Allied Health / ECEI
Are art and music therapy funded by the NDIS?
Art and music therapy are growing in popularity, but the NDIA and planners can be reluctant to approve these supports in plans. I tend to believe government bureaucracies are naturally suspicious of anything that looks a little too much like fun - call me a conspiracy theorist if you must. But sometimes the fun factor is exactly what makes something effective.
In this article, we are going to explore what art and music therapy are, common reasons funding is turned down, and hot tips for report writers.
So, get your paint brushes out, and let’s get started!
What are art and music therapy?
Art and music therapy are allied health supports that help people navigate challenges and achieve mental, social and physical goals. Both supports can be an alternative outlet for exploring and processing emotions. This is often particularly beneficial to people unlikely to respond to traditional talk therapy, such as non-verbal communicators or people with cognitive or communicative disabilities.
Music therapy is also used to help people develop communication skills and improve their articulation. Working with an art or music therapist can help individuals develop fine motor control, hand-eye coordination, and spatial awareness.
The purpose of art and music therapy is not to produce great art or music. The next Rembrandt or Taylor Swift will not be discovered in the therapy room.
Both supports should be delivered by an appropriately qualified professional. The Quality and Safeguards Commission requires registered art therapists to be a member of Australian, New Zealand and Asian Creative Arts Therapies Association (ANZACATA) and registered music therapists to be a member of the Australian Music Therapy Association. Both these organisations have minimum qualification requirements for members. So that well-meaning local musician who is kind of attractive (but not as much as he thinks he is) who calls himself a music therapist because he believes in the healing power of the guitar? Probably best you check his credentials before handing over your NDIS funds.
Does the NDIS fund art and music therapy?
Short answer: yes. Both these supports even have dedicated line items in the Pricing Arrangements and Price Limits document.
But as with all things NDIS, what happens in practice is much more complex. It’s quite common for people to struggle to get art or music therapy funding in their plans. And the objections from planners tend to follow similar themes:
“It’s not evidence-based”
The reasonable and necessary criteria say that all NDIS funded supports must be ‘effective and beneficial’ with regards to ‘good practice.’ The effectiveness of art and music therapy is sometimes looked upon with suspicion because art and music therapists are not regulated by AHPRA - the Australian government regulator of allied health professions. Art and music therapy are self-regulated professions with their own registration systems, just like speech therapy or dieticians. They are also registered by the National Alliance for Self-Regulating Health Professions.
But there is a growing body of evidence that backs the effectiveness of these supports. ANZACATA, the peak body that represents art therapists, has developed a resource which collates academic research on the effectiveness of art therapy. It includes studies on the use of art therapy for people with cognitive disabilities, behaviours of concern, anxiety, depression and trauma. AMTA also has a resource highlighting the evidence for music therapy for people with goals for mood and behaviour, thinking and communicating, movement skills and social engagement. Additionally, both AMTA and ANZACATA have their own peer reviewed academic journals.
The Administrative Appeals Tribunal (AAT) has also concluded there is enough evidence to fund art and music therapy. In NDIA v MY, there was some dispute about the effectiveness of art therapy with clinical psychologist and Emeritus Professor Stewart Einsfield arguing that the evidence-base is ‘weak.’ However, this was disputed by the AAT sitting member who said, ‘The literature, both in Australia and internationally is extensive and the value of arts-based therapies in the management of both mental and physical health conditions is overwhelming.’
‘It duplicates other supports’
The NDIA sometimes considers art or music therapy a duplication of supports, particularly if the person has funding for other allied health supports, such as psychology or occupational therapy (OT). The NDIS Rules prohibit funding supports that ‘duplicates other supports delivered.’ It’s also less likely to meet the value for money reasonable and necessary criterion. Usually, art or music therapy will only be funded in addition to other allied health supports if they are working towards a different outcome. For example, the NDIS is unlikely to fund both an art therapist and OT to support somebody developing fine motor skills. But a person might get funding for an OT to work on fine motor skills, and an art therapist to focus on emotional regulation.
‘It doesn’t matter because Improved Daily Living is flexible’
Like most allied health supports, art and music therapy usually comes out of the Improved Daily Living support category. As long as a support isn’t stated, Improved Daily Living funding can be used flexibly within the support category. Because of this, the NDIA sometimes argue anyone with funding in this category can access art or music therapy. This is both technically true, and not always helpful. Improved Daily Living funding might (usually) be flexible, but it’s not limitless. If a plan isn’t built to include a support like art and music therapy, or to work towards the outcomes they would support, then people usually have to choose between it and something else they also need.
‘It’s a health-related expense’
The NDIS will not fund any support that it considers the responsibility of other parts of government, including the health system. This may be an issue for to people seeking art or music therapy to support their mental health and wellbeing. My colleague Kylie has written a great article exploring when a support is the responsibility of the mental health system v the NDIS.
Tips and tricks
With all that in mind, here are some tips for making a strong case for art or music therapy funding:
Team work makes the dream work. Getting allied health professionals to work together as a support team to coordinate recommendations increases the chance of a support being funded, particularly if each provider discusses how other supports will complement the work they are doing. It also helps address the duplication issue head-on- by making it clear how art or music therapy will be working towards a different outcome than other supports.
Itemise the hours required for each allied health support being requested, with clear explanations of the outcomes each professional is aiming to reach.
If the planner is sceptical that art or music therapy are effective and beneficial, you might want to point to relevant studies in ANZACATA’s academic collection, AMTA’s journal and information booklets, or the AAT cases where it has been an approved support (which you can find here and here). If you have evidence of how it has been personally effective for you, this would also be considered.
For the love of all-things-holy, make sure all reports address each of the reasonable and necessary criteria.
Avoid health-system language. Some big no-no words include: treatment, mental health, rehabilitation, injury. Whereas good words are: capacity building, ordinary life, functional impairment, etc.
With the NDIS’s growing budget dominating news headlines, it’s reasonable to evaluate the value for money of different supports. But just because something is a bit outside what we consider mainstream, doesn’t mean it’s not effective. The best way to improve Scheme sustainability is to invest in capacity building and innovation, not to just tighten our purse strings and hope for the best.
Artwork by Shai de Vletter-Sont