I thank the Chairman for the invitation to address the committee on music therapy. As the course director, since 1999, for the only music therapy training available in Ireland, I have a particular interest in ensuring that music therapy is recognised as a means by which services to people in a range of health and care contexts can be optimised and enhanced in this country. I am delighted the committee asked me to make a presentation and I would particularly like to mention how appreciative I am, along with my music therapy colleagues, of the contribution the Chairman, Deputy Keaveney, has made to the understanding and promotion of the professional practice of music therapy in Ireland.
I wish to make some comments about the general importance of the arts in health and the specialist role of the music therapist in service delivery. The arts invite us to explore our identity as individuals, within communities and as a wider society. The arts engage, challenge, teach and inspire us. At the heart of all the arts lies the work of the human imagination. The arts reflect our history, our identities and ourselves. People with compromised health and reduced abilities have the right to exercise and experience the breadth of their imaginative potential through access to the arts. We should not be obliged to ask what is the work of the imagination for but rather how can we maximise the potential of every citizen to use his or her imagination to its fullest.
There is a vibrant arts health movement in Ireland that is exemplified in the employment of arts officers in hospitals, the funding of arts health programmes through the Arts Council and the development of community initiatives and arts in health through such organisations as Music Network. At the same time, the creative arts therapy professions have been building their expertise and profile here. There is an association for creative arts therapists, formed in 1992, and for a number of years specialist postgraduate qualifications have been available at third level in music therapy, art therapy and drama therapy.
Music therapists work as members of multidisciplinary teams, in a range of health and education settings, to identify, address and ameliorate needs in psycho-social, emotional, developmental and cognitive domains. At the heart of our work is the process of imagining and creating change through the medium of music for the benefit of clients. For the past 13 years, in my work as an educator of qualified music therapists, I have facilitated future professionals in the creative arts therapy and profession of music therapy to develop skills in the assessment of clients needs, the delivery of effective programmes to meet these needs, the evaluation of the extent to which needs were met through music therapy, and skills in reporting clinical outcomes of music therapy work.
I now wish to comment on the music therapy profession in Ireland. For a number of reasons it is difficult to provide exact information about the professional profile of qualified music therapists in Ireland. However, it can be noted that 46 qualified music therapists are members of the all-Ireland music therapy e-mail discussion group. There have been 20 graduates of the MA in music therapy at the Irish World Academy of Music and Dance since the two year masters programme commenced in 1998. A further nine students will complete the programme in the middle of this year.
A broader picture cannot be given since, as there is currently no award designation, music therapists are often employed under other occupational titles. I would argue that this seriously limits the development potential of music therapy here in Ireland. When a music therapist leaves a job the post can often revert to the general pool of posts in the facility or service. Since there is no professional registration available, there is no way to ensure that people who are called music therapists have appropriate qualifications to practise. Very few music therapy jobs are offered full-time; most opportunities are through sessional or part-time work.
There is currently one music therapy post available where the pay is so low that no one will apply for it. Therefore, it has remained vacant for several years in spite of having had a qualified professional working previously in demonstrating the effectiveness of the role. It is arguably a situation where these highly trained professionals cannot afford to work as music therapists.
I now wish to comment on the current lack of parity between working pay and conditions of qualified music therapists in Ireland and other English-speaking countries, most notably the United Kingdom. In other English-speaking countries, such as Australia, New Zealand, the United Kingdom and the United States, award conditions and professional recognition are available for qualified music therapists. In the United Kingdom, qualified music therapists are registered with the Health Professions Council. Since 1999, they have been registered under the occupational designation of "arts therapists". They share this designation with drama therapists and art therapists. This registration protects the occupational titles drama therapist, music therapist, art therapist and art psychotherapist. At the same time well established award conditions for qualified music therapists allow health services to decide to create or maintain posts and develop services to which music therapists can contribute their professional expertise.
In Ireland, it is heartening that Vision for Change, a recently published report by the expert group on mental health policy, mentions the use of creative therapies several times. However, there is no strategy as yet to indicate how service providers within the HSE can employ creative therapy experts, or even what that description needs since there is no such job title officially in the health service.
Recently, the European music therapy confederation was recognised as an official professional body in Brussels. This allows the confederation to develop a procedure for registration of music therapists throughout Europe. This could result in the anomalous situation where a professional may have a therapy qualification that is recognised Europe-wide but cannot be employed in this occupational title in the Republic of Ireland.
Current findings of local and international research show the value of music therapy for people of all ages receiving special education and health care services. Music therapy is an evidence-based profession. This means that the actions for therapists to address needs of patients or clients are based on published reports from expert clinicians as well as published findings from research studies. Where there is none, the therapist seeks to develop knowledge through description and evaluation in the first instance, leading ultimately to research studies. There are many hundreds of research studies to show that music therapy has a positive effect for many psychiatric, developmental and medical conditions.
Recently the Irish World Academy of Music and Dance at the University of Limerick received funding from the Health Service Executive mid-western area to investigate the effects of music therapy and art therapy on the agitation behaviour of patients in a specialist continuing care unit of the Limerick mental health services for older people. All the patients had a form of dementia. At the end of a 28-week period, agitation was significantly decreased for the participants and, therefore, the quality of life of these residents improved. This decrease in agitation was not only statistically verified but could be described as meaning some patients changed from demonstrating agitated behaviours such as calling out several times an hour to calling out only once or twice per day.
In March 2006, a short paper entitled Music Therapy in the Treatment and Management of Mental Disorders was published in the Irish Journal of Psychological Medicine. The paper, which presents a number of research studies that provide evidence for a clinical role for music therapy in the management of symptoms of mental disorders, was circulated to members. This is more than living in hope that participation will be enjoyed by patients. Instead, it is the quantified and proven benefit of music interaction provided in therapeutic service by a highly trained professional.
Support is requested from the committee for recognition of the distinct role of the arts worker qualified in the professional field of music therapy and further support is sought to have this role negotiated and defined as a professional title within the education and health sectors in Ireland. Music therapy requires validation as an occupational title within health and education services in Ireland. The profession of music therapy needs recognition through the process of registration of the profession. This will ensure people employed as music therapists can deliver accountable and effective services to vulnerable groups such as those in aged care services, survivors of sexual abuse, adults with intellectual disability and other community members who require services from properly accountable, trained advocates.
It is extraordinary that music therapy has such a developed role, for example, in the UK. However, no distinction is made in Ireland in a health or education setting between the work of a musical volunteer, a professional arts performer and a qualified music therapist. Every day our work is cut out for us defining our role, responding to misconceptions about our work and identity and working for positive change, not only for our professional future but also for the benefit of patients and families for whom this expert service is warranted. I seek the support of the committee for the proper recognition of the profession of music therapy in Ireland and I thank the Chairman for the invitation to make a presentation.