What is Music Therapy?

In music therapy, the therapist and client use music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help the client improve or maintain health. In some instances, the client’s health needs are addressed directly through music and its intrinsic therapeutic properties; in others they are addressed through the relationships that develop between the music, client, therapist, and other participants. Clients do not need any previous musical training to participate in or benefit from music therapy. The therapist always designs the music activity or experience according to the client’s abilities and interests. Four basic types of music experiences are used for therapeutic purposes, depending on the client’s needs. They are: listening, re-creating, improvising, and composing.

Listening

Music listening in a therapeutic context often involves activities such as relaxation, meditation, movement, perceptual exercises, free-association, story-telling, imaging, reminiscing, and so forth. These kinds of listening activities are used when clients need to be activated, soothed or exercised—physically, emotionally, intellectually, or spiritually. For example, hospitalized patients find music listening helpful in relaxing, reducing stress, managing pain, and regulating body functions such as heart rate, and breathing. With psychiatric patients, listening to songs accesses ideas and thoughts that need to be examined and discussed, while also bringing to the surface feelings that need to be expressed and shared. With individuals in psychotherapy, music listening can be used to stimulate images, fantasies, associations, and memories, all of which provide rich opportunities for identifying and working through therapeutic issues. With elderly individuals, listening to music can facilitate reminiscence or a review of their lives. With learning disabled and mentally retarded children, perceptual listening tasks can be used to build auditory processing skills. Listening to songs and following the lyrics can also help these children to learn and memorize colors, numbers, vocabulary, behavior sequences and a host of other academic subjects. Finally, with all client populations, music listening is of inimitable value in bringing about spiritual highs or peak experiences. Such experiences instill hope and courage, while reaffirming the beauty of life. Perhaps the most widely used listening model of music therapy is Guided Imagery and Music (GIM). In GIM, the client generates images or fantasies while listening to music in a deeply relaxed state. Client and therapist maintain a dialogue throughout the music-imaging experience. For detailed information on this model, see: Music and Consciousness: The Evolution of Guided Imagery and Music, and Guided Imagery and Music: The Bonny Method and Beyond.

Re-creating

Clients are engaged in singing or playing pre-composed music when they need to: develop sensorimotor skills, learn adaptive behaviors, maintain reality orientation, identify with the feelings and ideas of others, learn group skills, or merely share in the joy of making music—as these are the skills involved in recreating music. For example, singing can help individuals with speech impairments improve their articulation or fluency; group singing can build reality orientation in elderly individuals, or help mentally retarded people develop adaptive behavior. Playing instruments can help physically disabled clients develop gross and fine motor coordination, and when combined with reading notation, playing instruments can help learning disabled children integrate auditory-motor or visual-motor processes. With emotionally disturbed children, instrumental ensembles can be used to overcome behavior problems, control impulsivity, and build interpersonal or group skills. Examples of how singing and playing are used in music therapy include: Schwartz’s Music, Therapy, and Early Childhood, Uhlig’s Authentic Voices, Authentic Singing, and Levin’s Learning Through Music, to name a few.

Improvising

Clients improvise or make music up as they go along when they need to develop spontaneity, creativity, freedom of expression, playfulness, self-awareness, and interpersonal or communication skills—as these are the basic characteristics involved in extemporaneous music-making. Many different clients manifest these needs, from emotionally disturbed children to acting out adolescents, and from developmentally delayed children to adults with psychiatric disorders. Improvising enables these clients to communicate and share feelings with others, while also helping them to organize their thoughts and ideas in a meaningful way. There are two prominent approaches to improvisational music therapy. In Nordoff-Robbins Music Therapy, the therapist and client improvise together with two aims, to musically explore the client’s way of being and relating in the world, and to develop a communicative and expressively free relationship. The groundbreaking work of these two pioneers can be read about and actually heard in their culminating work, Creative Music Therapy (Second Edition). In Analytical Music Therapy, developed by Mary Priestley, the client improvises music to portray a particular feeling, person, situation, or image, and with the musical and verbal assistance of the therapist, explores all the therapeutic implications. More information on Priestley’s work can be found in her book, Essays on Analytical Music Therapy.

Composing

Clients may also compose songs, pieces, music videos, or recorded programs or collages of music, most often with the technical assistance and support of the client. Clients compose whenever they need to learn the perceptual and cognitive skills required of a composer, or whenever they want to create songs to express their thoughts and feelings about significant events, people, or relationships in their lives. With hospitalized children, writing songs can be a means of expressing and understanding their fears of a particular medical procedure, or they can be used to soothe the child during the actual procedure. Song-writing can also provide adults dying of cancer with a container for expressing their feelings—about life and death—while also serving as a parting gift to loved ones. Clients with drug or alcohol addictions often find group song-writing to be an excellent vehicle for examining irrational beliefs and fears, and for documenting their intention to change. A new book that provides step-by-step protocols is Reitman’s Songs in Group Psychotherapy for Chemical Dependence.

Current Applications of Music Therapy

Given its wide range of therapeutic potentials, music therapy is used with individuals of all ages and with a variety of conditions, including: psychiatric disorders, medical problems, physical handicaps, sensory impairments, developmental disabilities, substance abuse, communication disorders, interpersonal problems, and aging. It is also used to: improve learning, build self-esteem, reduce stress, support physical exercise, and facilitate a host of other health-related activities. Given its wide applications, music therapists may be found in general hospitals, psychiatric facilities, schools, prisons, community centers, training institutes, private practices, and universities.

About Music Therapists

Music therapists are highly trained professionals who learn how to use their musicianship to help people with a wide range of illnesses, disabilities, and problems in living. This requires an interdisciplinary understanding of music, special education, psychology, and medicine. To practice music therapy in the USA, one must: complete a bachelor’s or master’s degree in music therapy at an accredited college or university, complete an internship (about six months), and pass a national examination to obtain certification. Over 70 colleges and universities in the USA offer undergraduate and graduate degree programs in music therapy. Information on these programs is available from the American Music Therapy Association.

Music Therapy Publications

Although music therapy is a relatively young field, it has a rich literature on practice, theory, and research in the field. There are ten journals in the English language, published in the USA, Canada, Australia, United Kingdom, New Zealand, and Scandinavia. Several other countries also publish journals in their own language. There are also many excellent books on music therapy. Probably the best and easiest way to get an overview of the field is to read books containing case studies. For example, see: Case Studies in Music Therapy, or Developments in Music Therapy Practice: Case Study Perspectives, or Psychodynamic Music Therapy: Case Studies.