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Rolvsjord, Randi (2010). Resource-Oriented Music Therapy In Mental Health Care. Gilsum, NH: Barcelona Publishers. 282 pp, ISBN 978-1-891278-55-6
Reviewed by Alexander Crooke, University of Melbourne
 Randi Rolvsjord is a registered and practicing music therapist, and an Associate Professor at the Grieg Academy and the Grieg Academy Music Therapy Research Centre (GAMUT), in the department of music at the University of Bergen. She has been publishing in the field of music therapy since 2004, and publishing on the concept of resource-oriented music therapy since 2005, with more than ten publications, including this, her third book.
This book gives a comprehensive account of the different theories that underpin and contribute to the practice of resource-oriented music therapy. It illustrates the need to consider the value of a resource-oriented approach in the light of recent academic and political debates in a number of disciplines, including music therapy, musicology, psychology, psychiatry, sociology as well as more general challenges to the medical model of health and illness. By discussing the theoretical landscape that surrounds it, Rolvsjord gives a sound basis for her own conceptualisation of what is needed for a resource-oriented approach, and why it is important to consider the “therapeutic value of the ‘nonpsychotherapeutic’ work in this field” (p 5). This is further illustrated in light of her own music therapy work, both in terms of how her work with clients has informed her own thinking regarding a resource-oriented approach, and how this approach has helped her to make sense of the interactions between her and her clients, and the way that these clients have gone on to use their own musical resources outside of the therapeutic setting.
It is clear that Rolvsjord and her work are driven by two main factors; first is an obvious and deep level of respect for her clients including the acknowledgement of their abilities to use music to help themselves, and their abilities to challenge and help her grow both as a therapist and as a musician; second is the combination of passion and experience in her chosen field, as illustrated by her mastery and knowledge of the vast array of literature and interrelated theories that inform it, both in this book, and in her numerous other publications.
As a result of her insights from both the literature and her own practical experience, Rolvsjord makes the claim that, in general, “Therapy can be as much about nurturing resources and strengths as it is about fixing pathology and solving problems” (p 5). Rolvsjord goes on to argue that, while at first glance a resource-oriented approach to therapy might be seen primarily as focused on strengths, is not limited to this aspect; the role of addressing problems is just as pertinent. In fact it is the critique of the binary conception of health/illness or problems/strengths embedded in the traditional therapies of the “medical model” which informs her claim that: “clearly, strengths and problems both have a place in therapy […] These need not be treated as separate parts of the therapeutic process, but might rather be seen as interacting aspects” (p 177). Indeed this claim is substantiated throughout this book.
The book is divided into three main sections. The first section, “Frames and Descriptions”, sets out the theoretical framework for Rolvsjord’s approach by giving an insightful and rich account of the literature in a impressing range of fields. This starts by covering recent academic and political debates regarding music therapy and mental health care, including sociological and psychological critiques of the “illness ideology.” It goes on to cover the philosophies and conceptualisation of a number of approaches to therapy that challenge the “illness ideology”, including empowerment, the common factors approach, and positive psychology. Rolvsjord then takes a look at music in and of itself, citing recent musicology and music therapy critique, as well articulating the concept of affordances. Finally, as the title of the chapter suggests, this section culminates with an account of how the previous chapters lend themselves “Toward a Concept of Resource-Oriented Music Therapy”, in which she stresses the importance of concepts of equality and collaboration between therapist and client.
The second section presents moving and engaging case studies with two of her clients. The case studies are based on Rolvsjord’s observation over a number of sessions, as well as in-depth interviews. Each client gets two chapters, the first from the point of view of Rolvsjord as the therapist, and a second focused more towards the voice of the clients and their self reported experiences. This section finishes with a reflection of the sessions with both clients and how they relate to the need to address both problems and resources.
The last section Rolvsjord uses both the case examples presented in the second section and pre-existing literature to provide a basis upon what a resource-oriented approach to music therapy might involve. While plainly stating that it is not “a recipe for how to work” (p 181), she does suggest some tenants for both the client’s, and the therapist’s role in therapy of this sort. For the client this includes, among other things, the ability to actively contribute to therapy, and their competence in using music in their own lives. For the therapist, Rolvsjord identifies a number of principles that should be considered in a resource-oriented approach to music therapy.
As previously mentioned, Rolvsjord’s command of the literature is impressive, as is her ability to relate it to her own work. The book makes clear connections between theory and practice in a way that has the potential to engage people from many disciplines. The case studies are presented passionately and honestly, both from the point of view of the client, and the therapist. One cannot help but to be drawn in to the stories of the two young women and their therapeutic journey, made all the more richer by Rolvsjord’s open accounts of when she was both challenged and enriched as a therapist, and as a person, in the process.
Overall, Rolvsjord writes with a directed passion that gives a clear and concise rationale for why a resource-oriented approach should be considered in music therapy, and therapy in general. Given the range of disciplines from which her arguments are informed, this book would surely be of interest to many different people, from sociologists, to musicologists, to psychiatrists, to counselors, to community workers, and anyone with a general interest in music or health. Having said that, the implications of the arguments, theories and philosophies presented within this text make it much more than a common interest text. While an important contribution to the field of music therapy in particular, I would argue that anyone in the many clinical therapy disciplines should read this book, and that anyone thinking about a resource-oriented approach to music therapy must read this book.
Music therapy education and training: From theory to practice, by Karen D. Goodman. Springfield: Charles C Thomas Publisher Ltd.(2011), 324 pp, ISBN 978-0398086091.
Reviewed by Simon Gilbertson, University of Bergen
 Karen Goodman’s landmark book, “Music therapy education and training: From theory to practice” provides a unique and excellent resource for the field of education and training in music therapy.
The beautifully printed and laid-out book is organized into seven chapters: Chapter 1. Music therapy education and training in the United States, Chapter 2. Competency-based education and training, Chapter 3. Preprofessional clinical training, Chapter 4. Advanced competencies, Chapter 5. Theories of teaching and learning, Chapter 6. Music therapy pedagogy, Chapter 7. Around the globe. The book also has two appendices and a comprehensive bibliography. Goodman has experience in music therapy education and training from over 3 decades that provides a fundamental core of experience that informs and supports the careful detail and comprehensive depth of the treatment of the selected topics and themes.
In the first chapter, the book focuses on an overview of the structure of music therapy programs in the United States, incorporating information on history, academic standards and related levels of practice according to education and training. In this chapter the reader is introduced to the many levels of education and training from undergraduate, graduate and post-graduate training and can read how these are related to the levels of practice suggested. The chapter is rich in information and presented in a clear and accessible way. It also provides the basis for a consideration of the competencies at entry-level music therapy studies as approved by the American Music Therapy Association in Chapter 2.
Chapter 2 is focused on introducing the reader to the relationship between entry-level competencies/requirements for fulfilling standards of practice and the implications and effects these have on music therapy education and training. Rather than simply presenting this information, Goodman provides an excellent opportunity to reflect on the topic by way of introducing a commentary on responses to the definitions of competencies and reaction to these definitions by educators. The chapter does an excellent job in raising an awareness of each of the areas of competencies through discussion sections related to each area. Though this section is based on the specific context in the United States and the AMTA Professional Competencies, the model of reflection on the topic can easily be used in consideration of competency-based education and training in education and training sites outside of the United States.
It is in Chapter 3 that Goodman takes the reader into the realm of pre-professional clinical training during practicum and internship phases. By considering the structure, support and supervision in relation to these phases, Goodman excellently highlights the nature of pre-professional clinical training and incorporates research on, and in these phases of music therapy training. The chapter is a valuable resource in identifying not only the ongoing student learning processes, but also the relational condition of clinical training by including supervisor relevant themes and topics. The chapter maintains the focus on AMTA approved competencies as in chapter 2.
Chapter 4 considers the educational and training of advanced competencies in music therapy. Based on the most current AMTA approval of advanced competencies that was made in 2009, chapter 4 provides a thorough and well-informed presentation of the topic. Maintaining also the pattern of presenting and explaining the competencies as in earlier chapters, Goodman then goes on in each area of competency with a discussion and critical reflection. It is in these discussions that Goodman’s wide range of experience and expertise as an educator comes to the fore. Rather than simply providing a bland listing of information, Goodman spices each of the discussions with pertinent and succinct widening and deepening of each of the issues considered.
Chapter 5 turns the reader’s attention to theories of teaching and learning leading through the themes of behaviorist, cognitive constructivist and social constructivist theories before turning to the topic of how teaching is molded to achieve intended learning outcomes. Goodman does this step by introducing theories on constructive alignment, stages of learning and categorizations of learning styles. This chapter is very useful in generating a bi-directional perception of the teaching and learning process, not resisting the temptation to solely focus on the learner, but also the educator. Importantly, throughout the book Goodman reminds the reader of the significance of learning for the teacher, and also how important it is for the educator to facilitate the student in learning how to learn, a core topic for educator and student alike.
Chapter 6 is a most valuable resource for the consideration of pedagogy in music therapy education and training. By tracing the study process from admission to completion and evaluation, Goodman provides a multitude of suggestions and critiques in advising, curriculum design, teaching, and evaluation techniques. The section on “Purposes and types of reading/writing/presentation in music therapy” is linked to a list of books published on music therapy in the book’s second appendix (Appendix B). The whole chapter is a trove of ideas, reflections and resources related to music therapy pedagogy and will certainly be highly useful for all involved in music therapy education and training.
The book focuses on the topic in the context of Karen Goodman’s own country of residence, United States of America, however, in the final chapter 7, Goodman provides a useful perspective on music therapy education and training in 30 countries from around the World. This adds to the usefulness of the book thus making the book relevant globally by adding perspectives towards and from the United States.
In addition to the seven chapters, the book has two appendices: Appendix A provides five addresses to “Major websites in music therapy for education and training resources.” The short length of this list hints towards an idea that a wider range of web-based resources related to music therapy education and training may offer additional channels of communicating and developing this aspect of the field of music therapy. Appendix B adds a very significant and useable list of “Books/monographs published in the English language in music therapy” from 1954 up to 2010 (including the book itself in 2011).
Finally, the bibliography of the book is in itself a significant contribution to the topic of music therapy education and training and will, along with the rest of the book certainly become a reference resource that will be most useful for those involved in the field. It is a very fitting conclusion to a book in which the writing ranges from easy-to-read introduction to topics, in-depth analysis of research fields and practices, and thought-extending questioning of core themes in music therapy education and training. In writing this book, Goodman has done an excellent service to the profession of music therapy.
By fusing information about the history, current standards, expectations and premises on which contemporary music therapy education and training is built, Karen Goodman provides the profession not only an excellent reference resource, but an opportunity for those involved in education and training to consider and re-consider the design, content and provision of their own educational and training processes. Simply put, this an essential book that demands consideration and reflection from all involved in music therapy education and training.
Music Therapy and Parent-Infant Bonding, edited by Jane Edwards, Oxford University Press, Oxford, UK (2011) ISBN 978-0-19-958051-4.
Wolfgang Schmid, University of Bergen
 The book Music Therapy and Parent-Infant Bonding edited by Jane Edwards presents a carefully compiled collection of work on music therapy and parent-infant bonding with the focus on infants and adults in challenging life-situations.
Within 13 chapters an international range of authors from Australia, Ireland, the UK, and the USA introduce and discuss current practice and research, showing how music therapy can contribute effectively to the promotion of attachment between primary caregivers and vulnerable infants.
The book is divided into an introduction and three sections, each with several chapters presenting a rich body of diverse perspectives and approaches to the field.
In the introduction the editor, Jane Edwards, discusses a selection of current theoretical formations about the musically primed infant, the musical relating in parent-infant communication, as well as findings on the parent-infant bonding and approaches in parent-infant music therapy. These four aspects function as a prelude for the whole book, guiding and preparing the reader for the subsequent chapters. In the first section examples for music therapy research and practice to reduce or prevent vulnerability in infancy are introduced. This includes the use of music therapy to assist the developing bond between traumatized children and their new adoptive parents (by Tiffany Drake), as well as music therapy for depressed mothers and their infants (by Alison Levinge). One chapter questions the role of music therapists when working together with parents and their children in music therapy (by Amelia Oldfield), another chapter evaluates the challenges and successes of parent-child group music therapy programs citing the Australian program Sing & Grow as a case example (by Kate E. Williams, Jan M. Nicholson, Vicky Abad, Louise Docherty and Donna Berthelsen).
Two contributions of group music therapy programs in a school-based-setting are presented in the second part of the book. One chapter portrays a project supporting families with an early-intervention group music therapy program (by Karen Kelly); the other chapter is a reflection on practical and professional aspects of extending group music therapy to families in schools (by Alison Ledger). In the other three chapters of this section, the chapters focus on music therapy with very young children and their parents or carers (by Margareta Burrell), the promotion of attachment between mother and baby in marginalized communities (by Joanna Cunningham), and music therapy to support mothers who have experienced abuse in childhood (by Toni Day and Helen Bruderer) is presented.
The third part of the book includes three chapters on music therapy in medical contexts: the first two chapters are about parents and newborn infants, translating infant-directed singing into a strategy for the hospitalized family (by Helen Shoemark), and on music therapy for hospitalized infants and their parents (Joanne V. Loewy). The third chapter discusses how music therapy can support parent-infant attachment in families affected by life-threatening cancer (by Clare O´Callaghan and Brigid Jordan).
With this variety of contributions and perspectives, the book presents several ways in which music therapists promote healthy relationships between the vulnerable infant and their vulnerable caregiver. With an emphasis on practical work presented in case studies and project reports, a foundation and consolidation for applied music therapy is given. The book underpins and extends existing publications on music therapy with children and their families in hospices, psychiatric units (Oldfield and Flowers, 2008), in neurorehabilitation (Gilbertson, 2008), and home based care (Schmid and Ostermann, 2007) in a fundamental way. The manifold, careful interweaving of practice and theory is a convincing strength of this book. It provides an excellent basis for further music therapy practice and research, and provides links to recent publications on communicative musicality as a basis of human companionship (Malloch and Trevarthen, 2008), and developmental psychology (Stern, 2010).
The congenital repertoire for musical communication and interaction in human beings provides a strong basis to promote secure bonding between infants and their caregivers in and with music. A multimodal, resource-based space is offered to the dyad or triad –of infant, parents and therapist and/or teachers- to safely explore, develop and renew relationship. On this background the book also provides strong arguments for music therapy as a preventive and early-intervention resource.
The immediacy and reflectiveness of how all authors share their experiences is an outstanding quality of this book. The open and very sensitive way of how each author presents and discusses her or his work, shows the facets of how a resource-guided music therapy perspective can be useful in complex vulnerable systems involving two, three and more people. The reader can easily access a close look to the challenges and questions and also to the power of the fragile therapeutic processes. The extension of music therapy not solely to a group but to a system of people widens the focus of who is initiator and receiver of therapeutic efforts and change. Parents, infants, but also care-givers and music therapists contribute and receive as participants and evaluators in these scenarios. It is a circular, refreshing process of learning more about our own discipline and potentials for its development.
In my view, the authors tell us about the roots of music therapy, and –by doing this- root and embed the discipline as a core approach in the context of building up healthy human communication and relationships.
I can very much recommend this book for students, practitioners and researchers from music therapy, and also from adjacent disciplines including pedagogy, psychology, and psychiatry and all those interested in the field of music and parent-infant bonding.
Literature
Gilbertson, S. (2008) The Silent Epidemic of Road Traffic Injury: What Can Music Therapists do About It? Voices: A World Forum for Music Therapy, 8, 1 (2008).
Malloch, S. and Trevarthen, C. (2008) Communicative Musicality: Exploring the Basis of Human Companionship. Oxford: Oxford University Press.
Oldfield, A. and Flower, C. (2008) Music Therapy with Children and their Families. London: Jessica Kingsley.
Schmid, W. and Ostermann, T. (2010) Home-based music therapy – a systematic overview of settings and conditions for an innovative service in healthcare. BMC Health Services Research 2010, Retrieved from http://dx.doi.org/10.1186/1472-6963-10-291
Stern, D. N. (2010) Forms of Vitality. Exploring Dynamic Experience in Psychology, the Arts, Psychotherapy, and Development. Oxford: Oxford University Press.
Stern, Daniel (2010). Forms of Vitality: Exploring Dynamic Experience in Psychology, the Arts, Psychotherapy, and Development. Oxford: Oxford University Press.
Reviewed by Simon Gilbertson, University of Bergen
 Daniel Stern’s work has played a highly significant role in the field of music therapy for decades. Since the early 1980’s Stern has moved through terms such as vitality affects, temporal feeling contours and vitality contours during over three decades of work on the concept, forms of vitality which is culminating in this 2010 book, Forms of Vitality: Exploring Dynamic Experience in Psychology, the Arts, Psychotherapy, and Development.
At the last Nordic Conference of Music Therapy in Aalborg, May 2010, Daniel Stern held a keynote presentation via video link from Geneva on the topic of this current book. It was Professor Tony Wigram, who most sadly passed away recently on June 24th 2011, who played a tremendously important role as the conference Scientific Coordinator making that keynote possible, transcribing Stern’s presentation into an article in the NJMT (Stern, 2010) and by creating a link, both personally and technologically, so that the wider music therapy profession could have the opportunity to listen to Daniel Stern and learn about ‘forms of vitality’ and the relation to music therapy theory, practice and research (Wigram, 2010).
Stern has organized’ Forms of Vitality’ in three parts, which in total contain seven chapters and a reference list:
- Part I: Introduction and Background
- Chapter 1. Introducing Dynamic “Forms of Vitality”
- Chapter 2. The Nature and Theoretical Framework of Dynamic “Forms of Vitality”
- Chapter 3. Ideas from Psychology and Behavioural Science Leading to Dynamic Forms of Vitality
- Chapter 4. A Possible Neuroscientific Basis for Vitality Forms: the Arousal Systems
- Part II: The Role of the Arousal Systems, and the Example of Music, Dance, Theatre, and Cinema
- Chapter 5. Vitality Forms in Music, Dance, Theatre, and Cinema
- Part III: Developmental and Clinical Implications
- Chapter 6. When do Vitality Forms begin? A Developmental View
- Chapter 7. What implications do Forms of Vitality Have for Clinical Theory and Practice?
All of the sections provide the reader with an almost immediate entrance into a hidden world of the stuff that human experience is made of. At the outset Stern determines the role that “movement, time, force, space, and intention/directionality – taken together give rise to the experience of vitality. As a globality, a Gestalt, these five components create a ‘fundamental dynamic pentad’” (p.4). Stern asserts that, as is obvious in the arts and present but at times hidden by daily routine and habituation, that a complex spectrum of these five components, are the stuff and material of what human experience and inter-relating is made of. As an example, he suggests that the dynamic form of a dancer’s movements can be sensed, perceived and understood and can be extracted from the actual physical event to be available to other dynamic media, music, for example. A contemporary dancer, Steven Paxton, well known for his development of contact improvisation who Stern writes about in this second part of the book, is an excellent example of this. As the developer of contact improvisation, Steven Paxton’s solo dance choreography with Glenn Gould’s recordings of the Goldberg variations or his “Material for the Spine” (Paxton, 2008) are prime examples of the material that is becoming more and more important in my own study and teaching on relational improvisation in music therapy. Stern’s perspective on human action and interrelation is founded in millennia of infant-care giver interaction, music and movement choreographies, and can be seen in such diverse activities such as synchronized underwater swimming, the spontaneous shouts and calls of young siblings playing unattended, and the most sophisticated of hip-hop dance-offs. Stern provides most wonderfully transparent and thought-provoking examples throughout the text for the primacy of the “forms of vitality.”
From this core, the book unfolds layer upon layer of human experience through discussing the dilemma confronting the sciences when dealing with Gestalts, to how psychology, behavioral science and a relational-neuroscientific perspectives are coming closer to dare to consider new and innovative neuroanatomical and neurofunctional and neuro-relational basis of “forms of vitality.” Those convinced of, and on the search for isolated locations of music function in the brain will finish this book empty handed; the book challenges the reader to extend towards new explanations and consider these in place of the old.
Following a feat of mastery in providing a narrative that challenges deeply the heart of reductionist science models while at the same time demonstrating directions of new paths of discovery, the first section leads the reader through a most fascinating consideration of “forms of vitality in music, dance, theatre and cinema” which is to be found in the second part. The section truly opens a kaleidoscope view of time-based human action and experience within the arts and provides exemplar and reflection through modern ballet and film, 20th century music composition and experimental theatre.
The third part of the book is “Developmental and Clinical Implications.” In this third and vital section, it may interest readers from the music therapy profession to find music therapy in the role of a prime example of Stern’s concept of forms of vitality in the section titled, “Vitality forms and intersubjectivity” (p.137). It is music improvisation in therapy that Stern uses to portray how “the role of vitality forms in intersubjectivity leads to a renewed interest in some of the basic notions of non-verbal therapies” and he refers to Tony Wigram’s descriptions of basic therapeutic methods of mirroring, matching, empathetic improvisation, grounding-holding-containing, dialoguing and accompanying, in Wigram’s 2004 book, Improvisation: methods and techniques for music therapy clinicians, educators and students. By focusing on Gro Trolldalen’s writing on music interplay (Trolldalen, 1997), Stern describes how “as the therapist and patient enter the same dynamic flow created by the music, there will emerge moments of ‘mutual recognition’ when they both realize, at the same time, that they are sharing a common experience. This is brought about through affect attunement, joint attention, and mutual confirmation. Such shared moments then act as do ‘moments of meeting’ in changing the relationship and moving it to a deeper level of intersubjectivity (BCPSG, 2008)” (p.140). It is clear that the mechanism of reciprocity is made of forms of vitality. It is then of course, no surprise that in the dance of improvised music, the senses combine and dissolve before our very eyes – ‘forms of vitality’ provides a way of staying with what remains, the essence and source of being human.
Stern closes the book with a succinct summary:
This book calls attention to the domain of dynamic forms of vitality. It demonstrates that such a domain exists, and shows that it is separate and distinct from the domains of emotion, sensation, and cognition. It stands on its own.
The second task has been to describe the scope of the domain of dynamic forms of vitality in psychology, the arts, psychotherapy, development, and neuroscience. It is ubiquitous as a part of all experience.
Finally, it intends to influence some of our current notions and suggest further paths of inquiry into this domain and all that it touches (p.149)
Daniel Stern’s Forms of Vitality is essential reading not only for music therapists, but also for anyone who is prepared to reconsider how humans experience themselves and others in relation. It is so beautifully written it can be read by students, therapists, educators and researchers, parents, and anyone who is willing to learn and grow through change.
References:
Paxton, S. (2008) Material for the Spine. (DVD) Brussels: Contradanse.
Stern, D. (2010). The issue of vitality. Nordic Journal of Music Therapy, 19(2), 88-102.
Trolldalen, G. (1997). Music therapy and interplay. Nordic Journal of Music Therapy, 6(1), 14-27.
Wigram, T. (2004). Improvisation: Methods and techniques for music therapy clinicians, educators and students. London: Jessica Kingsley Publishers.
Wigram, T. (2010). Keynote presentation by Professor Daniel Stern: Preface. Nordic Journal of Music Therapy, 19(2), p.87.
Ridder, Hanne Mette. (2005). Musik & demens: Musikaktiviteter og musikterapi med demensramte. Århus: Klim.
Reviewed by Solgunn E. Knardal, Bergen Red Cross Nursing Home, Bergen, Norway.
The area of music therapy in the care for elderly is becoming increasingly significant. Reflecting demographic changes, we are seeing an increasing number of music therapists working in the field and also more research is being carried out in the area. Hanne Mette Ridder’s Musik og demens provides a thorough and excellently presented overview on music activities and therapy with people with dementia.
This book is divided into three parts. 1: Music Activities 2: Theory 3: Literature Review. In this format it is both easy to read and also simple to use as a reference resource. This is a book to come back to, to reflect, to read again and is a place where the reader can find everything from practical descriptions to relevant references to published material. The book outlines ways in meeting patients suffering from dementia and describes the differential competences that are needed to do this.
Part One, titled “Music activities” is organized and presented very clearly, and takes the perspective on music therapy from a level of using music simply “to make the elderly happy” to provide a deeper understand of the mechanisms of change in music therapy which are grounded in research findings. The ways of working are also presented systematically: basis principles, setting, content, examples, comments and discussion. I imagine that music therapists working with elderly people will nod and recognize the descriptions of the work also some characteristics of the case narratives.
The section describes the diverse use of music in the care for elderly, from meeting a basic need for pleasurable experiences – to finding space for inner peace, something this section portrays very well in addition to describing how music becomes relevant in meeting the patient with dementia in the very last phase of life. The section demonstrates how music therapy with people with dementia is diverse and contrasting. The use of music is one major factor whereby the individual has great possibilities to be clear and to be seen. With the use of music can calm down, relax, stimulate and increase the quality of life for the individual. Several of the surveys show this. The use of music when being around others (fellow patients, relatives, personnel) can also show favorable effects.
Part two, titled “Theory” is divided into three sections: The pleasure of music – constructive regression, the inner space of peace, where making routines in everyday life gets essential. A person suffering from dementia will often have challenges on regulating oneself, and music has been shown in its use in reducing extreme states of arousal. In this section a systematic review is presented of music therapeutic interventions to meet these patients. The section shines with an open attitude towards people suffering from dementia, and how interventions should be considered in terms of providing space for the individual to be a whole human being. Three different types of interventions are shown to be relevant; activities for pleasure, therapeutic activities and psychotherapy. It is suggested that therapy is very beneficial where it is dialogue-based, and the aims are clearly communicated to those involved, including to relatives and caregivers. The chapter on ‘music in the brain’, where studies have been selected to shows that music can “bypass” the brain, and create new links to non-damaged areas, is useful both when working with people with dementia, and also for the music therapist when communicating about work with this group of individuals.
Part three, titled ‘Literature review’ includes 92 studies from 12 different countries that were selected with specific inclusion criterion. The review is an excellent resource and provides a solid and reliable basis for understanding themes and topics that have received research attention during the development of music therapy in this area.
Though “quality of life” is often challenging to capture in research, this review shows how there is openness and interest also for this dimension in research in music therapy. In this review, Ridder provides clear and succinct information about the benefits of using music activities and music therapy in the care for people suffering from dementia, and how it can have positive effects on communicative, cognitive, physiological and social domains. Even if active participation reduces as dementia increases, it is possible to observe how people with dementia react positively with and through music. Still, as a conclusion, there is a large amount of research to be done on this significant and valuable topic.
With ‘Musik og demens’ (Music and Dementia), Ridder has provided a most valuable contribution to the literature. It is written by an experienced music therapist, educator and researcher who clearly has great expertise in working and writing about music therapy with people living with dementia. The knowledge and overview of the practice, theory and research is well balanced and integrated and throughout the book, there is a sense of the author’s deep respect for each individual, just as they are. As a result, this is a book that will be of interest to students, therapists and researchers interested in the role music can play in the lives of those with dementia.
McFerran, Katrina (2010) Adolescents, Music and Music Therapy. Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers.
Reviewed by Philippa Derrington MA. Music therapist at Cottenham Village College and Centre School, Cambridge UK.
 Adolescents, Music and Music Therapy - © Jessica Kingsley Publishers Adolescents, Music and Music Therapy by Katrina McFerran is the fifth book in a methods series published by Jessica Kingsley. The previous publications are: Improvisation (Wigram, 2004); Songwriting (eds Baker, F. and Wigram, T. 2005); Receptive Methods in Music Therapy (Grocke, D.E. and Wigram, T. 2006); and Microanalysis in Music Therapy (eds. Wosch, T. and Wigram, T. 2007).
This book provides a balanced theoretical and practical guide to working with adolescents. Music therapists, whether newly qualified or with experience in the field will find this book useful. It offers detailed explanations for realistic ways of working with adolescents and is packed full of ideas: from the description of an adolescent-friendly instrumentarium to a Symphonic model of music therapy group development – with an introduction, exposition, development, recapitulation and coda. ‘Teenagers exist on the cusp between expression and articulation, and music matches this level of experience very successfully’ (p. 137).
Based on years of experience working with adolescents with very different needs and in a wide variety of settings, McFerran clearly sets out her method and explains her reasons for ways of working including different types of activities she uses. The breadth of her experience is evident in the illustrative vignettes which accompany each section of her clearly defined method. McFerran’s experience with adolescents has included work in a range of community and institutional settings and examples range from work in a hospice and hospital, to special schools. The adolescents may have profound and multiple learning disabilities, emotional and behavioural difficulties, be facing terminal illness, loss or grief.
From the beginning, as the author explains how and why music and music therapy is relevant for adolescents, McFerran’s passion for her work is obvious. Her engaging style draws the reader in and the clarity of the text and layout of each chapter is well designed. The book has four parts:- Background; Song methods and teenagers; Using improvisation with teenagers; and Contemporary approaches.
The systematic view of the literature, chapter 1, includes a look at how many therapists are working in this area, in what settings and what they use in their method. Interestingly, McFerran discovers that, although adolescents spend most of their (weekdays) time in school, the majority of music therapy work does not take place in educational settings but in hospital, inpatient health care settings or hospices. McFerran also uncovers through the literature that there is no significant one way, nor a prescriptive method for any particular setting. The author’s response and intention with this book, underpinned by her doctoral research, was ‘to provide a Map, or a guide, that encourages music therapists to approach adolescents in their own way’ (p. 279). The following chapter leads on to McFerran’s description of her blended eclectic model of music therapy, ‘The real deal on how to work with adolescents’.
The final chapter (3) in part one is an ‘overview of some key ideas in relation to four elements of adolescent health – resilience, identity formation, competence and connectedness’. This is a very useful and welcome chapter for those who have attempted to find out more about adolescents and been daunted by the vast literature on the subject.
Parts two and three encompass the practical material and descriptions of the author’s work. The parts are divided into three sections, when the music therapist’s focus is on 1.Fostering understanding; 2.Offering acceptance; and 3.Facilitating development. Each method she describes has a section for ‘Setting and purpose’, ‘Illustrative vignettes’, ‘Evaluating effectiveness’ and ‘Key points’.
In part two, McFerran explores the use of existing songs (chapter 4) and the composition of original songs (chapter 5). In part three, the author discusses the use of composition with teenagers in both groups (chapter 6) and individually (chapter 7). ‘The unique attitudes and needs encountered with this age group are at the centre of each of these practical chapters’ (p. 22). The reader cannot help but be enthused by the vivacity and clarity of McFerran’s text.
Finally, in part four, McFerran looks at contemporary approaches to music therapy, the need to look at the adolescent in context and with more focus on developmental achievements that take place outside of the music therapy setting. Within the framework of community music therapy (chapter 8) and contemporary practice, McFerran discusses the use of performances and recordings. Again, the author illustrates her approach with vignettes which successfully capture the enthusiasm and energy of the teenagers and therapist.
Chapter 9, ‘Four brief approaches to grief’, sets aside this crucial area for adolescents who may be experiencing all kinds of loss. As well as describing her work with adolescents, McFerran highlights the importance of running workshops to youth professionals and ways of using music with the young people. Her honest and expert reflections on her experiences of this work are valuable. Vignettes from a bereavement support group demonstrate the author’s point concerning preparation for performances (chapter 10) and the therapist’s responsibility to constantly check the impact that this has on the therapeutic process.
This book not only updates music therapy literature, which had lacked such a text that focused solely on adolescents, but has added a wealth of information. McFerran’s writing is genuine, inspiring and certainly reflects her passion and understanding of work with young people. The book will be helpful to music therapists working with adolescents in any setting and should generate further interest and research in this area because, as McFerran’s book makes clear, there is very little research that specifically addresses the value and effectiveness of music therapy for adolescents.
I shall leave the last word to Tony Wigram, whose foreword to this book reflects his high regard for the author, both as researcher and clinician. He writes: ‘Music is an integrating, emotional and highly attractive art form, and Kat McFerran demonstrates here with all her exciting ideas and methods how the power and value of music can be a positive force in the lives of adolescents’.
References:
Wigram, T. (2004) Improvisation: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Baker, F. and Wigram, T. eds (2005) Songwriting: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Grocke, D. and Wigram, T. (2006) Receptive Methods in Music Therapy: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers
Wosch, T. and Wigram, T. eds (2007) Microanalysis in Music Therapy: Methods and Techniques for Clinicans, Educators and Students. London: Jessica Kingsley Publishers.
Meyer, P., De Villers, J. & Ebnet, E. (2010). Guitar skills for music therapists and music educators. Barcelona Publishers, Gilsum. 143 pp., ISBN 978-1-891278-56-3
Reviewed by Viggo Krüger, PhD Candidate, GAMUT / Music therapist, Aleris Ungplan
 Cover from Guitar skills for Music Therapists - ©Barcelona Publishers I will begin this book review with a personal point of view. As a music therapy student back in 1997, I recall being told by teachers and older music therapy students that most music therapists used the piano in their work, regardless who they were working with. Now, in 2011, the situation of the role of guitar in music therapy seems to have changed. The guitar has a new and altered status in music therapy, at least speaking from the perspective as a music therapist in Norway. As it seems, many music therapists use guitars in their work, and therefore a book about guitar skills for music therapists is particularly welcome.
Meyer, De Villers and Ebnet have published a guitar book that set out to give music therapists and music educators a tool to use in their work. The book is meant to give beginners and intermediate guitar players suggestions and pointers to improve their knowledge base and technique. The text offers material that can be used in functional guitar courses for music therapy and music education majors as well as anyone interested in learning the basics of guitar playing. Topics covered include basic and advanced techniques such as strumming patterns, fingerpicking, flatpicking, barre and power chords as well as authentic stylistic accompaniment in styles such as Pop, Blues, Jazz, Rock and Rhythm and blues. The book is designed to assist the learner in developing his or her practical guitar skills in a format that can be used in both the classroom and for individual self study. The text begins with the very basic exercises of guitar playing and expands into more challenging material as book progresses throughout the chapters. The book has a chapter called music therapy techniques. In the chapter on rules for improvisation, techniques on how to use open tunings and slide guitar are described. The DVD follows up the descriptions with demonstrations so that the reader can both see and hear how the techniques are used.
As a guitar playing music therapist and a teacher in guitar skills for music therapy students, I basically find the book usefully and well made. I think that both the written material and the DVD can function well as scaffolding in learning process whereas the learner is looking for tips on how to play ordinary guitar skills needed for playing western music genres such as rock, pop and blues. However, the book may in some regard seem a little too much as an ordinary guitar book and I miss more material on actual guitar skills for music therapists and also on other “world music” genres from countries such as Asia or Africa. Taken into consideration that all three authors are music therapists, the chapter on music therapy techniques is a little too short regarding content of guitar skills for music therapists. Both descriptions and demonstrations of different modes, open tuning and the slide guitar are useful, but can we really consider them music therapy techniques? Actually there is only one page describing how the guitar can be used in music therapy techniques such as improvisation, questions and answer or how to leave space (page 112).
In my view, Meyer, De Villers and Ebnet have made a book that illuminates the need for elaborations and descriptions on how the guitar is a useful instrument in music therapy. The questions, ‘How?’, ‘For whom?’ and ‘Why?’, they have left for others to describe and explore. From my own experiences with guitar in music therapy processes, and from those I have been talking with about such processes, there certainly lie great potentials and resources to be used and discovered. Maybe now is the time to open up for such stories and knowledge. However, most such knowledge may remain as what Polanyi calls tacit knowledge (Polanyi, 1966). And in relation to the discussion on tacit knowledge, if we don’t give our knowledge names and make stories about our experiences, they will remain silent, but not necessarily useless.
References
Polanyi, M. (1966), The tacit dimension, Doubleday, N.Y and Routledge & Kegan, P. London
Twyford, K., & Watson, T. (Eds.). (2008). Integrated team working: Music therapy as part of transdisciplinary and collaborative approaches. London: Jessica Kingsley.
Reviewed by Alison Ledger, Leeds Institute of Medical Education, University of Leeds, United Kingdom (A.Ledger@leeds.ac.uk)
 The publication of Integrated team working in 2008 marked a significant step in the development of music therapy as an allied health profession. In preparing this text, Twyford and Watson gave due consideration to an important yet frequently overlooked aspect of music therapy practice – working with others. Twenty-four contributors discussed the benefits and challenges of collaborative work in music therapy and reflected on the role of the music therapist in interprofessional teams. This writing exposed teamwork as an essential part of music therapy practice that is not necessarily easily and comfortably achieved. Effective teamwork was presented as an accomplishment that requires considerable time, commitment, flexibility, reflection, and skill. This was significant, as it promoted open discussion of an aspect of practice that many of us have experienced as stressful. Additionally, it allowed exploration of ways in which services for clients could be improved.
Following a helpful introduction to collaborative working by the editors, the book is neatly structured into chapters by client group (children, adults with learning disability, adults with mental health issues, adults with acquired neurological conditions, and the elderly). Short case studies are presented throughout and provide practical examples of music therapists’ collaborations with a diverse range of professionals. Alison Barrington then places collaborative working in a wider historical and political context, before the editors summarise the key themes arising from the book. The writing is scholarly throughout and the contributors demonstrate ways in which aspects of music therapy work can be clearly articulated to others. This is a major contribution of the book, as effective communication has been identified as a core competency of interprofessional working (Suter et al., 2009).
A particular strength is the way in which the contributors locate teamwork in particular contexts. Each chapter or case study begins with a description of the location, the history of the organisation, the needs of the particular client group and/or the theoretical assumptions underpinning the collaborative work. Although most of the work was undertaken in the United Kingdom, by music therapists who trained at Roehampton or the Guildhall, sufficient detail is provided for readers to understand why a particular approach was taken. Readers are then able to determine whether an author’s experiences are relevant to their own particular work contexts. This is critical, because no two care teams are the same and the work of teams is likely to be influenced by a range of complex historical, organisational, and interpersonal factors (Atwal, 2002; Kvarnström, 2008; Suter et al., 2009).
The back cover states that the book is intended for music therapy students and practitioners, as well as professionals who work alongside music therapists. I believe that it is music therapy students and other health care professionals who will benefit most from this publication. Students are provided with a solid introduction to a number of client groups, a range of organisational contexts, and the various ways in which music therapists have worked with other professionals and family members. For health care professionals, the book offers ideas for collaborative work with music therapists and motivates and inspires further collaboration. The clever use of headings and introductions at the start of each section also means that it is not essential to read the book in its entirety. Readers with limited time can extract a chapter or case study that is most relevant to their own work. I discovered this feature during my doctoral research on music therapy service development, when I considered similarities between the strategies needed for collaborative working and the ways in which music therapy services can become successfully established. It was then helpful for me to limit my attention to the “guidelines for good practice” provided at the end of each chapter. Now that I am working in a medical school, I could imagine showing short sections of the book to colleagues to explain how music therapists fit into interprofessional teams.
As an experienced music therapy practitioner and researcher, the honesty of the case studies was refreshing. I appreciated the contributors’ generosity in sharing how their collaborative work was planned and what their experience of team working was like. Many of the contributors described vulnerabilities and uncertainties in working with other professionals. These descriptions resonated with my own experiences and indicated that music therapists are becoming less guarded in discussing their work. The case studies also give a rare insight into other professionals’ experiences of working with music therapists. I was particularly struck by a clinical psychologist’s account of her feelings of anxiety in working with musical instruments for the first time. This account showed that other professionals may be willing and able to collaborate with music therapists if they receive adequate preparation and support.
If I was to make one suggestion, it would be that the contributors could have gone even further in their descriptions of obstacles to collaborative working. Several of the contributors alluded to tensions, hostilities, and competitiveness in their work with other professionals. Claire Miller’s chapter on collaborative working in mental health was especially revealing in terms of the power struggles and rivalries that music therapists have experienced when working in teams. However, the case studies tend to read only as a collection of interprofessional success stories. For experienced clinicians, it would be helpful to read more detailed descriptions of the problems others have experienced and the ways in which interprofessional tensions have been resolved. For example, the broader health care literature indicates that there may be some negative consequences to interprofessional working when professional boundaries become blurred. “Role blurring” has been identified as a potential source of conflict, confusion, and burnout in healthcare teams (Brown, Crawford, & Darongkamas, 2000; Hall, 2005). I would therefore welcome further consideration of the ways in which boundary blurring may challenge music therapy practitioners’ conceptions of what music therapy is and how a music therapist’s identity may become altered through collaborative working. Additionally, I would suggest greater reflection on whether music therapists have played an equal or an adjunct role in their collaborative work. This type of reflection could be a little overwhelming for student readers, but would be useful for practitioners who are grappling with these issues.
The editors concluded with a hope that they will have an opportunity to provide a second volume, to further explore collaborative and transdisciplinary approaches in music therapy. Based on my reading of this pioneering text, I would strongly encourage the publisher and editors to do so. A second volume could include contributions from a wider range of countries and contexts and provide additional examples of ways in which challenges to collaborative work have been addressed.
References:
Atwal, A. (2002). A world apart: How occupational therapists, nurses and care managers perceive each other in acute health care. British Journal of Occupational Therapy, 65(10), 446-452.
Brown, B., Crawford, P., & Darongkamas, J. (2000). Blurred roles and permeable boundaries: the experience of multidisciplinary working in community mental health. Health and Social Care in the Community, 8(6), 425-435.
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(Supp 1), 188-196.
Kvarnström, S. (2008). Difficulties in collaboration: A critical incident study of interprofessional healthcare teamwork. Journal of Interprofessional Care, 22(2), 191-203.
Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(1), 41-51.
Ludtke, Karen (2009): “Dances with Spiders: Crisis, celebrity and celebration in Southern Italy” New York, Oxford Berghahn Books. 254 pages. Series: Epistemiologies of Healing
Reviewed by Simona Nirensztein Katz. MA Tavistock School of London. MT, AD Jerusalem. “Shir”: Psychodynamic Music Therapy Association, Florence Italy.
In her book “Dances with spider”, Karen Ludtke, DPhil in Social Anthropology at the University of Oxford, guides us in the world of past and present Tarantism with passion but without losing the perspective of a contemporary scholar.
The author’s poetical, yet not rhetorical, prose gives the book’s ambitious project a fluent and realistic description that makes you feel as if sitting among the olive trees in Salento or admiring the baroque stuccos of Galatina. These enchanting images are mixed with the ones of perspiring bodies of exhausted dancers and with the pounding sounds of drums and violins. As a reader one is impressed by how respectful and rigorous is the author’s description of the homes of the “Tarantati” and by her attempt to reach their psychic sufferance. At the same time she is fascinated by the “neo-Tarantati” and their search for a generic well being through rhythm and performance.
The book edited by Bergham Books is part of a series titled “Epistemology of Healing” which addresses issues of medical anthropology.
The author’s remarkable passion for the subject has led her on a seven year long field study which constitutes the core of the book. The essay maintains an overview on how Tarantism has been considered, practiced and studied throughout the centuries. Personally, I have found the analysis on the cultural and anthropological aspects of the phenomena, the newest and most stimulating part of the research.
Before entering a more detailed description of the essay it might be useful to define Tarantism. We speak about it as a phenomenon documented since medieval times in Salento in Puglia (the heel of the Italian boot) where a spider called “Tarantola” was supposed to bite and provoke, mostly in women, a complex series of psychic and neuro-vegetative symptoms which could be alleviated only by certain kinds of music.
The principal symptoms included loss of balance, nausea, anxiety, psychokinetic agitation or catatonic depression, closure, variations of appetite, libido and mood.
The spider’s bite, which has rarely been proved, occurred normally in the harvesting period during the long and hot summers. The” bitten” person often was going through a difficult moment of her life which could be a sad love affair, a family crisis, an imposed wedding, or an unwanted pregnancy.
At the propitious moment for the curative ritual a real setting would be prepared; the musicians (tambourine, voice, violin and accordion), the patient, and often a public would gather around scenographical and symbolic elements such as mirrors, colored cloths and sacred images. The musicians would play until they found the appropriate music for the white-dressed patient, and for her “spider”; tarantulas could be of a singing, dancing, frenetic, erotic, but also slow weeping and even funereal kind. At the moment of the musical matching, the patient reacted with a movement of recognition that could be a spasm or fainting or the classic “hysteric arc” where the whole body would become stiff from head to feet. Following this moment usually there was an ecstatic dance until final collapse and then, after a long sleep and rest, there was an improvement of the symptoms.
To ultimate the ritual and bring healing, St Paul’s mercy was necessary, and annually the cured women would go and give thanks in the saint’s chapel. The crisis often would recur in June in the days near St Paul’s day.
Let us now go for an overview of the four parts of Karen Ludtke’s book.
The first part “Past and present spider webs” sets the scene with a tribute to St Paul. The author brings us to Galatina, cross roads of ancient and new “Tarantati”, and asks how come both the myth and the music of the Taranta have been both preserved and reinvented. The narration fluctuates between an objective, historic tone to a more vivid and cinematographic one. For example when telling about Evelina:
this tiny elderly lady….[…] now she is better but in the past she would faint before leaving the house on St Paul’s day and her family had to drive her to Galatina unconscious […] she was lying on the back seat, giving off muffled sounds. Her fingers were clawed like the fangs of a spider (p. 39).
Ludtke enquires upon an important matter: Does Evelina and the other Tarantati really want to get better, or do their actions reinforce the status quo of the cause of their suffering? These are the kind of questions that are precious for us as music therapists.
In the second chapter through a rich overview of old and new Tarantism, Ludtke gives an historical perspective and confirms that the roots of Tarantism remain a mystery. Although some people search even for satanic origins, Ernesto de Martino (1961), the major scholar on the issue, locates the first Tarantism phenomena between the ninth and the fourteenth century in the period of the Islamic expansions in Apulia. According to De Martino, Tarantism arouse out of the dual need to deal with actual spider epidemics and with the changing socio-political and religious conditions. Other roots can be sought in European dancing manias like St. Vitus or Saint John’s dance in the Netherlands and in Germany in the thirteen and fourteen century A.C. . Even more ancient and interesting parallels to Tarantism have been drawn with the Dionysian and Orphic cults of Greek origins. All these manifestations were characterized by the cathartic use of dance and music. The complex and ambivalent relationship with Christianity is obviously the core of the healing rite.
Ludtke gives place to De Martino’s view that sees the phenomena as a culturally specific response to harsh living conditions of women in Southern Italy:
De Martino proposed a psychoanalytically tinged interpretation viewed within a historical and socio-economic framework. Tarantism was defined as a “religion of remorse” allowing the payment of debts contracted on an existential level (p. 64).
Of particular interest in Ludtke’s broad overview is her underlining throughout different stages of European history, the link between the different perspectives on this issue and different conceptions on human nature and society.
The second part of the book, “The spider’s cult today” brings us abruptly in our present times and begins a very long explanation on how and why the neo-tarantism emerged. The question in itself is fascinating and can be applied to many different musical or healing traditions. What links the ancient ritual to the satellite broadcasted mega concerts taking place nowadays? Why have the sounds and, I would like to add, the setting used as a cure for suffering and oppressed women, become in the last ten years an occasion for mass entertainment? Maybe, as the author suggests, “today’s buzz around the tarantula music and dance can serve to blind us to socio-cultural implications of contemporary afflictions ad to re-appropriated discourses on healing and well-being?” (p.77).
Chapter three reveals that the traditional curative form is almost completely disappeared. Most of the Salentine people are thankful to the eradication of a phenomena that relate them to an obscure and poor past, and only a few of them, in closed circles, still feel that Taranta and St Paul saved them from misery. But everybody is happy about the fact that the music and pathology of the taranta serves now contemporary purposes, which are sometimes connected to personal or social wellbeing and sometimes to the cultural and economical growth of Salento’s society.
Ludtke brings us joyfully through the different summer “taranta nights” that resonates with rhythms and sounds through the wonderful piazzas and beaches. She seems comfortable and absolutely not judgmental even when she observes the exhibitionism of musicians and dancers, that has nothing to do with the true suffering of women that we have seen in De Martino’s documentary films. If to a music therapist this might look as a cheap sale of music’s curative potential and of the musician’s capacities to attune to the woman’s needs, according to the author this is the natural development of the phenomena. Watching a singer on stage swept by the catharsis of music and imitating the spasms and contortions on the Tarantate apparently does not make her uncomfortable.
As the author writes, to some extent also the ancient ritual was used in some manipulative manner and not merely to heal the victim. Today “it is a means of advertising Salento without consideration of its cultural heritage […] but it also represents a key to developing this area according to culturally sensitive and environmentally sustainable parameters […]; a closer looks reveals how tarantula’s music and dance are still, or again, being liked to experiences of recovering well-being.” (p.116).
The third part of the book titles “From ritual to Limelight” and is the longer and in my opinion the less clear and convincing one. In the effort to address the important matter of analyzing “the underlying factors influencing self-perception, human relations, power issues and vision of reality sabotaging or nourishing well being” (p. 137) the reader could feel disorientated.
The author shifts from the attempt of interpreting the symbolic meaning of the spider’s bite, to rapid digressions on the real motifs of the women’s sufferance.
She inserts long interviews with the so called “new Tarantate” women that search in the pizzica’s throbbing rhythm and ecstatic dance the possibility of expressing sensuality and instinctual energies. Often they find in altered states of consciousness provoked by movement and rhythm some kind of well being, and sometimes a shortcut in the search of their real self or of their own roots. Ludtke doesn’t questions about how deep and stable are those states of “well being”, while these rituals might appear hazardous shortcuts to those that work using the deep curative potential of music.
It is surprising that the author does not mention the lack of containment as a possible danger for those that attempt a “do it yourself” kind of therapy. What could be interesting is asking what has changed in the conception and cure of psychic agony in these last decades.
The author’s anthropological perspective has the important role of widening the views we normally have , but in such a vast overview on the subject I feel the lack of a deeper analysis of the curative dimension of such an interesting ritual: in the first place the recognition of the psychic suffering of each single patient, the containment granted by the family and the community which had to name and accept this affliction; the possibility of a woman muted by a poor oppressive catholic society to express her agony using her whole body, and last but not least the capacity of the musicians to attune with voice and instruments to the specific needs of the woman and of “the spider’s bite”, in other words to her distress.
It can be interesting to add Adriano Primadei’s (Primadei, A. and Nirensztein, S. (2007) psychoanalytical view: He makes an association between the spider and “the Uncanny” by Sigmund Freud. Freud (1919) wrote that “the uncanny is undoubtedly related to what is frightening — to what arouses dread and horror; (…) it tends to coincide with what excites fear in general.”(p.81). In Primadei reflections “Karl Abraham (1922, p. p.464) identifies the spider as the oneiric symbol that can arouse the feeling of the uncanny. The spider, according to Abraham, is a “masculine mother” that can penetrate with a poisonous bite.”. He thinks that in a sense “the role of Tarantism as a symbolic order was to create a protection net to prevent the person from drowning into anxiety…. The spider .. gives a symbolic meaning and form to this anxiety…. if the feeling of anxiety cannot be named, and has no meaning, then it cannot be thought or processed. ” (Primadei, A. and Nirensztein, S., 2007. p.7)
In the fourth part of the book “Conclusion”, the author synthesizes the core of the book, as an attempt to understand “how has the tarantula’s dance changed over time and what it reveals about the link between performance practices and well-being” (p. 213).
In the reflections on the role of rhythm and on the role of art as a form of expression of the self and on how “soundness emerges where the sense of self integrates” we find the motifs that make this book worth reading. The large bibliography is really admirable.
The music therapist looking for a detailed discussion on the therapeutic effects of the “pizzica” music on the psychic state of the Tarantati might be disappointed. Nonetheless, this essay is rich of interesting and stimulating thoughts even if sometimes slightly verbose and unclear.
References
Abraham, K. (1922). Il ragno come simbolo onirico. In Opere, vol II. It. ed. 1997
Bollati Boringhieri. Torino
De Martino, E. (1961) La terra del rimorso: contributo ad una storia religiosa del Sud. Il Saggiatore. Milano.
Freud, S. (1919). Il Perturbante. in Opere vol IX. It.ed.1989 Bollati Boringhieri. Torino.
Primadei, A. and Nirensztein, S. (2007) Tarantism in music therapy: a dialogue between traditional music and psychic suffering. Keynote: 7th European Music Therapy Congress. Eindhoven, the Netherlands.
Karkou, Vicky & Sanderson, Patricia (2006). Arts Therapies – A Research Based Map of the Field. London, UK: Elsevier (307 pages).
Reviewed by Lucy O’Grady, University of Bergen, Norway
The relationship between music therapy and other arts therapies is not a ‘hot’ topic at this point in the development of music therapy-specific literature. Apart from some focused exploration of the issue from Smeijsters and Cleven (2006), Faire and Langan (2004) and myself (O’Grady, 2010), it may be fair to say that music therapists are at this time sufficiently occupied with the complexities of their own discipline, let alone the complexities of the arts therapies as a whole. Perhaps a ‘hotter’ topic at this point in music therapy is that of developing indigenous theory and this is where a research-based map of the arts therapies could be a timely contribution. In order to discover what is unique to music therapy, we may be well-served to ask what is shared and what is different across all arts therapies. The book, Arts Therapies – A Research Based Map of the Field, is based on this very premise.
The book really should be called Arts Therapies ‘in the United Kingdom’ – A Research-based Map of the Field since it is based on interviews and survey questionnaires of over 580 arts therapists practicing in the United Kingdom. However, it is only the title which is slightly misleading since in their introduction the authors acknowledge this scope which is defined both by the research sample and reference to predominantly British literature. The authors define the arts therapies field as consisting of four separate disciplines: 1) Music Therapy (MT), 2) Art Therapy (AT), 3) Drama Therapy (DT), and 4) Dance Movement Therapy (DMT). The authors claim to be the first to try to delineate through empirical research the commonalities and the differences between these four arts therapies in terms of theory and practice. The authors also acknowledge the methodological complexity of doing so, however they suggest that it is worth the attempt in order to clarify misconceptions, advance the progress of the profession(s) and to promote collaboration between different arts therapists while strengthening the theoretical positions of each discipline. The authors are clear that their book does not represent a suggestion that all four arts therapies should become one; instead, there is the clear implication throughout that each arts therapy can be strengthened through consideration of the other. Through these ambitious aims, the authors identify three main audiences for the book: arts therapists, lay readers, and other health professionals.
The book is divided into two main sections, with four chapters in each. Section 1 considers the field as a whole in terms of its historical development, boundaries and definition, common features and common theoretical frameworks. Section 2 addresses the arts therapies as separate modalities and focuses on the uniqueness of each discipline, illustrating through case examples presented in table format. The authors state that they do not intend to offer in-depth accounts of each discipline in this section, but enough that the reader may have “the possibility of a first, comprehensive understanding of the field” (p 4). Each chapter follows a clear format, with the overall structure and key issues highlighted at the beginning of the chapter and much of the text illustrated through tables and diagrams.
Chapter 1 presents an overview of the professional development of the arts therapies as a whole. The role of western traditions in the development of arts therapies is largely emphasised, while the use of the arts by shamans and within indigenous cultures is mainly relegated to pre-historic times. The emphasis on western historical influence is reiterated in chapter 2, where arts therapies are delineated from traditional therapies such as acupuncture based on the assumption that “arts therapies are a product of western society” (p. 36). This rather simplistic emphasis and brevity of discussion begins to clarify just how large and potentially over-ambitious the scope of this book may be. In this sense, the first chapter seems most to serve the lay person or the beginner-reader. A potentially more interesting discussion for arts therapists in chapter 1 concerns how up until now the different disciplines have been separate due to the fear that merging them would develop practices with questionable depth in understanding the art form and thus questionable therapeutic value. This idea is supported recently by Gold, Wigram & Voracek (2007) whose statistical analyses indicated that clients showed greater health improvement when music therapy was limited to discipline-specific music therapy techniques and did not include media from other arts therapies disciplines. The authors of the book note exceptions to the current status of separate arts therapies disciplines through the ‘expressive arts therapies’ movement in the USA and the Institute for the Arts in Therapy and Education in the UK. They do not mention the Netherlands as another major exception to the rule, where the different arts therapies are served by the professional Dutch Association for Creative Therapy (Smeijsters & Vink, 2003). Nevertheless, the first chapter in the book highlights an interesting trend across the arts therapies, in that the most common area for arts therapists to work in terms of client difficulties is with emotional\behavioural issues (59%).
In Chapter 2 the authors discuss the boundaries of the field in relation to the therapeutic arts (arts in health), arts education, other therapies and other health practices, a discussion which then culminates in a definition of the arts therapies as a whole field. One of the differences between the therapeutic arts and the arts therapies, reiterated throughout the chapter, is that the therapeutic arts emphasise the product while the arts therapies value instead the process. This is arguably an outdated assumption and an unnecessary split between process and product, since there are examples of artists working in health who also recognise the importance of process and attempt to balance the two (O’Grady, 2010). The privacy and inward processes of arts therapies as well as their dyadic or small-group constituents are also emphasised in this chapter, which is interesting to consider in the light of Community Music Therapy discourse where “out and around processes” (Stige, Ansdell, Elefant & Pavlicevic, 2010) are also valued and whole communities may be worked with (Stige, 2002). After discussing the boundaries of the field, the authors in this chapter examine past definitions of each arts therapy and track changes in emphases over time. For example, from 1989 to 2004 MT definitions are interpreted as changing from a humanistic emphasis to more of an acceptance of a diversity of approaches and practices. Chapter 2 culminates bravely by presenting a definition of the arts therapies as a whole field.
The third and fourth chapters are among the most valuable in the book because of the interesting commonalities they present. In chapter 3 the authors suggest that there are five main assumptions common to MT, AT, DT and DMT: 1) the ‘arts’ are defined in broad terms, 2) there is a focus on the process, 3) there is a belief in the preverbal development of engagement in the arts, 4) the arts are holistic and, 5) the arts offer therapeutic potential. Furthermore, the authors suggest that the main features across the arts therapies are an emphasis upon creativity; imagery, symbolism and metaphor; non-verbal communication; the triangular relationship between the client, the art-form and the therapist; the therapeutic relationship as both transferential and real; and finally, the formulation of therapeutic aims that reflect overall psychotherapeutic orientations of either behaviourism, humanism or psychoanalysis. This final idea is developed further in chapter 4, where six theoretical trends are identified across MT, AT, DT and DMT:
1) Humanistic, 2)Psychoanalytic\Psychodynamic, 3) Developmental, 4) Artistic\Creative, 5) Active\Directive – which the authors relate to Wheeler’s (1983) first level of music psychotherapy as well as to behaviourism, and 6) Eclectic\Integrative. The prevalence of these particular theoretical approaches for different client groups is identified. For example, the psychodynamic\psychoanalytic approach is predominantly used for clients with mental health issues. In terms of developing indigenous theory in music therapy or across the arts therapies, the artistic\creative theoretical trend is perhaps the most relevant but is also presented by the authors as the least theoretically developed so far.
As an arts therapist (music), I find the second section less interesting to read. Perhaps this is because the focus upon the idiosyncracies of each particular arts therapy in terms of its pioneers and their myriad collection of diverse and sometimes unrelated theoretical ideas renders it difficult for me to gain a coherent, concise picture of the uniqueness of each arts therapy. I cannot imagine which of the identified audiences would benefit most from this section. Instead, I find the introductory page to each chapter where key issues are highlighted the most helpful and interesting part of Section 2.
The idiosyncracies of MT are addressed first as Chapter 5. In this chapter it is interesting to learn that in some ways MT leads the arts therapies, since it was the first discipline of the arts therapies to form a professional body and also receive early recognition. The authors explain that this may be in part due to the high value accorded to music in western traditions compared with other art-forms. It is also interesting to learn that music therapists in the UK predominantly work through improvisation and with children who have learning difficulties. The authors link this to the early pioneers of music therapy in Britain, Alvin and the Nordoff-Robbins partnership. The authors also highlight their findings that there are comparatively few music therapists working with people whom they label ‘normal neurotics’ and few in private practice. They also emphasise the divide between active and receptive techniques in music therapy as well as the importance of the ‘iso’ principle, an idea which dates back to Plato and that, in music therapy, relates to matching a person’s mood with music. Of interest to the move to develop indigenous theory in music therapy, the authors also suggest that “MT, in comparison with other arts therapies, draws less heavily upon related fields in order to provide a theoretical justification of its practice” (p. 124). Case examples, presented in table format, from Oldfield, Bunt, Ansdell, Sobey, Levinge and Odell-Miller are used to highlight different theoretical approaches to music therapy that have developed from Alvin, Nordoff and Robbins, and Priestley. The authors also briefly discuss GIM and behavioural approaches to music therapy but suggest that these are less popular in the UK. A similar format is used for the following three chapters, of which I will only highlight a few points concerning the relationship between the arts therapies. This is because for those readers who are interested in learning about each discipline in particular rather than how they relate to each other, I recommend reading this book or, for more depth, other books that are focussed on the particular arts therapy discipline of interest.
Chapter 6 presents AT as a unique arts therapies discipline. The authors highlight how art therapists in the UK emphasise psychoanalytic\psychodynamic thinking and value much less an artistic\creative theoretical framework. The authors also discuss the heated debate in AT surrounding directive vs. non-directive approaches which stems from the move to distinguish AT from the more directive use of arts in occupational therapy.
Chapter 7 focuses upon DT as a unique arts therapy. It is interesting to learn in this chapter that a relatively large proportion of DTs in the UK work with people who do not present an apparent difficulty (more than 10%). The authors suggest that this may be partly due to the verbal nature of DT which makes it better suited to clients with some degree of cognitive\physical\emotional skills. It is also interesting to learn that DTs place more emphasis on humanistic theories and artistic\creative principles and are less in agreement with psychoanalytic\psychodynamic thinking than other arts therapists. In chapter 8, it is interesting to learn that DMT is the most recently established arts therapy in the UK and that these arts therapists place a comparatively higher value on humanistic understandings of their work.
The authors offer a concluding chapter in which they suggest that arts therapists from each separate discipline can look to the strengths of the other disciplines in order to work on the weaknesses of their own. For example, they suggest that “MT can offer knowledge and experiences of undertaking extensive research work in MT practice and creating a public profile that can be useful for all arts therapists. In terms of clinical practice, the relative aversion of music therapists to eclectic\integrative principles can remind arts therapists that within a postmodern era that values diversity, it is important to retain a clear sense of professional identity that is not in danger of fragmentation or diffusion and at the same time does not lose essential flexibility” (p. 276). Furthermore, the authors’ conclusions point toward the need to explore commonalities and distinctive practices amongst different arts therapies in order to begin to develop indigenous theory for each discipline.
Due to the ambitious scope and variety of intentions underlying this book, the three identified audiences (arts therapists, lay readers and health professionals) are not consistently addressed throughout. Different audiences may prefer different parts of the book. For example, chapter one may be particularly useful for lay people or prospective arts therapies students, whilst chapters 3 and 4 may be of most interest to arts therapists who are wondering how they might collaborate with other arts therapists. The second section may also serve this purpose but is probably most useful for other health-care professionals who are questioning the relevance of the arts therapies to their own work or which arts therapy may be particularly appropriate in their workplace. I suggest that the key issues highlighted at the beginning of each chapter in the second section will be the most helpful in this regard. More obviously, this book will probably be of most interest to arts therapists, lay readers and health professionals in the UK, however it is also a useful starting point for considering the commonalities and differences amongst the arts therapies in other parts of the world. For music therapists in any country, the fact that this book is grounded in research makes it a useful tool for continuing the development of indigenous music therapy theory and for considering our part in the development of indigenous theory for the arts therapies as a whole.
References
Faire & Langan (2004). Expressive Music Therapy: Empowering Engaged Citizens and Communities. Voices: A World Forum for Music Therapy. Retrieved February 8, 2010, from http://www.voices.no/mainissues/mi40004000159.html
Gold, C., Wigram, T., & Voracek, M. (2007). Predictors of change in music therapy with children and adolescents: The role of therapeutic techniques. Psychology and Psychotherapy: Theory, Research and Practice, 80m 577-589.
Smeijsters, H., & Cleven, G. (2006). The treatment of aggression using arts therapies in
forensic psychiatry. The Arts in Psychotherapy, 33, 37-58.
Smeijsters, H., & Vink, A. (2003). Music therapy in the Netherlands. Voices: A world
forum for music therapy, Retrieved 01/10/2009, from voices.no/country/monthnetherlands_september2003.html
Stige, B. (2002). Culture-centered music therapy. Gilsum, NH: Barcelona Publishers.
Stige, B., Ansdell, G., Elefant, C., & Pavlicevic, M. (Eds.). (2010). Where music helps:
Community music therapy in action and reflection. Surrey: Ashgate.
Wheeler, B. (1983). A psychotherapeutic classification of music therapy practices. Music
Therapy Perspectives, 1(2), 8-16.
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