Music therapy:

How Boulder companies work to be culturally inclusive while fighting the stigma

The client’s referral for individual music therapy treatment sessions with Anastasia Canfield came a few weeks after being transferred from a forensic hospital. He had been found incompetent to proceed with his trial and was transferred to Canfield's unit at the Colorado Mental Health Institute at Fort Logan. He was guarded and his treatment team did not have much information to work with. They hoped music therapy would help.


Music therapy is commonly referred to as the use of music for non-musical goals by a trained professional. It can be used to treat a range of needs that primarily focus on neurological and developmental issues, such as Alzheimer's disease, autism, post-traumatic stress disorder and anxiety. National Public Radio released an article in August on the use of music therapy to help Parkland students cope with the school shooting at Marjory Stoneman Douglas High School.


While the different uses of music therapy are being discussed on a national level, the conversations in Boulder are focusing on the different clients of music therapy and how to best serve them. As a board-certified music therapist working for both the Colorado Mental Health Institute and Rocky Mountain Music Therapy, Canfield is no stranger to diversity.


“Each day looks different,” said Canfield. “I serve a number of different clients, all different ages, different populations, various diagnoses. And within that, they all have very specific needs.”


Encountering a wide variety of clients is not a unique experience for music therapists. Leah Quiller is also a board-certified neurological music therapist and  is the owner of her own private practice in Boulder called Peak Pathways.


Typically working 20 individual and group music therapy sessions each week, Quiller primarily serves clients that are aging adults with neurodegenerative disorders, such as Parkinson’s disease, and children with developmental disabilities or neurologic impairments. As a result, Quiller encounters clients not only with different diagnoses and ages, but also clients of different cultural backgrounds.


“Pretty much everybody you work with is different from you,” said Quiller. “And there is this perception out there-- there’s a common saying, ‘Oh music is the universal language’. Actually, it’s really not, because different cultures use music in different ways.”


Having served clients from Hispanic, African, Asian and many other cultural backgrounds, Quiller has learned how to approach new cultural experiences rather than focusing on learning each individual culture. She begins by asking what types of music the client enjoys listening to. From there, Quiller is the able to inquire more about the values and life experiences of the client in order to learn how to best serve them.


Canfield also focuses on approaching new cultures through asking questions, and she teaches others to do the same. This past November, she presented a continuing music therapy education course during a national conference entitled, “Cultivating Cultural Awareness and Competence in Music Therapy”. The presentation aimed to offer ways for music therapists to approach culture rather than provide answers to specific cultural questions.


“There’s really no way to teach every aspect of culture,” said Canfield. “We want music therapists to do their own research and to continue addressing cultural issues that are related specifically to their populations, their workplaces [and] their own particular biases.”


Chelsie Ozga, the owner and services coordinator for the music therapy organization Music Plus, combines these methods of basic research and asking clients questions. She begins sessions by asking clients if they have religious practices she should be aware of. For example, when serving an Orthodox Jewish client, Ozga will wear a long skirt instead of pants and will not play songs with religious connotations, like “Jingle Bells”.


Additionally, Music Plus offers Spanish-speaking music therapy services. Although the organization does not currently have a fluent Spanish-speaking therapist, Ozga supplies her therapists with a “cheat sheet” filled with Spanish phrases and questions commonly used during a session.


Primarily working with autistic children, Ozga said it is important that music therapists try to speak the language to establish a connection not only to the clients, but also to the parents. To not do so, on the other hand, can isolate them.


“That breaks my heart for the parents because typically we serve in-home,” said Ozga. “So to go into someone’s home and not even attempt to speak their language just because the child is growing up bilingual, it doesn’t seem right to me.”


For Ozga, the focus should not be on the differences between herself and clients, but rather on learning new things together. In this way, she has clients teach her about cultural values she is unaware of. By doing so, she hopes to recognize the past of her clients to better help them in the present.


“I wonder if when families immigrate to the United States …and they have native, English speakers who are white, coming into their homes, I wonder if they feel like their previous experiences aren’t relevant and don’t have merit,” said Ozga. “...So I always just try to include and move togetherness forward, move that warmth forward.”


“It’s always an eagerness to learn [and] never pointing out a difference,” Ozga continued.


Although music therapy is expanding in its ability to serve many different needs of many different people, it is still limited in its services due to the stigma behind it. A stigma that almost kept Leah Quiller from joining the profession.


“Growing up, I had always heard ‘Oh music therapy, you’re gonna hold hands and sing kumbaya and feel better’, and so that was what kind of drew me away from it, initially,” said Quiller.


Quiller's perception changed after learning that music therapy helped Gabrielle Giffords, a former U.S. representative who was shot in the head in 2011, retrain a part of her brain to take over speech operations. The scientific and neurological capabilities of music therapy intrigued Quiller.


Now, Quiller aims to educate more people about music therapy and how it is a research-based service that can really have an impact.


“It has often been looped in with retail therapy or aromatherapy… whereas there is legitimate, peer-reviewed research out there, and the term music therapy is a clinical term, not just a feel-good term,” said Quiller. “Music therapy is a healthcare profession.”


Despite the scientific support behind music therapy, the stigma persists. Canfield thinks the use of music by many people might be part of the reason why.


“Because people all have a connection to music, there’s already this preconceived notion that’s created in their mind of what a music therapist might do,” said Canfield. “There is a lot of misperception and misinformation about music therapy out there,” said Canfield.


One common misconception, Canfield said, is that a person who has not been trained as a music therapist that plays music at a nursing home is acting as a music therapist. While Canfield said this is a great thing to do, it is not music therapy because it is not working off research towards a functional goal.


However, even though this person may not be a professionally trained music therapist, they can still call themselves one. This is because while there is national board certification and legislation, the Colorado Department of Regulatory Agencies does not have state legislation for licensure of music therapists. This means that a person can advertise themselves as being a music therapist even if they have not gone through any professional training.


As a result, there is a lack of clarity on what music therapy is and who it can serve. Such misconceptions can prevent people from trying music therapy in the first place.


To avoid such, music therapists in Boulder focus on being culturally inclusive in hopes of serving as many clients as possible and increasing awareness about the profession. The goal is that with this awareness comes more people benefitting from the practice itself.


“This is a very niche market, and it shouldn’t be,” said Ozga. “It really is a relevant, necessary therapy and it’s really seen as an extension of a core therapy. And to be seen more as a core therapy, we need to be able to serve everyone effectively.”