Music therapists encounter a wide variety of potentially vexing misperceptions, misunderstandings, assumptions, and stereotypes about their work. As a result, many of them quickly learn how to dialogue with uninformed or misinformed members of the public in tolerant, patient, diplomatic ways, in the interest of advancing the music therapy profession.
One phenomenon of this sort (at least in the United States) is the common use of the misnomer, musical therapy. Speaking on my own behalf, particularly during my earlier years as a music therapist in the 1990’s, I recall having some rather strong, defensive reactions to the occurrence of this term, as if it indicated some sort of deliberate expression of belittlement, denigration, or deep insult, directed at me and my profession. At very least, it seemed to convey ignorance regarding the field in which I had invested myself so deeply. In spite of what was (admittedly) an irrational overreaction on my part, I still managed to maintain a calm and professional demeanor, while inwardly hearing a semi-poetic string of Brooklyn style expletives.
Apparently, many of my colleagues were having similar reactions. I found myself joining in with the inside joking and "folklore" surrounding the misnomer. Commiserating at professional conferences, we would construct our own imaginative ideas about what the term musical therapy actually signified (e.g., the image of a room in which three very anxious psychoanalysis clients march around two couches, while a bearded Viennese man plays an excerpt of "Pop Goes the Weasel," of indeterminate length, on an old-fashioned phonograph).
Over the years, I have been afforded many opportunities to help educate the public about music therapy—not only thanks to "musical therapy," of course. Such opportunities have motivated me to become as concise and articulate as possible in my ways of describing the nature of music therapy, and to do so in a manner sensitive to the particular audience I would be addressing. Of greatest importance to me in offering these descriptions was to cultivate and refine my own understanding of the core, indigenous features of music therapy, so I would be able to share with clarity that which distinguishes music therapy as unique among other health fields.
But what precisely is indigenous to music therapy, and just what can be distinguished as uniquely characterizing the music therapy discipline and the music therapist’s expertise?
In pursuing this very question over my years of studying and practicing music therapy, I have found myself consistently drawn toward perspectives on the discipline with an emphasis on the central role of music as a common core—not only as just one among many possible means that may be employed in technical ways to address conventional health domains—but as a guiding principle, pervading the entirety of the work and its purpose, informing and driving both the form and function of the discipline as a whole. In each of these views is some way of construing music therapy through an artistic lens, in which the value of the work and its goals are weighed according to such criteria as experiential depth, narrative coherence, personal meaningfulness, and expressive beauty.
From these perspectives, the work is understood as musical, involving client and therapist in clinical-musical relationship with one another. The musicality here can be based in actual sound expressions of music, and/or other aesthetic ways of being-together-in-time, analogous to musical sound forms (i.e., the musical ways in which a client and therapist breathe or move together, the musical contours and forms of verbal conversation, the musical ways in which a single session or whole therapeutic process unfolds, etc.). In this way of understanding the work, the music therapist’s musicianship and general artistic sensibilities extend themselves to all corners of the therapy.
Likewise, from these perspectives, the goals are understood as musical, in that music can be viewed as an expression of health itself. Achieving new ways of being in more broadly and deeply musical ways relate to other domains (i.e., the depth, coherence, meaningfulness, and beauty expressed in aesthetically integrated movement, speech, thought, feeling, communication, etc.). In the simple act of expanding one’s capacities for musical experience and play in particular ways, beyond one’s previous limits to these capacities, one has shifted something fundamental about one’s being, relevant to numerous other domains of health and the bases for the initial music therapy referral (or self-referral). Yet, at the same time, there is something in music that transcends those other domains. Just as any health domain cannot ultimately be reduced completely to any of the others, music as a health domain holds its own intrinsic legitimacy and meaningfulness as health, independently of what it signifies with respect to other domains—and it addresses dimensions of a person not necessarily articulated by the referring discipline. This concept is particularly fascinating to me, as it suggests that working on one’s music can mean something very different from engaging in music education to learn music as a skill (perhaps roughly analogous to the differences between physical therapy and physical education).
For me, contextualizing both the work and goals of the discipline musically is one viable way of identifying music therapy’s indigenous features, and of distinguishing it as fundamentally unique among the greater health care community. While other disciplines may (and do) use music, their practice does not necessarily require the competence to do so musically, nor to promote a clinical-musical relationship in the service of music-based health goals. I believe this unique characterization is not limited only to music therapy models that are self-identified as "music centered." Any true model of music therapy is informed by the music therapist’s unique set of competencies—and, in theory, it can involve some form of clinical-musical relationship, and target outcomes that can be understood musically, in some way.
If one grants that being musical is at least one legitimate way of describing the essential, distinguishing features of both the work and outcomes of music therapy, then perhaps the term "musical therapy" is really not such a horrible misnomer after all. In fact, it may even carry some helpful implications about how music therapists view their own field. Perhaps, by identifying the field uniquely by its musical core, the music therapy professional community can more readily understand its purpose as an independently valid discipline, beyond what I have often witnessed to be an adjunctive or subservient role with respect to other disciplines. By the same token, perhaps emphasizing the unique areas addressed by music therapy would help avert the often perceived competitive dynamic ("turf threat") sometimes encountered in relation to other health professions, and help render unnecessary the need to justify the value of music therapy according to how it does what other professions do, but better (as is sometimes suggested by the manner in which research and evidence about music therapy are framed and presented). Perhaps, most importantly, identifying the field in this way may encourage more music therapists to live, in their work, the very principles that attracted many (if not all) of them to the field in the first place—a love for music, and a sense that being in aesthetic ways relates to (or is) health.
So, whenever I encounter the term "musical therapy" these days, I still offer the standard, respectful correction. Yet now I also use the opportunity to share just a bit about what I believe to be at least one important way of understanding the uniqueness of music therapy. Also, in place of inward cringing and silent expletives, I now enjoy a deepened appreciation for the virtues of understanding the essential core my chosen field musically.
Abrams, Brian (2010). Musical Therapy?. Voices: A World Forum for Music Therapy. Retrieved May 17, 2013, from http://testvoices.uib.no/?q=colabrams050410