INSIDE MUSIC THERAPY: CLIENT EXPERIENCES.
J. Hibben (Ed.)
Reviewed by Robin Howat, RMT
(Coordinator of the
Graduate Diploma in
Creative Music Therapy,
University of Western Sydney)
The Australian Journal of Music Therapy (2000), 11 (1), 56-59
Reprinted with permission of the AJMT

For music therapists, qualitative and phenomenological research methodologies have come to prominence in the last twenty years to stand alongside existing quantitative approaches. Clinicians are asking ‘how do clients find meaning in their music therapy experience?’ Phenomenology seeks to understand the meaning of music therapy from the client’s point of view, and therein is the challenge: ‘how can we assess meaning – how can we gain an insight into the thoughts, experiences and feelings of the clients in therapy?’ Questions of meaning and the interpretation of meaning have been reflected in recent literature, e.g. Pavlicevic (1997).
.....The editor of this new book “inside Music Therapy” notes that “therapists typically write from the perspective of their own theories and techniques” (preface, p. xix). The book there fore aims to address this imbalance. It presents the therapy experience of the clients directly, or as directly as possible. Theory and technical descriptions about therapy are kept to a minimum which makes “Inside Music Therapy” very accessible to musicians (and many non-musicians I would think) who are interested in learning about music therapy as well as to music therapists who want to deepen their understanding of therapy and the role of music in therapy.
.....Every client has a story to tell – if only we can find the way to discover it and tell it. “Inside Music Therapy” comprises the narratives of 33 clients. The narratives are helpfully placed into 5 categories. More than one third of the narratives describe improvisation as the primary music experience and ten are based in the work of Guided Imagery and Music (GIM). There is a list of the music therapy contributors and the stories come from therapists working in Australia, Canada, Great Britain, Israel, Italy, Japan, The Netherlands, Norway and the U.S.A. The type of music making in the session can be summarized briefly as: improvising, listening, re-creating and composing. The five categories are:

Part I: Clients Write About Their Experiences
.....“in these narratives, clients write about themselves, about what they experience in music therapy, and, in some cases, how music therapy affected their lives. At the beginning of their narratives, the therapists briefly introduce their stories. For four of the narratives, the authors are music therapists who write from their experiences as clients of music therapy.”
Seven out of the eight narratives involve GIM but each one illuminates a different facet of this rich and fascinating approach. “The music had all the elements that allowed me to break through (my) strongly erected barrier of control and pseudosafety” (p. 11) writes one GIM practitioner writing as a client. Another therapist-as-client signifies the vital importance of music therapy when she is diagnosed with cancer. “The music was very powerful in supporting and magnifying my emotions, helping me acknowledge them, express them and then find solutions for how to deal with them. I found I anticipated where the music would take me and could feel it drawing me to its core…” (p. 26).
.....Should all music therapists have music therapy as part of ongoing professional development? These narratives make a strong case for taking this idea seriously.

Part II: Clients Tell About Their Experiences in Their Own Words, Gathered by Their Therapists
.....“In these narratives, the words of clients about their music therapy experiences are gathered by their therapist in these ways: through interviewing, by transcribing client words from video- or audiotapes, or by jointly reviewing therapy sessions with the client. Some of the narratives contain examples of client music, lyrics, or poetry.”:
.....“Singing My Way Through It: Facing the Cancer; Darkness and Fear” by Maria Logis and Alan Turry; “The Quiet Soldier: Pain and Sickle-Cell Anemia” by Joanne Loewy, and “many Stories, Many Songs” by Diane Austin are just three of the nine narratives that are moving accounts of the pain filled world of some clients. “Family Day: An Interview With A Family” should be read by anyone involved in family therapy. Tai, 16 years old says: “I…think that music is a good way of kind of, like, hide…It’s more like just express yourself, you know, through music or whatever…It sneaks up on you, you know, ‘cause you’re [asked], “how do you feel singing that song?” And I’m like, [saying], “Ewww” or “I thought blah blah blah last week.” And it just comes out. It’s real comfortable thing…just like friends talking” (p. 82).
.....William, a businessman, working in GIM with Alison Short says something similar to Tai, but in his words: “I have had talking therapies…but it wasn’t – it never has been – a real natural way of communication. I know I have had to work at it, and coming to music therapy, that was something It rusted and that was what I think triggered the freedom. I was relaxed then” (p. 161).

Part III: Client Experiences Are Written About by Parents
.....“In these narratives parents write about the music therapy experiences of their children or adolescents. The parents are speaking for children who are unable to unavailable to write themselves. Their narratives present broad stories of the children’s lives and lifelong experiences with music.”
.....These certainly brought me to a renewed appreciation of music therapy from a parent’s perspective. The story of John (child on the autistic spectrum) is told by his mother and the therapist Amelia Oldfield. “I continue to enjoy the music therapy sessions with John very much” writes John’s mother.” I feel as though I am sharing something with him that he really enjoys, and that he very much wants me to be there with him. I like laughing with John and Amelia in the sessions and enjoy making a bit of a fool of myself…” (p. 171). “Three stories about Suzuki Piano Education” focuses on how one music therapist integrated the Suzuki music education process into her music therapy practice with significant and joyful outcomes for the three children.

Part IV: Client Experiences Are Inferred by Therapists Through Multiple Meanings
.....“In these narratives, the experiences of clients who do not have meaningful language or whose words are not available are presented by their therapists. The writers use more than one means or source to suggest the experience of their client(s): observation and description of behavior; testimony of spokespersons, such as co-therapists, observers, or parents; the client’s music; the therapist’s journals; and imaginative representations in soliloquy form of the client’s thoughts and feelings are inferred from long experience with the client and from a synthesis of the above sources. By these multiple means, the writers attempt to go beyond description of the client’s behavior to suggest what the client’s experience of music therapy might have been. In two narratives, joint writers combined their analyses to present the experience of the client.”
.....Each of these narratives is rich in meaning and each is beautifully articulated. This is the heart of the book for me, perhaps because most of my own clients are non-verbal…(though not all of these are by any means). We are introduced to Rose, a 90-year-old nursing home resident with schizophrenia and Alzheimer’s Disease; Marco, a 19 year old man with cancer; Tammy a severely multiply disabled girl; the children and adults in a pediatric nursing home… “Parallel Experiences” is different to the other narratives in that the therapist and her supervisor use the concept of parallel process to suggest that the client’s feelings about the therapy (the client is non-verbal) are parallel to the therapist’s concurrent feelings about her supervision. Do we as music therapists have a high enough regard for supervision in the light of this, I wonder?

Part V: Client Words About Experiences Are Gathered by Researchers
.....“In these three narratives qualitative researchers compile studies of client experiences of music therapy by presenting client words. The researchers organize the words to clarify the experiences… Two of the researchers present the verbatim words of their clients, then synthesize or distil the meaning contain in the words.”
.....Hank Smeijsters, Dorit Amir, and Denise Erdonmez Grocke are the contributors. The three clients in Amir’s contribution “Tales from the Therapy Room” each describe the discovery of creativity and freedom in the session: “being creative is just sitting down and really feeling certain things, certain feelings you get, and trying to write a song as good as possible, you know; that’s where creativity comes in” (p. 268). “Well, music therapy is really the concept of having the freedom to explore and play…and it’s usually the most spontaneous amazing things that come out” (p. 273).
.....This is an immensely compelling and approachable book – a milestone in the literature. The narratives are imbued with courage and hope often in the face of tragedy and everyday struggles, as the clients, therapists, sometimes families, work and struggle together to find the healing power in music. Every one of the 33 stories contributes something unique to the collection. The writing is very articulate overall and suggests that Julie Hibben has done an excellent editorial job. If the book has any unifying theme, it is perhaps that when music becomes therapy then people find a voice, a means to express – to articulate the inner life, inner processes, struggles, questions, uncertainties, confusion – but always there is the moving towards the light. “I feel that connecting with light was a beginning of having light to see by, to work on issues in myself” writes a client in GIM (p. 271). Every music therapist working with clients in whatever situation will draw inspiration and hope from this book.
.....There is much to inform and inspire clinical practice, supervision, research. There are many challenges as I hope I have indicated. Clearly the writing of the narratives has brought a new dimension to the therapy process for some clients and their therapists. “Entering the world of the professional writer enables the therapist to make use of techniques for therapeutic ends. Poetry, narrative, journal writing are a few of the techniques available” (Finlayson, p. 160). Perhaps may of us would be enriched through narrative writing…maybe some of our clients would welcome the opportunity too.
.....“Inside Music Therapy” is a tribute to the courage of clients, therapists, parents, families and researchers in their search for meaning both in the present and in what the future brings.

References

Finlayson, R. (1999) Music Therapy in Palliative Care, Chapter 11 “Writing and Therapy: Into a new Tongue” Jessica Kingsley Publishers
Pavlicevic, M. (1997) Music Therapy in Contest. Music, Meaning and Relationship. Jessica Kingsley Publishers.