Healing with Sound: On Music Therapy

Emily Lehr is a board-certified music therapist (MT-BC) and Communications Secretary of the West Virginia Music Therapy Association. She provides clinical music therapy services to the WVU Cancer Center in Morgantown, WV. Emily has a background in medical music therapy and psychiatric music therapy and is an advocate for music therapy in the state of West Virginia and beyond.

Per the American Music Therapy Association (AMTA), music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. Music therapy must be facilitated by a board-certified music therapist who has completed a bachelor’s degree or higher in music therapy from an AMTA approved college or university, completed 1200 hours of clinical training, and been issued certification by the Certification Board for Music Therapists (CBMT). For more information, visit musictherapy.org.

The purpose of this article is to advocate for the clinical practice of music therapy and to provide information on how to get connected to services. If you are interested in receiving music therapy services, visit cbmt.org or musictherapy.org to find a board-certified clinician.

Music therapy is the clinical application of the musical elements for the purpose of helping clients and patients reach health-related goals. It is an evidence-based allied health profession facilitated by board-certified music therapists, regulated by the Certification Board for Music Therapists, in which clinicians provide services to clients across all settings and treatment goals. It originated in the 1940s as a response to the need to treat WWII veterans. As a board-certified music therapist (MT-BC), I have worked in a variety of settings, primarily treating people in psychiatric settings and medical environments. I utilize a humanistic, or client-centered, approach to music therapy practice. This means that I encourage my clients to have an active and directive role in their treatment, and I hold the therapeutic relationship between clinician and client as a primary catalyst for growth and change. Music therapists work with four main intervention types: re-creative, receptive, improvisational, and compositional.

Many people are not aware of music therapy as a certified healthcare profession. Because of this, there are several misconceptions about what music therapy is. Two of the most common music therapy myths that I hear are:

• Myth: You have to be musical to engage in music therapy.

  
  

Fact: Anyone can engage in music therapy, regardless of musical skill or experience. The foundation of music therapy relies on the inherent ability to engage in musicking of all individuals and on research findings from the field of music neuroscience, which supports the capacity of music to promote change and growth in the brain.

• Myth: Any talented musician can be a music therapist.

  
  

Fact: Music therapists must be board-certified by the Certification Board for Music Therapists. The board-certification process requires a bachelor’s degree or higher in music therapy, 1200 hours of clinical training, and completing the board certification exam. While a musician playing music may provide a positive auditory stimulus to a space or positively impact listeners, this is not music therapy.

Let’s break this down a bit further with an example. There is a difference between songwriting as a therapeutic intervention vs. songwriting as a personal vehicle for emotional expression and creativity. I am a songwriter outside of my clinical practice. Songwriting is a craft that brings me much fulfillment and catharsis. Creative expression can be very healing! But it does not include the same process, intention, and containment that a music therapy session with songwriting as an intervention does.

When I write songs within my own creative process, I am not assessing or treatment planning. I don’t necessarily have a goal I am trying to reach! I am also engaging in the process by myself or with friends. There is no clinician or therapist present to provide containment for the musical process or the emotional expression. There is no outside stimulus or catalyst for therapeutic change. Both types of songwriting have their value and purpose, and they may even lead to similar results, but they are not the same.

Therapeutic songwriting facilitated by a board-certified music therapist, like any form of music therapy, follows a treatment process. The typical stages of music therapy treatment include:

1. Assessment

2. Treatment Planning

3. Active Intervention

4. Evaluation/Termination

Songwriting in music therapy can take many forms. I often utilize a fill-in-the-blank, or “MadLibs,” structure when I facilitate therapeutic songwriting. For example, I have frequently used “Both Sides Now” for songwriting interventions in my work as a psychiatric music therapist and as an oncology music therapist. This is the template I use:

I’ve looked at ___ from both sides now

From ___ and ___

And still somehow

It’s ___ illusions I recall

I really do/ don’t know ___ at all

I then encourage my patients to fill in the blanks. Perhaps they will choose to write about their diagnosis, their hospitalization, a relationship, self-care, or something entirely different. This format of songwriting, along with my presence as the clinician to guide the writing process as necessary, allows space for the patient to process significant life change.

It’s important to note that other clinicians practice differently from me. There is no one size fits all to music therapy — or any therapy, in my opinion. Just like it’s important to find the right clinical therapist for your talk therapy journey, it’s important to find a music therapist who will be a good fit for you. Everyone practices differently, so there are a variety of options depending on where you are located. If you are interested in exploring music therapy as a client, you can visit CBMT’s Certification Directory:: to locate a music therapist in your area.