Smiles, Fears and Hope in Music Therapy

Having spent the last few months writing about the facts, the theories behind music therapy,

and advocating for its versatility and effectiveness it feels like maybe the most important

things haven’t had enough time to shine. That is the music, and the therapeutic relationship.

All of the children I work with at Music House are wonderfully different. They may be

broadly thought about as the same client group of ‘additional needs’, ‘neurodiverse’, or

‘learning disabilities’, but for me those things are not a description of a person, but rather an

indicator as to some of the challenges they may face in everyday life. Every session in my

week is different, children have different favourite instruments, different preferred session

structures, different triggers, different types of play, and part of my role is to learn this and

remember it. The list of differences can seem endless which is why the relationship between

myself and the client is so important. If there is trust, compassion, and understanding within

the relationship then the sessions can tolerate moments of uncertainty, volatile emotions, and

miscommunications, all of which will inevitably occur at some point during the work.

But what makes the therapeutic relationship? What sustains it throughout months or even

years of work?

For me it’s shared experiences. Shared smiles, shared fear, and shared hope.

Smiles

Moments of joy and happiness within music therapy are imperative. While the end goal of

therapy is rarely for the child to ‘have fun’, enabling the client to have fun along the way can

lead to increased engagement, increased commitment, and help creates a relaxed, low-

pressure environment.

*Example: 6-year-old with global developmental delay

Bens’ favourite song was Itsy Bitsy Spider, we spent weeks singing it

together over and over again doing a scuttling motion with our hands

on djembe drums. Ben would smile and laugh as the song got faster

and our scuttling motion got bigger. As time passed, I gradually

introduced new ways of playing the drum, single taps for the drip drop

of rain, tapping up the side for the spider climbing up the spout. Ben

would see this and copy me, demonstrating his capacity and desire to

communicate with others. He slowly began to introduce his own ways

of playing, showing his ability to initiate social interaction, be more

independent in his play, and a growth in confidence. This all was

enabled through recognising his favourite song, and enabling him to

have fun through sound and movement.

Fear

Fear can often be an emotion that is avoided, but within the therapeutic space, sharing and

exploring fears can be an important aspect of the work. Thinking about what scares us and

why, what makes us anxious, or sad or defensive is a valuable use of the therapeutic time and

can result in us having an increased understanding of these things and helps us regain control

over the things we were once too scared to think about.

Example: 7-year-old with autism

Tims’ way of accessing music therapy was through highly creative

make-believe play. Gathering drums became boats, boom whackers

were swords, and egg shakers became bits of tressure that we had to

collect along the way. The music was often used to support this play,

creating soundscapes of storms and battles. A distinctive feature of this

play was how client and myself would always be in parallel worlds,

one of us in the ‘safe world’ and the other in the ‘unsafe world’. One

session during a particularly intense battle scene the client suddenly

covered his ears and said “stop that music, you’re scaring me”.

I stopped the music and asked Tim what he was scared of. “I’m lonely”,

he replied. Through the play he was exploring the sense of danger he

felt being in a world that at times seemed overwhelming and scary,

creating in himself a sense of isolation and fear.

Hope

Hope is an essential ingredient for successful therapy, acting as both a unifying and

motivating factor between therapist, client and their families. A shared believe that positive

progress is possible, that things will become easier for the child and their family, and that

over time connections are made that result in meaningful and lasting change.

Example: 7-year-old with Pathological Demand Avoidance

Bella liked to have control within music therapy sessions, she would

decide our activities, decide our instruments, what we would play and

how we would play it. Often, this would involve me taking on the role

of ‘audience’ while Bella performed me a song and I clapped at the

end. For a long time, all attempts to join in with her playing were

quickly shut down. After about 3 months of sessions, Bella was able to

tolerate more flexibility within the structure of the session so I thought

it might be another good time to try playing again. When I got

designated my role as audience member once more I started to gently

join in with Bellas’ music. She carried on playing and we played

together for several minutes before Bella asked me to stop. This in

itself was huge progress, but additionally she was able to communicate

her desire for me to stop playing clearly while staying emotionally

regulated. This interaction of 2 minutes was the result of months of

work, and offered us all hope for the months of work to come.

The moments described here are just a small handful of the things I get to be a part of

everyday, and it really is a privileged position to be a witness to children’s moments of joy,

vulnerability, and positive change.

For more information on music therapy please contact martha@musichouseeducation.com *All examples are being shared with parental consent, and with the children's names changed for anonymity.