Are Music Therapists at Risk for Voice Problems? Raising Awareness of Vocal Health Issues in Music Therapy

ABSTRACT: Music therapy can be a vocally demanding profession. The purpose of this article is to raise awareness within our profession of the physiological, environmental, and personal factors that may lead to vocal strain or abuse. In an extensive literature review and database search, no articles were found on the prevalence of vocal health issues among music therapists. However, it is logical that with the daily vocal demands faced by music therapists, they may be at risk for vocal problems. This article identifies some of the environmental and habitual factors that influence vocal health. Parallels are drawn between the vocal demands and working environments of music therapists and other professional voice users such as teachers for whom prevalence, causal factors, and treatment modalities are known. It is hoped that by raising awareness, music therapists experiencing difficulty with their voices will be more likely to seek medical assistance and consider the habits and surroundings that may pose risks to their vocal health. There is a great deal of literature that addresses the use of percussion, guitar, and piano in the field of music therapy. Though instrumental and vocal improvisation have emerged as viable music therapy approaches and techniques, an area that has had little exposure is the role of vocal health for the music therapist. Many students receive only the minimum amount of voice training required by their collegiate program. As a result, these same students may receive little or no guidance in vocal health issues that can arise once they are working as a professional music therapist. Vocal problems develop for individuals in the teaching profession as well as other vocations that require a high level of voice use (Koufman, 1999; Voice Academy, 2003e). Music therapists are not exempt from these problems. Even those students with several years of applied vocal study can develop vocal problems once they enter the professional realm. As music therapy educators, we have observed vocal health issues arise for our students in music therapy fieldwork, during internship, and into the professional world. These issues have affected both those who claim the voice as a primary instrument of study as well as those who claim it as a secondary instrument. There appears to be little to no awareness about the vocal demands and needs of music therapy students among conventional voice instructors. In addition, many attendees at our state, regional, and national music therapy conference presentations, who have ranged from students through seasoned professionals, have discussed their own vocal struggles and clinical challenges and have expressed eagerness for more information on this topic. The current American Music Therapy Association (AMTA) (2004) professional competencies addressed the vocal ability/ skills required for entry-level practice are as follows: 1. Music Theory and History 1.3 Sight-sing melodies of both diatonic and chromatic makeup 6. Voice Skills 6.1.1 Lead group singing by voice 6.1.2 Communicate vocally with adequate volume (loudness) 6.1.3 Sing a basic repertoire of traditional, folk, and popular songs in tune with a pleasing quality 8. Improvisation Skills 8.2.1 Compose and develop original melodies, accompaniments, and short pieces extemporaneously in a variety of moods and styles, vocally, and instrumentally (p. 27) Clearly, the AMTA places a major emphasis on the use of voice by music therapists. While the AMTA professional competencies outlined the use of voice in various capacities, curriculum in schools can vary greatly thus impacting the level of awareness about vocal health issues for each music therapist. Undergraduate requirements for students not pursuing a concurrent degree in vocal performance do not necessarily address physiological understanding or care of the voice, yet the voice is a primary instrument in a music therapist's clinical work. …