Abstract: This article offers a brief reflection upon one music therapist’s practice in mental health care while also considering the possibilities that music therapy can offer to service users within this context.
On my desk are a pile of scripts – the 2nd year students of the MA Music Therapy programme have just completed their mental health exam. This is a form of assessment that requires students to demonstrate a range of theoretical and practical knowledge relating to the application of music therapy in mental health care. As I read through these scripts I notice how the students have referred to the music therapy ‘evidence-base’ in order to support notions of efficacy and effectiveness of this practice. They have also described, in very practical terms, how music can be used to assist and support people at times of distress or difficulty. The combination of medical and ecological language featured in the students’ answers is striking. This causes me to reflect upon my previous role as a music therapist in mental health and consider the possibilities that this practice can offer to service users as they overcome illness and journey towards wellness.
In 2006 I successfully completed the MA Music Therapy programme at the University of Limerick which was, and still is the only professional training programme in music therapy on the island of Ireland. Three days after graduation I began my role as inaugural music therapist at a large mental health service in the west of Ireland where I practised across a range of inpatient and outpatient settings. Depending upon the needs of those who attended music therapy, sessions were offered on an individual or group basis. This required a flexibility on my behalf to work within a range of contexts such as in a designated ‘music therapy’ room, at a patient’s bedside or, in a communal area of a community day centre or residential home. All the while I witnessed music’s capacity to evoke, engage, motivate and stimulate. Used within a therapeutic milieu, music offered service users a creative avenue for relating with others but also a container for self-reflection that did not necessarily rely upon the use of words. Indeed, many people attend music therapy in mental health because it offers a non-verbal and creative means of expression that moves beyond the convention of words.
Similar to other allied health professions, it is inherent that music therapy practice is grounded within an evidence-base in order to ensure the highest standards of service provision. During my early days of practice I frequently referred to the music therapy evidence-base, particularly when providing a rationale for its role and application in mental health care. However, having recently completed doctoral research that focussed on service user evaluation of music therapy in mental health, those who have attended sessions revealed that music therapy is about so much more than reducing symptoms or addressing one’s pathology. Service users highlighted that music therapy involves building relationships with others beyond the use of words. It offers a way of acknowledging one’s personhood and connecting with a sense of wellness, even when this may sometimes seem overshadowed by illness. Service users also relayed how group music therapy offered them a forum in which they could contribute to the benefit of others through musical play which in turn lead to a sense of belonging and achievement. Such outcomes of practice are difficult to quantify within a clinical discourse, yet they are incredibly important to the service users of music therapy who participated in this study.
This brief reflection has reminded me that music therapy can be framed within a clinical context but also within a beautiful ordinariness that makes this practice accessible to service users at perhaps extraordinary points in their lives. As I return to mark the exam scripts, I welcome the students’ mix of medical and ecological descriptions of practice which mirrors many of the debates and complexities of this field.
Dr. Tríona McCaffrey is a qualified music therapist and Lecturer on the MA Music Therapy Programme at the Irish World Academy of Music & Dance. She specialises in the field of music therapy in mental health care and has practiced in the areas of Recovery, Community Mental Health, and Psychiatry of Old Age. She is particularly interested in the recovery approach in mental health and recently completed her doctoral studies which focussed on service user evaluation of music therapy.