The Art of Re-Framing

By Ana Navarro Wagner


This article discusses a way of re-framing the experiences of four European music therapists working with local disadvantaged children in Gulu (North of Uganda, Africa) from a Community Music Therapy (CoMT) point of view. CoMT offers certain qualities that help to rethink conventional boundaries in context and to widen the cultural sensitivity of the music therapists. The art of re-framing according to the context is the art of looking with other frames, the art of allowing different patterns to arise. The art of re-framing helps to create cultural sensitive and thus more meaningful practices in context.

Keywords: Community music therapy, Uganda, cultural sensitivity, context

Kasese (Uganda), December 2011:

These days in Kasese, sharing our experiences in the Gulu project with Bethan (Does what we do help at all? How far can we really reach considering all the cultural barriers? Can we call it music therapy?) and in general in Uganda (What will happen when I go back to Spain? What and how have I changed? From where am I going to digest all this?), I begin to notice how, barely two weeks after leaving Gulu, I start building my discourse, I start molding the accumulation of experiences, I start giving shape to all that content from a distance. And I realize that the way I create that discourse influences the experience itself! How I formalize, how I TELL what I've lived, makes the sediments of the experience settle down in one way or another. In short, so much talking about the importance of the content and it turns out it's not so easy to separate it from the FORM! They walk closely together, one influencing the other, the other marking the steps of the one ... depending on how you tell it, you will remember it ... depending on how you remember it, it will BE. Hence the power of discourse to integrate. But also to CONTROL. (Ana Navarro Wagner. Extract from field notes www.musictherapyinuganda.wordpress.com)

One of the topics of the WFMT World Congress that took place in Krems, Austria, this summer (July, 2014) was: What impact do cultural influences and values [the way of looking] have on practice, research and the provision of therapy [ the way of doing]?

According to many authors (Kenny, 2006; Stige, 2002; Pavlicevic & Ansdsell, 2004; Ruud, 1998) culture influences every aspect of music therapy work: practice, research, theories, pedagogy and philosophy. This is because culture is a way of putting frames on what we see, on what we feel, on what we understand, on what we need, on what we expect. As anthropologist Finnström (2008) advocates, culture is ''both a resource and a constraint in human activities. It is situational, neither total nor final, and more about existential orientation than anything else, and activated by "the drive to experience the world as meaningful, 'the most prominent of human universals' " (p.7).

Every look has a boundary, a cultured boundary, a cultured frame. Because culture is a way of being in the world, a way of looking at it, a way of creating patterns in it and a way of telling those patterns. The way I see it, one of the most important aspects of going into therapy is to learn to look at yourself and others from another point of view, that is, to learn to re-frame relationships, to learn to re-frame the way of looking. When you look at yourself differently, other patterns arise. When somebody looks at you differently, new patterns are allowed to emanate. As music therapist Brynjulf Stige (2002) says:

What happens when an experience, a phenomenon, or an object is framed or reframed is that new aspects and values may be discovered. Provided one is open for it, a process of reflection upon and redefinition of one's own values and perspectives may start. In music therapy one could say that psychological processing and aesthetic framing become reciprocal and dependent upon each other (p.60).

These new possibilities allow healing to emerge, because a person is no longer stuck in a one and only rigid pattern or compulsive frame. So a significant part of the healing process, I think, is about being able to engage with the world through flexible inter-active frames, about allowing change, about expressing those changes. And change normally comes when a paradox opens a path to different possibilities (Fiorini, 2007): the possibilities of being different, depending on where you are, who you are with, what you need...that is, depending on the CONTEXT -as a frame and as a link (Rolvsjord & Stige, 2013). As music therapist Carolyn Kenny (2006) says:

The primary aspect of creativity that emerges as a consideration in healing is acknowledgment and utilization of paradox, being able to accept and use mixed feelings or contradictory circumstances for growth and change (p. 56)

That's why the arts are so useful in therapy, because they help engage with and ex-press the flexible processes of creating framed meanings. Creating "things" from something that comes or presses from the inside is a basic tenet of the creative therapies (Fiorini, 2007; Machioldi, 2008; St. Thomas & Johnson, 2007).

This article is concerned with the art of re-framing according to context, with the art of framing through different patterns. It's an art, because it's connected to the inter-active, aesthetic, relational and expressive processes involved in creating chunks of patterned meanings. It's a RE-FRAMING process, because it's connected to attending the how and from where we give those patterns new forms to look from.

About My Frame...

From September to November 2011 I volunteered in the Community Based Organization (CBO) “Music for Peaceful Minds” (MPM), which carries out a music therapy program with primary school children in Gulu, in the north of Uganda, Africa. During my volunteer time, I encountered many difficulties that made me experience conflicting elements in the music therapy practice. I realized that music was an amazing tool for communicating with the children, but “something” didn't work out. This “something” was linked to the different ways of perceiving the world, relationships, ourselves...of what was meaningful for me, as a white Spanish music therapist that goes to Africa to “help” and what is meaningful for them, Acholi children who are still surrounded by the consequences of a 20-year political conflict. My initial feeling was that, yes, Gulu is filled with music everywhere, therefore music “helps” somehow in their daily lives. But, no, music therapy doesn't work there, because “something” related to how we perceive the world is just too different. How could that be? -I asked myself- How could music be everywhere but music therapy not work?

When I finished my volunteer period and went back to Spain, I started reading about Community Music Therapy (CoMT) and other experiences similar to mine. I was amazed to see how other people had reflected upon many of the same issues I had experienced and how they had found a way of framing those issues in a way that made sense to them. Mercédès Pavlicevic, for example, talks about ''re-visiting'' some of her assumptions and norms in her music therapy practice regarding tenets such as skills, health, roles and timing during some of her work in South Africa (Pavlicevic & Ansdell, 2004). She also talks about music therapist Carol Lotter, who works in a youth outreach program in South Africa and never knows who will come to the music therapy sessions but that ''this is part of her work: to be here on Monday and Tuesday afternoons, and see what happens'' (Stige, Ansdell, Elefant & Pavlicevic, 2010, p. 220). In his book ''Living with Bad Surroundings'', Finnström (2008) is constantly re-framing concepts (such as trauma, humanitarian relief and moral truths) from the dominant Western discourse to the war-affected Acholiland context. Journalist Richard Dowden talks about re-learning some behavior rules to function better in Africa, like, for example not looking for definite resolutions, not expecting integral truths and being patient (Dowden, 2010). Through these experiences, I understood the importance of the frame in order to approach a situated practice. I also realized how important theory was in the construction of a discourse in order to create the frame, that is, in order to give meaning to an experience.

The difficulties I experienced were later collated in the following categories:

  1. Keeping boundaries of time in the sessions.
  2. Emphasizing privacy issues in the therapeutic relationship.
  3. Maintaining a (closed) safe therapeutic space.
  4. Developing creativity with the children.

I soon realized that these difficulties clearly came from my personal assumptions, worldview and music therapy background: my personal frame. In Gulu, my assumptions were totally out of context. They had no skeleton to hold onto and they felt meaningless.

In this article -and in my master’s dissertation- generalizations about “Western” and “Non-Western” or “African” cultures or worldviews are made. This is due to two reasons. The first one is that this is a part of the experiences of the European music therapists. In Gulu, many people referred to themselves as “Africans” and to us as “Munu” which, in Acholi, means “white person”. In other parts of Uganda the popular word for white person is “Mzungu”. This was understood not only as a skin color difference, but also as a cultural difference, a different way of perceiving the world. Many conversations with locals and with Westerners would take place regarding the differences between “African people” and “Mzungus”. The second reason is that these generalizations are used in the Critical and African-Centered Psychology literature (Byakutaaga, 2006; Duncan, 2004; Fairfax, 2008; Harlacher, 2009; Kwate, 2005) as well as the in the anthropology literature ( Breslau, 2004; Finnström, 2008; Gouk, 2000; Small, 1998; Summerfield, 1999). Cameroon economist Daniel Etounga-Manguelle asks himself “Does generalizing about African culture as a whole make any sense at all?”, and he answers “I believe it does. The diversity, the vast number of subcultures, is undeniable. But there is a foundation of shared values, attitudes, and institutions that bind together the nations south of the Sahara, and in many respects those to the north as well” (in Harrison & Huntington, 2000, p.67).

The intention of using these generalizations is not to claim that all people of a same continent feel, understand and behave the same way, but to embrace under two wide frames a sense of the different kind of approaches people of a same continent tend to have. In the literature consulted, and also in this article, all reference to 'African' is understood as people based within Sub-Saharan Africa.

About the Commuity Music Therapy Frame...

Community Music Therapy (CoMT) is a relatively new approach based on a sociocultural perspective. This approach highlights a context-sensitive way of looking at music therapy practice through a constant re-thinking of concepts in their context. According to music therapist Brynjulf Stige and social psychologist Edvard Aarø (Stige & Aarø, 2012), defining CoMT is not easy because of the different contexts of contemporary practice and because of the pressure that conventional clinical music therapy still exercises over the definition. They state that the definition of practices and disciplines should always be understood in their historical and socio-cultural context. Because these change over time and space, it is necessary to assume that re-defining music therapy will be a constant activity in the broad field of CoMT. According to Stige (2002), “Culture-centered perspectives suggest that music therapy be conceived as a situated practice, which again indicates that no final or universal definition of music therapy will do” (p.181). He draws attention to an awareness about music therapy as culture, that is, music therapy as a practice and discipline that has its origins in a specific historical moment, in a specific socio-cultural context, with specific constructed meanings. Following this point of view, it is not possible to just “export” a kind of music therapy practice, there is a need of creating it in its socio-cultural context. He also points out that, in order to do this, music therapist's need to relate to other disciplines such as anthropology and ethnomusicology (Stige, 2008). According to Finnström (2008), anthropology is a social science that aims to investigate and analyze “common, general, mainstream, and even taken-for-granted stuff of everyday life in a particular context” (p.10).

Reflexivity, the ability and process of thinking of oneself in relation to others, is also considered very important in the CoMT approach (Pavlicevic & Ansdsell, 2004; Ruud, 1998; Stige, 2002; Stige, Pavlicevic, Ansdell & Elefant, 2010; Stige & Aarø, 2012). According to South African psychologist Nhlanhla Mkhize (in Duncan, 2004), “reflexivity will enhance the ability of psychologists and other social scientists to understand and interpret others' lives meaningfully” (p.5-18). He states that “traditional Western approaches to psychology are based on certain presuppositions about the person and the world” (in Duncan, 2004, p.4-2) and that a critical emancipatory psychology should consider indigenous people's worldviews, philosophies and languages. He defines “worldview” as a “set of basic assumptions that a group of people develop in order to explain reality and their place and purpose in the world” (in Duncan, 2004, p.4-12). He considers four components of a worldview: time orientation (where one comes from, where one is and where one is going to), orientation to nature (how people relate to nature), human activity (what the preferred human activity is) and relational orientation (how the self defines itself in relation to the others). Critical and African-Centered Psychology deal in depth with ahistorical assumptions of the conventional Western psychology discipline and with its power relations of domination through discourse.

In the CoMT literature I found a more flexible way of looking, a more context-bounded frame...this new look has offered me another way of understanding my experience of music therapy. The following CoMT qualities (all extracted from Stige & Aarø, 2012) were used to change the quality of my frame:

  1. Participatory: instead of using terms like “client” or “treatment”, the CoMT approach prefers to talk about “participants in a collaborative process” (p.21). So this quality frames the therapeutic relationship not as a one way healing power (therapist →→client), but as a mutual empowerment (therapist ↔↔client) and as an opportunity for social participation.
  2. Resource-Oriented: instead of concentrating on diagnosis and treatment, the focus of the CoMT approach is on mobilizing social, cultural and material resources (such as music organizations and traditions) in order to make available health-musicking situations (the term musicking is explained in the following section).
  3. Ecological: this biological term is used in CoMT to highlight the reciprocal influence of socio-cultural life between organisms and their environments, that is, to address context and cultural sensitivity.
  4. Performative: some CoMT practices include activities that are not conventionally labeled as “therapeutic” -such as performing- but that might be important for the musical identity of the participants. This quality acknowledges that in many non-Western cultures performance is not a separated concept of musicking, but a part of it (Small, 1987).
  5. Reflexive: refers to the importance of local knowledge and to the openness of the music therapists for integrating theory, action and research. CoMT proposes cultivating a high level of self-critical awareness in relation to forms of knowledge.

These qualities are useful tools that can help our music-therapeutic way of looking (framing) to include cultural aspects of the participants, that is, to include their ways of being in the world.

About My Re-framing Process...

After my volunteer period, I decided to use my master's dissertation to study this paradox more deeply: why could I feel that music therapy was not useful in a place where music filled daily life? Without knowing it, I was actually wondering about musicking, a concept developed by musicologist Christopher Small (1998) from New Zealand, who insists that “music” as a “thing” does not exist. According to him, music can only be understood as action and interaction in social/cultural contexts. Therefore, to music is a verb, an action. Making music is musicking, and this can be any activity surrounding the musical context. He explains that the Western tendency of talking about abstract “things” as if they actually exist (like “music”) is linked to reification and to accepting universal assumptions without attending to the role of culture and context in the construction of meanings. The musicking concept is, therefore, commonly used in the CoMT view, because it understands music in everyday life as a social resource and a potential healing force.

Musicking, according to my experience, was an ongoing activity in Gulu: it was present in the way people talked, the way they laughed, the way they walked, the way they moved. Singing voices came out of the market, out of the schools, out of workplaces and homes, out of the churches, out of the buses. People would swing their hips and howl during hours at weddings, rhythms would emerge from all around in the streets. Musicking was everywhere, but music therapy -I felt- didn’t work.

I thought it would be useful to interview other European volunteers that had participated in MPM's project to see if my experience was unique or if other people of a similar culture had experienced similar issues. Three Skype interviews were carried out with three music therapists: the English creator and director of MPM, a Dutch volunteer and a Scottish volunteer. The interviews were semi-structured with open questions. The final goal was to try to capture the music therapists' experiences in their practice in Gulu (see Appendix A for the interview guideline).

In my master's dissertation (Navarro Wagner, 2013) I analyzed the qualities of CoMT that can contribute to re-framing the experiences of four European music therapists when engaging with local disadvantaged children in Gulu's sociocultural post-war context. Through a phenomenological and hermeneutic analysis of the researcher's field notes and of the interviews of three music therapists, a series of CoMT qualities were used to re-frame common patterns of their experiences. Phenomenological descriptions involve a systematic analysis of experience and subjectivity. In the field of psychology, phenomenology focuses on how people interpret and construct their experience in the world. According to Carolyn Kenny (2006), hermeneutics -the science of interpretation- is “a particular area of phenomenological research pertinent to the creative arts therapies” (Kenny, 2006, p. 95). Because of my interpretative approach to the experiences of the music therapists, the analysis of the data (researcher’s field notes and interviews) is considered phenomenological and hermeneutic. A grounded theory method was used to move gradually from a descriptive level of the music therapist’s experience to a theoretical one. The researcher's worldview was contemplated in the phenomenon of study and reflexivity is considered a relevant concern.

The analysis of my field notes and of the interviews led me to the following process: beginning from the common pattern of the participant's experiences, a general quality of the CoMT orientation was used to re-frame the categories. This quality led to an anthropological and Critical Psychology approach to Gulu's context, which was used to define the quality of the situated practice. This final viewpoint led to a conclusion that went back to the experience in order to re-frame it and to offer a new insight of it.

Figure 1. The re-framing process.
Figure 1. The re-framing process.

About the Re-framed Categories...

The re-framing process was done with each of the final categories that emerged from the analysis of the interviews and the researcher's field notes. I will now present the final categories and the re-framing approach:

Keeping boundaries of time in the sessions

All participants agreed that trying to set up a therapeutic timetable was a problematic issue in Gulu. Children didn't show up, timetables weren't respected, greetings “ate up” a big part of the session...that is, timetables didn't work out in a “natural” way as they worked in other European contexts. CoMT considers that establishing a rigid therapeutic timetable is an inheritance of the psychotherapy model - which had its function and meaning in the context where it was created- but argues that this convention should be ready for reflection and rethinking according to the context. The ecological quality of the CoMT point of view suggests that the different interaction levels of the participants (the mutual relationships between organisms and environments) should be taken into consideration (Stige & Aarø, 2012) so that the context helps to define how music therapy should happen (Pavlicevic & Ansdell, 2004). In this category, this means acknowledging Acholi people's orientation to nature and the environment, that is, considering their worldview in relation to their sense of time.

According to a Critical Psychology and anthropological point of view, Ugandans have an agricultural time orientation, so their sense of time has more elastic boundaries than Western standards (Byakutaaga, 2006). This perspective acknowledges that, whereas industrialized cultures view time in terms of minutes and hours, agricultural cultures view it in terms of seasons or wide periods of work routine. This agricultural time orientation also corresponds to a more traditional African worldview were the past (relationship with ancestors) and the present (relationship with community) is much more important than the future (Dowden, 2010; Etounga-Manguelle in Harrison & Huntington, 2000; Kapuscinski, 1998; Mkhize in Duncan, 2004). According to this worldview, the passage of time and it's mathematical division isn't as significant as the establishment of good relationships.

For a situated music therapy practice, the ecological quality in Gulu's context would mean taking into consideration the local wide sense of time. That is, not insisting so much on establishing an “industrialized culture” timetable (in terms of hours and minutes) but a more “agricultural culture” one (in terms of wide periods of work routine). This would mean including the greeting time or the “gathering of the group time” as an important part of the process of getting to the music session, instead of viewing it as something that isn't linked to the session. The role of the therapist would then include “sharing the time of the gathering” or “sharing the porridge (breakfast) time”, where musicking affords to take place (sing songs, play rhythms...) but doesn't necessarily have to (maybe just chatting with the staff while waiting for the groups to start is also important).

Emphasizing Privacy Issues in the Therapeutic Relationship

All participants agreed that privacy within the group was a problematic issue in Gulu. Many external people would watch or try to get into the group and this was experienced as a cultural but conflicting element. The CoMT literature points out that the priority of the conventional music therapy model is helping clients throughout the therapeutic relationship and to impede external interferences in the process. This approach is supported by an individual psychological model (Ansdsell, 2002). The participatory quality of CoMT aims to frame the relationship between the “therapist” and the “client” as “mutual empowerment” (Stige & Aarø, 2012). This means that the practice is not focused on the conventional therapeutic relationship but on providing possibilities for musicking participation. Instead of working “down and within” the client (that is, working down into the person’s psyche/personality, as the conventional psychological model approach suggests), the participatory quality seeks to work “outwards-and-around” (that is, working with the possibility of participating in meaningful health musicking situations). This does not necessarily mean that the ''down and within'' approach is rejected per se, but that -if appropriate- it should be included from the ''outwards-and-around'' passageway to the participants. Privacy, therefore, is not considered the most relevant issue, but increasing the opportunities for participation is.

The ecological quality suggests that other levels of human activity (individual, organizational, community, environmental and spiritual relationships) are to be dealt with (Stige & Aarø, 2012). In this category, this means acknowledging the social nature of the individual's sense of self (Pavlicevic & Ansdell, 2004). Because people perceive themselves in relation to their meaningful relationships, cultural and social determinants of selfhood are to be worked with (Ansdell, 2002). If these relationships aren't taken into consideration, the ability to give meaning to Acholi people's world might be interfered with. This quality, therefore, leads to the relational orientation of a worldview.

According to anthropological views, Ugandans don't have the same sense of privacy or personal space as Westerners (Byakutaaga, 2006). This is because their worldview is linked to a traditional African relational orientation where personhood is understood as a process in relation to the participation in the community (Dowden, 2010; Duncan, 2004; Etounga-Manguelle in Harrison & Huntington, 2000; Kapuscinski, 1998; Fairfax, 2008). Critical Psychology literature states that traditional Western cultures regard an individual sense of self, which is defined in terms of its internal attributes and capacities. This individual sense of self implies a contrast to a more non-Western collectivist self, which is defined by the reciprocal relationships with the others and the cosmic unity (Fairfax, 2009; Finnström, 2008; Harlacher, 2009; Mkhize in Duncan, 2004). Traditionally, Africans believe that everything in the universe is connected, including objects, spirits and beings.

Maintaining a (Closed) Safe Therapeutic Space

Because the only clear pattern regarding this category was the statement that there were no closed therapeutic spaces to carry out the sessions in, and because privacy and space were linked themes in the interviews, "Maintaining a (closed) safe therapeutic space" was finally considered a sub-category of privacy. Here the focus isn't on the conventional therapeutic relationship, but on the conventional boundaries of the (closed) therapeutic space, which all participants agreed on as a problematic issue. The performative quality of CoMT accepts and involves activities that are not labeled as therapy and that sometimes leave the context of a session or the therapy space. There is less focus on “fixing” peoples problems and more on generating “well-being musicking” situations (Pavlicevic & Ansdell, 2004; Stige & Aarø, 2012; Stige, Andsell, Elefant & Pavlicevic, 2010). Here the CoMT overall orientation of working “outwards-and-around” emerges again. In this category this means that the focus is not on the space itself but on the relationships that come into contact with the musicking situation. This quality, then, leads us to understand how health-musicking might happen in Gulu.

The literature states that music in Acholiland has a very important social role in the community (Edmonson, 2005; Finnström, 2009; Gray, 2010; McClain, 2009; Nannyonga-Tamusuza & Solomon, 2012). This could lead to the argument that music in Northern Uganda is not designed for privacy because it is not perceived in private contexts. In fact, some ethnomusicologists (Janzen in Gouk, 2000; Small, 1987) state that the concept and practice of music in Africa isn't separated from dance and performance: it's focused on the social interaction and social purposes and not on the music itself. Musicking includes the idea of performance. Performance is an important part of the healing process for the Acholi society in their post-war context (Bernstein, 2009; Fine & Nix, 2007; McClain, 2009; Nannyonga-Tamusuza & Solomon, 2012).

So, in a situated music therapy practice in Gulu, the participatory quality would mean not focusing on the conventional therapeutic relationship as a means of recovery, but as a bridge for musicking participation. The means of healing would be in the musicking itself and in the processes of participation. Musicking could then take place following an ecological quality, that is, taking into consideration the Acholi people's collectivist self and musicking in the open, where other members of the educational community could also participate by just watching, being present or joining in the music. This would finally lead to the performative quality, which would include musicking not as a private group activity but an activity that affords other members opportunities to join in or just observe and admire.

Developing Creativity with the Children

The developing creativity category was the most complex one because it easily led to different interpretations. I wasn’t able to establish clear boundaries of the category in the interviews and, therefore, different meanings arose for each participant. What “creativity” meant for each informant was not clear. But, despite the lack of a shared definition, there was -strangely enough- a clear pattern that emerged from the data: all participants agreed that creativity is a basic goal to achieve in music therapy.

The initial intuition of the study was to link this category with the collective self of the African worldview. A general characteristic I had observed in many children was systematic obedience, emotional numbness and lack of initiative and creativity. I thought this was because of the 20 year civil war they had been born in, life in the Internal Displacement camps and the authoritarian approach of the education system. I thought it would be very important to try to develop creativity in the music therapy sessions but I experienced some difficulties when trying to do so: a) participants would expect my instructions, b) try to please me, c) copy each other when my facial expression was of approval and d) repeat my modeling examples. Later on, I realized this difficulty was because, even though the music sessions were in a group, my approach to the children had been carried out in an individualistic way. I was trying to bring out individual values (like autonomy, uniqueness, originality) where group values (like blending, dependency, togetherness, mutuality, following) were more significant. This is why I decided to ask the informants about this category and compare their experiences. But, when examining the data, it turned out to be impossible to analyze because of my initial unclear concept of creativity in the therapeutic context.

The assumption that “creativity is a basic goal to achieve in music therapy” seems to emerge quite strongly from the experiences of the interviewees, the general literature of music therapy (see, for example, Malchiodi, 2008; Nordoff & Robbins, 1977; Sutton, 2002) and the training programs for music therapists (see Kenny, 2006; Wigram, Pedersen & Bonde, 2002). Following the CoMT belief that each context should define how music therapy happens (Pavlicevic & Andsell, 2004) and considering that, during my research time, nothing relevant was found for this category in the Critical Psychology approach, an interesting research field could be opened: what does creativity mean in Gulu's context? How is creativity perceived and developed in Gulu's musicking context? Is this category related to the individualistic Western-self or can it be developed from the non-Western collective self? Could this category be included in the way musicking “works” in Gulu?

Carolyn Kenny (2006) refers to McCormick's (1995) idea that expression (through ceremonies, arts or storytelling, for example) is the most important means of healing among indigenous people. Creative processes are linked to ex-pression: combining, experimenting and playing with different resources (flexibility) in order to find a suitable vision (frame) that helps release the pressure from within. Music therapy and other art therapies deal with creative processes as the basic healing powers, so I would follow Kenny's suggestion that ''we might ask questions about the deprivation of certain opportunities for expression that serve to keep a person healthy over time'' (Kenny, 2006, p.161). How do people tend to ex-press themselves in Gulu? How can a music therapist help in the development and practice of expression and creativity in this context?

Language Barrier

This category wasn't experienced as conflicting in the researcher's experience, so it was not initially contemplated in the interviews. But because two of the informants refer to this theme as a meaningful one in their experience, it was included in the analysis.

The 'language barrier' category, as experienced by two informants, underlines a psychotherapy approach, where verbal communication is considered essential to bring to consciousness what happens in the session. Both informants mention the “language barrier” theme as an impediment to go “deep” into the child's psyche. In the CoMT approach musicking is the main activity. The resource-oriented quality aims at mobilizing different available resources (social, cultural and material) such as music organizations and traditions. This view proposes that music therapy should work in the ways in which music commonly works in the individual and social life of the participants. According to many authors (Bernstein, 2009; Cagney 2011; Edmondson, 2005; Nannyonga-Tamusuza & Solomon, 2012;) music, dance and drama have an important role in the cultural identity of the Acholi. These performing arts are the most significant indigenous long-standing cultural patterns in Acholi culture (McClain, 2009) but, because of the war, these patterns of expression were disrupted and compromised (Bernstein, 2009; Cagney, 2011). Developing significant expressive art patterns has been argued as helpful for dealing with war/post-war issues and to help reclaim cultural identity in different contexts of Acholiland. Music has played an important role in war rehabilitation centers (Edmonson, 2005), in strategic programing through Mega FM radio (McClain, 2009), in participating at the National Music Competition for primary schools (Fine & Nix, 2007), in integrating and educating communities (Gray, 2010) and in church groups (McClain, 2009). Also, Acholi popular musicians have composed music to articulate the war situation (Wadiru in Nannyonga-Tamusuza & Solomon, 2012).

The resource-oriented quality of CoMT would mean that providing and developing musicking opportunities is the main goal. In this post-war context where access to performing arts is considered significant, the resource-orientated approach seems appropriate to develop a context-sensitive frame. According to this quality, the lack of verbal language to understand the child's psyche wouldn't be considered a barrier for the musicking to happen. The goal is rather to activate existing resources (music traditions, teachers, social workers, musicians or counselors, for instance) and work together. A more effective role for the music therapist -considering the cross-cultural setting- might include facilitating musical and communication skills to community workers or providing health-musicking situations to those who don't have access to them (like Special Need Units in Primary Schools, Rehabilitation Centers, marginalized neighborhoods or villages and hospitals). Being able to communicate with the people in order to understand what, how and when music works is essential for the effectiveness of the music therapeutic frame creation and development. Language is important to create bridges and culturally sensitive settings, but not a barrier for musicking with the participants, because the focus is not so much on interpreting the participant's psyche, but on humans connecting through music. In the CoMT approach, musicking is understood as a social-musical process (Stige, Ansdell, Elefant & Pavlicevic, 2010), which will be more extensively dealt with in the following category.

The Music Therapist's Role

“Who are we and what are we doing here?” is -even if not articulated in those exact terms- a question all of the participants asked themselves in their volunteer period. All participants refer to some kind of reflection about what they were trained for and the contradictions that came out when dealing with such a different context. Therefore, this led to the underlying theme of “the music therapist's role”.

A common pattern of-feeling of three of the volunteers was that playing music with the children offered many communicative possibilities and outward changes (such as expressing some kind of emotion) but that “just” playing music wasn't enough to consider their practice a professional one (a practice that was effective in achieving the goals). Many doubts regarding the effectiveness of the therapy arose during their volunteer period, mostly related to conventional therapy patterns (the therapeutic relationship, verbal narration, psychological interpretation, privacy). This embraces a certain topic that is extensively dealt with in the CoMT approach. The reflexive quality of CoMT involves not just “clinical reflection” in relation to the music-therapeutic work, but a more broad “reflexive practice” in terms of the sociocultural context. CoMT requires a high level of self-critical awareness in relation to forms of knowledge (Stige & Aarø, 2012) and I consider this as essential when traveling to other cultures in order to offer a music therapy service. The underlying approach of how music “works” in CoMT is a sociocultural one. That is, that musicking (perceived, experienced and acted upon) takes place when “para-musical” (extra-musical aspects, like, relaxing, enjoying, communicating, identifying) are incorporated into musicking and, consequently, the musical seems to afford the para-musical (Stige & Aarø, 2012; Stige, Pavlicevic, Ansdell & Elefant, 2010). This means that, in order to find out how music “works” or “helps”, we must explore how it is perceived, experienced, acted and reflected upon in its sociocultural context. So maybe the goals in such a context might be ''just'' playing music, or playing to support communication possibilities and outward changes. A practice that does not address difficulties in non-verbal communication or does not achieve a conventional therapeutic relationship through privacy wouldn't mean that the practice is not a professional one. The resource-oriented quality, again, suggests that the important focus is to mobilize available resources in order to promote health-musicking situations. One of the basic roles of the music therapist would then be to make these resources available to people that don't have easy access to them. Health-musicking situations are very useful in a post-war context to promote healing, well-being and conflict resolution (Lance, 2012; Malchiodi, 2008; O'Connel & Castelo-Branco, 2010; Osborne, 2009; Sutton, 2002; Vaillancourt, 2009).

The literature sates that Acholi use performance of traditional songs and dances as a hidden form of activism in their war and post-war contexts. Children feel cultural identity, group connection, pride, hope, joy and a sense of belonging when performing traditional Acholi songs and dances (Bernstein, 2009; Edmonson, 2005; Fine & Nix, 2007; Gray, 2010; Whittaker, 2010). According to McClain (2009), this is because music, dance and drama are long-standing cultural patterns that resonate deeply in the Acholi society.

The reflexive quality would consider it important to understand the way musicking happens in Gulu and what paramusical elements it affords. This quality helps to understand and frame the music therapist’s role in a cross-cultural setting, which is crucial for the well-being of the music therapist and of the community. The resource-oriented quality would suggest that providing musicking participation opportunities through the mobilization of available resources (local teachers, social workers, musicians, counselors, instrument makers etc.) is the music therapist's role in this context. This would mean sharing communicative and interpersonal musical skills with local teachers, social workers and counselors, taking local musicians to places with reduced access to musicking situations, providing musical instruments, creating spaces and moments for performances, etc. Health musicking situations in Gulu may be achieved through the performance of traditional Acholi music, popular music, dances, etc. Music in Acholiland is generally shared amongst a community and observed/enjoyed by crowds of onlookers.

Some Conclusions...

The outcome of this article -based on my master's dissertation- is a reflexive theoretical frame constructed from the experiences of four European music therapists and through a CoMT point of view. This is just an example of what a situated music therapy program could be in Gulu. These CoMT qualities (participatory, resource-oriented, ecological, performative, reflexive) have opened up my view about what music therapy can offer. They have also helped me to create a multi-layered sense of what musicking can be in an inter-active context. Now I no longer have the feeling that music therapy can't work in Gulu. I also feel that these qualities can help to frame an activity that takes a place in every culture: musicking. As Bunt and Stige (2014) say: ''The ever-changing, open-ended, connected and interactive nature of artistic processes has much that is complementary with these new constructs'' (p. 214).

I think that the art of re-framing can be very useful for any music therapist that has to work in different contexts. Training in flexibility and an ability to re-frame is necessary in every context, but it is especially delicate -I think- when ''ex-porting'' or bringing a practice to a different culture. As music therapists that start creating practices in diverse and cross-cultural settings, we are responsible for preserving the art of re-framing according to the context. According to my experience, the CoMT qualities are a good guide to accompany this process.

Currently MPM's program has benefited from the CoMT approach. Instead of taking certain groups of children out of their classrooms to have music therapy sessions, the current and local MPM workers go into classrooms and provide opportunities for musicking with the whole group and their teachers. At the Deaf Unit of a primary school and the Special Need Unit of another one, all the children have music therapy sessions together with the local staff. This way of working is more accepted by the educational community and, therefore, is more efficient in achieving goals that include expressing, communicating and sharing.

The diversity of contemporary music therapy practices is a challenge to the creation of the discipline (Stige & Aarø, 2012), so as music therapists we have the responsibility of reflecting about our frames. This article acknowledges the need of phenomenological and ethnographic research in music therapy in order to help create situated frames. These frames are created by reflecting on conventional boundaries/assumptions and by stretching them out, so as to frame the context where practices take place. Experience of work within a specific context and its local knowledge are -therefore- considered very important in the creation of a discourse that validates a practice.

When we position ourselves differently, the view of what we look at changes. And healing can only appear when changes are allowed to emerge and allowed to be ex-pressed within a frame of reference. The way of looking changes the perception of who you see, and the way you are looked at changes how you are with others. And that is what I think therapy is about: allowing changes in order to get closer to who and how we want to be with others.


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Appendix A

Interview guideline

After participating in MPM's music therapy program in Gulu from September to November 2011, I am now reflecting about my experience in my master's thesis. I would like to interview you about your personal volunteer experience. In the context of your work time at MPM's project in Gulu, please answer the following questions as coherent with your experience as you can. Thank you!

  1. What made you decide to volunteer in/start MPM's music therapy program in Gulu?
  2. How much time did you volunteer/work for? Why was it that amount of time?
  3. What was your role at MPM?
  4. Could you describe in general terms the characteristics of the children you worked with?
  5. During your work time at MPM, what aspects of music therapy (approaches/activities/methods) do you think worked better for the children? Could you explain why?
  6. During your work time at MPM, what aspects of music therapy (approaches/activities/methods) do you think didn't work? Could you explain why?
  7. Could you describe a specific situation in the music therapy practice where you felt your pre-understandings where challenged or didn't work? If so, why do you think this happened?
  8. During your work time at MPM, did you experience any difficulties with any of the following issues? If so, how did you deal with these difficulties?
    1. Emphasizing privacy in the sessions
    2. Maintaining a clean and safe therapeutic space
    3. Keeping time in the sessions
    4. Developing authenticity and creativity with the clients
  9. During your work time at MPM, did you experience any moments of doubts regarding the professionalism of the music therapy practice? If so, could you say something about those doubts?
  10. Are you familiar with a relatively new field in the Music Therapy discipline called Community Music Therapy? If so, could you tell me something about it? If so, what do you think about this approach in unconventional music therapy practices such as MPM's project?