Voices ResourcesA website for the worldwide community around the journal Voices: A World Forum for Music Therapy

Humankind has been using the therapeutic effect of music since olden times. The tradition of listening to the music for therapeutic purposes is thousands years old, however, music therapy both as a research-based subject taught at universities and as a profession emerged in the world's culture as late as in the middle of the 20th century. Modern authors writing of music therapy issues stress the complexity of the subject, which is determined by: a) intermingling of music, science and the communication process; b) different concepts and methods ensuing from them; and c) the diversity of goals pursued by therapeutic practice. Account is also taken of the amorphousness of the subject arising from the differences in the development of theories in various socio-cultural environments, as well as of intensive development of music therapy as a new branch of science (Bunt, 1996; Bruscia, 1998; Ruud, 1998; Stige, 2002).

In Lithuania, music therapy has just started its path of development, with the first signs of professionalism appearing in recent years. This paper aims to present an overview of development of music therapy in Lithuania and to answer the following questions:

• what did determine the rudiments of music therapy in Lithuania?
• what and how did influence its development and along what lines did it develop?
• what is the current situation and prospects of music therapy?

To find answers to these questions the author employed the methods of literary analysis and interview and used her personal experience. It should be noted that in this paper the evaluation of development of music therapy in Lithuania is based on the one of the modern definitions of music therapy: "Music therapy is a systematic process of intervention wherein the therapist helps the client to promote health, using music experiences and the relationships that develop through them as dynamic forces of change" (Bruscia, 1998, p. 20).

The Beginnings of Music Therapy in the Field of Medicine

The development of music therapy in Lithuania was determined by historical conditions, i.e. the country's belonging to the Soviet Union in 1945-1990. In Lithuania, just as throughout the entire former USSR, the humanities and social sciences - psychology, psychiatry, pedagogy, art criticism etc. were politicized and had to be based on the principles of dialectical and historical materialism. Other philosophical theories were either criticized or ignored, while the works by criticized authors were available only to very few. Thus the formation of the rudiments of music therapy took place in a closed environment formally separated from the experience accumulated by foreign countries.

At the end of the 1970ies, investigations into the role of music in treating psychosomatic diseases and dysfunctions of the central nervous system were started in the Laboratory of Resort Treatment Research (the investigations were lead by Vytautas Meška, MMSc). The investigations were based on the works of V.Bekhterev, Ch.Schwabe, E.Lecourt etc. It was assumed that illnesses are caused by emotional stress and falling ill with a chronic disease results in damage both to physical and mental health; therefore, various neurotic, depressive or psychosomatic syndromes appear. It has been stressed that the employment of music in treatment is important mainly because it helps change the intensity of vital processes of the nervous system, make recovery dominant in the cortex, and stimulate physiological functions.

Investigations were carried out in music therapy rooms set up in the sanatoriums of Druskininkai resort; this resulted in the working out of methods based on special programs of works of classical music[1]. On the basis of these investigations a thesis on music therapy, the first of its kind in Lithuania, was written (Юргутите, 1987). Music therapy rooms continued to function in Lithuanian resorts during the 1980ies. Unfortunately, due to historical and economic changes in the country the financing of research was stopped and only few of these rooms established by researchers survived in the last decade. However, the rudiments of music therapy were already formed, the basis for its development was laid, and methods that are still in use today were formulated.

Overview of the music therapy in the field of resort treatment, looking from the standpoint of modern music therapy theory and practice, allows to assert that music therapy applied by the Lithuanian resort treatment researchers was perceived as a method the substance of which lied in the listening to music as an application of an additional force of dynamic change in order to improve the condition of patient's health. Based on K. Bruscia's notion (1998, p. 20), today we could no longer evaluate such application of music as a comprehensive music therapy because: 1) there was no specialist with a degree in music therapy; 2) interpersonal relationship between the client and the music therapist was not taken into account; 3) the effect of a work of music was treated "pharmacologically", i.e. as a medicine in case of certain diagnosis.

The Rudiments of Music Therapy in the Field of Psychotherapy

In the mid eighties, setting up of relaxation rooms started in Lithuania. In these rooms music recordings were used to achieve the effect of relaxation. They were particularly popular in factories those had funds for the fitting out of such rooms. Psychologists tested musical relaxation in their practice without having high ambitions to go deep into music therapy. The method of musical relaxation is still popular in today's psychotherapeutic practice where both foreign recordings of relaxing music and a recording of Lithuanian relaxing music "Rojaus Sodas" (Garden of Eden) are used. The latter presents two systems: an autogenous training and progressive relaxation according to Jacobson plus music background. Thus, in this case the effect of music is used rather as an augmentative level to psychotherapy (Bruscia, 1998, p. 168-169).

In 1985-1990 music was used in Vilnius Psychiatric Hospital in order to assist people in solving their psychological problems. The formulation of methods for working with psychiatric patients was based on the statement by V.L. Levi, J. Alvin, I. M. Saltshaker et alias to the effect that, during musical activity, experiences present at the subconscious level of the mind become part of consciousness and help to perceive emotions and to know oneself. Psychotherapist Grazina Gudaite who started practicing the music therapy methods in psychiatry stressed that music therapy as an effective way to express emotions from sub consciousness and to purify oneself from unpleasant and tormenting affects was important both for diagnostics and treatment. She wrote: "In substance, music therapy is directed towards the sphere of feelings but through it - also to the patient's behavior and thinking. ... A selection of appropriate works of music may help the patient to recall pleasant experiences of life as a result of which the patient becomes more open to himself and others." (Gudaite, 1988, p. 16).

An interest in the application of music therapy in psychotherapy is obvious - already in 1992 a course by H. Bonny, the author of the GIM method [2], was organized. However, economic situation in the country prevented continuation of this work. On the other hand, the project, even though it aroused interest and was necessary, still lacked potential power because of certain spontaneity and insufficient understanding of requirements for the modern music therapy profession. Psychiatrists, psychotherapists, psychologists participating in the course lacked the requisite musical background in order to get interested in the deeper studies of music therapy, but representatives of musical professions were not invited.

The practice of music therapy in the field of psychiatry was interrupted in the beginning of the last decade but intensive activities in Klaipeda Psychiatric Hospital having good prospects have recently started. In 1999, music therapy rooms were set up for work with clients having neurotic, depressive and personality disorders and 2000 saw the founding of a center for psychiatric music therapy.

Music Education for the Handicapped

In Lithuania, the subject of music in distinction to that of painting, drawing etc. was not included in the program of training for special teachers. The reason is explained by Vytautas Karvelis, one of the authors of this program. According to him, musical training occupied a considerable part of the program, leaving too little space for social subjects. What is why the program was not approved by the Ministry of Education of the former Soviet Union. It was subjected to a number of corrections, resulting in a full refusal from the music subject in the final version (Karvelis, 2000). Since qualifications of a music teacher in special education were not defined, no studies were conducted in this field, and music education work with disabled children proceeded solely by the efforts of individual enthusiasts. It was only in the last decade that interest in the musical education of the disabled was revived.

The restoration of Lithuania's independence in 1990 provided a stimulus to changes in many areas of life. The author of this paper links the new phase in the development of music therapy (1990-2001) with the striving for the integration of the handicapped and particularly with the ideas of the socialization of the disabled through arts. The facts of isolation of handicapped people revealed in the former Soviet Union contributed to the development of ideas of social integration and psychological rehabilitation. In 1991, the Law on Integration of the Disabled was adopted in Lithuania, which laid the basis for a comprehensive system of medical, professional and social rehabilitation. The National Education Concept of the Republic of Lithuania places emphasis on the principle of humanistic education ensuring the individual's right to additional or specialized education in case of physical, mental or socio-cultural peculiarities or conditions. Special education institutions of humanistic type (just as in the establishments for rehabilitation of the disabled, psycho-neurological establishments) needed both new methods of work and specialists.

Disabled people were afforded a possibility to speak about their spiritual needs and to show their capabilities. By the efforts of several talented music pedagogues based on deep understanding of disability and musical intuition, a folk music band of rural young people with intellectual disorders "Pliauškutis" emerged (led by Romualdas Brūzga and Valerija Brūzgiene), musical performances were staged in the Vilijampole boarding school for children with mental disabilities (Ilona Papečkyte), and concerts by children with cerebral palsy from the Education Center of Vilnius "Viltis" were held (Jautre Šinkuniene). Believing in the disabled children's unexpressed possibilities and the need to assert their social value, these and other music pedagogues found, intuitively and empirically, their own ways of musical communication with the disabled, which were close to the methods employed by the pioneers of music therapy in foreign countries. However, these were enthusiasm-driven activities carried out on individual basis. The concept of music education of the disabled did not change in substance. "Practical implementation of humanistic aspirations did not correspond to the content of obligations of the Lithuanian state because: 1) there was no special state program; 2) properly trained specialists were lacking; and 3) an obvious backwardness of public awareness inherited from the Soviet policy was observed" (Piličiauskas, 1997, p. 8-12).

Having obtained financing from non-governmental organizations and sponsors, A. Piličiauskas, Professor at the Lithuanian Academy of Music, in 1992 founded a Lithuanian Center for Alternative Music Education, which united pedagogues propagating innovative and non-traditional content and methods of education. A. Piličiauskas advanced an idea that both psychological rehabilitation and social integration could be achieved through artistic self-expression of the disabled, and that the term of "forgetting disability" could be used to describe the tactics of socialization of the disabled, when due to pedagogical multi-measures the individual forgets his or her disability and when one may say: "A spirit in an excellent state can be found in an unhealthy body as well, while damaged psyche may feel spiritual comfort and harmony under the influence of art" (Piličiauskas, 1997, p. 11). On the initiative of the Center for Alternative Music Education the following changes were brought about during the last decade:

• music, art and drama classes for children and adults with various disabilities were set up in the biggest cities of the country ("Credo" classes);
• young scientists were referred to doctorate studies to investigate problems of artistic education of the disabled;
• national scientific conferences on the issues of artistic education of the disabled were held in Vilnius (1997), Panevežys (1998) and Šiauliai (1999);
• the founding of the Lithuanian Association of Educational Music Therapy and the Association for the Application of Art Therapy was initiated (1997), with comprehensive support for these associations;
• actions promoting the interaction between artists and the disabled;
• preparation of the Program for Art's Education of the Disabled, which is now well under way;
• since 2000, the introduction of the subject of music education of the disabled at the Kaunas Faculty of the Lithuanian Academy of Music - for BA students and at the Faculty of Arts of the Klaipeda University - for MA students of music pedagogy.

A brief description of the Program for Art's Education of the Disabled and the "Credo" classes is provided below since these activities are linked with the integration of the music therapy methods into education. The objective, the strategy and the tactics of the program are as follows:

• the objective is to "enhance, through artistic activities and self-expression, self-confidence of the disabled, creating conditions for him/her to find spiritual harmony and to seek psychological rehabilitation and adequate socialization";
• the strategy is to "using the potential of effect of art, to form a humanistic approach of a democratic society towards the disabled, to foster their dignity and experiences of full-fledged life"; and
• the tactics that consist in "finding the areas, methods and forms of activities through arts that ensure optimum revelation of the disabled person's talent and capabilities, bring joy because of successful activity and moving forward, and emphasize cultural and social value of efforts by the handicapped student"
  (Piličiauskas, 1998, p. 79).

The humanistic orientation of the program is obvious. In addition to its educational objective, the program covers psychological, social, and therapeutic aims (self-expression, confidence, spiritual harmony). In the program prepared by Piliciauskas, the roles of a teacher and a therapist partially overlap [3].

As no studies in the field of music education of the disabled have been conducted in Lithuania, Program for Art's Education of the Disabled provided for the promotion and support for research work. On the initiative of the Lithuanian Center for Alternative Music Education and the Community for Caring for People with Intellectual Disorders "Viltis", doctorate studies were organized in the Vilnius Pedagogical University. The Credo Class teachers investigated the problems of music education of the disabled, with the subjects selected including the importance of music education of the disabled for their social integration (Vilkeliene, 2000), music communication in educating children ill with cerebral palsy (Šinkūniene, 2001), music education of general capabilities in children with intellectual disorders (Aleksiene, 2001), education of stuttering children through musical activities (Kačiušyte-Skramtai, 2002). The program of the doctorate studies was focused on the educational aspect of investigations, however, the researchers took interest in all efficient methods of the education process including the methods of music therapy that had not been previously applied in Lithuania.

In seeking knowledge in music therapy contacts with the leading Norwegian experts in music therapy were established in 1996. This was the spark that started the activities of educational music therapy in the country.

The Beginnings of Educational Music Therapy in Lithuania

In 1997 the Center for Alternative Artistic Education organized the first national conference "Art's Education of the Disabled" in Vilnius. At this workshop music pedagogues from specialized educational establishments spoke openly about their problems such as gaps in professional and psychological training, lack of literature and special methods for work with the handicapped people.

On the initiative of A. Piličiauskas and the doctorate students of the Vilnius Pedagogical University, an organization of music pedagogues was formed at the conference (June 1997) and started working as music subsection of the Program for Art's Development of the Disabled. They stated their aims as 1) the formation
of a framework for the development of professional music therapy; 2) taking care for the development of music teachers working with the disabled by adding knowledge in music therapy to their professional background; and 3) promoting, in a creative manner, mental health, communication and socialization of disabled people. The organization chose its name as the Lithuanian Association of Educational Music Therapy in accordance with Bruscia's notion (which corresponds to the organization's aims) that educational practices of music therapy include the various uses of music with handicapped or disabled students in an educational or school setting which have curricular or developmental learning goals for handicapped, in either musical and onmusical domains (1989, p. 84, 105). Having a wish to develop their skills in the area of music education of the disabled and to acquire qualifications of a music therapist, the managers and ordinary members of the association organize workshops inviting music therapy specialists from abroad.

In cooperation with their Norwegian counterparts, the Lithuanian Association of Educational Music Therapy launched a project covering courses in music therapy (1997-2000) whose objective was to master certain methods and techniques of educational (didactic) music therapy to facilitate the music teachers work with the disabled.

The first phase of professional qualifying of the members of the Lithuanian Association of Educational Music Therapy focused on the Nordoff-Robbins music therapy method (Nordoff & Robbins, 1977), because: firstly, this method is applicable in the work with handicapped persons, secondly, it corresponds to the humanistic trend of the new education and development programs undertaken in Lithuania, and thirdly, the Nordoff-Robbins' attitude [4] is apparently close to the above-mentioned concept of art's development of the disabled worked out in our country.

Four sessions of the Music Therapy Courses took place. The lectures and workshops were delivered by foreign music therapists practicing the Nordoff-Robbins method. Assoc. Prof. Brynjulf Stige from the Sogn og Fjordane University College conducted a cycle of lectures and workshops entitled "Introduction to Music Therapy", which acquainted the Association's members with the history of modern music therapy, methods of music therapy, application of psychological concepts, and latest literature. Participants in the 2nd session observed and analyzed the work with the handicapped children by Assoc. Prof. Tom Næss from the State Academy of Music of Norway and studied music therapy techniques and the basics of clinical improvisation. During the 3rd session delivered by Dr. Clive Robbins, a co-author of the Nordoff-Robbins music therapy model, teachers of music were afforded a possibility to familiarize themselves in detail with the application of the methods of Creative Music Therapy in educating children with hearing and intellectual disorders. The lecturer of the 4th session, Assoc. Prof. Stige, presented new attitudes toward music therapy, analyzed relationships between musical education and music therapy, and made an interesting presentation of case studies from his own practice. The workshops of this session were led by 12 students of the Sogn og Fjordane University College under the guidance of Assoc. Prof. Stige. Working groups were set up in which the Lithuanian teachers of music and the future Norwegian music therapists shared their experience and analyzed differences and advantages of educational and therapeutic approaches and methods. Thus, Lithuanian specialists interested in music therapy were provided with a possibility to acquire minimal but substantial theoretical and practical knowledge in music therapy. The methods of work with the disabled shared at the workshops are now applied, more or less successfully, at the workplaces of the participants in the courses. Elements of the Nordoff-Robbins method of music therapy have been integrated into the investigations conducted by the above mentioned doctorate students.

Making an evaluation of development of music therapy in Lithuania, the author is of the opinion that fruitful cooperation with the Norwegian music therapy specialists helped to direct this development towards professionalism. A cooperation agreement
between Vilnius Pedagogical University and Norwegian music therapy program was concluded in 1998 and renewed in 2000, as a result of which (and particularly due to sincere efforts by Brynjulf Stige), four Lithuanians are studying and two have already completed a course in music therapy at the Sogn og Fjordane University College. Thus the way has already been paved for music therapy specialists in our country; joining the Lithuanian Association for Educational Music Therapy by professionals means that one may expect new qualitative developments in the field.

Studies of psychology, psychotherapy, psychiatry, special pedagogy, physiology, neurology, as well as art's therapies account for a large share of hours in the music therapists' training programs. Therefore, the Lithuanian Association for Educational Music Therapy and the Lithuanian Association for the Application of Art Therapy implemented a joint project "A Program of Psychological Training" in 1998-2000. On the basis of the Norwegian music therapy studies, seminars on clinical psychology, social psychology, children's psychiatry, psychotherapy etc. and drama and movement therapy workshops were held. The cooperation of the associations continues in establishing a professional basis for the development of music therapy and art therapy.

Current Situation

Compared with other countries, music therapy in Lithuania seems to be still on the road of challenges. There are more and more institutions that apply music therapy (without having necessary knowledge and responsibility). An opinion poll, made in the year of 2000 among the members of the Lithuanian Association for Educational Music Therapy showed that methods of special music/music therapy were put into practice in the following fields/ services:

1. education (educational programs),
2. health (rehabilitation, psychic health and psychological aid programs),
3. social (preventive programs).

An application of music therapy remains problematic in all the fields. Difabove mentionedferent basic education of the practitioners determines different and sometimes incompatible views/conceptions. The notion of music therapy prevailing in individual groups of professionals is commonly one-sided [5], so the importance of creative interpersonal relationship within the triad "client-music-therapist" for personality changes is not revealed.

Some main problems came to light revealing the following:

• lack of understanding of music therapy professional identity;
• lack of theoretical/ practical basis;
• absence of relevant education.

There is an urgent need for a professional and systematic training of new type specialists - music therapists in Lithuania. The idea about establishment of a music therapy educational program is realistic at present due to:

1. The interest and demand for music therapy service in society;
2. The interest in the new services/professions at the Lithuanian Ministry of Education and the Ministry of Health;
3. The interest in new training programs at the Vilnius Pedagogical University and the Vilnius University;
4. The collaboration with Norwegian music therapy program and growing number of professional music therapists (educated at the Sogn og Fjordane University College).

Prospects for Music Therapy Development

Forecasting either dynamics or rates of development of the modern music therapy area in Lithuania is difficult while the country still has economical problems. To foster developmental process it is important to join the international projects/programs.

With one accord in 2000 - 2001 Lithuanian Association for Educational Music Therapy and the Lithuanian Association for the Application of ArtTherapy started working on a joint project for establishment of postgraduate studies in art/music therapy in Lithuania. The idea of this project was to initiate the international dissemination in art/ music therapy fields in Lithuania and legitimize academic model of training professional art and music therapists. This model will have to be developed under supervision/cooperation with foreign institutions of music/ art therapy education: Sogn og Fjordane University College (music therapy program) and University of Hertfordshire (art therapy program), and in partnership with a few regional institutions of education [6]. The project "Dissemination of Art/ Music therapy in the Baltic Region I. Lithuania/ Vilnius" is submitted to UNESCO in 2002.

To summarize this paper one may conclude that:

1. The emergence of music therapy in Lithuania was determined by the need for methods supplementing medication in the area of resort treatment (1980ies), psychiatry and psychotherapy (end of 1980ies), and by the lack of effective methods in the area of musical education of the disabled (mid-1990ies).
2. In Soviet Lithuania, the formation of a basis for the development of music therapy in the area of resort treatment was started, but economic changes after the restoration of independence caused a recession in this area. Those who applied music therapy in resort treatment, psychiatry and psychotherapy lacked professional training for a music therapist's work.
3. After the restoration of independence, humanistic trends in the social area and the implementation of ideas of artistic integration of handicapped people in recent years enabled the development of educational music therapy, while intensive cooperation with foreign music therapists led to the beginnings of modern professional music therapy in Lithuania.
4. In the long term one may expect an increasing demand for music therapists, which is hardly to be met by the practice of training these specialists in foreign countries. Therefore, an establishment and legalization of a music therapy educational program in Lithuania is the main goal at present.

References

Aleksiene, Vilmante (2001). Sutrikusio intelekto vaikų muzikinis bendruju gebejimų ugdymas: edukologijos daktaro disertacija (Development of general skills of children with mental retardation in musical education: doctoral dissertation). Vilnius: VPU.

Bruscia, Kenneth E. (1989). Defining Music Therapy. Spring City, PA: Spring House Books.

Bruscia, Kenneth E. (1998). Defining Music Therapy. Gilsum, NH: Barcelona Publishers.

Bonny, Helen (1978). Facilitating GIM Sessions. Salina, KS: Bonny Foundation for Music-centered Therapies.

Bunt, Leslie (1994). Music therapy: an art beyond words. London and New York: Routledge.

Gudaite, G. (1998). Muzikos terapijos galimybes. Respublikinio mokslinio praktinio seminaro "Estetoterapija ir sanogeneze" medžiaga (Potentials of Music Therapy. Materials of the Republican Seminar "Aesthetic Therapy and Sanogenesis"). Vilnius.

Kaciusyte-Skramtai, L. (2002). 5-7 metu mikciojanciu vaiku ugdymo optimizavimas muzikine veikla: edukologijos daktaro disertacija (Optimizing upbringing of 5 -7 years children who stutter by using music activities: doctoral dissertation). Vilnius: VPU.

Lassahn, R. (1999). Pedagogikos ivadas (Introduction to Pedagogic). Vilnius: Margi raštai.

Maslow A.H. (1986). The farther reaches of human nature. New York: Penquin Books.

Nordoff, Paul and Robbins, Clive (1977). Creative music therapy. New York: Harper and Row Publishers.

Piličiauskas A. (1997). Neįgaliujų menine socializacija: situacija, galimybes ir perspektyva (Socialization of the handicapped through arts: present situation and prospects). Viltis (2), 8 - 12.

Piličiauskas A. (1998). Neįgaliujų meninio ugdymo strategines nuostatos. In: A. Piličiauskas (red.). Neįgaliujų meninis ugdymas: psichologines reabilitacijos ir socializacijos galimybes (74 - 75). (Strategical Attitude of the Arts Education for the Handicapped. In A. Piliciauskas. Arts Education for the Handicapped: prospects for the psychological reabilitation and socialization). Vilnius: LAMUC.

Ruud, Even (1998). Music therapy: improvisation, communication and culture. Gilsum, NH: Barcelona Publishers.

Stige, Brynjulf (2002, in press). Culture - Centered Music Therapy. Gilsum, NH: Barcelona Publishers.

Šinkuniene J. (2001). Cerebrinio paralyziaus vaiku neverbelinio komunikavimo ugdymas muzikine veikla: edukologijos daktaro disertacija (Development of non-verbal
communicativeness of children with cerebral palsy by musical expression: doctoral dissertation). Vilnius: VPU.

Vilkeliene A. (2000). Integruotas muzikinis ugdymas neigaliujų vaikų socializacijos procese: edukologijos daktaro disertacija (Integrated musical education of the handicapped children in the process of their socialization: doctoral dissertation). Vilnius: VPU.

Юргутите А. А.(1987). Музыкальная мераnuя как меmоò mсuхоэмоųuональноŭ коррекųuu. Вильнюс. [Jurgutitje, A. A. (1987) Music therapy as a method for the psycho-emotional correction. Vilnius.]

Notes

[1]The principle of using music for therapy was built upon the precept
that first of all the patient should listen to a work of music conforming to his/her emotional state and then the music should be changed consistently in order to create the desired mood.

[2] GIM - Guided Imagery of Music (Bonny, 1978).

[3] As it is known, humanistic education is based on A. H. Maslow's psychological and C. Rogers' psychoterapeutic principles that imply the convergence of education and therapy (Lassahn, 1999, p. 125-127).

[4] An assumption that the development of musical self (musical self-expression,
communication, etc.) has a profound effect upon the child's general development underlies the objectives of the method.

[5] While teachers of music emphasize self-confidence or self-expression, psychologists and psychiatrists focus on relaxation and self-perception, and the medical profession on the physiological effects of music.

[6] In partnership with Vilnius University, Vilnius Pedagogical University, Vilnius University of Professional Studies, Vilnius Academy of Fine Arts and others.

How to cite this page

Aleksiene, Vilmante (2004). Music Therapy in Lithuania: A Brief Review. Voices Resources. Retrieved January 10, 2015, from http://testvoices.uib.no/community/?q=country/monthlithuania_march2002