Funding and employment conditions: critical issues for Australian Music Therapy beyond 2009.

Abad, Vicky ; Williams, Kate

2009 and Beyond

Australia has changed over the life of the Australian Journal of Music Therapy. It is a different country from what it was in 1989. What lies ahead in the 20 years beyond 2009? What are the main challenges facing Australia and more specifically our profession? The current working climate in Australia is changing as a result of many factors, and several of these impact on music therapists.

Firstly, the world is experiencing an economic downturn that many have tipped will be potentially worse than anything seen since the Great Depression of the 1930s. This has implications for funding and working conditions. Funding may be cut to services that are not considered core and periodic funding grants may not be renewed. Ironically, this will happen as the demand for services for vulnerable community members dramatically increases as people's personal resources become stretched and the disadvantaged become even more disadvantaged. Given that many music therapy programs are funded in a periodic manner, to specifically meet the needs of the disadvantaged, this environment leaves the profession in a rather precarious position.

Secondly, Australia is experiencing somewhat of a ground swell in regards to employment conditions. Many Australians are beginning to demand that a better balance be struck between their professional and personal lives, and that they be paid a fair wage for their work. The public tide of opinion is turning against large multi-million dollar corporate pay outs, while it is increasingly recognised that nurses, teachers and other helping professions are largely underpaid and under-recognised. Parents in particular, often want better working arrangements that allow them to be present for their children. The Australian government continues to discuss the possibility of paid parental leave; however, despite being only one of three Western countries to not provide mandatory paid maternity leave, the government have shelved discussion at this time (Lunn, 2008). Given that 90% of music therapists are women, and many RMTs are parents, the need for family friendly workplaces is paramount.

These issues in fact may represent the start of an exciting opportunity for music therapists, if they are willing to embrace the challenge. Sadly, it seems that cyclic and grant funding will remain a large part of music therapy funding beyond 2009. What then, are the key issues in sourcing and maintaining such funding? One key to unlocking funding opportunities is quality data--data that provides an unequivocal evidence-base for music therapy's positive impact on people's health and wellbeing. In the day to day clinical lives of music therapists this may seem impossible to achieve. We will investigate some options. Non-government funding options will also be briefly mentioned. We will also discuss how music therapists as employers and employees can work together to raise the bar on workplace conditions, ensuring that people receive fair and equitable wages, and work in family friendly and flexible environments.

Funding

Whilst government funding will, and should, remain a major source of resources for music therapy programs over the next 20 years, it is also going to be necessary to pursue other lines of funding. Although music therapy in Australia does have some history of being funded through both philanthropic and corporate sources, we suspect that corporate sponsorship will become particularly necessary in the future. Regardless of the type of funding body, though most especially in the case of government, the next 20 years will also likely see an increase in the need for high quality data to support funding requests. Potential funders are generally no longer satisfied with anecdotal evidence that suggests music therapy works. Whatever the client population, governments want empirical data that will stand up to scientific scrutiny. They need to be accountable to the tax payer, and they want to know the programs they fund make a clear difference to the lives of the people involved. High quality evaluation research of music therapy work therefore has a large role to play in moving the profession forward.

Music therapists, like all clinicians, must strive to find ways to balance the need to produce scientifically sound data whilst still working under "real world" conditions, where research gold standards such as randomised control designs may not be ethical or practically feasible. While there is a clear imperative for high quality evaluation research, music therapists may lack the time, research expertise or confidence necessary to undertake rigorous evaluations of their programs. In recent years research training in music therapy has increased at Australian universities. The fact that all music therapy courses in Australia are postgraduate courses with most having a research component, is indicative of the fact that all clinicians must have competent skills in evaluating their work if they are to be successful in sustaining the resources required to continue the work. Whilst many Australian music therapists are international leaders in their area of research, not all clinicians have a desire to become full time or even part time researchers. They may wish to continue their primary role as clinicians but need scientifically rigorous evaluation outcomes to support their work and secure funding. One solution is to seek formal, mutually beneficial partnerships with professional researchers.

From 2001 to 2004, the federal government funded Sing & Grow program (provided in Queensland only at that time), was evaluated using a process of data collection and analysis designed by the music therapy team delivering the program. This design had several features that are potentially common to many music-therapist designed evaluations, such as: 1) Parent questionnaires that were non-intrusive and user friendly; 2) Questions using a yes/no response format that were easy to analyse and produced statistics that were simple to communicate; 3) Open-ended questions that provided a richness of information that was clinically useful; and 4) Clinicians' written records that were used to effectively illustrate program successes in the form of case vignettes.

Such evaluation tools led to a wealth of qualitative and anecdotal data that suggested that Sing & Grow was effective in meeting the needs of at-risk families (Abad & Williams, 2007). However, there were significant limitations to the design including: 1) A lack of repeated measures to show change over time; 2) A lack of scaled responses for sensitivity of measurement; and 3) No established validity or reliability of measures (Williams, 2006).

The outcomes of the initial evaluation contributed to securing funding for national expansion of the program in 2005 with one of the conditions of funding being the mandatory independent evaluation of all program outcomes. The Sing & Grow management team therefore initiated discussion with several potential evaluators in order to create a partnership that would allow the music therapists to continue being clinicians, and the independent evaluators to work as the primary researchers, but without the clinical and management team handing over complete power of the evaluation design to the researchers. The research partners were chosen based on the following criteria: 1) Extensive research experience and proven expertise, particularly in the evaluation of early intervention programs; 2) An open and inquiring mind in regards to music therapy (none of the shortlisted candidates had prior experience with music therapy); 3) A willingness to listen to and value the views of the Sing & Grow management and clinical teams; 4) Recognition of the vulnerability of the program's clients and the need to place the least amount of burden as possible on them; and 5) A willingness to find creative yet valid ways of measuring program outcomes.

A formal partnership was negotiated and it has proven to be a fruitful one for all parties for the last four years (Docherty, Nicholson, & Williams, 2007). Whilst this working partnership was formed and negotiated with the backing of reasonably substantial funds, both the Sing & Grow program, its staff, and the researchers have contributed and gained more than that money alone could buy. The researchers have developed an interest and passion for music therapy as an intervention and as such have become advocates of the profession, putting in many unpaid hours in data analysis and reporting to assist the advancement of the project. Sing & Grow staff have gained research skills that will allow them to continue to more effectively evaluate future work even if the resources to contract the research team are no longer available.

Australian music therapists are encouraged to pursue such partnerships where and when they can. They need not be as formal or as financial as the one described, but may begin quite informally, with the exchange of ideas and expertise between clinician and researcher. Discussions about music therapy can ignite passion and interest in academics and researchers looking for the next innovative idea to be involved in and, "from little things big things grow". Clinicians should not be deterred by a complete lack of research budget, as once a potential research partner becomes interested, they often have their own ways and means of securing funding to evaluate innovative programs. If you are writing a funding submission always include a component for evaluation costs.

Music therapists must also be keenly aware that governments are not the only potential funders of our work. Many readers will be aware of positions funded by philanthropic or charitable bodies, but perhaps less aware of corporate opportunities for funding. Music therapy can be very highly regarded as a human interest "good news" story. Clinicians can use the potential of such good media to sell program sponsorship to corporations looking to raise their profile as socially responsible entities. Whilst clinicians should be aware of any strings attached to such funding, it is also important to recognise the opportunity as a potentially positive one, and to not shy away from negotiating sums of money that to a music therapist might be substantial, but to a large corporation, might represent 5% of their annual charitable budget. In this area, partnerships (both formal and informal) with professional lobbyists and public relations professionals can prove fruitful and should lead to music therapists gaining enhanced skills and experience in selling their own product. Again, clinicians might begin small, with small business coalitions present in their own local community.

Employment Conditions

As more people demand wages that reflect their expertise, and increased flexibility in order to better balance work and private commitments, the workforce will surely change beyond 2009. The large majority of music therapists in Australia are women, many of whom have families. Working conditions impact directly on their ability and availability to work. Male music therapists who are parents may experience similar issues and have the added demand of being the perceived "bread winner" of the family in a professional area that traditionally underpays.

One way of supporting improved working conditions is to continue raising the profile of music therapy in the community sector. This will lead to better understanding and more realistic expectations of music therapists in terms of their employment conditions. The Australian Music Therapy Association is in the process of actively addressing this issue with their commitment to pursuing improved government relations and partnerships with key lobby groups.

On an individual level, people are in a position to politely demand that they be paid the wages and offered the working conditions they deserve. This may mean negotiating over a period of time with an employer with the long term goal of improving the conditions of a job you love, but that does not have the conditions you would like. Nothing ventured is nothing gained and most employers are unlikely to offer improved conditions unless employees request them.

Data was collected on recruitment, employment conditions and retainment as part of the Sing & Grow national evaluation. Outcomes showed that recruitment levels were high but staff retention dropped to 44% towards the end of 2007 due to: 1) uncertainty in future funding (at the time of data collection funding was due to cease at June 2008); 2) maternity leave; and 3) uncertain and inconsistent hours of work in the project (by contracted workers).

Working conditions were generally viewed as positive by the employed management team, with flexible hours and optimal opportunities for skill development, but they generally felt their pay was low compared to their non-music therapist colleagues with similar management responsibilities. Contracted clinicians, paid on a sessional basis, felt the rate of pay and professional work was very good but the hours of available work were too infrequent.

As a result of these outcomes, several strategies were put in place and employment conditions were revised to meet the needs of a changing workforce, encourage retainment of staff, improve job satisfaction, and save costs on recruitment and training. These strategies included: 1) paid maternity leave; 2) home offices for all interstate staff to allow for more family friendly work practices; 3) flexible working hours that could be organised around young children / school pick ups; 4) flexible travel arrangements that allowed for staff to travel with children, or late in the evenings / early mornings around their family schedule; 5) increase in the hourly rate of pay for the management team; and 6) introduction of more employed part time positions and less contractual positions for clinicians where viable.

Conclusion

The next twenty years represent a time of great change in the profession as the economic and workforce conditions in which we function will change. These are exciting times, if we as a profession are willing to take up the challenges of lobbying government in order to improve their understanding of the work opportunities and conditions for music therapists. The Sing & Grow program has been continually funded for 8 years (at the time of writing) and yet has had to adapt many times to suit changing working and employment conditions and to meet evolving funding requirements. With a little know-how and a lot of heart it is possible for all of us to achieve great things. We can start small but dream big. As they say, "from little things big things grow".

References

Abad, V., & Williams, K. (2007). Early intervention music therapy: Reporting on a 3-year project to address needs with at-risk families. Music Therapy Perspectives, 25(1), 52-58.

Lunn, S. (2008). Economic crisis puts baby leave on hold, The Australian. Retrieved December 16, 2008 from http://www.theaustralian.news.com.au/story/0,,24450844-2702.00.html

Docherty, L., Nicholson, J., & Williams, K. (2007). Sing & Grow: The coexistence of evaluation research and clinical practice in an early intervention music therapy project. New Zealand Journal of Music Therapy, 5, 5-20.

Williams, K. (2006). Action inquiry into the use of standardized evaluation tools for music therapy: A real life journey within a parent-child community program. Voices: A World Forum for Music Therapy, Retrieved February 23, 2007, from http://www.voices.no/mainissues/mi40006000208.html

Vicky Abad, BMus PGDipMusThy RMT

Sing & Grow, Playgroup Queensland

Kate Williams, BMusPGDipMusThy RMT

Sing & Grow, Playgroup Queensland