A Comprehensive Guide to Music Therapy Theory, Clinical

Practice, Research and Training - 2nd Edition

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A Comprehensive Guide to
Music Therapy
2nd Edition

Theory, Clinical Practice, Research and Training

Edited by Stine Lindahl Jacobsen, Inge

Nygaard Pedersen and Lars Ole Bonde
 The accompanying music can be downloaded from www.jkp.com/voucher using the code GAUREXY

First edition published in 2002

by Jessica Kingsley Publishers
London, UK
A version of this edition first published in Danish in 2014
by Forlaget Klim
Ny Tjørnegarde 19
DK-8200 Århus N
www.klim.dk
This edition published in 2019
by Jessica Kingsley Publishers
73 Collier Street
London N1 9BE, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © Jessica Kingsley Publishers 2019
Foreword copyright © Helen Odell-Miller 2019
There are supplementary materials which can be downloaded from
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Library of Congress Cataloging in Publication Data
A CIP catalog record for this book is available from the Library of Congress
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN 978 1 78592 427 9
eISBN 978 1 78450 793 0
To Tony Wigram
 Contents

Foreword by Helen Odell-Miller . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

1 Introduction to Music Therapy

1.1 Music Therapy – A Historical Perspective . . . . . . . . . . . . . . . . . . . . . 17
Lars Ole Bonde
1.2 Definitions of Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Lars Ole Bonde
1.2.1 Music Therapy and Music Education . . . . . . . . . . . . . . . . . . . . 36
1.3 A Therapeutic Understanding of Music . . . . . . . . . . . . . . . . . . . . . . 40
Lars Ole Bonde

2 Theoretical Foundation of Music Therapy

2.1 Music in Body and Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Erik Christensen
2.2 Therapy Theories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Lars Ole Bonde
2.2.1 Cognitive-Behavioural Approaches . . . . . . . . . . . . . . . . . . . . . 67
2.2.2 Psychotherapeutic and Psychoanalytic Approaches . . . . . . . . . . . . 69
2.2.3 The Influence of Therapy Theories on Music Therapy – An Overview . 73
2.3 Analytical and Psychodynamic Theories . . . . . . . . . . . . . . . . . . . . . 75
Inge Nygaard Pedersen
2.3.1 Classical Psychoanalysis . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Inge Nygaard Pederse
2.3.2 Mentalisation-Based Treatment . . . . . . . . . . . . . . . . . . . . . . . 93
Niels Hannibal
2.3.3 Daniel Stern’s Theories on the Interpersonal World of the Infant,
Change in Psychotherapy and the Dynamics of Vitality . . . . . . . . . . . . 97
Niels Hanniba
2.3.4 Communicative Musicality – A Basis for Music Therapy Practice . . . 104
Ulla Holck
 2.3.5 Play and Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Karette Stensæth
2.4 Transpersonal and Integral Psychology . . . . . . . . . . . . . . . . . . . . . . 121
2.4.1 Intersubjectivity and ‘Surrender’ . . . . . . . . . . . . . . . . . . . . . . 121
Katarina Mårtenson Blom
2.4.2 Wilber’s Integral Psychology . . . . . . . . . . . . . . . . . . . . . . . . . 125
Lars Ole Bonde
2.5 Music as Analogy and Metaphor . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Lars Ole Bonde
2.5.1 Music as Analogy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
2.5.2 Music as Metaphor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
2.5.3 The Psychological Functions of Music – A Taxonomy and
Metaphorical Listening to Four Selections of Baroque Music . . . . . . . . . 144

3 Selected Music Therapy Models and Interventions

3.1 Perspectives on Internationally Well-Known Music Therapy Models –
An Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Lars Ole Bonde and Gro Trondalen
3.2 The Bonny Method of Guided Imagery and Music (GIM) . . . . . . . . . . . 160
Lars Ole Bonde
3.3 Analytically Oriented Music Therapy (AOM) . . . . . . . . . . . . . . . . . . 167
Inge Nygaard Pedersen
3.4 Nordoff-Robbins Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Lars Ole Bonde and Gro Trondalen
3.5 Benenzon Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Lars Ole Bonde and Gro Trondalen
3.6 Cognitive-Behavioural Music Therapy . . . . . . . . . . . . . . . . . . . . . . . 183
Lars Ole Bonde, Gro Trondalen and Tony Wigram
3.7 Community Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Gro Trondalen and Lars Ole Bonde
3.8 Free Improvisation Therapy – The Alvin Model . . . . . . . . . . . . . . . . . 189
Tony Wigram
3.9 Methods in Music Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Stine Lindahl Jacobsen and Lars Ole Bonde
3.9.1 Improvisation-Based Methods . . . . . . . . . . . . . . . . . . . . . . . . 193
3.9.2 Songwriting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
3.9.3 Therapeutic Voice Work . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
3.9.4 Receptive Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
3.10 Physiological Reactions to Music . . . . . . . . . . . . . . . . . . . . . . . . . 204
Tony Wigram and Lars Ole Bonde
3.11 Music Medicine and Music Therapy . . . . . . . . . . . . . . . . . . . . . . . 209
Lars Ole Bonde
3.12 Music and Healing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Lars Ole Bonde
3.13 Health Musicking – Music and Health: A Final Discussion . . . . . . . . . . 223
Lars Ole Bonde

4 Music Therapy in Clinical Practice

4.1 Referral Criteria and Clinical Practice in Music Therapy –
An Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Tony Wigram, Anne Mette Rasmussen and Stine Lindahl Jacobsen
4.2 Music Therapy for Psychiatric Clients . . . . . . . . . . . . . . . . . . . . . . . 236
4.2.1 Music Therapy for Adults in Hospital Psychiatry . . . . . . . . . . . . . 236
Inge Nygaard Pedersen, Niels Hannibal and Lars Ole Bonde
4.2.2 Music Therapy in Social Psychiatry . . . . . . . . . . . . . . . . . . . . . 258
Niels Hannibal, Inge Nygaard Pedersen and Trine Hestbæk
4.3 Music Therapy for People with Developmental Disabilities . . . . . . . . . . . 262
4.3.1 Music Therapy for Children with Developmental Disabilities . . . . . . 262
Ulla Holck
4.3.2 Music Therapy for Adolescents and Adults with Developmental
Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Ulla Holck
4.4 Music Therapy for Persons with Acquired Neurological Conditions . . . . . 283
4.4.1 Healthy and Active Ageing: Music as Prevention . . . . . . . . . . . . . 283
Hanne Mette Ridder
4.4.2 Music Therapy for Adults with Acquired Brain Injury . . . . . . . . . . 290
Søren Vester Hald and Hanne Mette Ridder
4.4.3 Music Therapy for People with Dementia . . . . . . . . . . . . . . . . . 300
Hanne Mette Ridder
4.5 Music Therapy for People with Somatic Diseases . . . . . . . . . . . . . . . . 317
4.5.1 Music Therapy in Paediatrics . . . . . . . . . . . . . . . . . . . . . . . . 317
Ilan Sanfi and Lars Ole Bonde
4.5.2 Music Therapy for Adults with Somatic Diseases . . . . . . . . . . . . . 326
Karin Schou and Lars Ole Bonde
4.5.3 Music Therapy in Palliative Care . . . . . . . . . . . . . . . . . . . . . . 335
Lars Ole Bonde
4.6 Music Therapy for People with Psychosocial Problems . . . . . . . . . . . . . 342
4.6.1 Music Therapy for Refugees . . . . . . . . . . . . . . . . . . . . . . . . . 342
Bolette Daniels Beck
4.6.2 Music Therapy in Family Therapy . . . . . . . . . . . . . . . . . . . . . . 352
Stine Lindahl Jacobsen
4.6.3 Music Therapy for People with Stress . . . . . . . . . . . . . . . . . . . . 357
Bolette Daniels Beck
4.6.4 Music Therapy with Children and Adolescents at Risk . . . . . . . . . . 368
Stine Lindahl Jacobsen
4.7 Music Therapy and Personal Growth . . . . . . . . . . . . . . . . . . . . . . . 374
Inge Nygaard Pedersen and Lars Ole Bonde

5 Music Therapy Research and Evidence-Based Practice

5.1 Music Therapy Research: An Overview . . . . . . . . . . . . . . . . . . . . . . 391
Hanne Mette Ridder and Lars Ole Bonde
5.2 Assessment and Clinical Evaluation in Music Therapy . . . . . . . . . . . . . 410
Stine Lindahl Jacobsen, Tony Wigram and Anne Mette Rasmussen
5.2.1 Case: Joel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 424
5.3 The Aalborg University PhD Programme . . . . . . . . . . . . . . . . . . . . . 429
Hanne Mette Ridder and Lars Ole Bonde
5.4 Evidence-Based Practice in Music Therapy . . . . . . . . . . . . . . . . . . . . 437
Hanne Mette Ridder and Lars Ole Bonde

6 Music Therapy Training – A European BA and MA Model

6.1 An Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Lars Ole Bonde, Stine Lindahl Jacobsen, Inge Nygaard Pedersen and Tony Wigram
6.2 Musical Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457
Lars Ole Bonde, Stine Lindahl Jacobsen, Inge Nygaard Pedersen and Tony Wigram
6.3 Experiential and Resonant Learning Processes: Music Therapy
Self-Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Lars Ole Bonde, Stine Lindahl Jacobsen, Inge Nygaard Pedersen and Tony Wigram
6.4 Clinical Training, Internships and Supervision . . . . . . . . . . . . . . . . . . 467
Lars Ole Bonde, Stine Lindahl Jacobsen, Inge Nygaard Pedersen and Tony Wigram

List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 470

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551
 Foreword

I need a music therapist today – will

a music therapist relate to the team?
Early this morning I was telephoned by the manager of a local rehabilitation centre,
who was considering setting up a new music therapy service. The ensuing conversation
included me providing some descriptions of what might happen in the room for the
people concerned linked to their specific needs, references to research and literature
in the field and practical issues such as equipment, funding and training. A major
question was: how will the music therapist work within the multidisciplinary team?
At no point did I need to explain or convince the person at the other end of the phone
about ‘why music?’, or ‘why music therapy?’.
In general, music is a crucial part of what makes us human and is part of our
earliest experiences of communicating. Most people are convinced of the purpose
and function of music in their life, be it part of their leisure or work, but further,
music therapy is now professionally on the map. Case studies are available, including
evidence and research, in most fields of music therapy and many are collected and
gathered together in this book. Further, some deep theoretical and philosophical
aspects of the history and practice of music therapy are considered.
Every day I am asked a multitude of questions about music therapy. These include
questions about how music therapy works, how it helps particular people, how music
therapists are trained, what approaches are used, what is the evidence for the benefits
of music therapy, what is the difference between a music therapist and a music teacher
and what is the difference between a music therapist who has done this training or
that training? In many countries music therapy is no longer marginal, and in others
there are also questions to be asked about how culturally specific music therapy
needs to be, in any given situation. This book is a testimony to the culturally specific,
coming from the well-known, established Danish tradition of music therapy, but
also to how widely this radiates within the international knowledge base and repute
that music therapy has worldwide. It helps me and other music therapists do our
work in providing knowledge of music therapy in detail, to others; interdisciplinary
landscapes are key.

11
12 A COMPREHENSIVE GUIDE TO MUSIC THERAPY

Only last week I was giving a keynote talk at the annual conference for the
Association for Cognitive Analytic Therapy in the UK, where the topic for the whole
conference was creativity and authenticity in the therapeutic relationship. In order to
understand this topic in more depth, colleagues in the verbal psychotherapy field had
chosen to invite me, reflecting their interest in examining their practice, including the
place of creativity and authenticity within it, from a music therapy perspective. They
enjoyed reflections upon the therapeutic relationship through a musical lens. For
example, I invited them to think about the unspoken sounds inside and outside the
therapy room, including musical parameters such as speech prosody, rhythms and
intonation in their dialogues with patients. They became interested in how thinking
and listening musically to what was being said, and the manner of its saying, might
inform and help to develop the authentic therapeutic relationship in their mainly
verbal cognitive analytic therapy practice.
Further, whilst writing this foreword I attended a conference on psychoanalysis
and musicology where the primary aim was to examine the connections between
these two disciplines and music therapy. I found myself explaining that historically
musicology had been linked closely to music therapy specifically through analysis
of the music made in therapy sessions, and there followed a discussion about the
analytic frame – both psychoanalytical and musicological. It transpired through this
discussion, that modern music therapy literature, in a quest for finding connections
to and between patient/participant and client groups, had become focused upon
describing what works for whom and how. In doing this, there may have been a
general move away from musical analysis and an examination of how music works
in music therapy (with some exceptions), in order to translate from music processes
what is actually going on, in written words and spoken language. This book redresses
the balance by encompassing the whole process from many different standpoints.
It has been absolutely crucial and necessary for others outside of the music therapy
discipline, particularly colleagues in the multidisciplinary team and potential
participants in music therapy, to further their understanding about music therapy,
specifically how it helps populations in our society worldwide.
Music therapy has developed so far now that there are research outcomes,
informed by clinical discourse, including neuroscientific research and research
arising from narrative and psychoanalytic perspectives, demonstrating that specific
aspects of music therapy are more applicable and beneficial in some circumstances
that others. In addition, the physiological, psychological, musicological, cognitive
clinical, medical psychoanalytic and sociological (emphasising community) are
important disciplines or theoretical standpoints which underpin practice, or which
nowadays, music therapy informs. Music therapists and stakeholders need to be clear
– that the function of music therapy might be for different needs.
The largely Danish team of writers for this book, come from a long-established
tradition at Aalborg University, and no stone is left unturned. Between the writers, they
include a truly comprehensive approach with music therapy traditions included from
 Foreword 13

all over the world. This book is adapted and re-written, including some of the original,
intact chapters, from the 1st edition, which was led by the late Tony Wigram, with
co-editors and writers Inge Nygaard Pedersen and Lars Ole Bonde. Tony Wigram’s
pioneering work and contribution to the clinical research and education fields of music
therapy is fundamental to this volume and his inspiration enabled the foundations for
the original work to be realised, leading to the new volume presented here.
Explaining and researching music therapy at a meta level, including issues
of musical diversity and equality, training developments and modern developments
in music therapy technology is essential in the modern world, and this book succeeds
in achieving this. It includes the most up-to-date research and clinical approaches
written for those new to practice, and it will appeal to those already more informed. It
is rare to find all of this in one place, with a description of how health is delivered and
an in-depth discussion across many populations about including cognitive, narrative,
social, psychoanalytic, technical and musicological levels – and using receptive and
active music-making techniques.
This new edition is translated, updated, developed and re-written from the
original Danish version published in 2014, and it includes a rich overview of modern
music therapy, including descriptions of the roots of music therapy. It is a scholarly
work and will appeal to all, answering those many questions about music therapy.

Helen Odell-Miller
 1
Introduction to
Music Therapy