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Rain-soaked and laden with bags bearing stringed and percussion instruments, music therapist Kate Beever arrives for her next house call.
Her client is a 67-year-old developmentally disabled woman believed to be severely hearing and visually impaired. She lives in a supervised home with another female resident, two caretakers and a gray cat who likes perching on the kitchen counter.
Like a small child welcoming a favorite relative, the woman pulls Beever by the hand to her room to fetch her ukulele before they're back in the kitchen for a strumming duet and some light dancing.
Beever has been working with her for more than a year to improve movement and motor skills.
“When I met her she was holding on to the sides of things in the house to move around, and the staff had trouble getting her out of bed in the mornings,” Beever recalls. “She's super happy now.”
Beever later switches to a small acoustic guitar, demonstrating where to press the fingerboard or gently tap to sense the rhythm. A bit later, they tilt a bead-filled ocean drum back and forth to produce a gentle swish. Although the client can't express herself verbally, she uses some sign language and gives a frequent thumbs-up — plus a hug when the hour is up.
Beever, 34, is one of 13 board-certified music therapists in Maine — and 7,850 nationwide. It's a small but growing niche that added 73 new full-time jobs in 2013, including four in New England.
Like other self-employed professionals, Beever has a busy schedule, balancing client visits and other work across southern Maine while running and growing her business, Maine Music & Health LLC. So does Carla Tanguay in Mount Desert, who works with clients in homes, schools and facilities in Hancock and Penobscot counties.
Both have been at the forefront of advocating on the profession's behalf, including efforts to eventually get MaineCare reimbursement, and increasing awareness among the public. Both were youngsters when they first heard about music therapy, Beever when writing a ninth-grade research paper about teaching music to blind children and Tanguay during a high-school science project.
“I knew right away that was what I wanted to pursue,” Tanguay says.
Music has been used to heal since ancient times and was used after the world wars to help veterans suffering from physical and emotional trauma. The first college training programs were created in the 1940s.
Today there are 70 approved undergraduate and 30 graduate programs in the country, and a national Certification Board for Music Therapists established in 1983. Therapists are required to have knowledge of medicine, psychology and music, but those they're treating need not have a musical background.
The therapy involves the use of music — from listening and moving to melodies and rhythms to singing, songwriting and playing instruments — to meet specific physical, emotional, cognitive and social goals. Attending a concert or listening to an iPod in one's room isn't music therapy, there has to be an intervention by a credentialed therapist who gives personalized care and can tweak the treatment as needed — like, for example, if a melody triggers a bad memory.
While most commonly used in mental health, music therapy is also used to help people with Alzheimer's and dementia, cancer, developmental disabilities and neurological disorders such as Parkinson's disease, as well as pain management and coping with everyday stress.
Beever underscores that music therapy enhances and complements traditional medicine, and works because of its effect on all parts of the brain, saying: “Music fires up the memory center of your brain, the emotional side and the analytic side. It also locks into rhythm — that's the math side — and brings up all these feelings, so it's really motivating for people.”
That's increasingly backed up by medical research and success stories like that of former U.S. Rep. Gabrielle Giffords, who suffered a traumatic gunshot wound to the brain in 2011 but regained her speech through music therapy. Dr. Oliver Sacks, the late British neurologist portrayed by Robin Williams in the film “Awakenings,” also brought attention to music's medicinal benefits in his 2007 book “Musicophilia: Tales of Music and the Brain.”
Therapists, who are required to have knowledge of music, medicine and psychology, provided services to more than 1.2 million people nationwide in 2013, at more than 29,000 facilities, and earned an average hourly rate of $69 for group services and $64 an hour for individual services, according to the 2014 American Music Therapy Association annual survey and workforce analysis report.
Full-time music therapists working 45 or more hours a week earned an average salary of $50,808, depending on the region, with four out of seven regions reporting increases since 2013. In New England, the average salary was $56,651, with a range between $30,000 and $100,000.
About 29% of respondents said they were reimbursed either through government funding or third-party reimbursements for their services. Funding sources include hospitals, endowments, private insurers, grants and donations and Medicare, which covers music therapy in specific situations. MaineCare still doesn't cover music therapy despite a push by Beever and others, nor is there a state music therapy license as is the case in at 10 other states (including New York, Connecticut and Rhode Island) according to the national certification board.
In Maine, there are board-certified music therapists in a number of communities working in a variety of medical settings, including two interns every four months at Birch Bay Retirement Village in Bar Harbor. The nonprofit retirement community is a member of the Mount Desert Island Hospital Organization.
Melissa Violette, Birch Bay's music therapy program director, has been working as a music therapist for more than 25 years and in Maine since 2015.
“When I came to Maine, I was really surprised I was one of a handful of music therapists, that it wasn't more established,” she says. “I feel like it's growing in Maine, some of it because of my interns.” Though some head out of state afterwards, she says her most recent graduate hails from California but plans to stay in Bar Harbor and hopes to find a music therapy job in Maine.
Violette, who works predominantly with people dealing with dementia, says she can't imagine doing anything else. Years ago in Georgia she worked with a 22-year-old psychiatric patient suffering from dementia who had withdrawn into herself, until she broke out in song to “The Greatest Love Of All,” starting softly and building to a full, clear voice that moved everyone in the room to tears.
Through one of the most powerful experiences of her career, Violette downplays her role, saying, “It was the music, it wasn't me.”
Similarly, Patricia Mulholland of Arundel underscores that there's a distinction between music therapy and performance, and that she is there to provide a service. Clients include a female stroke survivor she's helped write a piano sonata documenting her journey in five movements, and an elderly woman with dementia who's come out of her shell through singing and co-songwriting.”
“She's quite gifted with language and is very open to improvisation,” Mulholland explains a few days after letting Mainebiz observe and photograph part of a session. After breathing exercises, they sing “Summertime” from Porgy & Bess, the client gracefully moving her arms as if she's conducting.
Mulholland, who also does consulting and wellness work, sees about five private clients a week and finds it challenging to build her practice.
“If I were earlier in my career,” she says, “I would be a little more pro-active.”
Much newer to the profession, 2011 University of Maine graduate Brian Harris and his business partner Owen McCarthy aim to use technology to bring music therapy to as many people as possible not just in Maine but worldwide.
They are developing a platform to help people with neurological injuries and diseases as they work toward getting FDA approval for prescription products and ramp up hiring engineers and a commercial position.
Harris is a certified music therapist, while McCarthy studied biological engineering, and they just raised $5 million in Series A venture capital financing for their Portland-based startup, which is called MedRhythms. Harris says they're teaching the algorithm to think like a clinician and maybe even do a better job than humans with all the data it's collecting from the sensors.
“The future of health care is in digital therapeutics,” he says.
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