Music Therapy

January 18, 2011

You’ve probably heard the term “Music Therapy” and even if you’re not familiar with the profession, you can probably imagine what it’s about: helping people through the use of music. If you think that, you would be right; however, there’s much more to it.  Despite the fact that Music Therapy, as a profession, is now entering its 60th year, many people are still unfamiliar with it, or don’t understand it.

In order to understand what music therapy is, it helps to know what it is not. Ask someone on the street what music therapy is and you are likely to get all kinds of responses. Some common perceptions of Music Therapy can include:

“It’s playing music for people so they feel better.”
“It’s when you relax to music that you like.”
“It’s when you play those gongs and healing bowls.”
“It’s using instruments to get out your feelings.”
“It’s when a musician receives therapy.”

The Music Therapist

One of the first things to learn about Music Therapy is that it’s something that is done by a trained and certified Clinician. Requirements for becoming a Music Therapist (in the US) include: receiving a Bachelor of Music degree from an accredited Music Therapy program, completing a supervised internship (1100 hours), and passing a certification exam administered by the Certification Board for Musci Therapists. (That’s what the ‘BC’ in ‘MT-BC’ stands for: Board-Certified). The skills, knowledge, and experience needed to become a Music Therapist are similar to those required in other allied health professions, such as speech therapy, physical therapy, and occupational therapy. Music Therapists study physiology, psychology, physics of sound, clinical techniques, musical styles, instrumentation, leadership, discussion techniques, adaptive strategies, documentation, and much more. Additionally, the Music Therapist works within the profession’s Scope of Practice and meets specific Clinical Standards to ensure that clients receive only the highest quality services.

Client-Centered

Another key feature of Music Therapy is that it is designed specifically for the client(s). The Music Therapist gathers information about the client through a process called assessment. This step is a lot like your first meeting with a doctor when they get all your health care history and current condition. They ask you what’s going on, examine you, and try to get a good idea of how best to help you, based on your needs and abilities. It’s the same with Music Therapy. The Music Therapist often works with other members on a treatment team to gather and share information about clients and discusses ways to best serve them. Music Therapy is not a one-size-fits-all approach, but a dynamic  process that is driven by the client and his/her unique needs. Music Therapy is done with someone, not to someone. Music Therapy is not a ‘program’ that can be universally applied to any population with specific outcomes in mind. On the contrary, it honors the unique needs of each client, even in group settings.

Treatment Program

After the initial assessment, the Music Therapist designs a treatment program. The treatment goals in a Music Therapy program are often the same goals as for other forms of therapy (physical, cognitive, occupational, etc.). The main difference is in the way the Music Therapist helps the client reach their goals. While physical therapists uses all kinds of exercise experiences (custom machines, rubber bands, balls, massage, adaptive technology, coaching, etc.) to help their clients reach various therapeutic goals, Music Therapists use music-based experiences (playing instruments, creating music, listening to and discussing music, moving to music, adaptive technology, etc.), to help their clients. It’s quite common for a music therapist to share goals with physical, speech, talk, and occupational therapists. The main difference is in the way each therapist works.

Music Therapy is a dynamic process that is customized for the client(s), before and during a session. For this reason, the music therapist is highly skilled in many areas of music (plays many different instruments and styles of music), able to incorporate a wide variety of interventions (different types of musical experiences), and able to modify experiences to stay focused on the client’s needs (keeping them actively engaged while staying focused on reaching treatment goals).

Because music therapists work with virtually all populations, there is a wide spectrum of techniques and approaches within the field. As in the medical field, it’s quite common for a music therapist to specialize in a particular area, such as pre-natal, special education, traumatic brain injury, addiction recovery, hospice, etc.. Specialized training courses can supplement the music therapist’s core skill set, as well as Master’s and PhD degrees in music therapy.

The Music Therapist maintains documents that record and track client progress. At some point, he/she will determine weather to continue, modify, or terminate treatment. This choices are based on periodic evaluation of the client’s condition, needs, and goals. Music Therapists abide by a comprehensive Code of Ethics when delivering services.

As we learned at the top of this article, it’s not just that someone is playing an instrument or listening to music that produces a desired outcome, but rather that they are working with and under the guidance of a Board-Certified Music Therapist, someone who is knowledgeable and skilled in music, therapeutic interventions, and working with various populations. Music alone can be a power force, but it is when that power is skillfully and purposefully used that we can expect more than recreational outcomes. As you browse the internet and literature, you may come across terms and services that sound like music therapy. Some might even use the term Music Therapy or the name of an instrument, followed by the word Therapy. Here’s one way to tell if something is Music Therapy or not: A music therapist will have the letters MT-BC after his/her name. These stand for Music Therapist, Board-Certified.

Evidence-Based

Music Therapy is a profession based on evidence that is gathered through Scientific Studies. Both qualitative and quantitative research models are used and studies are peer-reviewed to ensure they are valid and relevant to the field. Music Therapy research is often quoted and used by those outside of the field to support the idea that there are “health-benefits” to “making music.” While it’s likely that there are some predictable benefits to be gained by engaging in any recreational activity, musical or otherwise, it’s difficult to say whether or not someone who is not a music therapist could provide the same types and quality of service to clients with various diagnosis and needs. As you know by now, the Music Therapist does a lot more than ‘play music’ with clients. They use evidence-based musical experiences within a therapeutic relationship to help the client make measurable and positive change.

There are hundreds of Music Therapy studies on a wide variety of topics available for review. To find out more about the Science of Music Therapy and learn more about how Music Therapists are helping clients live more productive and fulfilling lives while saving hospitals, families, and tax-payers money, visit the AMTA website and search the term ‘Music Therapy’ on PubMed or another resources. Note: Check to see if what is called ‘music therapy’ actually is, based on what you now know.

How it works

Music Therapy can take many forms as determined by the population, goals and objectives, and the treatment plan as designed by the Therapist. Therapists will often take different approaches to meeting the same objectives, depending on their unique perspective, expertise, and background. When designing a treatment program, the Music Therapist considers the primary goal area(s), determines one or more objectives to be met, then he/she selects and modifies music-based interventions to reach the objectives.

Example: A person with a developmental disability is working towards the self-care goal of dressing himself. Being able to dress himself will reduce his dependence on others, raise his self-esteem, and result in a savings to the facility is staff time and money. In order to reach his ultimate goal, he must first develop his fine motor skills (i.e., using his fingers to button a shirt or tie a shoe). The supporting goal of “increasing fine motor skills” then becomes the focus of the Therapist. The Therapist then chooses several the objectives that are designed to help reach the goal. One might be, “The client will use all four fingers and thumb of his his right hand to press the keys on the piano at least three times each within 30 seconds.” (This is both observable and measurable). With the objectives in place, the Therapist designs an intervention to meet them. To reach the above objective, the intervention might be to play the melody to “When the Saints Go Marching In” on the piano. When the client plays this song at a standard tempo, the objective will be met. For the client, this experience is likely going to be fun and musical – and it is. It is also a way to help the client develop the skills he needs to reach his ultimate goal of dressing himself. This process – of using musical experiences to reach non-musical goals – is at the core of Music Therapy. The practice is goal-driven, customized for the client, and based on observable and measurable outcomes. The musical experiences, coupled with the relationship with the therapist, are the vehicles that helps motivate and transform the client. When the client, the therapist, and the music are all working together, Music Therapy is taking place. Other examples of music therapy at work include:

  • inviting a group of adults in addiction recovery listen to and discuss the lyrics of specific songs. (The Therapist chooses songs because of their potential to open up discussions on various topics related to the therapeutic goals.)
  • helping a client in physical rehabilitation learn and participate in a traditional dance. (The therapist chooses the dance based on the inclusion of specific types of movements.)
  • showing a group of young mothers how to sing to and move with their infants. (The therapist writes songs that help the mothers bond with their babies and provides the infants with an important developmental foundation that will increase their chances to do well in school later on.)

Therapeutic Relationship

Music Therapy applies to almost any setting where a client is working towards a goal. General areas include physical (developmental, rehabilitation, habilitation, maintaining functioning, etc.), cognitive (educational, insight, psychiatric, remembrance, environmental, etc.), emotional (stress-reduction, coping skills, elevation of mood, adjusting to transitions, etc.). For more about Music Therapy approaches, applications, and populations, visit the AMTA website.

Common Misconceptions

It is not uncommon for a Music Therapist to hear the following statements upon entering a room at a facility.

  1. “Ok everyone, it’s time for music.”
  2. “Let’s get ready for your music lesson.”
  3. “Hey everyone, the music-lady (or man) is here.”

From the outside looking in, a Music Therapy session can appear to be a recreational music making experience (#1), a music education experience (#2), and even entertainment for clients (#3). This is understandable, since most people will categorize something under an already familiar heading. Some may see a music therapist helping a client learn how to play an instrument and come to the conclusion that a music therapist is a music teacher (or a recreational musician) who works with persons with special needs. Add to this the fact that there are indeed musicians who provide music lessons and recreational experiences to persons with special needs (who are not Music Therapists) and you can imagine how it could be confusing. Music Therapists are not the only people who use music, but they are the only ones who provide Music Therapy – the clinical and evidenced-based use of music interventions to accomplish individualized goals within a therapeutic relationship.

This is the primary difference between a Music Therapist and a recreational music facilitator, a music teacher, and a performing musician who might also “do music” with various populations. In those cases, the music is usually a recreational or supportive experience for a person or group. Recreational music making experiences can be provided by Music Therapists and non-Music Therapists alike. In fact, there are many organizations and programs that are specifically designed to help promote and provide recreational music making opportunities to people of all kinds. Some include:

Resounding Joy
Musicians on Call
Volunteer Music
Developmental Community Music
HealthRhythms

Applications

Music Therapists work in a variety of settings and with virtually all populations.

Settings can include:

  • Public and Specialty Schools
  • Hospitals and Hospice
  • Extended Care Facilities
  • Health Services Clinics
  • Adult Day Care
  • Residential Treatment Programs
  • Prisons

Populations can include:

  • Pre-Natal
  • Infants & Toddlers
  • Children
  • Teens
  • Adults
  • Elderly
  • Special Needs
  • Psychiatric Patients

Music Therapy includes providing services to many populations and within many settings, both enhancing the effectiveness of other allied health professions and extending the boundaries of treatment to maximize the potential for positive change. Music Therapy can include any experience that uses music, sounds, vibrations, and other aspects of music. It can also include related practices such as poetry, story telling, creative arts, movement, dance, listening, discussion, guided imagery, touch, massage, and more.

A Powerful Force

Music Therapy has been shown to be effective in areas where other treatments have not. Because music is a unique modality that can have deep and even profound meaning for may people, it has the ability to motivate people to do what they may have never done or say what they have never said. Music helps people speak without words, to communicate across the boundaries of language and culture, to reach people in ways that words and gestures cannot. Music is often felt as a deeply meaningful and even sacred aspect to the self and a culture.

Backed by 60 years of clinical service, scientific research, technical innovations, and intensive training and certification, the Board Certified Music Therapist (MT-BC) is in a unique position to harness the power of music and provide unique services to a wide range of populations.

For more information about music therapy, visit the American Music Therapy Association and  the Certification Board for Music Therapists.

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