15041611Voices: A World Forum for Music Therapy1504-1611GAMUT - Grieg Academy Music Therapy Research Centre (NORCE &
University of Bergen)10.15845/voices.v22i1.3367ResearchWork Satisfaction Levels of Music Therapists in the United
States: A Mixed Methods AnalysisMeadowsAnthonyameadows2@su.eduEyreLillianGollenbergAudraShenandoah University, Winchester, USATemple University, Philadelphia, USAEslava-MejiaJuanitaHeiderscheitAnnieWagnerHeather1320222216620211012022Copyright: 2022 The Author(s)2022This is an open-access article distributed under the terms of the
http://creativecommons.org/licenses/by/4.0/, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.https://voices.no/index.php/voices/article/view/3367
This mixed methods study reports levels of work satisfaction of music therapists
working in the United States. A total of 1,154 board-certified music therapists
completed a 28-question survey focused on their workplace, work, and professional
development experiences, along with their levels of stress, burnout, and happiness.
Two open-ended questions asked respondents to reflect on their identities as music
therapists. Composite work satisfaction scores were subsequently divided into
quartiles, characterizing high, moderate, and low work satisfaction groups. Music
therapists reporting high work satisfaction indicated significantly higher levels of
positive agreement with questions regarding work satisfaction than did music
therapists reporting moderate or low work satisfaction. Work satisfaction was also
significantly associated with stress, burnout, and happiness. The profiles of music
therapists reporting high, moderate, and low work satisfaction were further connected
to their identities as music therapists, illuminating the characteristics of music
therapists who are thriving, those who are moderately satisfied at work, and those
who are struggling. These profiles provide insights into the occupational wellbeing
of the profession.
levels of work satisfactionstressburnouthappinessoccupational wellbeingidentitymusic therapistsIntroduction
This article continues a line of research in which we examined the work lives of music
therapists in the United States. In the first article from this research project (Meadows et al., 2022; companion article appearing in
this issue), the workforce characteristics, workplace, and job satisfaction of
1,154 music therapists were described, along with their levels of stress, burnout, and
happiness. These data revealed that, on the whole, these music therapists were happy
with their workplace and job conditions and experienced moderate stress and low burnout.
In addition, when asked about their overall professional happiness, 74% of respondents
somewhat or completely agreed with the statement “I am happy at work,” 83% somewhat or
completely agreed with the statement “I am happy I became a music therapist,” and 72%
somewhat or completely agreed with the statement “I believe I have a future in the
profession.” These findings provide an encouraging overall picture of the field, while
also highlighting areas of concern that may provide opportunities to strengthen the
overall health of the profession.
In our discussion of these findings, three specific areas were identified that warrant
further investigation (Meadows et al.,
2022). First, there appears to be disparate salaries paid to music therapists.
While the average full-time salary of a music therapist ($53,634.59) provides an
encouraging economic outlook, the average reported salary (full- and part-time) is
$42,544.40, and the average reported salary for a music therapist with less than 1 year
of experience is $36,456.90. Further, while 1,007 music therapists provided salary data,
only 596 reported full-time salaries, or 59.19% of respondents. Additionally, of the 109
early-career music therapists (with less than 1 year of experience) who provided salary
data, only 62 (56.8%) reported full-time salaries. While these music therapists may have
chosen to work part-time, responses to related survey questions suggest otherwise. When
asked to respond to the statement “My music therapy income meets my basic needs,” only
23.6% of respondents completely agreed and 34.2% somewhat agreed, while 18.7% somewhat
disagreed and 15% completely disagreed. Further, when asked to rate their degree of
satisfaction with their salary, only 17.5% were completely satisfied and 36.9% somewhat
satisfied, while 27.7% were somewhat dissatisfied and 8.7% completely dissatisfied. This
suggests that, on the whole, some music therapists have concerns about their salaries,
and the extent to which this impacts their overall work experience is worthy of further
examination.
Second, variations in job satisfaction, stress, burnout, and happiness call for further
analysis (Meadows et al., 2022). Composite
job satisfaction scores indicated that 66% of music therapists responded to a series of
job satisfaction questions in ways that suggested a positive job experience, whereas 21%
responded in ways that suggested the opposite. Composite workplace stress scores
indicated that 52% of music therapists responded in ways that suggested they experienced
low workplace stress, whereas 32% responded in ways that suggested the opposite.
Composite burnout scores indicated that on average 61% of music therapists responded in
ways that suggested they have low levels of burnout, whereas 23% responded in ways that
suggest the opposite. Finally, composite happiness scores suggested that 73% of music
therapists provided responses that indicated they were happy professionally (somewhat or
completely), whereas 14% responded in ways that suggested they are unhappy.
Third, music therapists appear to have a broad range of professional development
opportunities, including varied opportunities for career development (Meadows et al., 2022). While 56% of
respondents somewhat or completely agreed with the statement “I have the same number of
learning opportunities in my job that my colleagues do,” 29% somewhat or completely
disagreed with the statement. When participants were asked four questions regarding
financial support and paid time off for continuing education (including conferences),
the average level of agreement (somewhat or completely) was 43%, whereas the average
level of disagreement was 44% (somewhat or completely), suggesting that less than half
of survey respondents received adequate support for professional development. Finally,
when asked whether they had “opportunities for research at their job and the support to
do so,” 37% of music therapists somewhat or completely agreed, while 39% somewhat or
completely disagreed.
When these job satisfaction, professional development, stress, burnout, and happiness
data were examined as a whole, they suggested a range of work experiences that included
music therapists who experienced high satisfaction in their work lives, those who
experienced moderate satisfaction, and those who experienced low satisfaction. In this
article, we differentiate these levels of work experience by quartiles, with the highest
level of satisfaction attributed to the highest quartile of survey responses (top 25%),
moderate satisfaction to the middle two quartiles (26%–74%), and low satisfaction to the
lowest quartile (bottom 25%). We then examine a range of variables in relation to these
levels of satisfaction, seeking to define and differentiate each level.
In addition to examining differences in responses to categories of survey questions, we
analyzed written responses to two questions regarding how respondents thought about being
a music therapist (“When I think about being a music therapist, the first thing that
comes to mind is…”) and their identities as a music therapist (“When I think about my
identity as a music therapist, the first thing that comes to mind is…”). Responses to
these questions provide insight into how music therapists think about their professional
identities, and differences in these responses illuminate core characteristics of these
music therapists that may clarify the nature of the struggles some music therapists
experience in relation to the overall quality of their work lives, while also
illuminating the characteristics of those who are thriving professionally.
We propose that these data provide insight into the occupational wellbeing of our
profession. Occupational wellbeing can be defined in a number of ways. Van Horn et al. (2004) defined occupational
wellbeing as “a positive evaluation of various aspects of one’s job, including
affective, motivational, behavioral, cognitive and psychosomatic dimensions” (p. 366).
Taking a different perspective, Doble and Caron Santha (2008) suggested that occupational wellbeing occurs when
individuals have the opportunity to engage in a variety of occupations that foster
meaning and satisfaction. According to these authors, occupational wellbeing has several
prerequisites or intrinsic needs, which they refer to as occupational needs. These needs
include experiences of agency (a sense of control over how and when one
engages in their occupation), accomplishment (feelings of mastery),
affirmation (praise and acknowledgment), pleasure
(fun), renewal (rest and relaxation),
coherence (connecting one to their past, present, and future), and
companionship (closeness and connection to others).
Through an examination of the characteristics of each level of work satisfaction, our
aim is to define and differentiate these levels, contextualizing these data according to
various components of occupational wellbeing. In so doing, we seek to define and
differentiate levels of occupational wellbeing and to consider these dimensions as
indictors of occupational identity (Skorikov &
Vondracek, 2011).
MethodParticipants
Detailed demographic data along with the workforce characteristics of survey
participants can be found in Meadows et al.
(2022). In total, 1,154 music therapists completed some or all of the
survey questions, a 14.59% response rate. Participants were predominantly female
(88.2%), and their age reflected a bimodal distribution, with most ages between 20
and 29 years (36.7%) and 30 and 39 years (30.3%). All seven regions of the American
Music Therapy Association were represented, with the majority of participants from
the mid-Atlantic (27.7%) and Great Lakes (24.7%) regions. Further, 56.83% of
respondents were members of the American Music Therapy Association.
Ethical Approval
This study was reviewed by the Shenandoah University Institutional Review Board
(protocol #752) and was adjudicated as exempt from further review.
Survey Design
The survey consisted of 25 multiple-choice and three open-ended questions. The
multiple-choice questions related to demographic information (17 questions),
workplace satisfaction (1 question; 7 items), professional development (1 question; 6
items), job satisfaction (4 questions; 11 items), stress (1 question; 11 items),
burnout (1 question; 16 items), and happiness (1 question; 7 items). Participants
were also asked to write in their exact salary. In addition, at the end of the
survey, they were invited to provide written responses to two open-ended questions:
“When I think about being a music therapist, the first thing that comes to mind is…”
and “When I think about my identity as a music therapist, the first thing that comes
to mind is….”
Further details regarding survey construction and distribution can be found in Meadows et al. (2022).
Data Analysis
Data analysis occurred in three phrases, consistent with an explanatory mixed methods
design (Burns & Masko, 2016). First,
survey responses were categorized and examined according to level of work
satisfaction. Second, written responses to two open-ended questions were analyzed
using methods consistent with thematic analysis. Third, qualitative and quantitative
data were then combined to provide a comprehensive picture of the levels of work
satisfaction. Each phase is described in further detail below.
Quantitative Analysis
Composite scores for happiness, burnout, stress, and work satisfaction were
calculated by summing the reported values for each question in their respective
domain. To allow for internal comparisons between groups of music therapists,
quartiles of scores were created for each domain. A chi-squared test for
significance was utilized when comparing the distribution of categorical
variables. Correlation between individual job satisfaction questions and composite
satisfaction scores were determined using Spearman correlations. All statistical
analyses were completed using SAS University Edition software (version 9.2).
Qualitative Analysis
Open-ended responses to two survey questions were analyzed according to level of
work satisfaction. These analyses were based on an inductive approach to thematic
analysis using the question itself as a first cycle coding method. Second cycle
coding methods focused on pattern coding to compare the similarities, differences,
and frequencies of responses (Saldaña, 2016, p.
236) and on values coding to identify attitudes, values, and beliefs
(Saldaña, 2016, p. 131). Simultaneous
coding was applied to analyze the valence of each code (negative, positive,
neutral, or mixed), thereby indicating the range and complexity of responses
(Saldaña, 2016, p. 83).
After becoming familiar with the responses as a whole, the first and second
authors then analyzed each question using the following steps: 1) each response
statement was coded according to patterns and/or values, 2) each code was
simultaneously assigned a valence, 3) these codes were reduced in number by
combining codes with similar constructs and distributions of valences in order to
create categories, 4) categories were combined to create themes and were evaluated
for accuracy by returning to the original data to determine goodness of fit, and
5) each theme was then characterized in narrative form, providing an overall
description of these themes according to level of work satisfaction. See Appendix
A for coding rules, including details of how data such as “mixed” responses were
analyzed.
Mixing Data
High, moderate, and low work satisfaction profiles were then developed by
combining quantitative and qualitative data into a narrative form. This included
combining survey responses and qualitative themes that characterize each level of
work satisfaction and then examining satisfaction levels according to their
similarities and differences. Finally, satisfaction levels were examined according
to the characteristics associated with professional identity and occupational
wellbeing (Doble & Caron Santha,
2008).
Results
Total work satisfaction scores were calculated by combining responses to two questions
regarding workplace satisfaction, job satisfaction, and professional development (24
items). Total scores were then divided into quartiles to differentiate levels of work
satisfaction. Music therapists who scored in the highest quartile (n =
246) were characterized as having high work satisfaction, those in the middle two
quartiles moderate satisfaction (n = 447), and those in the lowest
quartile low satisfaction (n = 240). The characteristics of music
therapists in each quartile were then examined in a variety of ways to understand more
about the attributes of each group.
Characteristics of High, Moderate, and Low Work Satisfaction
Music therapists in the highest quartile of work satisfaction reported significantly
higher levels of positive agreement with questions regarding work satisfaction than
did music therapists in the middle (p < 0.0001) and lowest
quartiles of work satisfaction (p < 0.0001). That is, when taken
as a whole, music therapists in the highest quartile of work satisfaction reported
more satisfying work conditions, greater work satisfaction, and more satisfying
professional development opportunities than did those in the middle and lowest
quartiles. Music therapists in the moderate satisfaction group tended to report
moderate agreement, albeit with some variation, with questions related to workplace
and job satisfaction, but had significantly higher satisfaction than did those in the
lowest quartile group (p < 0.0001). However, when each of the
survey questions was examined to determine the extent to which it was uniquely
associated with a level of work satisfaction, each question was significantly
associated with the workplace satisfaction composite score (p <
0.0001). Further, each question had a moderate correlation with the composite score,
with a range of Spearman correlation coefficients from 0.4 to 0.6 (p
< 0.0001). This suggests that while a complex constellation of factors were
associated with work satisfaction levels, as represented in the 24 questions
associated with work satisfaction, each of these factors was of equal importance in
understanding work satisfaction. Table 1 provides a summary of the distribution of
scores for each work satisfaction level. Lower scores equate to higher satisfaction.
Distribution of Composite Work Satisfaction Scores by Level of Satisfaction
Relationship Between Work Satisfaction and Demographic Variables
Overall, male music therapists were more likely than female music therapists to be
categorized in the high work satisfaction quartile (p = 0.01). There
were no differences in work satisfaction levels by age (p = 0.48),
race/ethnicity (p = 0.44), degree (p = 0.07), years
working as a music therapist (p = 0.28), or years in current
position (p = 0.11).
Work satisfaction was impacted by the settings in which these music therapists
worked. Music therapists working in medical settings, universities and colleges,
hospice, and “other” (a composite work category) were more likely to be categorized
in the highest quartile of satisfaction. Conversely, music therapists working in
older adult/long-term care communities, in mental health settings, and as
self-employed/private practice or community music therapists, were more likely to
fall in the lowest quartile of satisfaction (p < 0.0001). Table 2
provides a summary of the distribution of music therapists in each quartile by work
setting.
Levels of Work Satisfaction by Setting
Setting
High Work Satisfaction
Moderate Work Satisfaction
Low WorkSatisfaction
Total
n
%
n
%
n
%
n
%
Children’s facilities and schools
36
27.7
65
50
29
22.3
130
14.0
Community music therapy
9
23.7
18
47.7
11
29.0
38
4.1
Older adult/long-term care communities
9
12.7
39
54.9
23
32.4
71
7.6
Hospice
30
30.6
46
46.9
22
22.5
98
10.5
Medical settings
39
48.2
36
44.4
6
7.4
81
8.7
Mental health, including addiction treatment
25
17.7
71
50.4
45
31.9
141
15.1
Self-employed/private practice
42
21.8
95
49.2
56
29.0
193
20.7
Universities/colleges
11
33.3
14
42.4
8
24.4
33
3.5
Other
45
30.6
62
42.2
40
27.2
147
15.8
Annual salary was also associated with work satisfaction. Music therapists reporting
the highest work satisfaction were more likely to report annual salaries greater than
$45,000.00 (p < 0.0001). In fact, 42% of music therapists who
reported salaries in the $60,000.00–$75,000.00 range and 58% of music therapists who
reported salaries greater than $75,000.00 reported the highest work satisfaction.
Conversely, music therapists who reported the lowest work satisfaction also reported
the lowest salaries. In fact, 51% of music therapists who reported salaries below
$10,000.00 and 47% of music therapists who reported salaries in the
$10,000.00–$20,000.00 range reported the lowest work satisfaction.
Concomitantly, work satisfaction was associated with income satisfaction. Music
therapists with high work satisfaction reported higher levels of income satisfaction,
and these satisfaction levels were significantly different from those of music
therapists who reported low work satisfaction (p < 0.0001). In
fact, 54% of music therapists who completely agreed with the statement “I am
satisfied with my music therapy income” also reported the highest work satisfaction,
whereas 51% of music therapists who completely disagreed with this statement reported
the lowest work satisfaction. Additionally, 47% of music therapists who completely
agreed with the statement “My music therapy income meets my basic financial needs”
were also identified as having the highest work satisfaction, whereas 62% of music
therapists who completely disagreed with this statement were identified as having the
lowest work satisfaction.
Finally, work satisfaction was also associated with satisfaction with hours worked
(p < 0.0001). When asked to indicate their level of
satisfaction with their hours worked, 37% of music therapists who indicated they were
completely satisfied reported the highest level of work satisfaction. Conversely, 62%
who indicated they were completely unsatisfied reported the lowest level of work
satisfaction.
Work Satisfaction, Stress, Burnout, and Happiness
Not surprisingly, work satisfaction was associated with stress, burnout, and happiness
(p < 0.0001). Music therapists reporting the highest work
satisfaction reported the lowest levels of stress and burnout and the highest levels
of happiness. Conversely, music therapists reporting the lowest work satisfaction
reported the highest levels of stress and burnout and the lowest levels of happiness.
Table 3 provides a summary.
Music therapists reporting high work satisfaction (n = 246) had the
following profile related to stress, burnout, and happiness: 52% reported low levels
of stress, 62% reported low levels of burnout, and 53% reported high levels of
happiness. In contrast, 7% reported high levels of stress, 1% reported high levels of
burnout, and 8% reported low levels of happiness.
Levels of Work Satisfaction, Stress, Burnout, and Happiness
Wellbeing Measure
High Work Satisfaction
Moderate Work Satisfaction
Low Work Satisfaction
Total
n
%
n
%
n
%
n
%
Stress*
Low
120
58.5
75
36.6
10
4.9
205
23.2
Moderate
96
23.0
223
53.4
99
23.7
418
47.3
High
17
6.5
122
46.7
122
46.7
261
29.5
Burnout*
Low
141
69.5
57
28.1
5
2.5
203
29.6
Moderate
83
19.8
262
62.5
74
17.7
380
43.2
High
3
1.2
92
37.3
152
61.5
239
27.2
Happiness*
Low
19
8.0
100
41.8
261
29.5
260
29.6
Moderate
90
23.7
198
53.4
99
23.7
380
43.2
High
125
48.1
117
45.0
18
6.9
239
27.2
*p < 0.0001
Music therapists reporting moderate work satisfaction (n = 447) had
the following profile related to stress, burnout, and happiness: 18% reported low
levels of stress, 14% reported low levels of burnout, and 28% reported high levels of
happiness. In contrast, 29% reported high levels of stress, 22% reported high levels
of burnout, and 24% reported low levels of happiness.
Music therapists reporting low work satisfaction (n = 240) had the
following profile related to stress, burnout, and happiness: 4% reported low levels
of stress, 2% reported low levels of burnout, and 8% reported high levels of
happiness. In contrast, 53% reported high levels of stress, 66% reported high levels
of burnout, and 52% reported low levels of happiness.
Work Satisfaction and “Being a Music Therapist”
In addition to examining differences in responses to categories of survey questions,
we analyzed written responses to two questions regarding how respondents think about
being a music therapist (“When I think about being a music therapist, the first thing
that comes to mind is…”) and their identities as a music therapist (“When I think
about my identity as a music therapist, the first thing that comes to mind is…”) in
relation to their level of job satisfaction. These data provide additional insight
into the overall wellbeing of these music therapists, illuminating core
characteristics of their professional identities. Tables 4 and 5 provide a summary of
the major themes related to each of these questions.
Highly Satisfied Music Therapists
When highly satisfied music therapists (n = 207) were asked to
think about the first thing that comes to mind regarding being a music therapist,
77.8% (161) of their responses were positive, 7.8% (16) were negative, 10% (20)
were mixed, and 4.8% (10) were neutral. Positive responses related to
helping others (32%), being grateful (9%)
finding the job enjoyable and rewarding (8.7%), experiencing
pride and passion (8.2%), and finding satisfaction and
fulfillment (8.2%). These music therapists also noted music
and creativity (6.3%) as positive elements of being a music therapist.
Negative responses related to being misunderstood and constantly
needing to advocate for the profession (4.8%). Having to
advocate for the profession was also reported in mixed
responses (3.4%). Other mixed responses tended to focus on challenges associated
with low salaries (4.8%) and fewer job
opportunities (2.4%). For these respondents, their work as music
therapists was unique and fulfilling, but this was tempered by
these challenges, along with concerns about administrative load
and feeling frustrated, under-appreciated, and
under-represented.
Moderately Satisfied Music Therapists
When moderately satisfied music therapists (n = 373) were asked
to think about the first thing that comes to mind regarding being a music
therapist, 64.3% (240) of their responses were positive, 16.4% (61) were negative,
8.6% (32) were mixed, and 10.7% (40) were neutral. Positive responses related to
helping others (27%) and feeling fulfillment
(11.8%), passion and pride (10.7%), and
gratitude (5.4%). Negative responses related to
salaries (3.5%), challenges (2.9%),
limitations and disappointment (2.7%), and advocacy
(2.7%). Mixed responses related to challenges (3.5%),
feeling misunderstood (1.9%), and salaries
(1.6%). Neutral responses (7%) related to the profession as a whole, with no
discernable valence. These responses included comments related to one’s position,
job tasks, and identification with a particular approach or population.
Music Therapists with Low Satisfaction
When music therapists with low satisfaction (n = 211) were asked
to think about the first thing that comes to mind regarding being a music
therapist, 43.6% (92) of their responses were negative, 40.3% (85) were positive,
10% (21) were mixed, and 6.2% (13) were neutral. Negative responses related to
feeling misunderstood, having to constantly
advocate for themselves and the profession, and questioning
the value of music therapy (13.7%). These music therapists also
expressed concerns about their salaries (8.5%) and a range of
challenges (6.6%) that included how hard the
work was, inadequate to hostile work environments, and
few opportunities for advancement. Positive responses related
to helping others (18%); gratitude, fulfillment, and
pride (12.8%); and enjoyment and excitement (7.1%). Mixed responses, which
included combinations of positive and negative responses, focused primarily on
salaries (4.3%), challenges (3.3%), and
feeling misunderstood and undervalued (1.9%). Neutral responses (6.2%) were related to
professional issues and had no discernable valence. When the negative and mixed
response data were combined, three themes were reaffirmed: feeling
misunderstood (15.6%), concerns about
salaries (12.8%), and challenges (10%).
“When I think about being a music therapist, the first thing that comes to
mind is…”
Level of Satisfaction
%
High Work Satisfaction (n = 207)
Positive
Helping others
32.0
Being grateful
9.0
Enjoyable and rewarding
8.7
Experiencing pride and passion
8.2
Satisfaction and fulfillment
8.2
Creativity
6.3
Negative
Advocating for the profession and being
misunderstood
4.8
Mixed
Advocating for the profession and being
misunderstood
3.4
Salaries
4.8
Fewer job opportunities
2.4
Moderate Work Satisfaction (n = 373)
Positive
Helping others
27.0
Fulfillment
11.8
Passion and pride
10.7
Gratitude
5.4
Negative
Salaries
3.4
Challenges
2.9
Limitations and disappointment
2.7
Advocacy
2.7
Mixed
Challenges
3.5
Feeling misunderstood
1.9
Salaries
1.6
Low Work Satisfaction (n = 211)
Positive
Helping others
18.0
Gratitude, fulfillment, and pride
12.8
Enjoyment and excitement
7.1
Negative
Misunderstood, advocate, and questioning the
value of music therapy
13.7
Salaries
8.5
Challenges
6.6
Mixed
Salaries
4.3
Challenges
3.3
Feeling misunderstood
1.9
Work Satisfaction and Professional IdentityHighly Satisfied Music Therapists
When highly satisfied music therapists (n = 205) were asked to
think about the first thing that comes to mind regarding their identity as a music
therapist, 65.9% (135) of their responses were positive, 9.2% (19) were negative,
9.8% (20) were mixed, and 15.1% (31) were neutral. Positive responses included
pride (e.g., pride in one’s work and the profession; 12.2%),
gratitude and fulfillment (e.g., having a career and job that
one loves; 12.2%), value (e.g., unique benefits of music therapy;
8.3%), and good fit (e.g., loving to work creatively with
clients; 8.3%). Negative responses included the interconnection of
feeling misunderstood, advocacy, and recognition (e.g., dealing with
people’s misconceptions about music therapy; 5.4%) and challenges and
self-doubt (e.g., work–life balance being difficult to find because of
overwhelming workload; 3.9%). Mixed responses echoed the negative responses:
challenge and isolation (e.g., loving and finding value in the
job but being concerned about burnout and lack of opportunities for advancement;
2.9%) and misunderstood and recognition (e.g., feeling respected
by clients, but also misunderstood; 1.5%). Neutral responses focused on
professional role and clinical approach (e.g., identification
with one’s approach or client group; 6.3%).
Moderately Satisfied Music Therapists
When moderately satisfied music therapists (n = 363) were asked
to think about the first thing that comes to mind regarding their identity as a
music therapist, 63.4% (230) of their responses were positive, 17.4% (63) were
negative, 13.8% (50) were mixed, and 5.5% (20) were neutral. The highest positive
responses were pride (e.g., pride in the work one does and the
clients one serves; 15.7%); approach (e.g., identification with a
particular approach one uses—for example, humanistic, music-centered,
psychotherapeutic, or neurological; 7.4%); helper (e.g., being in
service of others; 7.2%); and a combination of role, professional, and competent (e.g.,
the competence one has developed working with a particular population; 6.9%). The
highest negative response was a combination of misunderstood
and limitation (e.g., a primarily negative
association with one’s identity based on belonging to a profession that is
misunderstood and perceived as limited; 9.6%), while the highest mixed responses
focused on disidentification with music therapy (e.g., while
being grateful for the knowledge gained through education and clinical experience,
not self-identifying primarily as a music therapist; 2.8%) and challenges
and burnout (e.g., loving and being proud of one’s work but being
concerned with professional issues such as exhaustion and burnout; 2.2%). Neutral
responses focused primarily on being unsure (e.g., feeling
uncertain, unclear, undecided, or in the process of forming their identity;
3.9%).
Music Therapists with Low Satisfaction
When music therapists with low satisfaction (n = 206) were asked
to think about the first thing that comes to mind regarding their identity as a
music therapist, 40.3% (83) of their responses were positive, 32.5% (67) were
negative, 18.9% (39) were mixed, and 8.3% (17) were neutral. The highest positive
responses included pride and passion (e.g., pride in the work
music therapists do with their clients; 9.2%), role (e.g.,
identification primarily with one’s role as a helper, therapist, supervisor, or
educator; 6.8%), good fit (e.g., that one’s job is one’s destiny
or purpose in life; 5.8%), and gratitude and fulfillment (e.g.,
gratitude for being able to help others through music and relationships; 4.9%).
Negative responses focused on feeling misunderstood (e.g., being
perceived as an entertainer, a volunteer, a music teacher, the “music lady,” or a
“joke”; 12.1%); the interconnection between self-doubt, shame, failure,
and regret (e.g., feeling inadequate and insecure about one’s
knowledge and clinical contribution in the workplace; 6.8%); and the combination
of disidentification with music therapy and the belief that
the profession needs to change (e.g., not identifying or no
longer identifying as a music therapist; 6.8%). Mixed responses focused on
challenges (e.g., having few professional opportunities or
feeling burned out and exhausted; 4.9%) and advocacy (e.g.,
although clinical work is enjoyable, it requires constant advocacy, sometimes
leading to exhaustion; 4.4%). Neutral responses focused primary on feeling
unsure (e.g., unsure of one’s identity; 2.4%).
“When I think about my identity as a music therapist, the first thing that
comes to mind is…”
First Thing That Comes to Mind
%
High Work Satisfaction
Positive
Pride
12.2
Gratitude and fulfillment
12.2
Good fit
8.3
Value
7.3
Negative
Feeling misunderstood, advocacy, and recognition
5.4
Challenges and self-doubt
3.9
Mixed
Challenge and isolation
2.9
Feeling misunderstood and recognition
1.5
Moderate Work Satisfaction
Positive
Pride
15.7
Approach
7.4
Helper
7.2
Role, professional, and competent
6.9
Negative
Feeling misunderstood and limitations
9.6
Mixed
Disidentification with music therapy
2.8
Challenges and burnout
2.2
Low Work Satisfaction
Positive
Pride and passion
9.2
Role
6.8
Good fit
5.8
Gratitude and fulfillment
4.9
Negative
Feeling misunderstood
12.1
Self-doubt, shame, failure, and regret
6.8
Disidentification with music therapy and belief that the profession
needs to change
6.8
Mixed
Challenges
4.9
Advocacy
4.4
Discussion
When the high, moderate, and low work satisfaction levels of music therapists were
examined, three distinct profiles emerged. Highly satisfied music therapists reported
more satisfying work conditions, greater work satisfaction, and more satisfying
professional development opportunities than did music therapists who reported moderate
or low satisfaction. Concomitantly, moderately satisfied music therapists reported more
satisfying work conditions, greater work satisfaction, and more satisfying professional
development opportunities than did music therapists who reported low satisfaction.
Differences in overall satisfaction were also associated with salaries, income
satisfaction, and satisfaction with hours worked, with highly satisfied music therapists
reporting significantly higher levels of satisfaction when compared to music therapists
with moderate and low satisfaction. A comparable difference was also evident between
music therapists with moderate and low satisfaction.
Workplace Satisfaction
Importantly, no single workplace or job satisfaction question was uniquely associated
with satisfaction levels, suggesting that each question is of equal importance for
understanding work satisfaction. Table 6 presents differences in responses to
questions associated with workplace satisfaction. Response distributions reveal
important differences in levels of agreement (somewhat or complete agreement) with
survey questions, especially with regards to questions that focus on budget, space,
and session interruptions. In addition, only 47.92% of music therapists with low
satisfaction reported somewhat or completely agreeing with the statement “I have
access to the instruments I need for my music therapy sessions,” suggesting a
fundamental challenge for some music therapists in providing music experiences during
their sessions.
Levels of Agreement with Specific Workplace Satisfaction Questions
Workplace Satisfaction Question
High Work Satisfaction(n = 242)
Moderate Work Satisfaction(n = 437)
Low Work Satisfaction(n = 240)
“I am generally happy with my work conditions”
98.35%(238)
84.21%(368)
46.67%(112)
“I am allocated an adequate budget to carry out my duties”
91.32%(232)
56.75%(248)
17.92%(43)
“I have appropriate space allocated to me for my music therapy
sessions”
90.50%(219)
64.99%(284)
32.92%(79)
“I have access to the instruments I need for my music therapy
sessions”
97.52%(236)
82.38%(360)
47.92%(115)
“I can carry out most sessions with my clients without
interruptions”
87.60%(212)
58.81%(257)
31.67%(76)
A similar distribution of responses was evident when questions associated with job
satisfaction were examined, as presented in Table 7. Highly satisfied music
therapists reported high levels of agreement with each question, except for the two
supervision questions, which gained moderate levels of agreement. Moderately
satisfied music therapists reported moderate levels of agreement with each job
satisfaction question, except for questions related to music therapy or creative arts
therapy supervision, which gained a level of agreement of only 34.55%. Music
therapists with low satisfaction reported moderate to low levels of agreement with
each question, with particularly low levels of agreement concerning team meetings and
supervision. These differences highlight the characteristics of highly satisfying
jobs, while also indicating the importance of increasing supervision opportunities
and opportunities for music therapists to meaningfully contribute to team meetings.
Access to music therapy/creative arts therapy supervision appears to be an important
consideration for employers and policy makers. Lack of access to music therapy or
creative arts therapy supervision may inhibit the professional development of a music
therapist and may be negatively associated with identity development and professional
wellbeing (Gamliel et al., 2020; Thaker & Diambra, 2019).
Levels of Agreement with Specific Job Satisfaction Questions
Job Satisfaction Question
High Work Satisfaction(n = 242)
Moderate Work Satisfaction(n = 437)
Low Work Satisfaction(n = 240)
“In my setting I have the opportunity to use the most appropriate music
therapy interventions for my population”
98.35%(238)
84.21%(368)
52.50%(126)
“I can access client records in a timely manner so that I can assess
clients appropriately”
95.45%(231)
76.66%(335)
41.25%(99)
“I have the opportunity to document my clients’ progress”
97.93%(237)
87.87%(384)
62.08%(149)
“I am included in team meetings appropriate to my work duties”
94.63%(229)
66.13%(289)
31.67%(76)
“My perspective on clients is valued in team meetings”
91.74%(222)
67.73%(296)
30.42%(73)
“I have access to music therapy or creative arts therapy
supervision”
61.98%(150)
34.55%(151)
15.42%(37)
“I have access to non-music therapy supervision at my job”
75.62%(183)
58.58%(256)
30.42%(73)
Reponses to questions related to professional development again highlight disparities
between music therapists with high and low satisfaction (Table 8). Indeed, 90.91% of
highly satisfied music therapists reported somewhat or completely agreeing with the
statement “I have the same number of learning opportunities (in-services, meetings,
lectures, etc.) in my job as my colleagues do,” whereas only 56.29% of music
therapists with moderate satisfaction and 19.27% of music therapists with low
satisfaction reported agreement with this statement. Similar levels of disparity were
evident in responses to two questions related to financial support, with music
therapists with low satisfaction reporting very low levels of financial support for
conferences and continuing education. These differences appear, once again, to
highlight the significant professional challenges music therapists with low
satisfaction experience, challenges which may impact their abilities to grow
professionally and feel connected to other music therapists. According to Doble and
Caron Santha (2008), agency (a sense of
control in how and when one engages in one’s occupation) and companionship (closeness
and connection to others) are important dimensions of occupational wellbeing,
dimensions that appear to be distressed for music therapists with low
satisfaction.
Levels of Agreement with Specific Professional Development Questions
Professional Development Question
High Work Satisfaction(n = 242)
Moderate Work Satisfaction(n = 437)
Low Work Satisfaction(n = 240)
“I have the same number of learning opportunities (in-services,
meetings, lectures, etc.) in my job as my colleagues do”
90.91%(220)
56.29%(246)
19.17%(46)
“My employer provides financial support to attend at least one
conference a year”
78.10%(189)
34.10%(149)
8.33%(20)
“My employer provides financial support for continuing education”
78.51%(190)
35.93%(157)
11.25%(27)
Stress, Burnout, and Happiness
Not surprisingly, levels of work satisfaction were strongly associated with levels of
stress, burnout, and happiness, with distinct profiles emerging for each satisfaction
level. Furthermore, the settings in which music therapists worked were also associated
with stress, burnout, and happiness. Music therapists working in medical settings,
universities and colleges, hospice, and “other” (a composite work category)
experienced the lowest levels of stress and burnout and the highest levels of
happiness, whereas music therapists working in older adult/long-term care
communities, in mental health settings, and as self-employed/private practice music
therapists or as community music therapists experienced the highest stress and
burnout and the lowest satisfaction. These distinct workplace experiences are worthy
of further investigation, both to more fully understand the features of highly
satisfying work settings and to understand the factors that negatively impact a
healthy, satisfying work life. It would be, for example, important to understand
those factors that are institutional (e.g., when low work satisfaction, high stress
and burnout, and low happiness are experienced by the majority of workers in a
workplace) and those that are specific to the workplace, job, and professional
development experiences of music therapists. Furthermore, understanding the
workplace, job, and professional development characteristics of highly satisfying
work settings provides a template for advocacy efforts and may inform how music
therapy educators prepare their students for professional life. Placing an increased
emphasis, for example, on teamwork, interprofessional communication, advocacy for
regular and ongoing supervision, and communication with administrators about music
therapy’s benefits may positively impact the work experiences of music therapists,
especially those early in their careers.
Work Satisfaction and Professional Identity
We also examined written responses to two questions that focused on how respondents
thought about being a music therapist (“When I think about being a music therapist,
the first thing that comes to mind is…”) and on their identity as a music therapist
(“When I think about my identity as a music therapist, the first thing that comes to
mind is…”). Core characteristics of respondents’ professional identities were
illuminated, providing additional insight into how these identities vary according to
work satisfaction. Significantly, across all levels of satisfaction, the music
therapists identified as helpers (helping others) who felt pride
(passion and pride), gratitude (gratitude, fulfillment,
and pride), and fulfillment in their work (satisfaction and
fulfillment). Across all levels of work satisfaction, when a negative
response was expressed, it focused on advocacy (having to advocate for the
profession; misunderstood, advocate, and questioning the value of
music therapy; feeling misunderstood, advocacy, and
recognition). Across all levels of work satisfaction, when a mixed
response was expressed, it focused on feeling misunderstood (misunderstood,
advocate, and questioning the value of music therapy;
misunderstood and recognition) while also recognizing a positive
aspect of the profession.
Different responses to these two questions may also reveal differences in the kinds
of challenges music therapists experience in identity development. Music therapists
who reported low work satisfaction also reported higher levels of experience being
misunderstood, having to advocate for themselves, and feeling self-doubt,
shame, failure, and regret. For example, one respondent wrote the
following: “I am tired and burned out from advocating for my career and future, and
music therapy. I have no opportunity for growth and am undervalued.” Music therapists
in this quartile were also more likely to report concerns about their salaries when
asked about the first thing that comes to mind regarding being a music therapist and
were more likely to report a lack of career opportunity. For example, one respondent
wrote the following: “I love the work I do when I’m allowed to truly do it but I’m so
under-supported in my job. I’m just a glorified activities aide at this point.”
In contrast, highly satisfied music therapists reported higher levels of positive
comments overall (e.g., Joy; I love music therapy and know that it is my vocation),
and while also reporting concerns about feeling misunderstood, advocacy, and
recognition, did so at much lower levels than did music therapists with
low satisfaction. When concerns were expressed, they were also mitigated by positive
aspects of their job. For example, as one respondent explained: “low pay, high level
advocacy required, limited job options, but enjoyable, valuable work and I love being
a music therapist, I love my job. It is hard some days, and definitely
misunderstood.”
While understanding the work factors and identity attributes of highly satisfied
music therapists provides an educational and policy roadmap for the health of the
profession, it also highlights ongoing challenges music therapists experience
professionally. Depending on the level of work satisfaction experienced by a music
therapist, these challenges may include concerns regarding 1) salary (including the
ability to secure a full-time position), 2) feeling understood and valued as a
professional (advocacy), 3) belonging (feeling part of a community), 4) being able to
develop as a professional (supervision, continuing education, conference attendance),
and 5) being able to maintain one’s health while working as a music therapist
(managing stress and burnout).
Occupational Wellbeing
These findings also invite the music therapy community to think broadly about the
occupational wellbeing of the profession. Occupational wellbeing is defined as “a
positive evaluation of […] one’s job, including affective, motivational, behavioral,
cognitive and psychosomatic dimensions” (van
Horne et al., 2004) and as a set of intrinsic needs that characterize one’s
work experience: agency, accomplishment, affirmation, pleasure, renewal, coherence,
and companionship (Doble & Caron Santha,
2008). While occupational wellbeing as a construct was not specifically
investigated in this study, survey data appear to reflect three levels of wellbeing:
the work experiences, stress, burnout, happiness, and identities of music therapists
who are thriving (high work satisfaction), of those who are moderately satisfied
(moderate work satisfaction), and of those who are struggling (low work
satisfaction).
Music therapists who reported high work satisfaction appeared to experience, to
varying degrees, agency (a sense of control in
one’s work environment, including one’s ability to arrange, structure, and implement
client/patient sessions in ways one believes are most beneficial to one’s
clients/patients), accomplishment (identifying strongly as a
helper; feeling mastery over one’s work),
affirmation (feeling satisfied with one’s income; pride; feeling
passionate about one’s work; being valued as a team member),
pleasure (fulfillment), renewal (receiving
support to attend conferences and continuing education; career development),
coherence (good fit), and companionship (feeling
part of a team; feeling connected to others). These music therapists tended to report
lower levels of stress, lower levels of burnout, and higher levels of happiness
compared to music therapists who reported moderate or low work satisfaction.
In contrast, music therapists who reported low work satisfaction appeared to
experience, to varying degrees, disruptions to agency (a
lack of control in one’s work environment, including disruptions
to one’s ability to arrange, structure, and implement client/patient sessions in ways
one believes are most beneficial to one’s clients/patients),
accomplishment (feeling challenged), affirmation
(feeling dissatisfied with one’s income; misunderstood; lacking value as a team
member), pleasure (feeling inadequate), renewal
(lacking support to attend conferences and continuing education events;
lacking support for career development), coherence (disidentifying
with music therapy), and companionship (not feeling part of a team;
feeling colleagues and administrators do not understand or value one’s work). They
also tended to report higher levels of stress, higher levels of burnout, and lower
levels of happiness compared to music therapists who reported moderate or high work
satisfaction. Even with these challenges, however, music therapists who reported low
work satisfaction still expressed pride in being a music therapist, passion for their
work, gratitude, and a sense of fulfillment, attesting to their resilience and
connection to the healing power of music.
Implications for the Profession
These findings have important implications for the profession and are presented in
summary form to promote further discussion:
Disparate salaries, and the strong association
between work satisfaction and salary satisfaction, raise important questions
about the perceived value of music therapy, as expressed by employers in the
salaries paid to music therapists. Addressing salary variability appears to be
an important focus for advocacy efforts at the state and national level.
The challenges to everyday practice reported by music
therapists with low work satisfaction are not only impactful of their work
lives but also appear to fundamentally impact their clients. Lack of access to
instruments, lack of appropriate session space, and session interruptions
warrant immediate attention, given the potential impact on the health and
safety of clients.
Grassroots advocacy, undertaken by music therapists
in their everyday work lives, may have limited impact on their overall work
lives. Targeted national advocacy efforts by representatives of the profession,
especially efforts focused on institutional decision-makers, may be more
effective than ad hoc individual advocacy.
Further examination of the characteristics of highly
satisfying workplaces may build a profile of healthy career development and
support the occupational wellbeing of the profession. In particular, promoting
workplace characteristics that support the dignity of the music therapist and
provide an optimal therapeutic environment for clients may advance the
profession as a whole.
Career development appears to be an important topic
of conversation for educators and American Music Therapy Association leaders.
An examination of how academic programs prepare students for the challenges of
professional life and equip them with the tools to address these challenges
appears to be important to ensuring the stability and growth of the field.
Workplace infrastructures that support regular
supervision and promote career development appear to vary considerably across
workplaces. Access to supervision and regular, ongoing opportunities for
continuing education appear to be central to ensuring the wellbeing of music
therapists and to supporting their professional growth.
A careful examination of the characteristics of music
therapy in older adult/long-term care facilities, mental health settings, and
private practice appears to be an important undertaking if work conditions in
these settings are to be improved.
Consideration of the profession’s growth in terms of
occupational wellbeing affirms healthy workplace standards and lifts up the
profession as a whole.
Affirming our identity (identities) as music
therapists locates us within educational and healthcare settings in ways that
affirm our place in these communities. Celebrating our identity (identities),
while also supporting early career professionals as they shape theirs, appears
to be central to ensuring the long-term health of the profession.
Conclusion
Examining the work lives of music therapists by levels of satisfaction provides insight
into the workplace, work, and professional development experiences of music therapists
who are thriving, of those who are moderately satisfied, and of those who are
struggling. The profiles of music therapists who are thriving provide a template for
professional growth that advances the wellbeing of the profession. The profiles of music
therapists who are struggling offer insight into the challenges the profession faces,
while also providing a roadmap for a healthier profession. These profiles ask one to
reconsider a) the focus of advocacy efforts, including those concerned with salary equity;
b) the extent to which education and training programs prepare students to engage in
workplace challenges that improve their work lives; and c) the focus of the profession
to ensure its relevance and sustainability.
About the Authors
Anthony Meadows, PhD, MT-BC, is the Director of Music Therapy at Shenandoah University,
Winchester, VA. Correspondence: ameadows2@su.edu
Lillian Eyre, PhD, MT-BC, is Associate Professor of Music Therapy, NTT, at Temple
University, Philadelphia, PA.
Audra Gollenberg, PhD, is Professor of Public Health at Shenandoah University,
Winchester, VA.
Acknowledgements
The authors would like to thank Cassie Byers, MMT, MT-BC, for her assistance with data
analysis.
Appendix
Appendix A is available at the following link: https://voices.no/index.php/voices/article/view/3367/3384
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