Expert opinion: what is music therapy and who needs it
Music therapy is a relatively new direction in health care. A specialist in this field – a music therapist – works at the intersection of psychology, music, pedagogy, rehabilitation and medicine.
Music therapists work with the elderly, patients with psychiatric disorders, neurodegenerative disorders, and neurological patients. While in some countries the profession of music therapist is recognized and official, in Russia such specialists are just emerging, and there are no standards for the profession.
About whom can become a music therapist, how and why to do it, as well as the prospects for development of music therapy in our country, the editorial staff of VSTI. Medina talked with experts who, using fundamentally different approaches to music therapy, based on Russian and foreign experience, are developing and promoting this field in our country.
Is a music therapist a medical specialty or a pedagogical one?
“Music therapist is an auxiliary profession in the field of health, on a par with physical therapists, speech therapists, occupational therapists, psychotherapists and others. Music therapists work in many fields: it is both medicine and pedagogy. They help clients and patients of all ages.
“Music therapy is an integrative specialty. That means it has something from medicine, something from pedagogy, psychology, and, of course, music.
In my opinion, in music therapy training, it is fundamental to give theoretical knowledge in parallel with practical knowledge. By practical, we mean not only musical skills directly, but also competencies that are important for the therapist, for a specialist in the helping professions.
Music therapy is a very practical profession, in which it is difficult to remain a theoretician without picking up musical instruments and interacting with real clients. Of course, this does not invalidate the scientific activity in this field.”
“I believe, and I promote this through research programs that are implemented in clinical and educational practice, that there should be profiles in music therapy: medical, psychotherapeutic and pedagogical.
Medical professionals without music training (at least a minimal education) cannot get such a specialty (profile), musicians-teachers can get additional professional education in the field of clinical or pedagogical music therapy.
What should be the training and work standards for such a specialist?
“The basic standards of the profession have long been prescribed by the World Federation of Music Therapists and include intensive education with practice, music education, biology, psychology, sociology (many programs have added neuroanatomy and understanding of how music affects the brain), knowledge of music therapy theory, principles, directions, methods of working with people of different ages and with different conditions, supervision during practice is mandatory.”
What does it take to become a music therapist?
“I, who studied in Canada and the United States, speak from the perspective of American realities. You have to be a musician to begin with, because music therapists have many instruments. Everyone needs to be able to sing and know music theory and history. Clinical improvisation and composition skills are absolutely essential to the job.
Knowledge of medicine, including an understanding of various diseases and conditions, and knowledge of human developmental psychology are also needed. Depending on where and with whom the music therapist works, more in-depth knowledge is added: geriatrics, for example.
What tools should such a specialist have?
“Guitar, piano or any keyboards, lots of different percussion, ethnic instruments (especially in the realities of different cultures), flutes and other wind instruments (we often work on breathing, sound production, and wind instruments are very helpful in this).
In my work with children, I use nonmusical tools, like those used by physical therapists – for example, balls of different sizes, balancing boards. Neurological music therapists, of which I am one, are trained to look at what nonmusical helps a particular person, to add music, rhythm, instruments to these exercises, increasing duration, increasing motivation, engaging all areas of the brain.
“It depends on the methods and techniques mastered by the music therapist based on previous basic qualifications – musical instruments of choice, perhaps special acoustic rooms or beds with access to audio systems.”
What can you say about clinical trials of music therapy?
“They are conducted on a point-by-point basis, by individual researchers; in particular, a lot of research has been conducted in clinical practice by V. Mastnak and his graduate students from various countries. In Russia, my graduate students and I conduct such research, and several dissertations have already been defended on the basis of evidence-based methodology.
Often music therapy is presented as just a pleasant pastime and social support, which is also important. This, however, tears apart the understanding of music therapy, especially in the eyes of representatives of medicine and consultative psychology and psychotherapy.
Do approaches differ for different illnesses, or are there uniform principles?
“Approaches differ, of course. What a child with autism needs is different from what an adult with dementia needs, for example. There are also different schools and directions (e.g., neurological muzo therapy with 19 protocols; analytic; music-oriented; Nordoff-Robbins approach and others).
There are also unified principles: it is a focus on the client’s capabilities, his interests, (client-centered approach), Rogers’ basic therapeutic techniques, and the “do no harm” principle.
“Naturally, in each case or typology of disorders, the targets of influence achievable for musical activity are highlighted. They are treated with the help of music technology, which leads to the emergence of special music therapy protocols for specific clinical situations.
We have developed and received confirmations of the effectiveness of music and activity therapy protocols for psychosomatic asthma in children and adolescents, for work in the neurology department with patients with Parkinson’s disease and other disorders, which lead to the status of cannulated patients.
Like any therapy, music therapy can have contraindications. What are they related to, what are they?
“Music can retraumatize because it directly affects memory. It is because of this that it is dangerous to let non-professionals work, for example, with post-traumatic syndrome, or with people who cannot verbalize their feelings and emotions. This also applies to infants: often what the average person sees as a “nice” reaction is a manifestation of sensory over stimulation and irritation.
You have to know the specifics of each condition, the diseases we work with.”
How does therapy selection take into account the characteristics of the client?
“Therapy selection is the most important stage of the therapeutic relationship with the client. You can’t just look at a medical record and prescribe certain music, an instrument, or exercises. Certainly, a good experienced music therapist has a theoretical basis in his head and can refer to quality research and his own experience, but without a careful, thoughtful meeting with the client, the selection of therapy is impossible.
When I speak of an encounter, I don’t just mean a diagnostic one-time session, I mean an encounter on a deep personal level. And this ability of the therapist to be open to this encounter, to the fact that the client can refute all your theoretical attitudes and previous experience, is a very important quality, a skill, a tool that needs to be developed. This quality can be called empathy, something that stands between sympathy and antipathy.
It is important not to merge into infinite tenderness in front of the client and to avoid cold detachment, when you stop seeing a personality and see only a set of symptoms. It is necessary to constantly work with yourself, to understand your limitations.
Just observe, learn to see the world and the person, hear what they want to tell you, show you, open up. Because that’s usually where the path for therapy is, the right instrument, the song, the tone, the word. If the therapist has this quality, he or she will be able to make a diagnosis in such a way that the paths to therapy, to helping the client in some way, will open up.
But to have in your head or on paper a certain list of diagnostic tools that you use and tick off there is very important!
A therapist has to be a person with a warm heart and a cold mind at the same time. It turns out to be such a superhero, a little bit.”
In August 2019, the Department of Health launched an initiative recommending that employers create psycho-emotional release rooms for employees. Being in such rooms, which are supposed to house aroma lamps, music therapy equipment, sleep capsules and massage chairs, will help relieve stress and improve performance.
Is the Health Department’s music therapy equipment initiative feasible?
“Music therapy is a ‘triangle’ in which there must be a patient/client, music and its elements, and a music therapist. If there is no latter, there is no therapeutic relationship.
Recent studies show that this relationship is 60% of the success of therapy. So no amount of miracle robots, iPads with headphones and other technology can replace human communication, participation, understanding, empathy – all those important components of good therapy.
“This issue requires careful consideration, there is no single set of equipment for all areas and spheres of application, a targeted approach with professional consulting in each case and institution is needed here.
How do I get started in music therapy?
There are a few different ways to get started in music therapy. One way is to become a certified music therapist. To become certified, you need to have a degree in music therapy from an accredited program, pass an exam, and complete a supervised clinical internship. Another way to get started in music therapy is to become a music therapist assistant. To become a music therapist assistant, you need to have a degree in music or a related field, pass an exam, and complete a supervised clinical internship. If you are not interested in becoming a certified music therapist or a music therapist assistant, you can still work in the field of music therapy. There are many jobs in the music therapy field that do not require certification. These jobs include music therapist intern, music therapist aide, music therapist research assistant, and music therapist marketing assistant.
Is becoming a music therapist worth it?
There is no one-size-fits-all answer to this question, as the value of a music therapist career depends on a variety of factors, including personal preferences, professional goals, and the needs of the local community. However, in general, a career as a music therapist can be both rewarding and fulfilling. Music therapists are typically employed in a variety of settings, including hospitals, schools, nursing homes, and private practice. They work with clients of all ages who are struggling with a range of issues, such as mental health disorders, developmental disabilities, physical disabilities, and chronic illnesses. By using music as a tool, music therapists are able to help their clients address and resolve a variety of issues. Music has a unique ability to touch people’s emotions and can be used to improve communication, boost self-esteem, and reduce stress. In addition, music therapy can also improve cognitive function and help people with disabilities learn new skills. If you are interested in a career in music therapy, it is important to do your research and find a program that is accredited by the American Music Therapy Association. Once you have completed your training, you will need to become licensed in your state. The average salary for a music therapist ranges from $40,000 to $60,000 per year. Overall, a career as a music therapist can be both rewarding and fulfilling. It can be a great way to use your love of music to help others, and it can be a meaningful way to make a difference in people’s lives.
What do you need to study for music therapy?
There is no one answer to this question as the study requirements for music therapy vary depending on the institution and country you are looking to study in. However, some general things you may need to study include music history, music theory, and psychology. Additionally, many music therapy programs also require students to complete clinical placements, which provide hands-on experience working with patients.
How do music therapist make money?
There are a few different ways that music therapists can make money. They can work for a clinic or hospital, work for a private practice, or work freelance. Music therapists can also teach classes or workshops on the use of music in therapy.