One word in this definition is changed from the first edition: “to achieve health” has been substituted with “to promote health.” This change reflects an important change in the author’s ideas about ‘heath’: he dismisses the ‘pathogenic’ point of view, from which health is an either-or state; now he advocates a ‘salutogenic’ (or ‘holonomic’) understanding of health as a continuum – inspired by the work of A. Antonovsky and K. Wilber. This important shift and its implications for music therapy are discussed in chapter 10. The result is a new definition (p. 84): Health is the process of becoming one’s fullest potential for individual and ecological wholeness. And the perspective is music (therapy) as a factor connected to our ‘quality of living’ (cf. the works of Even Ruud and David Aldridge). ‘Ecology’ and ‘Wholeness’ are important new concepts not only in this context. Bruscia has even identified a new “Ecological’ area of music therapy practice (discussed in chapter 23).
.....Another very important theoretical novelty is chapter 13: Bruscia has made the client’s ‘musical experience’ the core of his theoretical discourse – instead of just ‘music’. Music is really in the foreground of this new ‘score’, and this may not be very surprising to those who know Bruscia’s unremitting work as a major contributor to the development of an indigenous music therapy theory – always trying to connect the specific musical dimension of music (therapy) with the dynamic (interior/exterior & individual/collective) world of the client.
.....Bruscia offers the following definition of music – and I will italicize the four ‘main methods’ of music therapy identified by the author:

Do I need to say that all elements in this definition are discussed in detail in the text?
.....To this reader the most important part of the book is the middle section (Chapters 13-15), presenting a general theory of musical experiences found in clinical work, condensed into (a figure of) Six dynamic models of music therapy (p. 133): Subjective/Objective/Collective/Universal/Aesthetic/Transpersonal Music experiences. Bruscia’s basic idea is that ‘the client music interaction lies at the very core of music therapy, shaping the dynamics of all other relationships” (p. 131). This may seem self-evident, but it is not. One of the implications is – as I understand it – that the client’s perspective (the specific qualities of her music experience) must always be the ultimate guide of the therapist – not the theoretical framework of the therapist/institution or ‘objective properties of music’. Fortunately the field of client experiences is (almost?) unlimited!
.....The book is clear and systematic – very systematic; and we know that not all music therapists like that. In his forward Bruscia gives a lively and precise description of how readers dis/liked the first edition. It was not so much a question of theoretical orientation, more of how the reader dis/liked the way the book “put into boxes the many magical things we do as music therapists” (p. ix).
.....Let me give just one example of how Bruscia deals with an area of confusion – and develops his constructs (often ‘definitions’ – or ‘boxed’!): There is often great confusion about what is ‘methods, models, techniques’ etc. within music therapy theory and practice. In chapter 13 Bruscia suggests a careful and precise way of defining these important and interrelated terms, and the quote also illustrates the importance given to the client’s experience: “A method is particular type of music experience that the client engages in for therapeutic purposes: a variation is the particular way in which that music experience is designed; a procedure is everything that the therapist has to do to engage the client in that experience; a technique is one step within any procedure that a therapist uses to shape the client’s immediate experience; and a model is a systematic and unique approach to method, procedure and technique based on certain principles” (p. 115).
.....Personally I admire and enjoy Bruscia’s overview and systematic sense. No aspects of current music therapy practices and theoretical concepts are left out, and – most important – Bruscia makes it clear that he is presenting his own constructs, not ‘the final truth’. We are reading a systematic and comprehensive, but not a dogmatic text. This is also apparent in the last big section of the book (chapter 17-23). Here the author defines ‘Areas and Levels of practice’. In the first edition there were eleven, now there are six main areas: Didactic, Medical, Healing, Psychotherapeutic, Recreational and Ecological. The four levels of practice are the same: Auxiliary, Augmentative, Intensive, and Primary.
.....There is a chapter for each area – with subdivisions according to the four levels. I find this part of the book even more helpful that it was in the first edition, also because of the many updated references to examples in the literature (the reference list is over 20 pages!). I like the way Bruscia avoids name-dropping, both in his overview of practices and models. Pioneers and their work are acknowledged, of course, but the author is essentially looking for systematic similarities and differences, independent of personal merits or idiosyncrasies. This is what I think the development of music therapy (theory) needs on the threshold of a new century.
.....The ‘Coda’ of the book are chapters on implications for training and professional associations; the three chapters on research and music therapy theory will be well known to readers of Bruscia’s contributions to B. Wheeler (Ed., 1995) Music Therapy Research, from which they are adapted.
.....In his forward Bruscia mentions, how often he has heard lay people ask the question, “But what is music therapy??” and how often applicants at music therapy training entrance tests talk about their split motivation: “Well, I have always loved music, and I have always loved psychology, and I would really like to have a job where I can help others; and so when I discovered…etc.” (p. x). I think most educators and practicing music therapists will recognize this! The book outlines the dilemmas and polarities inherent in these initial questions and statements. However it is not written for lay people. It is addressed to music therapy students and to music therapists interested in a systematic overview of their discipline and profession. The new edition gives not only a stunning overview of relevant questions – but also surprisingly many answers and inspiring constructs! It should be included in the curriculum of every Music Therapy training program in the world. After reading it you may even be able to give a qualified answer the ever-returning question…