The Intersection of Music Therapy and Counseling

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Listening to music can be a therapeutic activity. Whether an individual comes home after a long day of work and puts on his or her favorite music while decompressing or a couple replays their wedding song and memories come alive with the music, the act of listening — and not just the notes themselves — can have a placating effect. Some genres of music, on the other hand, can motivate listeners, possibly through inspiring lyrics, or maybe a thumping bass line; think of the athlete or performer who uses music to get in a fired-up mindset.

Regardless of how or why an individual listens, music is a potent stimulant, able to generate a deep response within the listener and enable them to tap into their emotions. As the counseling field continues to progress alongside modern techniques and modes of thinking, many individuals have latched on to music’s power as a clinical tool for use in client interactions. However, these sessions are about more than simply listening: Clients and their therapists may create music to act as a way of expression, or sing or otherwise act out to music to elicit a cathartic release. Music therapy is a legitimized field of study wherein counselors can attain certification. There are fact-based recommendations for music therapy, and it can be used to treat a number of conditions.

The intricacies and practical application of music therapy studies require much understanding — from settings best suited for the therapy to the techniques used and the research and reasoning behind it all. As an introduction, interested students may want to contact a representative at Bradley University to learn more about the online Master of Arts in Counseling program to establish a base of counseling studies to perhaps later build a music therapy specialization.

What is music therapy?

Defined by the American Music Therapy Association (AMTA), music therapy is “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” Some results that music therapy can facilitate, according to AMTA, include physical rehabilitation, improving a client’s openness to engaging in treatment, promoting emotional support to client and families, and serving as a conduit for personal expression.

As important as it is to define what qualifies as music therapy, it’s equally critical to define what music therapy is not. Clinical music therapy practice requires an assessment of the client and the suitability of music therapy in the course of his or her treatment. The use of music as a motivating tool isn’t considered musical therapy, such as a person with Alzheimer’s disease listening to favorite songs on a personal device or a choir singing for hospital floor patients, according to AMTA. The difference is that clinical standards and processes are not met or used and the environment is unscientific and uncontrolled.

Music therapy sessions entail more than mere ambient taking in of music but instead consist of constructive listening, vocalizing, composing and instrumentation exercises geared toward positive outcomes through musical intervention. AMTA noted that specific activities in sessions may take the form of:

  1. Musical improvisation
  2. Receptive music listening
  3. Songwriting
  4. Lyric discussion
  5. Music and imagery
  6. Singing and musical performance
  7. Movement to music

Just as different methodologies of other specialties are applied according to a patient’s unique needs, the context of the client relationship and his or her treatment goals will dictate which musical intervention will prove the most fitting to achieve positive results. For instance, active music creation may be used to help clients stay focused or shape motor skills through structured music lessons and practicing of scales. When in an ensemble setting, compositions exercises condition clients to social interactions and teamwork, which can lead to healthy self-expression. Lyrical examination, on the other hand, may be used to help clients identify or reflect on personal situations and emotions that can be addressed through counseling.

Percussionist’s hand rested on drum.

Who benefits from musical therapy and how?

One advantage of music therapy is it can be used in many client scenarios. Still, specific client populations are most receptive to music therapy’s stimuli and structure. AMTA cites particularly disposed demographics as children, adolescents, adults and seniors with mental health needs, as well as development and learning disabilities; individuals struggling with substance abuse; and clients with acute or chronic pain, which may be caused by physical disabilities. The Center for Music Therapy expanded on these segments to include prematurely born infants, people with autism or cerebral palsy, individuals with psychiatric disorders, persons with Parkinson’s disease and geriatric clients suffering from aging and dementia symptoms.

This wide reach is evident in a 2012 AMTA member survey, in it, respondents were asked which age group they serve, and seven groups each received 13–17 percent representation: seniors, mature adults, adults, young adults, teens, preteens and infants/children.

An interesting highlight was the 1 percent who practiced prenatal music therapy. Word-of-mouth referrals from mothers about playing Mozart to soothe infants in the womb have roots in the scientific application of music therapy, and a study using first-time mothers found infants who were exposed to music during the pregnancy period scored higher on measures like habituation, motor performance and reflexes.

Children are an especially receptive client population to music therapy, which is true whether they have a developmental disability or not. Communicating can be difficult with children, especially those who are in pain, who have extreme difficulty in social situations, who are nonverbal or who have experienced a traumatic event. However, music therapy can be used to break down barriers that otherwise conversation-based interviews may be unable to breach. Children also respond well to musical games and are more likely to engage when creating or singing a song about a favorite subject, like an animal. The forces behind musical therapy create a disarming environment that can put an anxious child at ease. Put wooden blocks and a soft mallet in front of a child, and it’s likely she or he is going to be intrigued and start playing around with it. Distraction is a key element to music therapy, as it may draw children away from focusing on pain and result in a more cheerful mood.

Another draw to specialization in music therapy is the range of settings the practice can be applied in, including day care, assisted living communities, psychiatric institutions, mental health centers, substance abuse programs, education, halfway homes and private practices.

It is important to note that clients do not need to have any familiarity or previous experience with musical learning or performance. Of course, therapists themselves must be well-versed in instrumentation (from strings to percussion), composition and theory, in addition to the general requirements of counseling, like being able to assess clients and prescribe treatments.

This wide applicability to the uninitiated is another strength of music therapy, as clients who may be obstinate or hesitant can soon learn challenges (like learning a chord progression) are overcome more easily than initially thought.

What conditions can be addressed with music therapy?

The conditions that can be treated with music therapy will depend on the client and the setting, but as has been the case, a number of diverse symptoms can be addressed with music therapy. In the 2012 AMTA workforce survey, when asked what kind of clients respondents served, the most cited areas (outside of “all other” with 40 percent) were mental health (18 percent), developmental disability (15 percent), medical/surgical (11 percent) and neurological disorders (6 percent).

Music therapy has particular use in treating that last cohort. Neurological disorders may be related to mood disorders, as Italian researchers noted in a recent study on music therapy, making those clients impressionable to music. In the study, participants with depressive symptoms were engaged in musical interventions. The team found that musical exercises present a treatment option that is “valid and without side effects” for alleviating psychological and behavioral triggers, as well as contributing to recovery from such disturbances. Researchers pointed to not only the neurochemistry at work (how music stimulates different regions of the brain that perform irregularly in a depressive person) but also how music therapy can promote better social cohesion, self-esteem and communicative skills on a psychological level.

Pain management is another area in which music therapy excels. A 2017 study published in The American Journal of Orthopedics stated that music therapy was found to decrease pain symptoms in clients recovering from spinal surgery. This efficacy has gained note among counselors and other stakeholders as music therapy presents an alternative treatment regimen devoid of drug dependency, possibly helping tackle the growing opioid abuse crisis.

“The degree of change in the music group is notable for having been achieved by non-pharmacologic means with little chance of adverse effects,” said Joanne Loewy, co-author of the study and director of The Louis Armstrong Center for Music and Medicine, of the Mount Sinai Health System. “Pain is subjective and personal, and warrants an individualized approach to care. Certified, licensed music therapists are able to tailor treatment to each client’s musical preferences and meet their pain level.”

Music therapy has wide use in perioperative patients — those either being prepared for surgery, undergoing an operation or in the recovery/postoperative stage — because of its dopamine-inducing effects, which are similar to what opioids are used for but with less risk involved.

AMTA outlined how music therapy might manifest in different settings. For instance, in hospitals, music therapy can be used for calming and sedating purposes along with anesthesia. In nursing homes, music therapy may take the form of “sensory and intellectual stimulation” to keep seniors active, both in a physical and cognitive sense. Music therapy often is used in these settings to promote social bonding. When it comes to schools, AMTA noted music therapy may be used for individual learning plans and as a tool to improve nonmusical skills like communication. Music therapy in psychiatric settings can be used in conflict mediation and problem-solving, in addition to its use as a personal empowerment exercise.

Learn more about Bradley University

Music therapy is an increasingly popular mechanism for counselors to more effectively connect and serve their client populations. As demonstrated, music therapy has a wide range of applicable uses, from children to seniors, from hospital operating rooms to assisted living communities, from mood disorders to chronic pain management. The creation, performance and interpretation of music can generate positive outcomes in clients if practiced properly.

As an introduction to music therapy, applicants may want to learn more about Bradley University’s online Master of Arts in Counseling degree program. Music therapists, while often trained musicians, also must be qualified and certified counselors. There is no substitute for having the foundational knowledge of how to assess and treat clients.


Recommended Reading

How Virtual Reality Therapy Impacts Veterans With PTSD

Neurocounseling: Bridging The Gap Between Brain and Behavior

Bradley University Master of Arts in Counseling Program