Music therapy
Overview
 
Music therapy is an allied health profession and one of the expressive therapies
Expressive therapy
Expressive therapy, also known as expressive arts therapy or creative arts therapy, is the use of the creative arts as a form of therapy. Unlike traditional art expression, the process of creation is emphasized rather than the final product...

, consisting of an interpersonal process in which a trained music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients to improve or maintain their health. Music therapists primarily help clients improve their health across various domains (e.g., cognitive functioning, motor skills, emotional and affective development, behavior and social skills, and quality of life) by using music experiences (e.g., singing, songwriting, listening to and discussing music, moving to music) to achieve treatment goals and objectives.
Encyclopedia
Music therapy is an allied health profession and one of the expressive therapies
Expressive therapy
Expressive therapy, also known as expressive arts therapy or creative arts therapy, is the use of the creative arts as a form of therapy. Unlike traditional art expression, the process of creation is emphasized rather than the final product...

, consisting of an interpersonal process in which a trained music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients to improve or maintain their health. Music therapists primarily help clients improve their health across various domains (e.g., cognitive functioning, motor skills, emotional and affective development, behavior and social skills, and quality of life) by using music experiences (e.g., singing, songwriting, listening to and discussing music, moving to music) to achieve treatment goals and objectives. It is considered both an art and a science, with a qualitative and quantitative research literature base incorporating areas such as clinical therapy
Therapy
This is a list of types of therapy .* Adventure therapy* Animal-assisted therapy* Aquatic therapy* Aromatherapy* Art and dementia* Art therapy* Authentic Movement* Behavioral therapy* Bibliotherapy* Buteyko Method* Chemotherapy...

, biomusicology
Biomusicology
Biomusicology is the study of music from a biological point of view. The term was coined by Nils L. Wallin in 1991. Music is an aspect of the behaviour of the human and possibly other species...

, musical acoustics
Musical acoustics
Musical acoustics or music acoustics is the branch of acoustics concerned with researching and describing the physics of music – how sounds employed as music work...

, music theory
Music theory
Music theory is the study of how music works. It examines the language and notation of music. It seeks to identify patterns and structures in composers' techniques across or within genres, styles, or historical periods...

, psychoacoustics
Psychoacoustics
Psychoacoustics is the scientific study of sound perception. More specifically, it is the branch of science studying the psychological and physiological responses associated with sound...

, embodied music cognition
Embodied music cognition
Embodied music cognition is a direction within systematic musicology interested in studying the role of the human body in relation to all musical activities....

, aesthetics of music
Aesthetics of music
Traditionally, the aesthetics of music or musical aesthetics concentrated on the quality and study of the beauty and enjoyment of music. The origin of this philosophic sub-discipline is sometimes attributed to Baumgarten in the 18th century, followed by Kant...

, and comparative musicology. Referrals to music therapy services may be made by other health care professionals such as physicians, psychologists, physical therapists, and occupational therapists. Clients can also choose to pursue music therapy services without a referral (i.e., self-referral).

Music therapists are found in nearly every area of the helping professions. Some commonly found practices include developmental work (communication, motor skills, etc.) with individuals with special needs, songwriting and listening in reminiscence/orientation work with the elderly, processing and relaxation work, and rhythmic entrainment
Brainwave synchronization
Brainwave entrainment or "brainwave synchronization," is any practice that aims to cause brainwave frequencies to fall into step with a periodic stimulus having a frequency corresponding to the intended brain-state , usually attempted with the use of specialized software...

 for physical rehabilitation in stroke victims.

The Turco-Persian psychologist and music theorist al-Farabi
Al-Farabi
' known in the West as Alpharabius , was a scientist and philosopher of the Islamic world...

 (872–950), known as "Alpharabius" in Europe, dealt with music therapy in his treatise Meanings of the Intellect, where he discussed the therapeutic effects of music on the soul. Robert Burton
Robert Burton (scholar)
Robert Burton was an English scholar at Oxford University, best known for the classic The Anatomy of Melancholy. He was also the incumbent of St Thomas the Martyr, Oxford, and of Segrave in Leicestershire.-Life:...

 wrote in the 17th century in his classic work, The Anatomy of Melancholy
The Anatomy of Melancholy
The Anatomy of Melancholy The Anatomy of Melancholy The Anatomy of Melancholy (Full title: The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it. In Three Maine Partitions with their several Sections, Members, and Subsections...

, that music and dance were critical in treating mental illness, especially melancholia
Melancholia
Melancholia , also lugubriousness, from the Latin lugere, to mourn; moroseness, from the Latin morosus, self-willed, fastidious habit; wistfulness, from old English wist: intent, or saturnine, , in contemporary usage, is a mood disorder of non-specific depression,...

.

Forms

There are several concepts regarding the foundations of music therapy, including philosophies based on education, psychology, neuroscience, art/aesthetics, and music therapy itself.

Approaches used in music therapy that have emerged from the field of education include Orff-Schulwerk (Orff), Dalcroze Eurhythmics, and Kodaly. Two models that developed directly out of music therapy are Nordoff-Robbins and the Bonny Method of Guided Imagery and Music.

Music therapists may work with individuals who have behavioral-emotional disorders. To meet the needs of this population, music therapists have taken current psychological theories and used them as a basis for different types of music therapy. Different models include behavioral therapy, cognitive behavioral therapy, and psychodynamic therapy.

One therapy model based on neuroscience, called "neurological music therapy" (NMT), is "based on a neuroscience model of music perception and production, and the influence of music on functional changes in non-musical brain and behavior functions." In other words, NMT studies how the brain is without music, how the brain is with music, measures the differences, and uses these differences to cause changes in the brain through music that will eventually affect the client non-musically. As one researcher, Dr. Thaut, said: "The brain that engages in music is changed by engaging in music." NMT trains motor responses (i.e. tapping foot or fingers, head movement, etc.) to better help clients develop motor skills that help "entrain the timing of muscle activation patterns".

Music therapy for children

Two common approaches are used when conducting music therapy with children: either as a one-on-one session or in a group setting. When a therapist meets with a child for the first time, customarily the therapist and child develop goals to be met during the duration of their sessions. Music therapy can help children with communication, attention, motivation, and behavioral problems.
Therapy rooms should have a wide range of different instruments from different places. They should also be colorful, and have different textures. The therapist should either play a piano or guitar to keep everything grounded and in rhythm. The most important thing, though, is to have high quality and well-maintained instruments. As some children will be able to handle an instrument while others cannot, the child should be given an instrument adapted to them. All these elements help the experience and outcome of the music therapy go better and have more successes for the child.
In fact according to Daniel Levitin
Daniel Levitin
Professor Daniel J. Levitin, Ph.D. is a prominent American cognitive psychologist, neuroscientist, record producer, musician, and writer...

, it started inside the womb, surrounded by amniotic fluid, the fetus hears sounds. It hears the mother’s heartbeat, at times speed up, at other times slow down, not only that but other music, conversations, and environmental noises. Alexandra Lamont of Keele University in the UK discovered the fetus hears music. She found that, a year after they are born, children recognize and prefer music they were exposed to in the womb. The auditory system of the fetus is fully functional about twenty weeks after conception.

Music and mood disorders

According to the Mayo Health Clinic http://www.mayoclinic.com/, out of every 100,000 adolescents, two to three thousand will have mood disorders, out of which 8-10 will commit suicide. Two prevalent mood disorders in the adolescent population are clinical depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

 and bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...

.

On average American adolescents listens to approximately 4.5 hours of music per day and are responsible for 70% of pop music sales. Now with the invention of new technologies, such as the iPod and digital downloads, access to music has become as easy. As children make the transition into adolescence they become less likely to sit and watch TV, an activity associated with family, and spend more of their leisure time listening to music, an activity associated with friends.

Adolescents have identified many benefits of listening to music, including emotional, social, and daily life benefits, along with the formation of one’s own identity. Music can provide a sense of independence and individuality, which in turn contributes to one’s own self discovery and sense of identity. Music also offers adolescents with relatable messages that allow him/her to take comfort in knowing that others feel the same way they do. It can also serve as a creative outlet to release or control emotions and find ways of coping with difficult situations. Music education programs provide adolescents with a safe place to express themselves and learn life skills such as self-discipline, diligence, and patience. These school programs also promote confidence and self esteem. Ethnomusicologist Alan Merriam (1964) once stated that music is a “universal behavior;” it is something that everyone can identify with. Among adolescents, music is a unifying force, bringing people of different backgrounds, age groups, and social groups together.

Referrals and assessments

Adolescents may listen to music for its therapeutic qualities, but that does not mean every adolescent needs music therapy. Many adolescents may go through a period of teenage angst, characterized by intense feelings of strife, caused by the development of their brains and bodies. Some adolescents can also develop more serious mood disorders such as major clinical depression and bipolar disorder. Adolescents diagnosed with a mood disorder maybe referred to a music therapist based on observations by the diagnosing physician, therapist, or school counselor/teacher. When a music therapist gets a referral it is important to first assess the patient and create goals and objectives for him/her before beginning the actual music therapy. According to the American Music Therapy Association Standards of Clinical Practice assessments should include the “general categories of psychological, cognitive, communicative, social, and physiological functioning focusing on the client’s needs and strengths…and will also determine the client’s response to music, music skills, and musical preferences” The result of the assessment is used to create an individualized music therapy intervention plan.

There are many different music therapy assessment tools, but one particularly suited to adolescents is the “Music Therapy Assessment for Emotionally Disturbed Children.”,. The term “emotionally disturbed children” refers to a diverse group of diagnoses including behavioral disorders, schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

, affective/mood disorders, autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...

, anxiety disorders, and attachment disorders. This assessment concentrates not only on the facts of developmental skills but on the quality, content, and development of these affective behaviors. This music therapy assessment tool consists of seven main areas. The assessment starts with an interview with the patient regarding his/her, and their family’s, previous background in music. Next, the music therapist is to assess developmental appropriateness of the patient’s social and emotional functioning while in the music therapy setting, and then assess the patient’s ability to organize his/her musical experience. An important part of the assessment is to follow the changes in musical behaviors exhibited by the patient over the course of the session, and find any possible meanings in these variations. While interpreting the patient’s musical behavior, the music therapist must consider family history, current behavioral problems, affective developmental levels, and the patient’s current diagnosis. Last, the music therapist must investigate musical responses characteristic of the patient’s particular pathology.

Another assessment tool for adolescents is the Beech Brook Music Therapy Assessment http://www.beechbrook.org. This assessment measures the patient’s behavioral and social functioning, emotional responsiveness, language and communication skills, and musical skills. Beech Brook, a child oriented treatment facility in Cleveland, Ohio, designed this assessment to help evaluate children beginning music therapy and then throughout the music therapy process, and focuses more on the reasons for referral than the previously mentioned assessment. This assessment uses a quantitative
Quantitative research
In the social sciences, quantitative research refers to the systematic empirical investigation of social phenomena via statistical, mathematical or computational techniques. The objective of quantitative research is to develop and employ mathematical models, theories and/or hypotheses pertaining to...

 numbered scoring system in which the total score indicates an overall trend of behavior exhibited by a client. Both of these assessment tools help the music therapist plan the client’s treatment process and also establish credibility though accountability.

Treatment techniques

There are many different music therapy techniques used with adolescents. The music therapy model is based on various theoretical backgrounds such as psychodynamic, behavioral, and humanistic approaches. Techniques can be classified as active vs. receptive and improvisational vs. structured. The most common techniques in use with adolescents are musical improvisation
Improvisation
Improvisation is the practice of acting, singing, talking and reacting, of making and creating, in the moment and in response to the stimulus of one's immediate environment and inner feelings. This can result in the invention of new thought patterns, new practices, new structures or symbols, and/or...

, the use of precomposed songs or music, receptive listening to music, verbal discussion about the music, and the use of creative media outlets incorporated into the music therapy. Research also showed that improvisation and the use of other media were the two techniques most often used by the music therapists. The overall research showed that adolescents in music therapy “change more when discipline-specific music therapy techniques, such as improvisation and verbal reflection of the music, are used.” The results of this study showed that music therapists should put careful thought and deliberation into their choice of technique with each individual client. In the end, those choices can effect the positive or negative outcomes of music therapy treatment.

To those unfamiliar with music therapy the idea may seem a little strange, but music therapy has been found to be as effective as traditional forms of therapy. In a meta-analysis of the effects of music therapy for children and adolescents with psychopathology, Gold, Voracek, and Wigram (2004) looked at 10 previous studies conducted between 1970 and 1998 to examine the overall efficacy of music therapy on children and adolescents with psychopathology, which can be broken down into three distinct categories: behavioral disorders, emotional disorders, and developmental disorders. The results of the meta-analysis found that “music therapy with these clients has a highly significant, medium to large effect on clinically relevant outcomes.” More specifically, music therapy was most effective on subjects with mixed diagnoses. Another important result was that “the effects of music therapy are more enduring when more sessions are provided.”

Music therapists work with these adolescents on increasing emotional and cognitive stability, identifying contributing factors of current distress, and initiating changes to alleviate that distress. Music therapy may also focus on improving quality of life and building self-esteem, a sense self-worth, and confidence. Improvements in these areas can be measured by a number of tests, including qualitative questionnaires like Beck’s Depression Inventory, State and Trait Anxiety Inventory, and Relationship Change Scale. Effects of music therapy can also be observed in the patient’s demeanor, body language, and changes in awareness of mood
Mood (psychology)
A mood is a relatively long lasting emotional state. Moods differ from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event....

.

Group meetings and one-one sessions are two main methods for music therapy. Group music therapy can include group discussions concerning moods and emotions in/to music, songwriting, and musical improvisation. Groups emphasizing mood recognition and awareness, group cohesion, and improvement in self-esteem can be effective in working with adolescents. Group therapy
Group therapy
Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group...

, however, is not always the best choice for the client. Ongoing one-on-one music therapy has also been shown to be effective. One-on-one music therapy provides a non-invasive, non-judgmental environment, encouraging clients to show capacities that may be hidden in group situations.

Though more research needs to be done of the effect of music therapy on adolescents with mood disorders, most research has been finding positive effects.

As stroke therapy

Music has been shown to affect portions of the brain. Part of this therapy is the ability of music to affect emotions and social interactions. Research by Nayak et al. showed that music therapy is associated with a decrease in depression, improved mood, and a reduction in state anxiety. Both descriptive and experimental studies have documented effects of music on quality of life, involvement with the environment, expression of feelings, awareness and responsiveness, positive associations, and socialization. Additionally, Nayak et al. found that music therapy had a positive effect on social and behavioral outcomes and showed some encouraging trends with respect to mood.

More recent research suggests that music can increase patient's motivation and positive emotions. Current research also suggests that when music therapy is used in conjunction with traditional therapy it improves success rates significantly. Therefore, it is hypothesized that music therapy helps stroke victims recover faster and with more success by increasing the patient's positive emotions and motivation, allowing them to be more successful and driven to participate in traditional therapies.

Recent studies have examined the effect of music therapy on stroke patients, when combined with traditional therapy. One study found the incorporation of music with therapeutic upper extremity exercises gave patients more positive emotional effects than exercise alone. In another study, Nayak et al. found that rehabilitation staff rated participants in the music therapy group were more actively involved and cooperative in therapy than those in the control group. Their findings gave preliminary support to the efficacy of music therapy as a complementary therapy for social functioning and participation in rehabilitation with a trend toward improvement in mood during acute rehabilitation.

Current research shows that when music therapy is used in conjunction with traditional therapy, it improves rates of recovery and emotional and social deficits resulting from stroke. A study by Jeong & Kim examined the impact of music therapy when combined with traditional stroke therapy in a community-based rehabilitation program. Thirty-three stroke survivors were randomized into one of two groups: the experimental group, which combined rhythmic music and specialized rehabilitation movement for eight weeks; and a control group that sought and received traditional therapy. The results of this study showed that participants in the experimental group gained not only more flexibility and wider range of motion, but an increased frequency and quality of social interactions and positive mood.

Music has proven useful in the recovery of motor skills. Rhythmical auditory stimulation in a musical context in combination with traditional gait therapy improved the ability of stroke patients to walk. The study consisted of two treatment conditions, one which received traditional gait therapy and another which received the gait therapy in combination with the rhythmical auditory stimulation. During the rhythmical auditory stimulation, stimulation was played back measure by measure, and was initiated by the patient's heel-strikes. Each condition received fifteen sessions of therapy. The results revealed that the rhythmical auditory stimulation group showed more improvement in stride length, symmetry deviation, walking speed and rollover path length (all indicators for improved walking gait) than the group that received traditional therapy alone.

Schneider et al. also studied the effects of combining music therapy with standard motor rehabilitation methods. In this experiment, researchers recruited stroke patients without prior musical experience and trained half of them in an intensive step by step training program that occurred fifteen times over three weeks, in addition to traditional treatment. These participants were trained to use both fine and gross motor movements by learning how to use the piano and drums. The other half of the patients received only traditional treatment over the course of the three weeks. Three-dimensional movement analysis and clinical motor tests showed participants who received the additional music therapy had significantly better speed, precision, and smoothness of movements as compared to the control subjects. Participants who received music therapy also showed a significant improvement in every-day motor activities as compared to the control group. Wilson, Parsons, & Reutens looked at the effect of melodic intonation therapy
Melodic intonation therapy
Melodic Intonation Therapy is a therapeutic process used by music therapists and speech pathologists to help patients with communication disorders caused by brain damage...

 (MIT) on speech production in a male singer with severe Broca's aphasia. In this study, thirty novel phrases were taught in three conditions: unrehearsed, rehearsed verbal production (repetition), or rehearsed verbal production with melody (MIT). Results showed that phrases taught in the MIT condition had superior production, and that compared to rehearsal, effects of MIT lasted longer.

Another study examined the incorporation of music with therapeutic upper extremity exercises on pain perception in stroke victims. Over the course of eight weeks, stroke victims participated in upper extremity exercises (of the hand, wrist, and shoulder joints) in conjunction with one of the three conditions: song, karaoke accompaniment, and no music. Patients participated in each condition once, according to a randomized order, and rated their perceived pain immediately after the session. Results showed that although there was no significant difference in pain rating across the conditions, video observations revealed more positive affect and verbal responses while performing upper extremity exercises with both music and karaoke accompaniment. Nayak et al. examined the combination of music therapy with traditional stroke rehabilitation and also found that the addition of music therapy improved mood and social interaction. Participants who had suffered traumatic brain injury or stroke were placed in one of two conditions: standard rehabilitation or standard rehabilitation along with music therapy. Participants received three treatments per week for up to ten treatments. Therapists found that participants who received music therapy in conjunction with traditional methods had improved social interaction and mood.

In heart disease

According to a 2009 Cochrane review of 23 clinical trials, it was found that some music may reduce heart rate, respiratory rate, and blood pressure in patients with coronary heart disease. Benefits included a decrease in blood pressure, heart rate, and levels of anxiety in heart patients. However, the effect was not consistent across studies, according to Joke Bradt, PhD, and Cheryl Dileo, PhD, both of Temple University in Philadelphia. Music did not appear to have much effect on patients' psychological distress. "The quality of the evidence is not strong and the clinical significance unclear", the reviewers cautioned. In 11 studies patients were having cardiac surgery and procedures, in nine they were MI patients, and in three cardiac rehabilitation patients. The 1,461 participants were largely white (average 85%) and male (67%). In most studies, patients listened to one 30-minute music session. Only two used a trained music therapist instead of prerecorded music.

In epilepsy

Research suggests that listening to Mozart's piano sonata K448 can reduce the number of seizures in people with epilepsy. This has been called the "Mozart effect
Mozart effect
The Mozart effect can refer to: * A set of research results that indicate that listening to Mozart's music may induce a short-term improvement on the performance of certain kinds of mental tasks known as "spatial-temporal...

." However, in recent times, the validity of the "Mozart Effect" and the studies upon which the theory is based have been questioned, due to reasons such as the limitations in the original study and the failure to replicate the effects of Mozart's music in subsequent studies.

Avant-music therapy

Music therapist, music researcher, and experimental composer Enrico Curreri clinically explored theories and concepts developed by the American composer John Cage
John Cage
John Milton Cage Jr. was an American composer, music theorist, writer, philosopher and artist. A pioneer of indeterminacy in music, electroacoustic music, and non-standard use of musical instruments, Cage was one of the leading figures of the post-war avant-garde...

. For example, in various music therapy sessions with a patient diagnosed with depression and anxiety disorder, Curreri performed Cage's seminal composition of silence 4′33″ and utilized aleatoric
Aleatoric music
Aleatoric music is music in which some element of the composition is left to chance, and/or some primary element of a composed work's realization is left to the determination of its performer...

/chance procedures, as well as investigated experimental
Experimental music
Experimental music refers, in the English-language literature, to a compositional tradition which arose in the mid-20th century, applied particularly in North America to music composed in such a way that its outcome is unforeseeable. Its most famous and influential exponent was John Cage...

 and microtonal music.

Australia

In Australia in 1949, music therapy (not clinical music therapy as understood today) was started through concerts organized by the Australian Red Cross along with a Red Cross Music Therapy Committee http://www.austmta.org.au/about/our-history/.Key Australian body, AMTA, Australian Music Therapy Association, founded on 1975.

United States

Music therapy has existed in its common current form in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 since around 1944, when the first undergraduate degree program in the world was founded at Michigan State University
Michigan State University
Michigan State University is a public research university in East Lansing, Michigan, USA. Founded in 1855, it was the pioneer land-grant institution and served as a model for future land-grant colleges in the United States under the 1862 Morrill Act.MSU pioneered the studies of packaging,...

 and the first graduate degree program at the University of Kansas
University of Kansas
The University of Kansas is a public research university and the largest university in the state of Kansas. KU campuses are located in Lawrence, Wichita, Overland Park, and Kansas City, Kansas with the main campus being located in Lawrence on Mount Oread, the highest point in Lawrence. The...

. The American Music Therapy Association (AMTA) was founded in 1998 as a merger between the National Association for Music Therapy (NAMT, founded in 1950) and the American Association for Music Therapy (AAMT, founded in 1971). Numerous other national organizations exist, such as the Institute for Music and Neurologic Function
Institute for Music and Neurologic Function
The Institute for Music and Neurologic Function is a US nonprofit organization conducting research into and applying music therapy. It is located in The Bronx, New York City....

, Nordoff-Robbins Center For Music Therapy, and the Association for Music and Imagery. A music therapist may use ideas or concepts from different disciplines such as speech/language, physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

, medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

, nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....

, education
Education
Education in its broadest, general sense is the means through which the aims and habits of a group of people lives on from one generation to the next. Generally, it occurs through any experience that has a formative effect on the way one thinks, feels, or acts...

, etc.

A music therapy degree candidate can earn an undergraduate, masters or doctoral degree in music therapy. Many AMTA approved programs offer equivalency and certificate degrees in music therapy for students that have completed a degree in a related field. Some practicing music therapists have held PhD
PHD
PHD may refer to:*Ph.D., a doctorate of philosophy*Ph.D. , a 1980s British group*PHD finger, a protein sequence*PHD Mountain Software, an outdoor clothing and equipment company*PhD Docbook renderer, an XML renderer...

s in non-music-therapy (but related) areas, but more recently Temple University
Temple University
Temple University is a comprehensive public research university in Philadelphia, Pennsylvania, United States. Originally founded in 1884 by Dr. Russell Conwell, Temple University is among the nation's largest providers of professional education and prepares the largest body of professional...

 has founded a PhD program specifically in music therapy. A music therapist will typically practice in a manner that incorporates music therapy techniques with broader clinical practices such as psychotherapy, rehabilitation, and other practices depending on client needs. Music therapy services rendered within the context of a social service, educational, or health care agency can be reimbursable by insurance and sources of funding for individuals with certain needs. Music therapy services have been identified as reimbursable under Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...

, Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...

, private insurance plans and other services such as state departments and government programs.

A degree in music therapy requires proficiency in guitar, piano, voice, music theory, music history, reading music, improvisation, as well as varying levels of skill in assessment, documentation, and other counseling and health care skills depending on the focus of the particular university's program. To become board certified, a music therapist must complete a music therapy degree from an accredited AMTA program at a college or university, successfully complete a music therapy internship, and pass the Board Certification Examination in Music Therapy. The credential, Music Therapist-Board Certified (MT-BC) is granted by The Certification Board for Music Therapists (CBMT), upon successful passage of the Board Certification Examination. A music therapist may also hold the designations CMT (Certified Music Therapist), ACMT (Advanced Certified Music Therapist), or RMT (Registered Music Therapist)—initials which were previously conferred by the now-defunct AAMT and NAMT, and which will remain legitimate until 2020. To maintain the credential, either 100 units of continuing education must be completed every five years, or the board exam must be retaken near the end of the five year cycle. The units claimed for credit fall under the purview of The Certification Board for Music Therapists to assure continued competence in music therapy.
Many states recognize the professional status of Music Therapists. As of June, 2011, the State of Nevada recognized and has provided legislation adding Music Therapy as an obtainable license in the state which can now be obtained through the state board of health.

United Kingdom

Live music was used in hospitals after both of the World War
World war
A world war is a war affecting the majority of the world's most powerful and populous nations. World wars span multiple countries on multiple continents, with battles fought in multiple theaters....

s, as part of the regime for some recovering soldiers. Clinical music therapy in Britain as it is understood today was pioneered in the 60s and 70s by French cellist Juliette Alvin
Juliette Alvin
Juliette Alvin was a music therapist active in Britain from the 1950s until her death. She founded the Society of Music Therapy and Remedial Music in 1958, , and, in 1967, initiated Britain's first music therapy training program at the Guildhall School of Music and Drama in London.Alvin authored...

, whose influence on the current generation of British music therapy lecturers remains strong. Mary Priestley
Mary Priestley
Mary Priestley, a music therapist from Britain, is credited for development of Analytic Music Therapy, a synthesis of psychoanalytic theory and music therapy. Drawing on the theories of Carl Jung, Sigmund Freud, and Melanie Klein, analytic music therapy involves the use of musical improvisation to...

, one of Juliette Alvin's students, came to discover/create "analytical music therapy". Analytical music therapy is a form of music therapy which together with the Nordoff-Robbins School of Music Therapy, form the two central forms of music therapy used today. Mary Priestley's books Music Therapy in Action, first published by Constable and company ©1975 (ISBN 0-09-459900-9) and Essays on Analytical Music Therapy, Barcelona Publishers ©1994 (ISBN 0-9624080-2-6) form part of the core course work for students of analytical music therapy all over the world.

The Nordoff-Robbins approach to music therapy developed from the work of Paul Nordoff and Clive Robbins in the 1950/60s. It is grounded in the belief that everyone can respond to music, no matter how ill or disabled. The unique qualities of music as therapy can enhance communication, support change, and enable people to live more resourcefully and creatively. Nordoff-Robbins now run music therapy sessions throughout the UK, US, South Africa, Australia and Germany. Its headquarters are in London where it also provides training and further education programs, including the only PhD course in music therapy available in the UK. Music therapists, many of whom work with an improvisatory
Improvisation
Improvisation is the practice of acting, singing, talking and reacting, of making and creating, in the moment and in response to the stimulus of one's immediate environment and inner feelings. This can result in the invention of new thought patterns, new practices, new structures or symbols, and/or...

 model (see Clinical improvisation), are active particularly in the fields of child and adult learning disability
Learning disability
Learning disability is a classification including several disorders in which a person has difficulty learning in a typical manner, usually caused by an unknown factor or factors...

, but also in psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

 and forensic psychiatry
Forensic psychiatry
Forensic psychiatry is a sub-speciality of psychiatry and an auxiliar science of criminology. It encompasses the interface between law and psychiatry...

, geriatrics
Geriatrics
Geriatrics is a sub-specialty of internal medicine and family medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or...

, palliative care
Palliative care
Palliative care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients...

 and other areas.

Practitioners are registered with the Health Professions Council and from 2007 new registrants must normally hold a master's degree in music therapy. There are masters level programs in music therapy in Bristol
Bristol
Bristol is a city, unitary authority area and ceremonial county in South West England, with an estimated population of 433,100 for the unitary authority in 2009, and a surrounding Larger Urban Zone with an estimated 1,070,000 residents in 2007...

, Cambridge
Cambridge
The city of Cambridge is a university town and the administrative centre of the county of Cambridgeshire, England. It lies in East Anglia about north of London. Cambridge is at the heart of the high-technology centre known as Silicon Fen – a play on Silicon Valley and the fens surrounding the...

, Cardiff
Cardiff
Cardiff is the capital, largest city and most populous county of Wales and the 10th largest city in the United Kingdom. The city is Wales' chief commercial centre, the base for most national cultural and sporting institutions, the Welsh national media, and the seat of the National Assembly for...

, Edinburgh
Edinburgh
Edinburgh is the capital city of Scotland, the second largest city in Scotland, and the eighth most populous in the United Kingdom. The City of Edinburgh Council governs one of Scotland's 32 local government council areas. The council area includes urban Edinburgh and a rural area...

 and London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

, and there are therapists throughout the UK. The professional body in the UK is the Association of Professional Music Therapists while the British Society for Music Therapy is a charity providing information about music therapy.

In 2002, the World Congress of Music Therapy was held in Oxford
Oxford
The city of Oxford is the county town of Oxfordshire, England. The city, made prominent by its medieval university, has a population of just under 165,000, with 153,900 living within the district boundary. It lies about 50 miles north-west of London. The rivers Cherwell and Thames run through...

, on the theme of Dialogue and Debate. In November 2006, Dr. Michael J. Crawford and his colleagues again found that music therapy helped the outcomes of schizophrenic
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 patients. In 2009, he and his team were researching the usefulness of improvisational music in helping patients with agitation
Psychomotor agitation
Psychomotor agitation is a series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual. This includes pacing around a room, wringing one's hands, pulling off clothing and putting it back on and other similar actions...

 and also those with dementia
Dementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...

.

Africa & Tanzania

Research has shown that in many parts of Africa during male and female circumcision, bone setting, or traditional surgery and bloodletting, lyrical music related to endurance has been used to reduce anticipated pain, therapeutically. In 1999, the first program for music therapy in Africa opened in Pretoria, South Africa. Research has shown that in Tanzania patients can receive palliative care for life-threatening illnesses directly after the diagnosis of these illnesses. This is different from many Western countries, because they reserve palliative care for patients who have an incurable illness. Music is also viewed differently between Africa and Western countries. In Western countries and a majority of other countries throughout the world, music is traditionally seen and used for entertainment purposes. Whereas in African cultures, music is used in recounting stories, celebrating life events, or sending messages.

In a study done in 2003, 20 Scottish patients and 24 Kenyan patients, all having advanced cancers, were asked questions of their experiences, needs and available services. It was found that the Scottish patients and their caregivers thought the emotional pain of facing death was the prime concern. Whereas, in the Kenyan patients and their caregivers, they were most worried about physical pain and financial problems.

In Tanzania, music has strong associations with faith and lifestyle. For instance, Taraab music of Zanzibar is associated with Moslem recreational music. Christian churches are associated with European hymns. Weddings are interestingly enough associated with brass bands and drums are associated with traditional celebrations. Finally, clubs and bars are associated with dance music.

Tanzanian people varied in the type of music to be used in different circumstances, such as for pain. In a study taken by 17 Tanzanian palliative care participants, two people said they would not use music for patients in pain because of the belief that it could raise the patient's blood pressure and make it worse. The rest of the participants agreed that music would help decrease pain in patients, but they did not know if certain forms of music were better than others in decreasing pain. In this same study, four participants believed that the most helpful form of music would be one that the patient chose as their favorite. Another person believed that music videos could be beneficial because it would use both sound and vision as a distraction for patients. The final 12 participants believed that joyful, up-beat songs would help the patients more, especially if they were having difficulties with loneliness and depression or despair.

In Tanzanian cultures, music without lyrics does not have a lot of meaning, due to most music in Tanzania being used to bring about a message.

Ethnomusicology

Ethnomusicology is the study of music in its cultural context, or the anthropology of music.

Notable practitioners and authors

  • Al-Farabi
    Al-Farabi
    ' known in the West as Alpharabius , was a scientist and philosopher of the Islamic world...

  • Juliette Alvin
    Juliette Alvin
    Juliette Alvin was a music therapist active in Britain from the 1950s until her death. She founded the Society of Music Therapy and Remedial Music in 1958, , and, in 1967, initiated Britain's first music therapy training program at the Guildhall School of Music and Drama in London.Alvin authored...

  • Helen Bonny
    Helen Bonny
    Helen Lindquist Bonny is a music therapist who developed "Guided Imagery and Music" often referred to as "GIM".Music therapist Kenneth Bruscia uses the following definition to describe Guided Imagery and Music:...

  • John Carmichael
    John Carmichael (composer)
    John Carmichael OAM is an Australian pianist, composer and music therapist who has long been resident in the United Kingdom. One of his best known works is the Concierto folklorico for piano and string orchestra. His works for piano form much of his musical output, although he composes for many...

  • E. Thayer Gaston
    E. Thayer Gaston
    Everett Thayer Gaston was a psychologist active in the 1940s-1960s who helped develop music therapy in the United States...

  • Paul Nordoff
    Paul Nordoff
    Paul Nordoff was an American composer and music therapist. His music is generally tonal and neo-Romantic in style.-Career:...

     and Clive Robbins of Nordoff-Robbins
  • Mary Priestley
    Mary Priestley
    Mary Priestley, a music therapist from Britain, is credited for development of Analytic Music Therapy, a synthesis of psychoanalytic theory and music therapy. Drawing on the theories of Carl Jung, Sigmund Freud, and Melanie Klein, analytic music therapy involves the use of musical improvisation to...

  • Oliver Sacks
    Oliver Sacks
    Oliver Wolf Sacks, CBE , is a British neurologist and psychologist residing in New York City. He is a professor of neurology and psychiatry at Columbia University, where he also holds the position of Columbia Artist...

  • Concetta M. Tomaino
    Concetta M. Tomaino
    Dr. Concetta M. Tomaino, D.A., MT-BC, LCAT , is a pioneer in the field of music therapy for individuals suffering the effects of stroke or other brain trauma or are afflicted with such degenerative neurological diseases as Parkinson’s or Alzheimer’s...

  • Alfred A. Tomatis
    Alfred A. Tomatis
    Dr. Alfred A. Tomatis was an internationally known otolaryngologist, and inventor. He received his Doctorate in Medicine from the Paris School of Medicine...


See also

  • Affective neuroscience
    Affective neuroscience
    Affective neuroscience is the study of the neural mechanisms of emotion. This interdisciplinary field combines neuroscience with the psychological study of personality, emotion, and mood.-Brain areas related to emotion:...

  • Biomusicology
    Biomusicology
    Biomusicology is the study of music from a biological point of view. The term was coined by Nils L. Wallin in 1991. Music is an aspect of the behaviour of the human and possibly other species...

  • Chronobiology
    Chronobiology
    Chronobiology is a field of biology that examines periodic phenomena in living organisms and their adaptation to solar- and lunar-related rhythms. These cycles are known as biological rhythms. Chronobiology comes from the ancient Greek χρόνος , and biology, which pertains to the study, or science,...

  • Embodied music cognition
    Embodied music cognition
    Embodied music cognition is a direction within systematic musicology interested in studying the role of the human body in relation to all musical activities....

  • Melodic intonation therapy
    Melodic intonation therapy
    Melodic Intonation Therapy is a therapeutic process used by music therapists and speech pathologists to help patients with communication disorders caused by brain damage...

  • Musical analysis
    Musical analysis
    Musical analysis is the attempt to answer the question how does this music work?. The method employed to answer this question, and indeed exactly what is meant by the question, differs from analyst to analyst, and according to the purpose of the analysis. According to Ian Bent , analysis is "an...

  • Music cognition
    Music cognition
    Music cognition is an interdisciplinary approach to understanding the mental processes that support musical behaviors, including perception, comprehension, memory, attention, and performance...

  • Music theory
    Music theory
    Music theory is the study of how music works. It examines the language and notation of music. It seeks to identify patterns and structures in composers' techniques across or within genres, styles, or historical periods...

  • Music Therapy in Canada
    Music Therapy in Canada
    Music therapy has existed in Canada in various forms since the 1950s. As of 2009, there were six undergraduate and two graduate music therapy training programs in Canada.-History:...

  • Music psychology
    Music psychology
    Music psychology,or the psychology of music, may be regarded as a branch of psychology or a branch of musicology. It aims to explain and understand musical behavior and musical experience...

  • Psychoacoustics
    Psychoacoustics
    Psychoacoustics is the scientific study of sound perception. More specifically, it is the branch of science studying the psychological and physiological responses associated with sound...

  • Psychoneuroimmunology
    Psychoneuroimmunology
    Psychoneuroimmunology is the study of the interaction between psychological processes and the nervous and immune systems of the human body...


Further reading


External links

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