In this section, we’ll focus on a few clinical examples in which music was improvised to engage clients. Notice the range of music that each of us can offer, based on many considerations.

My many years of clinical experience has demonstrated to me the direct communicative power of spontaneous music and musical changes. 

  1. Step 1: Be present, listen, observe, and be in touch with your clinical intuition & experience

  2. Step 2: Play, form, develop

  3. Step 3: Incorporate, listen, change, develop, end


The music we create in sessions is based upon many variables:

  • the client's musical and clinical goals

  • his present state of receptivity, energy, affect

  • the music therapist's available musical craft, repertoire and style

When we make an opening musical initiative, we are creating a basis or structure from which we can then elaborate, develop and change.

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

As the therapist improvises in a blues style, the client sings and plays the piano beautifully engaged in a flow of music. He seems to relate strongly to this style of music and even plays single tones related to the key of the music.