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Music Therapy

What is music therapy?

Music therapy is the skillful use of music and musical elements by an accredited music therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health. Music has nonverbal, creative, structural, and emotional qualities. These are used in the therapeutic relationship to facilitate contact, interaction, self-awareness, learning, self-expression, communication, and personal development.

Who benefits from Music Therapy?

Music therapy is used with individuals of various ages, abilities, and musical backgrounds in institutional, community and private practice settings. This includes but is not limited to:

  • Acquired Brain Injury
  • AIDS
  • Autism and other Pervasive Development Disabilities
  • Critical Care
  • Developmental Disabilities
  • Emotional Traumas
  • Geriatric Care
  • Hearing Impairments
  • Mental Health
  • Neonatal Care
  • Obstetrics
  • Oncology
  • Pain Control
  • Palliative Care
  • Personal Growth
  • Physical Disabilities
  • Speech and Language Impairments
  • Substance Abuse
  • Teens at Risk
  • Victims of Abuse
  • Visual Impairments

Education and Training

Accredited music therapists, MTAs, complete a minimum four-year Bachelor of Music Therapy degree followed by a 1000-hour supervised clinical internship.

University Education: University coursework consists of supervised clinical fieldwork placements and the academic study in the areas of music therapy research, music, and psychology.

Internship: Following the completion of a university degree in music therapy, the music therapist in training completes a 1000 hour supervised internship.  During the internship, the music therapy intern consolidates their knowledge and skills in music therapy, develops competence with one or more clinical populations and gradually assumes the full range of responsibilities of a professional music therapist.  Following the internship, the intern submits a written portfolio about their music therapy philosophy, internship experience, and case study.  Upon approval from the Accreditation Review Board, the intern is given the title Music Therapist Accredited, MTA.

Continuing Education: The education and development as therapists does not end with the completion of accreditation.  MTAs must maintain their credential every five years through the CAMT continuing education process.  MTAs thus are continually seeking to advance the theoretical and practical application of music therapy techniques.

Clinical Process

Clinical work involves preparing, implementing, and evaluating music therapy programmes with individuals and groups. The music therapy process frequently begins with a referral from healthcare professionals, educational professionals, or from individuals who self-refer for music therapy services. The music therapist then completes an assessment through the study of medical or education records, interview of the client and/or family members and, unique to the music therapy assessment procedure, the observation of clients’ responses to music therapy techniques in group and/or individual settings.
Based on this information as well as input from the person, family members and other health care and education professionals, the music therapist formulates goals. These are generally long-term and are achieved in time by the successful completion of smaller and short-term objectives in a group or individual setting. It is these goals and objectives along with intervention procedures and materials that constitute the treatment plan which the music therapist implements.

After implementing the treatment for a reasonable period of time the therapist evaluates the plan to determine whether the methods of treatment are effective and whether the person is making progress in reaching the defined goals and objectives. The treatment plan is modified accordingly. Therapy is terminated when goals have been achieved, the person is discharged from a facility, or when the person can no longer benefit from the services. Throughout the treatment process the music therapist documents assessments, progress, observations, and recommendations regarding the person’s progress. There is ongoing communication between the music therapist and the person who is the recipient of music therapy services, as well as with other members of the interdisciplinary team.

Music Therapy Techniques

Music therapists use various active and receptive intervention techniques according to the needs and preferences of the individuals with whom they work. These techniques include, but are not limited to the following:

Singing is a therapeutic tool that assists in the development of articulation, rhythm, and breath control. Singing in a group setting can improve social skills and foster a greater awareness of others. For those with dementia, singing can encourage reminiscence and discussions of the past, while reducing anxiety and fear. For individuals with compromised breathing, singing can improve oxygen saturation rates.  For individuals who have difficulty speaking following a stroke, music may stimulate the language centres in the brain promoting the ability to sing.

Playing instruments can improve gross and fine motor coordination in individuals with motor impairments or neurological trauma related to a stroke, head injury or a disease process. Instrumental ensembles can enhance cooperation, attention, and can provide opportunities for practicing various leadership-participant roles.  Playing instruments may assist those with prior musical experience to revisit previously learned skills, thereby allowing the individual to experience a renewed sense of pleasure and enjoyment. It can also develop increased well-being and self-esteem in those who are learning to play an instrument for the first time.

Rhythmic based activities can be used to facilitate and improve an individual's range of motion, joint mobility/agility/strength, balance, coordination, gait consistency and relaxation. Rhythm and beat are important in "priming" the motor areas of the brain, in regulating autonomic processes such as breathing and heart rate, and maintaining motivation or activity level following the removal of a musical stimulus. The use of rhythmic patterns can likewise assist those with receptive and expressive processing difficulties (i.e. aphasia, tinnitus) to improve their ability to tolerate and successfully process sensory information.

Improvising offers a creative, nonverbal means of expressing thoughts and feelings. Improvisation is non-judgmental, easily approached, and requires no previous musical training. As such, it helps the therapist to establish a three-way relationship between the client, themselves and the music. Where words fail or emotions are too hard to express, music can fill the void. Where trust and interaction with others has been comprised due to abuse or neglect, improvisation provides a safe opportunity for restoration of meaningful interpersonal contact. Where learning ability is limited, the opportunity to try different instruments, musical sounds, timbres and mediums may provide an opportunity for mastery of a new skill and increase life satisfaction.

Composing / Songwriting is utilised to facilitate the sharing of feelings, ideas and experiences. For example, with hospitalized children, writing songs is a means of expressing and understanding fears. For people with a terminal illness, songwriting is a vehicle for examining feelings about the meaning in life and death. It may also provide an opportunity for creating a legacy or a shared experience with a caregiver, child or loved one, prior to death. Finally, lyric discussion and songwriting can help adolescents deal with painful memories, trauma, abuse, and express feelings and thoughts that are normally socially unacceptable, while fostering a sense of identification with a particular group or institution.

Imagery based experiences, such as Guided Imagery and Music (GIM), can provide opportunities to reflect, process, and interact with unconscious or conscious material that may be reflected in an individual's life. Other expressive modalities, such as artwork and movement, can be used in combination with the music.

Listening to music has many therapeutic applications. It helps to develop cognitive skills such as attention and memory. For example, for those facing surgical procedures, it allows the individual an opportunity to exert a sense of control over their often unpredictable environment. During pregnancy, music listening can provide a connection between the uterine environment and the external environment following delivery. During childbirth music listening can facilitate and support the different stages by promoting relaxation and providing distraction for the labouring mother. In situations where cognitive perceptions are comprised, such as in early to mid stage dementia, listening can provide a sense of the familiar, and increase orientation to reality. For those with mental illnesses such as Schizophrenia or Bipolar Disorder, music listening can facilitate increased openness to discussion and provide motivation for engaging in social activity.

Clinical Settings

Music therapists work in a variety of clinical settings. The following is a sample of where you might find a music therapist:

  • Hospitals
  • Day treatment programs
  • Community programs
  • Correctional Centres
  • Long term care centres
  • Substance abuse and addictions centres
  • Schools
  • Hospices
  • Private Practice

Autoria: Wilfrid Laurier

Com a colaboração: CAMT : Canadian Association for Music Therapy: UniversityWaterloo-Ontario