CBMT Examination - Hurdle to Certification? Or Necessary Hurdle to Ensure Competence?

Currently, there is a discussion about the Certification Board for Music Therapists' examination going on over on my social media feeds. (We've moved away from the whole MLE debacle, so of course we have to stress over something else...) People seem to be upset that the practice tests are not the same as the real test, that standardized testing is the entry standard for certification, and that other people passed but are "not good therapists." There is a bit of "poor me" attitude going on, and I, for one, am not really all that sympathetic.

My mother and I are currently engaged in a conversation about our respective professions, occupational therapy and music therapy. Between us, we have over 75 years of experience in our work, and quite frankly, we've seen lots of stuff happen over the years. Mom went through the OT master's level entry process when it happened in the 90's (just let that sink in!!! OT transitioned almost 20 years ago!!!) and found that her bachelor's education and continuous registration and certification was no problem during that transition. I've been part of the MLE discussion for music therapy since the beginning of that discussion and think that there are many things that are wrong with our profession. I also think there are many things wrong with how we educate and train music therapists at this point. I also think that there are many things that we do right, and one of those things is the board certification examination.

The comments and complaints about the CBMT examination are the same that have been happening since the beginning of the CBMT (I've seen the archives and know this to be true!). The test is difficult. There is no way to predict what you need to know in order to pass the test. Not everyone takes tests well. Standardized testing is biased in its very construction. The tests are heavily biased against non-native English speakers. The test questions had nothing to do with my job or my education. The test questions were heavily skewed towards one topic or another. All of these things have been talked about over and over again. Yet, this is what we have. This is what most helping professions have as the final test of competence - certification as a therapist through an examination.

As it has been pointed out in the discussion that I've been reading, standardized testing was developed by cisgendered white males. I am a good tester, so testing has never been a problem for me. I have never felt discriminated against in a testing situation (other than in the PSAT - never took the SAT for that reason). I cannot comment on the experiences of others from that point of view, but I have difficulty believing that everyone should pass the certification test.

I also feel that certification examinations should not be the only criterion- and ours is not at this time. Education programs have the final say over whether a student is competent (Internship directors have little to no say other than indicating to CBMT that the student has completed their internship hours). It is up to the educational program to decide whether a degree is granted to the student, competent or not.

I agree with the original authors of the social media posts that this system is not the best in the world, but at the moment, it is what we've got. 

What I hate about these types of posts is that everyone complains and complains ("poor me," "it's not fair," "well, it's the fault of someone else that I didn't do what I needed to do...") but no one steps up to do the job of being on the examination committee or tries to take some responsibility for themselves. "I've done the practice exams, but none of those questions were on the test." My attitude? Well, duh! Are you expecting to have all the questions BEFORE you take the test? Why? We are not testing your ability to take a test! We want to know if you have any critical reasoning skills AT ALL!! Obviously, you do not. 

This leads me into thoughts and discussions about being a gatekeeper for the profession.

I've been an internship director for almost 20 years now. I've shepherded 24 interns through the experience of being a therapist. I have been fortunate in that I have never let an intern go who I felt was not entry-level competent in our field. I've never had to flunk an intern (again, very fortunate), but I've had to counsel others who have done so - both situations. I have worked with interns who I felt were not ready for the certification examination, but I have always felt that they were able to be therapists. As part of my job, I have to write a letter to CBMT for each intern indicating that he/she has completed the internship time. That's the only input I am able to give during the certification process. I don't think that's right.

I know of situations where interns have not passed their internships because they were not able to be therapists and have been granted degrees, have passed the exam, and have gone out into the world of therapy.

I feel strongly that the views and opinions of internship directors (like myself, so recognize that there is HUGE bias in this statement) need to be given more attention in the certification process, but there are problems with that as well. Internship programs are not consistent in what they expect their interns to do. What I expect from my interns is significantly different from what the MTs six miles away expect. That is a problem, and one that has no easy solution either. 

We need significant changes in our education and clinical training processes. We know that. If nothing else came from the MLE discussions over the past 8 years, that was a positive result. We all know that there are problems. We know that we need to be more consistent in training and education. We won't be able to make everyone happy - OBVIOUSLY - but that should never be the goal of any type of educational or clinical decision.

Here's what I am thinking about this right now.
  • First of all, if you flunk the examination, then you flunk. There is more to do ON YOUR END! Sure, the testing system is biased, but that's the way testing is. Study differently, don't think that the practice examination is giving you the answers for the real thing, and recognize that this experience is supposed to make you think for yourself.
  • Second, there has to be some more consideration for clinical skill. At this point, my input into whether my interns are ready for entry-level jobs is negligible. Yet, I am the one who sees their clinical interactions and function within a real world situation.
  • Third, we need more consistency in expectations across education programs and internship opportunities. We need more of a common language so that we are all evaluating the same things.
  • Fourth, the system is broken, but no one individual is being singled out for unfair treatment. This is the way it stands at this point. Until we start to make a commitment to finding change and we support that change with some foundation of knowledge and calm, we are NEVER going to make things better. Things will remain the same forever and ever.
Just so you know, I passed the examination the first time I took it. I thought I flunked it and had to wait six weeks for my results to arrive in the mail. That envelope was the most difficult envelope I ever opened in the mail. I passed, but I have no idea how well I did. Scoring was weird back then. I have made a concerted effort to NEVER take the exam again - I do most of my CMTEs for free and have never had to scramble to find credits. Maybe I will be able to help folks come to a new way of doing things. Maybe I'll fill out the CBMT nomination form today to volunteer to be part of this entire process...Hmmm. Join me?


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