Music Therapists’ Insights Regarding a Shift in Practice Orientation

A Clinical Retrospective Self-Study




retrospective self-study; reflexive phenomenology; theoretical orientation; music therapists' lived experiences


This report details a clinical retrospective self-study that we undertook to gain insights into our experiences as an undergraduate practicum student and clinical supervisor. We studied our lived experiences of a shift in practice orientation that we implemented with a child with communication and behavioral challenges. Recognizing a few weeks into treatment that our initial outcome orientation and behavioral approach was not meeting the child’s needs, we abruptly shifted to an experience orientation and music-centered approach, commensurate with Bruscia’s (2014) Integral Thinking and Practice model. Curious as to whether our initial perceptions of this shift would hold up to investigative scrutiny, we undertook this retrospective study to answer the following questions: (1) What factors and circumstances may have precipitated (i.e., activated) the shift in orientation? (2) What factors and circumstances may have enabled (i.e., supported) a shift in orientation? and (3) What individual and collective insights might we gain about our lived experience of the shift relative to integral thinking and practice? Findings from thematic analysis of clinical artifacts inform recommendations aimed at helping music therapists to recognize theoretical influences and feel freedom and confidence to make shifts in practice as warranted. We advance reflexivity as a key strategy to improve clinical services and supervisory practices.

Author Biographies

Susan C. Gardstrom, Department of Music, University of Dayton, USA

Susan C. Gardstrom, PhD, MT-BC is Professor of Music Therapy at the University of Dayton, USA, where she currently serves as Graduate Coordinator of Music Therapy. She holds degrees from Michigan State University in music therapy and music education and a Master of Community Agency Counseling and specialty Certificate in Drug and Alcohol Abuse from Western Michigan University. Gardstrom has worked with adjudicated adolescents in residential treatment, school-aged children with physical and learning challenges, and adolescents, adults, and older adults in recovery from addictions. She is a frequent conference presenter and has published in peer-reviewed journals such as Journal of Music Therapy, Music Therapy Perspectives, Nordic Journal of Music Therapy, and Voices. Gardstrom is the author of Music Therapy Improvisation for Groups: Essential Leadership Competencies and Women’s Chants for Unity and Strength (Volumes I and II) and co-author of Music Therapy With Women With Addictions (Barcelona Publishers).

Marie Reddy Ward, Kansas City, MO, USA

Marie Reddy Ward is a board-certified music therapist based out of Kansas City, MO, USA. She graduated with a bachelor's degree in music therapy from the University of Dayton and completed her internship in hospice care. She has since worked in memory care and assisted living facilities, in addition to providing home-based music therapy services for adults and children with intellectual and developmental disabilities. Apart from music therapy, Marie is also passionate about music ministry and has worked and volunteered for many years as a musician in Catholic churches.

Photo of the authors Susan C. Gardstrom and Marie Reddy Ward




How to Cite

Gardstrom, S. C., & Reddy Ward, M. (2023). Music Therapists’ Insights Regarding a Shift in Practice Orientation: A Clinical Retrospective Self-Study. Voices: A World Forum for Music Therapy, 23(1).