What is Music Therapy?

By David Cifarelli

Music therapy has been around for more than a century, but the profession is getting new recognition in today’s complicated world. 

The American Music Therapy Association (AMTA) defines music therapy as “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship.” While the earliest mentions of music therapy date back to the 1700s, the field did not become an established health profession until the 1940s. 

Today there are more than 8,000 certified music therapists in the United States. These therapists utilize various music-related treatments to assist clients in physical rehabilitation, treatment engagement, providing emotional support and expressing feelings. People often misinterpret the work they conduct. 

“They think I’m just coming in and singing songs and doing a happy dance then leaving. Like they don’t understand the therapeutic power of what I’m doing.” 

Erin Williams is a board-certified music therapist who works with at-risk children at Foundations Behavioral Health in Doylestown, Pennsylvania. Williams is constantly explaining the mechanics of her work to others, including co-workers. 

The therapist says most people do not understand that music therapists are trained professionals who perform essential practices. “We can’t just have a person from the Hartford Symphony Orchestra come in and play music for [patients],” Williams says, “It’s not music therapy.” Instead, music therapists work in very specific realms to assist in various recovery processes. 

Annette Whitehead-Pleaux is an associate professor of music therapy at Berklee College of Music. The professor’s career has lasted nearly 27 years and mainly focused on working with burn victims at Shriners Hospital for Children in Boston.  

Whitehead-Pleaux says music therapy looks pretty similar across the board. “Anything from listening to music, talking about the lyrics or doing music, relaxation through listening to music to singing songs or playing instruments and improvising to music or song writing kind of looks the same.” 

However, the slight alterations in these practices will elicit different responses. “I could play a song by Elvis and that might spark some memories” Whitehead-Pleaux says, “but if I play Elvis singing, sometimes that will spark a lot more memories of when they listen to him.”  

The Coronavirus Pandemic has greatly impacted the field of music therapy. “About 80 percent of my caseload is not happening right now.” Rebecca Gildea is a board-certified music therapist who works at the Sonatina Center in Dover, New Hampshire. Gildea’s work primarily focuses on adults in mental health settings.

The therapist works alongside her clients in order to discover “what their definition of wellness is and what their definition of a good life for themselves looks like.” Due to the pandemic, she has only been treating clients in person whose cases are considered essential.

Corinne Pickett is obtaining her master’s in music therapy at St. Mary of the Woods College in Indiana. She has taken a number of counseling and assessment courses that allow her to deeply explore the connections music can have with patients. “As a music therapist,” Pickett says, “we don’t get to diagnose people, but this is going to help us to understand a little bit more and maybe see things that others haven’t caught.”

Pickett’s says her school has been very gracious with their students during the pandemic. “It’s different because things are not in person, so we don’t have that same kind of in person conduct, but they have been very, very good about moving things around to make it possible.”

Pickett talks about her inspirations for entering the field of music therapy, how music has impacted her own life and specific instances she’s seen the healing power of music take form

COVID has pushed music therapists to explore new and creative ways of therapy. Pickett says that students are becoming more flexible and better at “doing things on the fly that are going to help the client.” She says this virtual therapy has required her to find new and different ways to work. 

“I have a handful of individual clients,” Gildea says, “that I have been working through Telehealth. I’ll be making music with that person and we’ll be engaging through this kind of format and that has been surprisingly good.”

However, not being able to interact with clients in person still poses some challenges. Some of Pickett’s clients are struggling to pay attention during their sessions. “We’ve found ways around that as well and [we’re] just doing our best to try and keep people safe while still helping them to progress and not regress.”

Social isolation is specifically impacting people living in long-term care facilities. Older adults’ health is being shown to decline at a quicker than normal rate during the pandemic.

COVID has already made it difficult for in-person visits, but it is nearly impossible if cases have been reported within facilities. Individuals suffering from dementia, or with limited access to electronics might not even be able to FaceTime their families or understand the concept of video calling. However, technology has allowed music therapists to create more interactive forms of treatment.

“Technology’s been such a cool part of being a music therapist and throughout my career,” says Whitehead. During the professor’s time at Shriners, Whitehead-Pleaux helped children create different types of videos. “One kid, he wanted to create a horror movie [so] we did like a ten- or 12-minute horror movie where we orchestrated it and [put] everything together.” Whitehead-Pleaux also created music videos with children.

“A lot of music therapists have discovered that many of the apps from their iPad can be put onto their computer and shared that way,” says Pickett. She adds that if clients do not have instruments at home, it is helpful for their families to download music apps so they can play alongside their therapist. 

Whitehead-Pleaux talks about the inspirations behind their book, “Cultural Intersections in Music Therapy: Music, Health and the Person,” and how music serves as a linkage factor between cultures

“Music therapy is a diverse field, not diverse racially, or economically or gender,” Gildea says, “diverse in perspectives and experience.” The field is extremely hegemonic and patriarchal, and most therapists identify as white, cis-gender females who come from higher socioeconomic backgrounds. 

“There are some folks who are very aware of white privilege in the systems that we live in and there is a large community that is completely ignorant of that,” says Gildea. These people oftentimes seek validation through a system perpetuating racism and oppression. They are also more prone to reject personal growth and awareness.

Whitehead-Pleaux has conducted research on cultural responsiveness and social justice issues for decades. The therapist feels that music therapists “really need to be much more educated around cultural responsiveness and cultural humility.” In turn, this will allow therapists to fulfill their clients’ needs without promoting their own culture over others.

The Black Lives Matter movement has inspired music therapists to bring more attention to issues surrounding racism and oppression. Whitehead-Pleaux has seen people highlighting works of black authors, researchers and music therapists throughout social media. The professor adds that the field is seeing this now more than ever and hopes these dialogues will continue in the future.

“I think if you are going to be a therapist of any kind, that you need a certain set of values that speak to reflexivity in your own practice,” Gildea says. She also thinks therapists should “have a drive to change the systems that we work in.”

A majority of challenges that LGBTQ individuals face in the field “have to do with relationships that are harmful, or experiences with different people that have been harmful.” By practicing a feminist and queer-centered approach, Gildea works towards empowering these individuals so they can find their sense of identity. In turn, they will be able to build healthy relationships, sustain boundaries and continue validating themselves.

As a queer/trans individual, Whitehead-Pleaux assembled a group of music therapy professionals to strive for equal representation of the LGBTQ community in the field. Team Rainbow, assembled nearly a decade ago, has suggested the best practices for LGBTQ concerns and individuals, been published numerous times, and presented at regional, national and international conferences.

More recently, the group created a Facebook page for queer music therapists and students. This has helped Team Rainbow become a strong voice for queer people. “We feel like we can now go back to figuring out what we’re going to do next and our game is to continue to further this,” says Whitehead-Pleaux.

Gildea shares her thoughts about the connection music has had on her life, as well as people’s lives in general