[Social-sciences-list] Introduction, then a serious question

[Kaiti Shelton]

Hi all,

Some of you may have seen me around on other lists; I'm a junior music
therapy major, and the president of the Ohio Association of Blind
Students.  In case you're wondering what music therapy is, it is the
evidence-based use of music to address individualized goals through
music and therapeutic relationships, carried out by a professional who
has completed an approved music therapy training program and earned
board-certification by passing an exam for accreditation.  To simplify
that, in my field I will use music to address musical and nonmusical
goals, including gait regulation, memory recall, enforcing positive
behavior in children, improving social skills, improving/maintaining
quality of life, increasing fine and gross motor skills, improving
appropriate communication, etc.  I'm a lot more like a physical or
occupational therapist than a music teacher or performer, because I do
keep track of data and evidence to back up research and keep track of
progress.  End plug, but if you have any questions about what music
therapy is, feel free to ask.  I'm really looking forward to
interacting on this list.  I have been on the human services list for
quite a while, but I'm wondering if social science might be a little
more in-line with what I'm going to talk about in the next paragraph.
I'm also working towards a minor in psychology, so that's another
reason why I joined.

Anyway, the serious stuff that I mentioned.  I just returned home from
the national conference for AMTA, the American Music Therapy
Association.  I had a great time overall, and learned a lot, but it is
one of the things I've learned that has me really worried about some
ethical concerns I see.  I went to a session on Friday night called
Musical skills and competencies: essential or not?  The AMTA has
established competencies which all music therapy students must meet in
order to earn certification, but there is no standard protocol or
guidelines for accommodating when students with disabilities have to
make modifications.

The presenter used a student who is currently a senior in her program
as an example (with the student's permission).  This student lost her
left hand due to cancer when she was a kid, and is now looking for
music therapy internships.  It was apparent when she came to the
school for music therapy that guitar just wouldn't be an option for
her, since one hand needs to play chords and the other strums.  The
professor, having no idea what to do for this situation, called AMTA.
They told her, "You'll have to decide how to accommodate her."  They
offered this professor no guidance, no suggestions, not a single clue
about what should be done to make sure this student can get the
competency.  So, the professor accommodated by letting the student use
an IPad app to create the sound of a guitar in her sessions.
Otherwise, she's a really good music therapist in the making, and can
apparently play piano very well.  Aside from one hand being missing
and guitar in the traditional sense being a problem, there is nothing
that suggests to this professor that this student wouldn't be an
exceptional therapist.  However, she has had to have conversations
with the student, in which she has had to explain that the
accommodation process for music therapy students is completely
subjective.  The professor sees the IPad as an accommodation to meet
the guitar competency, but an internship director might see that the
competency is unmet and not take this student into their program
because of it.  The professor expressed worry, because on one hand she
wants this girl to succeed and knows her skills, but doesn't want to
set her up for failure if no one else agrees with her on
accommodations in an internship.  On the one hand, she wants to
believe that music therapy can be an accessible career to those with
disabilities, but she also feels like she needs to be a gatekeeper for
the competencies so the integrity of the field is maintained, and the
integrity of the college is upheld.  She's very worried because she
realizes that as music therapy has grown, more and more students with
disabilities are going to be coming into the field.  Competencies just
keep getting added to the litany, but none have been taken away or
modified.

I had a situation last semester, where my professors didn't know how
to accommodate me in documentation.  While this session focused on
accommodating for the music competencies, the problem is still the
same.  I question how on Earth a profession which accommodates for
individual client needs on a daily basis around the world doesn't have
policies in place for accommodating students with disabilities who
wish to become professionals?  How is it okay that there is no
standard system in place for this?  I understand every student is a
case-by-case basis really, but there is nothing at all for professors
to go by, so they don't know what is okay and what is breaching the
competencies.  I wonder how many students have been held back for one
reason or another, because they couldn't meet a competency in the
cookie-cutter way due to their disability?  But let me tell you the
kicker in all of this; let's say that student X with the hand problem
is hypothetically told by someone that she can't get an internship
because she can't actually play guitar.  After the internship and
completion of the college program for music therapy, all students must
take an exam to earn certification.  The exam does not test musical
skill at all.  To my knowledge it also does not test one's ability to
actively assess clients, which is the issue I ran into last semester
when I was having difficulty providing visual feedback on my group.

As a student, I understand why we have the competencies.  This is a
profession that has had to advocate itself to death for the past 60 or
so years because it is so new and out of a typical person's norm, but
if we keep making it harder by adding competencies and pushing out
potential therapists with disabilities, I think detriment will be done
to the field.  The whole reason I learned about music therapy was
because I worked with a blind music therapist as a child.  She taught
me to be okay with the fact that I was different from my sighted
classmates, emphasized the importance of using braille and a cane, and
encouraged me to practice music.  When I got older, she was a role
model I could talk to about general blindness issues, and was a mentor
once I figured out I wanted to go into music therapy.  I remember
being 8 or 9 years old, and worrying about how I would go to the
grocery store by myself when I was older.  I think she and I had a
closer therapist-client relationship because she was someone I could
ask questions that others wouldn't understand.  I am hoping to do the
same thing for other students with disabilities who may become my
clients, and it would be a shame if others with disabilities can't
serve as role models and mentors to their clients.

Is it ethical for a profession which strives to accommodate clients to
push those who have disabilities and want to be a part of the striving
away?  To me, that says that I as a blind person am good enough to
receive services from a music therapist, but I'm not good enough to be
a provider, and if I modify a competency so that I get the same basic
result but in a different way I'm not actually a complete music
therapist.  I personally don't think it is sound, but there are those
who cling to the clinical competencies like ethically, it is the most
important thing to protect them.  I'm not saying that protecting the
integrity of the competencies isn't important, but for students with
disabilities there has to be some middle ground.

I don't quite know what to do about this.  I've emailed a bunch of
people to start a think tank, which includes one blind and one sighted
music therapist, a socialworker who is their supervisor, a woman I
know who knows more than I thought there was to know about disability
rights for students, and my state NFB president, but other than that
I'm stumped.  This issue really bothers me, but I also want to take it
easy since I still have yet to get through my own training and figure
out my own accommodation issues.  Thoughts?