In the therapy sessions conducted with Robbie, music was not the only medium of change. The therapist also used other forms of art (painting, clay modeling, dancing etc.), as well as play (games with sand and water). Moreover, Robbie’s peers were taking part in some of the sessions, which lead to significant changes in his social interaction. Therefore, it was the music in therapy intervention, since music often served merely as the background for other therapeutic media. However, in the first sessions, the role of music was central as it helped the therapist to establish rapport with the patient and then to introduce other media, based on his preferences and needs. The intervention was health-focused, with its primary goal being to improve the psychological health of the boy. It is well-established that music can modulate the factors of emotion, cognition, attention, behavior and communication (Koelsch, 2009): since Robbie showed considerable deficiencies across all these areas, music therapy was the most relevant intervention for him.
The therapist mostly followed the client’s lead in structuring her sessions and even determined their duration depending on his mood. However, in deciding which new media had to be introduced and at what point she mostly acted at her own discretion, considering the needs of the client and the objectives of the therapy rather than the client’s preferences. Thus, the sessions were semi-structured and non-directive. The therapy was outcome-oriented rather than experience-oriented because it was aimed particularly at the improvement of the client’s functioning, with the focus on his maladaptive patterns and problem behaviors. The stage structure is not described clearly by the therapist: it can be seen, though, that no psychological tools were used for assessment and evaluation of outcomes, so the therapist relied upon her own perception of Robbie’s progress. The sessions were not knowledge-based: though she relied on some of the concepts of Virginia Satir, the therapist did not refer to current research to evaluate potential alternatives to the methods she applied. The sessions were not implicitly regulated with any clinical or ethical standards.
Only the first two sessions of the music therapy were sound-centered. Further, the therapist focused on the development of Robbie’s creativity and self-expression rather that the qualities of different sounds. Finally, the sessions 71-120 can be described as relation-centered because Robbie was developing his social skills in interaction with the therapist and with other children.
- Koelsch, S. (2009). A neuroscientific perspective on music therapy. The Neurosciences and Music III—Disorders and Plasticity: Annals of the New York Academy of Sciences, 1169, 374–384.