Hi all, this is a throw-back-Sunday blog entry! This entry, written by Dr. Brian Abrams, was originally posted on 2/2/12. Based on the dialogue the developed as a result of my previous blog entry, I feel that this entry is a perfect continuation regarding the topic of “working-in” and “using” music. 

Ways of Thinking Musically in Music Therapy

In November 2011, at the annual conference of the American Music Therapy Association in Atlanta, Georgia, Dr. Kenneth Bruscia, the William W. Sears Distinguished Lecture Series Speaker, delivered an outstanding lecture entitled “Ways of Thinking in Music Therapy,” in which he examined different perspectives on understanding the practices and purposes of music therapy.

Dr. Bruscia, who was the most central mentor in the development of my professional identity as a music therapist, has always inspired others to think deeply about themselves and their work. For me, his guidance always prompted the question: What makes the work of a music therapist special and unique? Or, in other words: What differentiates it from other disciplines and professional practices? … or … How can we “locate” it, conceptually, as a specific construct? This was more than a mere intellectual exercise–it held a certain sense of urgency (at least for me) in understanding and advocating for the non-replicable value of music therapy in serving clients and the public via our modality.

For me, these questions were never adequately answered by considering the procedural components of music therapy alone, as popularly described. For example, it was not merely the use of music in a health promotion process that defined the distinctive essence of music therapy for me. Other health care professionals could certainly utilize music in their work, as part of facilitating various therapeutic outcomes–and yet they are most definitely not music therapists. Likewise, I had experienced music therapy sessions (both in the role of therapist, and as client) in which no conventional sound-forms of music were employed, and yet the work was most definitely music therapy! What could possibly make this so, even in the absence of musical sound? I have not found an answer to this question amidst the items included in the Certification Board for Music Therapists (CBMT) Scope of Practice. While the Scope of Practice itself is quite comprehensive, and most certainly is unique as an aggregate list, it is not immediately clear (to me) that any given item in that list is exclusive to the field of music therapy (even though that item may not appear in scopes of any other profession, with quite the same wording).

Just as procedural components did not resolve the elusiveness of music therapy, qualifications and credentials did not seem to help either. Completion of training in an approved academic program does not necessarily render everything one does “music therapy”…one needs to express one’s acquired expertise in the field, intentionally, and in a certain professional context, in order to be actually doing music therapy. What was the qualified music therapist doing at these times, to make the practice “music therapy”? While the knowledge, skills, and abilities specified in AMTA’s Professional Competencies are of paramount importance to the integrity of the music therapy field, the qualifications that allow the music therapist to do what she/he does is not the same as understanding what she/he is actually doing, when she/he is doing music therapy.

The more I sat with this, the more I realized that it was neither a set of procedures nor a set of qualifications; rather, it was a particular way of being, guided by a particular way of thinking, that ultimately distinguished music therapy on an essential level. While any healthcare profession has particular ways of construing health and health-promoting processes, only in music therapy are these intentionally construed musically. Only a music therapist is fully equipped to understand the health implications of being-with others via musical, dynamic forms in time–even in the absence of conventional, musical sound. Thus, it is not a question of whether or not musical sound is used within a therapy session–it is a question of how the music therapist’s unique ways of thinking can guide ways of being-with clients in uniquely, clinically indicated, musical ways, all in the service of promoting the client’s musical health.

The music therapist’s unique sensibilities for thinking musically about health and health promotion are cultivated through years of rigorous studies in music, as well as “immersion” in mentored, supervised training environments. Such an “immersion” cannot be replicated via intellectual understanding alone, nor via some sort of analogous training format in another field, as these cannot afford one the capacity to construe either the clinical work (processes) or the outcomes (goals) of that work, musically–at least, not in quite the same ways, and not to the same degrees of competent breadth and depth, as are afforded music therapists.

As music therapists, shouldn’t we manifest these indigenous sensibilities to their full extent, including the ways in which we communicate the nature of the work to others, the ways in which we conceptualize clinical goals, and so forth? Is it really such a stretch that we write motor skills goals, cognitive skills goals, emotional development goals, interpersonal communication goals, etc., in musical terms (e.g., flow, form, phrase, timbre, volume, contour, tempo, meter, accent/articulation, syncopation, range, melody, harmony, iconicity, etc.)? Must we specify that clinical music therapy goals are “non-musical,” simply to differentiate ourselves from the field of music education?

But this is not just about establishing an indigenous music therapy language, or about any other specific set of procedures–it is about the unique ways of thinking that guide us about our formulation of therapeutic processes and goals themselves. To me, our first order of business is to reconcile our own true, unique expertise with the work we do on a daily basis in the “real world.” Once we experience this sense of internal congruence, we manifest our greatest potentials as helpers, and feel most grounded about what we do (and, most likely, are less likely to experience burn out). It is my belief that a greater capacity for articulating and advocating, in diplomatic and accessible ways, would follow quite naturally, and others would come to understand and respect the profession of music therapy in ways we have not yet witnessed. In my opinion, many of us have long strived to do this in a backward fashion–that is, first to seek acceptance by other disciplines and paradigms, and then attempt to understand what we do in terms of those disciplines and paradigms. While there are many theories explaining our field’s struggles with identity, and with our music therapy professional population’s “ceiling”–at least in the USA (somewhere in the neighborhood of 5000 MTs nation-wide for many years), I submit that obstacles, constraints, and our own resistance to embracing musical ways of thinking in our work is at least ONE significant factor in the equation of our field’s development.

Please share any thoughts (musical or not!) in response to what I’ve shared here. I genuinely appreciate any feedback and/or dialogue others care to offer on this topic.

Musically yours,