The Music Therapy Equation

Recently we had a discussion with our apprentice, Dana, about the music therapy equation. Is there a formula for music therapy similar to the way math or physics equations work? Is there a way to define music therapy in such a way that encompasses the full breadth and scope of practice?

Once we began to think about it, the phrase that kept popping up was:

There are so many applications of this profession and approaches to music therapy practices. What you can accomplish is truly only as limited as the therapists and clients abilities and openness to creative intervention. Certified music therapists are all trained in the basic elements of music, psychology, physiology, and their interconnected relationship. In essence, we follow the same structure as many equations:

Presenting stimulus + Imposed stimulus = Outcome/Response

However, in music therapy there are many ways this can be accomplished based on a therapists training, skill set, and focus. Examples include, but are not limited to,…

• Neurologic music therapy (NMT): a research-based system of 20 standardized clinical techniques for sensorimotor training, speech and language training, and cognitive training. It’s treatment techniques are based on the scientific knowledge in music perception and production and the effects thereof on nonmusical brain and behavior functions. (Thaut,2015)

• Analytical music therapy (AMT) refers to a specific model of practice and not just to any application of music therapy incorporating psychoanalytic practices or theories. (Aigen, 2021). AMT encourages you to use an improvised, musical "dialogue" through singing or playing an instrument to express your unconscious thoughts, which you can reflect on and discuss with your therapist afterward. (Very Well Mind, 2021).

• Music psychotherapy: the use of music experiences to facilitate the interpersonal process of therapist and client as well as the therapeutic change process itself. (Bruscia, 2018)

• Creative music therapy (Nordoff-Robbins): an improvisational approach to therapy that also involves the composition of music. Originally created as a therapeutic approach for children and adults with significant developmental disabilities (e.g., intellectual, sensory, or motor disability). This approach is practiced worldwide with a variety of patients of different ages (Britannica).

• Cognitive-Behavioural Music Therapy combines cognitive behavioural therapy (CBT) with music. In CBMT, music is used to reinforce some behaviours and modify others. This approach is structured, not improvisational, and may include listening to music, dancing, singing, or playing an instrument (Very Well Mind, 2021).

• Community music therapy: This format is focused on using music as a way to facilitate change on the community level. It’s done in a group setting and requires a high level of engagement from each member (Very Well Mind, 2021).

• The Bonny method of guided imagery and music (GIM): This form of therapy uses classical music as a way to stimulate the imagination. In this method, you explain the feelings, sensations, memories, and imagery you experience while listening to the music (Very Well Mind, 2021).

Beyond this, there are additional philosophies a music therapist can abide by. For instance:

• Anti-oppressive practice and philosophy,

• Person centred practice,

• Humanistic approaches to practice,

• System centred practice,

…and others.

This unique blend of experience, perspective, and evidence based-approaches leads to a diverse practice that is highly individualised from one music therapist to another with core standardized practice measures. One of which is ethics.

All certified music therapists adhere to their governing bodies code of ethics and professional standards of practice. This unifies all practicing therapists despite the variation in stream or methodology.

Then what is the music therapy equation?

Music therapy is undoubtedly one of the more dynamic forms of mental health care, therefore its equation must be one that allows for variation and creativity. As like many creative arts or expressive therapies, responses to this art form are diverse because humans are diverse and complex. When you have an evidence-based therapy that deals with both the pragmatic elements of rehabilitation AND human emotions/social connection there are many possible outcomes. However, the basic formula should always remain the same...

Music (and it's elements) + Therapeutic relationship = Impact and Response

Why this equation?

Well, the elements of music include sound (pitch, timbre, duration, etc.), rhythm, melody, tonality, harmony, expression (tempo, articulation, dynamics), and resonance (vibration, reverberation, vibrato, feedback, etc). Humans are designed with similar systems of rhythm, harmony, expression, sound, tonality, and resonance. Think about your heartbeat, your pulse, your sleep cycles, your breath, the sound of your voice - it's pitch and inflection, your expression, your joy when a group of individuals find harmony or synchronicity. This makes music a useful tool to use as a form of therapy. Because of this:

• The use of singing and breath work can help to calm the sympathetic nervous system and emotionally regulate the body. 

• Music is registered all over the brain and can therefore be used as an access point for rehabilitation when there is damage to one section of the brain. 

• Rhythm can be used as an entrainment tool to help your brain and body calculate and anticipate movements necessary for daily activities including walking and navigating your environment.

• Of all 5 senses, hearing/sound is the very last to deteriorate in an ageing or palliative body. 

• Music makes us happy! The "pleasure" hormones and neurotransmitters, dopamine and serotonin, are released when listening and engaging in musical activity. 

...and more.

This is what makes music an effective tool for therapy.

When added to the trust and social connection formed within the therapeutic relationship (certified music therapist + service user/s), the impact and response to therapy is so much greater. “The goal of developing a good rapport is to improve your chances for a successful outcome, along with developing mutual trust and respect, to foster an environment in which you, the client, feel safe. To develop a good rapport, your therapist must, among other things, demonstrate empathy and understanding. Therapeutic rapport is a cornerstone of most forms of (therapy)” (Very Well Mind).

At Synergy MT we add a commitment to cultural safety within any therapeutic relationship we build. We also aim to promote the collaborative creation of safe and brave spaces. In doing so, we are committed to being an inclusive and accessible service for all persons no matter their social locators.

It’s also important to note that therapy requires relationship. It requires both the therapist and service user to have an active role in developing goals, implementing techniques learned, and showing up consistently.

Here are a few tips for ways you can make the most out of your first therapy experience.

The impact and/or response to music therapy can be varied. Someone may enter music therapy with a language or physical rehabilitation end goal. Another person might enter music therapy with a goal of increased socialization. Similarly, someone else may enter therapy with the desire to process challenging emotions and establish coping strategies that have transferable applications. Again, because music therapy is one of the more dynamic forms of therapy, its equation MUST be one that allows for variation and creativity. Responses to music are diverse because humans are diverse and complex. That’s what makes it beautiful! It allows us to connect with the essence of our humanity.

Essentially, no matter the impact and/or response, music therapy requires the existence and combination of these two things: music (and it’s elements) + therapeutic relationship/rapport.

Would you agree?

xoxo Hayley & Kim