Spinning and weaving are activities whose genesis is lost within History’s tangled strings, which were warped as responses to those needs that sprang from natural and cultural proddings. To perform such activities, animal or vegetal fibers are raveled and from these the threads are prepared that will grow into tissues of manifold textures, imprints, hangings, and thicknesses. [1]
Many are the threads that are supposed to be warped and woven towards the building up of a new career. Many are the hands necessary both to warp and to weave. Much time is needed so that a new career is ready to be created and to wax its identity strongly so that it achieves credibility across several segments of a society that blend together to contribute to the development and dignity of human beings.
The state of Rio de Janeiro, whose capital city bears the same name, lies in the southeastern area of Brazil, a section of the country which occupies 10.85% of Brazilian total territory and is also the most developed, more densely populated, and the richest part of the country. It was in the city of Rio de Janeiro that the threads of music therapy have been spun and woven ever since the 1950s, by the hands of music educators who first lent themselves to the employment of music within mental health hospitals, rehabilitation clinics, and special education facilities -- an activity that heralded the birth and exercising of music therapy clinical practice.
It may be said that here, not unlike the way it happened in almost every other country in the world, the first thread to be warped was that of clinical practice, followed by the need for the practitioners to organize themselves within an institution capable of giving them the necessary backing for the creation and strengthening of a still unextant identity or one that was faced mostly under the bias of musical education.
As a result of such a need the then-called Associação Brasileira de Musicoterapia [Brazilian Association for Music Therapy] or ABMT was founded in 1968 by a group of medical doctors from a great psychiatrical hospital sponsored by one of the biggest public universities in the country the Universidade Federal do Rio de Janeiro [Rio de Janeiro Federal University]. This is the event that highlights the “official” beginning of music therapy in the city of Rio de Janeiro and whose 40-year anniversary is to be celebrated in 2008.
Departing from this inception another thread grew, that of the professional capacity of music therapists. All the while music employment was being expanded and soon the need for the realization of qualifying people for this practice was unavoidable. From 1968 on, short-term courses began to be offered as a means to pave the road to the 1972 organization of the first undergraduate-level major on Music Therapy which was installed in the Conservatório Brasileiro de Música at the Centro Universitário of Rio de Janeiro, [Brazilian Conservatory of Music at Rio de Janeiro University Center] or CBM-CEU, the first college-level set of courses in this field to be offered in the country.[2] This major degree was acknowledged by the Ministério da Educação [Brazilian Ministry of Education] in 1978, therefore, in the present year we also celebrate its thirtieth recognition anniversary.
The clinical practice and creation of this college major showed the need for a new thread to be worked: that of theoretical development, necessary as a backing for actual practice. The organization of small courses by the former Brazilian Association for Music Therapy, now called Associação de Musicoterapia do Estado do Rio de Janeiro [Rio de Janeiro State Music Therapy Association] or AMT-RJ, almost always in constant partnership with CBM, was brought in to support such development.
However, many other strings and threads pitched in to promote the growth of music therapy. Among these can be named: courses given in Rio de Janeiro by foreign music therapists; access to international literature, books and journals; the translation of books written by foreign music therapists; the participation of Brazilian music therapists in scientific events both in Brazil and abroad; the publishing of papers and books by Brazilian authors and of articles by music therapists on Brazilian music therapy results in Brazilian and international journals; the setting up in Brazil of discussion forums on issues pertinent to theory, practice and professional formation as a way to add depth to the field; the broadening of the job market; and a rather noteworthy fact, to wit, the insertion of music therapy in the hospitals supported by the several corporations of the armed forces r the Army, the Air Force, and the Navy.
In the Hospital Central do Exército [Central Army Hospital],[3] music therapy service was created in 1983, with the initial goal of giving special care to psychiatric patients under internment in the Pavilhão Psiquiátrico [Psychiatric Ward], but soon extended to physical and/or sensorial disability patients attending the Clínica Neurológica [Neurological Clinic] and the Serviço de Reabilitação [Rehabilitation Service]. Then a day care patient service oriented to children bearing behavioral disorders and/or language deficiencies or learning disabilities was begun, followed up by care given to patients affected by cancer. A while later transdisciplinary care groups were created with the participation of a team of other professionals from different health areas. Since then, in-checked as well as day care adult patients began to be served. All the while support and orientation were provided to the relatives of all cared-for patients. Currently, activities oriented to hospital humanization are also being performed, with groups of musicians going in to musically visit those patients who are in medical or surgical wards as well as usually closed areas, like the Centro de Terapia Intensiva [Intensive Therapy Unit], the Unidade Coronariana [Coronarian Ward], and the Unidade Renal [Renal Ward] of that hospital. Workshops for the teaching of music are set up and also a choir group with the goal of promoting patient health by means of expressive and creative activities oriented both to the institution personnel and its patients, a project intended to further humanize the hospital environment and to broaden the patient/health worker integration.
As to the Air Force,[4] clinical music therapy was begun on 1985 at Casa Gerontológica [Gerontological Home], a long-term facility for the elderly.[5]
More recently, a music therapy project was added to the Unidade Integrada de Saúde Mental da Marinha [Navy Integrated Unit for Mental Health].[6]
In 1990, the city of Rio de Janeiro seated the VI Congresso Mundial de Musicoterapia [Sixth World Music Therapy Congress], an event that can be considered as a watershed for the development of music therapy in the state and therefore in Brazil. This event framed the main discussion issue as the diverse possibilities for the theoretical support for music therapy. The theories were placed on the discussion board by means of lectures presented by Brazilian and foreign guest lecturers who spoke about the several theoretical streams most accepted as its foundations.
In the congress, music therapists from twenty-six countries presented their clinical works on theory, professional training, and research subjects. The presence of these invitees advanced the achieving of a meeting among the members of the World Federation of Music Therapy, Inc. the only international organization exclusively devoted to the development and promoting of music therapy created in Genoa, Italy, on 1985. This meeting afforded a contribution to the development and growing organization of the World Federation.
The appearance of Internet increased the capacity for information exchange with the creation of a communication network, not only among music therapists from different cities and states within a continental-sized country like Brazil but also with practitioners from other countries, contributing to the growth of this field.
However, the last thread to be woven into the fabric and the hardest one to be inserted into the networked tissue is that of research. Lack of resources and financial backing renders greater the present-day hindrances in this area. Several music therapy associations already canvassed in 1995, into the União Brasileira de Associações de Musicoterapia [Brazilian Union of Music Therapy Associations] or UBAM, decided to set up a yearly meeting for doing research in the music therapy field with the specific goal of stimulating and furthering investigations within the field.[7] In addition, we can mention the presentation of research results in Seminars, Forums, Meetings and Symposia on Music Therapy that were organized along the road, all the while this very year we are getting ready for the VII Encontro de Pesquisa [Seventh Research Meeting] as an integrated part of the Fortieth Year celebrations.
The signing up of agreements established between CBM and several institutions contributes to the development of professional training and, consequently, to the growth of the field. One example is the Maternidade Escola [Maternity School] sponsored by the Rio de Janeiro Federal University where there is an ongoing music therapy project with pregnant women as well as with the mothers of premature babies, a research field pointing toward the music therapy contribution to stress the importance of maternal/child health care and the Instituto Nacional do Câncer [National Cancer Institute], a reference facility for oncological treatment, which shelters the Projeto Encanto de Musicoterapia [Charm in Music Therapy Project].[8]
We should further emphasize the importance of the creation of the music therapist function in the Quadro Permanente de Pessoal do Poder Executivo do Município [Permanent Personnel Cadre of Rio de Janeiro City Hall Executive Power] by means of the Municipal Bill #1,666/99.
The outbreak of some new diseases, like AIDS, for instance, leads to new developments in medical research, like more sophisticated techniques for illness diagnosis, to wit, scanning devices, all of which highlight the discoveries that boomed into the so-called Brain Decade; outcomes in Neuroscience show the real interest of the medical community in the study and unveiling of connective processes between musical reception and production and the physiological brain circuitry.
On the other hand, the growing violence in the big cities and the grouping together of people within large communities are also opening new trends which prod into the growth of music therapy employment, showing it the need for adequacy to the newer circumstances of the modern world, as well as of following the new market demands.
Recommendations of world public policies on the health areas also point toward preventive action and primary health. Music therapy, formerly included only among palliative treatments for dementia or terminal patients is now being opened to early intervention. This expands the field of action for music therapy, all the while the job market broadens for the area. Public contests are being opened for the hiring of music therapy professionals in the federal, state, and county levels. Nowadays music therapy is active in 14 cities in the state of Rio de Janeiro only. Many of these practitioners were hired after selection in public contests.
A Reforma Psiquiátrica [Psychiatrical Renewal] led to the creation of the so-called Centros de Atenção Psicossocial [Centers for Psycho-social Care], where music therapy practitioners were officially called into action on 2002 to perform in the mental health area as supporting aids to patients in psychic distress. There is a growing visibility on music therapists’ work which, inserted into interdisciplinary teams, affords effective contribution to the development of ongoing work inside such centers and also involves, through musical employment, not only the patients, but every health professional deployed to this job.
Still, the lack of masters’ formative courses in the country, provoked by the difficult compliance to the strict rules imposed by the Ministério da Educação [Federal Board of Education] for the organization of such courses has led music therapists toward the most diverse areas to press on with their graduate education. Evidently, this is a fact to be deeply regretted but, on the other hand, we should emphasize that this raiding of music therapists into other territories, often formerly hostile to this field, can be fruitful even when generating a stressful relationship within interdisciplinary contexts. This can encourage the reduction of estrangements and a broadcasting of the tasks performed within the field, resulting in mutual enrichment both by means of critics and collaboration.
On the other hand, the presentation of papers on music therapy in Collective Health, Interdisciplinarity, Contemporariness, and Science and Technology events, among other fields, has contributed toward a change of outlook among professionals of different areas in relation to music therapy.
Finally, it should be emphasized that public health, according to the Brazilian Constitution, is a citizen’s right and a duty of the State. The main challenge imposed by this constitutional right is that of insuring, by means of public policies, that total care and universal access to health facilities be freely granted and that equity, participation, and the social control be achieved, so that all of these rights can be duly enforced.
The Rio de Janeiro State Music Therapy Association and the Brazilian Conservatory of Music have both played out their best efforts toward the inclusion of Music Therapy within all health care services provided to the population at large, with the stated goal of contributing toward everyone’s access to this type of treatment.
These institutions also join the Brazilian Union of Music Therapy Associations, or UBAM, in the shared fight for the Music Therapists’ profession being officially regulated, a process on assessment by the Brazilian Senate since 2001, under the Proposed Bill #4827/01.
In these forty years, many are the practitioners who worked toward weaving and warping all these threads, so that music therapy could be developed and might reach the largest number of people in need of the benefits it can afford them toward a life more humane and endowed with dignity.
[1] This column was woven with such threads that were warped by the following Rio de Janeiro music therapists:
[2] This course was created by the musical educators, Cecília Conde, current Headmistress of CBM-CEU; Dorys Hoyer de Carvalho, and Gabrielle Souza e Silva, the latter working as a music therapist and also heading the Setor de Musicoterapia da Associação Brasileira Beneficente de Rehabilitação [Music Therapy Department, Brazilian Beneficial Rehabilitation Association], since 1964.
[3] The music therapy service is here headed by the music therapist, Leila Brito Bergold, since 1983.
[4] The Music Therapy Department of this facility is headed by the music therapist, Márcia Godinho Cerqueira de Souza.
[5] Pinto, Silva Patrícia de Castro, et al.. O Desafio Multidisciplinar, um modelo de instituição de longa permanência para idosos: Casa Gerontológica da Aeronáutica Brigadeiro Eduardo Gomes [The Multidisciplinary Challenge, a Model of Long-permanence Facility for the Elderly: Air Brigadier Eduardo Gomes Air Force Gerontological Home], São Caetano do Sul,; YENDIS Editora, 2006.
[6] Lizandra Maia Gonçalves was hired after taking tests and attending a preparatory course to take up the music therapist function currently held by Flávia Christine Dal Pizzol.
[7] The current UBAM Secretary is the music therapist and art therapist, Marco Antonio Carvalho Santos, Ph. D. on General Education and professor in the Music Therapy Undergraduation and Graduation Courses at Brazilian Conservatory of Music – University Center, Rio de Janeiro, as well as a teacher at the Escola Politécnica [Polytechnical School) sponsored by the Fundação Oswaldo Cruz [Oswaldo Cruz Foundation] z FIOCRUZ.
[8] This project was first installed by the music therapist Marly Chagas, on 2002 and remains open since then.
Barcellos, Lia Rejane Mendes (2008). Warping and Weaving Threads. Voices Resources. Retrieved January 11, 2015, from http://testvoices.uib.no/community/?q=colbarcellos250208