American Music Therapy Association

By Don Marshall,2014-05-08 20:28
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American Music Therapy Association

    American Music Therapy Association

    National Roster Internship Application

Facility/Program Name:



     phone fax email

    Proposed Internship Director:

Supervising MT's:

Licensure/Certification of Site(s):

    Will your site require a legal affiliation agreement with the intern’s academic institution? yes no

Population served:

Internship Director Information:

    How many years have you practiced music therapy? (indicate full or part time) How long have you worked at your present facility? (indicate full or part time) How many hours of direct music therapy contact do you provide each week? List your credentials:

    Have you ever been reprimanded or sanctioned for misconduct or found negligent

    in your professional practice? Yes No (If yes, please provide more information):

Supervising music therapist information: (complete for all supervising music therapists)

    How many years have you practiced music therapy? (indicate full or part time) How long have you worked at your present facility? (indicate full or part time) How many hours of direct client music therapy contact do you provide each week? List your credentials:

    Have you ever been reprimanded or sanctioned for misconduct or found negligent

    in your professional practice? Yes No (If yes, please provide more information):

Revised 1/2010, AIAC committee 1


    Please attach the following items as separate documents or attach as one document but in consecutive order:

    A. A copy of a "fact sheet" for your specific internship site, suitable for distribution to prospective interns, academic sites, and professional colleagues, including at least the following information:

; Name and address of internship site

    ; Description of population served

    ; Description of the internship experience--what should the intern expect?

    ; Description of entry level requirements/competencies and how they will be evaluated (e.g.: examples of

    experience and/or recommended skills (music, clinical, professional, etc.) which may be needed for your specific


    ; Description of professional staff working with the intern (list music therapy staff and describe other professional

    disciplines with whom the student would have contact/interaction during internship)

    ; List other on-site student training programs (e.g.: does your site also train occupational/physical therapy students,

    social work, nursing, medical, etc?)

    ; List other on-site educational programs offered at or near your site (e.g.: inservices, professional conferences,


    ; Name and contact information for the Internship Director

    ; Provide information on the following items: available housing, meals, stipend, transportation and liability


    ; Other applicable site-specific administrative requirements that will pend acceptance to internship: State what

    requirements need to be met/approved prior to the intern’s start date as applicable (legal affiliation agreement,

    CPR training, health and drug screen, finger printing, criminal background check, etc). Please state if any of the

    listed items will require related fees to be paid by the intern.

    B. Written responses to the following essay questions:

    1. What is the philosophy of your music therapy program? In your own words, discuss your views

    about how and why music is effective in therapy/as therapy. You may include your beliefs regarding the

    value of music in therapy, the role of music in therapy, the role of music as therapy, clinical techniques, uses

    of music, and/or theoretical models. Mention specific theoretical frameworks and describe how and why

    those models are used/integrated into your clinical practice.

    2. What is your philosophy regarding training interns? In your own words, describe your beliefs

    about how interns effectively learn skills in clinical practice. You may include statements regarding your

    style and approach, the methods of training you intend to employ, what you consider to be the most

    important aspects of a successful internship experience.

    C. A series of at least three (3) sample internship schedules (indicating the number of hours of

    music therapy treatment groups (opportunities for the student to observe, co-lead, and/or lead sessions), documentation, team meetings, in-services, observation and supervision time in an average week) reflecting the developmental sequence of the training process. (Please note that

    observation and supervision times are those opportunities for the Internship Director to directly

    observe and/or work with the intern.)

    D. A written example of three (3) sample goals with corresponding measurable objectives. Submit two (2) goals related to your client population/program and one (1) competency-based goal related to intern skill development. All goals need to be written in the S-M-A-R-T format (Specific, Measurable, Attainable, Realistic, and Time-Referenced).

    Revised 1/2010, AIAC committee 2

E. Copies of internship forms developed for your site, including:

; Application for internship

    ; Orientation Checklist (Be sure to include the necessary AMTA Professional Documents as outlined in the National

    Roster Guidelines and the contact information of your regional AIAC representative ) ; Competency-Specific Intern Evaluation Form/Intern Self-Evaluation Form (Midterm and Final). This form

    must include reference to expected level of performance in the areas of Music Foundations, Clinical Foundations, and

    Music Therapy (refer to the AMTA Professional Competencies as your guide).

    ; Site evaluation form (please include a statement at the end of the document that copies of the completed form will be

    provided to the intern, academic advisor and regional AIAC representative)

    ; Intern Dismissal Policy and Procedure Document. Include a form that documents intern's acknowledgment of the

    policy. Be sure to incorporate involvement of the intern’s academic advisor in the procedure of dismissal/remediation.

    F. A vita for the Internship Director and each supervising music therapist, indicating education,

    internship experience, and work history.

G. Letters of support/recommendation, including:

; A letter of support for the internship program from the facility administrator/CEO

    ; Two (2) letters of recommendation for the Internship Director that reflect professional clinical skills, supervisory

    skills, professional qualities and characteristics, and verbal and written communication skills. It is strongly

    recommended/encouraged that one letter come from another music therapist or music therapy educator.

    H. Documentation of minimum of 5-hour formal training in supervisory processes and

    techniques (e.g., certificate of completed supervision CMTE course offered at regional and

    national AMTA conferences, transcripts from graduate course, or other related supervisory

    training course).

    Revised 1/2010, AIAC committee 3

     Responsibilities of the Internship Director

    ; Structure and implement an internship program in accordance with the AMTA National Roster Internship


    ; Respond to student requests for information and applications.

    ; Review applications, select music therapy interns and communicate with students.

    ; In partnership with the academic faculty, develop an Internship Agreement based on the needs and abilities

    of each intern, including types of/numbers of music therapy groups, documentation, special projects, etc. ; Provide the intern with a thorough orientation, including facility tour, review of AMTA documents (i.e.:

    Standards of Practice, Organizational Structure, Code of Ethics, National Roster Internship Guidelines, and

    the AMTA Professional Competencies), the CBMT Code of Professional Practice, applicable Policies and

    Procedures of the Site, and Intern Dismissal Policies.

    ; Provide viable music therapy role model(s) for interns.

    ; Provide at least one (1) hour of supervision per week for the intern. (adjust accordingly for part time


    ; Provide for at least four (4) hours of observation (formal and informal) per week for the intern. (adjust

    accordingly for part time schedules)

    ; Establish and coordinate a network of supportive professional contacts.

    ; Communicate information to the intern regarding ongoing seminars, conferences, workshops, and

    community resources.

    ; Complete and review midterm and final evaluations with the music therapy intern; Provide copies of the

    evaluation to the intern's academic site.

    ; Provide the intern with a site evaluation to be completed at the end of the internship. ; Review the site evaluation with the intern. (This review should occur after the intern's final evaluation has

    been discussed and should be used to help identify areas for improvement in the site.) ; Provide copies of the intern-completed site evaluation to the intern, academic advisor and regional AIAC


    ; Maintain continuous communication with the intern and his/her academic faculty regarding all aspects of

    the internship process including all site-specific requirements and the intern’s progress.

    ; Initiate performance improvement plans with the intern and academic faculty, when necessary. ; Accept no more than two interns per full time supervising music therapy staff at any given time. ; Accept interns no more than a year in advance of the internship start date.

    ; Upon request of the intern, provide a letter of verification documenting successful completion of internship. ; Notify the national office and Association Internship Approval Committee regional representative of any

    significant changes within the established clinical training program.

    ; Adhere to National Internship Roster Guidelines and initiate exception requests as needed. ; Monitor and act on any non-compliance issues that may arise.

    ; Follow established policy and procedure regarding dismissal of interns.

    ; Pursue opportunities for continuing education in the area of clinical training and supervision. ; Submit an annual report to your regional AIAC representative.

    ; Maintain communication with the association internship approval committee regional representative.

     I understand and accept the above-stated responsibilities of the role of the internship director.

     I verify that the content of this application is my original work, unless credit has been given to the

    original author.



    Revised 1/2010, AIAC committee 4

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