Music Therapy in Sweden
Introduction
For many people Sweden represents an unfamiliar, far away place. This is understandable since the country is located in the most northerly corner of Europe. During the summer months we have light days which are cherished and needed for coping with the dark days during wintertime. This is reflected in our different kinds of music including folk, classical and pop. One often speaks of it as "Swedish melancholy." But as we live with this contradiction between dark and light we are also deeply intertwined with European history. We have roots in Greek antiquity which influences our democratic system and ways of thinking. This is also represented in the Swedish music therapy field as three main approaches: Analytical Oriented Music Therapy, Guided Imagery and Music (GIM) and Functionally Oriented Music Therapy (FMT). These approaches are built on different foundations and have developed different types of training over the years. Thus, in this article you will find short presentations of each music therapy approach performed in various ways. You will first meet the Music Therapy program at the Royal College of Music in Stockholm which is inspired by Analytical Oriented Music Therapy. Following that a presentation of training, practise and research in GIM and FMT, and then a presentation about the Association for Music Therapy in Sweden (FMS). The article ends with some words from the chairman of the board of FMS and I will conclude with a final thought about the future of music therapy in Sweden.
A Short Review
By Ingrid Hammarlund |Author bio & contact info|
In 1974 Paul Nordoff and Clive Robbins visited Sweden and gave workshops for teachers in the field of special education. This can be seen as the beginning of the development of music therapy in Sweden and a Swedish association for music therapy (SFM) was organised with the main purpose to initiate professional music therapy training at an academic level. Many interesting seminars and courses for music teachers and special educators were organised by the board members of the association (Anki Sandell, Britt Marie Adolfsson, Lasse Hjelm, Urban Yman) often in cooperation with the music therapy associations in Norway and Denmark (Even Ruud, Unni Johns, Tom Naess, Søren Muhlhausen, Claus Bang) (Grönlund, Alm och Hammarlund, 1999).
In 1981 the Royal College of Music in Stockholm introduced short courses in music therapy marking the beginning of a journey towards a complete music therapy training programme. In the following years a growing interest for music therapy developed, not only in special education, but also in the fields of child psychiatry, adult psychiatry, neurological rehabilitation, cancer care and geriatrics.
Finally in 1991 Ingrid Hammarlund and Margareta Wärja, trained in England and the United States respectively, were employed by the Royal College of Music in Stockholm to begin developing a three year, comprehensive professional music therapy training programme. Since 1994 ninety music therapists have completed this programme and since 2003 it has been a four year part-time programme leading to a Masters degree.
The Music Therapy Programme at the Royal College of Music in Stockholm
By Ingrid Hammarlund |Author bio & contact info|
The entrance requirements of this programme include a completed Bachelor degree in music or music education, a successful entrance exam, and an interview with integrated musical activities and improvisations. The programme is founded on a broad humanistic and psychodynamic basis with a focus on communicative musicality and the meaning of music for the patient and the therapist. It is designed to also include a basic psychotherapeutic training level and ones own personal psychotherapy experience.
Music therapists mostly work in multidisciplinary teams. Being often the only professional music therapist requires comprehensive interdisciplinary knowledge. The programme aims to equip students with practical, observational and clinical skills required for music therapy clinical work within a variety of clinical settings. Students are expected to acquire highly developed skills in musical communication integrated with theoretical knowledge from musical, psychological, psychotherapeutic, medical and other clinical literature. The emphasis of the programme is on the practicum (individual therapy and group therapy) which occurs over six semesters. This, along with regular supervision by trained music therapy supervisors, provides the basis for the methodological and theoretical studies. Theory of science and research and writing a masters thesis provides the students with systematic and critical skills for the music therapy clinical field.
Program courses:
- Music therapy theory and philosophy
- Music therapy methods: expressive and receptive methods with individuals and groups
- Problem based project work in music therapy clinical settings
- Practicum work with supervision
- Clinical therapy skills, case study and report
- Ethics
- Musical improvisation and musical analysis
- Inter-therapy
- Introduction to dance, art and drama-therapy
- Developmental psychology
- Psychology of Music
- Psychopathology and psychotherapy theory and methods
- Paediatrics and Neurology
- Theory of science and research in music therapy
- Master thesis
Teaching staff 2008:
- Ingrid Hammarlund, music therapist, MA, supervisor, BMGIM-therapist
- Ann-Sofie Paulander, music therapist, MA, supervisor, doctoral student
- Gabriella Rudstam, music therapist, supervisor, reg. psychotherapist, BMGIM-therapist
- Dag Körlin, PhD, psychiatrist, BMGIM-therapist
- Björn Wrangsjö, PhD, psychiatrist, supervisor, BMGIM-therapist
GIM in Sweden - Training, Practice and Research
By Dag Körlin |Author bio & contact info|
GIM in Sweden started in earnest in 1992 with Fran Goldberg and Margareta Wärja, who conducted the first introductory courses, and since then have trained mostly all of the Swedish fellows. There are at present two certified "primary trainers" (Margareta Wärja and Dag Körlin) and one more fellow (Katarina Mårtensson-Blom) is soon to increase that number to three. Presently Margareta Wärja, with a team of four Swedish fellows, has concluded training in MAI (Music and Imagery). There are now about 15 fellows and MAI-trained therapists who apply GIM in a variety of contexts, ranging from personal development and coaching to psychotherapy within adult and child psychiatry. Their professional backgrounds come from music therapy, social science, psychology and psychiatry.
GIM is practised both in its original form, the Bonny Method of Guided Imagery and Music, (BMGIM), and in short term individual and group applications. Music and Imagery, (MAI), is taught and practised as a general short term application. Groups are conducted both with general and traumatised psychiatric outpatients (Körlin, 2004). GIM is also being adapted for persons with complex trauma through the adaptation of Breath Modulated GIM (Körlin, 2002; 2008).
GIM was the focus of a doctoral dissertation in 2005 (Körlin, 2005), where differences in treatment effects where found for traumatized patients' vis-à-vis non-traumatized patients (Körlin et al, 2000). An effect study was performed (Körlin & Wrangsjö, 2002) and gender differences in effects were explored (Körlin & Wrangsjö, 2001). The dissertation also contained a neuropsychological theory of GIM in trauma (Körlin, 2002).
The FMT Method - Functionally Oriented Music Therapy
By Hans-Olof Johansson |Author bio & contact info|
Initially there was just one movement of music therapy in Sweden but during the process of creating an educational programme one of the pioneers took his own path. His name is Lasse Hjelm and he was working at the Bernadotte home, a rehabilitation centre in Uppsala, Sweden. Hjelm developed the FMT-method during his 15 years of practical experience there. The method is today in use in hospitals, schools, psychiatric clinics, etc. all over Sweden and Finland and is currently spreading to Italy, Japan and Cuba (Granberg, 2000).
Non-verbal
Within this method there are no verbal instructions, spoken evaluation or words of encouragement. Hense the individual's own experience and the dialogue in the music itself is what carries the client through the process of development. There is no chance to hide behind the spoken word; the communication through the music is instant. Since the therapy is always practiced in a one to one situation the therapist and the client are creating a "room" where music and silence make place for structured sensory-motor processing under joyful circumstances. The client's own activity and initiative makes the progress of personal development. It involves a neural reorganisation where perceptual, motor, cognitive and emotional integration create opportunities to bridge motor or mental disorders developed by interferences in the natural growth process (Eriksson, 2001).
The Music
During the sessions the therapist always plays the acoustic piano and the clients are mostly offered drums and cymbals to be played with specially designed drumsticks. Recorders and other wind instruments are also used for breathing development. By placing the instruments in certain predetermined positions the client is stimulated to act in collaboration with therapist and at the same time making use of his motor skills, all in all encouraging the progress of development. The silence when the therapist waits for the clients answer is a central part of the method. The music played by the therapist is composed by Lasse Hjelm and consist of short, structured melodies, called codes, that tempt the client to respond. Each code has a corresponding pattern of drums and/or cymbals and for some there are the wind instruments. There is no improvised music but the therapist changes his/her way of playing the codes in order to answer or to support the clients in their process. Some of this music is sedative and some is rhythmic. The intervals and the tension between chords and minor and major tonalities are also used in a purposeful way to establish contact and collaboration. By observing the client's response and how he uses his body the therapist can analyse the problems or disorders that may appear.
Variation in Placement
By changing the position of the instruments, varying posture between sitting and standing, using blocks of wood or drums under the feet and by using specially designed drumsticks and wind instruments the therapist also can stimulate several sensory an motor systems in a structured way:
- Auditory perception - timbre, sound level, tempo, continuity, flow of frequency, distance,
pitch, etc. - Visual perception - colour, form, structure, size, distance, direction, quality, speed of movement, etc.
- Tactile perception - quality, cold and warmth, different materials in the drumsticks, form, distance, direction, angle and position in the grip of the hands, pressure against the supporting part of the body, etc.
- Perception of vibrations - quality, strength, direction, tempo, frequency in sound waves sent to the brain from the hands, supporting parts of the body, vibrations from wind instruments and body movement, etc.
- Proprioception - direction, distance, strength, tempo, quality, etc.
- Vestibular perception - position, stability, direction, tempo of movement, flow of movement, strength of movement and muscles, etc.
- Viscelar perception - strength, use of energy, tempo, etc.
As you can see there is an opportunity for sensory integration where the whole brain is at work. The whole person is involved in the process. The variation in placement of the instruments also gives the chance for a great processing of motor activity;
- Development of gross motor ability - is promoted while working with breathing, balance, stability of the body, cross movements, parallel movement in both sides of the body and coordination between hand and feet. It is also promoted when stimulating rotation of the upper part of the body while the trunk is stable in sitting or standing position.
- Development of fine motor skills - is promoted while working with the grip and position of the hands, movement of the wrists, angle of the hands and eye-to-hand coordination.
The variation in placement should always be very subtle to make the client feel secure.
Depending where the client is situated he is given the opportunity to make certain choices. After observation and analysis the therapist offers the therapy in accordance to the clients individual condition an level of functioning.
As said above, the FMT-method is always used in a one-to-one situation but during the FMT training at Ingesund College of Music at University of Karlstad you also learn to work with six year old children before they start their schooling. This is a group activity that takes ten weeks. The sessions are very structured; there is a list of songs to sing with movements and in a specific order. During these weeks it is possible to observe which children are in need of music therapy and which are not (www.fmt-metoden.se).
The Association for Music Therapy in Sweden (FMS)
By Rut Wallius |Author bio & contact info|
History and Aims of the Association
The association for music therapy in Sweden, now called FMS (Förbundet för musikterapi i Sverige) was founded in March 2000 as a reconstitution of the former national organization, SFM. FMS emphasizes cooperation between music therapists of different schools, but is also open for other persons interested in music therapy.
Members
The number of members has varied between 150 and 230. Before 2005 there were several associations for music therapists in Sweden related to three different kinds of training programs. In 2005 the professional association for music therapists trained in AOM, Analytical-Oriented Music therapy, decided to end its activities and transfer its members into FMS, and 2007 the Functional Music Therapists also joined the association. The benefit of this development was that it can concentrate the work within the larger association rather than splitting it up in smaller entities.
Visibility
Besides publishing a journal, FMS hosts a website www.musikterapi.se and organizes an annual meeting including lectures. FMS collaborates with other art therapists by participating in psychotherapy fairs that takes place every other year. It also takes part in the international work for music therapy within EMTC. In June 2006 FMS was the organizer of a Nordic conference, Nordic Sound, hosted by the Royal College of Music in Stockholm. The conference was held in English and had about 200 participants mainly from the Nordic countries, but also from a lot of other countries which was a nice surprise for the organizers. Since 2005 FMS has administered a co-operative with music therapists in Bolivia, a project financed by a governmental aid organisation. The project will continue throughout 2008, possibly longer, and involves seven music therapists from each country.
Challenges for the Future
There are two main tasks for the association; to enable contact between music therapists and to promote recognition of music therapy. At present the focus is on creating and developing forums for the members to meet. Annual national conferences with a scientific approach is one forum planned to begin in 2010, the 10th anniversary of FMS. It is an important task to unite music therapists of different schools and build relations based on mutual respect and acknowledgement. We believe that gathering and strengthening the identity of music therapists can be a way to build a strong association that may influence both educators and employers; this will benefit the development of music therapy in Swedish society.
One Final Wish From the Editor
By Ann-Sofie Paulander |Author bio & contact info|
One great additional challenge for the future is to develop music therapy research. Music therapy in Sweden has an interdisciplinary character and could be experienced as a difficult area to investigate. The interplay between music and man is inherently complex in that it is influenced by a variety of different situations and settings. Music therapists have a specific kind of ethical and esthetical knowledge connected to music and musical activities. A wish is that research in music therapy continues to deal with these kinds of issues since they are of great of importance for the society as a whole.
References
Eriksson, H. (2001) Neuropsykologi. Normalfunktion, demenser och avgränsande hjärnskador. Stockholm: Liber.
Granberg, A. (2000). Tre svenska utbildningar i Musikterapi. Stockholm: MPC Kungliga Musikhögskolan i Stockholm.
Grönlund, E., Alm, A. & Hammarlund, I., (1999). Konstnärliga terapier. Borås: Natur och Kultur.
Körlin, D., Nybäck, H. & Goldberg, F. (2000). Creative Arts Groups in Psychiatric Care: Development and Evaluation of a Therapeutic Alternative. Nordic Journal of Psychiatry, 54, 333-340, Oslo.
Körlin, D. & Wrangsjö, B. (2001). Gender differences in outcome of GIM therapy. Nordic Journal of Music Therapy, 10(2), 132-143.
Körlin, D. (2002). A Neuropsychological Theory of Traumatic Imagery in the Bonny Method of Guided Imagery and Music (BMGIM). In K. Bruscia & D. Grocke (Ed.), Guided Imagery and Music - the Bonny Method and Beyond. Gilsum, NH: Barcelona Publishers.
Körlin, D. & Wrangsjö B. (2002) Treatment Effects of Guided Imagery and Music (GIM) Therapy. Nordic Journal of Music Therapy; 11(1): 3-15.
Körlin, D. (2004). The Spektrum GIM Group Therapy. In I. Frohne-Hagemann (Ed), Receptive Music Therapy - Methods, Theories and Praxis. Wiesbaden, Germany: Ludwig Reichert verlag.
Körlin, D. (2005). Creative Arts Therapies in Psychiatry. A clinical application of the Bonny Method of Guided Imagery and Music (BMGIM) and Creative Arts Groups. Doctoral Dissertation, Karolinska Institutet, Stockholm, Sweden.
Körlin, D. (2008). Breathe Grounding and Modulation of GIM - a method in development. Manuscript accepted for publication in the Journal of Music and Imagery.
Web Links
How to cite this page
Paulander, Ann-Sofie (Ed.)(2008). Music Therapy in Sweden. Voices Resources. Retrieved January 09, 2015, from http://testvoices.uib.no/community/?q=country/monthsweden_june2008
