On a therapeutic note:

An introduction to music therapy

By Carol Lotter




On a therapeutic note:

An introduction to music therapy

By Carol Lotter

The notion of music as a therapeutic medium has been both understood and practiced in different contexts since antiquity (Gouk, 2000). On the continent of Africa, traditional communities have embraced the healing power of music over many centuries. Currently, the traditional expression of voice, drumming and dance continues to resound in healing rituals in many communities across the continent. Music therapy as a formalised, established profession has been in existence for the past 60 years. In South Africa it was first established in 1999. The University of Pretoria is the only university in Africa to offer a MMus(Music Therapy) degree. Graduates of the programme are eligible for registration with the Health Professions Council of South Africa.

Defining Music Therapy

The field of music therapy comprises diverse approaches and is, by no means, formulaic or to be regarded as a ‘one size fits all’ profession. Rather, it is dynamic, evolving and informed by, inter alia, musicology, ethnomusicology, psychology, music psychology, sociology, anthropology, medicine, and education.

To define music therapy, thus, is no easy task. The World Federation of Music Therapy (1996) provides a broad definition, which seeks to encompass the various approaches comprising this diverse field.

Music therapy is the use of music and/or musical elements (sound, rhythm, melody and harmony) by a qualified music therapist with a client or group, in a process designed to facilitate and promote communication, relationships, learning, mobilization, expression, organization and other relevant therapeutic objectives, in order to meet physical, emotional, mental, social and cognitive needs. Music therapy aims to develop potentials and/or restore functions of the individual so that he or she can achieve better intra- and inter- personal integration and, consequently, a better quality of life through prevention, rehabilitation or treatment. ( Wigram, 2002 p.30)

Music Therapy Approaches

For the purposes of this article, six music therapy approaches will be described. They are Creative Music Therapy, GIM (The Bonny Method), Analytically Oriented Music Therapy, Behavioural Music Therapy, The Drum/Improvisation Treatment Group Model and Community Music Therapy.

Creative Music Therapy

Creative music therapy was developed in the 1970s by Paul Nordoff, an American composer/pianist and Clive Robbins, a British special needs educator. Together, they developed an improvisational model which assumes, as its departure point, the innate capacity for each person to communicate in a musical way. “This innate musicality, often subsumed by the emergence, and eventual primacy, of words, is tapped in music therapy precisely because its essential nature is emotional” (Pavlicevic, 1997, p.118). Nordoff and Robbins (1977) speak of the ‘music child’. “Music therapy improvisation addresses the music child – by inviting the person to express him or herself through sounds and by reading the child/adult’s capacity for flexibility in organizing rhythm, melody, tempo - as portraying the person’s expressive and communicative, reciprocal capacities” (Pavlicevic, 1997, p. 118).

Ansdell (1995) identifies specific processes in clinical improvisation which detail how music works in creative music therapy.

¥ Meeting

Ansdell (1995) draws from Martin Buber in his work on the nature of dialogue. He draws attention to the difference between what he terms ‘I-it’ and ‘I-Thou’ relationships. Applying this to Improvisational Music Therapy, the music therapy process typically begins with client and therapist being very distinctly ‘I’ and ‘You’. The goal is to move from ‘I/You’ to ‘We’ – a shared encounter where there is a flow of musical interaction. It may take many sessions to arrive at this point and there is no formula attached to the process. Intrinsic to this process is the client being heard and hearing themselves in the music and within the relationship. In this approach the therapist works with both the musical and non- musical contributions of the client in attempting to create a musical therapeutic frame in and through which to work. In creative music therapy, ALL that the client brings is read as music, whether that be through a gesture, a vocal sound, a moment of eye contact or the rhythm of breath.

¥ Quickening:

The effectiveness of music lies in the fact that it contains the capacity to move us emotionally, spiritually, cognitively and physiologically. The basic elements of music, such as rhythm, melody, harmony, timbre and phrasing used in varying combinations, renders music a powerful medium for communication and the expression of emotion. Our human bodies are organized in terms of rhythm, pulse and cycles. It is important to understand that, for many clients for whom Creative Music Therapy is an appropriate intervention, the rhythm, phrasing and pulse of their bodies is often extremely limited due to physical, cognitive or emotional challenges. Ansdell’s (1995) Clinical improvisation utilises the basic elements of music to quicken within the client what was lost, weakened or under developed.

¥ Creating

Winnicott’s (1971) theory of ‘play’ provides a useful analogy for extending our understanding of clinical improvisation in music therapy. In playing within the potential space between itself and the mother, the infant develops the capacity for receiving ideas introduced by another, trying out these ideas through exploration and risk-taking whilst being contained by the other and gradually moving towards a more independent state in which reciprocal relating can develop. Clinical improvisation affords a transitional music space for therapist and client within which to work in which “an intimate and dynamic inter-subjective relationship is possible” (Pavlicevic, 1997, p. 150-151).

¥ Listening:

The importance of listening in clinical improvisation cannot be emphasized enough. For the therapist, listening to the whole person is crucial for the co-creation of music. Clinical Improvisation implies a new way of listening where the therapist tunes into the non- verbal, verbal and musical material offered by the client, astutely attending to the emotional and musical rhythm of the client in order to respond to what the client brings in the moment.

Creative Music Therapy is a suitable intervention across a range of client groups, in particular, clients with mental and physical challenges, children and adults with autism, psychogeriatric clients and clients for whom verbal communication is limited.



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