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Social work as a profession and discipline has adopted various psychological therapeutic interventions throughout its history. One of such interventions is music therapy which is aimed at helping people in a sensitive way accurately adjusting the possibilities this therapy may offer to the requirements of a particular client of a group of clients. Music as a method of treatment has been used for several centuries and exists as a discipline for approximately seventy years (Wheeler, 2015).
Since ancient times, people have been using music for healing and ensured the power of music to be a source of positive influence to make a change. Reflecting the cultural background and the views of particular nations on music and its conceptualization, music therapy grew as one of the most frequently and effectively applied interventions.
In the 19-20th century, it developed into a distinct academic discipline. The earliest publications were made by Edwin Atlee and Samuel Mathews in the first decade of the 19th century (American Music Therapy Association, 2019). In the 1950s, the National Association for Music Therapy was organized in the United States which gave a start to multiple similar institutions not only in the USA but also around the world.
In the US, music therapy emerged as a part of the recreational movement, which included other kinds of arts used for treatment interventions (Kelly & Doherty, 2017). Thus, the factors that influenced the development of music therapy are related to the historical, religious, and overall cultural background on the earlier stages of its advancement, as well as the belief that recreational activities have a prospective positive influence on both, mental and physical health of a person.
Music therapy is based on several theories of human behavior. They include behaviorism and social learning theory, and psychodynamic theory (“Overview of theories of human behavior & the social environment,” 2008). Within the psychodynamic theory, a person’s problem is viewed from the perspective suggesting that the cause of the issue “lies within an individual” and might be eliminated through a change in a personality by overcoming the defensive obstacles (Maguire, 2002, p. 45).
Another theory, behaviorism and social learning, concentrates on how people “develop cognitive functioning” and learn with the help of the environment they are in (“Overview of theories of human behavior & the social environment,” 2008, p. 2). This theory applies to behavioral and symptomatic change and provides a broad range of interventions. Music therapy ground on these theories and enables taking into account the environment and the level of psychological development to find an individual approach to each client and ensure his or her efficient recovery.
Music therapy has acquired a wide range of principles and concepts throughout its history. According to the American Music Therapy Association (2019), 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” (para.1).
This intervention provides opportunities for a therapist to resolve different physical, emotional, social, or cognitive issues by initiating listening to, creating, or dancing to music. The main principle of this intervention is that it focuses on helping clients “to develop skills, adapt behavior, and overcome obstacles” (Wheeler, 2015, p. 5). The clinical goals are achieved with the help of restructuring human behavior, provoking emotions and reactions, as well as establishing an opportunity for a person to express him- or herself through music. According to Rolvsjord and Stige (2015), the concept of context is crucial when carrying out music interventions.
A qualified therapist should incorporate the data about the social, environmental, historical, and cultural context the therapy is applied in to reach the highest level of efficacy when introducing an individualized approach to clinical treatment.
The main music therapy strategies involve some specific approaches to the organization of work with diverse patients to succeed in their recovery. Since there exist a broad array of interventions and issues where music therapy applies, there might be many variants of strategies’ utilization. The primary action is determining the therapeutic effect which might be gained with the help of such methods as receptive activity, composition, improvisation, and performance (Wheeler, 2015).
Another strategy is the application of musical improvisation to facilitate the expression of emotions and enhance awareness about them (Lee et al., 2018). A music therapist might introduce diverse interventions for both, individual and group sessions, thus enforcing bonding with the patients and improving the clinical context for the comfort of the clients.
This intervention is considered to be an evidence-based one, as it follows from the definition presented by the American Music Therapy Association (2019). Evidence-based practice requires constant updating of the theoretical and practical data serving as a basis for the interventions following the latest findings and literature publications (Wheeler, 2015). Since music therapy is a multidisciplinary area of work, it needs to be performed in agreement with the principles of other disciplines to deliver the anticipated results. Within this area, a social worker needs to be aware of the latest findings of the application of music therapy in many psychiatric and medical fields, the outcomes and positive implications.
The analysis of academic literature provides an opportunity to characterize music therapy as a multifaceted discipline capable of being applied to various health problems (mental and physical) to reach clinical goals. The collected evidence underline the positive outcomes music has provided for physical rehabilitation, Parkinson’s disease, dementia, autism spectrum conditions, depression, substance abuse disorders, and many others (Greenberg, Rentfrow, & Baron-Cohen, 2015; Hohmann, Bradt, Stegemann, & Koelsch, 2017; Ragilo, 2015; Wheeler, 2015). These types of problems might be addressed in different client groups.
The specific populations with which music interventions work well include people of different age and with various health issues. According to Porter et al. (2017), some positive effects were found upon the application of music-related procedures for children and adolescents experiencing behavioral and emotional problems. At the same time, this approach showed significant results for seniors with depressive disorders, as well as groups of patients going through rehabilitation after a physical injury (Wheeler, 2015).
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Another population that music therapy works well with is people suffering from substance use disorders (Hohhman et al., 2017). Therefore, music-oriented procedures are adequate for minors, adolescents, adults, and seniors who experience a range of health issues from anxiety and depression to substance use and autism.
The music-related interventions are universal and address multiple clinical issues but do not embrace every client group subject to therapy. For example, music therapy will not provide any effect for the deaf or people with significant auditory sense disorders. Also, according to Wheeler (2015), the implementation of music in therapy for the end-of-life clients did not show sufficient evidence proving the ability of the intervention to reduce anxiety and suffering in this population.
The same insufficient results were achieved for mechanical ventilation and coronary heart disease patients (Wheeler, 2015). Thus, there are specific groups of patients with whom music-related therapeutic procedures do not work well. However, the significantly large number of issues where this therapy is effectively applied validates its inclusiveness and potency.
As mentioned earlier, music therapy is closely intertwined with the cultural background of a person under treatment. The very nature of music as a type of art that emerges on the background of some national beliefs and traditions imposes a great cultural sensitivity of this method. However, it is vital for a therapist to adhere to some rules and ethical norms to ensure cultural competence. When introducing music-related interventions for a client, it is important to obtain “cultural empathy, openness, and a nonjudgmental attitude” (Wheeler, 2015, p. 61).
For example, it would be applicable to incorporate traditional songs and melodies in the therapy with First Nations peoples. Also, the professional utilization of music specific for the ethnicity of a particular client will enhance the therapeutic effect of the procedure. Apart from ethnic groups, music therapy allows for the treatment of disorders in LGBT patients. Despite its potential in application to sexual minorities’ therapy, a multicultural competence in music interventions is difficult to achieve due to the complex history in work with this population.
According to Bain, Grzanka, Crowe (2016), the modern LGBT therapy lacks tolerance and is mostly heterosexually oriented. Thus, it is important to incorporate “diverse sexual orientation and gender identity issues into an existing disciplinary framework that has been historically hostile towards non-normative sexualities and genders” (Bain et al., 2016, p. 22). Since LGBT youth struggles with prejudice in the society, as well as in clinic environment, it is vital to develop a culturally sensitive therapy capable of resolving the issues of sexual minorities with the help of music.
Regarding the above-mentioned issues concerning cultural competence in music therapy, it is relevant to introduce specific ways to improve the interventions for the benefit of all client groups. According to National Association of Social Workers (2015), a culturally competent social worker has to foster self-awareness about the cultural background of his or her own and apply the same respectful attitude to others, especially those in therapy.
To succeed at this, a music therapist should not only possess a significant level of expertise in the psychological area but be a professional musician, who has a good command of culture knowledge (Wheeler, 2015). Therapists should improve their understanding of cultural groups that they serve, “identify the limitations and strengths of contemporary theories and practice models,” and demonstrate cultural empathy (National Association of Social Workers, 2015, p. 28). It has to take time and effort to implement these considerations in practice.
In conclusion, a significant number of research studies on music therapy suggests its many strengths. This intervention applies to children, teenagers, adults, and the elderly experiencing depression, physical rehabilitation, behavioral and cognitive disorders, Parkinson’s disease, autism, and substance use. It is also effective in cultural context due to the nature of music as a characteristic of ethnic arts. However, there are some limitations to this therapy because it does not provide sufficient results in end-of-life care, the deaf, and LGBT clients.
The research of this intervention has increased the level of professional knowledge about the possible application of music in therapy. It is evident that there is a scope of literature devoted to procedures for diverse groups of clients. Thus, a therapist’s practice might benefit from the utilization of existing studies. At the same time, the detected gaps in research allow for further investigation of some areas of music interventions application, including the LGBT population and the issues specific for particular ethnic groups.
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Greenberg, D. M., Rentfrow, P. J., & Baron-Cohen. S. (2015). Musical experience through the empathizing–systemizing (E-S) Theory: Implications for autism. Empirical Musicology Review, 10(1), 80-95.
Hohmann, L., Bradt, J., Stegemann, T., & Koelsch, S. (2017). Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review. PLoS ONE 12(11): e0187363.
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