Reflections on being an International Music Therapy Student in the United States of America

"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. 
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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.
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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