Music therapists work in special schools, prisons, hospitals, and private practice—in short, wherever there is a need. Clients of all ages come from a variety of backgrounds and include autistic children, people with mental or developmental disorders, and geriatric patients.

Palliative care

Deborah Salmon, a music therapist at Montreal’s Royal Victoria Hospital, visits patients in the palliative care unit. She may compose a song with a patient’s help, improvise with another, play an immigrant’s favourite national folk tune, or help a patient breathe evenly in response to the rhythms of her flute. “You can comfort someone through music, break through a patient’s isolation, and soothe fears about death,” she says.

Lilian Eyre conducts music therapy sessions with adult psychiatric patients at the Montreal General Hospital. She likes to use group improvisation, which allows patients to express their moods and ideas on their preferred instruments. Improvisation encourages musical dialogue, and patients must learn to compromise, to listen and adapt their playing to what the others are doing. “Patients who suffer from anxiety, are schizophrenic, or manic-depressive develop basic abilities that help them function in society,” Eyre explains. For the last three years she and Dr. Marie-France Bourdeault have organized a choir called Music Art. This innovative project, which won the first prize offered by the Canadian Psychiatric Association in 2000, requires motivation, discipline, and concentration on the part of the patients. “Following this experience, some patients have been able to move back into society through volunteer work or parttime jobs,” says Eyre.

Musical self-expression

Debbie Carroll, professor of music therapy at UQAM (Université du Québec à Montréal) says that to appreciate the uniqueness of this therapy you must understand music’s basic characteristics. Unlike verbal expression, which is linear, music offers many elements (notes, rhythm, dynamics, timbre, and texture) that allow people to express themselves on several levels at once. Music also stimulates a variety of responses, and the therapist’s choice of music will depend on the treatment’s goal. Music provides a stable framework with a definite beginning, climax, and ending. The music therapists’ role is like directing improvised theatre. They guide the sessions without imposing their own ideas, making sure the experience remains positive and enriching. Most of all, therapists must be musical jacks-of-all-trades, able to arrange and transpose tunes, to play one instrument well, and to sing and play guitar with reasonable ease.

A bachelor’s degree in music therapy is offered by four Canadian Universities: Capilano College in British Columbia, Windsor and Wilfrid Laurier universities in Ontario, and UQAM in Quebec. The curriculum includes general music courses, a music therapy section (methodology, techniques for different types of client or patient, and three periods of in-service training. “The academic courses give a good theoretical grounding, but it’s mainly the internships that teach you the actual work and enable you to go out on your own,” says Carroll. After the degree, the student has to complete 1000 hours of supervised internship to get professional accredication from the Music Therapy Association of Canada.

Once accredited, therapists must make their own way. The reality of this still young profession often includes parttime contracts, the need to create one’s own job, and lack of financial support (especially in hospitals where, although music therapy is appreciated, it isn’t considered essential). Lilian Eyre continues to be optimistic, because once openings are created they tend to remain. The effects of music therapy are clearly recognized. With the growing number of therapists has come an increasing amount of documentation and research in the field, she points out. Wilfrid Laurier University is offering a master’s degree in the subject, starting this year, and there is talk of a combined program of therapy through the arts at UQAM and Concordia University in Montreal. In July 2002 the tenth music therapy world congress will be held in Oxford.

In Canada, the CAMT is organizing lectures and workshops to increase public awareness of the work of music therapists. Debbie Carroll notes the growing number of recent publications. She says this progress has been made possible by the daily work of deeply committed music therapists.

[Translated by Jane Brierley]