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Music IN Therapy vs. Music AS Therapy: My Perspective

by Kimberly on March 8, 2012 · 4 comments

It was–rather surprisingly–not that long ago that I first heard this question on how music therapy works: is it music AS therapy? or music IN therapy?

A couple weeks ago, I invited student music therapist Kyle Fleming to share his thoughts on the topic that were prompted by a class discussion. Below are my thoughts. I don’t feel this in any way “resolves” the issue, but perhaps this is a debate that will continue to evolve and grow as we evolve and grow as professionals and as a profession. With that in mind, I invite you to share your thoughts in the comments section below. Do you think it’s music IN therapy or music AS therapy?

Before sharing my feelings on the matter, allow me to outline 3 scenarios for you:

Scenario 1
A group of older adults, all with a history of some type of neurologic insult (e.g. stroke, Parkinsons, TBI, etc.) are sitting in a circle, working through a series of upper and lower extremity exercises. The music therapist, autoharp in hand, is providing a variety of dynamic, harmonic, range, and timing cues that prompt and enhance the exercises.

Scenario 2
A cancer caregiver support group is meeting during their regular biweekly time. There is a new member this week and a guest facilitator, a music therapist. After initial introductions and a brief overview of music therapy, the music therapist sings Sarah McLachlan’s “I Will Remember You.” The new group member begins to cry, then after the song ends, takes a breath and opens up about the approaching one-year anniversary of her sister’s passing.

Scenario 3
A child with a history of complex trauma has been in the “quiet area,” kicking, yelling, screaming, and trying to run for about 10 minutes. The music therapist walks in and starts singing and rocking to their regular, weekly, “calm down” song. By the end of the song, the child is calm enough to follow one-step directions, which prompts to music therapist to get her guitar and sing through one of the child’s favorite songs. After this, the child begins to process–verbally and through song–what triggered the episode.

The Dilemma: Music IN or Music AS Therapy?

I share these 3 scenarios because they are all experiences I have had and I feel they highlight how music therapists can use music BOTH in and as therapy. The first scenario is an example of music as therapy. The music, in this case, was doing the work. I was playing the music, yes, but it was the inherent qualities and characteristics of the music itself that was providing the necessary timing, force, and range cues for the clients.

The second scenario is an example of using music in therapy. The “therapy” work in this scenario primarily took place after the song ended during the verbal “talk therapy” group processing. This is, I feel, one of the biggest ways other professionals use music in their therapy. Psychologists, OTs, PTs, social workers, speech-language pathologists all can, and many do, use music in their work. This is analogous to me using an art experience. I have used art IN my music therapy sessions, but I do not have the skill set nor training to use art as a therapy. I am not an art therapist.

What makes a music therapist unique is that we can use both. We have the skill set and flexibility to use music both in and as therapy. Scenario 3 is an example of that, of using music both in and as therapy. It was “as” therapy in the sense that the rhythmic structure and melody of the “calming song” were used specifically to promote sensory organization and emotion regulation. But that scenario also incorporated music “in” therapy in that I drew strongly on my therapeutic relationship and the verbal processing that followed the music experience to help the child regulate and process the experience.

Perhaps it is important to embrace both sides of this issue and to use whichever works best based on the context. Context may include the clinical site, population, individual client, day of the week, or time of day. Part of being a therapist is using those contextual cues to inform the experience you facilitate on that given day. Part of being a music therapist is to know,  based on those contextual cues, what is the best way to use music–in or as therapy–to help meet the needs of your client in that moment.

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{ 4 comments… read them below or add one }

Margie Webb March 8, 2012 at 3:38 pm

Music therapy is a relatively new field of study, and I think that allows music therapists the flexibility to use music in a way that is most suitable to each client. I agree that it is both an in and as situation, and it is important that professionals not limit themselves to one or the other. I understand that it may be frustrating when people who know little about it try to stereotype the profession as one or the other,
but the fact that it is flexible is what makes it so beneficial to so many different populations!

JoAnn Jordan March 8, 2012 at 8:18 pm

You hit the nail on the head at least for me and how I function in my work. That said, I think it is an area for continued conversation and reflection. I have a feeling context is key.

Antoinette Morrison March 11, 2012 at 12:46 pm

I agree with everything you said and use both myself. I think the most satisfying for me personally is when I get to use music “as” therapy.

Marlys Woods April 29, 2017 at 9:30 pm

Hello! Wonderful blog. Very clear definitions of Music-in verse Music-as. I use both in my practice.
I wonder if you could help me. I am attempting to create my own facts sheet and would love input. I’d like to have more solid information to bring to the table with contracting sites on the question of the differences and benefits of a Music therapist providing music therapy verse “Psychologists, OTs, PTs, social workers, speech-language pathologists all can, and many do, use music in their work”
Thanks in advance!

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