Music Therapy

Music therapy—a type of expressive arts therapy that uses music to improve and maintain the physical, psychological, and social well-being of individuals—involves a broad range of activities, such as listening to music, singing, and playing a musical instrument.

This type of therapy is facilitated by a trained therapist and is often used in hospitals, rehabilitation centers, schools, correctional facilities, nursing homes, and hospices.

• History of Music Therapy
• Who Can Benefit from Music Therapy?
• What Happens in a Music Therapy Session?
• Training for Music Therapists
• Limitations of Music Therapy

History of Music Therapy

Music has been used as a therapeutic tool for centuries and has been shown to affect many areas of the brain, including the regions involved in emotion, cognition, sensation, and movement. This fact, combined with the engaging nature of music and the diversity of music forms, makes music uniquely effective in the treatment of a wide array of physical and mental problems, including depression, anxiety, and hypertension.

Gradually, colleges and universities began to include music therapy as part of their curriculum, beginning with Michigan State University in 1944. In 1950, the first major professional organization for music therapists was formed, and it became known as the National Association for Music Therapy (NAMT). In 1998, the American Music Therapy Association (AMTA) was formed out of a merger between the NAMT and the American Association for Music Therapy. The AMTA focuses on increasing awareness of and access to music therapy services while promoting the advancement of education, training, professional standards, and research in the field of music therapy.

Who Can Benefit from Music Therapy?

Music therapy can benefit many individuals. The diverse nature of music means it can be applied in the treatment of concerns both physical and psychological. In some instances, the therapeutic use of music has been able to help people in ways that other forms of therapy have not, as it can sometimes elicit responses that may not appear through more traditional forms of treatment. When people find it difficult to express themselves verbally, they may display a greater degree of interest and engagement in music therapy than they would in a more traditional form of therapy. No background in music is required for a person to benefit from this approach.

Because music can evoke positive emotions and stimulate reward centers in the brain, music therapy is often able to alleviate symptoms of mental health concerns such as:

• Depression  
• Mood-related concerns
• Anxiety
• Schizophrenia
• Substance dependency
• Autism
• Personality issues
• Insomnia
• Dementia

Music therapy can both assess and enhance cognitive, social, emotional, and motor functioning, and studies have shown positive results among individuals who have intellectual or physical difficulties, brain injuries, or Alzheimer's. This type of therapy has also been used in the treatment of physical ailments such as cancer and hypertension.

The positive effects of music therapy are not limited to those coping with severe or long-lasting physical and psychological problems, and this therapy can benefit people in a variety of situations. Music is frequently used to reduce stress levels and pain perception among mothers in labor and has been associated with improvements in self-esteem, self-concept, verbal communication, prosocial behavior, socialization skills, group cohesion, and coping skills.

What Happens in a Music Therapy Session? 

The intervention methods employed in music therapy can be roughly divided into active and receptive techniques. When a person is making music, whether by singing, chanting, playing musical instruments, composing, or improvising music, that person is using active techniques. Receptive techniques, on the other hand, involve listening to and responding to music, such as through dance or the analysis of lyrics. Active and receptive techniques are often combined during treatment, and both are used as starting points for the discussion of feelings, values, and goals.

Music therapy can be conducted with individuals or in groups, and the music may be chosen by the therapist or by the person in therapy. A music therapist will generally ensure the type and mode of the chosen form of music, as well as the timing of the music intervention, are appropriate for meeting the needs and goals of the individual in therapy.

When introducing music, therapists often base their selections on the Iso principle, which states music is more likely to have influence if it matches an individual's current condition. Therapists therefore try to ensure the lyrics and melody of a selected piece of music are well matched with the mood and psychological state of the person in therapy.

Songwriting is commonly used in music therapy and may involve writing original songs or modifying existing ones, with the latter being a more structured approach to writing. A person might modify a song by changing some of the words or lines, adding new verses, or writing entirely new lyrics to match the existing tune. In cases when songs are freely composed, the therapist may provide an emotion or topic to serve as a starting point. 

Music therapy can be used in a variety of ways:

• When a person experiences difficulty communicating after a stroke, singing words or short phrases set to a simple melody can often enhance speech production and fluency.
• A person with impaired motor skills might improve fine motor skills by playing simple melodies on a piano or tapping out a rhythm on drum pads. Listening to a rhythmic stimulus, such as a metronome, can also help a person initiate, coordinate, and time their movements.
• A therapist might play a piece of music for children with autism who have limited social skills and ask them to imagine the emotional state of the person who created the music or the person who is playing it. Doing so can help a person with autism develop or strengthen the ability to consider the emotions others are experiencing. 
• Group drumming circles have been used to induce relaxation, provide an outlet for feelings, and foster social connectedness among members of a group. Group members might sit in a circle with a hand drum while the therapist leads them in drumming activities that may involve group members drumming one at a time or all at once. Those who are part of the circle may be asked to express how they feel by playing a rhythm on their drum or the group might be asked to improvise music as a means of increasing group cohesiveness.
• Music might be incorporated into guided imagery or progressive muscle relaxation techniques to enhance the effectiveness of these methods.

Training for Music Therapists

Those wishing to become a music therapist must have at least a bachelor's degree in music therapy from an institution approved by the American Music Therapy Association (AMTA). Music therapy programs involve coursework as well as an internship in an educational and/or health care facility. After successfully completing one of the AMTA-approved programs, individuals must take the national examination offered by the Certification Board for Music Therapists (CBMT). If they are successful in the examination, they receive the credential Music Therapist-Board Certified (MT-BC), which is required for professional practice. Board certification is renewed every five years, and in order to maintain this credential, music therapists must retake the CBMT examination or complete 100 recertification credits within each five-year period.

Limitations of Music Therapy

Music therapy generally produces positive results, but it is not recommended as a stand-alone treatment for serious medical and psychiatric issues. While music may help to alleviate some of the symptoms of these conditions, other forms of treatment such as medication, physical therapy, or psychotherapy may also be necessary.

Further, while it is possible for any form of music to be used effectively in music therapy, not all individuals will find each type of music to be therapeutic. The benefit of a particular type of music will often depend on an individual's preferences and the condition experienced by that individual, and some music forms may actually cause agitation. To achieve success with music therapy, a therapist will likely need to ensure the musical preferences of the individual in treatment are taken into consideration.

References:

1. American Music Therapy Association. (2015). What is music therapy? Retrieved from http://www.musictherapy.org/faq/
2. Boxill, E. H., & Chase, K. M. (2007). Music therapy: An overview. In Music therapy for developmental disabilities (2nd ed.) [E-reader version]. Retrieved from http://www.proedinc.com/Downloads/12109Ch01.pdf
3. Gooding, L. F. (2008). Finding your inner voice through song: Reaching adolescents with techniques common to poetry therapy and music therapy. Journal of Poetry Therapy, 21(4), 219-229.
4. Jamabo, T. A., & George, I. R. (2014). Music as a therapy for depression in women: A theoretical perspective. International Journal of Academic Research, 6(4), 227-231.
5. Thompson, W. F., & Schlaug, G. (2015). The healing power of music. Scientific American Mind, 26(2), 32-41.
6. Winkelman, M. (2003). Complementary therapy for addiction: "Drumming out drugs." American Journal of Public Health, 93(4), 647-651.