The American Music Therapy Association (2005)1 has its official definition, but I like to define Music Therapy as the intentional use of music to achieve improvements in an area of your life that needs improving. To better understand this, let’s take Henry as an example. Henry had severe dementia2. Prior to listening to music, he would barely respond and would be slumped in his chair. But when a caregiver would let him listen to his music, Henry would sit up and move to the music and would remain in a lively demeanor with the ability to respond to questions even after listening3. This example shows the natural benefits that music can give people, but it’s not music therapy. Music therapy provided by a board-certified music therapist is able to capitalize on these natural benefits and make them purposeful to achieve desired outcomes intentionally, and more frequently.
Music therapy has been an established profession since the 1950s4 and even has its own Standards for Education and Clinical Training, Standards of Clinical Practice (i.e., scope of practice), and Code of Ethics5,6,7.
“It is used in a wide range of health contexts including (but not limited to) cardiac cases of anxiety, autism, children and adolescents with psychopathology, stressed cancer patients, those suffering postoperative pain, migraine sufferers, and the terminally ill. Stress is placed on the professional application of music for therapeutic ends; and so its function is explicitly not for education or entertainment” (3, p. 577).
It can also treat conditions like dementia3 and pain and distress from pain8, and schizophrenia9. Music interventions can even alter your opioid and non-opiod intake, heart rate, blood pressure and respiration rate8. From a practical perspective, I’ve personally found that almost any condition can be treated with music therapy. What matters is how well the patient connects to the music. To me, if the patient can connect with the music, then that patient will achieve better outcomes.
Music therapy is a multidisciplinary field. On one hand, we can use different psychological theoretical frameworks to treat; so, we can be psychodynamic music therapy, humanistic music therapy, behavioral music therapy, cognitive-behavioral music therapy, etc. We also have different types of music therapy, like the Bonny Method of Guided Imagery, Dalcroze Eurythmics, Kodaly, Neurologic Music Therapy (NMT), Nordoff-Robbins, and Orrf-Schulwerk. All of these different types of music therapy require their own discussion, but you can read a synopsis of them here10.
On the other hand, instead of just the arts, we also draw from mathematics, natural sciences, behavioral and social sciences. When music therapists treat,
We’re musicians who apply 1) artistic principles of musicology and music psychology; 2) behavioral/social science principles from sociology, psychology, and therapy; 3) an understanding of medicine, biology, and physics, and 4) a basic understanding of statistics to track and visualize progress11.
Music therapists then combine all of this knowledge with their understanding about the broad range of clinical populations that they treat to design music-based interventions to intentionally address an area where the patient needs to grow. A music professor once told me that he’d never met a music therapist who wasn’t scattered. With all of the roles that we undertake to make sure that we are giving our clients the best possible care, it’s easy to become scattered as we switch between multiple roles throughout the day. All of this knowledge requires that music therapists have a degree in music therapy, a sixth-month internship, and a passing score on a board-certification test before we can practice. With all of this knowledge combined, music therapists will then implement the interventions through a therapy plan and monitor progress through an evaluation method12.
What happens in a music therapy session?
If you were to come to a music therapy session, the music therapist would build a therapeutic relationship with you based on trust. Then the music therapist would work with you to develop music-based interventions that you would enjoy and that would address your needs. Finally, the music therapist would help you resolve the tensions that brought about the needs13.
You can bring your own music to a music therapy session. In fact, using your preferred music will bring about better improvements in your needed areas of improvement14,15,16. The music can be used as a starting point to address bigger issues or even work through your concerns through the song’s symbology. You’ll be able to have a say in the design of your interventions, change the music, and even use humor in the session, all while sharing your thoughts and experiences17.
Sharing the music you like can even help you form a therapeutic relationship with the music therapist, who can also share his or her preferred music. As one client stated,
“B: What’s nice with the music therapist is that she/he can teach me things that she/he likes too. And I like a lot of the same music as she/he does.” (18, p. 308)
In my sessions, we would determine a baseline level of behavior through an assessment. If we determined that you needed to work on self-exp ression, we will decide on how to address that together, but interventions might be to sing a song and then talk about it, express anger through drumming, or express different emotions while playing the piano, while I tracked your progress. Sessions would continue until our agreed upon goal in the treatment plan was met, but you could also take the therapeutic experiences into your everyday life by buying a piano or drum set and practice at home, like clients often do18.
How does MT Work?
One model for how music therapy works states that music grabs our attention in ways that other modalities cannot, that music helps us modulate our emotions, that music changes how you think about things (and does so within your cultural symbolic meanings), that music can change how you do things, and that music and be a form of nonverbal communication to help you change how you communicate11.
It’s important to remember that there are also brain-related changes when doing music therapy. Not only does the music repair and regenerate the parts of the brain that its affecting, but it’s also protecting the brain. It’s protecting through repetition and associations, which can delay degeneration or slow the progression of disease. Finally, it can reactivate a dormant neural system3.
Overall music therapy is effective and cost-saving. It can help people who have mental illness improve their global state, general and negative symptoms, depression, anxiety, and function with small changes in just 3–10 sessions and large effects in 16–51 sessions when added to standard care19. For children and adolescents with autism, music therapy increased socially appropriate behaviors, attention, vocalizations and verbalizations, communication, self-care. It also reduced anxiety20. It saved $2984 in hospice care compared to standard care21 and it saved $10,000 per infant in NICU while also increasing non-nutritive sucking and decreasing length of stay in the hospital22. It can even help with echocardiograms in children by eliminating patient sedation and decreasing the number of staff members needed for procedures while saving $74 per child23.
1.American Music Therapy Association (2005); 2. Footage of Henry; 3. Mathews (2015); 4. Geist, Creagan, Neugebauer, Elkins (2018); 5. American Music Therapy Association (AMTA) (2014a); 6. American Music Therapy Association (AMTA) (2014b); 7. American Music Therapy Association (AMTA). (2014c); 8. Lee (2016); 9. Tseng et al. (2016); 10. Smith (2021); 11. Hillecke, Nickel, & Bolay (2005); 12. Robb (2014); 13. Bailey (1984); 14. Chlan et al. (2013); 15. Jiang, Zhou, Rickson, & Jiang (2013); 16. Garza-Villarreal et al. (2014); 17. Moghimi et al. (2015); 18. Rolvsjord (2015); 19. Gold, Solli, Kruger, & Lie (2009); 20. Whipple (2004); 21. Romo & Gifford (2007); 22. Standley & Swedberg (2011); 23. Walworth (2005).
