Every three years, the international music therapy community gathers at the World Congress of Music Therapy. This meeting of students, clinicians, educators, and scholars offers opportunities to examine culturally embedded assumptions about the nature of “music” and “health”; to learn how the relationship between music and health differs across cultures; and to directly connect with colleagues from across the globe. The World Congress, this year held at Tsukuba, Japan, also provides the opportunity to reflect on three years’ worth of clinical, scholarly, and theoretical progress.
Unexpectedly, the expanding role of reflexivity in music therapy was a common thread. Reflexivity, according to Bruscia, is defined as “the therapist’s efforts to continually bring into awareness, evaluate, and when necessary, modify one’s work with a client”. The concept has important implications for the music therapy clinician and researcher.
For the clinician, reflexivity involves a challenge to be:
- mindful of the cultural, social, and spiritual factors present in the therapy setting;
- self-aware of personal motivations and how they may impact the therapist-client relationship; and
- responsive to in-the-moment events that can inform or change the therapeutic process (e.g., a client becoming unexpectedly agitated to a familiar, oft-requested song).
Through these perspectives, music therapy clinicians can leave space for clients to be involved in their own therapy process, allowing for them to articulate their understanding of their own illness, disability, and needs, as well as to identify their personal goals for therapy. This movement moves towards a dynamic process of therapist-client collaboration—one in which problems, interventions, and goals are identified based on working together rather than being “prescribed.”
Such a process may occur, for example, in symptom management. A recent study highlighted the “silent and subjective symptoms” when articulating a case for strengths-based and resource-oriented treatment approaches for the chronically mentally ill. Traditional treatment approaches emphasize more observable symptoms (e.g., on-task responses to group activities) that can readily translate to treatment plans. However, in the process they may overlook or marginalize needs more crucial to the client (e.g., the need to feel belonged in their community). By considering the client’s perspectives and needs, music therapists are empowered to facilitate therapeutic processes more relevant to the client.
This process may also manifest when the music therapist is from a different cultural background than the client. Music therapists are extensively trained to facilitate – using voice, guitar, piano, and percussion – live music experiences that support clients to engage through their own musicking. However, this training has been largely predicated on a Western, classical tradition. What are best practices when an Indian client requests a raga, or a Mexican client requests mariachi? Do we attempt faithful recreations of musical genres that we are neither musically nor culturally trained in, or do we play recordings and risk upholding commonly held assumptions that music therapy is equivalent to a radio or CD player? Even if research was more conclusive on this topic, there is way to manualize the “right” way to respond given variations across therapeutic situations. Music therapists are therefore challenged to be mindful of (a) their cultural background and associated assumptions, (b) their client’s cultural background and expectations of the music therapist, and (c) how clinically-informed and culturally-informed goals can interact to address holistic needs.
A similar challenge arises for the music therapy scholar. Here, the concept of reflexivity involves a challenge to:
- be adaptable to the research, philosophical question(s), and emerging data, rather than adhere to a pre-conceived agenda;
- be daring to embrace potential tension and discomfort of what we do not know;
- challenge our assumptions.
Several music therapy scholars seem to be embracing these challenges and using them to spark innovative ways of approaching and conducting research. This includes, for example, developing music-based assessment for neurodevelopmental disorders, utilizing neuroimaging in development of music interventions with mental health populations, and expanding the breadth of multicultural competencies.
One development in particular—arts-based research—has demonstrated considerable growth over the past five years. There is a saying: Writing about music is like dancing about architecture. This suggests we may lose or distort something essential when one medium (music) is translated into another (written word).
Arts-based research seeks to minimize such loss or distortions by offering ways of designing studies, collecting and analyzing data, and reporting results that are authentic to therapeutic music interactions. This means embracing the hard-to-describe aspects of engaging in a music experience, aspects that more traditionally have been whittled into codes and themes. While more easily analyzed and understood, these codes and themes are also arguably less authentic to the music experience itself. Thus, arts-based research embraces mediums such as music, movement, and visual arts as valid to the collection, analysis, and reporting of research findings.
This growing understanding of reflexivity in music therapy has stimulated exciting new directions in research and clinical practice that will likely be sustained in years to come. We look forward to seeing what new areas of growth this summer’s World Congress will stimulate.
Featured image credit: piano by Clark Young. CC0 Public Domain via Unsplash.