Art and music therapy in Brazil's public health system

Domain VIII · Creative & expressive arts therapies · 2017 · Brazil

What it is

This is not a single therapy and not a psychotherapy method in its own right. It is a public-health policy framework: since 2017 art therapy and music therapy are listed as Práticas Integrativas e Complementares em Saúde (PICS) that SUS services may offer and record, mainly in primary care (Atenção…

Format

• Stage A. Legal and professional eligibility (before any session).
• Nurses: Cofen Resolução 739/2024 lets nurses practise art therapy "desde que capacitados" (provided they are trained), with a minimum of 120 hours for free courses.

Who practises it, and how they are trained or regulated

• Music therapy is a regulated profession under Lei 14.842/2024. Art. 3 allows practice by: (I) graduates of a recognised Brazilian bachelor's degree in Musicoterapia; (II) foreign graduates with a diploma revalidated in Brazil; (III) people who completed a lato sensu postgraduate course in Musicoterapia within 24 months of the law's publication; (IV) people who prove at least five years' practice as a music therapist…
• Art therapy is not a regulated profession. A 2024 Cofen opinion records that PL 3416/2015 (regulation bill) was still pending, that the CBO occupation code 2263-10 Arteterapeuta "não equivale à regulamentação profissional" (does not amount to professional regulation), and that UBAAT's recommended minimum of 520 hours of postgraduate training is a recommendation, not binding. A later bill, PL 4.815/2024, was approved…
• In APS, PICS are recorded in SISAB through e-SUS APS forms or the PEC electronic record; both codes are on the collective-activity code list. Specialised outpatient care uses SIA (BPA); establishments that offer PICS register service class 134 in CNES. Neither code is in the medium- and high-complexity (MAC) funded table. NASF teams are now eMulti teams (Portaria GM/MS nº 635/2023).

Evidence status, as the guide reports it

• Evidence status as sources give it. Portaria 849/2017 cites no clinical evidence; its justification is service presence (PICS found in over 5,000 establishments in the PMAQ evaluation) and WHO policy on traditional and complementary medicine. The 14 BIREME/PAHO–CABSIn evidence maps on PNPIC…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• One person's taste dominating; rotate choices.
• Dominant members; give everyone a turn and allow passing.
• People who dislike being named aloud; let them choose a nickname or pass.
• Absence as a sign of relapse or risk; follow the service's risk procedures.
• Loss of a valued social group; keep the workshop available alongside if the person wishes.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.