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The Architecture of Aesthetic Music Therapy

br2004_042Lee, Colin Andrew (2003). The Architecture of Aesthetic Music Therapy. Gilsum, NH: Barcelona Publishers. 254 pages and 2 CDs of music examples.

Reviewed by John Mahoney.

The Architecture of Aesthetic Music Therapy is comprised of 15 chapters (254 pages) plus 2 CDs of musical examples. The book includes musical analyses, case studies, philosophical discussion, discussion of musical and clinical form, and a substantial list of references (10 pages). The book also has a foreword by Rosemary Fischer, Professor Emeritus of Music Therapy at Wilfrid Laurier University in Ontario (where Lee heads the Music Therapy Department), acknowledgments by the author, an index of written musical examples, an index of CD extracts, and a preface.

Like the present reviewer, Lee is a Nordoff-Robbins trained music therapist, who holds many shared values; however, the value of this book goes well beyond the confines of Nordoff-Robbins practitioners-it makes a significant contribution to the field that should be of interest to all music therapists. In this book, Lee makes a persuasive and passionate call to the profession to reevaluate the role of music in music therapy. The book provides a compelling case for building music therapy theory that is based on music theory, musicology, and aesthetics, rather than on disciplines outside of music (e.g., psychology or medicine). Lee argues that music therapy is a balanced combination of “art” and “science.” He maintains that its potentials as such must be examined independently and combined, presenting a challenge and rationale for raising both musical and clinical standards for the field, contextualizing clinical work in terms of clinical listening and musical analysis.

Lee does not stand alone when he urges music therapists to focus on the musical aspects of music therapy. Other theorists outside of the Nordoff-Robbins tradition have also called for a shift in focus within the field towards the musical considerations of music therapy. For example, Michael Thaut (2000) states that, “…theoretical models of music in therapy have to be based on understanding the processes involved in musical behavior before translational therapeutic concepts can be developed. Consequently, models of the influence of music on nonmusical behavior, in order to be foundational therapeutic models, have to be based on models in music…”

Lee takes an approach to clinical listening and musical analysis similar to that found in Healing Heritage: Paul Nordoff Exploring the Tonal Language of Music. There Nordoff examined the fundamental musical elements involved in improvising (e.g., intervals, scales, phrasing, chords, idioms) and provided short examples from the Western European literature, including excerpts by Beethoven, Ravel, Debussy, Rameau, Schumann, and Brahms. Lee extends Nordoff’s explorations by looking beyond musical elements and techniques at the more detailed level of composition and improvisation to include the larger structures, such as musical form. This expands the focus of improvisational music therapy from individual improvisations to the form of an entire session. For example, Lee conceptualizes a music therapy session in terms of classical sonata form. In this book, Lee provides musical analysis and discussion of Bach’s Mass in B Minor, a Beethoven String Quartet, and prepared piano music of John Cage.

In his book, Lee calls for a deeper connection with, and understanding of, the music we bring to our work. The musical examples contained on the CDs that accompany the book are inspiring examples of creative musical commitment and mastery. In particular, Lee’s explorations with the Penderecki String Quartet and his own solo improvisation based on clinical themes developed in therapy with his clients, might be enjoyed for their musical sensibility, independent of their music therapy context-even while acknowledging Brynjulf Stige’s concerns about the possible adverse effects on the practice of music therapy of doing so. Stige (2002) cautions that when music therapists decontextualize the music that results from their therapeutic endeavors, emphasizing its value as works of art to be listened to, Therapy Music in music stores will be a logical consequence. This development could lead to a scenario in which music therapists are tempted to choose clients that are musically interesting in order to strengthen their chances in the Therapy Music market muddying a client-centered focus.

As a NR therapist, this reviewer was particularly alert throughout the book to identify aspects of AeMT that differ from the Nordoff and Robbins approach, a point of intent made clearly by the author in the opening chapter of the book. Lee maintains that he has extended his own theory and methodology to the point where they no longer fit within the parameters of the NRMT approach upon which it is based. This may or may not be so.

Lee suggests that AeMT evolved as an extension, or continuation of NRMT, and is distinguished as a separate method in that AeMT: (1) expands the study of improvisation to include pre-composed music literature, (2) extends the instruments used by the therapist to include guitar and other orchestral instruments in addition to the piano, (3) expands the musical resources used in the clinical setting to include present-day musical trends in classical, popular, jazz, dance, and world music, (4) understands music therapy in terms of music itself, (5) understands the music therapy process/session/improvisation in terms of universal musical structure, and (6) examines musical form from a music analytic and compositional foundation first and foremost. If Lee has pushed his methodology to the point where it can no longer be considered as belonging within the boundaries of the original NR model, a pertinent question could be whether other contemporary practitioners of the Nordoff Robbins approach have not moved beyond the parameters set by the original methodology as well. Although I can attest to the fact that elements from the author’s list of defining characteristics for AeMT can also be found in the work of other clinicians who consider themselves to be Nordoff Robbins practitioners, I am less confident in insisting that these current practitioners have remained within the original model as described in the writings of the founders. Indeed I would contend that NRMT has certainly changed in reaction to forces and events that its originators could not have possibly foreseen 25 years ago. Does that necessarily lead one to conclude that we are not currently practicing NRMT? I find this to be an ongoing, open question that eventually must be addressed.

The author identifies the cornerstone of AeMT as a belief that this model of music therapy offers clients the opportunity to be free of their pathology and/or illness. This philosophical viewpoint bears more than slight resemblance to Nordoff and Robbins’ concept of the Music Child, the individualized musicality inborn in every person. What parameters, then, could we agree upon that might inform us as to when new developments fall outside an original theoretical model: client population, the inclusion of a co-therapist in the process, the use or lack of use of spoken language in the process? Certainly believing that music is the central component in the therapeutic process is not exclusive to any one model of music therapy. Or, alternately, should the Nordoff Robbins model be defined by however it is that the clinicians on salary by the Nordoff Robbins organization practice at any given time, and thereby remain in a state of continual evolution? The problem with this idea is that we deny the opportunity for new theories to be clearly formulated.

There is a certain amount of arbitrary decision-making that needs to occur to clearly define an already existing theory. For example, if we look further through Lee’s lens of the sonata form, we find that it wasn’t until the second quarter of the nineteenth century that music theorists were able to agree on a construction that applies rather badly to many eighteen-century works, and in general misrepresents the compositional practices of that century. In actuality, there is no “real” sonata form that has remained fixed for even a decade during its heyday in the mid-eighteenth century. Charles Rosen, in his prize-winning writing on the subject points out that we “assume that a form has a history – in other words, that it is subject to change: but if a form “changes,” it is not clear when it would be useful to consider it the same form, although changed, and when we must think of it as a new form altogether.” This is not merely philosophical quibble: there is no biological continuity among sonata forms, and there are many sonatas more closely related to concertos, arias, and even fugues than to other sonatas. It wasn’t until composers essentially lost interest in working with sonata form that theorists were able to define it.

Perhaps there are too many clinicians who consider themselves to be part of the continuing evolution of the Nordoff and Robbins’ approach who feel it is too early to build a theoretical fence around the approach. However, until we do establish what determines when a clinician is working within a model, how are we to know when one has moved outside the model? It seems that it is still early to be able to declare that a new theory has built on the previously established theory, but again not so much due to questions of the validity of the new theory, but because the old one might not be ready to come out of the theoretical oven yet.

“The Architecture of Aesthetic Music Therapy” reads as intimate and personal offering by a gifted, talented, and dedicated musician and therapist, and as such is a valuable and inspiring book for all music therapists. “The Architecture of Aesthetic Music Therapy” also offers a challenge to Nordoff Robbins practitioners specifically-the idea that it may be the time to consider an attempt to further refine what it is that distinguishes NR work, rather than to wait for another 50 years to see it defined by people far removed from what actually happened. As Corsini points out, “If psychotherapy is essentially a matter of philosophy, then ultimately there will be multiple systems; if it is essentially a matter of science, then there will be one eclectic system.” It behooves us to make room for efforts such as Colin Lee’s by defining that from which he, and eventually others, will attempt to distinguish themselves.


Corsini, Raymond and Wedding, Danny (1989). Current Psychotherapies. Itasca, Illinois: F. E. Peacock Publishers, Inc.

Rosen, Charles (1980). Sonata Forms. New York, London: W. W. Norton & Company, Inc.

Stige, Brynjulf (2002). Culture – Centered Music Therapy. Gilsum, NH: Barcelona Publishers.

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