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  • Writer's pictureCarla Tanguay, MA, MT-BC

What Happens in a Music Therapy Session?

A music therapy session is a bit like a Russian nesting doll. On the outside, it looks pretty straightforward - people are participating in music. But inside, there is so much more going on. Right underneath the surface are the non-musical skills and goals that the session is built upon. Go deeper and you will find another layer representing all of the unique and amazing ways music engages the brain. Open another layer to examine the research that informs our interventions. Then, at the heart of it all lies the human connection that is the foundation of the therapeutic relationship.

If you have never participated in music therapy before, you might wonder what actually happens during a session. There is no simple answer, because there is no such thing as a “typical” music therapy session. Each session is different and tailored to the individual needs and preferences of the client or group. Sessions can look so different because music therapists work with a wide variety of ages and populations on many different goals. What sessions do have in common are the inclusion of music and goal or purpose.

In order to illustrate what might happen during a music therapy session, I've created five snapshots that provide a glimpse into several different music therapy sessions. Client names and details have been changed to protect privacy, but each of these vignettes presents an authentic example of what happens when the power of music meets a therapeutic relationship.



Kelli attends a preschool for children with Autism Spectrum Disorders, so she comes to music therapy sessions with her 1:1 ed tech. I provide sessions in a special room at the school, where I set up a variety of instruments, a movement area, and chairs. We start each session with the same greeting song in order to help frame our time together with a familiar beginning and ending. I sing and play this song on my guitar while seated across from Kelli, and provide opportunities for her to strum the guitar in order to keep the music going. Right from the beginning of the session, we are connecting through the music, which requires both of us to participate and work together in order to create the rewarding sounds of much-loved songs.



Brenda requested a music therapy consultation to help with problems she is having with her speech after a recent stroke. I arrive at her house for an assessment, and spend time talking with her and her spouse about her primarily challenges and what areas she hopes to improve using music therapy. We discuss the areas of her brain that were most affected, and what music therapy techniques have proven most effective in similar cases. We also talk about Brenda’s favorite types of music and her involvement with music throughout her life. As we talk, I evaluate her current speech patterns and I ask her to demonstrate reading out loud. I then ask her to sing a familiar folk song from memory and to sing the printed lyrics of a less-familiar song. We try several rhythmic techniques in order to determine their immediate impact on her speech, and then we develop a treatment plan that fits with her goals and budget.



Sam receives music therapy services at home, which allows his primary caregiver to participate in sessions and continue to use the techniques I demonstrate in between sessions. I arrive at the house with a large bag of instruments, puppets, and props, and my guitar slung over my shoulder. I typically sit on the floor in the living room, as this is where Sam spends most of his time playing and exploring. Today, we are working primarily on producing speech sounds, and I have brought along a variety of instruments and puppets in order to encourage vocalizations. I sing a variety of well-known and specially composed children’s songs that cue and encourage vocalizations. Sam’s father records some of these songs on his phone so that he can continue using them between visits.



When I arrive for a music therapy group on the memory care unit of a local residential care facility, the residents are seated in a circle awaiting my arrival. “Oh good, music!” I hear someone say as I unzip my case and pull out my guitar. I take a minute to tune my guitar, set up my speakers, connect my iPad, and check in with staff about any significant changes with any residents that I need to be aware of. As quickly as I can, I launch into our first song, which is the same each week in order to establish a familiar interaction that everyone can be successful at. During this song, I greet each resident by name and thank them for being part of our group today. This often elicits smiles and handshakes even from those who seldom speak. Today’s theme is “Summer,” and with my guitar and voice, I lead the group through a wide variety of popular songs related to summertime weather and activities. We incorporate opportunities for discussion, reminiscing, and seated dancing. Throughout this group, I am adjusting the music in real time to match the group’s energy level, pausing in order to encourage a specific resident to sing a word or line, making eye contact and tapping a rhythm with someone, and finding a way to connect with each participant.



Krista loves having sessions outside. When the weather cooperates, we lay down a blanket and unpack our ukulele’s in the shade of the porch. Krista sees me for adaptive lessons, as she has always wanted to learn to play an instrument but her short attention span and reading challenges made traditional music lessons frustrating. Today we are working on aural discrimination, or listening skills, so that Krista can identify when chord changes happen. Before we start, we use a few movement songs to get our bodies energized and mind focused. If you walked by at this point in our session, you’d see two people jumping up and down, freezing in place, and laughing!


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