Music Therapy

A brief guide

What is Music Therapy?• There are different approaches to the use of music in therapy. Depending on the

needs of the client and the orientation of the therapist, different aspects of the work may be emphasised. Fundamental to all approaches, however, is the development of a relationship between the client and therapist. Music-making forms the basis for communication in this relationship.

• As a general rule both client and therapist take an active part in the sessions by playing, singing and listening. The therapist does not teach the client to sing or play an instrument. Rather, clients are encouraged to use accessible percussion and other instruments and their own voices to explore the world of sound and to create a musical language of their own. By responding musically, the therapist is able to support and encourage this process.

• The music played covers a wide range of styles in order to complement the individual needs of each client. Much of the music is improvised, thus enhancing the individual nature of each relationship. Through whatever form the therapy takes, the therapist aims to facilitate positive changes in behaviour and emotional well-being. He or she also aims to help the client to develop an increased sense of self-awareness, and thereby to enhance his or her quality of life. The process may take place in individual or group music therapy sessions.

from Association of Professional Music Therapists website www.apmt.org

Psychotherapy Influences

• primacy of therapeutic relationship.

• based on mother-infant relationship, the first musical relationship (Daniel Stern).

• significant relationships may be acted out in client-therapist relationship.

• transference/countertransference

Influential Figures

• Freud - founding father of psychotherapy.

• Jung – appreciated the importance of the arts in our wellbeing.

• Winnicott – understood the importance of play, seeing psychotherapy as a sophisticated form of playing.

• Bowlby – Attachment theory, Secure Base.

Other influences

• Developmental Psychology – understanding the level at which the person is functioning.

• Neurology – understanding the effect music has on the brain.

• Physiology – understanding the effect music has on the body.

Different levels of work

All these occur within the therapeutic relationship

psychological

physical

developmental

social

spiritual

Where do Music Therapists work?

• NHS – Mental Health and Learning Disability services• Special Education• Palliative Care• Autistic Spectrum Disorder• Brain Injury/neurological disorders• Physical disability• Sensory impairment

• within multidisciplinary teams• privately

Case Study: James

Mental Health In-patient.23 years old.Reasons for referral:• auditory hallucination, experienced as “Friendly”

or “Bad”.• difficulty expressing emotions.• difficulty forming relationships, especially since

his mother had committed suicide (when he was fourteen).

Assessment Period

Six week assessment.

Each session lasted forty five minutes.

James initially apprehensive – not sure what he should do.

I played simple chords on piano, James played phrases above.

Further sessions offered, with a view to long term work

Emerging theme of Opposites:explored through various methods

Improvisation at the piano.

Structured improvisation on other instruments.

Sandplay work.

Further methods

• Listening activities.

• Exploring recorded music together.• I have published a paper based on this case study,

called “Parallel Journeys: how a Music Therapist can travel with his client.” This is now available on a new, free, online journal. Go to:

http://approaches.primarymusic.gr/

A Case Study

Music Therapy work with an autistic boy

The Therapy Room

Introduction to “J”

•Autistic and severe learning disabilities

•11 years old

•No verbal communication

•Variety of vocalisations

•Taps and flicks objects constantly

The Early Sessions

• Brought by speech therapist

• Found it hard to stay in room, becoming distressed

• Worked in corridor, gradually making contact

• Moved into room

• After six sessions able to stay alone

Theme: Progress

Developing relationship creating safe place

Joint play able to show distressas well as happiness

Physical contact musical contact

Emotional contact

Theme: Distance

important to give J space - let him initiate contact

Physical distance emotional distance

Room large enough sometimes J doesn’t want tofor J to retreat be really close and intimate

J sits on work surface

I stay at piano I allow him to be more “autistic”

I continue to respond to him musically, enough to let himknow I’m still there

Theme: Contact

emotionalphysical

musical (feeds into and fed by both)

Contact can be withMe instruments

aspects of himself

affectionate “non-autistic”/autistic flicking

sign of relationship need for reassurance checking environment

genuine warmth difficult life stage need to feel safe

(adolescence)

J needs safe, consistent relationship and environment in which he can confront and express confusing emotions and developments