[Original Voices: Essay]

Personal Reflections on Working as a Music Therapist, Music Therapy Groups and Music Making

By Becky White

Last year I reached my tenth year working as a music therapist and also completed a master’s top up degree in music therapy at Anglia Ruskin University in Cambridge, UK. In this paper I will explore how working as a music therapist has helped to develop my musicality, musical awareness and experience. In the master’s degree project I studied music therapy group work and this led me to start thinking in more detail about my own music making in groups and my own musical identity. In this paper I will briefly outline some of the subject matter covered in my master’s degree project and will also explain how this related to personal thoughts and experiences of music making.

A Fascination for Group Work

My project (White, 2011) focused on the analysis of a group for young people with low functioning autism and learning disabilities. Focusing on group work has been a theme in my career. Throughout my time as a music therapist I have always been fascinated by group work and I remember with fond memories some of the groups I have run in the past. I have previously written about one such group which was called the Whirl Wind Group, (White, 2005).

The Whirl Wind Group, (White, 2005), was made up of four young people with severe learning disabilities who seemed to really enjoy using instruments and music-making. My aim was to help them with communication and relationships and to provide emotional support. I had named the group Whirl Wind because when waiting for them to come to a session, I could hear them running energetically down the school corridor towards the music room; a bit like a whirlwind! Their enthusiasm and exuberance felt infectious, which was probably countertransference (as described by Priestley, 1994) but was very enjoyable to work with. The other aspect of this group that I enjoyed was the opportunity to examine in detail how the group members were relating together through the music. Most of them did not have any verbal language, so the music and sounds were the primary means of communication. After group sessions I would relish listening to the minidisk and analysing the events of the session: thinking about how the group had related and what had happened in the music. Playing back audio and video recordings is a part of music therapy work that I enjoy. I also enjoy analysing individual work, but with group work it is more complex—there are more threads to consider, more lines of music, more harmony and more rhythms—and I think it is because of this increased complexity that I enjoy listening to and analysing group work so much. In addition to analysis, an important part of working as a music therapist has always been reading what others are doing and how they are working, especially when working in relative isolation in education settings. In the following paragraph I will look at a little of the literature on group work for children with special educational needs.

Literature on Group Work for Children with Special Needs

Until around ten years ago the literature on group work for children with special needs was not particularly developed. Perhaps this is because children have been traditionally seen individually; as modelled by the individual work of Nordoff and Robbins (1971, p. 102, p. 104, p. 106). I think that music therapy groups can provide an important space for children to explore relating together and developing emotionally. Tyler (2002) states the positive effect that group work can have for children; that it is useful as both a diagnostic tool and as an intervention. Nordoff and Robbins (1971, 1983, 2007) as well as working individually with children, worked in groups, using musical plays (such as Pif-Paf-Pultrie) and singing groups to encourage social relationships and emotional awareness. Bryan (1989), in a group work case study, describes how autistic children who are isolated can become aware of others through music making, and emphasizes just how inclusive improvised music making is: even if a child is severally disabled, they can be included in the music. A book that I have referred to consistently throughout my work in schools has been Davies and Richards (2002). This is an excellent book that contains six chapters on children’s group work in music therapy. In one of them Walsh-Stewart (2002) describes running a group for children with autism, combining psychodynamic music therapy in combination with a TEACCH programme (UNC School of Medicine, 2010): this is very similar clinical work to that of my master’s project, and was invaluable when I was trying to understand how to do the work. Other chapters include those by Nicholls (2002) on working with young people with severe learning disabilities and emotional and behavioural difficulties, and an useful chapter by Grogan and Knak (2002) on how to create a framework for special needs children’s therapy groups (which I would recommend to anybody working in schools). Other music therapists have worked with parents and children together in groups (Woodward, 2003, 2004; Muller and Warwick, 1993; Burrell, 2005; Oldfield, 2006; Bull, 2008), demonstrating how groups can represent the larger family, providing support and understanding for the children. More recently Tomlinson, Derrington and Oldfield (2011) have made a vital contribution to the literature by writing and editing chapters about working in educational settings in the UK. In this book, individual work and groups are described, and the varying roles and ways of working in schools, nurseries and community settings are explored.

There are a number of research studies which describe the use of music therapy with children with autism in groups and individually. These studies focus on the effects of music therapy on communication skills and behaviour. Edgerton (1994) compared improvised music sessions to composed music sessions, with results showing that the children were more communicative when the therapist used improvised music. Plahl (Plahl, 2000, cited in Oldfield, 2006, p. 160) used video analysis, music therapy reports, rating scales, psychological tests and interviews with parents, to show positive outcomes in communication. Oldfield (2006) studied ten pre-school children, with results showing that children had an increase in positive behaviours. Warwick (1995) undertook a research project looking at the effectiveness of music therapy for children and mothers, showing an increase in communication and Holck (2004, 2007), used video analysis of interactions which showed joint play and communication. Rickson (2003, 2006) has written about the benefits of music therapy for adolescent boys with attention deficit hyperactivity disorder and autism, showing that it can help in the areas of emotional awareness and relationships with others. Another useful study, which compared toy play sessions to music therapy is the randomized controlled study by Kim, Wigram and Gold (2008) who investigated the effects of music therapy on joint attention in pre-school children with autism. The results showed the children were more engaged in music therapy and had more joint attention and communication, than in the toy play sessions. Kim, Wigram and Gold (2009) also used the same study to measure the ‘emotional, motivational and interpersonal responses of the children’. The study showed that during music therapy the children were more engaged and engaged for longer periods of time, and also had more positive emotional responses than in the toy play sessions. All these case and research studies suggest that music therapy can be of benefit to children and young people with special needs both individually and in groups, particularly in the area of personal relationships and early communication skills. As a result in my master’s project I focused on the analysis of how young people with autism related together and communicated with each other in a music therapy group.

Master’s Project

The project focused on a group for young people with autism and learning disabilities. I was fascinated with trying to understand how music can aid social interaction, especially for a group of people who find it so difficult to be together. With this group, I instinctively thought there was a lot of connection and interaction between them in the sessions. In the master’s project, I set out to try and understand what was happening, how and why. It was a small-scale project looking at the group over six months, with an in-depth analysis of four music therapy sessions.

When thinking about how to approach analysing the group work in the master’s project I decided to undertake some music transcription and music analysis. In the second year of my music degree, I developed a love of writing out sheet music: it feels similar to drawing or creating a piece of artwork (in those days I used manuscript paper, a pencil and then went over it with a lovely black drawing pen). So when thinking about how to approach analysing the group work in the master’s dissertation I decided to undertake some music transcription, this time using notation software. I wrote out four minutes from a passage in session 15 of the therapy in which there were significant vocal responses from the children. I analysed this same passage using video coding analysis (as used by Plahl, 2007 and Oldfield, 2006) and then combined the music notation and video codes onto one score. This allowed me to see small details in the children’s responses and provided additional information than if I had just used one type of analysis on its own.

The second part of the project was to analyse a further four complete sessions of 30 minutes each which were spread out over the course of the therapy. For this I only used video coding analysis, because of the time and difficultly in writing out long passages of notated music therapy. The video coding analysis was also time consuming, and involved using a five second sampling method in which you stop the video every five seconds and record the observable behaviours and responses of the children. I recorded communicative behaviours, socially rejecting behaviours, use of instruments, vocalising, use of words and movement to music. I am currently in the process of writing a paper, to be submitted to the British Journal of Music Therapy, if published this will explain in more detail how I combined the two methods of the analysis and the results. This was a painstaking process, but part of me delighted in being able to take the time to look in detail at interaction in a music therapy group.

Whilst documenting the project I was conscious of a growing awareness of the reasons for my choices of subject matter. I realised that I loved doing group music therapy, because I loved playing music in small groups. As I studied and went deeper into the analysis of the music therapy group, I was conscious of a growing need to do more playing and to experience more interaction and music making in small groups for myself. This may have been because I was spending a lot of time at the computer, but I also think it was to do with focusing and thinking in detail about music groups. This for me was an unexpected outcome of studying for the master’s degree. In the project I was focusing on trying to find moments of shared experience, (defined as the occurrence of mother infant interactions together with shared emotional experiences,(Trevarthen & Malloch, 2000)). Whilst writing the project, I found myself thinking and wondering if I had personally encountered any shared experience in music making and in small groups, and questioned if this why I was so fascinated with the subject. I realised that I often sought out opportunities to play with others in small groups, looking for that sort of experience. This made me think of Bull (2008), in which she writes about the therapy group reflecting family relationships, and I wondered if I was looking for the recreation of a family experience through music making, and this in turn made me reflect on my musical experiences of the past.

Past Musical Experiences

My first significant musical experience was as a young teenager playing trombone in a swing band. It was a very active band which did lots of concerts in venues such as social clubs and community centres, and was well supported by a group of enthusiastic jazz musicians. I remember being very excited about being in the band: during the rehearsals I experienced time passing very quickly and an absorption in the activity of music making. I felt a connection with the other young people in the band, even though we came from a wide geographical area and did not socialize together. In subsequent years, I have gone on to have these experiences in further music groups: the experience of time passing quickly and becoming absorbed in the music, and the experience of connection and relationship with people. I think that what I was experiencing in the swing band could be described as shared experience. I suspect that the other young people in the band also became absorbed in the music making. The rehearsals tended to be very intense and required a commitment of three hours a week, so anybody taking part had to be highly motivated to come.

Another formative experience happened in the 1990s when I played with a band called Spring Wood Musicians (Cross Rhythms, 1992), a church band, who used improvisation in a Christian worship context. It was in this context that I first started to improvise and experienced some of the interactions that can happen between people when playing spontaneous music together. I have since had other experiences of improvising with friends and colleagues; when we have felt a connection and the music has strengthened our relationship. For example I formed a duo with a friend who is a Korean music therapist (who I worked with in London) called Sounding Stones. We met regularly over a period of three years, experimenting with improvisation and unusual combinations such as fretless bass guitar and Lyre. I felt connected to her in the music, even though our cultures and life experiences were so different. Cskszentmihalyi (1996) writes about flow, which he describes as occasions when we lose track of time and become absorbed in the moment. This reflects how I have felt and feel in music-making in small groups: becoming so involved in the music nothing else exists at that time.

Over the past few days I have been involved in a recording brass parts for a friend who is a singer-song writer (www.juliaharris.net). This was a different sort of musical experience, standing in a room on my own with head phones on, playing along to a track. But when I was listening to the music I felt like I was physically in it (feeling the vibrations): I became so involved in the flow of the music that I felt that the sounds I produced were authentic and a real expression of who I am, and not just attempts to make a nice sound on a recording. When playing, it helped to imagine that the other musicians were there present with me, and this enabled me to play authentically to the tracks, I felt really in ‘flow’ with the music.

These different musical experiences have included both composed music and improvised, spontaneous music. In music therapy I have mainly used improvised or extemporised music, and the flow and connection often happens in the spontaneous. However, it does and can also happen in composed music.

I belong to a local town band (www.devizestownband.com), in this band the music is thoroughly composed and there is no room for improvisation. But there is a strong feeling of connection and community in the band, (and like the swing band we don’t really know each other that well socially). Pavlicevic and Andsdell (2009) write about the experience of people making music in groups. They hypothesize that music groups move through four stages which they call, "musicality, communicate, musical companionship and collaborative," (Pavlicevic & Ansdell, 2009:364). In the first stage the group starts as individuals, moves into two people relating (a bit like mother-infant interactions). The group then becomes "we", being together as a community, and then "us", collaborating together. I think this idea about groups moving between different stages is useful for understanding what happens in groups in music. In the wind band there is a feeling of community, of an ‘us’ (the third stage), even though it is not a community in any other context other than playing music together, its like the members feel connected through the joint effort of playing together, experiencing vibrations of sounds and performing together. I enjoy the community of the wind band; the friendliness of the others in the group and the inclusiveness. There are a lot of different musical abilities in the group, but everyone is accepted at what ever level of musicality they have. To me this feels like true, inclusive, community music - perhaps even music therapy in the community.

Since finishing my master’s degree, I have started doing more musicing. I have formed a jazz duo (www.kaitandbecs.com), and started to re-connect with old musical friends as well as making new ones. It might be that the experience of writing about music has encouraged me to do more practical music; or, it could be that I’ve simply got more time. But I do know that my own musicality is developing out of working and studying as music therapist, even though when I first trained it was suggested that it would be the other way round. Either way, for me the two are connected.

I feel that working as a music therapist and studying and reading about music therapy has made an important contributed to my own professional and personal life as a musician. Working as a music therapist has so far been a vital part of my musical journey. It has helped me to develop awareness about why we make music, who I am as a musician and what are the meanings behind musical activity. I think working as music therapist has also helped me to develop keen listening and reflective skills, which are extremely useful in small group settings, and I think this is a particular strength that many music therapists develop. The process of studying and critically evaluating a music therapy group, led me to reflect back on my own musical experiences in small groups in the past, and also led me forward to create new opportunities and develop further as a musician. I think for me this shows that the boundaries between the roles of music therapist, musician and researcher, are blurred and that all of these roles influence the other. Finally, in the Nordic Journal of Music Therapy, Gold (2011) writes about the research work of Tony Wigram who said that the "basis of good research was good clinical work and the basis of this was being a good musician." Perhaps it could work the other way round as well, and that being a good researcher and music therapist could also lead to being a good musician?

References

Bryan, A. (1989). Autistic group case study. British Society for Music Therapy Monograph, Music Therapy for Autistic Disability, (1960-1993). London: British Society for Music Therapy Publications, 28-33.

Bull, R. (2008). Autism and the family: group music therapy with mothers and children. In A. Oldfield and C. Flower (Eds), Music Therapy with Children and their Families. London and Philadelphia: Jessica Kingsley Publishers.

Burrell, M. (2005). Reflections on the links between education and therapy through music and movement with the early years and their parents. In British Society for Music Therapy (Eds.), No Man is an Island, Groups, Partnerships and Teams in Music Therapy: BSMT and APMT Conference, The Resource Centre, London, 4-5 February 2005 (pp. 27-30). British Society for Music Therapy Publications.

Cross Rhythms (1992, February 1). Springwood musicians: A Church Flying High in worship.Cross Rhythms. Retrieved from http://www.crossrhythms.co.uk/articles/music/Springwood_Musicians_A_Cardiff_church_flying_high_in_worship/35760/p1/

Csikszentmihalyi, M. (1996). Creativity, flow and the psychology of discovery and invention. New York: Harper Collins Publishers.

Davies, A., & Richards, E. (Eds) (2002). Music therapy and group work, sound company. London and Philadelphia: Jessica Kingsley Publishers.

Edgerton, C. (1994). The effect of improvisational music therapy on the communicative behaviours of autistic children. Journal of Music Therapy, Volume 31(1), 31-62.

Gold, C. (2011). Goodbye, Tony Wigram (1953-2011). Nordic Journal of Music Therapy, 20(3), 2054-2076.

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Warwick, A. (1995). Music therapy in the education service: Research with autistic children and their mothers. In T. Wigram, B. Saperston & R. West(Eds.), The art and science of music therapy. England: Harwood Academic Punlishers.

White, B. (2005). The whirlwind group, a group for young people with disabilities moving into adulthood, and the working relationships that supported the clinical work in a special needs school. No Man is an Island, Groups, Partnerships and Teams in Music Therapy: BSMT and APMT Conference, The Resource Centre, London, 4-5 February 2005: British Society for Music Therapy Publications, 71-75.

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