by Kaitlynn Daniels, Dr. Rachel Day, DMA, Associate Professor of Music

As professionals who sing and talk all day, maintaining good vocal health is important for longevity of the voice. However, many individuals may not know simple ways to take care of their voice. 

What is voice?
Three primary systems are involved in voice production: the respiratory system, the phonatory system, and the resonator system. The respiratory system, commonly referred to as “breath support,” includes the lungs, ribcage, chest muscles, diaphragm, and windpipe, and provides the airflow necessary for sound production. The phonatory system, also known as the larynx or “voice box,” includes the larynx and vocal folds (or “vocal cords”), where sound is generated through the vibration of the vocal folds as air passes through them. The resonator system, commonly called the “vocal tract,” includes the throat, nasal passages, and mouth, which shape, amplify, and modify vocal sound to create the unique quality and tone of an individual’s voice. The sinuses, while part of the system of vibrational feedback, do not primarily impact the sound quality expressed–it is part of the perceptual feedback that helps us to adjust our sound to desired qualities. These systems work together in coordination to support healthy and effective vocal production. 

Stay Hydrated
Drinking plenty of water is key to keeping their voice healthy and maintained, especially as a professional who sings and talks all day. How much fluid you use daily varies, but the general recommendation is to drink enough to not generally feel thirsty or enough that your urine is colorless or pale yellow. If you do drink caffeinated or alcoholic beverages, balance it out with water. Another great way to preserve your voice is to take vocal rests throughout the day, which can prevent overuse. Lastly, using a regularly cleaned humidifier at home, especially in the dryer seasons, can help keep your voice healthy with 30% humidity recommended. 

Maintain a healthy lifestyle and diet 
While keeping a healthy lifestyle and diet is important for everyone, it can also help maintain your voice. The NIDCD recommends you do these things: 

• Don't smoke, and avoid second-hand smoke.
  
• Avoid eating spicy foods and drinking alcohol.
  
• Include plenty of whole grains, fruits, and vegetables in your diet.
  
• Wash your hands often to prevent getting a cold or the flu.
  
• Get enough rest. Physical fatigue has a negative effect on voice.
  
• Exercise regularly. 
  
• Avoid mouthwash or gargles that contain alcohol or irritating chemicals
  

Use your voice wisely 
Warm up and cool down your voice prior to and after times of heavy voice use. Use straw phonation as a highly researched semi-occluded vocal tract exercise (SOVTE) which helps to balance air pressure and vocal fold pressure in phonation. 

Avoid habits such as overusing your voice, singing at the extremes of your range for long periods of time, and talking loudly in noisy areas may cause hoarseness or strain in your voice. The Lombard effect commonly adds to voice strain–it is the vocal phenomenon where our vocal effort increases in a noisy environment, including dining out at restaurants.

It is also a great habit to practice healthy breathing techniques, including prioritizing breathing through your nose whenever possible. “Supporting” your voice through easy breath flow rather than pressing through your throat reduces vocal strain. 

When to see a doctor
Any occurrence of illness which impedes voice use for two weeks or longer is time to see a medical professional–often an ENT (Ear/Nose/Throat doctor) . It is a good idea to request a video-stroboscopy (a strobe light video examination of the function of the vocal folds), which is commonly performed by a speech-language pathologist (SLP). Not all ENTs and SLPs are voice specialists–find one who prioritizes vocal function in their practice.

A voice issue (sometimes known as dysphonia) can sometimes feel personally threatening. Plan ahead and set up a care team, if you know, “I always lose my voice in January,” or have other regularly occurring illnesses which affect your speaking voice. You are a professional voice user and deserve to have it function to the best of your ability at all times. 

References:
Bottalico, P., & Murgia, S. (2023). The Effect of the Frequency and Energetic Content of Broadband Noise on the Lombard Effect and Speech Intelligibility. Acoustics, 5(4), 898-908. https://doi.org/10.3390/acoustics5040052, accessed 28 May 2026. 
Cleveland Clinic. (2024, July 24) Nose Breathing vs. Mouth Breathing: Which is Better? https://health.clevelandclinic.org/breathe-mouth-nose, accessed 28 May 2026.  
Jahn, Anthony F, and Youngnan Jenny Cho, 'The Vocal Apparatus', Keep Your Singing Voice Healthy! The Doctor's Guide to Vocal Vitality and Longevity (New York, NY, 2024; online edn, Oxford Academic, 2 Sept. 2024), https://doi.org/10.1093/9780197629703.003.0001, accessed 28 May 2026. 
Mayo Clinic Staff. (2026, January 21). Water: How much should you drink every day? https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256, accessed 28 May 2026. 
Ragan, K. (2018). The Efficacy of Vocal Cool-down Exercises. Journal of Singing, 74(5), 521-526. https://www.proquest.com/scholarly-journals/efficacy-vocal-cool-down-exercises/docview/2039854103/se-2, accessed 28 May 2026. 
Ravi,S., Lopez, V., Carter, K.V., Sharpe, S., George, D., Ebersole, B., Machiorlatti, M., and Jamal, N. (2025) Intersection of Mental Health and Dysphonia: A Scoping Review. Journal of Voice, Volume 39, Issue 5. https://doi.org/10.1016/j.jvoice.2023.04.007.
Risueno P. (2023). Larynx and breathing: The connection between the vocal mechanism and respiration. Int J Respir Med.; 8(3):151. https://www.alliedacademies.org/articles/larynx-and-breathing-the-connection-between-the-vocal-mechanism-and-respiration.pdf, accessed 28 May 2026. 
Tapson, Melanie. (2026). Straw Phonation. Melanie Tapson Voice Care. https://www.melanietapsonvoicecare.com/straws, accessed 28 May 2026. 
U.S. Department of Health and Human Services. (2025, June 11). Taking care of your voice. National Institute of Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/taking-care-your-voice 
VoiceScienceWorks. (n.d.) Straw Phonation. http://www.voicescienceworks.org/straw-phonation.html, accessed 28 May 2026.

"Do you know what a foreign accent is? It’s a sign of bravery."
— Amy Chua

When I received a generous scholarship to attend Berklee College of Music I did not know what Music Therapy was. I originally planned to do one year at Berklee, and then go back home. Even though I didn’t have to pay for tuition, the cost of living in Boston was immense compared to my hometown Köln, and the options for employment were limited for F-1 visa holders like me. After my first semester I realized that I had to stay. While Berklee has many flaws, one thing it does well is bring international students together. I connected to people from all over the world, who had a similar drive to make a difference in their environment. I learned that I had no idea how big, diverse, and culturally rich the world truly was. I got the chance to play Brazilian music with people from Brazil, and Jazz with people whose recordings I have admired forever. 
While all that happened I discovered Music Therapy and everything came together. I could use the years of music knowledge and performance experience to make a meaningful difference in people’s lives. I did the math and figured out that If I worked 20 hours a week (the maximum a student on an F-1 visa is allowed to do), tested out of as many required courses as possible, and taking liberal arts credits as CLEP exams to transfer, I could deal with the financial burden that was completing the remaining six semesters of coursework. 

As many of you might know, finishing the coursework is only part of what it takes to become a board-certified music therapist in the US. After completing the academic requirements, AMTA requires 1200 hours of clinical training, which I am going to realize through a 1040 hour internship.

The Internship Problem
While doing my internship, I am on an F-1 student visa with the “employment benefit” CPT (Curricular Practical Training). Under (CPT), I am not permitted to hold employment or earn income outside of my internship placement. This means that for the duration of my internship - in my case, nine months in New York City - my only options for supporting myself are personal savings, grants, family support, or a stipend from the internship site. Most internships don’t offer stipends. The ones that do mostly offer amounts too low to cover living expenses, let alone transportation that is needed in most cities in the USA.

My American classmates, if they need to, can pick up part-time work. They can teach, work a service job, or play gigs. I cannot. And yet I pay rent, health insurance, and taxes like everyone else. The financial burden of completing this required, unpaid training falls entirely on me and my family - and for students who don’t have family savings to draw on, it means debt. Since international students don’t qualify for federal financial aid, there is a high chance that they are required to take on private debt with unfavorable interest rates. This is not a personal failing. It is a structural barrier that makes music therapy - which is already an expensive profession to enter - significantly more inaccessible to people from countries where families don’t typically save for years to pay for (American) graduate education. 
​
Given all of this, people sometimes ask me why I don’t just go back to Germany.

I am building something here - a network, a clinical identity,  a research direction - that I couldn’t build anywhere else right now. The other question I also encounter is why I choose an internship without a stipend?

Truthfully, the assumption behind that question bothers me more than the question itself. It suggests that international students should make important career decisions based on what they can afford rather than where they can grow - giving the most choice to the people with the most financial cushion.
I chose the Louis Armstrong Center for Music and Medicine because it is the best place for me to become the clinician I want to be, in the city I think I can grow the most in - as a clinician, musician, and human being who thrives in intercultural environments. The fact it doesn’t offer a stipend often is, but in my opinion shouldn’t be, the reason to not choose an internship.

Maybe that is just How things are - but do they need to be?

I was fortunate enough to leave Berklee for my internship without debt. Without a full tuition scholarship I wouldn’t be here. But tuition is only part of the cost of becoming a practicing music therapist in America, and the longer I pursue this dream, the more I feel the weight of what comes next.

The Visa Labyrinth
After completing my internship I am eligible to sit for the MTBC board exam. And I better pass it right when the internship ends, on my first try. This is due to the fact that after my internship, to keep my visa, I will have to apply for Optional Practical Training (OPT). The OPT begins immediately after CPT ends. With the OPT I am allowed to work any job that is directly related to my major. As a music therapy major that would be a job as a music therapist. So if I don’t pass the board exam right away I will not be able to work as a music therapist (in most states). New York itself makes this harder because most music therapy jobs require the LCAT certification.

OPT is capped at one year. After that, I need an employer willing to sponsor an H-1B visa. H-1B sponsorship is expensive for employers, and currently has an annual cap of 85,000 visas, allocated via an electronic registration and lottery system. If I can’t secure an H-1B visa, my options narrow quickly. I could do graduate school, which would give me a student visa, another OPT after completion, and cost more money. This would give me better H-1B visa chances, and with a lot of luck also the option to apply for an EB-2 visa with a National Interest Waiver - which is designed for individuals whose work is deemed to be in the national interest of the United States. It is highly competitive, requires extensive documentation of contributions to the field, and takes years to process. Not much of a plan B. 

I am not sharing this to complain. I am sharing it because I think most people in our community don’t fully understand what international students (3.3% of MT students) are navigating beneath the surface of their academic performance.

Why do I subject myself to this?
I chose to stay in the United States and build my career here rather than return to Germany because of multiple reasons. Firstly, I am getting my degree here, connecting me with other MT students, professors, and professionals, giving me a network of future colleagues and employers. Secondly, Germany specifically lacks a professional practice law that defines and protects the scope of work. Additionally the variety of populations, settings, and research opportunities in the American music therapy landscape is genuinely extraordinary, and I want to learn from the amazing practitioners who built it, and keep building on their work myself. I also think that my experience as someone who was not born in this country, and who tries to build a career here is something that can resonate with clients.

When I work with clients that have been resettled from another country, or work with families in the NICU that are navigating the US healthcare system in their second or third language, I have points of relatability. While many have it much harder, I have some kind of idea about finding your place in a system that doesn’t necessarily make room for you.

I speak multiple languages, and I carry multiple cultural frameworks for what music means and what healing can look like. I have learned to accept uncertainty, to ask for help, and to keep going when the system makes it clear that it was not built for me.

Music therapy will be stronger for having people in it bring a different point of view, a different relationship with music, and a different perspective on what it means to be a music therapist. I hope our field - its training programs, internship structures, and professional organizations - starts building with that in mind.
​
To the international students out there. I hope you have the means to keep going and to realize what you can bring to the profession and to our clients. This country needs more of us.
​- Jan Portisch

​Hello all, My name is Sherri Rajesh, and I am currently a music therapy intern at Brenner Children’s Hospital in Winston-Salem, NC! I have been loving it so far, and it is so wild to think that my last day is in less than a month! Internship has really flown by for me, so I will share a little about my experience here and what it is like to intern at a hospital that has a dedicated music therapy space! Sophie’s Place, the dedicated music therapy space here in the hospital, was created in honor of Sophie Barton, an outstanding and amazing volunteer at Primary Children’s Hospital in Utah! She was a creative force who loved music and volunteering to support patients. She passed away unexpectedly, and to honor her memory, her family created Sophie’s Place! We are one of 9 in the country and the only one on the East Coast! It has been such an honor to work in a place that honors not only Sophie, but all of the patients she was able to impact. Our space has a fully electric drum set, several guitars and ukuleles, a full-size keyboard, a recording studio, and a surround-sound speaker system! Our most notable feature is a pink guitar that is signed by Taylor Swift! Before my internship cycle started, my supervisor and her intern at the time helped host a Swifty Experience for our pediatric patients, and Taylor Swift sent the guitar to support Us! The most impactful lesson I learned as an intern was to learn to be flexible with my session plans! I am a particular person about planning and anticipating different outcomes / behaviors but the reality is that flexibility is the only thing I can know for sure will be a part of my sessions. For incoming interns, make sure to refine those verbal skills as much as possible! It's important to know how to create safe and therapeutic spaces for clients to share in, and you don't want to be stumbling over your words. Throughout this internship I got to work and collaborate with various members of a care team and different types of patients. My favorite internship experience was a "Camp" Day we put on for a long-term patient here! She had undergone an intense procedure and was missing the camp she would typically be attending, so we gathered up instruments and crafts and brought the camp magic to her! It was such a fun day and served as a reminder that music therapy is all-encompassing in regards to creative ways to support patients. Through this internship, I have been able to collaborate with a multi-disciplinary team, write songs, lead groups, work individually, and be a part of so many meaningful moments with patients and their families here at the hospital. I have learned so much about the power and healing that music brings, especially to such an unlikely place such as a hospital. If you are local to NC, I would encourage everyone to apply to this internship! You will gain valuable professional and musical skills, and learn so much about a multitude of people and their diagnoses. Thank you for letting me share some words! Please feel free to reach out to me if you have any questions about this specific internship or music therapy in a pediatric medical setting. My email is [email protected].
​Peace + love, Sherri

​Music therapists work across diverse populations, including the LGBTQIA+ community, where affirming and inclusive care is vital. The Queer Music Therapy Model, introduced by Bain et al. (2016), offers a structured, identity-affirming approach to care that challenges the cissexist and heterosexist foundations of traditional therapeutic frameworks. This model recognizes the unique therapeutic needs of LGBTQIA+ individuals and supports clinicians in offering empowering care.
Originally developed for LGBTQ+ adolescents, the model encourages identity development and resilience through music rather than emphasizing vulnerability (Boggan et al., 2017). Interventions include musical autobiography assessments, gender-bending song parodies, critical lyric analysis, and group anthem writing. These techniques foster self-expression, community, and empowerment in therapeutic settings.
Adult and older LGBTQIA+ populations, particularly those from intersectional backgrounds, often face barriers to affirming care. Research confirms that older LGBTQ+ adults of color are frequently excluded from advocacy and policy, facing ageism alongside racism and heterosexism (Christian et al., 2021). Approaches like Relational–Cultural Theory (RCT) and the Multicultural and Social Justice Counseling Competencies (MSJCC) offer frameworks to support these clients through culturally responsive and justice-oriented care (Cole, 2021).
Queer music therapy can also be strengthened by using works from LGBTQIA+ artists to affirm identities and foster connection. Songs like “Born This Way” by Lady Gaga and “Chosen Family” by Rina Sawayama become powerful tools for healing and identity affirmation.
As the field evolves, the inclusion of affirming, intersectional, and research-driven practices like queer music therapy remains crucial. These practices not only foster resilience and connection but also challenge systems of oppression through the power of music.
References
Bain, C., Grzanka, P. R., & Crowe, B. (2016). Perspectives on queer music therapy: A qualitative analysis of music therapists’ reactions to radically inclusive practice. Journal of Music Therapy, 53(4), 375–404. https://doi.org/10.1093/jmt/thw010
Boggan, K. E., Grzanka, P. R., & Bain, C. L. (2017). The queer music therapy model: Empowering LGBTQ+ youth through musical identity. Voices: A World Forum for Music Therapy, 17(3). https://doi.org/10.15845/voices.v17i3.928
Christian, D., Osborne, J., & Samuels, D. (2021). Counseling older LGBTQ+ adults of color: Relational–cultural theory in practice. Journal of Counseling & Development, 99(3), 330–340. https://doi.org/10.1002/jcad.12378
Cole, R. (2021). Counseling LGBT military clients using the Multicultural and Social Justice Counseling Competencies framework. Journal of Military and Government Counseling, 9(1), 32–45. https://doi.org/10.1080/2326716X.2021.1945079
Johns Hopkins University. (2022). LGBTQ Glossary – Gender & Sexuality Resources. https://studentaffairs.jhu.edu/lgbtq/glossary
AAMFT Queer Affirmative Caucus. (2007). A companion to lesbian, gay, bisexual, transgender, and queer studies: Affirmative counseling techniques. American Association for Marriage and Family Therapy. https://www.aamft.org/queeraffirmative

Hi AMTAS community!
My name is Rebeca and I will be your secretary for 2025. I recently completed my course
work at Appalachian State University, and am beginning my internship with Symponia Hospice
in Decatur GA this summer. In addition to making music, I enjoy working out and journaling,
especially as forms of self care.
I’m so excited to serve you all this year, and work on sharing ideas through our AMTAS
Blog! As music therapy continues to grow and expand as a field, we as students must also
continue to explore new horizons and continue celebrating the little things which ultimately
culminate to larger accomplishments. My hope for this year is to share advice, ideas, and
accomplishments throughout our music therapy community.
In addition to offering blog posts written by the members of our eBoard, I also look
forward to sharing the experiences of students like you. Whether you have internship advice or
have developed a new way of learning repertoire, we want to hear from you! If you’re interested
in writing a blog post feel free to email me at [email protected] or you can DM us on
Instagram at @_amtas_ .
In the next few weeks we have various exciting events coming up including our Give
Lively campaign and our AMTAS merch design competition. For more information on both of
these events keep an eye on our Instagram and our website.
From all of us here on the AMTAS eBoard, we appreciate all you do as students and
members of the AMTAS community. We hope to continue serving you and providing you with
resources to help you become the best music therapy student you can be!

​

As we gather for AMTAS Passages 2024, we invite you to join us for a day dedicated to the exploration and celebration of our shared passion for music therapy. AMTAS Passages event, Soulful Sounds, happening on October 26th from 10:00 AM – 1:30 PM (EST), is a virtual event crafted by students, for students. This is more than just an event—it's an opportunity to connect with one another, reflect on our journeys, and draw inspiration from the collective wisdom of our community.

We'll begin the day with "Sip & Socialize," a warm and inviting space where you can enjoy your morning beverage while engaging in meaningful conversations with fellow attendees. Whether you're a seasoned networker or just looking to connect, this session is designed to set the tone for a day of sitting with our community. It's a casual start to the morning that allows us to ease into Passages, fostering connections that will enrich the rest of our time together.

Following our networking session, we are honored to present a keynote address by Chris Millet, MM, MT-BC. Chris will share insights and experiences that highlight the profound impact music therapy has on our personhood throughout many stages of our joining. From student, intern, professional, and seasoned professional, his words are sure to resonate deeply. 

Our student community is the heartbeat of AMTAS, and the event continues with a session dedicated to showcasing their incredible work. This segment of the day offers a platform for peers who are pushing the boundaries of music therapy through innovative research, personal stories, and new ideas. It’s a chance for us to support and learn from one another, and to witness the future leaders of our field as they share their visions.

The Internship Fair offers a unique opportunity to explore diverse internship opportunities and connect with potential supervisors. Whether you're searching for your next placement or just curious about what’s out there, this session will provide valuable insights into the possibilities ahead. It's an essential step in our professional journey and this fair is designed to make that step as informative and engaging as possible.

We'll close the event with a reflective session, celebrating the connections made and the knowledge shared throughout the day. This is a moment to look back on what we've experienced together and to consider how we can continue to inspire and support one another as we advance in our music therapy journeys.

As we look back on the challenges of recent years, including the global pandemic, civil unrest, international conflicts, and the constraints placed on us by external forces, we recognize the resilience and strength of our community. In the face of adversity, we have held space for reflection, growth, and solidarity, honoring the past while steadfastly moving forward.

In 2024, our focus remains unwaveringly on our student community. We are committed to serving them to the highest capacity possible, providing support, resources, and opportunities for growth. Our mission to promote, foster, and advance the education and training of our members is more important than ever as we navigate an ever-changing landscape.
​
We extend our heartfelt thanks to everyone involved in bringing "Soulful Sounds" to life. Your dedication and hard work are what make events like this possible. We personally invite each and every one of you to share your passion with us on October 26th. Let’s come together to connect, inspire, and be inspired as we celebrate our student community! 

Written by Sydney Winders, AMTAS President