Music Therapy Instruments and Techniques

Music therapy uses music, played and listened to, as the working medium of a therapeutic relationship. It may suit people who find talking difficult, and people for whom music already matters. Because music can be shared without words, it offers a way of expressing something and being heard when speech is hard to reach.

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Overview of Musical Instruments Used in Music Therapy

In music therapy, instruments are not only for making music. They are chosen for what they make possible in a session, such as emotional expression, sustained attention, or physical movement.

Common Instruments

• Pianos and keyboards: These are versatile, and their range of melody and harmony gives you room to work with feelings that are hard to put into a single sound or word.
• Percussion instruments: Drums and similar instruments are used to work on movement and coordination, and they invite unplanned, direct expression. In groups, percussion gives people something to do together without needing to talk.
• String instruments: Guitars and violins produce sounds that many people find settling, which can make space for quieter, more reflective work.

Unique Instruments and Found Objects

• Electronic sound-producing devices: These can be adapted for people with limited movement or strength, so that someone who cannot hold or strike a conventional instrument can still make the music themselves.
• Found objects: Making music with everyday items removes the question of musical skill, which some people find frees them to experiment with sound and rhythm.
• Voice: Singing and vocal exercises use the one instrument everyone already has. For some people the voice is the most direct route to expression; for others it feels too exposing, and that is worth saying to your therapist.

Instrument Selection by Therapists

Music therapists choose instruments with your therapeutic goals in mind, taking account of your physical abilities, how you are at the time, and the music you actually like. The aim is that each session works with you rather than around you, and that you stay engaged in it.

Core Techniques in Music Therapy

Music therapy draws on several techniques, applied according to what you are working on. They are used to support communication, emotional expression and, in some settings, cognitive and physical rehabilitation.

Improvisation

Improvisation is central to music therapy. You make music as it comes, without a set form to follow, so that what you are feeling can be expressed at the moment it arises rather than described afterwards. Improvising on a drum can give physical release to agitation; improvising with the voice can bring out tones a person would not have chosen deliberately. What comes of it differs from person to person and from session to session.

Rhythmic Synchronisation

This technique uses steady rhythmic patterns to support movement and coordination, and it is one of the more studied parts of music therapy in rehabilitation. A Cochrane review of music interventions after acquired brain injury found that rhythmic auditory stimulation may improve walking after stroke, while rating the certainty of that evidence as low to very low and calling for more high-quality trials [1]. People also use rhythmic work for anxiety and stress, and in groups the shared pulse gives people a common activity, though these uses rest on clinical practice rather than on a settled evidence base.

Melodic Intonation Therapy

Melodic intonation therapy is used with people who have communication difficulties, most often after a stroke. It works with the musical elements already present in speech, melody and rhythm, in structured exercises aimed at supporting language. The Cochrane review of music interventions after acquired brain injury reported that music interventions may be beneficial for communication outcomes in people with aphasia after stroke, and that more high-quality trials are needed before firm clinical recommendations can be made [1]. How the technique works in the brain is still being researched; explanations that describe it as rerouting speech around damaged tissue go further than the evidence does.

Advanced Techniques and Their Applications

As therapy goes on, your therapist may introduce more structured methods, depending on how you have responded so far. These are used where the work has become more complex, emotionally or cognitively.

Extemporising and Frameworking

These are forms of improvisation with more shape to them. Extemporising starts from a stated musical idea and lets you expand it, which can hold the work near a particular theme. Frameworking sets a basic musical structure and leaves you to improvise inside it, so there is something fixed to return to while you experiment.

Clinical Improvisation

Here the therapist plays with you and responds to what you play as you play it. The exchange is musical rather than verbal, and it is shaped by what is happening between you in the session rather than by a prepared plan.

Group Therapy Techniques

In group music therapy the techniques are used to support interaction, turn-taking and shared expression. Some people find a group easier than individual work, and some find it harder; which suits you is worth discussing before you join one.

The Therapeutic Relationship and Musical Tools

The relationship between you and your music therapist carries the work. Instruments serve that relationship, giving the two of you a way of communicating when words are not available or not enough. You can search for a qualified music therapist near you on TherapyRoute.

Building Rapport Through Music

Playing together often establishes contact before much has been said. Your therapist may use an instrument or a piece of music that means something to you, to make the early sessions less daunting. Starting with a familiar song is one common way of doing this.

Client-Centred Approach

Your preferences and your responses guide which instruments and techniques are used. Whether you are drawn to a string instrument or to a drum circle, the sessions should be shaped around what you are working on, not around a fixed programme.

Feedback and Adaptation in Sessions

Your therapist relies on your responses to adjust the work. That might mean changing the instruments, the pace, or the kind of music played. If something in a session does not sit well with you, saying so is part of the process rather than an interruption to it.

Innovations in Music Therapy Tools and Techniques

New tools and methods continue to enter music therapy practice, most of them widening access rather than replacing what already works.

Exploring New Instruments

Bringing in unfamiliar instruments can open different ways of playing. Electronic instruments that shape digital sound are often taken up readily by younger people and by anyone comfortable with technology.

Advancements in Techniques

Technology-assisted devices for making and controlling music allow people with limited movement to play rather than only to listen. For someone who has been excluded from music-making by physical difficulty, that difference in autonomy matters.

Integration of Digital Music Platforms

Digital platforms and software for creating and sharing music are increasingly used in therapeutic settings, to record sessions, to work remotely, or to shape sounds. They can also let you carry on with music between sessions.

Connection with Narrative Therapy

Music therapy is sometimes combined with narrative therapy, so that a person's own account of their life is worked into the music-making. Songwriting is the usual form this takes.

If music therapy does not appeal to you, look at the different therapy techniques and tools available and find an approach that suits you better.

Key Takeaways

• A wider range of options: New instruments and digital tools have broadened what music therapy can offer, particularly for people who cannot use conventional instruments.
• Access, not novelty: The value of adapted and electronic instruments is that they let more people take part, including people who have been left out of music-making until now.
• Sessions are individual: Instruments and techniques are selected around your goals, abilities and musical taste, and are changed as those change.
• Evidence varies by use: Rehabilitation uses such as gait and communication after stroke have been reviewed in trials, with the certainty of the evidence rated low; other uses rest mainly on clinical practice [1].
• Training and registration differ by country: Whether music therapy is a regulated profession where you live, and what qualification a practitioner must hold, depends on the jurisdiction.

FAQ

What qualifications are necessary to become a music therapist?

This depends on the country. In the United Kingdom, "music therapist" is a protected title and practitioners must be registered with the Health and Care Professions Council [2]. Elsewhere the profession may be registered under a different body, or not registered at all, and the required qualification ranges from an undergraduate degree with supervised placement to a postgraduate one. Training generally combines music, psychology and supervised clinical practice. Check the registering or professional body in your own country before assuming a standard applies.

How do I know if music therapy is right for me or my family?

If music already means something to you, or if you are looking for something alongside or instead of a talking therapy, music therapy is worth asking about. It is often suggested for people who find conventional therapy hard to use, or who have difficulty with speech. A first consultation with a music therapist will tell you more than a general answer can.

Can music therapy help with non-emotional issues like motor skills?

It is used for that purpose, through rhythmic techniques and instrument playing, particularly in rehabilitation after a stroke or other brain injury. A Cochrane review reported possible benefits for walking and for the timing of arm movement after stroke, but rated the certainty of that evidence as low to very low and concluded that more high-quality trials are needed before recommendations can be made for clinical practice [1].

What happens in a typical music therapy session?

A session may involve playing instruments, singing, writing songs, or listening to music, with the therapist working towards the goals you have agreed. There is no requirement to be a musician.

How are music therapy activities tailored to individual clients?

Activities follow from the initial assessment and from continuing discussion of what you prefer and how you respond. Your therapist adjusts the musical choices and techniques accordingly.

Can music therapy be combined with other forms of therapy?

Yes. It is often used alongside occupational therapy, speech and language therapy, or psychological treatment, as part of a wider plan rather than on its own.

What are the latest advancements in music therapy practices?

Current developments include digital music technologies, neurologic music therapy techniques, and continuing research into how music affects brain function. Much of that research is at an early stage.

References

1. Magee WL, Clark I, Tamplin J, Bradt J. Music interventions for acquired brain injury. Cochrane Database of Systematic Reviews, 19 January 2017. https://www.cochrane.org/evidence/CD006787_music-interventions-acquired-brain-injury
2. Health and Care Professions Council. The professions we regulate: arts therapists. HCPC, United Kingdom. https://www.hcpc-uk.org/about-us/who-we-regulate/the-professions/