rehabilitation (Evans & Adams, 2003). Of course these trends do not hold for all individuals.

Because people who are incarcerated in the U.S. have lost certain freedoms and people working in corrections (most of whom are white and male, according to Burkhardt, 2017) are in an elevated position of power, the correctional ideologies of correctional employees are of interest to researchers. In a meta-analysis on predictors of correctional officers’ attitudes and behaviors, Maahs and Pratt (2001) found that non-white correctional officers and those who had less role conflict more often held attitudes supportive of rehabilitation. Although race appeared to be related to correctional ideology for correctional officers, researchers found, in another study, that the same relationship did not hold true for prison chaplains. Sundt and Cullen (2002) explored the correctional orientation of prison chaplains and found that correctional approaches were influenced by their age, religious philosophy, and dynamics of the work environment, but not by race. The investigators found that chaplains who felt like their work was a calling from God and those who believed in religious forgiveness were less likely to support punishment for inmates. Sundt and Cullen also found that the majority of chaplains thought that treatment and rehabilitation for offenders were at least as important as punishment. Thus, race, religious beliefs, age, political affiliations, and work dynamics may relate to correctional ideology to differing degrees depending on the profession of correctional employees.

In spite of the differences in correctional ideologies related to political affiliations, there have been recent bipartisan efforts at prison reform in the U.S. (Dolan, 2020). One of the aims of the Formerly Incarcerated Reenter Society Transformed Safely Transitioning Every Person (FIRST STEP) Act, which the U.S. Senate and House of Representatives voted overwhelmingly to pass in 2018, was to prepare people who are incarcerated for release from prison and reduce the likelihood that they will return to prison (Formerly Incarcerated Reenter Society Transformed Safely Transitioning Every Person Act, 2018). Dramatic changes in corrections reform are also taking place at the state level to reduce incarceration, support the re-entry process, and to minimize the long-term consequences of incarceration in the U.S. (Porter, 2020).

Accessing adequate mental health care is one important step toward rehabilitation for people who are incarcerated. According to the authors of a study on the prevalence of mental illness in a state prison system, “correctional facilities have become a front line for mental health care” (Al-Rouson et al., 2017, p. 342). Another important step toward rehabilitation is acknowledging the incarcerated female population. While much of the corrections literature explores the incarceration of disadvantaged Black men, women are the fastest growing population in the corrections system (Beall, 2018). The U.S. alone houses one-third of the world’s incarcerated female population, although women only represent 5% of the global incarcerated population (Beall, 2018). In addition to needs related to mental health and gender, the aging population continues to grow and offers a unique set of needs to care for individuals aging in prison (Carson & Sabol, 2016).

Music therapy’s evidence-based research supports its efficacy in a variety of settings and populations such as rehabilitation (American Music Therapy Association, 2006), mental illness, the aging population, and the growing rate of women who are incarcerated. Thus, support for music therapy programs in the U.S. prison system continues to grow. It would seem valuable to learn more about the philosophies and practices of the music therapists who choose to work in correctional facilities. This knowledge could inform the practice of current music therapists, influence curriculum design for music therapists in training, and provide meaningful support for policy development in the service provisions for inmates.

Research on the use of music therapy with people who are incarcerated has been conducted in several countries around the world, including Australia (Daveson & Edwards, 2001), China (Chen et al., 2015), the Netherlands (Hakvoort et al., 2015), Norway (Gold et al., 2014), the U.K. (Odell-Miller et al., 2019), and the U.S. (Cohen, 1987). In the U.S., as early as 1923, Willem van de Wall's publication, Music in Correctional Institutions suggests music is a worthwhile method of rehabilitation because of its capacity to create an environment of expressive and thoughtful development and to provide opportunities for group work, self-expression, and self-discipline (van de Wall, 1923). Several scholars have published case reports on music therapy practices with incarcerated men (Nolan, 1983), violent offenders (Cohen, 1987), and psychiatric patients residing in prisons (Thaut, 1989). More recently, researchers have explored the effects of music therapy on mental health issues of people who are incarcerated related to anxiety, depression, self-esteem (Chen et al., 2015; Chen et al., 2016; Gold et al., 2014) anger management, and coping techniques (Hakvoort et al., 2015). Tuastad and O’Grady (2013) examined how music therapy enables those who are incarcerated to maintain their humanity while existing within the dehumanizing prison environment. Group singing and public performance as a therapeutic intervention has also been explored as it relates to enhancing levels of executive function (Segall, 2016) and increasing inmates’ potential to benefit from therapeutic interventions (O’Grady et al., 2015). Music therapy as a method of assisting former inmates with the re-entry process has also been explored (Tuastad & Stige, 2015) as well as the impact of music making as an everyday occurrence in prison culture (Hjørnevik & Waage, 2019), and the long-term effects of music therapy treatment (Gold et al., 2020). Although an encouraging body of evidence exists exploring the outcomes of music therapy with people who are incarcerated, little is known about the music therapists who are providing these services, and there has been little research conducted in the past 20 years on the use of music therapy in the U.S. correctional system. As the field of music therapy is constantly evolving to meet the needs of its growing body of patients, it’s important to examine every way in which music therapists are providing services. This is important as it informs curricula for music therapists in training, informs clinical practice for those currently working in the field, and can also support policy and decision making for individuals who are currently incarcerated and the profession of music therapy.

The vast majority of music therapists practicing in the U.S. are white women (AMTA, 2018), and this trend has not changed greatly in the past few decades (Silverman & Furman, 2014). In a study of membership trends in AMTA from 1998 to 2009, Silverman and Furman remarked that, with regard to gender, “data were extraordinarily consistent” (2014, p. 107). Over the course of that decade, about 87% of the membership was female and 13% was male. Assuming that the percentage of music therapists who are female has remained consistent over the past 20 years, the percentage of participants in Codding’s (2002) study who were male (29%) seems to be higher than one would expect based on the AMTA workforce analysis. Since most correctional employees are men (Burkhardt, 2017) and researchers have found relationships between race and correctional ideology (Maahs & Praat, 2001), it would be of interest to note whether music therapists working in correctional institutions are representative of the larger population of music therapists with regard to race/ethnicity and gender, and whether they are representative of the inmates they serve. In light of evidence that unintentional bias from white counselors and psychotherapists may interfere with development of therapeutic alliance with clients of color (Vasquez, 2007), it would be of particular interest to know the race/ethnicity of music therapists practicing in correctional settings, since people of color are overrepresented among incarcerated people in the U.S. (Sawyer & Wagner, 2020). Furthermore, since correctional ideologies are often related to religious beliefs and political affiliations, it would be of interest to know how music therapists describe their political affiliation and the degree to which their religious beliefs influenced their decision to work in corrections. This could help inform clinical practice by identifying the degree to which music therapists are at risk for issues that face other correctional workers like role conflict, which researchers studying prison chaplains and correctional workers have linked with stress, personal issues, and burnout (Allard et al., 2003; Denney, 2017; Sundt & Cullen, 2002).

Identifying reasons why music therapists in the U.S. choose to work in corrections—and reasons why they choose not to work in corrections—could help provide insight into factors related to correctional ideology (i.e., if music therapists choose to work in corrections to assist with rehabilitation and reform). It could also help provide information for music therapy educators and policy makers regarding the degree to which music therapists in the U.S. have opportunities to work in corrections and potentially help explain the reason there has been so little written about music therapy in the U.S. correctional system in the past 20 years given the high rates of incarceration in the U.S.

The most recently published information about music therapy practices in corrections is from a survey published by Codding in 2002 that reported the demographics, conditions of employment, service provision, assessment, therapeutic objectives, and related values of music therapists. Given changes that have taken place in correctional institutions in the U.S. and within the music therapy profession over the past 20 years there is a need for updated information about music therapy practices in the U.S. correctional system.

The purpose of this study was to explore current music therapy practices and protocols in U.S. corrections, as well as the philosophies of music therapists working in these correctional settings, using a survey approach with both descriptive and comparative design features. More specifically, we aimed to gain a broad overview of this area of practice in an effort to motivate further research in this area. In addition to updating information provided in Codding’s study, the authors of the present study sought to investigate why music therapists chose to work, or not work, in corrections; how safe music therapists feel working in correctional settings; and whether demographic representation of those working in prisons differs from music therapists who work with other populations.

Table 1 shows the gender and race/ethnic origin of participants who worked in prison compared to those who did not. Two Pearson's chi-square tests revealed significant differences between music therapists who worked in prisons and music therapists who did not work in prisons with regard to gender, χ² (1) = 6.57, p = .015, and ethnic origin χ² (1) = 5.82, p = .021. Among music therapists who reported they did not work in prisons, females outnumbered males by an odds ratio of 7.98, whereas female music therapists working in prisons only outnumbered male music therapists working in prisons by an odds ratio of 3.25. Among music therapists who did not work in prisons, white music therapists outnumbered under-represented minorities by an odds ratio of 7.71, whereas white music therapists working in prisons only outnumbered under-represented minorities by an odds ratio of 3.18. Based on the odds ratios, the odds of a music therapist being male or non-white were 2.46 and 2.42 times greater, respectively, if one practiced music therapy in prison settings. Figure 2 and Figure 3 show key differences in gender and ethnic origin for music therapists who worked in prisons and music therapists who did not.

Music therapists who reported not having worked in corrections (n = 490) frequently reported that they did not have the opportunity to do so (n = 340, 69%). Others reported that they did not want to work in corrections (n = 146, 30%) and a few respondents said that they did not think working in corrections was important (n = 3, 1%). Music therapists who reported working in corrections (n = 52) most often said they did so because it offered an opportunity to improve the lives of clients (n = 37, 73%) or because it offered professional challenges (n = 34, 67%). Some music therapists reported that they were at the beginning of their careers as music therapists and needed the experience (n = 10, 20%) or that their work in corrections was an expression of their religious beliefs (n = 4, 8%). About one third of respondents (n = 17, 33%) mentioned other reasons for working in corrections. Responses from those participants who wrote in reasons for working in corrections are summarized in Table 2. The researchers grouped the “other” responses participants wrote into the following three categories: desire to work with the population, circumstantial reasons, and preferable to working with an alternative population.

When asked about political affiliation, 17% (n = 9) of participants who reported working in corrections did not select a response. Of those who did select their political affiliation (n = 43), the majority (72%, n = 31) reported they were Democrats, whereas 21% (n = 9) were Independent and 7% (n = 3) were Republicans. Most of the participants (n = 50) who responded to the question “To what degree do you believe your religious and/or spiritual views influence your decision to work in correctional/forensic settings?” selected “not at all” (52%, n = 26), whereas fewer participants reported that their religious and/or spiritual views somewhat (26%, n = 13) or greatly (22%, n = 11) influenced their decision to work in corrections. Two participants who reported working in corrections did not respond to the question about religious and/or spiritual views.

The music therapists who reported which goals they addressed when working in correctional settings (n = 51) most frequently selected emotional awareness (n = 48, 94%), impulse control (n = 46, 90%), self-awareness (n = 44, 86%), and relaxation and coping skills (n = 84%). The most frequently reported musical experiences used to address goals in correctional settings were listening to music (n = 49, 96%), discussion (n = 48, 94%), playing instruments (n = 47, 92%), and improvisation (n = 44, 86%). When asked about treatment models, music therapists working in corrections most often reported using the behavioral approach (n = 30, 59%) or clinical improvisation (n = 28, 55%).

Several practices and protocols reported by music therapists in the present study (all of whom work in the U.S.) were different from those reported by Gold et al. (2014), whose research took place at a correctional facility in Norway. Respondents to our survey reported that they often used music listening, discussion, instrument play, or improvisation; this is in contrast to the most frequently used interventions reported by Gold et al. (2014), which were structured music interplay, singing, and verbal reflection. The music therapist in the study by Gold et al. (2014) reported a greater frequency of sessions (2-3/week, compared to 1-2/week in our study), and smaller groups (1-6 people, compared to 6-10 people in our study). It is unclear the degree to which these differences are due to the uniqueness of the correctional system in the U.S. (which incarcerates more people per capita than any other country). It could be speculated that these differences exist due to varying cultural perceptions of what it means to be incarcerated. It could also be reflective of the fact that the U.S. is singularly phenomenal in its treatment and judgement of criminals and these differences are further highlighted when compared to countries around the world. The centuries old U.S. treatment models of imprisonment that largely emphasize a punitive treatment model make implementing creative rehabilitative services such as music therapy challenging, but not impossible. It must be mentioned, however, that there are correctional facilities, organizations, and members of correctional leadership who value, promote, and support the use of music therapy in the rehabilitation of its inmates.

Since results indicate that several new music therapy programs have been established in correctional facilities in the U.S. in recent years, the information about music therapy practices in corrections presented in this study may be helpful for music therapists who are seeking to establish new programs in correctional facilities. Music therapists establishing new programs in correctional facilities in the U.S. should form strong working relationships with the social workers at their facilities, since participants in the present study reported that social workers were most likely to refer clients for music therapy services. The prevalence of group work for music therapists working in corrections indicates that music therapists hoping to work in corrections should have ample training and experience understanding and managing group dynamics.

Although we examined the philosophies of music therapists working within the U.S. correctional system, we recommend that music therapists better understand the philosophies of those who make broader policy and administrative decisions related to the criminal justice system in their country. Understanding how the U.S. criminal justice system works (and when, why, and for whom it does not work) can better help music therapists understand and connect with the incarcerated clients they serve and their family members. Furthermore, understanding the broader context of incarcerated clients’ experiences can help music therapists advocate for the rights of their clients at the individual, institutional, and policy levels, no matter where they live. Given the inherent power dynamics that exist within the relationship between music therapists and their clients who are incarcerated, music therapists working in or preparing to work in corrections should carefully consider how aspects of their identity and political/religious beliefs might influence their clinical practice, and take steps to improve their self-awareness, knowledge, and skills in order to provide culturally competent care.

Several limitations may have influenced the outcomes of this study. Due to the small sample size, it is difficult to determine the true response rate among music therapists who work in corrections. The overall response rate (9%) includes music therapists who did not work in corrections. It is possible that some music therapists who did not work in corrections chose not to participate because they read the study title and thought they were ineligible to participate. The wording of certain questions in the survey may have caused confusion for the participants and minimized the number of people appropriate for taking the survey. For example, one question asked participants, “Do you practice music therapy in a prison?” Those who answered “no” were thanked for their participation and the survey ended. This question would have excluded respondents working with individuals who are under correctional supervision, but residing outside of a prison setting. It is not clear to what degree the information collected reflects practice of all music therapists in the U.S. working in correctional facilities. Because of these limitations, music therapists working in other countries should take caution when generalizing results from this study to their practice.

Additionally, asking respondents to make generalizations about their previous work can dilute the accuracy of their reporting. What music therapists are actually doing in their daily routine may be different than the perceptions of what is actually happening. In this survey, for example, participants were asked to identify how many people were in their sessions and how long their sessions lasted; it is not clear how accurate their estimates are.

Existing literature supports the efficacy of music therapy in this setting and information regarding the music therapists who work within these settings is lacking. Knowing more about the relatively small workforce of therapists working in prisons is valuable so that the future of music therapy in prisons has a pathway for growth, success, and evidence-based outcomes. As a result of the information gathered from this survey, a plethora of future areas of research presents itself. It would be of benefit to know how demographics, religion, race, and gender impact each of these elements, how those experiencing incarceration respond to services, and in what ways these dynamics impact the daily functioning of a music therapist in this setting. Exploring the benefits to those post-incarceration and transitioning into civilian life could offer meaningful insight. For example: halfway houses, transition programs, or substance abuse/behavioral health settings might offer meaningful comparisons that can be helpful in further understanding the correctional setting. Conducting research in a prison is difficult at best and if conducting research in a parallel, civilian-like setting can offer insight that can be transferred to the incarcerated population, that would be valuable. Hopefully, this study initiates many more research studies in the future.