Music therapists work within many different therapeutic
frameworks. Through the research for this page, I discovered that all approaches
and perspectives mainly targeted the goal of wellbeing, although the way in which
music is used, treatment goals are made, and data is collected are all different.
The approaches are not mutually exclusive, and while some music therapists stick
to only one approach, many follow two or three and others take an eclectic approach
pulling bits and pieces from each. No approach is wrong or right, just different
and ultimately, we all acknowledge that music is inherently therapeutic and can
be used intentionally to improve human experience and well-being.
I do not claim to be an expert on any of these approaches, so if you have any input on these brief synopses, feel free to leave feedback through the Contact Us page.
Behavioral Music Therapy
Behavioral music therapy is influenced mainly by the psychological philosophy of behaviorism. The main principle being that therapy can help modify behaviors; therefore, music can be used to modify behaviors. Some ways in which music is used to modify behaviors are to structure, prompt, redirect, and reward. Behavioral music therapy strives for explicit, measurable goals typically based around changing maladaptive behaviors. Reinforcers (either musical, verbal, or social) are key to accomplishing the goal, and the structure of the session should be similar to that of experimental research (in other words, planned and repeatable).
Key Figures: Clifford Madsen (USA)
Cognitive Behavioral Music Therapy
Cognitive behavioral music therapy is based on the tenets of cognitive behavioral therapy developed by Aaron Beck. This approach focuses on the present with an emphasis on changing thought processes, which in turn changes behaviors. In terms of music therapy, the session should not dwell on the past or push towards the future, rather it should be focused on the present moment, what the client can do now. Song discussion and lyric analysis are typical interventions that can work towards changing thoughts which in turn changes behaviors in the present. This approach is typically used in the mental health field with higher functioning clients.
Key Figures: No key pioneers
Neurologic Music Therapy
Rhythmic Auditory Stimulation (RAS), Patterned Sensory Enhancement (PSE), Therapeutic Instrumental Music Performance (TIMP), Melodic Intonation Therapy (MIT), Music Speech Stimulation (MUSTIM), Rhythmic Speech Cueing (RSC), Vocal Intonation Therapy (VIT), Therapeutic Singing (TS), Oral Motor and Respiratory Exercises (OMREX), Developmental Speech and Language Training through Music (DSLM), Music Sensory Orientation Training (MSOT), Symbolic Communication Training through Music (SYCOM), Musical Sensory Orientation Training (MSOT), Musical Neglect Training (MNT), Auditory Perception Training (APT), Musical Attention Control Training (MACT), Musical Mnemonics Training (MMT), Associative Mood and Memory Training (AMMT), Musical Executive Functioning Training (MEFT), Music in Psychosocial Training and Counseling (MPC).
This approach is typically used in rehabilitation, hospitals, or schools with people with neurocognitive and neurodevelopmental disorders.
Key Figures: Michael Thaut (Canada), Corene Hurt-Thaut (Canada), Volker Hoemberg (Germany)
Biomedical Music Therapy
Biomedical music therapy is not a collection of procedures
or specific interventions, but rather a theory that helps explain why and how music
therapy works. The theory arose from the need for music therapy to better align with
the health field in terms of more evidence-based practices and observable, identifiable,
measurable, and predictable results. Early explanations of music therapy may have included
some physiological effects, but few understood or researched the biological and neurological
effects. As research in this area has grown, the backing of the biomedical music therapy
theory has too. The primary research examines the biological effects of receptive, expressive,
and physiological behaviors of a person participating in music. The next step of research
is to develop and test specific music interventions targeting non-musical goals to determine
A key principle of the biomedical music therapy theory is sensory integration, as it is considered to be necessary for human growth and development and is targeted by all music therapy interventions. Sensory integration involves simultaneously processing all sensory input. Music therapy alone may involve auditory, visual, tactile, proprioceptive, and vestibular input, thus a music therapist should be aware of a client’s sensory integration and how best to adapt and utilize sensory input to elicit behavior. The overarching idea behind this theory is that in music therapy music is changing the brain, and having research-based interventions is necessary for advocacy and efficacy.
Key Figures: Dale Taylor (US)
Creative Music Therapy - Nordoff-Robbins Music Therapy
Creative music therapy (CMT), also known as Nordoff-Robbins Music Therapy (NRMT), is a music-centered, improvisation-based approached rooted in the theories of Nordoff and Robbins. Additionally, theories from Abraham Maslow, Carl Rogers, and Rudolf Steiner create a strong base for the humanist perspective of CMT. The core belief in this approach is that every person has their own innate individual responses to music known as “the music child”. The therapist takes a collaborative and strengths-based approach to the sessions and focuses on connecting with the client and bringing out their music child. The goal is for the client to partake in self-expression and connection with others. Sessions are video recorded and data is collected post-session while assessing the video. CMT was initiated with children with disabilities but has since expanded to other populations as well.
Key Figures: Paul Nordoff (US), Clive Robbins (UK), Carol Robbins (UK), Alan Turry (US), Kenneth Aigen (US)
Aesthetic Music Therapy
Aesthetic Music Therapy (AeMT) is a music-centered approach with roots in Nordoff-Robbins. Initially, it was entirely comprised of improvisation and composition interventions but has since expanded to include other interactions with music using pre-composed songs and instrument play. AeMT still has a strong focus on active music making experiences, but the primary focus is on the aesthetic experiences that come from music making, which refers to how people react to and experience music whether that be emotionally, psychologically, physiologically, or physically. Key tenets are as follows: music can create the appropriate emotional arousal for growth, the client should be an active participant in the music making, and the music should be the main focus of the assessment and treatment.
Key Figures: Colin Andrew Lee (Canada)
Analytic/Psychodynamic Music Therapy
Analytic music therapy is inspired by the field of psychotherapy and the teachings of Sigmund Freud, Carl Jung and Melanie Klein; therefore, it does not follow just one theoretical concept, it borrows from all psychoanalysis. This approach is improvisational in nature although sessions may include verbal discussion and processing. Analytic music therapy believes that music can help access the unconscious mind, so music is viewed as symbolic of the client and what they are working through. The music is also used to help foster the therapeutic relationship as both the client and therapist are engaged in an activity together. The assessment phase of this approach focuses on early relationships involving parents and attachment, and deficits are considered indicative of maladaptive coping, which likely formed due to insufficient attachment or lacking early relationships. These are then revealed in the music created between the therapist. The therapist should also be aware of their own feelings, beliefs, attitudes, and most importantly reactions, which is also known as countertransference.
Key Figures: Mary Priestly (UK), Johannes Eschen (Germany), Susanne Metzner (Germany), Edith Lecourt (France), Florence Tyson (US), Juliette Alvin (France)
Vocal psychotherapy is a branch off of analytic/psychodynamic music therapy; however, the focus of the music is on the voice, both speaking and singing. The quality of a person’s voice can indicate trauma they may have experienced or a lack of self-confidence. Many physical and psychological benefits are linked to breath, which is the foundation of life in addition to singing and speaking. Deep breathing is known to slow the heart rate and promote relaxation while also creating support for full, rich vocal production.
Key Figures: Diane Austin (US)
Benenzon Music Therapy
Benenzon music therapy is involves nonverbal relational psychotherapy and is also influenced by the wider psychoanalysis and psychotherapy fields. The primary goal is the well-being of the client, which includes the steps of identity formation, reflection, and relationship formation. Part of identity formation is that every person has a sound identity discovered through music and movement. The music is then used to build the therapeutic rapport between the therapist and client. This rapport can assistant in learning about relationship formation. A major tenet is that music meets the human need to connect with others, so this rapport and bond helps meet that need.
Key Figures: Rolando Benenzon (Argentina)
Bonny Method of Guided Imagery and Music (BMGIM)
The Bonny Method of Guided Imagery and Music (BMGIM) is a
music-centered approach that uses receptive music listening to programmed music (typically
classical) to create music-induced imagery to journey through the unconscious. The goal is
to expand the client’s consciousness, positively affect well-being, and deepen self-understanding.
The view of altered states of consciousness is influenced by humanistic and transpersonal
psychology as well as some LSD experiments performed in 1969.
The music is viewed as a co-therapist in these sessions and is chosen specifically based off of key musical elements that provide structure such as consonance and dissonance, melodic flow, and texture. Pieces with specific use of these elements help induce, structure, and guide the client to images.
BMGIM is comprised of five stages. The first is preliminary conversation which is a verbal dialogue between the therapist and client to gain insight into the client’s current state of mind. Next is induction/relaxation which involves aspects of mindfulness to get the client relaxed and ready to begin the imagery. The bulk of the session is the music listening which is when the programmed music begins and the client verbally describes the imagery and any sensations they may have. The return phase gently guides the client to a more alert state, and in the postlude, the therapist uses the transcript of the client’s experience to connect the session to the client’s personal life.
This approach is typically used with adults without a clinical diagnosis or adults with non-psychotic mental health conditions.
Key Figures: Helen Bonny (US)
Community Music Therapy
Community music therapy, also known as social music therapy (coined
by Christoph Schwabe), describes an overlap between community musicians and music therapists
in which people in a community who do not typically have access to music are given opportunities
to partake in music. Therefore, there is no established clinical procedure. The people served
by community music therapy are typically part of marginalized or oppressed cultures or communities.
These groups may also include populations typically served by music therapists such as people
with disabilities, disorders, and diseases. Community music therapists acknowledge music making
as a human right and provide music opportunities to promote inclusion and overcome social divide
and boundaries. The therapist’s goal is also to empower the people that partake in community music
therapy which requires the therapist to include the culture-centered part of this approach and be
aware of biases, privilege, and cultural differences and commonalities.
Programs run by music therapists such as choirs, drama programs, bands, etc. can all be considered part of community music therapy, especially when these programs perform for the wider community. The ripple effect can even justify how typical individual or group music therapy sessions can be included under the community music therapy approach. When a client partakes in individual or group therapy sessions, the therapeutic effects do not stop at the client. The client’s growth can impact their immediate family and friends, then maybe their greater family and peers, then their school, then their community. Also not to be overlooked, the session has an effect of the therapist as well, and thus the ripple effect can stem from the therapist as well as the client.
Key Figures: Leif Edvard Aarø (Norway), Brynjulf Stige (Norway), Gary Andsell (Canada), Mercédès Pavlicevic (Canada), Christoph Schwabe (Germany), Even Ruud (Norway)
Culture-Centered Music Therapy
Culture-centered music therapy is based on the idea that music is an integral part of culture. While different cultures have different musical traditions and styles, the impact of music is consistent across cultures. One key point of this approach is that both engaging with others and being creative are human needs. Music making serves both of those needs while helping people engage within their culture and transcend communication barriers between cultures. Culture-centered music therapists acknowledge how music interacts with different cultures and are aware of their own culture and biases. With this knowledge at hand, these music therapists use their work to improve social interactions within one’s culture and between cultures.
Key Figures: Brynjulf Stige (Norway), Carolyn Kenny (Canada), Even Ruud (Norway)
Developmental Music Therapy
Developmental Music Therapy (DMT) encompasses multiple theoretical perspectives on development and applies them to music therapy practice. DMT music therapists focus on three main orientations: theories of stress, coping, and adaptation; human lifespan development; and ecological perspectives (i.e. Brofenbrenner’s bioecological model of development). Goals may be in any domain and are related to development such as expressive and receptive language, attention, problem solving, decision making, gross motor skills, fine motor skills, walking, balance, emotion regulation, emotion identification, emotion expression, turn taking, and sharing. Clients are typically 21 years or younger.
Key Figures: Edith Hillman Boxill (US)
Family-Based Music Therapy
Family-based music therapy is influenced by multiple psychology-based family therapies starting from the 1960s including cognitive-behavioral family therapy, psychoeducational family therapy, contextual/relational family therapy, systemic family therapy, and more. Two core theories from all of the aforementioned therapies are attunement and attachment, both of which the therapist keeps in mind throughout the sessions. This approach is strengths-based and requires every member of the family unit to take an active role in the music therapy session. A family-based music therapist serves all kinds of families, not just ones with children or traditional families. In addition, the therapist acts more as a coach or collaborator in this model. The main goals are to improve well-being, communication, coping strategies, and quality of family interactions. The therapist aims to convey that music and skills learned from the sessions can be taken outside of the therapeutic setting upon termination.
Key Figures: Beth Nemesh (Israel), Amelia Oldfield (UK), Stine Jacobsen (Denmark), Grace Thompson (Australia)
Feminist-Informed Music Therapy
Feminist-informed music therapy is rooted in the principles of feminism and uses these principles to understand the context of people’s needs. Contrary to the name, however, it is not only for women. Feminist-informed music therapy can be applied to any marginalized group. A therapist in this approach addresses language, social constructs, power relations, decentering, and diversity, as well as examines biases and assumptions. The therapist must also recognize the power difference between a therapist and a client, account for that, and consider any underlying biases within the music itself. Examples of those biases with music include unconscious gender oppression and the capitalist patriarchal pressures on the music industry. In addition, the therapist should be an advocate for the groups with whom they work. Client’s symptoms are viewed as a product of their experiences, but blame is not viewed as a viable coping mechanism. In other words, the client should not blame their oppressor or themselves for their symptoms because they will not be able to move forward, but they can view their symptoms as a natural reaction to the situation in which they were put. Perceptions, wants, and needs are discussed in order to understand the client’s experiences, set their goals, and form a plan for addressing them . All of this information is considered when selecting music for the sessions. Feminist-informed music therapists take issue with much of the current model of health care from access to assessment to treatment.
Key Figures: Susan Hadley (US), Nicole Hahna (US), Sue Baines (Canada), Sandra Curtis (Canada), Theresa Merrill (US), Elizabeth York (US), Jane Edwards (UK)
Resource-Oriented Music Therapy
Resource-oriented music therapy is strengths and potential-based and is influenced primarily by positive psychology. Therefore, the primary focus is on positive thoughts and health, and thus music is viewed as a positive health resource. Equality between the client and therapist is also a key component, and the therapist should be focused on empowering the client and nurturing their potential. The therapist should support the client to find inner resources for well-being while also acknowledging the client’s strengths, potential, and limitations.
Key Figures: Randi Rolvsjord (Norway)
Anthroposophical Music Therapy
Anthroposophical musical therapy (AnMT) has specific explanations
of human nature and how music interacts with it and is influenced by curative education.
Anthroposophy has multiple models of human nature and how the body, mind, soul, and spirit
relate to the greater world. Using these models, anthroposophical music therapy takes these
connections and expands them to musical instruments and sounds. For example, the head can be
connected with melodies and wind instruments, the chest with harmony and stringed instruments,
and the abdomen with rhythm and percussion instruments, which all relate to the threefold human
being model. The fourfold human being model connects different bodies such as the physical
body and astral body with music instruments and elements of music. For example, the ego
connects with wind instruments and form, the astral body with plucked instruments and color
(timbre, intervals), the ether body with bowed instruments and plastic principles (rhythm,
melody), and the physical body with percussion instruments and architectural principles
AnMT uses western harmonies and scales but also has its own scales and tonalities including planetary scales, the Mercury Bath, Tao sequence, and the Breathing Melody. Each root note of the planetary scales is connected to a planet; for example, C with Mars, D with Mercury, E with Jupiter, F with Venus, G with Saturn, A with the Sun, and B with the Moon. The planetary scales begin on each of these notes and each contain a different pattern of intervals; however, the pattern of intervals in the ascending and descending versions of the same scale are identical. For example, if the first interval of the ascending scale is a whole step (C to D), then the first interval of the descending scale is also a whole step (C to Bb). The Mercury Bath was composed by Maria Schüppel and is based in a ⅞ meter and constantly changes between major and minor. It is rooted in the Mercury scale starting and ending on D with no accidentals and playing alternating major and minor triads ascending and descending. The Tao sequence is very complex and therefore will not be fully discussed here, but the creator’s Tao consists of four tones that each are connected to a specific Zodiac, B to Scorpio, A to Taurus, E to Leo, and D to Aquarius. The Breathing Melody uses fourths and fifths arpeggiated to create constant movement and openness. Humming or sung vowels can accompany the melody, and each vowel can represent and introduce a different feeling. Instruments such as the lyre may also be included in the breathing melody. Traditional instruments are used in AnMT, although there are some unique instruments too, such as the lyre, chrotta, choroi flutes, and Bleffert metal instruments.
Key Figures: Rudolf Steiner (Austria), Andrea Intveen (Germany)
Music Education Approaches
Many music therapists draw from the following music education approaches in their practices as they have been used to teach music to children of varying abilities: Orff-Schukwerk, Dalcroze Approach, Kodály Approach, and Music Learning Theory.
Orff-Schulwerk teaches musical skills through improvisation, exploration, experimentation, and play. The goal is for the music and experience to be elemental or primal. A focus on rhythm, percussion, and barred pitched instruments such as the xylophone are essential, but the voice is the most used and valued as it considered the most natural. Orff music therapy was actually started by Gertrude Orff and follows a humanistic approach. The sessions are a multisensory experience and usually involve instruments as well as visual stimuli such as scarves and hand puppets. Key principles that overlap with much of music therapy are: that everyone can participate in music, music is a multisensory experience, that learning should begin where the child is developmentally, and the focus should be on the process not the product.
Key Figures: Carl Orff (Germany), Gertrude Orff (Germany), Gunild Keetman (Germany)
The Dalcroze approach puts an emphasis on music as a sensory experience and learning through the combination of the mind, body, and emotion. Three main facets make up this approach: eurythmics, solfege rhythmique, and improvisation. Eurhythmics involves purposeful movement to music. Learning music through the body can help teach rhythm, phrasing, tempo, intensity, and more. Solfege rhythmique uses rhythm and movement along with sung solfege so that pitches become engrained both physically and vocally and helps improve audiation. Improvisation bridges the gap from movement improvisations to vocal and instrumental ones and helps translate the knowledge more smoothly. In terms of music therapy, Dalcroze can be employed to give clients an outlet to express and explore through movement. Some of the games designed by Dalcroze can also be used to work with clients with motor difficulties or visual impairments to find ways to teach, experience, and understand music while working on therapeutic goals.
Key Figures: Emile Jaques-Dalcroze (Sweden)
The Kodály approach views music as a language that should be learned as early as possible when language is easiest to pick up. Music training, especially audiation and ear training, begins as soon as possible and focuses on the voice as it is more accessible than instruments. Four key elements of this approach are singing, folk music, solfege, and movable do. The solfege also incorporates the use of John Curwen’s hand signs. Music learning typically begins with pentatonic so students can be successful quickly and begin to understand the difference between major and minor modes. An additional technique employed is solmization, which involves using syllables that represent note durations. The core principles of of the Kodály approach all apply to music therapy including the innate musicality in all persons, music as a language, and music being necessary for development. Some of the non-musical concepts, such as Curwen hand signs and visual aids, may be helpful with clients with disabilities.
Key Figures: Zoltán Kodály (Hungary)
The Music Learning Theory focuses on audiation and maintains a belief that each child is born ready to audiate. Types of audiation include listening to, reading, writing, recalling and performing, recalling and writing, and creating and improvising. Some of the activities and theories overlap with those of Orff-Schulwerk, Dalcroze, and Kodály, but the Music Learning Theory has specific sequenced exercises to teach different tonalities and meters from music literature. Music aptitude tests are used not to exclude people, but to figure out how to teach to their individual differences. The clearest connections to music therapy are the belief that all people are capable of making music and that therapists and teachers should work within individual differences.
Key Figures: Edwin E. Gordon (US)