Music 2MT3: Overview of Music Theory
What is music therapy?
Definition: a discipline in which a credentialed professional (MTA: Music Therapist Accredited) uses music purposefully within a therapeutic relationship to support the development, health, and well-being of an individual. The credentialing body in Canada is CAMT (Canadian Association of Music Therapists).
Scope: music therapists address human needs across cognitive, communicative, emotional, musical, physical, social, and spiritual domains.
Universal phenomenon vs universal language:
Music is a universal phenomenon used globally to support wellness and social connection.
How music is used, what scales/instruments are used, and cultural traditions are not universal; culture and context shape the practice.
Music can be responsive in real time to the client, enabling flexible, goal-directed interventions.
Therapeutic use of music vs music therapy:
Music therapy involves a credentialed music therapist working within a therapeutic relationship to achieve health care goals.
The therapeutic use of music (e.g., leisure listening, entertainment, or music education) can have benefits but is not music therapy unless facilitated by an MTA with health care goals.
Mechanisms/benefits:
Music can influence mood, evoke memories, support distraction from pain, evoke movement, and aid social engagement.
The in-the-moment adaptability of music allows tailoring to client responses for health care outcomes.
The rationale for the profession’s existence:
Music use in health care is long-standing but the term and profession are relatively modern in Canada, recognized as a health care profession since the ; Canada lagged behind the in the U.S. for regulation.
The CAMT protects the MTA credential and governs standards in Canada.
What music therapists do in practice:
Work with diverse populations across settings and ages; employ a range of interventions to meet health care goals; integrate creativity and evidence-informed practice.
What music therapy is not
Not entertainment: playing live or recorded music for leisure or to entertain is not music therapy unless directed toward health care goals within a therapeutic relationship.
Not music lessons: learning an instrument or improving performance skills, even with therapeutic aims, is not music therapy unless the facilitator is a music therapist working toward health-related goals.
Not special music education: while music education can be adapted for learners with disabilities, it remains distinct from music therapy unless delivered by an MTA with health care goals.
Not a generic prescription: there is no simple music prescription (e.g., a fixed hour of Mozart or a standard playlist) for all clients; therapy is individualized and goal-driven.
How to become a music therapist in Canada
Credentialing body and title:
CAMT is Canada’s self-regulating body for music therapy; the protected title is MTA (Music Therapist Accredited).
The MTA status requires ongoing professional development and CAMT membership to maintain credentials.
Training pathway:
Six universities in Canada offer CAMT-approved music therapy degree programs (at either undergraduate or graduate levels):
Acadia University — Bachelor of Music Therapy (BMT).
Canadian Mennonite University — Bachelor of Music Therapy (BMT).
Capilano University (British Columbia) — Bachelor of Music Therapy (BMT).
Wilfrid Laurier University — Bachelor of Music Therapy (BMT) and Master of Music Therapy (MMT).
Concordia University — Graduate Diploma or Master of Music Therapy.
University of Toronto — Master of Applied Music in Health.
Admission prerequisites: applicants must be proficient in music before entering the program; the program does not teach instrument proficiency or music reading from scratch.
Auditions are required to demonstrate flexibility across genres and improvisation ability; applicants should show ability to play in multiple styles (e.g., jazz, classical, pop).
Practical skill requirements: ability to read music and improvise; strong cross-genre adaptability; creativity in applying music to health care goals.
Internship and certification:
After completing the degree, candidates must complete a one -hour internship, with supervision hours provided by a CAMT-recognized supervisor.
Following the internship, candidates must pass an exam administered by the Certification Board of Music Therapists (CBMT), referred to here as the CDMT in the transcript.
Upon successful completion of the internship, exam, and CAMT submission, the candidate is granted MTA status.
Professional practice and provincial considerations:
In Canada, health care is regulated at the provincial level; however, music therapy remains governed by a national body (CAMT) for entry and ongoing competency.
In Ontario, if a music therapist works in mental health and uses the Psychotherapy Act framework, they must also meet mandates of the CRPO (College of Registered Psychotherapists of Ontario) and obtain RP (Registered Psychotherapist) status in addition to MTA.
Where can one study and what to expect in training
Programs emphasize: pre-professional music skill (instrumental playing, reading music), and improvisation ability as part of the audition.
Flexibility across genres is crucial; clients may engage with jazz, blues, classical, pop, etc., depending on their preferences and goals.
Training expectations:
Applicants often come with a background in piano, flute, trumpet, percussion, voice, etc.; the goal is to demonstrate versatility and improvisational ability across styles.
Practical competencies:
The ability to improvise is taught and assessed; improvisation in therapy is about self-expression rather than following traditional musical rules.
Who do music therapists work with and where
Client population (age range): newborns to the elderly.
Diagnoses and clinical areas:
Acquired brain injury, autism, cancer care, neonatal care, palliative care, geriatric care, mental health, substance abuse, pain management, and general health care support.
Settings:
Hospitals, long-term care facilities, day programs, private practice, schools, rehabilitation programs.
Some MTs work across multiple sites, contracting with hospitals, schools, and community programs.
Core aim across populations:
Highlight abilities, support health care goals, improve mood and engagement, facilitate movement, speech, cognition, and social interaction.
What does a music therapy session look like
Session structure (typical):
Begin with a greeting or hello song to signal the session has begun.
Middle interventions: any combination of interventions such as singing, instrument playing, improvising, lyric analysis, songwriting, or listening to music.
End with a goodbye song to wrap up the session.
Greeting song considerations:
Should be age-appropriate, simple, and predictable to set the client up for success.
Can incorporate the client’s name (e.g., Hello to Rachel) to promote engagement and social interaction.
A pause may be included to allow the client to respond, supporting speech or social goals.
Interventions in practice:
A session may use one or multiple interventions (pre-composed music, listening, singing, improvising, lyric analysis, songwriting, etc.).
Client vs patient terminology:
In hospital settings, individuals are often referred to as patients; in private practice, as clients. The terms are interchangeable here and reflect context, not a difference in therapy.
Example of practice in action:
Boston Children’s Hospital music therapy program demonstrates how music therapy supports motor, speech, and cognitive development; facilitators use live instruments (e.g., guitar) and sometimes group sessions to promote social skills and normalcy.
Key takeaway about tools:
Therapists may adapt the instruments (guitar, chimes, etc.); clients do not need prior musical background to participate.
Group vs one-on-one:
Music therapy can be delivered individually or in groups; both formats support different goals and social experiences.
Music therapy interventions in detail (overview)
Pre-composed music (existing songs):
Used to evoke memories, influence mood, and support cognitive skills like attention and memory.
Meaningful pieces can aid reminiscence (e.g., dementia care) but care must be taken to avoid triggering traumatic memories.
Music can evoke orientation to reality and support mood regulation through beat, tempo, and rhythm.
Listening: active listening with meaning, not background music; supports cognitive development and dialogue about the listening experience.
Singing:
Supports articulation, speech rehabilitation after stroke, breath control, rhythm, and group cohesion through singing together.
Singing familiar songs can aid reminiscence in dementia and boost self-esteem through lyric recall.
Improvising:
In therapy, improvisation is about free expression with no right or wrong outcome; no requirement for musical training.
Therapists may provide simple constraints (e.g., use only black keys on piano) to reduce overwhelm and build confidence.
Songwriting:
Process-based and product-based benefits: expressing inner world, building confidence, and creating a tangible song that can be shared.
Clients can influence melody and lyrics; therapists provide options and collaborate; the end product is not the sole focus—the process is.
Songwriting supports self-expression, meaning-making, and potential legacy-building (especially in serious illness or hospitalization).
Lyric analysis:
Exploring why a particular lyric resonates reveals important client feelings and needs; can guide further therapeutic work.
Often combines with other interventions (e.g., singing or songwriting) for integrated therapy.
Interventions in practice:
Interventions are not used in isolation; therapists often weave multiple approaches to meet client goals.
Special notes on dementia/ memories:
Music can restore access to long-term memories and lyrics, supporting self-esteem and recognition of abilities despite cognitive decline.
How to engage in music therapy (referral, assessment, treatment planning)
Referral process:
Anyone can refer; self-referral is possible in community settings or hospitals.
Referral should specify the health care goal or symptom, not just a diagnosis (e.g., for speech rehabilitation after stroke, or improving attention).
No background in music is required to be referred or to start therapy.
Assessment process:
Duration varies by setting and individual; may take from a single day to several weeks.
The process involves trying different interventions, observing responses, and building rapport.
The assessment informs the treatment plan and goals.
Treatment planning and goals:
The plan specifies how interventions will meet health care goals (e.g., increase vocabulary, attention span, speech therapy goals).
Examples of goals include:
Increase vocabulary to include social interactions (e.g., hello and goodbye) leveraging the Hello/Goodbye songs.
Increase attention span to a target (e.g., minutes per intervention) through instrument playing or song-based activities.
Plans are tailored to client preferences (e.g., Elvis Presley music) and modality (live vs recorded, guitar vs piano).
The plan should be detailed enough for another MT to replicate the session.
Reassessment and documentation:
Reassessments occur typically every weeks if sessions are weekly, to determine whether to maintain or adjust the treatment plan.
Music therapy approaches and models
Neurologic Music Therapy (NMT):
Involves standardized techniques; MTs using NMT implement interventions in a consistent, evidence-based way.
Nordoff-Robbins (NR):
Emphasizes music creation as the driving force of change; therapy focuses on the music itself as a catalyst for growth.
Psychodynamic music therapy:
Music is a tool for facilitating change, with verbal processing and reflective discussion integrated into sessions.
Guided imagery-derived approaches:
Uses music listening to evoke guided imagery and imagery-based processing.
Training and variation:
Some MTs are trained in one or more of these approaches; others integrate multiple approaches depending on the client and setting.
Note on future webinars:
The webinar notes that more detail on these approaches will be provided in future sessions.
Practical takeaways and real-world relevance
The profession is diverse and flexible:
MTs work in hospitals, long-term care, schools, day programs, private practice, and rehabilitation settings.
They may specialize in specific areas (e.g., pediatric oncology) or work across multiple settings.
The emphasis is on process, not product:
The therapeutic aim is to facilitate health care goals through meaningful musical experiences and collaborative decision-making.
Ethical and professional considerations:
Use of music therapy requires ethical practice, patient-centered care, cultural sensitivity, and evidence-informed methods.
Summary statements:
Music therapy is a credentialed profession in Canada governed by CAMT; entry requires CAMT-approved university training, a 1000-hour internship with supervision, and a CBMT/CDMT exam.
In Ontario, mental health practice may require RP status under CRPO in addition to MTA.
Sessions are tailored, varied, and can be delivered one-on-one or in groups, with greeting and goodbye structures and a range of interventions designed to meet individual health care goals.
Key terms to remember
MTA: Music Therapist Accredited (CAMT-protected credential)
CAMT: Canadian Association of Music Therapists
CAMT-approved programs: Canadian universities offering degrees in music therapy
1000-hour internship with CAMT-supervised hours
CBMT/CDMT: Certification Board of Music Therapists exam
RP: Registered Psychotherapist; CRPO regulations in Ontario
NMT: Neurologic Music Therapy
NR: Nordoff-Robbins approach
Guided imagery: imagery-based listening approach
Hello/Goodbye songs: session boundary and goal-oriented tools
Quick examples cited in the session
Boston Children’s Hospital example:
Clinically trained MTs work with patients and families on diverse goals; use of guitar and other instruments; group and individual sessions; promote coping, communication, and motor/speech/cognitive development.
Dementia and memory:
Familiar pre-composed music can evoke memories and support orientation, but care must be taken to avoid triggering trauma; singing familiar lyrics can bolster self-esteem and reminiscence.