The Netherlands

History and background . . .

Music therapy in the Netherlands has a long history which goes back to the beginning of the 20th century. A Dutch harp player, Willem van de Wall, who worked in the United States, wrote in 1929 ‘Methodical application of music in the treatment of unusual persons’, a book that was translated to Dutch and afterwards he wrote in 1935 ‘Music in institutions’. The dissertation by psychiatrist Bernard Lievegoed: ‘Measure, rhythm, melody – foundations for a therapeutically use of musical elements’ (1939) was grounded in anthroposophical medicine. After the Second World War the interest in music therapy STARTED to grow and first music therapists started to work. In 1957 psychiatrist H. van der Drift wrote ‘Cultural therapy’, the first original work on music therapy (and other arts therapies) in psychiatric institutions. Nowadays, more than 500 music therapists are working in different fields like mental health, care for the elderly, rehabilitation centres, special needs education, forensic psychiatry and in private practices.

Professional profile
An important step in professional development was made in 1987 with the publication of the ‘Professional profile of the creative therapist’, which in 1999 was completed with the official ‘Professional profile of the music therapist’ (NVvMT). This profile was updated in 2009 by the NVvMT. The professional profiles are the basis for the BA training programs. In 2012, the FVB and the branch organisation of mental health care institutions (GGZ Nederland) together completed the ‘Profile of the mental health arts and psychomotor therapist’ (GZ-Vaktherapeut.) This profile represents an important step towards recognition to music therapy by government, employers and health insurance.

Registration and CPD
In 1987 the NVCT took the initiative to protect the profession of creative art therapists, including music therapists, by establishing the independent ‘Foundation Registry for Creative Therapists’ (SRCT). In 2006, with the start of the FVB, the name changed into SRVB, and psychomotor therapists joined the registry. In 2014 the registry became part of the FVB. There are two levels of registration: basic (bachelor certification plus two years of work experience and extra supervision) and senior level (master certification). As part of the registration, continuing professional development (CPD) for Dutch therapists is monitored by the Registry Committee of the FVB. Every five years all registrants have to submit a log of all CPD activities, including working hours, peer review or supervision and continuing vocational training. In 2014, 70% of NVvMT members have been registered on a basic or senior level or are preparing to be registered.

Theoretical Foundations . . .

Music therapy in the Netherlands was grounded in practice work in psychiatric institutions. Important founding figures are Dr. A. Salomé-Finkelstein and Clemens Holthaus (Sinaï Kliniek, Amersfoort and Rosenburg, Den Haag), who designed the first diagnostic tests (rhythm test). Most influential music therapy theory came fourth out of the ‘creative process theory’, by Brom, Kliphuis, Waardenburg and Wils at Middeloo training institute, located in Amersfoort. Other training institutes in Baarn and Nijmegen developed their own research on the function of art within creative arts therapies. During the 80′s the emphasis shifted to the differentiation of working fields, and psychotherapeutic methods. Effect research into music therapy began on a very small scale in the Music therapy laboratory in Nijmegen with van den Berk and Smeijsters. In the nineties, the ‘analogy-process’ MODEL by Smeijsters was influential. He also wrote the important handbook for music therapy ‘Handboek Muziektherapie’. From 2000 on, practice based research in the Netherlands has steadily grown , there are numerous Master studies and now three PHD studies completed (Vink 2013, Poismans 2014 and Hakvoort 2014). Nowadays, many music therapists are ‘eclectic’ working and they specialize themselves in neurological music therapy by Michael Thaut, and other evidence based methods, often linked to psychotherapy.

Definition of Music Therapy
In 2009 the NVvMT published the following definition:‘Music therapy is a methodical form of care, in which musical means are used within a therapeutic relationship to achieve change, development, maintenance and acceptance in emotional, behavioral, cognitive, social and physical areas.

Recognition and approval . . .

In 2004 the government introduced a system to clearly defined occupational groups in mental health care (‘CONO-beroepentabel’). The occupational groups are: nurses, doctors, health care-psychologists, psychotherapists, pedagogical professions and ‘arts and psychomotor’ (vak)therapists. Music therapists in this system belong to the last group, together with the art, drama, dance and psychomotor therapists. This was an important step towards recognition by the government. The profession in this system has two levels of training; a basic (BA training), and a differential level (Mental Health ‘GZ-Vaktherapeut’). Because of this position music therapy in mental health institutions is reimbursed. The creative arts and psychomotor therapists have applied for inclusion into the so called ‘BIG-register’ (Professional Occupations in Health Care registry), which since 1993 is organised by the Ministry of Health & Welfare (VWS). This will result in achieving protected status for the name ‘music therapist’ for those who have followed the official BA and MA training courses. This is a lengthy process, considering that the first contact about this form of protected status dates from around 1998. The Ministry of Health & Welfare is still considering the final criteria relating to the BIG title protection.
It could be important not only for the public, who can rely on qualified therapists, but also for the reimbursement of music therapy by Health Insurance Companies. Only a small part of the music therapists (10%) work in their own private practice, because health insurance companies are not very willing to pay for it. An extra insurance package that covers the costs is quite expensive.

In the Netherlands the Trimbos Institute took the lead to implement national multidisciplinary guidelines for mental health. Music therapists have contributed to these guidelines, but it was difficult to find research on a high enough level to get this accepted. Despite of these problems, music therapy is mentioned as beneficial to treatment, in guidelines for anxiety disorders, schizophrenia, depression and personality disorders.

Research and literature . . .

More can be read about history and theoretical foundations of MUSIC therapy in the Netherlands in the following publications;

  • Wall, W. van de. (1929). Methodische toepassing der muziek bij de behandeling van ongewone personen. Amsterdam; Wereldbibliotheek
  • Lievegoed, B. (1939). Maat, ritme, melodie, grondslagen voor een therapeutisch gebruik van muzikale elementen. Zeist; Vrij geestesleven
  • Drift, H. van der.(1958). Beknopte leidraad bij de toepassing van speltherapie, culturele therapie & bewegingstherapie in de psychiatrische inrichtingen. Utrecht; erven J. Bijleveld.
  • Wils, L. (1973). Bij wijze van spelen. Alphen aan de Rijn; Samson
  • Schalkwijk, F.W. (1984). Grondslagen van muziektherapie. Nijmegen; Dekker& van der Vegt
  • Adriaansz, R., Schalkwijk, F., and Stijlen, L. (1986). Methoden van muziektherapie. Nijkerk; Intro
  • Smeijsters, H. (1991). Muziektherapie als psychotherapie. Assen; Van Gorcum
  • NVCT. (1993). Beroepsprofiel van de creatief therapeut. NVCT, Utrecht.
  • Smeijsters, H. (2006). Handboek Muziektherapie. Houten; Bohn Stafleu van Loghum
  • Berman, A, Henstra, S. and Laansma. M. (2009). Beroepsprofiel van de muziektherapeut. Utrecht; NVvMT
  • FVB and GGZ Nederland (2012). GZ Vaktherapeut beroepscompetentieprofiel. GGZ Nederland, Amersfoort.
  • Bosters, T. and Berman. A. (2013). Onderzoek Muziektherapie in Nederland.NVvMT, Utrecht.
  • Bruijn, M. de (2013). Muziektherapie in de revalidatie. Apeldoorn; Garant
  • Vink, A.C.(2013). Music therapy for dementia: the effect of music therapy in reducing behavioral problems in elderly people with dementia. Groningen; RUG.
  • Poismans, K. (2014). Geteilte zeit-gemeinsame zeit. Entwicklung eines Messinstruments zum TIMING in der Musiktherapie met autistischen Kindern. Enschede; Ipskamp.
  • Hakvoort. L. (2014). Cognitive behavioral music therapy in forensic psychiatry, workable assumptions, empirical studies and theoretical foundations for primary goal-orientated treatment. Arnhem; ArTEZ press
  • Poismans, K. e.a. (2014), De ontwikkeling van muziektherapie in Nederland: Impressies van pioniers. Enschede; Stichting Muziektherapie

Selected links:

Professional associations . . .

Music therapy in the Netherlands was united for the first time in 1962 within the “Dutch association for creative arts and expressive therapies” (NVCT), an association founded by a group of psychiatrists like Vaessen and Van der Drift. The ‘Foundation for Music Therapy’ (Stichting Muziektherapie) started in 1969, because the psychiatry orientated NVCT couldn’t cover the broad spectrum of music therapy. In 1977 creative arts therapists ‘took over’ the NVCT, other professionals like psychiatrists and psychologists were no longer admitted to membership. Music therapists disbanded their own foundation and joined the NVCT. The NVCT existed until 2006, when the ‘Federation of creative arts and psychomotor therapies’, in Dutch called Vaktherapieën (FVB), was founded as an umbrella organization, and the Dutch Association for Music Therapy (NVvMT) was established.

The FVB unites the strengths of six associations in collective recognition procedures, job description of the therapies, registration matters, public relations, a professional journal and office facilities. Founded in 1987, the second ‘Foundation for Music Therapy’ main purpose is to organise (international) congresses, such as in Noordwijkerhout (1988), which is seen as the first ‘European Music Therapy Congress’ and Veldhoven (2007). The foundation is still active and maintains a website with an overview of music therapists in the Netherlands and activities home and abroad.

The professional association for Music Therapists in the Netherlands is the Dutch association for Music Therapy (NVvMT). It holds over 400 members and represents about 70% of all music therapists. The NVvMT is a very active and growing organization and has working field groups for: adult mental health, nursing homes, rehabilitation care, disabilities centres, children and youth psychiatry, forensic psychiatry and music therapy in private practice. There are commissions on: research, training, public relations and support for music therapists.

Since 2013 NVvMT organizes Music Therapy day, which in 2014 evolved to European Music Therapy Day, on the 15th of November. In 2015 NVvMT has started a public campaign: Music Makes Healthy! (muziek maakt gezond!), that includes a special website with good accessible information on music therapy, interactive possibilities and a ‘find a music therapist’ function.

Selected links:

  • Dutch association for Music Therapy (NVvMT): www.nvvmt.nl,
  • Public website NVvMT: www.muziektherapie.nl
  • Twitter account: @muziektherapie.nl
  • European Music Therapy Day: www.europeanmusictherapyday.com
  • Federation for creative arts and psychomotor therapies: http://www.vaktherapie.nl

Training programs . . .

In 1965 the first four year bachelor training for Arts therapies with music therapy as differentiated field of study, started in Amersfoort (Middeloo), followed by Nijmegen in 1978 (Kopse Hof, now HAN), Baarn in 1981 (Jelburg) and Sittard in 1984 (now Heerlen, Hogeschool Zuyd). In 1994 the Conservatory of Enschede (ArtEZ) started the only bachelor Music therapy. In 1988 Jelburg and Middeloo were merged into de Hogeschool Utrecht (HU). Since 2010 Leeuwarden (Stenden Hogeschool) also has an accredited part-time bachelor training course for Arts therapies with music therapy as field of study.

In 2014 there are five officially recognized BA training courses in the Netherlands. Music therapy is a four year fulltime or part-time training course, which includes practical training throughout the whole four years, and a one year internship during the third year. For music therapists there is only one (joint) MA training program, started in 2006, that specific focusses on research in arts therapies (Hogeschool Zuyd). Only bachelor certificated music therapists with two years working experience can apply for this MA program. Conservatory Enschede (ArtEZ) and Conservatory Rotterdam (Codarts) both have plans to start a Music Therapy Master program in the next two years.

The universities of professional education are:
HU – Hogeschool Utrecht, Bachelor creative arts therapies (music), Amersfoort www.hu.nl
HAN – Hogeschool Arnhem Nijmegen, Bachelor Creative Arts Therapies (music), Nijmegen www.han.nl
Hogeschool Zuyd – Heerlen, Bachelor Creative Arts Therapies (music), Heerlen, www.hszuyd.nl
KenVak, Master of Arts Therapies (Hogeschool Zuyd-Kenvak), http://www.kenvak.nl,
ArtEZ Conservatorium, Bachelor Music Therapy, Enschede, www.artez.nl
Hogeschool Stenden, Bachelor Creative Arts Therapies (music), Leeuwarden, www.stenden.nl