V is for Virtual Book Club (Chapter 5 of Music-Centered Music Therapy)

It took me awhile to read Chapter 5, probably because I was trying to read while watching my kid so there were distractions, but I did it! And I’m almost done with this A-Z blogging challenge!

Chapter 5 is called Rationales, Practices, and Implications of Music-Centered Music Therapy and I got a little confused as I read this. Aigen purported that music-centered music therapy focused on musical goals and that these are the same as clinical goals, because music is a healthy human behavior, so people who would seek therapy would engage in music-making (musicing) because the music itself is the agent which promotes health. Then he gave examples like music-making involves the client in community, which sounds like a non-musical goal to me. But he says that it’s not the case because community is an inherent part of music-making with another person. I believe all of that to be true about music, and one of the reasons that it is such a powerful therapy. So I got confused about the arguments that ALL music therapy isn’t music-centered.

Then towards the end of the chapter, he talks about generalization, which is when the abilities and skills addressed in therapy are seen in other areas of the client’s life. Aigen says that one way of looking at generalization is how the client’s musical functioning outside of the session is changed by the musical functioning inside the session. Ok, I can go with that if one subscribes to the belief that music is a biological imperative, which I do, that in order to be healthy one must “music” in some fashion, in the same way that one must eat, drink water, and sleep.

Or, Aigen says, generalization can be seen when the changes in musical functioning within the session are seen to influence non-musical functioning outside the session. The music-centered belief is that a change in musical functioning in the session would also result in a change in non-musical functioning within the session, in addition to a change in musical and non-musical functioning outside the session. I also agree with this and can see how other approaches, like the biomedical approach subscribes to this idea as well.

Then he talks about how speech therapists use speech as their medium of intervention to address problems with speech and physical therapists use muscular movement as their medium of intervention to address problems with muscular movement, so it stands to reason that music therapists would use music as their medium of intervention to address problems with musicing. Typically, music therapists are described as using music as the intervention to address problems with other areas of functioning. But if one considers musicing as an essential biological requirement, then it makes sense that there might be some disorders to this biological requirement.

So when a person has a stroke that affects their speech, music therapists often use singing to help retrain that area of the brain to handle speech. But often, we would need to build up the singing skill, which is usually still preserved to some degree, and then fade the singing. Neurologically, the patient is still singing, but with less obvious melody and less regular rhythm. In order to get to that point, however, the patient starts out by singing a clear melody and a very regular rhythm.

The music-centered therapist would work on singing for the sake of singing, which definitely has health benefits, regardless of why one is singing. The neurologic music therapist would work on singing to retrain the ability to speak. I imagine that the outcomes would be the same, and the means might look similar at times, but the goals and documentation would look pretty different.

Aigen ends the chapter by saying that generalization of functioning is not necessary for evaluating the success of the therapy.

“Because musicing is considered to be such an essential human activity, music-centered practitioners can accept that at times the client’s activity and experience of music and self and others in the music therapy session can be a self-justifying one.” (page 126)

I will have to try these ideas out to see how they fit. And continue reading…