On January 16, the New York Times ran a lovely piece on music therapy for the elderly. Kaitlyn Kelly, a music therapist at the Hebrew Home at Riverdale in the Bronx, teaches residents, most of whom suffer from dementia, to write and sing their own songs.
Some of Kelly’s patients are lost to the ravages of Alzheimer’s. They lie in bed quietly, unable to understand much of what happens around them. But sometimes a song or a tune will trigger a memory, and they come to life; they move to the rhythm and even sing long-forgotten words. The son of one resident remembers Kelly singing “Hava Nagila” and his ordinarily unresponsive mother suddenly joining in. “This strength was coming from somewhere, and she was belting ‘Hava Nagila.’ . . . It just brought me to tears, because I hadn’t seen that kind of energy for a while.”
It’s a very sweet and humane newspaper piece, but one point rankled. Music therapy, as the Times noted, is “a board certified health profession that has about 7,500 practitioners nationwide.” So Kaitlyn Kelly had to have a license. She had to pass courses and pay fees for the privilege of playing music for people suffering from dementia. Which in turn means that there are schools and academic departments established to dispense these credentials. Kelly, according the Times, is “enrolled in the graduate program for music therapy at Molloy College.” Her “expertise” is one of the field’s growing subspecialties: end-of-life music therapy.
Ten states require some level of certification in music therapy. The Certification Board for Music Therapists, located in Downington, Pa., can answer your questions about which states require what. If you wish to join a professional organization and confer with fellow therapists, you can join the American Music Therapy Association, headquartered in Silver Spring, Md. Representatives of these organizations, or lobbyists hired by them, work to persuade state lawmakers to introduce bills requiring licensure to practice music therapy. These bills, when passed, create licensing boards. Boards certify instructors, and eventually those instructors create academic departments and curricula. Thus does music therapy become a field of expertise with all the accouterments: conferences, peer review, subspecialties, tenure.
The trouble with all this isn’t that music therapy is a bogus enterprise. Not at all. Many people who practice it have a gift and use it to accomplish much good. It’s an ancient art, too. David, we’re told in the Book of Samuel, used a kind of music therapy for Saul when the king fell into a dark temper: “And whenever the evil spirit from God was upon Saul, David took the lyre and played it with his hand; so Saul was refreshed, and was well, and the evil spirit departed from him.”
It is an art and a gift. What it’s not is a clinical or academic discipline. The capacity to coax happy memories and lucidity from an ailing or impaired mind does not lend itself to precise descriptions and training regimens. The practitioner can improve in it, just as the painter or poet can improve by long hours of practice and reading and discussion, but requiring such a nurturing minstrel to undergo expensive formal instruction before attaining a state-issued license is preposterous.
We live in a country in which hair braiders and massage therapists and interior decorators must have a license before practicing their trade. Proponents of licensure justify their coalescing and use of state power on the grounds that the public must be protected from untrained or irresponsible practitioners. We don’t want untrained surgeons offering their services to unsuspecting sufferers. A shady dog trainer is one thing; a shady attorney is quite another.
But how much harm can an unlicensed music therapist do? The fact that someone is playing the guitar or the flute to exercise the imaginations of the infirm and lonely is surely a small victory in the cause of alleviating human sorrow. No ordinary person would be troubled by the possibility that this Good Samaritan may fail to abide by best practices according to some faraway credentialing board. I suspect it would only trouble those who do the training and credentialing, i.e., those with an interest in keeping the number of practitioners low and the price for their services high.
We read in First Samuel chapter 18 that in one of their lyre-playing sessions, Saul tried to kill David. “Saul had his spear in his hand; and Saul cast the spear, for he thought, ‘I will pin David to the wall.’ But David evaded him twice.” Maybe instead Saul should have reported him to the authorities for practicing without
a license.
