I recently published an article exploring burnout and the systemic challenges in the field of music therapy. As a complement to that viewpoint, I believe it prudent to discuss the other side of that issue: our individual expectations within the profession.
As a growing field, music therapy faces hurdles, from low reimbursement rates to insufficient quantifiable data on our financial value in healthcare. However, as practitioners, we also have a role to play in helping our profession evolve. Today, I’d like to offer a perspective on how music therapists’ expectations—about pay, workload, and career advancement - may need to adapt to the realities of our field, and what we can do individually to bridge this gap.
Expectations of High Wages and Work-Life Balance
It’s only natural to want fair compensation and work-life balance. The pressures of rising costs of living and student loan debt are real, and music therapists, like all professionals, deserve to feel financially secure and fulfilled in their careers. However, we also need to recognize the limitations in our field and understand why, in many cases, music therapy roles cannot yet offer the same compensation as other healthcare positions.
In my first full-time music therapy role, I was paid below the median salary and managed an unsustainably large caseload. I was the only music therapist for a hospice provider, serving over 2,000 patients across five counties. I worked overtime, driven by my desire to build a program for the community. While I was grateful for the chance to do this work, I eventually left, taking those lessons into a career in administration. The program I built continues today, and I’m proud of its legacy.
For music therapists, it’s important to recognize that, like in any profession, compensation is generally determined by market value and the skills we bring to the table, not the cost of living. In an ideal world, our profession would reward each therapist generously for the value they bring. But in reality, healthcare organizations still view music therapy as an ancillary service - and for many, it is. Unlike positions that directly impact reimbursement, such as nursing or physical therapy, music therapy often operates at a financial loss within institutions. This isn’t due to a lack of value in our work; rather, it reflects the fact that, for now, much of our value is qualitative rather than quantifiable.
Many music therapy programs are funded by donations, grants, or operating budgets that don’t allow for competitive salaries. That was the case for my first music therapy job. The program was funded wholly from the donations of a generous benefactor. And in cases like that, expecting a salary above the median or mode in one’s region can be a tall order. When music therapists, especially those early in their careers, expect high pay without yet establishing the financial value of their role, it creates tension between individual expectations and industry realities. My goal here isn’t to discourage these expectations but to encourage us to align them with the current state of the field and strategize ways to increase our compensation realistically. And there are ways for even new music therapists to receive higher compensation relative to the field, but it requires hard work.
The Reality of Limited Reimbursement and Financial Constraints
One of the biggest challenges facing music therapy is the limited reimbursement opportunities. Even in states that recognize music therapy through licensure, few insurers cover the service, and those that do often reimburse at low rates. Most organizations view music therapy as a non-billable service, which impacts its perceived value and limits resources for creating high-paying jobs. Without widespread reimbursement or robust funding, the options for offering high salaries and benefits are slim.
In my experience, the most effective way to address this issue and increase compensation is by leveraging a fee-for-service model. This model allows music therapists to focus on maximizing client volume, which directly impacts revenue generation. By concentrating their time on providing services rather than administrative tasks, therapists in this model can potentially earn more, particularly when paid on a per-session basis. This is precisely why we see so many contractor positions in music therapy. However, this approach also demands a high session volume, which can lead to burnout if not managed carefully.
It’s essential to understand that, until music therapy becomes a regularly reimbursable service, fee-for-service and similar high-volume approaches may be among the few sustainable options for higher compensation. While this model isn’t ideal for everyone, it underscores a fundamental truth: value drives compensation. If the value we provide is seen as marginal, we need to either increase our session volume or expand our skills to generate tangible financial contributions to the team.
Expectations of Flexibility and Work-Life Balance
In addition to financial expectations, many music therapists also seek flexibility, frequent time off, and work-life balance - a desire shared across many professions. However, the nature of music therapy work often requires high commitment and consistency, especially in clinical settings where therapists may work directly with vulnerable populations. Balancing these needs with the desire for flexibility can be challenging, particularly in fee-for-service models, where income directly correlates with the number of sessions provided.
From my perspective, this expectation of flexible hours, frequent time off, and high compensation reflects a broader societal trend toward prioritizing work-life balance. While there’s nothing wrong with this, it’s important to recognize that in a profession struggling for financial recognition, we may need to prioritize career growth and commitment to clients over flexibility, at least early on. As we work to establish our field’s value and secure higher pay, flexibility may not always align with the reality of current job structures.
Expanding Skills Beyond Traditional Music Therapy
Another way music therapists can increase their professional value is by expanding their skills outside the traditional scope of music therapy. When I worked at Seasons Hospice & Palliative Care (now AccentCare), I saw a model of integration I’ve admired ever since. They had a music therapist in corporate leadership who championed the field’s value. Seasons therapists coordinated referrals, educated families about hospice care, managed election of benefits (EOBs), and provided bereavement support. By incorporating learnable skills into their training, they expanded music therapists’ roles, creating paths for them to rise into operational, marketing, and leadership roles. Seasons demonstrated that with an interdisciplinary mindset, therapists could make a greater impact within healthcare organizations.
For those who may not be interested in broadening their skill sets, committing to a high session volume is another way to increase their value. While this approach is demanding, it reinforces the importance of the service they provide and helps address the compensation gap. These adaptations may not be the most popular, but they can be powerful steps toward enhancing the value of our roles.
Fast-Tracking to Academia
In light of the challenges we face, some music therapists may consider leaving the field altogether, pivoting to adjacent roles, or even “fast-tracking” to academia by pursuing positions in teaching or research after only a few years of clinical experience. While academia can be a rewarding path, it’s concerning to see therapists aim for teaching roles without substantial time in the field. Teaching music therapy without extensive real-world experience could limit the depth of knowledge passed on to future practitioners and risk creating an academic pipeline disconnected from the realities of practice.
Academic positions should ideally be filled by those with robust clinical experience who can convey practical knowledge alongside theoretical insights. While career progression is important, entering academia prematurely may inadvertently contribute to the very issues we’re discussing by fostering unrealistic expectations and limiting the practical skills imparted to the next generation.
Purpose and Professional Responsibility
As I mentioned in my previous article, music therapy as a field must learn to better value and quantify its contributions to healthcare. But this applies equally to individual therapists: we need to take responsibility for expanding our roles and increasing our measurable impact. If the organizations we work for don’t recognize our financial value, we need to be proactive in either generating that value through volume or through cross-disciplinary contributions.
It may be an unpopular opinion, but I believe we should remind ourselves why we entered this field in the first place. The work we do is deeply meaningful, and the opportunity to work as a music therapist is something we should approach with gratitude. In an era of high costs and economic pressures, our eyes may have shifted from purpose toward compensation. By re-centering on the mission that drew us here, we can find resilience in the face of financial constraints.
A New Mindset
In 2017, I was early in my career in administration. Like many people at the time, I’d jumped on theHamiltontrain, consuming every piece of content I could find about the production and its creative engine - Lin-Manuel Miranda. There was an interview Miranda did withFresh Air’sTerry Gross where she asked him about his dreams as an aspiring artist. His answer was simple but powerful:“A life in this business.”
That response resonated with me, immediately. It spoke to a humility and gratitude that I’ve always felt about this field. It reminded me of the privilege of building a livelihood from something as meaningful as music therapy. The idea of making a life from music—of walking into hospitals, schools, and hospice centers and bringing peace, transformation, even joy through music - is a beautiful and noble path, not just a job. Now, to harken back to one of the points made in the original Reddit post that inspired this article, "Why I Left Music Therapy." The author, so understandably, wrote, “I got tired of needing to simply be grateful for my inclusion on my professional teams. I got tired of having to feel grateful for the funding of my discipline because of my ‘ancillary’ status.”
Man, does that hit.
I certainly empathize with anyone struggling to feel like a legitimate member of his or her treatment team. But if we can’t change a thing, perhaps we can change how we look at it. If you’ll permit me a musical simile, I sometimes look at my career as a jazz solo - an improvised collage of choices - some planned, some I’m still trying to make work. There’s a share of well executed swings, and many that fell flat. But at the end of the day, I have been blessed - not to have to work a job I hate, or one that doesn’t matter. No. Igetto practice music therapy.
All of us could sit and wonder about the lucrative or prestigious careers that could have been. Frankly, some of us should pursue those. But we must never forget why we chose this wonderful field. And it is that passion that will enable us to overcome the obstacles it faces.
As Winston Churchill so aptly stated,“We make a living by what we get, but we make a life by what we give.”
