Friday, April 24, 2009

Day 2 - Defining music therapy

According to the Facebook site, "Top Ten Things That Music Therapists Love to Hear", the number one answer is, What is music therapy? This is meant sarcastically and not factually. It begs the question, however, of what, when and how is it necessary to define ourselves.

The what?

Bruscia (1998) devotes an entire monograph to the subject of defining music therapy. While there are many music therapy associations, each gives a different definition of music therapy. Davis, Thaut, & Gfeller (2008) clearly articulate that the definition of music therapy has undergone constant revision and evolution (p. 7-8). These are just a few of the difficulties that we, as music therapists, face when asked, "What is music therapy?".

The contextual approach

Music therapist work in a variety of clinical environments. These range from institutional to community based settings, educational to medical settings, individual and group therapy, using improvisational, recreative, and receptive methods. Clients can range in age from pre-term (during pregnancy) to age 100+. They can have physical, psychological, emotional, social, spiritual and medical issues independently or simultaneously. Thus, one approach to answering the question can be - to answer contextually.

For example, if I was answering a potential employer in a long-term care facility, I might answer in the following manner:

Music therapy is a form of therapy employing music and musical activities that encourages individual and group quality of life. Unlike entertainment, that seeks to simply entertain and encourages a passive response, I strive to engage my clients in music making, socialization, and physical activation. I also seek to provide opportunities for clients to develop former musical skills and/or develop new musical skills. My approach is based on scientific research and metholodogy developed over the past 30 years in which music therapy has been an established profession.

Answering a parent of a child with special needs, I might answer this question in this way:

Using music and musical techniques, I will strive to engage your child in a multisensory experience. In part, my approach will be driven by research findings and my training however I will take most of my cues directly from your child and their reaction(s) to the interventions (positive and negative, verbal and non-verbal) that I provide to him/her. I encourage questions and set clear goals and objectives in order to demonstrate my effectiveness.

Finally, answering a group of medical professionals, I might answer in the following manner.

Music therapy is a profession built on a solid base of quantitative and qualitative research. It is multisensory, employing largely non-verbal and musical interventions. Clear goals and objectives are formulated after the music therapist completes an initial assessment, including the medical, social and musical history of the client(s). Validation of clinical outcomes is ongoing and improved quality of life is viewed as a significant aspect of treatment outcomes. Finally, music therapy can serve as an independent treatment or be part of a multidisciplinary approach to treatment.

The simplistic approach

Given the complexity of contextualizing the description of music therapy, another approach can be to simplify the description of music therapy. Davis, Thaut, & Gfeller (2008) describe such an approach in chapter one of their text entitled, Clinical practice in music therapy. They, it can be argued, cite three elements as essential to music therapy - music, therapist, and client. Remove one of these elements and you are left with something that is not music therapy. For example, if you remove the "therapist", you are left with "client and music" and thus, someone who is capable of listening, and making music. The purpose of doing so, however, is not therapeutic and results are likely to be short-term or short-lived (i.e. going to a concert featuring your favorite band or artist). Remove the "client" and you are left with "therapist and music" or a situation in which the therapist is making music for themselves, perhaps for enjoyment purposes. Finally, remove the "music" and you are left with "therapist and client" in a verbal environment.

The "leave it up to public awareness" approach

Music therapy is a relatively new professional discipline, when compared to fields such as law/criminal defense, medical, or education. In the United States, the first music therapy association was formed in June 1950 (Davis, Thaut, & Gfeller, 2008, pg. 33). The Canadian Association for Music (CAMT) was formed in 1974. While the public thinks rightly, or incorrectly, that they understand what it means to be a "doctor", a "lawyer" or "teacher", they do not have the same understanding of what it means to be a "music therapist". Context can again come into play as an individual may answer from the viewpoint of being the parent or friend of a client, being a client themselves, or having no experience with music therapy and choosing to respond or give an answer.

Further complicating is the issue of "title protection". At present, there is no protection for the title of "music therapist" (at least in Canada). Thus, anyone can call themselves a "music therapist" without there being any assurance of their work experience or educational background. This means that public are given various examples of "what it means to be a music therapist" and "how music therapists work" without regulation or accountability to any professional body. In Canada, one can guarantee that a person is a music therapist by ensuring that they use the initials, MTA after their name. This is a credential referring to Music Therapist Accredited that is granted to individuals after they have completed their music therapy training, internship, and have had their work reviewed by a group of music therapy peers. In other countries, check for a professional association of music therapy and inquire of them what, and how, they certify individuals are music therapists.

Finally, there is the media or public organizations who often distort the terms "music therapist" and "music therapy". Frequent are news reports of individuals using music "as their therapy". But is this - "music therapy"? Similarly, if music has brought about a change in an individual, whether long term or short term, the word "therapy" is often applied. Public organizations or individuals can also report to provide recordings of music that are "therapeutic" or "soothing" and/or employ "music therapy techniques". The Mozart effect is one such highly public, and publicized, example. Another is "harp therapy". I am not saying that there are not therapeutic elements or benefits from such music or musical techniques, simply that it confuses the public with regards to the question of "What is music therapy?".

Clearly, there is no easy answer to the question - What is music therapy? Is it any wonder that music therapists shudder slightly when they are asked to explain what they do?

Bruscia, K. E. (1998). Defining music therapy. 2nd ed. Nilsum, NH: Barcelona Press.

Davis, W. B., Gfeller, K. E. and Thaut, M. H. (2008). An introduction to music therapy:
Theory and practice
. 3rd ed. Silver Spring, MD: American Music Therapy Association.

Tommorrow...."When" do you explain about music therapy.

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