Intersections of Music Performance and Music Therapy
Musical performance is an artistic expression and aesthetic experience for an audience, whereas music therapy is a clinical modality to help develop or rehabilitate speech/language, cognition, motor functions, etc. There are many skill sets one must have to function effectively in both professions, and some of these skill sets intersect. Here, we will lay out a few of these skills and reflect on how they relate to both professions.
Technical Proficiency
Performance: Technical proficiency in a performer’s respective instrument allows a performer to play their instrument with excellence and grace. Without technical proficiency, a musician is less able to provide a compelling performance to their audience. Technical performance is not enough to be an effective performer, although it is a foundational skill. For example, if a singer asks a performer to play a song in a different key, the performer must be able to transpose on the spot. This requires an understanding of music theory and the ability to play the chord progression in any key.
Music Therapist: As with performance, technical proficiency is a crucial skill for music therapists, although not the only skill. A key difference here is that a music therapist needs to have a well-rounded understanding of more than one instrument. Music therapists need to be technically proficient in guitar, piano, drums, and percussion because they will be working with many different people in a myriad of settings. The primary focus of music therapy work is on the client’s non-musical needs (speech, cognition, social skills, etc). These needs can be addressed through an intelligently designed clinical intervention that involves structured musical activity. This requires the music therapist to have at least a basic understanding of many different instruments. Technical proficiency in instrumentation is a foundational skill in music therapy because they need to focus their attention on the client/patient. This requires technical proficiency to be second nature. For example, when working with a client in a hospice setting, a music therapist must be able to play a preferred song while constantly assessing the emotional expression and affect of the client. If a music therapist is unable to play chords on the guitar without looking at the fretboard, they might not be able to observe the expressions of the client and adjust accordingly. In this situation, technical proficiency is a crucial skill for providing effective music therapy interventions.
Emotional Intelligence and Storytelling
Performance: Emotional intelligence refers to one’s ability to understand and navigate one’s own emotions, as well as recognizing and empathizing the emotions of others. A major part of what can make a musical performance so compelling is the performer’s capacity for emotional articulation through musical expression. This requires the performer to be keenly aware of their own emotions. This also helps the performer to convey emotions in an intentional manner. Proficient emotional expression (through the way lyrics are sung and through the non-verbal expression in the instrumentation) is one essential component in the art of storytelling which is the skill of conveying information in an engaging manner. Musicians can convey musical information in an engaging manner by expressing various emotions and situations in musical representation. Proficient emotional expression is one essential component in the art of storytelling, which is the skill of conveying information in an engaging manner. Musicians can convey musical information in an engaging manner by expressing various emotions and situations in musical representation. For example, one can use musical elements such as melody, harmony, timbre to convey information. An effective storyteller is able to capture the imagination, emotions, and attention of the audience by using musical elements (rhythm, harmony, melody, etc.) to convey emotion and information. Again, emotion can be expressed both verbally (through delivery of lyrics) or non-verbally (through instrumentation). In addition, the listener can also interpret the music in their own way. The performer doesn’t necessarily have to be aware of the emotional response of the listener.
Music Therapist: Emotional intelligence and expression is a fundamental skill for music therapists. Recognizing and empathizing the emotions of others can be considered an important skill for any social engagement, although it is especially crucial for the therapeutic setting. For example, let’s say a music therapist is conducting an intervention designed to help an individual in a mental health in-patient clinic to make sense of and express their emotional experience. To be aware of the client’s emotional response to the music is crucial so the therapist can recognize the emotional response and help the client to process the experience.
Another example is in hospice care. If a music therapist is playing a patient-preferred song and notices an emotional response in the patient, the music therapist can take this as an opportunity to help the patient process the experience. If the music therapist is unable to recognize the emotional response, then they are unable to help the patient process it.
Oftentimes, music therapists work with individuals or groups who are emotionally distressed or need help processing difficult emotional experiences. This requires the ability to manage their own emotions as well as help others to do the same.
Storytelling is also a useful skill as a music therapist, although the storytelling is meant to provide informative instruction or to teach a functional skill. For example, when working with a child with autism who has social skills deficits, the therapist may sing or write a song about what it means to have a conversation and how to initiate/maintain a conversation. The act of writing the steps out of the steps or the skills needed is called a social story. The addition of music creates a social song story.
Repertoire
Performance: Performers benefit greatly from having an extensive repertoire of songs that span a wide range of styles and genres. Some performers are in a specific niche such as jazz, classical, rock, etc. So, they may only need to focus on the repertoire within their genre/style. Of course, it is helpful to have a vast repertoire that spans across many genres and eras, as patrons often make requests for songs. If they are performing in set program, they only need to know the repertoire that is needed for the program.
Music Therapist: Having an extensive repertoire is important for music therapists. One key difference between music therapists and performers is that music therapists must know a wide range of genres and styles that is tailored toward each client/population they work with. This is a necessary skill because the music is administered as a clinical treatment and the music must be formed and delivered in a manner that addresses the therapeutic goals and objectives. Providing client-preferred music is very important, as it can help to relate with the client. For example, when working with a elderly individual in hospice, it is most appropriate to provide music from their era (music they listened to when they were younger (e.g. teens through early 20’s). A child might enjoy music from Disney movies. It is important to tailor the repertoire to the music that the client prefers and is motivated by.
Below is a table of how various musical elements are used in performance vs music therapy sessions.
| Musical Element | Musician/Performer | Music Therapist |
| Lyrics | A performer sings the lyrics of the composed song to tell the story and convey the emotions as intended by the composer. | A music therapist uses lyrics to:Teach concepts (e.g. how to have a conversation)To facilitate discussion or to process, self-insight, growth and learning through lyric analysisTo reminisce and bring back memoriesTo help orient a patient with dementia to |
| Mood of the song | The performer might use the mood of a song to convey a message from the composer in order to entertain or engage with the audience | A music therapy may play a song to change mood: Calm a client with dementia who may be agitated. To help regulate a child with autism whose sensory system is out of syncTo activate, coordinate and time functional motor movements (like walking, lifting arms, etc.) for someone recovering from a stroke.To utilize the iso principle to match the mood of the music to the client’s current emotional state and to modulate the mood accordingly |
| Song selection | The performer, band or conductor selects the set list or program. They may take requests from the audience. | A music therapist intentionally selects a song with purpose to meet the needs of the clients depending upon the goal of the intervention. Song choice includes client preferred music and client choice where possible. For example, when working with a hospice patient, if they are unable to communicate their preferences, a music therapist looks at a list of the patient’s favorite songs provided by the patient’s family to influence musical selection. |
| Tempo | If playing a cover song, the performer remembers and plays to the tempo of the original song. Of course there is room for interpretation and modulation, although it is not necessary to change the tempo necessarily | The music therapist plays to tempos that are appropriate for the client’s preferences and needs.For example, if a client is overstimulated as indicated by bouncing and jumping, the music therapists might utilize the iso principle to match the clients energy level and speed movements in order to gradually modulate the energy level of the client. However, if the client is working on motor skills in a rehab setting |
| Dynamics (ie. loud vs soft) | The performer might use dynamics to meet the aesthetic goal of the composition. | The music therapist might use dynamic to:Match the energy level or emotional state of the clientEmphasize a word or concept (for example, to emphasize a part of a word that the client is struggling to enunciate)To gain client attention |
| Harmonic structure | The performer will provide the harmonic structure as dictated by the composer. | The music therapist might:Adapt the harmonic structure to meet the emotional needs of a clientSimplify a chord progression to make a song more simple and understandable |
In conclusion, the skill sets of performance and music therapy intersect in many ways. It might be accurate to note that the skills required to be an effective performer are fundamental to the skillset of a music therapist, although performance skills alone do not suffice for being an effective music therapist. The goals for a music therapist involve clinical outcomes, whereas a performer’s goals involve goals related to entertainment. This requires a different mindset.
Written by Alec Johnson, Music Therapy Intern
