[Position Paper]

How Can Music Build Community? Insight from Theories and Practice of Community Music Therapy

By Megan Ellen Steele

Abstract

Community music therapy has emerged as a widespread approach to music therapy practice since the beginning of the twenty-first century. This article outlines its development from an initial reaction against the individualistic consensus model of traditional music therapy practice, towards its current application across diverse, international contexts. Landmark publications and key terminology will be introduced, and the acronym PREPARE (participatory, resource-oriented, ecological, performative, activist, reflective, and ethics driven) (Stige & Aarø, 2011) used as a means of outlining key qualities of community music therapy. The nature of community music therapy as a context-driven and ethical practice that builds on individual and community resources through collaborative musicking will be illustrated through examples from the literature. The emerging influence of matrix theory as a model for processes within community music therapy (Wood, 2016) and future implications for music therapists as they explore work that shifts between individual and social formats and aims are discussed.

Keywords: community music therapy, context-driven, collaborative musicking, music therapy matrix


Editorial note: In 2016, Voices hosted a special edition to accompany the launch of a Massive Open Online Course (MOOC) on the topic of "How Music Can Change Your Life". Thirteen authors agreed to develop position papers for the MOOC, with two articles being developed to accompany each of the six topics within it. Each author has highlighted the theorists and researchers who have influenced their thinking, and included references to their own research or music practices where appropriate. These papers have been written with a particular audience in mind—that is, the learners who participate in the MOOC, who may not have had previous readings in any of the fields being canvassed. We hope that you find these articles interesting, whether reading as a MOOC learner, a regular VOICES reader, or someone who is discovering VOICES for the first time.



Introduction

We live in a multimedia global era where social isolation is an increasingly common experience for people of all ages (Krivo et al., 2013, p. 197). As a result, practices that foster participation have become increasingly necessary, and music can provide helpful conditions for change. The practice of community music therapy is one approach that has been developed to facilitate the many benefits that community membership promotes (Andsell, 2014). Theorists in community music therapy discourse argue that music is an active social phenomenon that can be used to help create flourishing communities in which the diversity of individual difference is celebrated, and support is shared (Stige, Ansdell, Elefant, & Pavlicevic, 2010). This potential of music has long been evident in everyday uses of music, from the ritual singing of the Happy Birthday song, to the rousing chorus of fans at a soccer match, to swapping music playlists online across international borders; music is frequently shared by people in community. However it has only recently become necessary to develop theories and practices that explain how we can use music intentionally to enhance connectedness. Situated within a Massive Open Online Course (or MOOC) about the ways music can build health and wellbeing, this article will highlight both theories and practice of community music therapy to demonstrate how music is being used as a powerful resource in the support of healthy communities.

A Brief History of Music Therapy

In her essay on historical perspectives in music and medicine, Penelope Gouk noted that the concept of the doctor who is also a musician has been a recurring cultural ideal across centuries long before the establishment of the music therapy profession (2000, p. 172). Through the tracing of historical texts, Gouk concluded that the representation of music and medicine relies heavily on the intellectual bias of institutional disciplines. As such, much information about healing practices involving music has not been captured in historical records if they were perceived as being outside the boundaries of the professional fields of medicine and music. In the opening chapter of his book Music as Medicine, Peregrine Horden (2000) also wrote of the substantial historical legacy of the music therapy profession, from antiquity and across cultures, and advocates for an acceptance of this history by modern music therapists (p. 32). However, in his recent book The Study of Music Therapy: Current Issues and Concepts, Kenneth Aigen (2014) questioned the way both Gouk and Horden refer to music therapy as any use of music that focuses on therapeutic effect (p. 27). Music therapists consider the profession to be more specific and linked to particular competencies and ethical standards, requiring tertiary education about theory, research, and practice.

While some publications about the therapeutic use of music in medicine were produced in the 1800s, this development of music therapy as a profession bound by standards of qualification and governing educational and administrative bodies began to gain momentum in the United Kingdom (UK) and America in the early 20th century (Tyler, 2000). In the UK, music was initially used within hospital settings as a form of recreation and entertainment for patients, and music listening for patients was incorporated into medical treatment and experiments (Bunt & Stige, 2014, p. 6). Music continued to be used as a form of morale boosting for soldiers during the Second World War and increasingly in educating young people with disabilities (Tyler, 2000). In America, reports also exist of various individuals using music therapeutically in institutional settings, and many hospitals established music programs to assist with the treatment and rehabilitation of returned soldiers post-WWII (Davis, Gfeller, & Thaut, 2008, p. 32). However, the wider medical profession still did not support the benefits of such programs. As such, training courses for musicians who wanted to further systematise and improve their understanding of the therapeutic use of music were developed. The formation of the National Association of Music Therapy in America in 1950 (Davis et al., 2008, p. 33) and the future British Society for Music Therapy in 1958 (Bunt & Stige, 2014, p. 8) were key in the development of music therapy training and the beginnings of music therapy as a professional field.

After this point, several international pioneering schools of practice arose, including the work of Juliette Alvin and Nordoff and Robbins’ work with young people with disabilities in the UK, and American Mary Priestley’s practice in the context of adult psychiatry (Aigen, 2014, p. 194). The inception of a range of music therapy specific publications in the 1980s (Davis et al., 2008, p. 34) contributed to the growing sense of music therapy as a discipline. The consensus model of music therapy practice (as it is described by Andsell (2002a), had now been established. Kenneth Aigen described how the pioneers of the profession of music therapy often aligned their practices with those from medicine or psychotherapy due to the need to compete for resources within institutions (2014, p. 194), or as Even Ruud suggested, to legitimise and explain their methods (Ruud, 1980, p. 70). Therefore, with the consensus model, therapists (who describe themselves as clinicians) adopt an individualistic focus on the achievements of people (typically described as clients) through a process in which their relationship with the therapist and music is critical.

Key Texts in Music Therapy

During the beginning of the 21st century, this commitment to legitimacy within the medical model began to be supplemented by an increasing discourse related to the social model. The publication of Brynjulf Stige’s seminal text Culture-Centered Music Therapy in 2002 initiated a dialogue about emerging practices in Norway that sought to redefine music therapy “as a situated practice” (p. 181) dependent upon its unique context. Stige reflected on the continuing evolution of music therapy as a discipline, and the problems associated with aligning the discipline too closely with music therapy as a professional field. Stige advocated for music therapy as a discipline to enact a broad conception of music and health, offering the possibility for widening the scope of music therapy scholarship separate to the requirements of professional codes of practice (p. 199).

The concept of community music therapy was named by Gary Andsell in his landmark article “Community Music Therapy and the Winds of Change” (2002a) in the newly established online music therapy journal Voices (Kenny & Stige, 2002a). A range of respondents contributed to a stimulating debate in the newly available, open access journal that allowed almost immediate public interchange between scholars from around the world (Andsell, 2002b, 2005; Garred, 2005a, 2005b; Maratos, 2002; Pavlicevic, 2005; Ruud, 2004a, 2004b, 2005; Stige, 2004). Several international book publications describing the diverse practice of community music therapy followed in the years to come. Caroline Kenny and Stige published an anthology offering contemporary descriptions of practice from across the globe (2002b). Two years later, Mércèdes Pavlicevic collaborated with Gary Andsell to bring together a raft of authors to illustrate the widespread nature of the practice in their book Community Music Therapy (2004). This publication was closely followed by the co-authored book Where Music Helps written by Stige, Andsell, Pavlicevic and Cochavit Elefant (2010), in which each presented case studies of their work followed by a reflective and theoretical discussion chapter serving to further elucidate aspects of their practice with individuals and communities. By the end of the first decade of the 21st century, Voices had become established as the primary forum for authors who wanted to describe practices that were congruent with an approach such as community music therapy.

By that point, community music therapy articles were increasingly available in a range of print journals, describing work with young people with autism (Kern & Aldridge, 2006), adults with disabilities (Sohensky, 2011), students recovering from traumatic events (McFerran & Teggelove, 2011) and many other diverse contexts. The publication of another community music therapy textbook by Stige with colleague Leif Aarø (2011) also provided a range of carefully documented practice examples from music therapists as well as pedagogical features to support the access of readers, including students.

Various critiques of music therapy were also beginning to surface, either of its theoretical origins, or its need to be named a separate approach to practice (Aigen, 2014, p. 197). In her article “Challenging the Profession”, Alison Barrington (2008) argued that community music therapy relies too heavily on evaluation from external parties, and is contrary to a client-centered approach to practice. In her response to Alan Turry’s article proposing ways to reflect on aligning concepts of music psychotherapy and community music therapy (2005), Elaine Streeter described the potential dangers of allowing the destruction of therapeutic boundaries upon the music therapist’s ability to work sufficiently deeply with clients, or maintain the health of personal relationships (2006). Finnish music therapist, Jaakko Erkkilä (in Stige, 2011) even suggested that it would be professional suicide to move away from an individualistic, medical approach and towards a more social approach (p. 13). Despite these and other critiques, community music therapy has largely been accepted as the fifth wave of music therapy (Bruscia, 2002, p. xv) and provides important understandings about the uses of music to enhance connectedness and support communities, through both individual and group work.

Key Qualities of Community Music Therapy

In the most recent edition of Defining Music Therapy, Kenneth Bruscia (1998) described a range of ecological approaches to practice including “all applications of music and music therapy where the primary focus is on promoting health within and between various layers of the sociocultural community and/or physical environment” (p. 242). This definition emphasised the interactional relationships between individuals and the communities within which they live. Bruscia’s talent for definitions has not extended to community music therapy however, where the context-bound and broadly varied nature of community music therapy makes it difficult to create a succinct definition of its practice (Pavlicevic & Andsell, 2004). Indeed, Andsell (2005) made a plea for recognising connecting patterns within practice rather than coming to a final definition of community music therapy, and Stige (2002) reminded us that perhaps music therapy will require a constant redefinition as it continues to develop and change. Wood (2016) described how the term community music therapy has been criticised both for overlapping with already existing music therapy practice, and for being too broad a term to be meaningful (2016, p. 33). However, Wood believes that the lack of “predictive approaches and methods” (p. 44) within community music therapy is an asset because it permits questioning and openness of dialogue while allowing descriptions of work to remain close to the practice itself. In keeping with these positions, this paper will provide descriptions of community music therapy that set it apart from other forms of music therapy or community music work, rather than attempting to define it. Stige and Aarø (2011) have proposed the acronym PREPARE (participatory, resource-oriented, ecological, performative, activist, reflective, and ethics driven) as a useful means of outlining seven of the key qualities of community music therapy, and each of these will now be introduced with reference to examples from across the literature.

P = Participatory

Within the PREPARE acronym, Participatory concerns the way opportunities for participation in private or group music therapy are created (Stige & Aarø, 2011, p. 20), as well as the collaborative nature of the relationship between music therapist and participants. Traditional power structures are challenged by participatory practices, and there is an expectation that all the diverse voices engaged in the process have the right to be heard and made welcome (Stige & Aarø, 2011). The facilitator creates space to support the open and flexible sharing of (sometimes hidden) client perspectives and voices, whether expressed through verbal language or the music itself. Key to this is a focus on empowerment and enabling, or “building on people’s experience of who they are and what they can do” (Procter, 2001, para. 5) through music making, rather than pathologising or disempowering people with mental health issues and disabilities. Indeed, Procter spoke of the way that hearing all that an individual offers as music allows him to focus more on what he may offer to the partnership, and less on diagnosis.

Key to the participatory qualities of the approach is that the facilitator takes a back seat, allowing the participant or group members to inform the decision-making processes, and take responsibility for the construction of their own rules or boundaries (Stige et al., 2010). This concept is reinforced by Pavlicevic's (2010) case study of a choir for school-aged children run by two music therapists in South Africa, in which group members spent an entire session brainstorming rules together, and continued to enforce them over the course of the program with minimal input from the music therapists. It is not, therefore, that there is no structure within community music therapy programs, but rather that structure emerges from the group itself, with music therapist and participants sharing group ownership through their collaboration.

More recently, understandings of the nature of collaboration within participatory community music therapy practice have been extended by the work of Lucy Bolger (2015) describing her partnerships with marginalised young people from a range of community groups in Australia (2015). Bolger outlined the concept of being a player to denote the elements of collaboration a participant may engage in through the music. These include buying in to the process, continuing to negotiate aspects of their involvement, and contributing their own voice. The structure of sessions thus emerges based upon the collaboration between music therapist and participant/s. Although potentially challenging, collaboration is particularly important for individuals who are socially marginalised due to mental health issues, disability or other reasons (Stige, 2010, p. 125)

R = Resource-oriented

The resource-oriented quality of community music therapy practice seeks to build on the reserves or resources people have in their daily lives that they can use to problem solve and change (Stige & Aarø, 2011, p. 21). While resources may include tangible items such as materials, they may also include aspects of the social community, cultural artifacts (including music), and the unique strengths of the person or group engaging in the music therapy process. Randi Rolvsjord’s book Resource-Oriented Music Therapy (2010) described this orientation to practice in relation to practices in mental health care. Central to the idea that community music therapy allows all voices to be heard is the concept that all participants have something to offer, and the facilitator works to enable participants by focusing on their potential as a resourced person (pp. 44-45).

Lars Tuastad and Brynjulf Stige (2015) provided another exemplar of this concept though their article about a group of ex-prison inmates who form a rock band within a music therapy participatory action research project. Rather than stigmatising the men by labeling them as criminals, Tuastad et al. chose to emphasise the unique resources the men brought to the musical context, which included their skills as rock musicians. After the violent attack of one of their band members, the band members were able to resist the option of retaliating with violence that would jeopardise the continuation of their music project. Through their realisation that “music is of greater value than revenge” (p. 263), these men were able to move beyond their previous manner of responding to violence because of the resource emphasised through their band membership.

Another example of resource-oriented practice can be found in Pavlicevic and Sunelle Fouché’s (2014) example of a music therapy group for community members living in the South African Cape Flats community, described by the authors as “a dangerous place: awash with guns, drugs, money laundering, gang violence and shootings” (2014, p. 58). The writers depicted the way that the individual resources of group members were acknowledged and the resilience of group members flourished as they create their own experience of safety through the process of musical improvisation.

Tia DeNora’s notion of musical affordances (2000) is integrated within the resource oriented perspective, which emphasises the way that music can afford a range of resources used by individuals as they go about their daily social life (p. 45). An example of this can be found in American music therapist Patricia Winter’s account of a tour to Malawi (2015), in which she was employed as a consultant to suggest strategies for using music to further include young people with disabilities within the school system. In comparison to many western educators, Winter viewed the Malian teachers’ own ingrained cultural practices of singing, dancing, and using body and percussion as resources that they could use in the classroom. When it came time for Winter to provide professional development to the teachers, she capitalised on these resources to introduce the use of music as a classroom teaching strategy. Furthermore, Winter used the rhythmic and repetitive affordances of the music itself to plan a song-writing activity that tied together music making and reading lessons in an engaging manner.

E = Ecological

Pavlicevic and Andsell (2004) described the potential for musical interactions to spread and impact upon wider society through their discussion of “the ripple effect”; the way “music naturally radiates, like dropping a pebble in a pond and seeing the waves of energy spread out in concentric circles” (p. 16). This has some similarities to Bronfenbrenner’s (1992) ecological systems theory, which popularised a way of understanding how an individual is positioned within layers of interacting social systems, from close family members, to distant community members, through to the wider culture itself. Having an understanding of the reciprocal nature of the relationships between socio-cultural environments and people is important for facilitators when engaging in community music therapy (Bunt & Stige, 2014, p. 48).

One example of ecological qualities is provided by Elefant (2010) who followed her intuition to use music to bridge two groups of school students across a town – including one group who have a range of significant disabilities. Over the 4 years of the program, Elefant was able to identify changes in attitude and practice towards disability not only within the local, school-based context, but also systemically within the local council. Similarly, in their book Creating Music Cultures in the Schools, Daphne Rickson and Katrina McFerran (2014) described how principles of community music therapy can be applied in school contexts to identify key players across the school system. They suggested encouraging teachers, assistants, parents, and learners to include musical activities as a strategy for promoting change and positive relationships for all counterparts in a school environment, and discuss the way this fits alongside rationales of inclusive practice.

An ecological approach may also highlight aspects of a context that are either helping or hindering clients. Jeffrey Kittay (2008) wrote about conducting an audit of the soundscape of his daughter’s living environment in a group home. As a result, he encouraged music therapists and readers to pay close attention to aspects of the everyday music and sound present within the environment, from which potential affordances or negative sound experiences may be identified. This shows the value of assessing the needs of a setting separate from the needs of the individuals within the setting (Wood, 2016, p. 37).

P = Performative

Public performances are often described in community music therapy practices, however the term performative refers to performances that occur within sessions, as well as outside of them. This idea has been informed by musician and educator Christopher Small’s (1998) introduction of the concept of “musicking”. To Small, music cannot be seen as an object, but can only be understood as something that is performed actively, whether through listening to music while pushing a trolley around a supermarket, singing a baby to sleep, creating music with friends, or moving on the dance floor. In this way, every time music is performed (in public or everyday life) it occurs as part of relationships between human beings, and its use can impact upon the non-musical processes that take place alongside it (Stige & Aarø, 2011). “Health musicking” (Stige, 2002, p. 210), therefore, serves to identify the affordances implicit within the musicking process and use them to promote the health and wellbeing of the individual/s involved.

David Aldridge (2005) described the way that individuals experiencing illness may have the opportunity of performing a healthy identity through music therapy (2005, p. 48). This concept is illustrated in the example of Emhile, a small child with tuberculosis who was able to move past the illness and act out her healthy, childlike self through her musical participation (Oosthuizen, 2012). Amy Clements-Cortes and Susan Pearson (2014) also described the case of HG, a male musician and psychotherapist undergoing chemotherapy treatment for cancer who performed aspects of his well persona through giving performances for other patients during time spent in hospital.

Numerous authors described the benefits of working with their clients towards literal performances on stage within their community music therapy work. However, where performance does become the aim of the community music therapy program, Turry (2001) cautions that performances may impact on the therapist’s ability to respond to the needs of the participant. McFerran and Lucy O’Grady advised music therapists to be aware of both affordances and risks implicit in preparing, often vulnerable, group members for musicking on stage (2007). Aigen questioned the ethics of engaging in performances if the therapist and client are adopting a psychotherapeutic perspective, since it is crucial that music therapy participants are not concerned with how their music sounds to an audience in that context (2014, p. 208). Other authors suggested that holding a post-performance debriefing session is useful, as it was for assisting young people experiencing homelessness and family violence to process and reflect upon their performance (Fairchild, Thompson, & McFerran, 2016).

A = Activist

The activist quality emphasises the unequal distribution of resources among people in society (Stige & Aarø, 2011, p. 23; Vaillancourt, 2012). Although Guylaine Vaillancourt remarked that not all facilitators working from a community music therapy orientation will necessarily work with activist and social justice intentions, there is an implicit attitude that their work is in some way contributing to a wider social change agenda, whether this is consciously intended or not. In this manner, the practice of community music therapy offers the possibility of contributing to societal change, even if only in a small way.

One social change agenda that has been championed by many community music therapists is the inclusion of individuals with disabilities into their local community. Stige pointed out that as participation is “about having access to and belonging to a community” (2006, p. 135), the facilitator may sometimes need to engage in political action to address barriers to participation. Indeed, Stige recounted the story of Knut, a young man with Down syndrome who wanted to join his local marching band as a key determinant in him rethinking his approach to music therapy practice (2002, p. 3). CJ Shiloh and Blythe Lagasse (2014) provided an example of activist community music therapy practice in their description of the development of sensory friendly concerts, open to all members of the community, including those diagnosed with autism spectrum disorder. While serving to increase the self-advocacy skills of individuals who attend, the concerts were also created with the intention of changing greater societal perspectives of people on the autism spectrum.

When conducting a meta-synthesis of their previous research into the use of music therapy within prisons, Tuastad & O’Grady (2013) provided a further example of the activist potentials of community music therapy practice. Their study demonstrated that prisoners and ex-prisoners from both Australian and Norwegian contexts were able to use their musicking within music therapy as a “freedom practice” (p. 224), experiencing a sense of transcendence from their current reality, and in doing so explore possibilities for a hopeful future.

R = Reflective

The quality of engaging in ongoing reflective questioning of all aspects of the work, both personally, as well as in dialogue with others, is a critical feature of community music therapy (Stige & Aarø, 2011, p. 23). In the process, facilitators open themselves up to the possibility of continually changing and developing their practices (Mellor, 2011). When referring to his definition of community music therapy, Ruud (2010) described the need for both an ability to reflect and show awareness of culture and context, as well as to consider ethical issues associated with practice. Reflecting upon one’s own privilege and the distribution of power, as well as making conscious the biases and assumptions one brings to the work are also seen as crucial to the process of engaging in reflexive practice (Stige & Aarø, 2011).

Stige and colleagues highlighted the importance of reflexivity in Where Music Helps (Stige et al., 2010). Each case study of a community music therapy program is immediately followed up a reflective chapter, written in the first person, and openly engaging in deep reflection about the work. Further examples of reflexivity are illustrated by Sue Baines (2013) as she questioned the dominant power paradigms within a music therapy group for people with mental health issues, and Sandra Curtis (2012) reflecting upon her personal history and its influence on her subsequent feminist and social justice lens.

Stuart Wood’s (2006) matrix model of music therapy situates itself in a culture and music centered approach to practice, and states that as all music therapy is an example of “the way that music creates structure within and between us” (para. 5), all formats of music therapy are equally valuable. Wood called for reflexivity on the part of the facilitator in deciding upon appropriate formats, aims, understandings of context, and evaluation processes dependent upon the ever changing needs of the person involved (2016). He illustrated these concepts by providing a non-hierarchical matrix for each of these processes based on his practical experience at working as a music therapist in an English care home. Participants moved fluidly between individual and community based formats of music therapy depending upon Wood’s continual reflection on their current needs. Similarly, aims of music therapy sessions were also emergent and based on a reflection on the music itself as well as aims suggested by the music therapist and participant.

E = Ethics-driven

Ethics-driven practice is based in concepts of human rights (Stige & Aarø, 2011, p. 24), and directly related to the social justice aims outlined previously. O’Grady and McFerran (2007) highlighted the importance of ethics in relation to the concept of boundaries. They noted the differences between practices of community musicians (bound by the personal morals of the musician) and community music therapy (bound by the ethics of the professional governing body), and considered the relative merits of each. Bethan Shrubsole (2015) discussed the need for more fluid boundaries when practicing music therapy in the Ugandan cultural context, where the delineation between personal and professional does not have the same meaning as it does in Europe. While emphasising the importance of working within the realms of professional obligations, Shrubsole argued for flexibility about time and space.

One relatively recent ethical quandary that has emerged within the community music therapy literature is the focus on the sustainability of music therapy programs as a facet of ethically driven practice. Bolger described engaging in a year long community music program in a refuge for women and children in rural Bangladesh, with the concept of sustainable practice stressed throughout the duration of the project (Bolger & McFerran, 2013). Bolger wrote of the importance of awareness of the power dynamics implicit within the international development sector. Strategies such as consciously delaying her arrival at the music therapy group to allow the women to start without her were key to ensuring that the village women themselves ultimately held ownership of the music therapy group.

Where to Next?

This article highlighted some ideas present in discourse about community music therapy and outlines key qualities of practice. In an editorial on the special community music therapy edition of the International Journal of Community Music, Giorgos Tsiris (2014) wrote explicitly about contemporary societal changes and the ways these are impacting upon the delivery and practice of community music therapy. Tsiris pointed out new directions and avenues for the interdisciplinary study of music and health promotion not only in specialist, but also in everyday contexts. In a retrospective analysis of his landmark 2002 article, Andsell entertained the continued possibilities for collaboration between the fields of community music therapy and community music as well as the burgeoning field of music and health (2014). Ornette Clennon also provided a thoughtful description of “therapy-aware” (2013, p. 33) community music work, recounting the way an ability to enact community music therapy principles allowed the community musicians to achieve positive gains with clients within the mental health system. She also called for further discussion about the blurry “ecotone” between community music therapy and community music (p. 41).

Stige noted that some authors believe that general change in community attitudes towards participatory and activist practices mean that maintenance of a separate field of community music therapy is no longer required (2014). In spite of this, he sees challenging the status-quo within the largely individualised and medicalised Western health system through community music therapy as crucial and ongoing. The shift in epistemological and methodological perspectives from the evidence-based practice modes of the consensus model of music therapy towards a widening prominence of research based in ethnographic and participatory action methods is essential for this continuing development (Stige, 2002). And while an understanding of the use of the affordances of music towards the development of individual and community wellbeing is gaining traction amongst media and everyday dialogue, understanding about the way that music use may also be unhealthy is only just beginning to emerge (Saarikallio, Gold, & McFerran, 2015).

Within this article, I have canvassed some of the key writers on community music therapy, but there are many others who have made contributions to the discourse. In addition, the development of this particular way of thinking has emerged alongside other arenas, such as community music (Higgins, 2012) music sociology (DeNora, 2000), culture-centered music therapy (Stige, 2002), and more. While this article is an entry point into the discourse, the reader is encouraged to adventure further into the literature, exploring the vast terrain in which community music therapy exists.

Although initial descriptions of community music therapy were perceived as being worlds apart from traditional music therapy, perhaps over time the gap between these two approaches to practice has become blurred, as music therapists continue to work in varied ways based on the needs of their own unique context. Although we may plan to support an individual privately, the outcomes might ultimately benefit the community. Similarly, while we may aim to support a community on a political or social level, individuals could also be enriched by the experience. To Wood, music therapy “is made of individual stories that are also stories about groups and wider social considerations” (2016, p. 62). It is hoped that in the future, a wide conceptualisation of the discipline of music therapy including perspectives about the way individuals and communities are intrinsically intertwined will support the continued development of understanding about the way music may help.

References

Aigen, K. (2014). The study of music therapy: Current issues and concepts [Adobe Digital Editions Version]. Oxon: Taylor and Francis.

Aldridge, D. (2005). Dialogic-degenerative diseases and health as a performed aesthetic. In D. Aldridge (Ed.), Music therapy and neurological rehabilitation: Performing health (pp. 19-60). London; Philadelphia: Jessica Kingsley Publishers.

Andsell, G. (2002a). Community music therapy & the winds of change. Voices: A World Forum for Music Therapy, 2(2). doi:10.15845/voices.v2i2.83

Andsell, G. (2002b). Do we puncture the balloon or let it fly? [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Andsell, G. (2005). Community music therapy: A plea for "fuzzy recognition" instead of "final definition" [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Andsell, G. (2014). Revisiting ‘Community music therapy and the winds of change’ (2002): An original article and a retrospective evaluation. International Journal of Community Music, 7(1), 11-45. doi:10.1386/ijcm.7.1.11_1

Baines, S. (2013). Music therapy as an anti-oppressive practice. Arts in Psychotherapy, 40(1), 1-5. doi:10.1016/j.aip.2012.09.003

Barrington, A. (2008). Challenging the profession. British Journal of Music Therapy, 22(2), 65-72. doi:10.1177/135945750802200204

Bolger, L. (2015). Being a player: Understanding collaboration in paticipatory music projects with communities supporting marginalised young people. Qualitative Inquiries in Music Therapy, 10(3), 77-126.

Bolger, L., & McFerran, K. S. (2013). Demonstrating sustainability in the practices of music therapists: Reflections from Bangladesh. Voices: A World Forum for Music Therapy, 13(2). doi:10.15845/voices.v13i2.715

Bronfenbrenner, U. (1992). Ecological systems theory. London: Jessica Kingsley Publishers.

Bruscia, K. E. (1998). Defining music therapy. Gilsum: Barcelona Publishers.

Bruscia, K. E. (2002). Foreward. In B. Stige (Ed.), Culture-centered music therapy. Gilsum: Barcelona Publishers.

Bunt, L., & Stige, B. (2014). Music therapy: An art beyond words. East Sussex; New York: Routledge.

Clement-Cortes, A., & Pearson, S. (2014). Discovering community music therapy in practice: Case reports from two Ontario hospitals. International Journal of Community Music, 7(1), 93-111. doi:10.1386/ijcm.7.93_1

Clennon, O. (2013). Two case examples using participatory music as a therapeutic metaphor in a community mental health setting in the United Kingdom. International Journal of Community Music, 6(1), 33-43. doi:10.1386/ijcm.6.1.33_1

Curtis, S. L. (2012). Music therapy and social justice: A personal journey. Arts in Psychotherapy, 39(3), 209-213. doi:10.1016/j.aip.2011.12.004

Davis, W., Gfeller, K., & Thaut, M. (2008). An introduction to music therapy theory and practice (3rd. edition). Silver Spring, MD: American Music Therapy Association.

DeNora, T. (2000). Music in everday life. Cambridge; New York: Cambridge University Press. doi: 10.1017/CBO9780511489433

Elefant, C. (2010). Must we really end? Community integration of children in Raanana, Israel. In B. Stige, G. Ansdell, C. Elefant, & M. Pavlicevic (Eds.), Where music helps: community music therapy in action and reflection (pp. 65-73). Farnham, England; Burlington, USA: Ashgate.

Fairchild, R., Thompson, G., & McFerran, K. S. (2016). Exploring the meaning of a performance in music therapy for children and their families experiencing homelessness and family violence. Music Therapy Perspectives, Advanced Access, 1-14. doi: 10.1093/mtp/miw004

Garred, R. (2005a). Fusing (or confusing?) the terms "music therapy" and "community music": A plea for clarification [Contribution to moderated discussions]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Garred, R. (2005b). On the politics of community music and music therapy: The same or different? [Contribution to moderated discussions]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Gouk, P. (2000). Sister disciplines? Music and medicine in historical perspective. In P. Gouk (Ed.), Musical healing in cultural contexts (pp. 171-196). Hants: Ashgate.

Higgins, L. (2012). Community music in theory and in practice. New York: Oxford University Press. doi: 10.1093/acprof:oso/9780199777839.001.0001

Horden, P. (2000). Musical soulutions: Past and present in music therapy. In P. Horden (Ed.), Music as Medicine (pp. 4-40). Hants: Ashgate.

Kenny, C., & Stige, B. (2002a). Introducing voices: a world forum for music therapy. A new avenue for communication among music therapy communities. In C. Kenny & B. Stige (Eds.), Contemporary voices in music therapy. Oslo: Unipub.

Kenny, C., & Stige, B. (Eds.). (2002b). Contemporary voices in music therapy: Communication, culture and community. Oslo: Unipub.

Kern, P., & Aldridge, D. (2006). Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program. Journal of music therapy, XLIII(4), 270-294. doi:10.1093/jmt/43.4.270

Krivo, L. J., Washington, H. M., Peterson, R. D., Browning, C. R., Calder, C. A., & Kwan, M.-P. (2013). Social isolation of disadvantage and advantage: The reproduction of inequality in urban space. Social Forces, 92(1), 141-164. doi:10.1093/sf/sot043

Maratos, A. (2002). Debating the winds of change in community music therapy. [Contribution to moderated discussions]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

McFerran, K. S., & Teggelove, K. (2011). Music therapy with young people in schools: After the black Saturday fires. Voices: A World Forum for Music Therapy, 11(1). doi: 10.15845/voices.v11i1.285

Mellor, L. (2011). What is 'known' in community music in higher education? Engagement, emotional learning and an ecology of ideas from the student perspective. International Journal of Community Music, 4(3), 257-275. doi:10.1386/ijcm.4.3.257_1

O'Grady, L., & McFerran, K. (2007). Community music therapy and its relationship to community music: Where does it end? Nordic Journal of Music Therapy, 16(1), 14-26. doi: 10.1080/08098130709478170

Oosthuizen, H. (2012). Health, masks and music: Narratives of empowerment in a South African community music therapy project based in a tuberculosis hospital. International Journal of Community Music, 5(2), 175-188. doi:10.1386/ijcm.5.2.175_1

Pavlicevic, M. (2005). Community music therapy: Anyone for practice? [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Pavlicevic, M. (2010). Because it's cool. Community music therapy in Heideveld, South Africa. In G. Andsell, B. Stige, C. Elefant, & M. Pavlicevic (Eds.), Where music helps: Community music therapy in action and reflection (pp. 93-98). Farnham, England; Burlington, USA: Ashgate.

Pavlicevic, M., & Andsell, G. (Eds.). (2004). Community music therapy. London; Philadelphia: Jessica Kingsley Publishers.

Pavlicevic, M., & Fouché, S. (2014). Reflections from the market place – Community music therapy in context. International Journal of Community Music, 7(1), 57-74. doi:10.1386/ijcm.7.1.57_1

Procter, S. (2001). Empowering and enabling: Improvisational music therapy in non-medical mental health provision. Voices: A World Forum for Music Therapy, 1(2). doi:10.15845/voices.v1i2.58

Rickson, D., & McFerran, K. (2014). Creating music cultures in the schools: A perspective from community music therapy. University Park: Barcelona Publishers.

Rolvsjord, R. (2010). Resource-oriented music therapy in mental health care. Gilsum: Barcelona Publishers.

Ruud, E. (1980). Music therapy and its relationship to current treatment theories. St Louis: Magnamusic-Baton.

Ruud, E. (2004a). Defining community music therapy [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Ruud, E. (2004b). Defining music therapy II [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Ruud, E. (2005). Community music therapy III [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Ruud, E. (2010). Music therapy: A perspective from the humanities. Gilsum: Barcelona Publishers.

Saarikallio, S., Gold, C., & McFerran, K. (2015). Development and validation of the healthy‐unhealthy music scale. Child and adolescent mental health, 20(4), 210-217. doi:10.1111/camh.12109

Shiloh, C. J., & Lagasse, A. B. (2014). Sensory Friendly Concerts: A community music therapy initiative to promote neurodiversity. International Journal of Community Music, 7(1), 113-128. doi:10.1386/ijcm.7.113_1

Shrubsole, B. (2015). A community music therapy project's journey. Approaches: Music Therapy & Special Music Education. Retrieved from http://approaches.gr/a-community-music-therapy-projects-journey-by-bethan-lee-shrubsole/

Small, C. (1998). Musicking: The meanings of performing and listening. Hanover: University Press of New England.

Sohensky, R. (2011). Everybody is a star: Recording, performing and community music therapy. Music Therapy Perspectives, 29, 23-30. doi:10.1093/mtp/29.1.23

Stige, B. (2002). Culture-centered music therapy. Gilsum: Barcelona Publishers.

Stige, B. (2003). Elaborations toward a notion of community music therapy. (Doctoral Dissertation), The University of Oslo, Norway.

Stige, B. (2004). On defining community music therapy [Contribution to moderated discussion]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/debating-winds-change-community-music-therapy

Stige, B. (2006). On a notion of participation in music therapy. Nordic Journal of Music Therapy, 15(2), 121-138. doi:10.1080/08098130609478159

Stige, B. (2010). Musical participation, social space, and everyday ritual. In B. Stige, G. Andsell, C. Elefant, & M. Pavlicevic (Eds.), Where music helps: community music therapy in action and reflection (pp. 125-147). Farnham, England; Burlington, USA: Ashgate.

Stige, B. (2011). Elaborations toward a notion of community music therapy. Gilsum: Barcelona Publishers.

Stige, B. (2014). Community music therapy and the process of learning about and struggling for openness. International Journal of Community Music, 7(1), 47-55. doi:10.1386/ijcm.7.1.47_1

Stige, B., & Aarø, L. E. (2011). Invitation to community music therapy. New York: Routledge.

Stige, B., Ansdell, G., Elefant, C., & Pavlicevic, M. (2010). Where music helps: Community music therapy in action and reflection. Farnham, England; Burlington, USA: Ashgate.

Streeter, E. (2006). Response to "Music psychotherapy and community music therapy: Questions and considerations [Response to moderation discussions]. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=content/response-music-psychotherapy-and-community-music-therapy-questions-and-considerations

Tsiris, G. (2014). Community music therapy: Controversies, synergies and ways forward. International Journal of Community Music, 7, 3-9. doi:10.1386/ijcm.7.1.3_2

Tuastad, L., & O'Grady, L. (2013). Music therapy inside and outside prison – A freedom practice? Nordic Journal of Music Therapy, 22(3), 210-232. doi:10.1080/08098131.2012.752760

Tuastad, L., & Stige, B. (2015). The revenge of Me and THE BAND’its : A narrative inquiry of identity constructions in a rock band of ex-inmates. Nordic Journal of Music Therapy, 24(3), 252-275. doi:10.1080/08098131.2014.967713

Turry, A. (2001). Performance and product: Clinical implications for the music therapist. In D. Aldridge & J. Fachner (Eds.), Research news (Vol. II). Retrieved from http://www.wfmt.info/Musictherapyworld/startup/MTT2000-3.pdf

Turry, A. (2005). Music psychotherapy and community music therapy: questions and considerations. Voices: A World Forum for Music Therapy, 5(1). doi:10.15845/voices.v5i1.208

Tyler, H. (2000). The music therapy profession in modern Britain. In P. Horden (Ed.), Music as medicine (pp. 375-393). Hants: Ashgate.

Vaillancourt, G. (2012). Music therapy: A community approach to social justice. Arts in Psychotherapy, 39(3), 173-178. doi:10.1016/j.aip.2011.12.011

Winter, P. (2015). Perspectives on the practice of community music therapy in rural primary schools of Malawi. Nordic Journal of Music Therapy, 24(3), 276-287. doi:10.1080/08098131.2014.964752

Wood, S. (2006). "The matrix": A model of community music therapy processes. Voices: A World Forum for Music Therapy, 6(3). doi: 10.15845/voices.v6i3.279

Wood, S. (2016). A matrix for community music therapy practice. Dallas: Barcelona Publishers.