Using Primary Instruments in Music Therapy

As music therapists, we are trained on guitar, piano, voice, and percussion. But many music therapists spend years cultivating a personal relationship to music by learning a different instrument long before pursuing a career in the field. Yet, many MT-BCs don’t use their primary instrument in clinical settings. 

Music therapy interventions can be effectively facilitated on an instrument outside of those taught in music therapy curriculum. For instance, hearing a new sound can spark new curiosity and interest leading to increased engagement. Music therapists Amelia Oldfield, Jo Tomlinson, and Dawn Loombe have written about their experiences using their primary instrument clinically. Each shared how their enhanced proficiency, playfulness, and musical freedom can develop stronger relationships between clients and music therapists.

Similar to choosing an appropriate percussion instrument, consider your instrument’s timber and dynamic capabilities as it has the potential for harmful overstimulation or left unheard altogether. Additionally, some instruments, like bassoon, take longer to set-up/put away or face a greater risk of damage to a personal instrument. But done in the appropriate settings and facilitated by a trained professional, using a primary instrument can be a great tool to address a variety of clinical goals. Below are some intervention examples:

Name That Tune:

• Goals: reminiscence, cognitive stimulation, social engagement 

• How: Play short snippets of well-known songs (e.g. movie and tv show themes) and ask clients to identify the song.

• Tips: Use online resources like MuseScore to find sheet music.

Musical Conversation:

• Goals: social engagement, oral motor, vocalization

• How: Provide client time and space to select a wind instrument (like a reed horn or kazoo) and experiment with sound production. Help facilitate a musical conversation by providing musical or verbal prompts to take turns playing, just as you would take turns talking and listening in a verbal conversation. Gradually integrate vocalizing to further encourage sound production both with and without an instrument.

• Tips: This can also work with non-wind instruments. It could take a few minutes or several sessions to develop these sound production and social interaction skills.

Sound-to-Movement Association

• Goals: motor movement, cognitive stimulation, direction following 

• How: Associate specific sounds with physical actions (e.g. a trill = wiggling arms, an octave jump from low to high = hop). Playing the musical cue prompts the client to perform the corresponding action.

• Tips: Start with 1–2 actions and gradually add more. Switch roles where the client leads the movement and you respond with sound.

*For a less structured approach, use Nordoff Robbins improvisation technique to provide auditory feedback, validation of client’s movements, and encourage additional motor movement.

Music Discussion About Classical Music

• Goals: reminiscence, relaxation, social engagement, quality of life

• How: Ask the client about their relationship to classical music (favorite composers, musical periods, memories of attending concerts, playing an instrument, etc.). Play familiar excerpts on your instrument, and share interesting facts or stories about the music, the composer, or the instrument.

Tips: This is a great opportunity for classically trained vocalists to facilitate live preferred music (opera) and ignite a deeper discussion around opera and different singing styles.