[Report]

Celebrating 15 Years of Music Therapy Training in South Africa

By Helen Oosthuizen

Abstract

In 2014, the Music Therapy Master’s training course at the University of Pretoria, South Africa, celebrated its 15th anniversary. To mark the occasion, two showcases held in Gauteng and Port Elizabeth presented work that is being done by music therapists and community musicians across the country. Presenters included experienced music therapists as well as recent graduates and students from the Music Therapy Masters and Honours in Music Communication courses offered by the University of Pretoria. This report of the showcases highlights the calibre of exciting music therapy projects that are emerging and developing within diverse contexts and communities throughout our country.

Introduction

“A beginning has arrived and will hopefully be flexible enough to allow music therapy to develop as it will, here, in Southern Africa.” (Pavlicevic, 2003)

In this way Mercedes Pavlicevic (one of the founders of the Music Therapy Master’s course at the University of Pretoria, South Africa), marked the beginning of a very exciting journey.

The 15th anniversary of the Music Therapy Master’s course offered a suitable opportunity to celebrate and reflect on this journey. On Saturday 16 August 2014, approximately 200 people from many regions within South Africa gathered together for a showcase demonstrating the work of music therapists and community musicians in this country. Presenters included graduates of the Music Therapy Masters course, some with many years of experience in the field; current students; as well as recent graduates of the Honours in Music Communication course founded by the music therapy department in 2002. Music therapy clients and organisations affiliated with the music therapy department entertained us with vibrant performances. The event was a public affirmation of the quality and calibre of the music therapy department. In 15 years, this department has trained and equipped many therapists and community musicians who are initiating, developing and participating in transformative projects, offering their valuable clinical and musical skills in many parts of Southern Africa.

On 28th October 2014 the local Port Elizabeth representatives of the South African Music Therapy Association (SAMTA) held an additional Music Therapy Showcase in Port Elizabeth, attended by over 100 people – yet another accolade celebrating the profound work that graduate music therapists are doing around the country.

Attendees at the two showcases included fellow professionals from various clinical placements, including representatives from Chris Hani Baragwanath, Steve Biko and Weskoppies Hospitals. This is a positive indicator that in many sectors music therapy in South Africa is gaining recognition as a valuable contributor. The showcases were also supported by staff members from the broader university community including the Head of the Music Department and Dean of the Department of Humanities; music therapists; arts therapists from other modalities; musicians and those interested in the profession, including potential future students. In Gauteng, we were privileged to have Dr Mercedes Pavlicevic present, this time to represent the international music therapy community – from the Nordoff-Robbins Music Therapy Centre in London.

This report reflects some of the presentations, music performances, and posters that each added their own significant contributions to the showcases. My hope is that there will be many opportunities in the future, through published journal articles or conference presentations, where each contributor to these events will be able to present their work in more detail.

The Showcase Programme - Gauteng

“We sing together...energy, strength, life bursting forth like bright light shining! ... I feel happy...just like I am home.”
(Excerpts from a poem written for the showcase by Kerryn Tracey, a current music therapy master’s student)

In Gauteng, the showcase proceedings were opened by Prof Wim Viljoen, the Head of the Music Department at the university. He endorsed the value of the music therapy training course, saying that “...the music therapy programme is very important and close to our hearts, because it’s a very special specialisation” and “our university is the only one that offers a master’s degree in music therapy on the African continent.” His appreciation and thanks were offered to past and present staff members of the music therapy department. In particular, Mercedes Pavlicevic, Kobie Swart, Carol Lotter and Andeline Dos Santos were noted for their instrumental roles in founding, driving and developing the music therapy training course.

Attendees were drawn creatively into the world of music therapy through poems written by the current music therapy students accompanied by sounds, gestures and musical phrases played to match the mood of each poem. Andeline Dos Santos (who currently heads up the music therapy training course along with Carol Lotter) similarly presented a video that offered images, words and music to convey how the gestures and expressions we use to communicate can be read as having musical qualities. It is these musical qualities that music therapists are able to tap into to form relationships with clients that encourage healing and the exploration of new identities, enabling transformation and growth. The video articulated the potential of music as a therapeutic tool, illustrating concepts that so often elude being reduced to verbal definitions.

What followed was a range of performances and presentations highlighting the transformative power of music as revealed through the work of music therapists and community musicians trained by the music therapy department in South Africa.

Showcase Presentations

The Bachelor of Music Honours Degree in Music Communication offers theoretical and practical tools for using music as a means of communication – encouraging meaningful, creative interactions in music groups across a variety of contexts. In the first showcase presentation in Gauteng, Hillary Cromberg Inglis, a graduate residing in KwaZulu Natal, presented her work with a group of Zimbabwean refugees. In the evenings, this group of young men who were often marginalised due to their nationality were drawn together to make music. This was something many of them had done at home but had not had an opportunity to do in South Africa. Through the process, Hillary found she had to continually negotiate her role, reconsidering what instruments to bring and how to facilitate or support meaningful interaction within the group. However, group members soon became regulars, bringing along their own traditional instruments, enjoying the social and musical opportunities. As the group drew to a close, they performed for an audience consisting of predominantly white South Africans. Gradually, this audience that initially sat still and clapped politely were motivated to join the performance, being taught how to play parts of songs on a variety of instruments, and even dancing. It was a beautiful example of the power of music for drawing people together.

A presentation of the work of a Cape Town based non-profit organisation, MusicWorks (previously known as the Music Therapy Community Clinic) further emphasised how music is able to empower those on the margins of society. The director of the organisation, music therapist Sunelle Fouché, spoke very briefly about some of the projects MusicWorks has initiated in the Cape Flats (a group of townships outside Cape Town, known for high levels of violence, crime and poverty) for the last 12 years. The vision of MusicWorks is to offer hope and possibility for children’s lives through shared engagement with music. Sunelle stressed the importance of hope for changing children’s lives – supported by a study from the University of the Western Cape that found that hope was a stronger predictor of children’s well-being than exposure to violence (Savahl, Isaacs, Adams, Carels & September, 2013). MusicWorks’ projects include work with those affected by illness such as HIV or Tuberculosis and disability, which is often exacerbated by neglect. MusicWorks also offers interventions and support for young people exposed to continuous trauma and violence. The organisation offers music therapy for many children who would not otherwise receive psychosocial support, as well as after school music activities such as a choir, drumming or marimba groups, in their Music for Life programme. In this programme, music therapists partner with local musicians, including some past group members, to mentor and teach others – as a means of offering constructive social belonging within music. In their early childhood development programme, MusicWorks offers tools for teachers to use music creatively to motivate children to take initiative, engage playfully and receive validation.

MusicWorks is strongly underpinned by the community music therapy approach. Community music therapy does not delineate a specific therapy technique but rather emphasises that music therapy takes place within a particular context, and the work of therapists needs to be adapted and negotiated flexibly within this context (Stige, 2004). Music is an already flourishing resource within the communities MusicWorks offers their services, and rather than imposing their own structures upon a community, MusicWorks utilises these resources to offer ways in which this music can be used as a vehicle to bring about hope and transformation. Thus MusicWorks has strongly emphasised the need to grow a practice from the ground up, dependent on and unique to every community in which they work.

Sunelle’s presentation culminated with a powerful example of work with a group of young girls who felt as if they weren’t good enough in most aspects of their lives. As part of their therapy process, the girls identified one community member who valued them, who they then interviewed. The girls used this woman’s words to create a good enough song (for a link to this song, see http://musicworks.org.za/good-enough-songs/). The process of creating and recording this song validated the potential and worth of each girl participating in the group.

To follow this presentation, Tanya Brown, a music therapist working in Pretoria, presented a project she completed as part of her Master’s Dissertation. Here the value of song-writing as a means of empowerment and validation could be witnessed within a very different environment. Tanya collaborated with speech therapists to offer conversation groups to people with speech difficulties. Her presentation mapped this 12 week process, where every group member had an opportunity to discover their own potential through their ability to make music, whether this included beating a drum, singing along to songs, or even introducing songs of their own to the group. The decision to create a group song together offered a space where group members could openly share and reflect on their frustration and pain linked to their disabilities as well as aspects in their lives for which they felt grateful. Creativity and playfulness amongst individual group members emerged as the group continued to make music together. Certain group members were inspired to perform well known songs or compose their own, whilst one group member revived his interest in creating artworks. The group process worked towards a final performance, where this group of people who struggled to communicate verbally, used actions and their voices to articulate both their struggles and abilities.

Music therapy can also impact those who might appear to lack any ability to use their voices or gestures to sing, communicate or participate in social life at all. Heleen Bester, a recent music therapy master’s graduate residing in Port Elizabeth (on the East Coast of South Africa) presented her clinical work with an elderly lady who had suffered from a stroke 12 years previously. This woman had been in a residential home ever since, and it was said that she did not move independently and had not spoken at all during that time. As Heleen sang together with her client, responding to every slight movement she made, even to her breathing, the woman began slowly to beat a tambourine. Then, with a raspy, small voice, she started to sing along to bits of songs. After a few sessions, the increasing strength and vibrance of her voice emerged, and she began to take a strong lead in singing the song ‘Oh when the Saints’, rekindling a sense of her strong character and energy. The affordance of participating in music, and the presence of a supportive, sensitive therapist enabled this woman to find once more the life and spirit that remained within her.

Marie-Victoire Cumming, a music therapist with some experience in the field has had many opportunities to witness just this life and spirit that can be discovered and conveyed through music and the voice, no matter how disabled a person may appear. Marie presented some of the work she is currently doing at Little Eden, an institution that cares for children and adults with profound intellectual and physical disabilities – many whom have also been deserted by their families. Marie works in the Domitilla and Danny Hyams homes. These are two of three homes that make up Little Eden, and serve to provide care for younger residents or those in need of intensive care. Marie’s interest in this work grew from her clinical work as a master’s student, in particular with a young girl diagnosed with cerebral palsy and hydrocephalis, with tendencies towards self-mutilation. Marie was able to hold and contain this client through her improvised music-making that met the expressions of her client whilst offering constancy through her use of musical timing and phrasing. Marie also shared how the intensity and intimacy of music therapy work at this level led her to access and work through uncomfortable elements within herself.

Marie currently works at the homes together with a multi-disciplinary team, where techniques and ideas are shared to optimise the emotional, physical and psychological well-being of every resident. In particular, Marie focuses on the importance of using vocal and singing techniques at Little Eden as a means of enabling residents to centre on their own sounds and to use their voice to express their identity, despite their limitations. Marie showed excerpts from a concert the residents put on, where each was offered the opportunity to perform a short vocal solo. Residents weren’t expected to sing specific words or sounds, but vocalised freely, their expressions carefully supported by the therapist’s guitar playing, so that the short solos were held together within a musical framework. Every solo received warm applause from the audience, stimulating pride and confidence within the residents. Through their sounds, these residents were viewed as people with the capacity to communicate, to be creative and to interact regardless of their disabilities.

The majority of presentations focused on active music-making as a means of enabling growth amongst individual clients and communities. Yet, listening to a piece of music can be as powerful, in that it can evoke strong and clear images, memories, emotions or even bodily sensations. Kobie Swart offered an introduction to the Bonny Method of Guided Imagery and Music (GIM), a receptive music therapy approach based on the potential of music listening to evoke bodily or emotional experiences and reveal important personal insights. GIM was founded by Helen Bonny, a researcher and violinist, in the 1960’s and 70’s. Through her work at the Maryland Psychiatric Research Centre, and later with a broader range of clients, Helen Bonny discovered that listening to specifically chosen music in relaxed states facilitated access to deeper states of consciousness, inner wisdom and spirituality (Clarke, 2002). Bonny developed a number of music-listening programmes, made up of consecutive pieces of predominantly classical music (due to its complexity and variability). The experience of exploring images and sensations evoked by listening to these programmes along with the sensitive guiding of a qualified therapist allowed clients to work through aspects such as loss, nurturing the neglected inner child, or working with archetypes (for example, meeting the ‘wise old woman’). This process facilitated spiritual transformation and growth.

GIM is currently practiced in 23 countries worldwide. GIM training was introduced in South Africa in 2008, and there are currently 10 qualified practitioners in this country. Training is offered to those registered by the HPCSA in the area of mental health. In her presentation, Kobie Swart, the first South African GIM Primary Trainer, described the development of the Bonny Method of GIM, the GIM process, and offered examples of how this powerful technique has been used to bring transformation to adult clients in South Africa.

After these powerful examples of the calibre of clinical work that is emerging within the South African context, Mercedes Pavlicevic, co-founder of the South African Music Therapy Masters course and now research director at the Nordoff-Robbins centre in London, offered some international perspectives from the broader music therapy community. Mercedes noted that South Africa’s graduate level professional music therapy training leads to state registration, and this is an impressive achievement, given that this is still not the case in many countries. Music therapy spans a range and diversity of training courses, professional standards and methods; and many approaches are negotiated between where therapists work (e.g. educational, community, medical or forensic work places), and by theoretical music therapy frames. However, one thing all music therapists share, whatever their methods, is a passion for music and music-making. This is often evident at music therapy conferences which can include heated debates and disagreements – followed by the same therapists playing music together and dancing. That’s as important as disagreeing about research, theory and practices! Focusing on music therapy research, Mercedes introduced a number of prominent music therapy journals, each with a particular focus and summed up some of the current research trends within the discipline. Her presentation ended with a strong call to the South African music therapy community: “The work in South Africa is exciting, it’s pioneering ...but there’s not enough research going on and there’s not enough writing...the South African work needs to absolutely be far more prominent...your work absolutely has to be known.”

Some Music-Making

A music therapy showcase would not be complete without some musicking – opportunities to participate in different experiences of music-making as performers, audience or even in a collaborative improvisation including all showcase attendees. Woven in between the presentations were a number of upbeat performances. Julius Kyakuwa is the African Music lecturer at the university, who also conducts the African Music elective for the Music in Communication Honours course and sits on the auditioning panel for the Music Therapy Masters course. He introduced the Pretoria Technical High School Drumming and Percussion Ensemble. These young people entertained all with vibrant performances on drums and marimbas. A group from UNICA School for learners with autism, directed by music therapist Sherri Symons, played a structured music piece on a range of percussion instruments and then enthusiastically performed movements they had choreographed themselves to the song, "Together as One", by Mango Groove. Their performance demonstrated how through their access to music, these young people were able to express themselves and their potential with joy and confidence. Freeborn, a skilled jazz band made up of young people between the ages of 9 and 14 (directed by a 10yr old drummer!), offered an impressive performance of some complex jazz pieces including "Seventh Avenue" by Jonathon Butler (a well-known South African guitarist). The band offered a prototype of the work of the Tshwane School of Music based in Eersterust near Pretoria. The school, currently a community placement for Music Therapy Masters students, was founded by Freddy Arendse (who obtained his Honours in Music Communication degree at the University of Pretoria), and aims to draw young people from the community towards participation in positive social activities such as making music. Finally, Karen De Kock, a music therapist specialising in vocal work, led the entire audience in an interactive vocal improvisation, where we were all drawn together through some rather interesting sounds – releasing our own creativity and playfulness.

Celebrating 15 years of music therapy training in South africa: Excerpt from the showcases from GAMUT on Vimeo.

To conclude the showcase, Prof Stander, the Dean of the University of Pretoria’s faculty of Humanities thanked and encouraged the Music Therapy Department and music therapists for the work that we are doing, saying “I can now understand why some people say that music is the strongest form of magic, because it was incredible to see what is accomplished through music.”

The Port Elizabeth Showcase

The Port Elizabeth Showcase was enlivened with performances from the Lake Farm Centre Band, and music items performed by the Quest School for autistic learners. Lake Farm is a home for intellectually disabled adults. The Lake Farm Band, managed by John West, was formed 10 years ago and is very popular within Port Elizabeth. The Quest School is the only school in the Eastern Cape providing education for learners on the autistic spectrum. With the support of music therapists Christine Joubert and Kristle Williams and Dutch music therapy interns Bettine van der Sluis and Jonina Gervink, these learners performed for the very first time, capturing the audience. This musical introduction was followed by presentations that focused predominantly on music therapy work within the Port Elizabeth area.

Carol Lotter presented work with clients suffering from mental illnesses such as schizophrenia, and older clients. Her presentation included a summary of case studies she presented at the Africa Alzheimer’s Congress of her music therapy work with people suffering with dementia, and a single case study of her clinical work with an elderly lady with Parkinson’s disease. In each case presented, Carol utilised music therapy techniques to enhance the quality of life of her clients at a physical, mental, emotional and social level. Carol incorporated relaxation, drumming and instrumental improvisation, vocal work, movements or dancing and music listening into sessions. Activities were carefully selected and designed to support an increased ability and motivation to communicate and an increased control of movement. Music therapy sessions further offered a vehicle for self and emotional expression and support, and a means of increasing confidence and self-esteem. These were much needed tools which clients were able to transfer into other areas of their lives.

The potential of music therapy to enhance the quality of life with those struggling with disabilities was emphasised as Christine Joubert showcased the music therapy programme at Quest School for children with autism. Whilst the school does not yet have the funds to support a music therapist, Christine offers music therapy to individuals on a private basis, as well as offering a music therapy group and an after school programme for children in the hostel as a service to the school. Christine showed video clips to highlight moments in music therapy sessions where her music-making with children from the school specifically addressed the development of skills such as social interaction, emotional expression, communication, cognitive development as well as the development of gross and fine motor skills. In this way, music therapy was promoted as a beneficial and valuable intervention to address the needs of children with autism.

Whilst Christine has made a meaningful contribution to an entire school community, music therapist Kristle Williams concluded the Port Elizabeth presentations with a reflection of her work as a music therapy intern in the community residing in Nelson Mandela Bay. Through her work, Kristle has had the opportunity to witness how music empowers people living on the street, children at an inner-city school displaying signs of depression as well as people in a rehabilitation centre. Thus her music therapy has permeated and impacted many parts of this community. Audio clips from Kristle’s work, including a song written by a motor-accident survivor who lost her husband in the crash, once again affirmed the power of music and music therapy that is sounding from so many regions and communities in South Africa.

And the Posters...

The work presented in the showcase programmes was enhanced by a number of posters highlighting more music therapy projects that have been initiated in South Africa in many sectors of society – with different age groups.

A number of music therapists showcased work with people with mental or physical disabilities. Tanya Brown and Lise MacDonald presented their work at the Baby Therapy Centre and POPUP (an outreach project founded by the Baby Therapy Centre for those who cannot otherwise afford these services). They also presented their work at Chrysallis Pre-school (and their outreach project at Eersterust Care Centre). These centres offer therapy to children under three years of age, and 3-6 years of age respectively, with developmental delays or disabilities. In these four placements, Tanya and Lise’s collaboration within multi-disciplinary teams serves to enhance and encourage the optimal development of these young children. This will be pivotal in enabling them to reach their fullest potential in later years.

Complementing this work with children and disabilities, Ilse Tiran contributed a poster summing up her work with the Down Syndrome Association of Tshwane, where she adds her unique expertise as a music therapist to a multi-disciplinary team. The team works predominantly with young children to enable and support their optimal functioning. Sherri Symons also described her work with the learners from UNICA School for children with autism who performed at the showcase. She noted how music therapy offered learners a means of developing enhanced control of their movements and gestures, an opportunity to experience their increasing spontaneity and creativity and a space to interact meaningfully with others.

Whilst Marie-Victoire Cumming offered a poster summary of her work at the Domitilla and Danny Hyams homes of Little Eden (that she presented as part of the proceedings), Karen De Kock also presented a poster celebrating 10 years of her own work with residents at Little Eden’s Elvira Rota village. At this home, Karen offers individual and group music therapy, a vocal ensemble group and many other musicking opportunities for the residents who are older and whose disabilities and medical conditions require less intensive care than those at the Danny Hyams and Domitilla homes. This emphasised that music therapy focuses not only on the optimal development of children with disabilities, but can also enhance the quality of life of adults living with disabilities, offering them opportunities for social engagement, self expression and the enjoyment inherent in making music.

Carol Lotter and Petra Jerling similarly used music therapy to enhance the functioning and quality of life of adults. Carol’s posters visually captured her work with clients with Parkinson’s and dementia that she presented at the showcase in Port Elizabeth. Petra described her work with a former rugby player who, after sustaining an injury, was diagnosed with Guillane-Barre syndrome. This affected his nervous system and muscular movement. Music therapy offered this client a means of enabling increased control of his movement, confidence and psychodynamic support.

In addition to the phenomenal work with people with disabilities that was presented, Helen Oosthuizen presented work with groups of young sex offenders at the Teddy Bear Clinic for abused children. Here music therapy enabled a deeper, creative exploration of the young people’s offences through creation of stories based on specifically chosen music listening pieces and themed improvisations. Music groups also motivated healthy emotional and self expression and development of social skills, through group drumming. Further, the process of working towards a final group performance for parents and clinic staff was an opportunity for these adolescents to publically assert their accountability to others and indicate the responsibility they have taken for their own transformation process. Through the creation and performance of group and individual raps, offenders were able to communicate important expressions they struggled to speak of in other ways.

Music therapy can also offer adults an alternative means to communicate and express intimacy or love. Carol Lotter presented case studies of couples she worked with, using music therapy techniques including music listening, improvisation and role-playing as a means of enabling couples to connect more deeply, communicate creatively and thus rediscover and enhance their relationships with one another.

The creativity inherent in music can similarly enhance connection (with self and others) in broader sectors of society. In 2013, Karyn Stuart and Carol Williams founded the small start-up business Drumming with a Difference. Drumming with a Difference focuses on working within the health care sector and entrepreneurial development space, offering people within these sectors tools and techniques drawn from music therapy as a means of exploring their personal and professional lives.

Leading back to the training courses that have enabled music therapists and community musicians to initiate all these projects, showcase attendees were presented with information about the Music Communication (Honours) and Music Therapy (Masters) courses. These posters informed attendees of the wide range of clinical placements where students work as interns, engaging with a range of clients to gain in-depth experience.

SAMTA promotes and supports the music therapy profession in South Africa – encouraging an ongoing development of the field and connecting music therapists in this country. The association presented an informative poster, whilst also offering an opportunity to browse through a number of books on sale. Books and journals presented offered more in-depth descriptions of music therapy theory and practice, including some describing music therapy work that is taking place within South Africa (one example being the book Taking Music Seriously: Stories from South African Music Therapy (Pavlicevic, Dos Santos, & Oosthuizen, 2010)). The online journal, Voices: A World Forum for Music Therapy was highlighted as a journal where some South African music therapists have published articles.

Conclusion

These many stories offer only a taste of the vibrant work that is happening in every corner of this country, of how music therapists are adapting, advocating for, forming and reforming music therapy and community music practices that fit our unique context. Our music-making affords opportunities for the marginalised, the disabled, and many others to participate in musicking, and to discover the many profound meanings and possibilities music can offer for themselves and within their communities.

This is exciting work, and it is now time we contribute our particular viewpoints and expertise to the global music therapy community as well as to related professionals in the health, education and social development sectors.

Thanks to all the music therapists who offered presentations or posters to affirm the value of music therapy in South Africa, and guided the writing of their parts of this report.

References

Clarke, M. (2002). Evolution of the Bonny Method of Guided Imagery and Music. In K. Bruscia & D. Grocke (Eds), Guided Imagery and Music: The Bonny Method and beyond. Gilsum: Barcelona.

Pavlicevic, M., Dos Santos, A. & Oosthuizen, H. (2010). Taking music seriously: Stories from South African music therapy. Cape Town: The Music Therapy Community Clinic.

Pavlicevic, M. (2003) In the beginning. Voices resources. Retrieved January 09, 2015, from http://voices.no/community/?q=fortnightly-columns/2003-beginning

Savahl, S., Isaacs, S., Adams, S., Carels, CZ. & September, R. (2013). An exploration into the impact of exposure to community violence and hope on children’s perceptions of well-being: A South African perspective. The official journal of the international society for child indicators. Dordrecht: Springer Science and Business Media.

Stige, B. (2004). Community music therapy: Culture, care and welfare. In M. Pavlicevic & G. Ansdell (Eds), Community music therapy. London: Jessica Kingsley.