The use of sounds and music within an evolving relationship between child or adult and therapist to support and encourage physical, mental, social, emotional and spiritual well-being. Music has long been used as a healing force to alleviate illness and distress, but the specific discipline of music therapy developed only in the middle to late 20th century. There are differences within and across countries as to what specifically constitutes music therapy. In some ways the term itself is misleading, given that music therapists are not helping to develop a person's music, as might be implied by analogy with physiotherapy or speech and language therapy. Music therapy is not about developing musical skills or teaching people to play an instrument, though these may be unintentional by-products of the therapeutic process. Therapy implies change, and many definitions refer to the development of therapeutic aims and the dynamic processes that are at the core of a therapeutic relationship as it evolves. The provision of a safe and consistent space where these processes can take place is considered by most experts to be paramount, and it is important for sessions to happen on a regular basis and ideally at the same time of day. These boundaries allow for a feeling of trust to be established between client/patient and therapist.
1. The elements of music in music therapy.
3. Basic response to sound and music.
6. Different philosophies and approaches.
LESLIE BUNT
Sound has four major elements – timbre, loudness, duration and pitch – which manifest themselves in music as rhythm, melody and harmony. The music therapist observes and listens to how patients/clients make use of these different elements. This then influences the therapist's own response and style of music-making. Silence is also an important element: spaces between sounds add meaning and significance to the musical events. Of all the elements, rhythm is often given a central position within music therapy because of its potential to focus energy and bring structure and order (Gaston). Rhythm can be prominent at the start of a period of active music therapy, when an individual or members of a group are often invited to explore a wide range of tuned and untuned percussion instruments. The use of percussion provides opportunities for exploration from the simple (a small stroke on a cymbal) to the complex (an intricate rhythmic passage on a drum). The instruments, from a wide range of musical cultures, are accessible to people of all ages and abilities, regardless of musical experience and background. Children may be drawn to the shape, colour and size of an instrument, in addition to its sound. And the use of percussion frees adults from any reliance on preconceived views of what constitutes music, coming from the traditional western and somewhat restrictive emphasis on diatonicism. Percussion instruments also allow individuals to improvise, to make ‘sculpted sound’ as one patient described the music made by his group (Bunt). With very disabled people it may be necessary for the therapist to initiate some music, for example when grasping an instrument is difficult. Flexibility is also fundamental to an approach to improvisation adapted to the individual. Here the therapist as musician is trained to match an individual's own sounds, elaborating and structuring them into coherent musical forms, that are part of the present moment. Musical form provides some semblance of order and cohesion to the creative expression of the musical gestures, however fragmentary and disparate they might be. A moment of improvised music can simultaneously sum up the immediate past and predict the music's future. The technique of matching relates to the well established ‘iso principle’ (from Gk: ‘equal’), which may also be adapted to group work, where a search for some unifying musical common denominator is a feature. As many musical styles are used in music therapy as there are tastes in music: free improvisation, composed music (both live and recorded), folk music from different cultures and jazz all have their relevance in the different contexts in which music therapists work.
Definitions of music therapy range from an emphasis on the music on the one hand to the relationship on the other. Personal background, training, therapeutic orientation, and cultural and philosophical issues influence each therapist's position. In some countries music therapy is practised by musical physicians, psychologists or psychiatrists as an adjunct to another therapy, such as a verbally based psychotherapy, in what Bruscia (1987) refers to as ‘music in therapy’. For example, a psychotherapist might choose to include some joint listening to music as part of the therapy, to aid general relaxation or for the music to stimulate feelings and reactions that can be brought into the verbal domain. Other examples of music in therapy could be the use of music in dentistry or the operating theatre, with preferred music being played to patients directly through headphones or speakers during distressing procedures (see Standley in Wigram, Saperston and West). The alternative is what Bruscia calls ‘music as therapy’. Here the music is a central focus, with changes in the music often being mirrored in changes within the relationship. Musicians are very much at the centre, and clearly they need to feel comfortable and secure within their own use of music if they are to be able to listen openly, attend and engage fully in music therapy. The approach of Paul Nordoff and Clive Robbins is a well-respected example. Here improvisation is primary, the therapist improvising piano music initially to accompany and support whatever musical gestures are offered by the child or adult, containing them in a musical frame that develops form and variation as the musical relationship unfolds.
One common view among music therapists is that there will be some form of musical response despite serious degrees of cognitive impairment. Musical response seems to be stored at a very deep level. For example, Marin cites the case of a person with diffuse damage across both cortices able to sing with clear rhythm, intonation and prosody. Sacks gives eloquent descriptions of the stiff movements of post-encephalitic patients becoming freer and more natural while the music lasts, becoming ‘re-musicked’ as one patient described it. There are case reports of music being used to help recall patients from coma (see the work of Gustorff reported by Ansdell). Further evidence of this very basic response to sound arises from fortunately rare cases of musicogenic epilepsy, when a particular grouping of musical parameters can cause a temporary loss of consciousness (see Critchley and Henson).
Music therapy is used, both individually and in small groups, to help children and adults of all ages who have diverse kinds of physical and mental disability. Traditionally it has been proved to help overcome some major break in communication as a result of brain damage or mental problem. One successful and well-documented application has been with young children who have major communication difficulties such as autism (see Alvin and Warwick; Nordoff and Robbins; Robarts; and the papers by Howat and Warwick in Wigram, Saperston and West). The often fragmented musical gestures of many autistic children can be placed within the holding, connecting and cohesive musical forms improvised by the music therapist. The child is helped to hear and find meaning in the sounds, and to move eventually to a position of more shared meaning. Very often these interactions take place as indirect communications via the instruments, taking the pressure away from more – and often excessively – arousing direct communication. Some therapists may also work towards developmental objectives, the music helping the child, for example, to gain further physical organization and control. Music therapists are able to build on a child's innate curiosity about making sounds: a child is very often highly motivated to attend in an active musical environment, where the emphasis is away from divisive verbal exchange to the more uniting aspects of music-making (see Bunt for evidence of changes in levels of attention and motivation over time with groups of children).
With older children and adults with learning difficulties, music therapy has been found to help in developing physical skills, cognitive potential, motivation, speech and language, non-verbal expression, social skills, choice-making and independence. A very withdrawn or tense person can be gently encouraged to explore the instruments, building a trusting relationship with the therapist through the music over a period of time. A physically disabled person can be stimulated or relaxed by the appropriate music, the musical parameters closely adapting to the individual problems. The early pioneers of adult psychiatry soon discovered that music could influence changes in mood, expression of feelings, social interaction in a group and self-esteem, and such influences have been observed over a whole lifespan (see Odell in Wigram, Saperston and West). Music therapy has thus found a place in numerous settings: special hospitals and units for adults and children with a wide range of learning difficulties, physical disabilities, neurological problems and mental-health problems; pre-school assessment centres and nurseries; special schools; day centres, hospitals and residential homes for older people; centres for people with visual or hearing impairments; the prison and probation service; hospices and private medical practices (see Ansdell; Bruscia, 1991; and Wigram, Saperston and West for descriptive case studies). Music therapy can help those needing stress and pain reduction (Rider; Hanser), victims of sexual abuse (Rogers, 1992), cancer patients (Bunt and Marston-Wyld) and people living with HIV/AIDS (Lee). Such developments are enlarging music therapy's relevance to all kinds of treatment.
Music therapy is at once a physical, mental, emotional and social activity, with both children and adults. The experience of music therapy clearly involves the whole person. Sears (in Gaston) distinguished three sorts of experience in music: experience within structure, experience in self-organization and experience in relating to others. For example, in the first he described how music ‘demands time-ordered behaviour’. Sloboda (1992) found features such as melodic appoggiaturas or sudden shifts in harmony that are associated with crying or the commonly expressed ‘tingle factor’. Such empirical research by music psychologists can be related to the earlier work of Meyer, who found emotional response connecting with his notions of expectancy and violation of expectancy in musical form. On a more philosophical level, Langer is often cited by music therapists in their search for clues to the emotional meanings of musical gestures made by children and adults: especially suggestive is her hypothesis of an inner impulse expressed externally in the music's ‘significant forms’. This suggests that there is a close correspondence between internal state and musical gesture, and it opens a debate relating to cultural and individual influences, as well as to the absolutist/referentialist dichotomy. The worlds of poetry, myth and metaphor offer alternative points of reference.
Music therapy straddles many disciplines, including ethnomusicology, aesthetics and the psychology of music, and many differing schools of psychology and treatment. A developmental approach is often adopted when working with very young children. Here one reference point is the developmental psychology of music, a useful model being Swanwick and Tillman's spiral of musical development, which is based on analysis of over 700 spontaneous compositions by children. The spiral moves through the development sequences of mastery, imitation and imaginative play, combined with the manipulation of musical materials, expression on both personal and vernacular levels, and experimentation with musical form. At the top of the spiral are the more complex cognitive, symbolic and value-laden aspects of an older child's understanding of music. The multi-dimensional and multi-directional aspects of this model can be applied to work with adults too. An older person with an established, inflexible system of musical values may benefit from revisiting an earlier, more playful and freer exploration of sound.
Another point of reference is the micro-analysis of patterns in early child–adult relationships (see Robarts; and Pavlicevic in Gilroy and Lee), for very often musical parameters – stress, duration, timing, accent, phrase etc. – are used to describe these interactive patterns, and psychological concepts of intersubjectivity, joint attention and turn-taking can apply as much to musical exchange as to early child development. Aldridge extends these metaphors of music and development to make forms in music central to all biological patterning. He regards musical and biological form as isomorphic, and moves outwards from music to embrace other worlds; his notion of ‘symphonic beings’ describes how continuous processes of composition help to redefine a person. These views present music as a measure of health, so that an improvisation, for example, may be seen as a direct expression of the needs of the self, bypassing words. Capra has made synchronization a measure of health, ‘dis-ease’ being observed in a lack of synchronization within oneself, between self and others, and with the surrounding environment.
While music cannot represent objects as language does, some research has compared grammatical and structural similarities between music and language. Stern's work provides further stimulus for music therapists to explore the links between the dynamic forms of emotion and music. This notion of ‘affect attunement’ helps the therapist move beyond imitating the child's musical gesture to understanding the world of feeling that might lie behind – a kind of musical empathy. The therapist and child move towards joint and potentially reciprocal communication, towards equal partnership within the music.
For many years music therapists have also turned to other established therapeutic approaches to support their work (see Ruud). Connections have been made between listening and physiological changes in, for example, respiration, pulse rate, metabolism, attention and the electrical conductivity of the body (see Arrington in Podolsky). This early body of physiologically based research, though rather inconsistent and based on short-lived effects using a restricted range of recorded music, did a great deal to validate the emerging profession (see Saperston's critique in Wigram, Saperston and West). However, little research has examined the more interactive approach adopted by many therapists, where the variables are obviously vastly more complex than in listening to recorded music. The development of computer technology has instigated a return to a physiological approach, for example in vibro-acoustic therapy. Here a pulsed low-frequency tone is combined with pre-recorded music to help reduce muscle tone and spasm and induce a state of sustained relaxation for people with profound physical disabilities, thematoid conditions and pulmonary disorders (Skille and Wigram in Wigram, Saperston and West). It seems that a deep response to music can be so harnessed, though it is still notoriously difficult to separate physiological from emotional response.
While psychodynamic theory may not uncover the meaning of music (see Noy), several music therapists yet refer to the writings of psychoanalysts to provide an underpinning to their work. Freud was unable to derive much pleasure from music, being unable to rationalize how it affected him. His writings on creativity in general have been criticized by later analysts for their emphasis on the processes of sublimation, regression, fantasy, escape and compensation (Storr). Jung, however, is reported to have been impressed by the potential of music therapy, noting how music ‘reaches the deep archetypal material that we can only sometimes reach in our analytical work with patients’ (Hitchcock). His functions of the psyche – sensation, feeling, thinking and intuition – also seem to find correlations in musical experience (Goodman), and he even recommended music as an essential ingredient of every analysis.
In Priestley's analytical music therapy, the client/patient is encouraged to talk through the area to be explored in the traditional analytical way. This exploration is then enacted in musical improvisation, when the therapist and patient may take on particular roles. Priestley's sessions are completed by the playback of a tape and integration of the musical material into the final discussion. Other therapists use music as a supportive or projective technique in psychotherapy; Winnicott and others of the object-relations school have also been influential. Winnicott's notion of the ‘intermediary object’ can be applied to musical interaction, the child using an instrument to explore a sense of ‘not me’, a sense of self in interaction with another, an object through which meaning can be shared. Levinge related a two-and-a-half-year-old girl's development of self in a period of music therapy using the Winnicottian concepts of ‘me’ and ‘not me’. John also is concerned with the development of musical psychotherapy.
During the 1960s and early 70s many studies of music therapy in the USA had strong links to behaviour therapy, with music therapy often seen as a science of behaviour (see Masden, Cotter and Masden). Music was regarded not only as a stimulus but also as a reward for eliciting and maintaining certain behaviours. The very act of playing an instrument can be described as a positive self-reinforcing activity. Carefully designed studies demonstrated highly significant results when music was used, for example, to effect developmental changes in reading, numeracy and imitation skills (see Roskam, and Miller, Dorow and Greer) and to reduce aggression, stereotyped behaviours and hyperactivity (see Steele, Jorgenson, Scott and Lathom). This body of quantitative research did much to contribute to the growing credibility of music therapy.
Other therapists developed a more ‘client-centred’ approach with reference to Gestalt therapy (Perls, Hefferline and Goodman), a notion of ‘peak experience’ (Maslow) or concepts of empathy, acceptance and genuineness (Rogers, 1969). Also more humanistic is the phenomenological position that the therapy lies within the music itself (Ansdell). The developing use of ‘Guided Imagery in Music’, a specific training initiated by Helen Bonny, also has its roots here. Bonny's work, in exploring beyond pre-personal and personal states, moves music therapy into transpersonal and spiritual realms.
The wide range of approaches and the differing needs of children and adults present enormous challenges but also offer a rich descriptive background to further analysis and research. Music therapy is still criticized on the basis of insufficient evidence to support its effectiveness, particularly with regards to changes in the person outside the therapy. In response to that criticism, and as an alternative to the more behavioural approach adopted in the 1960s and 70s, researchers in the 1980s and 90s began to explore other methods to describe the work. Some have been influenced by ethologists such as Hinde and Richer who advocate periods of direct observation in naturalistic settings before any internal state of mood can be inferred or even guessed at.
Odell, for example, demonstrated that a period of music therapy significantly increased her elderly, mentally ill clients' levels of engagement as measured by eye direction and other means (see Wigram, Saperston and West). Bunt's work, with children with special needs, examined similar very basic changes over time in, for instance, vocalizations, imitation and initiation of ideas, looking behaviour, level of adult support and direction, and turn-taking. His series of interrelated studies demonstrated that music therapy positively influenced all these, against the controls of no music therapy or playing with a well-known adult. Oldfield and Adams investigated the benefits of music therapy in accomplishing a set of individualized objectives when working with a small group of adults with profound learning difficulties (see Gilroy and Lee). Video analysis showed that measurable skills, such as the ability to hold on to objects, were improved as a result of music therapy as compared with play activities. Aldridge has brought his extensive research background to examine methodologies that maintain the richness of the work without reducing it to a series of basic measures. He advocates single case studies that can be scientifically rigorous but also adapt to the individuals involved, whether patients/clients or therapists. There are many stories to be told, which can be reported in a rigorous way without losing any of the human aspects many music therapists consider central to their work.
Some research integrates objective and subjective stances. Hoskyns, for example, used an external system, Kelly's Theory of Personal Constructs, in devising detailed interviews with her offender clients before and after music therapy, and her findings show correlations between the results of the interviews and her own more subjective observations (see Gilroy and Lee). This more collaborative approach to research, employing direct reporting from the clients or patients, is felt by many music therapists to be more suited to the aesthetics and fundamental nature of music therapy. Another example of it is Rogers's research (1992) into music therapy and sexual abuse. In the move to understand more about the musical processes involved in any course of music therapy, there has been a shift generally to a more phenomenological and qualitative approach. Lee, working with HIV/AIDS patients, used techniques drawn from music analysis to discover what clients and therapists view as ‘significant moments’ in improvisations. These studies include powerful verbal evidence from the clients, alongside music analysis and verbal transcripts from other listeners.
The clinical profession of music therapy is relatively new, but music has been used as a healing force for a long time – longer perhaps than any other art form (see Fleshman and Fryrear). Examples appear throughout the Bible, in Eastern and Western mythology and in tribal medicine. Songs and such instruments as drums and rattles are still used in many healing rituals worldwide, and some music therapists (e.g. Moreno) explore links between contemporary music therapy and these more ancient healing traditions. The influence of music on the human body was mentioned in Egyptian medical papyri dating back to 1500 bce (Benenzon). In Book 3 of the Republic Plato promoted the discovery of rhythms expressive of harmonious and courageous lives, and warned against the use of certain modes that could promote indolence or sorrow, recommending those with stronger qualities. The astro-musicology of the Renaissance master Marsilio Ficino gives insights into the care of the soul throughout ‘a well-tempered life’ that are as relevant today as 500 years ago (see Moore). Goodman traces the growth of a therapeutic approach to music in different cultures from its use in magical and religious healing to the evolution of rational and scientific ideas about medicine and music.
Working within the Western medical tradition, Hector Chomet, a French doctor, wrote in 1875 of the effects of music on health, including its influence in helping to offset epileptic fits. A British cleric, Canon Harford, set up the Guild of St Cecilia in 1891 to introduce sedative music into hospital wards, sometimes by the newly invented telephone (see Davis). This use of music to boost morale and to provide an entertaining diversion persisted until well into the 20th century. Musicians were invited to play to large groups of patients on the vague assumption that it might activate certain metabolic functions and relieve mental stress (see Feder), and the early literature of music therapy abounds with anecdotal accounts of patients being reached by music. One famous example is of a schizophrenic musician being administered a daily dose of Chopin (see Podolsky).
The use of music in the rehabilitation programmes for returning combatants after World War II proved a watershed for the development of a more clinical approach to music therapy. The first academic courses were set up in the USA in the mid-1940s, and the earliest association dedicated to the specific promotion of music therapy, the National Association of Music Therapy, was founded in the same country in 1950. Europe quickly followed suit, and the British Society for Music Therapy was founded by Juliette Alvin in 1958. Since then the profession has developed rapidly, at a time when there has never been such a variety of music available to so many. By the early 1990s there were over 3000 qualified therapists practising in the USA alone, and over 300 in Britain, where the profession had gained recognition by the Department of Health as a para-medical discipline. Expansion since the 1970s has been part of a wider trend of increasing public interest in complementary medicine and of increasing research. Music therapists in over 30 countries are engaged in constructive work in a variety of settings (see Maranto).
An active World Federation of Music Therapy organizes international conferences and is developing standards in ethics and training. More students are turning to music therapy as a career, and opportunities to train are increasing. The British professional association supports six postgraduate degree courses, the two American associations over 70. These developments in training and practice are running in parallel with progress in music therapy assessment and research. The growing body of research is outlining both the specific therapeutic values of music and the processes by which therapeutic outcomes are achieved.
The profession of music therapy is at an interesting stage as it approaches its mature adulthood. There is room for a variety of approaches, backgrounds, methodologies and theoretical perspectives: process and outcome studies, for example, need not be separate, as long as the researcher presents the perspective clearly. Wheeler has published a comprehensive survey of research from both the established quantitative and more recent qualitative viewpoints, including contributions with a historical and philosophical reach. The boundaries are very blurred in music therapy between mind and body, active and passive, conscious and unconscious, subjective and objective, internal and external, right-brain and left-brain, observer and observed. But music therapy appears to be discovering its own methodologies from within itself (Aigen in Wheeler), and proving itself greater than the sum of its disparate parts.
D.H. Chomet: The Influence of Music on Health and Life (New York, 1875)
E. Podolsky: Music Therapy (New York, 1954) [incl. I. Altshuler: ‘The Past, Present and Future of Music Therapy’, 24–35; G. Arrington: ‘Music in Medicine’, 252–87]
P. Noy: ‘The Psychodynamic Meaning of Music’, Journal of Music Therapy, iii (1966–7), 126–31; iv (1967–8), 7–14, 45–51, 81–94, 117–23
E.T. Gaston: Music in Therapy (New York, 1968) [incl. W.W. Sears: ‘Processes in Music Therapy’, 30–44]
C. Masden, V. Cotter and C. Masden: ‘A Behavioural Approach to Music Therapy’, Journal of Music Therapy, v (1968), 69–71
H.L. Bonny and L.M. Savary: Music and Your Mind: Listening with a New Consciousness (New York, 1973, 2/1990)
J. Alvin: Music Therapy (London, 1975)
D.E. Michel: Music Therapy: an Introduction to Therapy and Special Education Through Music (Springfield, IL, 1976)
P. Nordoff and C. Robbins: Creative Music Therapy (New York, 1977)
E. Ruud: Music Therapy and its Relationship to Current Treatment Theories (St Louis, 1980)
R.O. Benenzon: Music Therapy Manual (Springfield, IL, 1981)
E. and B. Feder: The ‘Expressive’ Arts Therapies: Art, Music and Dance as Psychotherapy (Englewood Cliffs, NJ, 1981)
K.D. Goodman: ‘Music Therapy’, American Handbook of Psychiatry, vii: Advances and New Directions, ed. S. Arieti and H.K.H. Brodie (New York, 1981), 564–85 [incl. extensive bibliography]
K. Bruscia: Improvisational Models of Music Therapy (Springfield, IL, 1987)
D.H. Hitchcock: ‘The Influence of Jung's Psychology on the Therapeutic Use of Music’, Journal of British Music Therapy, i/2 (1987), 17–21
W.B. Davis: ‘ Music Therapy in Victorian England’, Journal of British Music Therapy, ii/1 (1988), 10–16
S. Hanser: ‘Controversy in Music Listening/Stress Reduction Research’, The Arts in Psychotherapy, xv (1988), 211–17
J. Moreno: ‘The Music Therapist: Creative Arts Therapist and Contemporary Shaman’, ibid., xv (1988), 271–80
D. John: ‘Towards Music Psychotherapy’, Journal of British Music Therapy, vi/1 (1992), 10–12
C. Maranto: Music Therapy: International Perspectives (Pipersville, PA, 1993)
L. Bunt: Music Therapy: an Art Beyond Words (London, 1994)
M. Priestley: Essays in Analytical Music Therapy (Philadelphia, 1995)
B. Wheeler, ed.: Music Therapy Research: Quantitative and Qualitative Perspectives (Philadelphia, 1995) [incl. K. Aigen: ‘Principles of Qualitative Research’, 283–311]
D. Aldridge: Music Therapy Research and Practice in Medicine: From Out of the Silence (London, 1996)
W. Lathom: ‘Music Therapy as a Means of Changing the Adaptive Behaviour Level of Retarded Children’, Journal of Music Therapy, i (1964), 132–4
A.L. Steele: ‘Programmed Use of Music to Alter Uncooperative Problem Behaviour’, Journal of Music Therapy, v (1968), 131–9
T.J. Scott: ‘The Use of Music to Reduce Hyperactivity in Children’, American Journal of Ortho-Psychiatry, xl (1970), 677–80
P. Nordoff and C. Robbins: Therapy in Music for Handicapped Children (London, 1971)
H. Jorgenson: ‘The Contingent Use of Music Activity to Modify Behaviours which Interfere with Learning’, Journal of Music Therapy, xi (1974), 41–6
D.M. Miller, L.G. Dorow and R.D. Greer: ‘The Contingent Use of Art for Improving Arithmetic Scores’, Journal of Music Therapy, xi (1974), 57–64
K. Roskam: ‘Music Therapy as an Aid for Increasing Auditory Awareness and Improving Reading Skill’, Journal of Music Therapy, xvi (1979), 31–42
K. Swanwick and J. Tillman: ‘The Sequence of Musical Development: a Study of Children's Composition’, British Journal of Music Education, iii (1986), 305–39
M.S. Rider: ‘Treating Chronic Disease and Pain with Music-Mediated Imagery’, The Arts in Psychotherapy, xiv (1987), 113–20
J. Alvin and A. Warwick: Music Therapy for the Autistic Child (Oxford, 1991)
K. Bruscia: Case Studies in Music Therapy (Phoenixville, PA, 1991)
P. Rogers: ‘Issues in Working With Sexually Abused Clients in Music Therapy’, Journal of British Music Therapy, vi/2 (1992), 5–15
A. Levinge: ‘Permission to Play: the Search for Self Through Music Therapy Research with Children Presenting Communication Difficulties’, Handbook of Inquiry in the Arts Therapies, ed. H.L. Payne (London, 1993), 218–28
G. Ansdell: Music for Life: Aspects of Creative Music Therapy with Adult Clients (London, 1995)
L. Bunt and J. Marston-Wyld: ‘Where Words Fail Music Takes Over: a Collaborative Study by a Music Therapist and a Counselor in the Context of Cancer Care’, Music Therapy Perspectives, xiii (1995), 46–50
A. Gilroy and C. Lee, eds.: Art and Music: Therapy and Research (London, 1995) [incl. C. Lee: ‘The Analysis of Therapeutic Improvisatory Music’, 35–50; M. Pavlicevic: ‘Music and Emotion: Aspects of Music Therapy Research’, 51–65; S. Hoskyns: ‘Observing Offenders: the Use of Simple Rating Scales to Assess Changes in Activity During Group Music Therapy’, 138–51; A. Oldfield and M. Adams: ‘The Effects of Music Therapy on a Group of Adults with Profound Learning Difficulties’, 164–82]
J. Robarts: ‘Music Therapy for Children with Autism’, Children with Autism, ed. C. Trevarthen and others (London, 1995), 134–60
T. Wigram, B. Saperston and R. West, eds.: The Art and Science of Music Therapy: a Handbook (Langhorne, PA, 1995) [incl. J. Standley: ‘Music as a Therapeutic Intervention in Medical and Dental Treatment: Research and Clinical Applications’, 3–22; O. Skille and T. Wigram: ‘The Effects of Music, Vocalisation and Vibration on Brain and Muscle Tissue: Studies in Vibroacoustic Therapy’, 23–57; B. Saperston: ‘The Effect of Consistent Tempi and Physiologically Interactive Tempi on Heart Rate and EMG Responses’, 58–82; H. Odell: ‘Approaches to Music Therapy in Psychiatry with Specific Emphasis upon a Research Project with the Elderly Mentally Ill’, 83–111; A. Warwick: ‘Music Therapy in the Education Service: Research with Autistic Children and their Mothers’, 209–25; R. Howat: ‘Elizabeth: a Case Study of an Autistic Child in Individual Music Therapy’, 238–60]
C. Lee: Music at the Edge: the Musical Experiences of a Musician with AIDS (London, 1996)
S.K. Langer: Philosophy in a New Key (Cambridge, MA, 1942)
L.B. Meyer: Emotion and Meaning in Music (Chicago, 1956)
C. Rogers: On Becoming a Person: a Therapist's View of Psychotherapy (London, 1969)
A. Maslow: Motivation and Personality (New York, 1970)
F.S. Perls, R. Hefferline and P. Goodman: Gestalt Therapy: Excitement and Growth in the Human Personality (Harmondsworth, 1973)
R. Hinde: ‘On Describing Relationships’, Journal of Child Psychology and Psychiatry, xvii (1976), 1–19
M. Critchley and R. Henson: Music and the Brain (London, 1977)
J. Richer: ‘Communication, Noncommunication, Culture and Autism’, Ethology and Nonverbal Communication in Mental Health, ed. S. Corson (Oxford, 1980), 259–68
B. Fleshman and J.L. Fryrear: The Arts in Therapy (Chicago, 1981)
F. Capra: The Turning Point: Science, Society, and the Rising Culture (London, 1982)
O.S.M. Marin: ‘Neurological Aspects of Music Perception and Performance’, The Psychology of Music, ed. D. Deutsch (London, 1982)
T. Moore: The Planets Within: Marsilio Ficino's Astrological Psychology (Lewisburg, PA, 1982)
J. Sloboda: The Musical Mind (Oxford, 1985)
D.N. Stern: The Interpersonal World of the Infant (New York, 1985)
A. Storr: ‘Psychoanalysis and Creativity’, Churchill's Black Dog, and Other Phenomena of the Human Mind (London, 1989, 2/1990), 151–74
O. Sacks: Awakenings (London, 1991)
J.A. Sloboda: ‘Empirical Studies of Emotional Response to Music’, Cognitive Bases of Musical Communication: Columbus, OH, 1990, 33–46