Music Therapy: A Typical Therapeutic Setting

In modern therapeutic settings, music activities are usually confined to achieve several benefits. Composing songs to express emotion, playing the piano to improve fine motor skills, use of instruments to improvise unspoken emotions, improving movement activities in patients, building up communication with the mentally retarded etc. fall under this category. 

In the American hospital setting, a music therapist adapts to the needs of several patients. Sometimes therapists visit the patients one after the other – often accompanied by a trolley, equipped with musical instruments, song books, recorded music and whatnot. A therapist travels from room to room, conducting sessions varying from say, 15-60 minutes in length, depending on the patient’s response and convenience. During such visits, patients are assessed for their musical preference. The session may include singing, playing drums and other simple rhythm instruments, learning to play the guitar or keyboard, listening to live vocal or instrumental music performed by a therapist, engaging in relaxation exercises with background music, composing original songs etc. Participation of the attendants from family or visitors is also encouraged for greater involvement of the patients. The session may thus, consist of only the therapist providing music or of both therapist and patient engaged in creating music together.

We know that music therapy sessions can be conducted either in a group setting or one-on-one set-ting (tete a tete). 

The length of the sessions can however, vary, though they are usually 30 to 60 minutes in length and in a frequency (one to five times per week).

A typical music therapy session in the USA at times begins with what is called a “hi song”, a bright and familiar melody which also ends with a summary “bye” song. All session interventions are tailor-made to address individual goals and therefore, are selected to meet the needs of the patient/client. Mu-sic therapy treatment sessions may include one or more of the follow-ing types of music interventions as may be prescribed by a therapist:

  • Movement to music
  • Music games/social interaction activities
  • Song-writing activities
  • Lyric analysis/discussion 
  • Singing and/or vocal improvisations
  • Playing instruments and/or instrumental improvisations
  • Music and relaxation activities
  • Music and guided imagery activities
  • Music performances
  • Drum circles 

Most common music therapy activities include: creating (improvising or writing lyrics for original pieces of music) guided imagery / relaxation exercises, listening (both live and recorded), moving, playing musical instruments, singing and vibrotactile experiences. 

It may be borne in mind that a single typical music therapy session is not workable as music therapists need to design sessions and select music specifically suited to an individual patient’s treatment plan. In a hospital ward setting, a music therapist has to follow the needs of several patients seen in sequence, say on a single floor. Normally a music therapist has to travel from one room to another with a cart loaded with musical instruments, song books and recorded music., conducting sessions varying between 15-60-minute duration. Before starting a session, the therapist assesses the patient and only after discussing his or her musical preference, he starts playing music.

A session may involve only the therapist providing music or some-times both the therapist and the patient/client. At times, even family members of the patient and the caregivers can be included to make the session livelier and more informal for the patient/client. 

The supportive activity-oriented music therapy of Wheeler involves: Group singing, playing instruments or musical games – design the activity to promote healthy behaviour and foster participation

  • For clients who are disoriented, withdrawn or anxious
  • For improved social interaction and awareness of others
  • Maintenance of reality orientation
  • Diversion from obsessions
  • Successful involvement in a group activity
  • Impulsive behaviour control
  • Healthy use of leisure time 

In catharsis-oriented music therapy sessions, music activities are used to primarily overcome the subconscious conflicts and traumas within. It is also a means for self-expression for otherwise suppressed feelings, thoughts and memories which can be painful. It is interesting to note that such group therapy sessions aimed at overcoming the bottled-up emotions work wonders within the group. It is found that these interactions promote enhanced social interaction within the group.

Indian music appears quite promising in this direction. As various ragas reflect different emotions / nuances of emotions, they are capable of inducing mood change in the desired direction. Through a selected raga the client can experience emotions. By identifying emotions and expressing them appropriately, one could easily perceive the emotions of others too. This helps in modulating one’s own emotional experiences.

In the late 1980s Thomas M. McKenna constructed melodies consisting of different contours using the same five tones and then recorded the responses of single neurons in the auditory cortices of cats. It was found that cell responses (the number of discharges) varied with the contour. Responses depend on the location of a given tone within a melody; cells may fire more vigorously when that tone is preceded by other tones rather than when it is the first. Moreover, cells react differently to the same tone when it is part of an ascending contour (low to high tones) than when it is part of a descending or more complex one. These findings show that the pattern of a melody matters: processing in the auditory system is not like the simple relaying of sound in a telephone or stereo system.

This article was published in Ayurveda for All – September 2009 – Page 18, 19

Edited by Geeta Shreedar, July 28, 2021