Principles of Clinical Composition II

Crafting Instrumental Experiences for Music Therapy

I. Introductory Readings


Composition can be a wonderful resource for expanding our clinical musicianship while enhancing the musical experiences we bring to clients in therapy. In Composition and Improvisation Resources for Music Therapists (Lee, C., Berends, A., & Pun, S.), the authors write:

Creating compositions, themes and song-structures for developing skills in clinical improvisation is a part of pedagogical development necessary for the development of clinical musicianship.  As a practice balanced between ‘art’ and ‘science’ therapists should be acutely aware of their own musical and therapeutic skills. Whatever theoretical orientation the therapist adopts they must all, in essence, respond to client’s playing with an informed clinical and artistic response.
— p.xv

The authors advocate for enhancing our musical awareness through the process of writing music, and then using those compositions as a platform for improvisation.

Creating compositions for developing musical resources should be a central exercise for music therapists. The practice of writing completed pieces as themes for improvisations is a creative and artistic activity that will inspire therapists to expand their musical knowing.  Identifying as a clinical composer will generate a musical freedom and expansion of styles for the client-therapist dialogue ultimately enriching the therapeutic process.  As the therapist’s musical repertoire expands so will their confidence and understanding of the balance between therapeutic and musical intent.  Clinical compositions are short pieces that can be practiced and then memorized as a part of the therapist’s musical palette.  They provide a structure that can be used for various different clinical aims. It is important once the piece is written to expand and explore the confines of its form and style. Play in different tempi and rhythms.  Alter and change the texture of the composition depending on your choice of instrument.  Considering clinical compositions as platforms to expand your musical horizons will bring ever-more creative inspirations into your work.
— p.2

Crafting musical forms independent of sessions can provide music therapists the time to explore a wider range of musical options.  In Defining Music Therapy (Third Edition), Kenneth Bruscia writes:

Composing involves all of the creative decision-making that improvising involves. The composer selects a medium (i.e., voice, instrument), selects a sound vocabulary, explores the options of the medium and vocabulary, creates certain forms and sequences, evaluates the options chosen, and then starts again to explore the myriad options for continuation.  The main difference is that composing does not require extemporaneous decision-making as improvisation does.  The composer may take whatever time is needed to deliberate and test various options before deciding on the actual content of the music.
— p. 150

Bruscia envisions composition on a deeper level as well, as a metaphor for qualities of our emotional lives:

Composing is constructing.  The composer builds a musical composition using sounds as the basic materials.  The emotional challenge is not merely finding the best combinations and sequences of sounds, but also the construction of a musical narrative that places the sounds into meaningful combinations and sequences of emotions.  The composer is expressing and commenting in sound how life unfolds—how ideas and feelings emerge, how they develop, how they become simpler or more complicated, how they return later, and how they finally arrive at some conclusion.  In this sense, a composer is an architect of emotions, expressed in sound.
— p. 147

Incorporating these composed “musical narratives” into sessions can lead to important experiences for our clients.

The use of compositions in music therapy is an important technique for expanding the musical possibilities offered to clients.  With the advent of Community Music Therapy (Stige & Aaro, 2012) and the expansion of therapeutic boundaries, creating compositions as both works in their own right and as seeds for improvisations becomes ever more relevant.  Performance as therapy (Aigen, 2014) is now being recognized as a valid part of the therapeutic process. With this understanding that allows for the boundaries of practice to be expanded, so our need for new musical structures becomes apparent.
— Lee, Berends, & Pun (Eds.) 2015, p.2

In the introduction to More Themes for Therapy, Ritholz & Robbins (Eds.) highlight the benefits of a combined clinical and musical strategy in specially written compositions.

(The collection)…offers opportunities for a diversity of musical participation… There are instrumental compositions that invite the playing of a single tone, and others that promote the skills required to play melodic phrases.  There are compositions written around simple rhythmic patterns, and others offering intermediate rhythmic experiences.  All the music has the effect of encouraging the development of listening skills, attention, and memory.
— p.6


Instructor Remarks: 

While some of you may not have composed music before, you will hopefully find the process of creating a composition a positive addition to your music therapy work, and enriching to you as a musician.

In composing for therapy, a musician has a double satisfaction: firstly, the musical satisfaction of working creatively with the marvelous expressive possibilities of melody, harmony, rhythm and form, and secondly, the purely human satisfaction of creating music caringly for the growth and fulfillment of those in therapy.  Compositions especially written to suit the clinical goals for an individual or group are often the source of continuity that carries a course of therapy forward.
— p.7