Prognosis Grim/Situation Hopeless: Making a Difference with Music Therapy

ABSTRACT: This article explores the development of music therapy over the last 35 years through the experiences and perspectives of a long-term music therapy practitioner and music therapy university instructor. The article demonstrates the relationship between music therapy practice and research through examples of clinical-outcome studies. The author recommends that practiced music therapists seek out new and returning professionals for mentorship relationships. She further challenges music therapists to develop their clinical ideas, test them through rigorous clinical applications, and disseminate the results. All efforts are certain to lead to better substantiated clinical practice. Throughout their careers, music therapists have struggled to identify themselves as professionals who are worthy of merit. One of the first major disappointments shared by pioneers in the profession occurred when Dr. E. Thayer Gaston traveled to Chicago to meet with Dr. Jules Masserman in the late 1960s. Masserman was the current president of the American Psychiatric Association, and Gaston pleaded with him for APA acknowledgment of music therapy as a viable approach to treatment. Masserman flatly refused Gaston's request on the basis of an inadequate body of research in the music therapy field. Gaston's hopes that music therapy would be acknowledged by the APA and would become known as an important discipline were dashed. He discussed his serious disappointment with students and colleagues after his return to the University of Kansas, and he persisted in his efforts to gain approval for music therapy through attendance at APA conferences. To the end of his life, his efforts failed. Gaston clearly thought that music therapy was doomed for not receiving APA approval, but, as it turns out, music therapists continued to grow in their efforts to establish the profession. They persistently labored to authenticate the results of their interventions through carefully designed protocols, clinical outcome research studies, and subsequent presentations and publications. Furthermore, the failed APA association allowed music therapists to branch out into practice areas that would not have been available to them had music therapy become a part of the American Psychiatric Association. The curricula for music therapy education and training were developed by the professionals in the field and were not dictated by the board of the APA. Because of one man's disappointment, music therapy thrives. The moral of the story is that when things seem their darkest, there may be a beginning that is better than ever dreamed. Those events and occasions that seem to knock the wind out of the sails can be, and usually are, the start of something wonderful. For us and for the world, the something wonderful has become the growing efficacy of music therapy. A quick look at the development of music therapy over the years reveals a central theme, "Music therapy catches on when it provides something very desirable in a hopeless or extremely unpleasant and undesirable situation." When the drugs are not enough to calm an agitated burn patient who has dementia, a music therapist can use music to do it. When a physician cannot examine a child who is screaming, a music therapist can make it possible. When a medical technologist cannot get a needle inserted because the patient is fearful and physically aggressive, the music therapist can make it happen. When a teacher cannot persuade a child to control impulses long enough to learn a concept, a music therapist can get the job done. Music therapy has always been a profession in which its practitioners "stand in the gap" to accomplish what cannot be done better in any other way. In this role, music therapy has moved far beyond using music to help people feel better, to express themselves, or to structure their unfilled time. Music therapy interventions go far beyond the music heard on the television or a radio at bedside, sometimes referred to by nurses as "music therapy. …