Music therapy musicianship: a call for change

The following is offered as a manifesto: a bold assertion of our unique musicianship. We – music therapists – are different from performers and educators. If you are a music therapy student or clinician, consider this an affirmation of who you are. Your musicianship matters much more than you know.

How are we different?

A focus on people

First and foremost, we are musicians of the people. When we engage with participants, we are employing musics that diverse people listen to in their everyday lives. We also use the instruments common to these musics.

An example: I (Bill) am a percussionist who sings and plays thousands of diverse songs, emulating the qualities of different genres. I change these qualities to sound like the original, or to convey a different feel. I improvise using a range of musical frames (e.g., rhythms, progressions, modes). I compose lyrics to songs on the spot while accompanying through an improvised structure. This is only a surface understanding of my unique musicianship, and only one example.

Interactive engagement

Performance is NOT our focus. We focus on musical interaction that can lead to growth or change. We develop shared intentions with participants based on strengths, needs, backgrounds, interests, access to music, and their musicality/musicianship. We navigate with our clients a dynamic balance between structure/safety and creativity/autonomy. Our music-making is not tied to a “score,” but rather to in-the-moment modifications. We are musically vigilant (Ruud, 2020) and musically responsive.

Aesthetic sensitivity

We center our aesthetic sensitivity on people. We listen for more than what is in a song or piece, more so to the qualities of the music that participants and the environment give us: in the sound of a voice faintly singing, in a drum profusely struck, in a breath, in the sound of an ICU machine. We listen as witnesses, and integrate and respond in kind.

We see the values of music in their diverse and connected presentations: as a human right (Clements-Cortės et al., 2024), as a human technology (Patel, 2007), as a tool (Thaut, 2005) or resource (Rolvsjord, 2005) for promoting health, and as a medium for experience (Aigen, 2005; Dewey, 1934).

Why is this difference important?

While affirmation is an imperative of this research, systemic change is our overarching goal. The musics and processes that we employ in our work as music therapists are often peripheral in academic training outside of music therapy-specific courses. Common curricula are greatly informed by classical training and performance, and do not provide our musicianship the amount of space it needs to be truly developed and reinforced.

In many schools of music, music therapy students provide a major portion of student credit hours and funding. Students should not be subsidizing a system that focuses on areas outside of their needs. They should be paying for engaging experiences that clearly prepare them for where they are headed. Students should be taking courses with faculty who create an engaging environment within which these students’ unique music knowledge, music skills, and aesthetic sensitivity are valued.

First steps toward change

We invite you to dig deeper into our two articles (Matney et al., 2024; Meadows et al., 2025) and their supporting analyses. For those of you who are music therapists, students, and educators, we think that you will see parts of yourself and your work authentically represented.

Moving forward, we believe the following offers us the beginning steps toward change:

1. Affirmation: Understand and affirm this uniqueness with those around you (and within you!). Small acts change cultures. For our colleagues in various music and health fields, we hope you may affirm those you work with.
2. Advocacy: Assert the difference, with both objectivity and with pride, in informal and formal conversations.
3. Instigation: Even if shifts begin small, we collectively can find ways to move the curriculum toward greater relevance for music therapy musicianship. We can discuss what content exists in what courses, and how that content does or does not meet the needs of music therapy students. We can instigate change, moving toward classes, content, and timelines that benefit each student’s effort and investment.

The 21^st Century Commission on Music Therapy (2024) has provided concrete and practical recommendations for restructuring curricula. Drafts of new AMTA musicianship competencies seek to provide greater detail, but do not yet go far enough in discussing the nuances of our musicianship: the processes of shared music making and musical responsiveness.

Affirm, advocate, and instigate. Together, we can shift the current culture to foster the future of music therapy as ‘musicians of the people.’

^{Feature image by Andrew K via Unsplash.}