Ask a Music Therapist

Ask a Music Therapist !

What is music therapy?
What kind of training do music therapists receive?
What kinds of professional certification do music therapists have?
How does music therapy work?
What kinds of issues can be addressed through music therapy?
Is there empirical evidence that demonstrates the efficacy of music therapy?
How can I find a Music Therapist?
What is Nordoff-Robbins Creative Music Therapy?
What are the benefits of working improvisationally?
Why are there two therapists in each session? Is there ever just one?
Why are sessions recorded?
Can my child benefit from music therapy?
What is the placement process at CMTS?
What is an intake session?
Is a group or individual session more appropriate for my child?

What is music therapy?

Music therapy is a widely recognized and uniquely effective treatment that is used with populations ranging in age from infants to geriatrics and ranging in description from multiply handicapped children to self-referred adults. The music therapy process helps to build communication skills, foster healthy, flexible interactions, and overcome emotional, physical and cognitive deficits. No musical skill or training is necessary to participate in this process.

What kind of training do music therapists receive?

Music therapists receive rigorous academic training at the undergraduate and graduate levels as well as extensive hands-on clinical experience. They become familiar with the different basic approaches to music therapy and the various special populations with which music therapists generally work, while continually expanding and perfecting their musical skills. They observe and assist in the work of experienced therapists in a variety of clinical settings. Training culminates in an intensive internship, where the student assumes the full range of entry-level professional duties under the supervision of qualified professionals. Music therapy training is currently available through the doctoral level.

What kinds of professional certification do music therapists have?

Music therapists who have completed an appropriate level of academic training take a national competency examination administered by the Certification Board for Music Therapy. Those who pass this examination are designated as Board Certified (MT-BC). Some states have licensing procedures for health professionals such as music therapists. This generally involves an examination administered by the particular state. The State of New York is currently developing such a program for licensure of a wide variety of mental health professionals, including music therapists. A formal examination has yet to be devised. In addition, music therapists can seek advanced certification in several of the particular approaches to music therapy that have been developed over the years. Music therapists at CMTS have certification in the Nordoff-Robbins approach to music therapy, which is described below.

How does music therapy work?

There are a number of qualities of music that make it a uniquely effective tool in therapy – make it “work.”

Music making involves more of the different centers of the brain that govern and coordinate mental and physical processes than almost any other activity. It is a complete mental (and physical) ‘workout,’ something that involves maximum human potential.
Music is a naturally expressive medium; it brings forth feelings and emotions with relative ease and clarity and gives matchless opportunities for self-expression. There is no height or depth of emotion that music cannot accompany and enhance.
Music can provide structure and form, making interaction with others simpler and less threatening. In music therapy, social interaction requires no special intelligence, skill or experience; it’s easy to know when and how to be interactive.
Since music can be non-verbal, it bypasses much of the mental and intellectual defenses against dealing with certain feelings or issues. Absorption in music can mean breaking free from repetitive and stifling ways of thinking.

This by no means exhausts the list of music’s special qualities, but it gives some idea of the potential of music as a therapeutic medium and how it might be used. The music therapy session can be a place where deficits and challenges of many kinds can be addressed successfully. Gains in music therapy can transfer “outside,” into the daily life of the participant.

What kinds of issues can be addressed through music therapy?

The kinds of issues that can be addressed through music therapy grow continually with the experience and inspiration of its practitioners. Here are some general categories of issues that music therapy is currently addressing with significant results.

Developmental: this would include areas such as pervasive developmental disorder or more circumscribed diagnoses such as those in the autism spectrum. Music taps into resources in individuals in this category that other approaches do not reach. Music therapy can further the development process; it can also provide opportunities for activity and interaction that are meaningful and rewarding to such individuals at their level of development.
Mental/emotional: music has profound effects on both thinking and emotion. It can be calming and soothing as well as energetic and motivating. It can stimulate recollection of past associations and events and fuel the capacity for imagination and fantasy. It is an invaluable tool in psychotherapy and in work with the chronically mentally ill.
Physical: Music is used with those whose physical deficits are considered permanent as well as those who are recovering from injury or illness. The ability of music to induce physical activity in individuals – and groups – no matter the level of physical deficit is widely acknowledged. Music, particularly in its rhythmic aspects, can help participants regulate activity, making it more consistent and focused, and thus maximizing the effective use of energy. It can also enhance endurance, as anyone who has exercised to vigorous music will attest to.
Crisis/trauma: music can play an important role in these areas. It is used in intensive care units, in pre and post-operative areas where pain management is a concern. It is helpful in working with chronically or acutely ill children who must endure invasive tests and procedures. It is valuable in the treatment of the post-traumatic stress of victims of physical or sexual abuse and of the September 11 th tragedy in New York City.

Is there empirical evidence that demonstrates the efficacy of music therapy?

Musical response has always been looked upon as notoriously difficult to describe, much less to quantify and evaluate empirically. Thus the preponderance of evidence for the efficacy of music therapy is anecdotal. That is, the testimony of clients, parents, guardians and the staff and administrators of the many institutions that employ music therapists – not to speak of music therapists themselves, who document and present their cases meticulously – is that music therapy is an effective intervention in an ever-growing variety of circumstances.

As the field grows in scope and stature, research is becoming more and more of a priority. This is evident in two areas. First, in the creation of scholarly journals which contain the results of empirical research studies undertaken by music therapists, such as the Journal of Music Therapy, published by the American Association for Music Therapy. Studies published are generally small in scale but significant in their results. Second, in the growth of doctoral programs in music therapy at major research universities, where fulfillment of degree requirements necessitates the conduct of significant research. Also significant is the substantial research conducted in a number of areas that concern the effects of music on the brain and the neurological system. This research, though it is not conducted by music therapists and does not study music therapy, extols the benefits of musical activity.

How can I find a Music Therapist?

If you are outside the New York City metropolitan area, you can contact the American Music Therapy Association in Silver Springs MD. Their website address is musictherapy.org or you can call them directly at (301) 589-3300.

What is Nordoff-Robbins Creative Music Therapy?

The Nordoff-Robbins approach to music therapy is the result of the partnership between Paul Nordoff, and American composer-musician, and Clive Robbins, an English special educator. Over approximately two decades in the mid-Twentieth Century, their collaboration produced a method for engaging clients – no matter their level of functioning – in active music making with significant clinical results. The distinctive qualities of the Nordoff-Robbins approach include:

Central role of music: the Nordoff-Robbins approach is music centered. In contrast to other approaches, where music might be thought of as contributing to the therapy process, in this approach the process of making music is the therapy. That is, clinical results that are observed both within and between music therapy sessions are directly attributed to the music making done among client(s) and therapists.
The team approach: teams of two therapists conduct music therapy sessions in the Nordoff-Robbins approach. One team member, usually designated the “therapist” and playing the piano, is largely responsible for the music of the session. The other therapist, usually designated the “cotherapist,” interacts more directly to help initiate and sustain the client’s musical activity.
Central role of improvisation: much of the music that comprises the therapy in the Nordoff-Robbins approach is improvised by the therapist at the piano in response to the physical, vocal and musical activities of the client. The music thus created is unique to the individuals involved and unique to the situation from which it develops. Music that initially occurs as improvisation can be brought back in future sessions to accompany particular activities or serve as the greeting and goodbye songs that begin and end each session.
Taping/indexing of sessions: Each session is taped – either audio or video – and reviewed prior to any further sessions. This enables the therapists, who are usually absorbed in the conduct of the session, to refresh their recollection of the session and to take note of any salient details they may have missed. It also allows the therapists to notate any music that is deemed significant and bring it back in future sessions.

What are the benefits of working improvisationally?

Using improvisational techniques allows the therapist to respond immediately and spontaneously to any of the client’s activities. This produces an immediacy, almost a suspense that helps to energize the session. One literally does not know what will come next. Improvisation also encourages the client to participate with the same spontaneity and ease as the therapist. The music that is thus produced is “the client’s own music.” He or she participates – directly or indirectly – in its creation, and helps to sustain or alter it during its duration. As improvisation continues, the music may vary and be continuously fresh, but the relationship between client and therapist that is engendered by this activity will stabilize and deepen. The songs and interludes that are initially improvised can be brought back in succeeding sessions as reminders of past activity and stimuli for further collaboration.

Why are there two therapists in each session? Is there ever just one?

The presence of two therapists is essential in situations where clients are resistant, reluctant, or is physically challenged to make music. These are the kinds of clients that the Nordoff-Robbins approached originated with. In such instances, the cotherapist can help to engage the client and guide him or her into musical activity. The cotherapist can also be another music maker, playing responsively with the therapist. This can be a kind of modeling, of demonstrating the musical behavior that the therapists wish to elicit from clients who may be totally unfamiliar with the instruments and the musical milieu. It can also have social implications, as if to say, “We’re having fun doing this. Why don’t you join us?” Having a second therapist can also diffuse some of the interpersonal intensity that can develop where only two people are present. There is always another person to relate to if the client is inclined to avoid one member of the therapy team. The therapy situation can simulate and have many of the benefits of a group therapy situation, even though strictly speaking it is “individual.”

Although a team is always clinically justified in the Nordoff-Robbins approach, there are some clients for whom having a team is not an absolute necessity. Clients who are oriented, willing, and have the physical capability to make music without assistance can be seen by a single therapist. The situation will still meet the basic requirement of the approach, that music be made. In settings where therapy teams are looked upon as an extravagant use of staff, single therapists in individual and group sessions are the rule.

Why are sessions recorded?

There are a number of reasons to record sessions. First, reviewing a session can familiarize the therapists with the details of the session that might not have been evident in the pressure of trying to conduct the session. Reviewing the previous music therapy session before conducting the next one is good clinical practice. Taping sessions gives therapists the possibility of notating clinically significant music that was initially improvised and bringing it back in the next session. This gives sessions a continuity that can be useful in addressing particular goals or issues or solidifying a musical relationship. Sessions from months – even years – past can give therapists a sense of the long-term course of therapy and the client’s development over time. This is helpful in writing reports and summaries. Finally, having sessions on tape can be helpful in preparing case presentations for professional and educational purposes. Such material assists in the development of techniques and methods that are useful to the field of music therapy as a whole.

Can my child benefit from music therapy?

Music therapists are increasingly confident about the beneficial results of the interventions they use in the therapy process. However, it is neither truthful nor ethical to assume that music therapy will be appropriate with a child who has never been seen. Therefore, it is more judicious to suggest that someone who is considering music therapy as an intervention for their child should contact a music therapist and perhaps have an intake session. For information as to how this might be arranged at CMTS, see the FAQ’s below.

What is the placement process at CMTS?

Placement at CMTS begins with contact by the client, parent, guardian, case worker or institution that is exploring the possibility of obtaining music therapy services. This can be done by phone, mail or on line. As a result of this contact, preliminary questions are answered and a brief Intake Request Form is completed. This provides information about the child and, should the prospective client wish to proceed with the process, results in the scheduling of an intake session.

What is an intake session?

An intake session is an initial music therapy session that has the purpose of introducing the client to the music therapy environment. For the therapists, the goal of the session is primarily assessment. They observe levels of general interest in music making, the particular ways in which music is made, whether there is interest in or aversion to particular instruments, styles and types of music that seem to elicit response, and the way the prospective client responds to the therapists interpersonally. Overall levels of functioning, communication skills, motor skills and the client’s relative strengths and challenges are also assessed.

For the client and those connected with the client who will determine whether therapy will continue, it is a chance to experience how music therapy actually looks and feels. They can get the reaction of the therapists to meeting and interacting personally. There can be further consultation and answering of questions, and a sense of how the therapy process will begin can emerge. These considerations lead to a decision about whether to continue music therapy.

Is a group or individual session more appropriate for my child?

Based on the information supplied about the client and the therapists’ assessment of the intake session, a decision about whether group or individual therapy is appropriate will be made. With children who are new to therapy and new to music therapy, the recommendation is often to begin with individual sessions. There are multiple reasons for this. First, the issues presented by the child may well best be addressed in individual therapy where the focus is entirely on the client’s needs rather than the larger group issues. Second, since the Nordoff-Robbins approach is so musically based, experience in making music and using the different instruments and voice in a communicative, related way is something of a pre-requisite for group participation. Third, individual sessions are an efficient way to assess social skills and to strengthen them where indicated. Even when placement in a group is the ultimate goal, therapy often begins individually.