Music therapy and Music and Health

Available in Norwegian - Free access:

https://hdl.handle.net/11250/5345243

From the Foreword:

Foreword

With this book, I have sought to provide a comprehensive account of knowledge within the field of music therapy. The text is intended as an introductory book for new students in the discipline, as well as for anyone interested in the connections between music, health, and therapy. At the same time, readers already familiar with music therapy will gain a broader understanding of the field, become acquainted with recent research, and encounter new ways of arguing for and conceptualizing the discipline. The book also aims to challenge prevailing ways of describing music therapy by proposing that it be situated within critical, posthumanist, and postmodern theoretical perspectives.

Music therapy has gained a firm foothold in Norway over the past fifty years, and music therapists are increasingly working in new areas of practice. Music therapists work, among other contexts, with children and young people in need of special educational support, within child welfare services, and in elder care with people experiencing memory challenges. They work in somatic hospitals, within the field of mental health, in correctional services, as well as in the treatment and rehabilitation of people with substance-use challenges.

Music therapy is established both as a professional field and as a research discipline concerned with the relationship between music and health. Within research, scholars study how music affects our emotions and self-perception, how it influences the brain and the body, and how music contributes to the creation of community and a sense of belonging. As a professional practice, music therapy seeks to demonstrate that music is important as a health-promoting and health-preventive measure, both in therapeutic and care-related work for individuals, groups, and communities—and as a public health initiative.

Music therapy has existed in Norway since the 1950s and 1960s, and formal education for music therapists has been offered since the late 1970s. Master’s and doctoral degrees in music therapy can be pursued at the Norwegian Academy of Music and at the Grieg Academy at the University of Bergen. A bachelor’s degree in music and health is offered at Ansgar University College in Kristiansand, in addition to a range of courses and shorter educational programs in the field of music and health at several other institutions.

With this book, I aim to provide an overview of the opportunities we have to use music to enhance health and well-being and to improve quality of life for people who, for various reasons, need support in coping with health challenges. At the same time, I seek to show how listening to music, playing instruments, and participating in musical life can increase experiences of health and well-being. The emphasis of this presentation is on offering a broad overview of the field and pointing to literature that can provide more detailed information and guidance for further study and professional work.

The approach is grounded in a humanistic and interpretive research tradition. This entails clarification of concepts, theory development based on knowledge syntheses, and critical reflection. The book is based on a review of current research, studies of Norwegian professional practice, reflections on working methods and approaches, as well as an overview of fields of practice and therapeutic models. The concept of music and health is given particular attention in an effort to establish a rational foundation that binds the discipline of music therapy together, with the aim of avoiding fragmentation and division.

I have attempted to provide a rationale for why music can be used as therapy and why it has health-promoting and preventive value. At the same time, I have sought to expand the scope of music therapy to include public health work.

I have placed particular emphasis on describing a Norwegian tradition in music therapy. Over the fifty years during which organized music therapy has existed in Norway, specific practices, professional roles, and a theoretical tradition have developed that give Norwegian music therapy a distinctive character. A broad practice has emerged, and music therapists operate in a wide range of arenas, including schools and kindergartens, municipal schools of music and performing arts, pediatric wards in somatic hospitals, district psychiatric centers, the prison system, and institutions concerned with elder care.

Norwegian music therapy is characterized by humanistic traditions, emphasizing care, experiences of mastery, the use of people’s resources, and the strengthening of resilience. Furthermore, a rights-based and socially oriented music therapy has been developed, which has received international attention and influenced the development of music therapy in many countries around the world.

Central to such a theoretical synthesis is the combination of an ecological and a relational concept of music. Within this view, music is regarded as a fundamental mode of expression whose purpose is to create relationships between people. This understanding of music has been developed by music therapists and leading music scholars. I connect this view of music with a concept of health that encompasses multiple dimensions of health, from the biological to the existential. In developing this concept of health, I draw on the sociologist Hartmut Rosa’s theory of resonance, which I incorporate into a notion of existential health.

Through this sociological turn, I also seek to contribute to a more sociologically and critically oriented music therapy. At the same time, this provides a foundation for developing my theory of music as a “cultural immunogen,” based on four musical “antigens”: vitality, agency, belonging, and meaning. Based on this understanding and justification of music therapy, I argue that music has the potential to contribute to public health work.

The introductory chapter provides a brief and general overview of music therapy’s fields of practice, goals, and working methods, as well as an outline of the history of music and health in Western culture. The chapter on music and public health demonstrates how music and musical activities—what we now refer to as musicking—can contribute to public health efforts through health-promoting and preventive measures. This chapter goes a long way toward describing musicking as a “cultural immunogen,” understood as engaging in music in order to strengthen one’s defenses against ill health and to seek the opportunities music offers for increased quality of life.

The third chapter provides a more detailed description of the user groups, pupils, patients, or clients that music therapists encounter. It offers an overview of the needs individual users may have, the goals music therapists set, and a brief account of the activities and working methods available to music therapists and music- and health professionals. This chapter is followed by a description of the main approaches, therapeutic theories, and models within music therapy.

The fifth chapter addresses what characterizes the understanding of music within music therapy. It highlights the view of music within the discipline and how attention must be paid to musical taste, genre, and the musical identity that users bring with them into the encounter with the music therapist. This is followed by a chapter reviewing the central working methods—the musical toolbox—that music therapists and music- and health professionals draw upon. This primarily includes improvisation, music performance, composition, songwriting, and music production, as well as listening to music.

A chapter on professional knowledge illustrates how music therapy has developed as a profession with the many professional roles music therapists can assume. Music therapists may take on roles as musicians and educators; they are therapists and caregivers, project leaders, supervisors, and collaborators. This chapter describes the unique competencies of music therapists, as well as competencies and skills shared with musicians, educators, and health professionals. Collaboration between music therapists and other music and health professionals is also addressed.

The final chapter focuses on music therapy as a discipline, knowledge development, and research. I describe what characterizes a Norwegian music therapy tradition, with an emphasis on humanistic values and an understanding of the importance of culture and society as foundations for professional practice. The chapter highlights the challenges the field faces in creating a coherent knowledge base from the broad interdisciplinary spectrum in which music therapy operates. This involves drawing on knowledge from neuropsychology and brain research, special education and clinical psychology, disciplines within musicology, and philosophical subjects related to ethics, philosophy of science, and definitions of core concepts such as health and music.

In a concluding afterword, I summarize by showing how music can be a source of existential health and motivate us to preserve our health. Music contributes to moderating bodily and disease-promoting processes by reducing stress levels in the body. Here, I discuss how music can assume a role as a cultural immunogen by sensitively offering emotional regulation, participation and community, as well as experiences of mastery and meaning. At the same time, I point to ways of describing the field that can counteract fragmentation and contribute to the development of music therapy as a discipline capable of evolving further in all its diversity. This involves developing a professional language informed by postmodern philosophies.

For readers who wish to explore specific themes in greater depth, I have provided a number of suggestions for further reading in an appendix. Research literature in music therapy has become so extensive that it is now possible to find support and evidence for a wide range of music therapeutic interventions. This research is updated daily. I have therefore chosen to point to sources for this knowledge and indicate how and where it can be accessed. In addition, an overview of websites and portals offering up-to-date knowledge syntheses within specific fields of practice is provided.

Over the years, I have written a number of articles and books on music therapy, both in Norwegian and in English. In this book, I have allowed myself to reuse some of this material, naturally with the necessary editing. Readers who search for textual similarities with my earlier writings will undoubtedly make interesting discoveries. Where I have drawn most extensively on previous work, I have noted this in footnotes. Otherwise, I have sought to provide references to other sources through footnotes and in the reference list.

A few words regarding terminology are necessary. Readers will encounter the neologism musicking, rendered here in Norwegian as musikkering. Similarly, I use the term health musicking to refer to music use that can promote health. Regarding the terms used for the people music therapists work with, I alternate between user, client, patient, and pupil, depending on context. I also alternate between terms such as “disabled” and “people with disabilities” when referring to people with different functional variations.

I have emphasized the use of literature and references supported by research. However, I hold a broad view of research and knowledge development. This means that I draw on knowledge developed through qualitative studies as well as quantitative research, meta-studies, and other empirical approaches. In addition, I emphasize the experiential knowledge that music therapists themselves have developed through practice.

At a time when the use of artificial intelligence opens up many possibilities for accessing information and knowledge, it is important to seek out scholarly works that place knowledge in context, within a historical perspective, and that offer reflection, critique, and guidance on the transfer of knowledge into practice. It is my hope that this introduction and overview of a multifaceted disciplinary and practice field can contribute to a holistic presentation and counteract the fragmentation of knowledge.

Producing a comprehensive account of the field of music therapy is an extensive process, with many opportunities for errors in the description of facts and circumstances within a shifting interdisciplinary landscape. I therefore wish to extend special thanks to Brynjulf Stige, who took the time to conduct a thorough review of the manuscript and provided numerous insightful, constructive, and kindly critical comments. The same thanks go to Gro Trondalen, whose reading resulted in important additions and linguistic clarifications.

A special thank you is extended to the Head of Research at CREMAH, Karette Stensæth, who contributed important editorial interventions, offered detailed feedback on text and content, as well as followed the project closely. Thanks also to the Norwegian Academy of Music and Anders Eggen for their effective implementation and support of the book’s publication.

Even Ruud