How Can We Increase Access to Music Therapy?
10 Questions with Nikki Belshe Lanza, Founder and President, Music Therapy Access Fund (formerly Fort Worth Music Therapy Fund)
At Heart and Harmony, we believe that therapy should be equitable, accessible, and normalized – music therapy included! When our founder, Nikki Lanza, saw how inaccessible music therapy services are in Texas, she created Music Therapy Access Fund (formerly Fort Worth Music Therapy Fund) to provide music therapy grants and intern scholarships to make music therapy more accessible in our state. We sat down with Nikki to learn more about how we can increase access to music therapy and to learn about the work that Music Therapy Access Fund is doing.
1. What is music therapy?
Music therapy is a healthcare profession in which music is used as the tool for therapy. Music therapy can be used to support cognitive, communication, physical, social, or emotional skills.
2. Who can benefit from music therapy?
Music therapy can support people of all abilities across the lifespan. If someone enjoys music and has a need in one or more of the areas mentioned above, they might be a good candidate. It should be noted that no prior musical training is required to benefit from music therapy.
3. How did you get started as a music therapist? Why did you pursue this career?
When I started college, I had no idea that music therapy existed. I was initially on scholarship for music education, but had a change of heart a few weeks in. I was considering changing my major to social work because I have a bleeding heart, but I risked losing my scholarship if I left the school of music. Fortunately I was at Sam Houston State University, one of only five universities in Texas that offers music therapy degrees (the others are Southern Methodist University, University of Incarnate Word, West Texas A&M University, and Texas Woman’s University). The director of the music therapy program invited me to take the Intro course to see how I felt. I sat down and read the entire textbook in just a few days! I was enamored.
4. How are music therapy services typically funded?
Music therapy funding looks different in each setting and state. Music therapists are sometimes employed by facilities such as hospitals, assisted living facilities, or rehabilitation centers, and in those instances some patients might receive music therapy sessions because music therapy is funded by the facilities themselves. In some areas music therapists are contracted or employed by school systems, and students may receive free services as part of their IEP. In Texas, two medicaid waivers actually fund music therapy as a specialized service, so many music therapists here contract with various agencies that work with those two waivers: Community Living Assistance and Support Services (CLASS) and Youth Empowerment Services (YES). A few other states have similar waivers that fund music therapy for residents that meet specified qualifications (often diagnostic in nature).
5. Does private insurance reimburse music therapy?
Private insurance sometimes reimburses music therapy services. It really depends on each individual plan, not necessarily the company. We always encourage those seeking private insurance reimbursement to first check the exclusions outlined in their plan. If music therapy is not specifically excluded, then they can call the 1-800 number on their insurance card to inquire about coverage.
6. Why is access to music therapy limited in comparison to access to other types of therapies?
It all boils down to funding difficulties. Music therapy has been an established field since the 1950s, and several academic and peer-reviewed journals for the profession exist (see JMT, MTP, Voices, DMTE, Imagine, and more). However, music therapy as a practice still faces much scrutiny. I personally think that some of the stigma comes from the fact that music therapy sounds too good to be true to a lot of folks. Music? Can rewire brains? Or, How can it be therapy when the participant is having so much fun? Music is intrinsically motivating, and as music therapists we know that’s part of the reason that music therapy can be so effective! But funders continue to raise their eyebrows, despite the field being evidence-based.
Also, I truly believe that the different credentialing requirements from state to state have an impact on funders’ perceptions of our field. For instance, in the United States, all board-certified music therapists are nationally certified through the Certification Board for Music Therapists. Some states have additional licensure or registries. In Texas, we do not currently have music therapy licensure (not for lack of trying), and I have been flat out told by insurance companies that they will not reimburse our clients’ services because we are not licensed here. When consumers do not qualify for the Medicaid waivers and cannot obtain private insurance reimbursement, they are forced to pay out of pocket for these services. I’ve seen many clients and families faced with making unfair choices – music therapy for brother, or swim lessons for sister? – and it’s not uncommon for folks to “pause” music therapy during the holidays when finances are tighter. People deserve access to life-enriching, evidence-based services, including music therapy.
7. You recently founded Music Therapy Access Fund, a non-profit dedicated to increasing access to music therapy in Texas. Why did you decide to start MTAF?
I founded MTAF after working a decade in private practice and seeing my clients fall in funding gaps, losing access to therapy because they moved across a county line, or their caregiver died and their living situation changed, or they needed to switch waivers because they needed more attendant care. Folks that I had worked with for years, who had made documented improvements in their cognitive, communication, social, motor, or emotional skill areas, were losing services because of technicalities. I’ve also done so many assessments for individuals who proved that they would benefit from music therapy but then did not have the financial means to continue with weekly or bi-weekly services.
8. How does Music Therapy Access Fund increase access to music therapy in Texas?
MTAF increases access to music therapy by supporting music therapy clients, music therapy students, and board-certified music therapists. We support clients through the Music Therapy Funding Resource Guide for Texas and the David Belshe Music Therapy Grant. Music therapy students can apply for support through the Music Therapy Intern Scholarship. Music therapy interns and board-certified music therapists in Texas also qualify for our Piano Program and Music Instrument Donations.
10. How can we advocate for increased access to music therapy this week?
Monday: Follow these social media accounts and like/share their posts to spread awareness of our field:
- Music Therapy Access Fund
- Texas State Task Force for Music Therapy Recognition
- Certification Board for Music Therapists
- Music Therapy Education Now
Tuesday: Build relationships with MT-BCs in your community to learn how you can support them! Do a quick internet search or visit CBMT’s website to find someone in your area. Reach out and ask them how you can support them and their work.
Wednesday: Do some passive advocacy and wear our message. Check out our hats, shirts, and other goodies at the shop here.
Thursday: Tell your friends what you are learning about music therapy! Especially your friends in healthcare or politics 👀
Friday: Become a sustaining donor of Music Therapy Access Fund. You’ll get cool swag, we’ll know that we can count on your $10/mo (which really helps with budgeting and planning!), and everyone wins – especially those in need of music therapy. Music Therapy Access Fund gave away over $20,000 in Music Therapy Intern Scholarships and David Belshe Music Therapy Grants in 2020 and 2021. How much more can we give with your support?
Do you have any questions about Music Therapy Access Fund? Reach out to Nikki and get involved!