Engaging Clients through Improvised Music

Part I: Definition, Approach and Readings

The CBMT Certification Domains include many music-related skills needed to work effectively. These include the ability to adapt music, use creativity and flexibility, and utilize improvisation. If you are a musician who has studied classical music, playing only from the page, or if you are a therapist currently playing songs in sessions but feel limited in how you can use them, we’ll look at ways in which you can take the next steps in creative freedom.  

Experience shows that music therapists can engage and support clients strive toward greater expression, musical participation, and relationship through our ability to create music spontaneously. Improvising or adapting music that relates closely to a client’s efforts, mood, or preferences can play a significant role in a music therapy process.

Gary Ansdell writes in Music for Life that relationship comes when the client “…experiences a relationship between his playing and the music of the therapist. He hears himself being heard and responds to his being responded to.”(p.29) As we embark on this course, keep in mind that everything discussed is in the context of therapy, human relationship, and music making in the service of the needs and goals of your client(s).

What is Improvisation?

The term improvisation has many meanings and, likely, many associations for each of you. Here are some typical definitions:

“In music, a performance that is not practiced and that is invented by the performers.”— Cambridge Dictionary

“Something that is improvised, in particular a piece of music, drama, etc. created spontaneously or without preparation.”— Oxford Living Dictionary

“A performance of a play or a piece of music in which the performer invents words or musical notes that they have not learned or prepared before—Macmillan Dictionary

These definitions seem reasonable; all refer to the spontaneous creation of something new. Yet, each seems to simplify the origins of improvisation, stating that it is “not practiced”, is “without preparation”, and is “not learned or prepared before.”

In reality, without the prior development of your musical craft, creating music, especially compositionally and clinically-based, would be quite difficult! Realize that the musical skills you already possess, along with your ability to be spontaneous in other areas of your life, will enable you to adapt or improvise new music.

A fourth definition, found in the article “Improvisation” from Grove Music Online may be more relevant and reflective of the range of what can occur during improvisation in music therapy sessions:

Creation of a musical work, or the final form of a musical work, as it is being performed. It may involve the work’s immediate composition by its performers, or the elaboration or adjustment of an existing framework, or anything in between.”
— https://doi.org/10.1093/gmo/9781561592630.article.13738

What is Improvisation in Music Therapy?

In my approach, improvisation refers to music crafted and played in response to the client, in pursuit of goals and to support the ongoing process in each session. The focus is on communication, interaction and relating purposefully through music. The term Clinical Composition is often used to address this clinically-directed music making.

Improvised music may take the form of:

  • Creating and developing new musical themes, songs and compositions->Compositional (Clinical) Improvisation

  • Extending and elaborating on pre-composed music (any genre, style, music therapy repertoire, etc.)

Compositional improvisation is based on the sense that form in music is vital. Form organizes the music we make and the way in which it is received by the client. Form can be based on any, or a combination of, the following ideas:

  • A rhythmic figure or groove

  • Tonality (major, minor, various modes),

  • specific musical style

  • Harmonic progression

  • Melodic phrases

Often there is repetition which helps us develop a sense of relationship to the music. Importantly, when we improvise, we can use form to organize ourselves and our musical creations.

What Compositional Improvisation is NOT:

  • Music making that lacks a clinical focus, i.e., free-wheeling or self-gratifying music making

  • Music that lacks any structure or organization

Important: I want to emphasize that I am speaking in a general sense here. Some clients will benefit by an intentional loosening of musical structure at times.

In the section entitled Preparation of a Session", Bruscia writes:

By their very nature, improvisational therapy sessions need to be spontaneous yet planned, and open-ended yet structured…

In some models, the therapist formulates a long-range goal plan or overall therapeutic approach at the beginning of therapy and modifies it at periodic intervals thereafter. In other models, the therapist maps out the direction of therapy in shorter time frames. In some models, the therapist makes detailed plans for each session, whereas in others, the therapist allows each session to emerge according to some natural or organic structure.

Whether the model employs highly structured, planned sessions, or very spontaneous and open-ended ones, all therapists make certain basic preparations.
— Kenneth Bruscia, Models of Music Therapy, p. 15.


This initial choice sets the stage for a musical path that follows predictably or with creative contrasts and surprise.

Know your musical craft


Working with Pre-Composed Music Improvisationally

The development of musical mobility will then depend on your deliberate use of what are here termed Expressive Components:

Changes in tempo: Accelerando, Ritardando, Tempo Contrast, Fermata, Rubato

Changes in dynamics: Forte, Piano, Crescendo, Diminuendo, Dynamic Contrast, Accentuation
— Nordoff & Robbins, Creative Music Therapy, p. 321




An ongoing examination of music and of the experiences individualized musical activity can bring to children shows what an enormous, unlimited range of active, self-integrative experience improvisation makes available for therapeutic realization. There is the open palette of emotional awareness on which to draw: in addition to the more commonly shared range of emotions, all kinds of individualized moods and nuances of feeling can be generated, all subtleties and progressions of change, all degrees of intensity, all qualities of intimacy and mutuality. Improvisation can readily convey experiences of form and order, from the minute to the extensive, the simplest to the highly complex. These include the predetermined forms that induce stability into activity, and the forms that are spontaneously, expressively realized.
— Nordoff & Robbins, Creative Music Therapy. p. 4.
Permeating everything musical are the basic elements of tempo and rhythm, fundamental to music and fundamental to our extramusical organization and life. The uniquely significant melodic element contains all the above, as well as the possibilities for expressive nonverbal communication. Moreover, the melodic element offers the evocative concurrences between speech and music—
which also make directly possible in song, the setting and expression of statements and concepts that have especial meaning for a child. All this is inherent in the relationship between the human being and music; all this is available for creative therapy with the music child.
— Nordoff & Robbins, Creative Music Therapy, p.4.