Music therapy: What is it?
Blood Biomarkers and the Future of Alzheimer Disease Risk Assessment
Katelyn Snyder
Summary: Music therapy is a clinical, evidence-based healthcare profession that uses individualized musical experiences to address physical, cognitive, emotional, and social goals. Katelyn Snyder explains how board-certified music therapists differ from volunteers or general music practitioners and clears up several common misconceptions about the field.
Music therapy is gaining more public attention because people are increasingly searching for non-pharmacological options for medical treatment (Toth, 2024). Since music therapy is gaining recognition for being an evidence-based, non-pharmacological approach to healthcare, it is important to dispel some commonly believed myths. I will address the following common myths about music therapy in this article.
(a) Anyone playing music is doing music therapy
(b) Music therapists only provide recorded music for their clients
(c) Music therapists use exclusively classical music
(d) Music therapists only use music to help calm people
(e) Everyone loves music therapy
(f) Music therapy is safe and non-invasive
Myth: Anyone playing music is doing music therapy
Many musicians provide music in hospitals and retirement facilities, but not all these musicians are music therapists. According to the American Music Therapy Association, “Music Therapy is the clinical & evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program” (AMTA, 2005). Musicians, such as music volunteers, certified music practitioners, music medicine practitioners, and thanatologists, work in health care settings. Music volunteers play music in lobbies and facilitate activities for enjoyment, certified music practitioners support healing and comfort by playing at bedside, and music medicine practitioners play recorded music to support medical treatment, and thanatologists primarily use the harp and different modes of music to support healing. Each of these musicians has a different scope of practice. Music therapists are different because they provide goal-directed treatment process within a therapeutic relationship. They do an assessment, treatment plan, and evaluation, whereas the others do not.
Music therapists also complete national board certification to become a board-certified music therapist (MT-BC). Many states have licensure or title protection for music therapists in order to ensure safe and effective services for individuals, groups, and communities. A music therapy student must complete a bachelor’s degree or equivalent from a program that is approved by the American Music Therapy Association, and “1200 hours of clinical training, including a supervised internship” (AMTA, 2026). Once certified, the Certification Board for Music Therapists requires that a MT-BC must complete 100 continuing education credits every five years to remain certified (CBMT, 2026).
Myth: Music therapists only provide recorded music for their clients
Music therapists use both live and recorded music. Music therapists utilize the guitar, piano, voice, percussion, and other instruments depending on the needs of the client. Music therapists use improvisation, composing, receptive music listening, and active music playing in their sessions. In some articles, music therapy is misrepresented as any health care profession that uses prerecorded music; however, these people would be music certified music practitioners or music medicine practitioners. Music therapists play the piano, guitar, and a variety of percussion instruments proficiently so that they can recreate their clients’ preferred music as accurately as possible.
Providing live music allows music therapists to adapt the music to the clients’ needs and abilities. For example, if a music therapist is trying to help someone relax using the song “You are my Sunshine,” the music therapist will play and sing quieter and slower. If the music therapist is prompting speech, the music therapist will play a line and leave out the last word of the line for the client to fill in. For example, the music therapist would sing, “You are my” and pause to prompt the client to say, “sunshine.” Also, music therapists will sing in a higher key if they are providing music in the neonatal intensive care unit (NICU) versus facilitating a group session with older adults.
Myth: Music therapists use exclusively classical music
Music therapists use patient-preferred music that is usually played live. Some music therapists (including those specializing in the Bonny Method of Guided Imagery and Music) use classical music, but most music therapists do not because patient-preferred live music more effectively engages patients than recorded or therapist-chosen music. The increased engagement may result from the patients being familiar with the music and being given the opportunity to choose the music (Ramaswami & Silverman, 2018).
Music therapists work with clients of all ages from premature babies in the NICU to older adults receiving hospice care, and everyone in between. Because they use patient-preferred music in their sessions and work with clients of all ages, music therapists must learn music from many eras. They learn children’s songs, traditional songs, early American classics, pop music, and everything in between because in a single day, a music therapist may be called upon to sing Frank Sinatra, Adele, Dolly Parton, and “The Wheels on the Bus.”
Myth: Music therapists only use music to help calm people
Music therapists set many different goals for their clients. While music therapists help lower people’s stress and pain levels using calm, quiet music, they can help people in many other ways. Depending on the client, the music therapist may set physical, social, emotional, or cognitive goals and then use music to help the client reach those goals. For example, a music therapist may play a steady beat and cue a client with Parkinson’s to take a step on each beat. The steady beat helps the client plan when to take the next step.
When working with a child with autism, a music therapist may set a social goal of interpersonal interaction. The music therapist may then play a xylophone and then wait for the child to respond. When the child plays their xylophone, the music therapist may copy what the child played, creating a musical conversation between the music therapist and child.
If a music therapist is working with a group of clients in a mental health facility, the music therapist may have a goal of having the clients identify emotions and appropriate responses. The clients may list emotions like sad, depressed, and frustrated, and then the music therapist would prompt them to name appropriate things they can do when they feel this way, such as talking with a friend, going for a walk, or taking a deep breath. Then, the music therapist would arrange these emotions and responses into lyrics and teach the clients to sing the song. Depending on the group, the music therapist may sing the lyrics to a well-known melody or compose a new melody.
Finally, music therapists may set cognitive goals for their clients. An example of a cognitive goal is waiting one’s turn to participate in an activity. To help preschool clients practice this skill, the music therapist may sing an action song. Whenever the music stops, the children raise their hand and wait to be called on to give an action they want the group to do. The music therapist would sing enough verses to give each child the opportunity to suggest an action.
Myth: Everyone loves music therapy
While many clients enjoy music therapy, not all clients do. Sometimes, the pitches or timbre of an instrument may hurt a client’s ears (Murakami, 2021). Once the music therapist observes this and changes the musical range or the instrument, the client may enjoy music therapy. However, some clients still do not enjoy music therapy services. For example, in hospitals, nurses will recommend patients to music therapy when they learn that the patient is or used to be a professional musician. Sometimes music therapy can be frustrating for these clients because they are no longer able to play instruments or sing like they used to. In such cases, because of the frustration engaging in music causes the client, the client may choose to discontinue music therapy services.
Myth: Music therapy is safe and non-invasive
Murakami (2021) observed that there are many ways that music can hurt a client in a music therapy session. As mentioned above, some pitches or timbres of instruments may hurt a client. For example, people with autism have very sensitive hearing and easily become overstimulated by complex music, so they may play music that is played with very few instruments. Also, hearing aids amplify higher pitches much more than lower pitches, so the high pitches of a flute or violin may hurt the ears of people who use hearing aids.
Certain songs may also trigger stress responses in a client because of associations the client has with the song (Murakami, 2021). For example, imagine that “Believer” by Imagine Dragons was playing on the radio when a client was involved in a car accident. While most young adults in the United States would enjoy this song, this client may experience an increase in heart rate, sweaty palms, and other physiological demonstrations of a stress response to the music because of the traumatic memory “Believer” evokes. The client may even grimace or have nightmares after hearing the song.
Even the way in which a music therapist facilitates an intervention can cause harm to the client (Murakami, 2021). For example, if a music therapist is doing a movement intervention with adults who do not have a lot of balance and coordination, the music therapist should be mindful of the movements they choose to do. If the clients are walking in a circle, they may become dizzy, fall, and get hurt. A similar situation may occur with clients with Parkinson’s disease. If the music therapist is working on gait training with a client and accidentally leaves something in the client’s path, the client may fall and get hurt. Music therapists also have to be careful to enforce safety rules, especially with impulsive clients who may throw instruments at each other.
Because there are several ways that clients may experience harm in a music therapy session, music therapists use their clients during the first session. A thorough assessment will help the music therapist avoid potential sources of harm in the subsequent sessions. Then, during the sessions, music therapists are trained to look for and recognize signs of harm. When they see a behavior that exhibits distress, music therapists stop the intervention to find the source of distress so that they provide a physically and emotionally safe space for their clients.
Conclusion
Music therapists are highly trained professionals who are board-certified and work within a therapeutic relationship and use music interventions to help clients reach individualized goals (AMTA, 2005). They provide patient-preferred live music in a safe environment using many different instruments. They also set a variety of goals that can be physical, social, emotional, or cognitive. While a few people do not enjoy music therapy, most clients find that music therapy motivates them to achieve their goals. Through music, music therapists help their clients maintain and develop skills so they can live life to the fullest.
About the Author
Katelyn Snyder is a music therapy master's-equivalency student at the University of Iowa. While the violin is her first love, she also plays piano, guitar, various percussion instruments, and sings. She enjoys working at Tremble Clefs Iowa, a local choir for people with Parkinson's disease led Dr. Abbey Dvorak, MT-BC, PhD, where she encourages a welcoming environment, sings with the group, and helps with passing out music and other logistical concerns. Katelyn completed advanced training in Neurologic Music Therapy® this spring and is looking forward to opportunities at Tremble Clefs where she will be able to apply the knowledge she gained at the training in physical, cognitive, and speech interventions (activities? Goals?) at Tremble Clefs. When she graduates from the University of Iowa, Katelyn wants to continue working with people with a variety of ages and diagnoses using Neurologic Music Therapy® techniques.