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Interactive Music Therapy - A Positive Approach

br2006_075Oldfield, Amelia (2006). Interactive Music Therapy – A Positive Approach. London and Philadelphia: Jessica Kingsley Publishers. 223 pages, ISBN 1 84310 309 5.

Reviewed by Lilach Yona-Blachman, MA, San-Jose, CA, USA.

The book Interactive Music Therapy – a Positive Approach, describes the author’s work in a child development center (CDC) and explores the characteristics of her specific music therapy approach. The author clarifies her special interactive and positive approach through her clinical work with various types of preschool children and their parents: children with autistic spectrum disorder, children with severe physical and mental difficulties and children with no clear diagnosis. The book presents case studies, reports (some of which written by parents and colleagues) and research investigation. These tools enable the reader to gain a deeper understanding of different aspects of the authors’ music therapy approach and its implications. This easily read book is of use both for music therapists and for members of multi-disciplinary teams, who work with children with special needs. The book includes seven chapters and some important conclusions, coda and appendixes. At the end of the book there is a subject and author index.

The opening chapter describes the author’s unique music therapy approach and builds the base for the reader to easily understand the following chapters. The author introduces an eclectic approach that does not subscribe to one psychological or music therapy model, but puts an emphasis on its positive and interactive elements. For example, although the author’s approach fits in with Alvin’s music therapy method and involves mostly improvised music making, more specifically than Alvin, she emphasizes the importance in that the child will experience the sessions as an enjoyable time. The author makes some interesting remarks regarding the link between her specific approach and her personal life narrative, as well as parallels between music therapy improvisation and chamber music playing. However, sometimes the variety of themes introduced in the first chapter, seem to be unconnected to one another. In the next chapters the author describes her music therapy approach in specific clinical situations.

Chapter two is about working with autistic spectrum disorder children (ASD) and their parents. In this chapter the author describes her work with the main client group that enabled her to develop a specific way of working throughout the years. This chapter introduces the reader to the setting of working with this client group in a CDC and provides some good suggestions about the procedure of writing notes and reports. In this chapter the author presents five very different case studies and shows the great variety of work in this area. While reading these case studies I could feel the enthusiasm of the author regarding the work with this client group and her special focus on the family as a whole unit through the sessions.

In the first half of chapter three, the author continues to describe her work with the same client group, but focuses on characteristics of her approach. Whereas in the former chapter she mentions along the case studies some important elements that are central to her approach, in this chapter she clarifies them. For example, the author elaborates the crucial point of structured sessions and music making, while regarding the case studies of the former chapter. In addition, there is an emphasis of her non-verbal improvised musical interactions in her work, which form her interactive approach. In the second half of this chapter, the author gives a comprehensive literature review and examines how her approach fits in with general approaches to autism and with other music therapist’s work. I find this chapter the most rich, interesting and useful one, since it ties both the clinical work and the theoretical materials, while stressing the uniqueness of the author’s positive and interactive approach. Some of the comments are very important for the beginner as well as the experienced music therapist, who work with children with autistic spectrum disorder. For example, on page 72 the author deals with the important issue of control, while working with ASD children and suggests several constructive interventions in how to handle it.

Chapter four deals with music therapy with individual children suffering from severe physical and mental difficulties. The author describes her work with this client group in three case studies, characterizes it and compares it to working with ASD children in a way that helps the reader to see the difference between these two client groups. The reflections part is written in a very sensitive manner, generously sharing with the reader not only the good feelings and the positive approach, but also the potential failures and mismatching with the client. For example, when the author writes about the slow pace of music therapy sessions with children with severe physical and mental difficulties she describes the danger of being drawn to low energies and passive moods.

Chapter five is about music therapy with individual children with no clear diagnosis. In this chapter, as well as in the previous ones, she focuses on working jointly with parents and on the strengths of both the child and the parent. This main factor in her approach relates to the positive aspect of being together in an enjoyable and playful situation, rather than looking for diagnosis or patterns of disability. In this chapter the author presents briefly three case studies and interweaves some interesting reports from co-workers and parents. These enrich the reader with another point of view about the child and the treatment. Like the other reflections which where mentioned along the book, the author has tried here to identify patterns in her approach to this client group. This time, the attempt seems rather artificial and does not convince me as a reader.

Whereas in the five previous chapters, the author described her approach regarding the individual music therapy sessions for three client groups and their families, chapter six considers the context of music therapy groups. Here, the author describes the special alignment, which has to be done towards a music therapy group session. She explains how she organizes and prepares for these sessions and how the thinking and objectives behind this work differs from individual music therapy. In this chapter she describes her work and approach with four different types of groups at the CDC and lists relevant musical activities. I find the part about seeing children in pairs, the most rewarding and interesting one, since this kind of work is quite complex and not so usual. This is an important chapter not only for beginners but also for experienced music therapists as well, and there are some very constructive remarks, such as, the one on page 131, under the headline “group objectives.” The author talks about the music therapy group as a support and teaching group for staff members, particularly when working with children with severe physical and mental difficulties. For music therapists who work with this client group this remark can give justification and legitimacy to keep these objectives in mind in some cases.

In chapter seven the author describes a research investigation into music therapy for ten children with ASD and their parents. In this chapter she uses aspects of the investigation in order to define her music therapy practice with this client group. I will mention some of the main aims in the study: finding whether changes were occurring in the children, finding out how the author distributed her time during the session between playing different instruments and using movement and looking at how the parents benefited from being in the music therapy sessions with their children. The study utilized various tools, such as: video analysis of the sessions, structured interviews, parenting stress index and music therapy reports.

The author, Amelia Oldfield is an experienced music therapist, who works with different kinds of client groups and their families, including psychiatry. She shares her experience and knowledge with the reader in a very honest and generous way. The book is well organized and flowing, with a short introduction, reflections and conclusion at almost every chapter. All of the above makes it easy to read and comprehend, even for people who are not professionals.

In summary, I recommend the book for music therapists who work with the mentioned client groups and especially with autistic spectrum disorder children and for those who work jointly with parents. Oldfield developed her approach through more than 20 years of clinical music therapy work mostly with nonverbal clients. Working with such client group usually requires the therapist to rely on spontaneous and intuitive musical improvisations. Oldfield’s years of experience helped her find the rational behind these intuitive improvisations. This book takes the reader through a journey of experience which inspires the reader to have an insight into his own developing approach with a specific client group.

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