About Music Therapy
What is music therapy?
Like other kinds of therapy (ex. counselling, psychotherapy, physiotherapy, or massage therapy) music therapy aims to help clients heal, strengthen, and develop. We use the dynamic qualities of music to this aim, and incorporate movement, props, imagination, instrument-play, improvisation, visualization, games, singing, songwriting, and much more.
The Canadian Association of Music Therapists defines music therapy this way:
“Music therapy is a discipline in which credentialed professionals (MTA*) use music purposefully within therapeutic relationships to support development, health, and well-being. Music therapists use music safely and ethically to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains” (http://www.musictherapy.ca/about-camt-music-therapy/about-music-therapy/).
Who is music therapy for?
Music therapy is for anyone and everyone, regardless of age, gender, ethnicity, ability, religion, or state of health. Music therapy is often used by people living in long term care, people with disabilities, and people with mental health issues. However, even if you have no diagnosis or disability, music therapy can help you explore your feelings, learn new skills, and work through issues you want to address.
What does music therapy help with?
Music therapists commonly help their clients set goals within 7 domains: The Social domain, the Emotional domain, the Cognitive domain, the Physical domain, the Spiritual domain, the Communication domain, and the Musical domain.
An individual with the social goal “I want to feel more connected to others” could achieve that goal by attending a music therapy support group, by attending a multi-generational music therapy music group, or by developing a healthy therapeutic relationship with a supportive music therapist.
An individual with the cognitive goal “I want to understand the concept of prepositions” could achieve this goal by singing songs with the music therapist that use “under, over, behind, in front, beside, etc…). Visuals, puppets, actions, and movement could be used in practice to reinforce this understanding.
An individual with the emotional goal of “I want to decrease my anxiety” could achieve this goal through singing, using familiar and preferred songs, trying musical improvisation techniques, and listening to music with specific rhythmic and harmonic qualities.
What is the difference between music therapy and other music professions?
Accredited music therapists must complete a Bachelor and/or Graduate degree in music therapy, and fulfill a 1000-hour supervised clinical internship. After graduation they must maintain their credential every five years through the CAMT continuing education process. There are other kinds of musical healers that exist, however if they did not complete the required CAMT training, they are not accredited music therapists.
Music therapy is not the same thing as music teaching. While both professions require musical training, their roles and approaches are very different. In the school system, for example, a music teacher must have an education degree, and their role is to educate students in core elements of music competence (ex. rhythm, melody, theory, sight reading, music history, and disciplined practice). A music therapist working in the school system uses music to help students focus on non-musical goals (ex. emotional expression, concentration/focus, anxiety-reduction, gross and fine motor dexterity, fitness, social skills, communication skills, etc).
What is a music therapy assessment?
The first step in music therapy is the assessment. During this initial session, the client and music therapist get to know each other and try out a few music therapy interventions to test the client’s skills and challenges. The assessment is also a time for the client and/or the client’s family members to express their hopes and concerns about therapy and to ask questions. The purpose of the assessment is also to determine if music therapy is an appropriate form of therapy for the client, and to see if the client and therapist are a good fit for each other. An assessment usually lasts approximately 30-40 minutes.
How long does a regular music therapy session last?
In my practice most individual and group sessions last 45 minutes-1 hour.
Where do music therapy sessions take place?
As a consultant, I come to the homes of my clients for individual music therapy sessions. Music therapy groups are held in schools, and/or rented spaces in the community (ex. a dance studio, or community center).
How frequently do client’s attend music therapy?
That is up to the client and their family (if applicable). Most of my clients have one session each week, though some have two. Others have one every 2 weeks.
Do you have to be a musician to participate in music therapy?
No way! In fact, most of my clients have no particular training. Everyone can be successful in music therapy because human beings naturally respond to music. Like language, humans learn to recognize music from infancy simply by being exposed to it! Even if a person has never taken lessons, they can still sing, hum, clap along, play a drum, listen, dance, appreciate, and notice the emotions that are conveyed in any piece of music.
Are sessions confidential?
Yes. Music therapists are bound to standards of confidentiality set by the Canadian Association of Music Therapists (CAMT). CAMT’s ethical guidelines (which includes confidentiality practices) can be found here: http://www.musictherapy.ca/wp-content/uploads/2016/04/codeofethics99.pdf
Music therapists collect information that is relevant to a client’s treatment, and keep clinical notes on their development and progress in sessions. We are required to ensure that notes are stored safely and securely.
What are the limits to confidentiality?
The CAMT code of ethics (II.18) outlines the situations in which a music therapist could be obligated to break confidentiality:
Never release the personal information of clients except in the following
instances: (a) with the client or legal guardian’s written consent; (b)
when there is reason to believe that a client is in danger of harming
him/herself or someone else; (c) when there is reason to believe that a
child has been or is likely to be harmed; (d) in compliance with a court
order, subpoena, or requirement of an act or regulation of Canada; (e)
when providing information to an employee or co-worker if the
information is necessary for the performance of duties of, or for the
health, protection or safety of the employee or co-worker; (f) when
exceptional or emergency situations require consultation with another
professional.
3 Vignettes:
These examples may help to illustrate some of the different ways music therapy is carried-out.
All stories are fictional.
Musical 4 year old with ASD: Simon was diagnosed with Autism Spectrum Disorder at age 3, and over the past year he has begun regular ABA sessions to help him learn a variety of skills. His mother noticed that he is very interested in music, and although he rarely speaks, he will sometimes sing or hum. He sees a music therapist twice a week, focusing on social and communication skills, and to support skills he learns with other therapists. Simon gets distressed about sharing his favourite instruments, so he and the music therapist practice turn-taking together. They pass and play his favourite tambourine for intervals of 5 seconds, and work their way towards longer intervals. Eventually Simon can tolerate sharing his instruments and waiting several minutes for his turn. Using a favourite children’s song, the music therapist sings “twinkle twinkle little ——” and waits for Simon to sing the last word himself. Simon blurts out “star!” because he cannot resist finishing the line. Eventually Simon is singing half of each line himself, and then the full song. Simon is encouraged to speak to ask for the instruments and activities he wants. Alternative communication tools such as PECS (Picture Exchange Communication Systems) and computer software are incorporated into the session to help him build his communication skills. Actions and instrument play help him to strengthen his fine-motor skills, while call-and-response songs help him practice imitation. Simon’s music therapy sessions continue over the years. The music therapist adapts the activities to become more challenging and age-appropriate as he masters new skills, and matures towards late childhood and adolescence.
Imaginative adolescent with a learning disability: Imran is 12 years old, and has trouble concentrating at school. He also has some difficulty with emotional self-regulation. He loves music but always quits his conservatory lessons because they are “boring and confusing.” After an initial assessment, Imran, his parents, and the music therapist agree to try a combination of music therapy and adapted music lessons. The music therapist uses his preferred music, and alternates highly-arousing activities with slow, calming activities to help him to improve his self regulation. Meanwhile, the music lessons aim to lengthen his attention span. Instead of focusing on scales and sight-reading, the music therapist gets Imran started on learning the basic chords to his favourite pop songs. This way, Imran feels rewarded much sooner for his efforts and stays engaged. The music therapist puts stickers on the instruments to help him remember where to place his fingers. She breaks the lesson up into smaller, digestible portions, with lots of breaks and extra rewards. She sets up a visual schedule and visual timer to help Imran stay on task. The music therapist also sets an achievable practice schedule for home that Imran’s parents can easily monitor. After a lot of hard work, Imran masters his chords, and attends to tasks for longer intervals than he could before. He is ready to advance towards learning more musical skills.
Adult woman, grieving: Greta is a 55 year old woman whose partner recently died. Although Greta has been emotionally stable most of her life, and has no disability, she feels overwhelmed by a flood of conflicting thoughts and emotions. After meeting with a music therapist for an assessment, Greta and the therapist agree to meet once a week for music therapy sessions. In these sessions Greta updates the music therapist about what she has experienced through her week, then they make music. They improvise on the piano, they sing the songs Greta associates with her late husband, they sing the blues, and on days when Greta feels happy and energetic, they laugh, dance and sing joyful songs. Greta decides she would like to write a song about her grief. The music therapist tries out chords, and Greta tells her when the chords “feel” right. They brainstorm lyrics, based on what Greta has experienced in her sessions, and the song emerges…
After a time, Greta begins to feel less overwhelmed and confused, and more stable. She feels that she can handle the challenges of day to day life now, and is thinking about taking a sunny vacation with her daughter. She sees her music therapist on an as-needed basis for mental health maintenance, as part of her ongoing support network.