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Community Music Therapy

Pavlicevic, Mercédès & Ansdell, Gary (Eds.)(2004). Community Music Therapy. London: Jessica Kingsley Publishers.

br2005_52This text is for music therapists who have found themselves asking, “Is the work I am doing really music therapy?” Although Community Music Therapy (CMT) was initially promoted as a “paradigm shift” (Ansdell, 2002), the editors are more cautious in this text about over-stating the originality of CMT. Instead they advise that the various authors “All are involved in some kind of re-thinking about the identity of music therapy” (p.22). In his foreword, Ruud describes this as a response to the post-modern climate we find ourselves in, where context is as an important consideration. Authors in this text reflect on their practice as it ‘fits’ within the context of their workplaces and the editors see context as a pivotal feature of this discourse.

The workplaces described are varied, and although the claim of international representation is perhaps a stretch, the authors have trained in the United Kingdom, Norway and the United States. The clinical work described is drawn more broadly from Israel, Germany, South Africa and Northern Ireland, as well as these countries of training. In analysing the context of this text, the final piece in the puzzle is the recognition that many authors are trained in the ‘old’ CMT – the Creative Music Therapy of Paul Nordoff and Clive Robbins. There are numerous links to this predecessor, from the emphasis on music therapy services being provided as a continuum, to the natural outcome of performance as a feature of this work.

The performances described in many of the chapters are touching and powerful. Zharinova-Sanderson outlines some empowering work with a Kurdish refugee from Turkey who is gradually able to accept his female music therapist as a collaborator in his musical expression. Together they work towards a performance of his traditional music to an audience of German politicians and VIPs who respond by joining in with the rhythmical pulse of the music. Amir describes supporting a Russian-born woman to integrate into Israeli culture through the re-igniting of her identity as a piano performer, celebrated through performance. Maratos challenges the carefully built boundaries of music therapy work in a psychiatric hospital when she chooses to incorporate a rehearsed performance of a musical into the program – the staff begins to wonder ‘whatever next?’ Aigen presents the work of three of his colleagues in New York, all of whom utilise performance as a regular outcome of their work. Powell incorporates her years of experience in community music into a nursing home setting, recognising the importance of creating performances from within the community as part of a spectrum of interventions that respond to identified need. Finally, Aasgard gloriously describes his impromptu performances within a paediatric hospital, asking “When am I therapist, when am I entertainer?” (p. 149).

This identity crisis within the multidisciplinary team is one of the challenges identified by authors adopting a broad approach to the music therapy encounter. Her peers question Maratos as they consider performance to be a risk to clients who experience performance anxiety in addition to their ongoing mental health issues. Ramsey (in Aigen’s Chapter) describes his own performance anxiety in the newly vulnerable identity as therapist/performer. Aigen also articulates the dilemma of less clearly defined relationships with staff because of the more challenging agenda. Powell clarifies this new position for the music therapist as extending the relationship with music beyond the music therapy session, and Amir emphasises the importance of being with the client as they move into more communal ways of musicking.

The editors acknowledge these challenges to our professional identity as THE question most commonly posed about the new CMT – is it dangerous? In response, they argue that this text highlights the importance of reflexive practice – practice that constantly questions and considers its value to clients, rather than assuming that regular meetings in boundaried spaces provide all the safety required for ethical practice. All the contributing authors consider these important issues around conduct, but will this always be the case as the inclusion of performance becomes more common?

This is where Procter argues that a political stance is a prerequisite for the community music therapist in order to maintain appropriate attention on this new work. The editors, who consider political stance to be a characteristic of the discourse, also endorse this position. However there seems to be some divide here between the theory and the practice of CMT. As Amir notes, the dichotomy between the ‘consensus’ and ‘community’ models does not exist so clearly in practice, where therapists are trained to be flexible and responsive to clients needs, and will commonly work in non-traditional ways when required. She describes the work of an Israeli music therapist in special education who regularly works towards performances for the last six weeks of his program as a “passage to community life” (p.264), rather than constructing music therapy as a closed educational unit. Yet the discourse on CMT implies a more focused approach to social justice and social change. Ansdell refers to ‘Musical Communitas’, and Stige to ‘culture-centered’, with both theorists promoting a greater awareness of the potential of music to promote community growth. Stige outlines the clients of CMT as “relatively disadvantaged” (p. 103), and constructs this within a relational concept of health. The rigorous underpinnings of Stige’s theoretical perspective are succinctly captured in his contribution to this text and are drawn upon frequently by the editors in their commentary.

But does the theory match with practice? And, does it need to? As promised early in the text, the editors have asked questions more than provided answers. Stige states that he cannot say what CMT is, only what it is for him, and this is reflected throughout the text. Instead of providing answers, the editors tentatively propose a metaphor for CMT – the ripple effect that is pictured on the cover. Personally, I still cannot decide whether a label is necessary for this work, as practiced. The clinical chapters describe work that is both fascinating and familiar. Perhaps the new CMT is, in fact, a theoretical framework that supports a new stance to practice rather than a new way of practicing. The recent forum at the 11th World Congress of Music Therapy in Australia provided some support for this (hosted by Ansdell, Pavlicevic and Stige), but also challenged training courses and professional associations to acknowledge this stance. The audience suggested that CMT requires re-clarification of ethics documents, appropriate training of music therapists to support this new emphasis on performance, and a willingness to be life-long learners who consider the implications of practice for clients and communities. This text has consolidated the debate and further articulated the discourse. I believe it is an important contribution to the development of music therapy.

References:

Ansdell, Gary (2002). Community Music Therapy & The Winds of Change. [online] Voices: A World Forum for Music Therapy. Retrieved July 26, 2005, from http://www.voices.no/mainissues/Voices2(2)ansdell.html

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