Guided Imagery and Music (GIM) can be considered a specialism in which qualified music therapists may train, along with mental health practitioners from other professional backgrounds including psychotherapists, psychologists, and psychiatrists. For this latter group of practitioners, identifying themselves as music therapists, or implying this when describing GIM as a music therapy method in advertising their services, is controversial. It may indeed even be unlawful in countries where music therapy training and practice are regulated by the state.
The situation is a complex and inherently confusing one. This is because on the one hand GIM is an acknowledged international model of music therapy. On the other hand, as a specialism, GIM is distinct from music therapy in both training and practice, with GIM practitioners having various professional backgrounds.
It is proposed that international collaboration and discussion are needed, with recommendations made to foster public confidence based on a clear understanding of who is and is not a qualified music therapist and member of the music therapy profession, and who is qualified to practice what safely and effectively. The article aims to illuminate the issues that may need to be taken into consideration in developing a consensus position.
Guided Imagery and Music (GIM) was cited at the Ninth World Congress of Music Therapy as
one of “Five International Models of Music Therapy Practice” (
The topic is complex at many different levels, with the spectrum of contemporary GIM
practice comprising not only the Bonny Method of GIM, but also other GIM and Music and
Imagery (MI) methods as discussed below (
It is nevertheless evident that some European GIM trainers consider GIM training to be
training in a type of music therapy, even if it does not lead to qualification as a
music therapist. It has even been suggested that the European Association for Music and
Imagery (EAMI) re-define the Bonny Method of GIM in part as a music therapy approach
(
With GIM internationally recognized as a music therapy model, Bonde (
It [The Bonny Method of GIM] is a truly international model of receptive music therapy, practised in five continents, and yet it is not registered or integrated in the European music therapy community, e.g. as related to the European Music Therapy Confederation (EMTC). (p. 86)
The author’s impression is, nevertheless, that GIM is becoming increasingly valued by
the music therapy profession as a specialism. Even if the EAMI, as a relatively newly
established association, is not yet a member organization of the EMTC as it might
potentially be, the EMTC in a Policy Statement do now formally recognize GIM as a
specialism for those already qualified as music therapists (
The difficulty, as discussed, is that it is not only those who are already qualified as music therapists who train in GIM. Thus, what needs to be clarified is whether GIM practitioners from other professional backgrounds should be describing GIM as a type of music therapy in advertising their services and/or whether they should be identifying themselves to be music therapists. It is evident that some are beginning to do these things in Europe, seemingly based on the way the method has been presented during training.
The author’s position is that there need be no conflict between fostering the ongoing recognition of GIM as a music therapy specialism on the one hand, and making sure that the public understand clearly that GIM training alone does not qualify practitioners as music therapists on the other hand. The public may become confused about this when practitioners who are not qualified music therapists describe GIM as music therapy in advertising their services. The US-based Association for Music and Imagery (AMI) appear to agree, advising their members:
Bonny Method [of GIM] training is not music therapy training. To avoid confusing the
public and misleading their current and potential clients, the AMI strongly advises
against non-music therapists (counselors, social workers, psychotherapists, or
others) who are trained in the Bonny Method referring to themselves as music
therapists or referring to their practices as music therapy. (
The author welcomes these newly published guidelines, where in his view it is the
international GIM organizations and GIM trainers who have the prime responsibility in
ensuring ethical practice in the presentation of GIM and in advertising services. Given
the apparent disparity between the views of some European GIM trainers who discuss
and/or promote GIM training as being in a type of music therapy on the one hand (
The matter is a complex, multi-faceted one that is as confusing for the GIM community, including trainees, as it is for the wider music therapy community, other professionals, and the public alike. This article aims to contribute to and help inform discussion, where GIM is in some senses a part of music therapy but is also distinct from it in training and in practice.
Before discussing the differences between music therapy and GIM as a specialism, it is necessary first to clarify the complexity of GIM as a field of practice and the author’s use of terms.
In this article, the term GIM, as an abbreviation of Guided Imagery and Music, is used
generically (
The designation/title GIM therapist is used in a similarly generic way to the term GIM
in the article.
The Bonny Method of GIM, and other GIM methods (as distinct from MI), are generally
those that involve the client imaging to music in an expanded (altered, or
non-ordinary) state of consciousness. The therapist guides the client’s spontaneously
evolving imagery process non-directively. In doing so, an interactive dialogue
develops. The client describes their experience which the therapist affirms, the
therapist asking open questions to support the unfolding of the client’s imagery
experience across what may be several different sensory modalities. These modalities
might include what is seen (mentally visualized) or smelt by the client (with eyes
closed, listening to the music in an altered state of consciousness), sounds and
voices heard, what is experienced through touch, the experience of warmth or cold,
and so on. The client’s active embodied emotional involvement in the process as
imager is encouraged as is their engagement with the music as co-therapist (
Traditionally, programmes of recorded music are used in the Bonny Method of GIM, with music chosen that comes from the Western classical tradition. A music programme is generally comprised of between four and eight separate pieces, often individual movements from complete works, the duration of a music programme typically between 30 and 45 minutes. The pieces are carefully sequenced so as to help structure an unfolding imagery experience that can help address therapeutic need. Different music programmes are intended to work with different areas of experience and aspects of need.
Helen Bonny, the music therapist who originally developed GIM in the US in the 1970s,
created a set of core music programmes which are still widely used (
Adaptations and modifications of the Bonny Method of GIM are identified in the
literature employing a wide variety of terms. Some of these are generic terms
including “Short GIM” (
Grocke explains why she conceives contemporary practice to be more a spectrum of different but related methods, than simply the Bonny Method of GIM and its adaptations:
I have a strong sense that GIM is going through a period of development not unlike
MT [music therapy] in the 1980’s and 1990’s, where we had the five music therapy
models (celebrated at the World Congress in Washington, 1999), but where each was
also evolving into something new [ … ] I see GIM as being poised on a similar path
of growth and expansion […] I don’t particularly like the way we distinguish
between the Bonny Method and the ‘not the Bonny Method’ way of thinking. I prefer
to think of what we do as being on a spectrum […] [with contemporary research
reflecting how] the Bonny Method is evolving into more discrete forms of therapy
practice. (
Beyond the specific models or methods that have been developed and named, there is no
international consensus about the use of generic terms to sub-categorise types of
practice within GIM. The use of such terms as Short GIM and MI is indeed inconsistent
in the literature with alternative terms also employed within the context of the
ongoing developments in the field discussed by Grocke (
In Short GIM, the procedure adopted in the Bonny Method of GIM is modified. The main
difference is that that there are typically between five and fifteen minutes of music
only, with other elements of the session potentially shortened as well (
In the Bonny Method of GIM, which Summer (
Group GIM has many similarities with individual work. Here the main difference is
that the verbal interaction during the music listening takes place either between the
therapist and group members, or amongst the group members alone (
MI methods, whether in individual or group work, are differentiated from the GIM
methods in that they do not involve the non-directive guiding and verbal dialogue
which are a core feature of the GIM methods. The client’s imagery experience is
unguided (
MI sessions are usually of shorter duration than the 1.5–2 hours needed for a Bonny
Method of GIM session. The work is typically, though not always, resource-oriented,
often using a single piece of music or a short sequence of music of between five- and
fifteen-minutes duration. Both individual and group work may be undertaken (
There may be an especial emphasis on the collaboration of client and therapist in MI.
In “Supportive Music and Imagery” (SMI) (
Bruscia defines the Bonny Method of GIM to include not only the type of individual
work described above but also the group form developed by Bonny. Bonny referred to
this as either “Group GIM” or “Music and Imagery” (
Both GIM and MI may be applied in individual and groupwork “for purposes of therapy,
healing, self-development, personal growth, or spiritual enlightenment” (
Whilst a single MI or GIM method may be employed for all the work with a particular
client (or group), different methods may also be used at different stages of work
with a single client (or group). In the Continuum Model, for example, either MI or
GIM may be employed, and work undertaken using one of these methods that is
supportive, re-educative or reconstructive in nature as needed. Indeed, different
methods and levels of work can potentially be combined within a single session as
part of a client-centred approach that is creative and flexible (
Just as GIM as a field of practice has steadily evolved over the course of several decades, so has GIM training, with training standards developed to help ensure safe and effective practice.
The US-based Association for Music and Imagery (AMI), which is the longest established
international GIM organization, endorses trainers and training programmes that meet its
published Training Standards (
The Music and Imagery Association of Australia (MIAA) registers GIM therapists who have
completed a MIAA approved GIM training programme. The MIAA also has a Code of Ethics
including a grievance procedure (
Apart from the AMI, the only international GIM organization to have published GIM
Training Standards is the EAMI (
GIM training is typically undertaken as training in a specialism (or advanced method
of practice) by those who are already qualified as music therapists on the one hand,
or who are qualified mental health counsellors, psychotherapists, psychologists,
psychiatrists or similar on the other hand. Whilst the EAMI require such previous
therapeutic training and experience as a pre-requisite for GIM training,
The AMI and EAMI Training Standards are competency-based, setting out the knowledge
and skills required of a professional GIM practitioner. The EAMI Standards embrace
the full range of contemporary practice including MI, reflecting the importance of
this in Europe (
require additional training in related techniques that are not covered in these
Standards. Such techniques may include applications geared towards short
experiences using many genres of music for both individuals and groups in a
variety of settings. These techniques are neither to be confused with nor named
The Bonny Method. Teaching methodologies, supplementary content, and resource
materials are left to the discretion of the Primary Trainer. (
Though all practitioners are taught the principles of adapting and modifying the
method according to client need,
Because those who train in GIM come from different professional backgrounds, the situation is an especially complex one. The extent of a GIM practitioner’s overall scope of practice will depend both on the knowledge and skill base associated with their original training which GIM training extends, and on whatever GIM and MI methods they may have been taught in addition to the Bonny Method of GIM. Therapists may also integrate elements of the different methods in which they have been trained, for instance Eye Movement Desensitization & Reprocessing (EMDR) and GIM, or music therapy improvisation and GIM.
Another factor is that separate training in MI is now increasingly available, with
the EAMI developing training standards for this (
Broadly considered, the competencies required for safe and effective practice in the Bonny Method of GIM (and similarly with other GIM and MI methods), can be clarified as they relate to the different phases of a therapy session, each phase having its associated knowledge and skill set.
Verbal skills are required to facilitate a discussion about the client’s current concerns and identify a focus for the session. An understanding of both conscious and unconscious processes and communication are needed. However, in GIM the client’s issues are not addressed in the way they are in verbal therapy. Rather, the verbal components of the session serve to prepare for, and afterwards to help the client process the therapeutic music and imagery experience.
This involves the therapist supporting the client to enter an altered state of consciousness ready for the central music and imagery experience that follows. GIM therapists learn how do use different types of relaxation procedure for different therapeutic purposes, how to match induction and music, and how to suggest an imagery focus, which could potentially be of many different types, related to the agreed aim of the session.
This is the central music and imagery experience. The knowledge and skills required in this part of the session relate to the music, to working with altered states of consciousness, to the guiding, and to the imagery:
The therapist needs to have a sophisticated understanding of the nature and function of the recorded music used in GIM, a thorough, experience-based knowledge of the music programmes, the ability to choose a suitable music programme for the client, along with the skills to adapt/swap a programme when necessary and/or to spontaneously programme the music for the client.
The therapist needs a thorough, experience-based understanding of altered states of consciousness, and of how to work safely and effectively with them, understanding the potential risks involved and how to mitigate them (for instance, involving the use of adaptations and modifications).
The therapist needs to know how to guide the client’s music and imagery experience non-directively using verbal and non-verbal interventions. The therapist needs to be able to guide a wide variety of different types of imagery experience. They need to know how to facilitate the deepening of the process and the client’s active multi-modal engagement in it, and how to facilitate the client’s engagement with the music as co-therapist.
GIM therapists need a comprehensive understanding of imagery; of its metaphorical nature; and of different types, modalities, and levels of imagery, ranging from the personal/psychodynamic, to the mythical/archetypal, to the transpersonal and spiritual. The therapist needs to have a sophisticated, experience-based understanding of imagery processes and associated with this of therapeutic change.
The therapist needs a specialist knowledge of mandala drawing as used in
Bonny Method of GIM work. An in-depth understanding of The Great Round of
the Mandala (
The therapist needs the specialist skills required to help the client transition from the music and imagery experience, possibly via the creative processing involved in mandala drawing, to verbal processing. The aim is to help the client make sense of and integrate the music and imagery experience and gain insight, with a non-interpretative, client-led stance generally being adopted.
Whilst there may be some degree of overlap with a therapist’s existing knowledge and
skills acquired from their primary therapeutic training, practice in the Bonny Method
of GIM requires a highly complex and sophisticated knowledge and skill set of its own
that is unique to the type of work that it is. The associated competencies and scope
of practice differ substantially from those of both music therapists and verbal
therapists, the Bonny Method of GIM not only a specialist but also an advanced method
in which already qualified therapists can train (
For music therapists, their original training represents an entry-level qualification to become a member of the music therapy profession. The associated competencies then form the basis for training in the Bonny Method of GIM, which imparts further specialist or advanced competencies. The situation however, is complex, and indeed confusing. This is because as an advanced-level training undertaken also by other professionals, GIM training does not in itself impart the entry level competencies acquired through music therapy training. Thus, in the US, for instance, training in the Bonny Method is
considered advanced training for a music therapist but such training is only one
component of achieving advanced competency as a music therapist (AMTA, 2015).
Moreover, Bonny Method training certainly does not bestow upon the trainee the
professional level of competence in music therapy (AMTA, 2013) that is
prerequisite to achieving advanced competence. (
Other professionals need to have acquired the foundational competencies required to
train in GIM through their original entry-level qualification as a credentialed
mental health or psychotherapeutic practitioner (
The unique, advanced-level, specialist therapeutic competencies acquired through training in GIM thus need to be differentiated from the competencies of a qualified music therapist not trained in GIM. Similarly in the case of the competencies of other professionals.
Those who call themselves music therapists normally have a bachelor’s degree or higher in music therapy or an equivalent level qualification in the discipline, dependent on the country in which they trained and on their training programme.
Music therapy training varies from country to country and often from course to course within a country. In general terms, it can be thought of as a training for musicians who learn how to apply, develop, and adapt their existing music skills to work therapeutically with clients in addressing need. Dependent on the training programme and country, there may be various ways in which practitioners are taught how active music-making and creation can be used to foster therapeutic engagement and process where interpersonal relating and/or social participation are central. Active music therapy approaches taught may involve improvisation, songwriting, and/or music performance and arrangement. Music therapists’ competencies acquired through training are principally those required to use these active approaches safely and effectively.
Whilst receptive- or listening-based approaches may also be taught, this is typically
only at a foundational level
Other receptive music therapy approaches that are distinct from GIM include song lyric
discussion and reminiscence, music appreciation, various methods that involve art media,
vibroacoustic therapy, and music and movement (
Muller (
With MI, the situation is especially complex. This is where the scope of practice of qualified music therapists in the US is defined by the American Music Therapy Association (AMTA) and Certification Board for Music Therapists (CBMT) to include “music and imagery”:
The music therapy interventions may include music improvisation, receptive music
listening, song writing, lyric discussion, music and imagery, singing, music
performance, learning through music, music combined with other arts, music-assisted
relaxation, music-based patient education, electronic music technology, adapted music
intervention, and movement to music. (
It is important not to confuse the receptive music therapy interventions including music and imagery that lie within the competencies of music therapists (not trained in GIM), with the specialist MI methods developed by GIM practitioners, that are therefore best not identified as receptive music therapy techniques.
The matter has the potential to become even more complex with MI training standards
being developed in Europe. These may include standards both for MI methods that “require
a psychotherapeutically informed prequalification as required in the EAMI Training
Standards,” and standards with reduced entry requirements for training in
“low-threshold” MI modalities which “do not go into therapeutic depths”
(Frohne-Hagemann, p. 4). This latter proposal is, however, a controversial and
problematical one in terms of ensuring client safety as is recognized by the EAMI.
Although GIM is a specialism that requires additional training beyond a music
therapist’s original qualification, music therapy training programmes (in the UK, for
example) increasingly include lectures about GIM, informing trainees about the method as
part of the broader field of practice. There are also a few music therapy training
programmes internationally where Level I GIM training is included
Whilst GIM training can be considered a further specialist training for music
therapists, it is also, as discussed, a training suitable for credentialed mental health
practitioners (
Music therapists who go on to train in GIM can legitimately claim it to be part of what they have to offer as music therapists. However, the situation is more complex for those trained in GIM who are not qualified music therapists. To help illuminate the matter, an outline of the situation in the UK is presented next, where the title music therapist is legally protected.
To use the title music therapist, UK-based practitioners are legally required to register with the Health and Care Professions Council (HCPC). This is the government-appointed body that regulates the profession. To apply for HCPC registration in the first place, practitioners must have qualified in music therapy on one of the HCPC approved music therapy MA training programmes which are themselves regulated by the HCPC.
The UK legislation set outs that a person who uses a protected title whilst
unregistered commits an offence which is prosecutable if they do so “with intent to
deceive (whether expressly or by implication)” (
On this basis, only those registered as music therapists with the HCPC, and not mental health practitioners from other training backgrounds, may state or imply in advertising their services that they practice music therapy. Anyone else doing this is liable to prosecution.
Thus, UK-based GIM practitioners not additionally qualified in music therapy, and therefore not registered with the HCPC as music therapists, would likely be committing an offence should they use the title music therapist or imply this by stating that they practiced receptive music therapy, for example.
The situation would be similar with practitioners not registered as music therapists
who had undertaken training in
The HCPC defines scope of practice as:
the area or areas of your profession in which you have the knowledge, skills and
experience to practise lawfully, safely and effectively, in a way that meets our
standards and does not pose any danger to the public or to yourself. (
Whilst ensuring that music therapists remain within their scope of practice, the HCPC standards of proficiency state that they must:
be able to use a range of music and music-making techniques competently including
improvisation, structured musical activities, listening approaches and creation
and composition of material and music technology where appropriate and be able to
help a service user to work with these. (
The HCPC recognize that therapist’s scope of practice may change over time. Registrants may specialize, developing and extending their skills and knowledge through further training, whilst their general scope of practice may nevertheless narrow:
The practice of experienced registrants often becomes more focused and specialised than that of newly registered colleagues. This might be because of specialisation in a certain area or with a particular client group, or a movement into roles in management, education or research.
Every time you renew your registration, you will be asked to sign a declaration that you continue to meet the standards of proficiency that apply to your scope of practice.
Your particular scope of practice may mean that you are unable to continue to demonstrate that you meet all of the standards that apply for the whole of your profession.
As long as you make sure that you are practising safely and effectively within
your given scope of practice and do not practise in the areas where you are not
proficient to do so, this will not be a problem. If you want to move outside of
your scope of practice, you should be certain that you are capable of working
lawfully, safely and effectively. This means that you need to exercise personal
judgement by undertaking any necessary training or gaining experience, before
moving into a new area of practice. (
The HCPC’s core concern is public protection (
The profession combines the three disciplines of art, music and drama. All share
common approaches to training and practice, but vary in the medium used. All
combine artistic proficiency with psychotherapeutic techniques. […] The
therapeutic process can be intense and sustained, and the techniques used are
powerful and potentially dangerous to both patient and practitioner if mishandled,
particularly where the latter is inappropriately trained or motivated. It is for
this reason that members of the professions seek and are trained to provide a safe
and secure environment in which to help healing. (
As is the case with the arts therapies in general, it has long been recognized that
GIM itself is powerful and potentially dangerous for clients if mishandled, with
risks that include inducing a psychotic episode, for example (
According to the HCPC, registrants should be informed by the advice of their
professional bodies in determining the level of knowledge, skill and experience
required to practice in a new area and whether further training is required to
practice safely and effectively (
As discussed above, the specialist competencies (knowledge and skills) required to
practice GIM safely and effectively are quite distinct from those acquired from music
therapy training, so that further training is needed. Although in the UK GIM training
is not itself regulated by the HCPC, there are, as discussed, internationally
approved training programmes in GIM, and associated training standards published by
the GIM organizations which allow practitioners to acquire the required competencies
(
The HCPC would likely be concerned about a music therapist practicing GIM who is
untrained in the method. Indeed, the HCPC could potentially consider taking action on
the basis of the therapist having failed to meet the HCPC standards of proficiency,
working beyond their scope of practice without the training that is internationally
recognized to be required, and therefore risking the safety of clients (
Whilst HCPC registration carries with it the legal entitlement to use the title music
therapist, this does not preclude practitioners from using other titles. These are
titles which may be used to indicate a specialism or seniority, for example. The HCPC
understands and has no objection to this (HCPC personal communication, February 13,
2013).
There is also no difficulty in UK music therapists using the title
Whatever titles are used, the HCPC standards require registrants to be honest about
their experience, qualifications, and skills, and ensure they do not mislead others
(
As a regulator, HCPC’s “overarching objectives” (
Protect and promote the health and safety of the public
Protect and uphold public confidence in the professions they regulate
Set and maintain professional standards and conduct for members of those professions
The need for regulation was elaborated in more detail when the case was originally made for it in the UK parliament:
Essentially, the case for state registration of arts therapists is that it gives a
clear and objective signal to the public and to colleagues making referrals. It
ensures the high standards of training, conduct and practice that they can expect.
The paramount interest is that of patients and carers who will often be in no
position to judge the standing of practitioners. They can be assured that both
those falsely claiming those standards, and those falling short of them, will be
effectively dealt with. In addition, state registration will provide a benchmark
for employers; [and] offer an opportunity to strengthen the collaboration between
the health professions. (
Central to regulation as discussed, is ensuring that practitioners do not mislead
others into thinking that they are trained, qualified, experienced, and fit to
practice when they are not. The key phrase in the legislation is “intent to deceive
(whether clearly or by implication)” (
Whilst there may be no conscious intention to deceive, the public may nevertheless be misled by the way in which therapists describe their work and identify themselves. This is explored further below in considering how some of the principals underpinning the regulation of music therapy in the UK may be helpful in reflecting on the complex relationship between GIM and music therapy in a broader international context.
Whilst GIM may be recognized as a music therapy model, it is noteworthy that at the time of writing, the international GIM organizations which endorse, register, or accredit practitioners do not describe GIM as a type of music therapy:
The Bonny Method of Guided Imagery and Music is a music-centered,
consciousness-expanding therapy developed by Helen Bonny. Therapists trained in the
Bonny Method choose classical music sequences that stimulate journeys of the
imagination. Experiencing imagery in this way facilitates clients’ integration of
mental, emotional, physical and spiritual aspects of well-being. (
Guided Imagery and Music (GIM) is a psychodynamic and multimodal therapy that
incorporates music listening in a deeply relaxed state to stimulate imagery, memories
and feelings to help the client understand life issues from a holistic perspective.
(
The Bonny Method of Guided Imagery and Music (GIM) is a music-centred integrative
form of psychotherapy. Specifically programmed music is used to facilitate a dynamic
exploration of consciousness and inner experiences in support of physical and
psychological transformation and well-being. (
The titles (designations) that these same organization use for their professional trained members are respectively:
In the author’s view, these descriptions of GIM and practitioner designations/titles, align with the principals underlying the regulation of music therapy in the UK, and do not imply that GIM therapists are music therapists (even though some may be).
The European Association of Music and Imagery (EAMI), above, characterise GIM to be a
psychotherapeutic method; a music-centred, integrative one. The Music and Imagery
Association of Australia (MIAA) describe theirs being “the premier association
advancing music psychotherapy in Australia” (
It is not only the Bonny Method of GIM that is internationally recognized as a form
of psychotherapy or music psychotherapy. Even some supportive MI methods are (
Whilst international definitions and guidelines are useful, there is also a need to acknowledge how the statutory regulation of professions such as music therapy and psychotherapy affects GIM practitioners in different countries and what the implications are. This is a topic that appears, very understandably, to be a cause of anxiety for some practitioners. National and international guidelines could usefully support practitioners and help inform other professionals, therapy bodies and the public alike, with a recognition that whilst GIM can be identified as a psychotherapeutic method, this is also problematical in some countries from a legal and/or professional perspective.
It is also useful to remember that the term psychotherapy potentially embraces a very
wide range of modalities including creative arts-based approaches. In the UK, when
the state regulation of the counselling and psychotherapy professions was being
considered, for example, it was reported that there were some “400–600 approaches in
use” (
In helping others understand the unique type of psychotherapy (or music
psychotherapy) that GIM is, and correct possible misunderstandings, Bruscia’s (
In clarifying the nature of psychotherapeutic work in MI and GIM, it is also helpful
to bear in mind the different levels of work that can be undertaken, often identified
following Wolberg (
In a 2018 policy statement, the European Music Therapy Confederation (EMTC) strongly
recommend that the additional specializations in which already-qualified music
therapists may train, where there are published training standards to ensure high
quality, be recognized by the national music therapy organizations. The EMTC cite GIM
and Neurological Music Therapy as examples of such specialisms. This recognition and
recommendation by the EMTC supports the integration and evolving valuing of GIM
within music therapy as a specialism, with GIM long identified to be an international
model of music therapy practice as discussed (
Cohen (
In the author’s own experience as a GIM trainer, the increasing availability of
separate training in the simpler and increasingly important Music and Imagery (MI)
methods within the spectrum of contemporary GIM practice and research (
In its policy statement, the EMTC (
What the EMTC does not appear to address in its statement (
To clarify the matter further, music therapy training can be identified as being necessary not simply to practice music therapy, but also to become a member of the music therapy profession. In the author’s view, public understanding and confidence in the profession would be supported if the term music therapy were solely used by those who have completed a recognized qualification in music therapy in describing what they do. This would include when specialisms are practiced, specifically identified to be types of music therapy.
Whilst music therapy is a profession, GIM is perhaps best not identified as such, but rather as a specialism in which practitioners from a number of different professions can train. On this basis, a psychologist trained in GIM, even if accredited, endorsed or registered with a GIM organization, does not become a music therapist and thus a member of the profession. Rather, they remain a psychologist by profession, but with a specialism in GIM. This specialism, in the author’s view, is best not described as being in a type of music therapy to avoid unnecessarily confusing the public and other professionals about the music therapy profession and who is a qualified member of it.
Similarly, a psychologist trained in
With trainings available in GIM,
Whether they are musicians or not, training in the Bonny Method does not make a non-music therapist a music therapist nor does it qualify them to practice music therapy. This can be confusing because Helen Bonny was a music therapist, and because the Bonny Method has been referred to as a form of music therapy. Bonny Method training certainly does not bestow upon the trainee the professional level of competence in music therapy […]. At the Professional level, music therapists are trained to create and facilitate a wide variety of clinical music experiences using both live music that is improvised, composed, or recreated by the therapist, and receptive experiences that use live and/or recorded music. (Association for Music and Imagery, 2021b, pp. 7–8)
Whilst the relationship between GIM and music therapy is complex, the point here is
that there are alternative ways to identify and describe GIM which are quite
adequate, with no need for those who are not music therapists to identify GIM as
music therapy.
This may be especially important in countries where the music therapy profession is
not regulated. In these countries, the public’s understanding of who is and is not a
qualified member of the music therapy profession and of who is qualified to do what
safely and effectively may well be confused, with individual therapists and
organizations needing to give out clear and consistent information to help foster
public awareness and confidence (
It may thus be best for GIM practitioners generally, including music therapists, not to name GIM as a music therapy method, but rather describe GIM in its own unique terms. To enable prospective clients to feel confident in GIM as a safe, internationally-recognized, and reputable therapeutic method (or spectrum of methods) in which the practitioner is properly trained and qualified, it is possible to refer to the evidence-base and/or professional membership of a GIM organization.
In their policy statement supporting inclusivity and the valuing of specialisms in music
therapy, the EMTC (
The author believes that a collaborative approach involving various national and international GIM and music therapy organizations, including training organizations, may be needed to ensure that the organizations involved do not work against one another as the EMTC imply is in no one’s interests and likely to undermine public trust and confidence. Whilst none of these organizations may have the legal authority to dictate how the title music therapist and the term music therapy (and variations on it), are used and by whom, the organizations can nevertheless make informed recommendations that are nationally and internationally consistent and take account of national differences in professional regulation and training. This is where GIM, in a complex and easily misunderstood way, is both part of music therapy and is also separate from it in training, practice, and professionally.
The author’s impression is that difficulties may occur when there are apparently
conflicting agendas, which may also be able to complement one another to everyone’s
benefit. Thus, promoting the formal recognition, valuing and integration of GIM within
music therapy does not need to conflict with agreeing not to use such terms as
Along with the GIM organizations, GIM trainers have an especial responsibility to educate trainees who are not music therapists about the basic differences between music therapy and GIM, and the safe, ethical use of GIM and music therapy titles and designations. The AMI clarifies this in relation its policy advising against non-music therapists referring to themselves as music therapists or to their practices as music therapy:
This draws a clear boundary, and any Trainer who advises their non-music therapist trainees to use the term "music therapy" in advertising their services is going against such advisement and may in doing so be violating the AMI Code of Ethics and Standards of Practice. The same goes for modifications and adaptations of the Bonny Method. The AMI recommends that only music therapists refer to their work as music therapy and thus Trainers who are training non-music therapists should not refer to their trainings as music therapy. (Association for Music and Imagery, personal communication, December 16, 2021)
Finally, although guidelines such as the AMI (
In summary, it is proposed the following be considered as the basic principles to inform further discussion:
Music therapy training and GIM training are distinct.
The professional competencies and scope of practice of music therapists and of GIM therapists are also distinct (unless the music therapist is also trained in GIM).
2.1. Music therapists are qualified in a broad range of active and receptive methods but tend predominantly to use active approaches.
2.2. The various receptive music therapy methods practiced by music therapists (not additionally trained in GIM) need to be differentiated from GIM itself. In this sense, receptive music therapy and GIM are best distinguished to avoid confusion.
2.2.1. In particular, Music and Imagery as practiced by music therapists (not additionally trained in GIM) needs to be differentiated from MI as developed and practiced by GIM therapists.
2.2.2. There is a general confusion and inconsistency around the use of terms in GIM, with the boundaries between different types of practice unclear:
Music therapy is a profession. GIM training alone does not qualify practitioners as music therapists and thus as members of the music therapy profession. GIM training is not a training in music therapy in this important sense.
GIM is best understood not as a profession, but as a specialism (of advanced-level practice) in which qualified members of various professions can train including music therapy, psychology, psychotherapy, and psychiatry.
4.1. When GIM is identified as a type of music therapy by members of other professions in advertising their services, the public may assume that these other professionals are also qualified music therapists. This has the potential to create confusion about the music therapy profession, about who is and is not a qualified music therapist, and about who is qualified to do what safely and effectively.
4.1.1. The misunderstanding generated may undermine public trust and confidence in both music therapy and in GIM as a specialism. This is likely to be especially so when there is an inconsistency of approach amongst different individuals and organizations within a country.
4.1.2. GIM can be effectively identified and described in other ways.
4.1.3. The term
4.1.4. There may be legal consequences in some countries.
4.2. Whilst GIM can be identified as a psychotherapeutic method, its music-centred nature needs clarifying, associated with the way it differs from verbal psychotherapy. This is especially important where in some countries characterising GIM as psychotherapy may be problematical for practitioners who are not legally registered psychotherapists.
4.2.1. Different levels of psychotherapeutic work can be undertaken in GIM (supportive, re-educative and reconstructive) with the work alternatively oriented towards healing, self-development and/or spiritual development.
Promoting the valuing and integration of GIM as an evidence-based specialism for music therapists does not need to conflict with clarifying the distinction between GIM and music therapy, in training, practice, competencies, and professionally.
When GIM training is characterised as being in a type of music therapy, prospective trainees may assume that they will become music therapists once qualified. Links with music therapy need to be very carefully made so that they do not confuse and create misunderstanding. Trainers have an especial responsibility in this.
The author is sympathetic with the arguments of those who promote GIM and training in it
as training in music therapy. However, until such time as GIM training alone is
internationally agreed to constitute a training that qualifies practitioners as music
therapists, the author considers that a consensus agreement aligned with the guidelines
recently published by the AMI (
It is in any case perhaps unlikely that there will ever be international agreement that
GIM training alone qualifies counsellors, psychologists, psychotherapists, and others as
music therapists
Martin Lawes is a UK-based music therapist additional trained in Guided Imagery and Music (GIM). He is endorsed as a GIM trainer by the Association for Music and Imagery (AMI) and is founder of the Integrative GIM Training Programme which offers online and in-person training. He has published about GIM in four peer-reviewed journals. Martin was former chair of both the board and education committee of the European Association of Music and Imagery (EAMI) and has served on the AMI Standards committee. Martin has a special interest in the culture and ethics of GIM and its organizations and is part of an independent think-tank set up to explore this. Along with others, he provides independent GIM ethics consulting and support for those who have concerns.
Whilst the GIM Training Standards published by the AMI (
Whilst the author has attempted to provide clarity in relation to his own use of
terms, the situation is a complex and indeed confusing one in the way different terms
and definitions are used in the literature. GIM may, for example, sometimes be used
as a generic term and sometimes be used to refer specifically to the Bonny Method of
GIM. Used as a generic term, MI may or may not be included as part of GIM and this
not always be clear. In relation to adaptations and modifications of the Bonny Method
of GIM, Grocke and Wigram (
In the case of MI, the situation is especially complex. Not only do the US music
therapy competencies include those in “music and imagery” (
All the above makes the situation a confusing one for the public as well as for the music therapy and GIM communities, and for other professionals. The author is aware of no publication that embraces the contemporary spectrum of practice in its full diversity, with an inconsistent and confusing use of terms amongst the different publications as discussed. What is more, in discussing and presenting about their work, different practitioners may use the same term, MI, for example, to refer to different methods and different levels of work. Thus, MI may on the one hand involve the client imaging to music in an altered state of consciousness, or on the other hand involve the client drawing whilst listening to music. A practitioner may use the term MI to refer exclusively to supportive level work, or they may include re-educative and reconstructive level work in addition.
The author would strongly recommend international discussion to agree on a consensus
position related to the use of terms by those trained in GIM and/or MI, that embraces
the full spectrum of contemporary practice globally, and provides clarity rather than
confusion for others. Muller (
Summer (
Focused Music Imaging (FMI) is a hybrid method where the client experiences a brief
period of mental imaging in a relaxed state with the music playing, the experience
structured by the therapist using a
In the Bonny Method of GIM, in contrast, the therapist needs to select the music
programme used, the client not being in a position to choose as this requires a
sophisticated familiarity with the music programmes and their potential in the work.
The process is, nevertheless, a deeply collaborative one in the way the client is
supported to engage in a highly personal, specific, intimate, and creative experience
of the music provided according to their needs (
The EAMI currently require applicants for GIM training to have already received a
substantial psychotherapeutic education, one that included supervised client work and
a self-experience component (equivalent to sixty European Credit Transfer and
Accumulation System [ECTS] points or 1,500 to 1,800 hours). In addition, applicants
must have a minimum of two years post-qualification experience working
psychotherapeutically before commencing GIM training (or at least before commencing
supervised client work during training). The psychotherapeutic modalities and
associated professions accepted by the EAMI, in which applicants for GIM training may
have received their psychotherapeutic education, include mental health counselling,
music therapy, the other creative arts therapies, body psychotherapy and verbal
psychotherapy (
The AMI (
The EAMI Training Standards (
The AMI do not define GIM to be psychotherapeutic in nature, the AMI Training
Standards (
In the author’s view, a difficulty with the AMI’s more open, flexible approach to
what is required for training, relates to the method being a powerful one with
considerable risks for the client in an altered state of consciousness, whatever the
orientation of the work is intended to be. Preventing, recognizing, and properly
handling these risks is of vital importance in terms of safe and ethical practice
(
The EAMI has recently begun to consider that the psychotherapeutic prerequisites for
training in GIM and MI set out in its Training Standards (
In view of the serious nature of the risks involved for both clients and therapists
when the latter is insufficiently well trained (
See note 1.
The situation is, of course, variable dependent on the country. In the former East
Germany, for example, Schwabe's “Regulative Music Therapy” (
See note 7.
The Appalachian State University in the US provides the full GIM training which may
be undertaken as part of the Master in Music Therapy degree, which in the US
constitutes advanced-level training in music therapy (
The Korean Association for Music and Imagery (KAMI) does not endorse, register, or accredit practitioners, its members AMI-endorsed practitioners. KAMI does, nevertheless, publish a Code of Ethics and grievance procedure (Jung Pyo Moon, KAMI President, personal communication, September 17, 2021).
It can be added here that the public are unlikely to understand the nature of GIM without clear explanation. The term Guided Imagery and Music itself, whether in English or translated, does not explain what the method involves. Prospective clients may indeed be misled by the associations they have with the individual words ‘guided’ and ‘imagery,’ and with the phrase ‘guided imagery,’ for example. The uninformed public are likely to have little if any understanding of what imagery means in GIM, and that GIM involves listening to recorded music in an altered state. Even if they do understand this, they may assume that the method involves directive rather than non-directive guiding. All this and more needs to be explained, so that potential clients can make an informed choice whether to try GIM.
See note 13.
See note 9.