\

UNIT TWO

CREATIVE MUSIC THERAPY

(NORDOFF-ROBBINS MODEL)

Introduction
Assessment and Evaluation
Treatment Procedures
Dynamics and Process
Summary and References
 Chapter One

INTRODUCTION

BACKGROUND
REATIVE music therapy is an improvisational approac? to individual
C and group therapy developed by Paul Nordoff, an Amencan composer-
pianist, and Clive Robbins, a British-trained special educator. Nordoff and
Robbins collaborated closely from 1959-1976 (22), working as therapist and
cotherapist with mentally, emotionally, and physically handicapped ~ildren in
a variety of settings and locations (15,16,17). During their 17 years of pioneer-
ing work, Nordoff and Robbins kept comprehensive notes of their clinical
work, and tape-recorded all of their sessions of individual music therapy. They
also wrote extensively about their clinical and research findings, and developed
a vast repertoire of musical materials for use in therapy.
Robbins has also collaborated with his wife Carol Matteson Robbins since
1975, when they began to develop a comprehensive approach to music for
hearing-impaired children (22). Since then the Robbins' have travelled exten-
sively in the USA and abroad, teaching creative music therapy and giving
workshops on their own work, while als_o continuing to do clinical work.
Since Nordoffs death in 1976, the~Robbins-Robbins team has worked
steadfastly to develop associations and centers around the world for the study
and advancement of Nordoff-Robbins therapy, and to archive the enormous
legacy of clinical and training materials produced over the years by Nordoff
and Robbins. To date, Nordoff-Robbins music therapy associations and cen-
ters have been established in England, Scotland, Denmark, West Germany,
and Australia (2), and various instructional materials have been prepared for
public~tion (10,11,17). In affiliation with the City University of London, the
cent.er m. England offers a one-year course leading to a graduate diploma and
cert1ficat1on as a Nordoff-Robbins therapist; the center in Herdecke, West
?ennany is initiating a two-year postgraduate course (2); and a training course
lS anticipated in Australia in 1986.

23
24 Improvisational Mod.tis of Music Therapy

SALIENT FEATURES

The Nordoff-Robbins approach is called "creative" because it involves the

therapist in three interrelated levels of creative work (23). First, the therapist
creates and improvises the music which will be used as therapy. Second, the
therapist uses the improvised music creatively within each session - to seek
out, gain, and maintain contact with the client from moment to moment- to
"create" the therapeutic experience. Third, the therapist also creates a progres-
sion of therapeutic experiences from session to session, supporting stages in the
client's creative development. Thus, the therapist creatts: the musical resources
to be used within each therapeutic experience, the therapeutic fxperiences and
techniques to be used in each clinical circumstance, and the· process whereby
these experiences and techniques are sequenced.
The primary purpose of the therapist's improvising is to, engage the client in
music-making (15). In fact, the client's responses to musi~·are at the very core
of the therapeutic experience, and it is through the coactive music-making of
the client(s) and therapist(s) that therapy takes place (16) .. '
Creative music therapy is an active rather than rec_eptive approach. That is,
the approach gives greater emphasis to making music than to merely listening
to it (11, 12, 13). Although listening can be clipically useful, active music-
making engages the child's attention, draws him/her into active involvement
and personal committment, and diverts inner experiences outward (4). In ad-
dition, as the child remains active, the music keeps changing. The changes in
the music in tum keep his/her emotional experiences in motion, thereby mak-
ing them accessible to exploration and transformation (13).
In the Nordoff-Robbins approach, music is used as therapy rather than in
therapy. That is, music is the primary means of motivating and effecting the
client's therapeutic growth, providing both a stimulus and a response medium
for the therapy process to take place. "It is out of this completeness of the rela•
tionship between music and the human being that music therapy in its truest
sense arises" ( 15: 17). Music is not used as one of many treatment techniques or
merely as a tool for establishing the therapist or therapist-client relationship
but as the principal therapeutic agent. Moreover, verbal intervention is kept to
a minimum (16).
In individual therapy, musical improvisation is the predominant means of
interaction between the therapist and client, and serves as the main crucible for
therapy.
. . . the therapist will find the essence of music aa therapy to lie in his impro-
visational creation of music as a language of communication between him
and an individual child. The •words" of this language are the components of
music at his disposal, its expressive content is carried by his use of them. In
the clinical situation he becomes the centre of musical responsiveness him-
self; the music his fingers draw from the instrument arises from his imprcs•
 Crtative Music Therapy 25

sions of the child: facial expression, glance, posture, behaviour, condition -

all express that presence his music will reflect and go out to meet. The flex-
ibility of his playing searches out the region of contact for that child, creates
the emotional substances of the contact and sets the musical ground for in-
teractivity. The timing of his playing-its tempo, its rhythms and pauses-
attentively follows, leads and follows the child's activity (15:143-144).
In group therapy, learning, performing, and responding to precomposed
music are the chief activities (16,22). The musical compositions may include
songs, instrumental pieces, and musical dramas (18). In addition, the therapist
may improvise music to accompany certain parts of an activity, and the clients
may engage in various forms of structured improvisation (15).
The improvisations in creative music therapy are most often nonreferential
in nature. That is, they are created according to strictly musical considerations
and do not refer to anything outside of the music for their meaning. Regarded
as intrinsically meaningful ( 15), the improvisations are not dependent upon
any extramusical program or theme for their interpretation.

CLINICAL USES

Nordoff and Robbins (15,16,17,18,19) found their model to be suitable for

.children with a wide variety of impairments, including autism, psychosis, emo-
tional disturbance, mental retardation, neurological disorders, physical im-
pairments, sensorimotor impairments, and learning disorders. Clinical
problems that have been addressed through creative music therapy include:
obliviousness, unresponsiveness, passivity, withdrawal, mutism, persevera-
tion, stereotypy, echolalia, regression, negativism, resistiveness, apathy, de-
pendency, insecurity, ego-disorganization, lack of control, lack of expressive
freedom, lack of creativity, and uncommunicativeness. The children were
treated in day programs, residential centers, and public school settings. More
h-· ·
recently, the Nordoff-Robbins approach has been applied to educational set-
tings for hearing-impaired children (22).
Although creative music therapy was originally developed for children.
Nordoff-Robbins therapists working in Germany, Great Britain, Scandinavia,
Australia, and the USA have also applied the approach to adults (23). Of par-
ticular research interest are the musical responses of adults hospitalized for
various medical problems.
Because most of the work has been done with children, and since most of the
references mention children specifically, the words "client" and "child" are used
interchangeably throughout this unit. In many instances, the information can
be applied to adults.
Given the wide range of clinical problems addressed by Nordoff and Rob-
bins, and the flexibility of improvisation as a therapeutic procedure, there ap-
26 Improvisational Models of Music Therapy
l
.
i

pear to be no prerequisites for participating in creative music therapy. The

client may be nonverbal and low functioning, or verbal and high functioning.
The use of creative music therapy is not limited to any chronological age f
bracket or developmental level.
II
l
THERAPIST QUALIFICATIONS

An essential requirement for practicing creative music therapy is the ability

to improvise music which is clinically effective. In a discussion ,with Nordoff
II
and Robbins, Dr. Herbert Geuter, one of their medical research consultants re-
1
I
marked:
Your students must get a feel for a personality, must get a feel for music, they I
must be able to compose music on the spot, just as they ipust be able to I
create an experience on the spot ... improvisation is the greatest factor in
music therapy bar none, and the improvisation has got to b~ excellent, of the
very best kind. This needs immense training (4:C-16).
Piano and voice are the primary media, though other instruments might also
be used occasionally. Hence, the improvisational abilities must be supported by
adequate keyboard and vocal facility (9,16) . Spe<tific improvisational compe-
tencies that are needed for creative music therapy were the subject of two train-
ing courses given by Nordoff (10,11) and are described later under "Musical
Resources."
The Nordoff-Robbins training course in London, England places great em·
phasis on musicianship. Only those students who already have a degree or di-
ploma in music and the required musical competence are admitted. The
one-year course includes musical studies, practical studies (supervised clinical
work), and medical studies. The musical studies emphasize keyboard improvi-
sation and its clinical direction, along with group improvisation, music litera-
ture, and voice and piano lessons as needed (2).
A diploma in Nordoff-Robbins therapy is given to individuals who com-
plete a prescribed training program. Though not required for practicing crea-
tive music therapy, the diploma serves as a certificate of competence in the
approach.

GOALS

General
Nordoff and Robbins based the overall goals of their approach on what they
believed to be the unique contributions of music to the therapeutic process. In
one of their first statements on the subject, they said:
r~
27
CmJliot Music Thrrapy

Used with all the resources belonging to its art, improvised music can estab·
lish communication, develop human relationships, initiate or extend speech,
dispel pathological behavioral patterns, and build stronger, richer personali·
ties (9:310).
Later, as their approach developed, they identified similar long-term goals in
their client evaluation scales ( 16). In the scales, the highest levels of therapeutic
growth are characterized by expressive freedom and creativity, communica-
tiveness, self-confidence, and independence, all of which are manifested within
the client's relationship to music and his/her musical relationship with the
therapist. What is important to note here is that in creative music therapy,
clinical goals are contained within the musical goals. Thus, personal freedom is
realized through musical freedom; interpersonal communicativeness is realized
through musical "interrcsponsiveness"; and self-confidence is realized through
independent creativity in music.
Music therefore becomes a sphere of experience, a means of intercommuni-
cation and a basis for activity in which handicapped children can find
freedom, in varying degrees, from the malfunctions that restrict their lives.
As such, music possesses inherent capacities for effecting a uniquely signifi-
cant contact with handicapped children and for providing an experiential
ground for their engagement, their personality development, their
integration - both individually and socially. To the extent to which music
achieves this it becomes music therapy... (15:16).
Nordoff and Robbins' therapy goals are closey aligned with humanistic
theories of psychology (viz., Abraham Maslow). They share a concern for
creativeness, intrinsic learning, peak experiences, growth motivation rather
than need motivation, and self-actualization (see Theoretical Orientations). It
is interesting to find that in their very first book, Nordoff and Robbins (13)
stated that goals for therapy should be geared to the client's individual potential
rather than to cultural expectations or universal standards for normality. For
them, the "freeing and development of the individual" is more important than
normalization" (p. 48).

Population Specific.
Because each handicapping condition carries with it certain restrictions in
individual freedom and specific developmental obstacles, broad goals can be
set for each population. Inevitably the goals are determined by what specific
benefits music can bring. For the mentally retarded, music therapy brings
vivid life experiences which are intelligible because they are concrete rather
than abstract. For the emotionally disturbed, it brings opportunities for expe-
riencing and communicating emotions, along with feelings of reassurance and
security. For the physically disabled, music motivates expressive movement
and helps to order and coordinate it (15).

I
 28 Impror,isalional Models of Music Therapy

Goals differ for younger and older children, due to differences in experience
and personality development. For younger children, therapy is concerned with
processes of inner differentiation and growth because their personalities are
still fluid and in the process of becoming; for older children, therapy is con·
cerned with a "rebirth of hopefulness, of self-confidence, and a reevaluation of
the feeling and meaning of self and of life's meaning ( 15: 131). When there has
been neglect or misunderstanding, therapy aims at restitution and compensa-
tion for the lack of fulfillment often experienced.
Goals for hearing-impaired children in a school setting and medical adult
patients are similar to the general goals cited in the previous se~tion.
,

Individual
Goals in creative music therapy are also individualized to address the
unique potentials and aspirations of the client. Individualized goals are es-
tablished as therapy progresses. The therapist:
(

takes his stan from the child and determines his clinical goaJs, session by ses-
sion, from the course of the child's response. He works freely within a
general framework of hierarchies of musical experience-activity and so
works for musical goals - while he works responsively for the psychological
developmental goals that musical activities caq ·achieve specifically for the
child (16:91).

SESSION FORMAT

Private Therapy
Individual therapy is the most appropriate setting for children who are ob-
livious or noncommunicative, or who have behaviors which interfere with peer
interaction or participation in a group musical activity (15). Individual therapy
is also the preferred setting for adults.
The length of an individual therapy session is determined entirely by the
client's capabilities for commitment to musical activity. If the client can tolerate
or commit him/herself to the work or situation for only five minutes, then the
session should last only five minutes. During the early stages of therapy, the
sessions can last anywhere from 5-20 minutes, and as therapy progresses the
sessions can extend up to 30 minutes or longer. The average session lasts 15
minutes. What is important to note is that the length of an individual session is
not fixed or predetermined according to an arbitrary schedule but rather
geared to the tolerance and commitment level of the client. Generally, individ-
ual therapy is provided from one to three times weekly (16).

Group Therapy and Instruction

Group therapy is provided under a variety of conditions, before, during, or
after individual therapy, or in place of individual therapy.

L
 Crtatioe Music Therapy 29

Group therapy may be offered prior to individual sessions whenever a child

is threatened by working with adults alone, and when working with a few peers
would provide the modelling and support needed to develop a response reper-
toire upon which individual therapy can then build (9,15).
Group work is offered as a supplement to individual therapy, in order to
broaden the client's social and musical experiences, and to provide supplemen-
tary opportunities and materials for individual work (16). Group therapy can
also replace individual therapy. This is appropriate when a client has reached a
plateau in individual therapy and needs the social stimulation of being with
peers. With these clients, individual therapy is suspended until the client is
ready to resume private work.
Group therapy can also be offered towards the end of or after individual
therapy. This occurs when the child has achieved the musical independence
and communicativeness necessary for learning role behavior in a group, and
when the child has outgrown the need for a one-to-one relationship with the
therapist (16). In these instances, it usually signifies therapeutic growth (16).
Since creative music therapy activities are designed to allow children at various
ability levels to participate successfully, the main criteria for being placed in
such a group are a degree of commitment to musical activity and sufficient
concentration (16).
Group work is also done in educational settings, where despite individual
differences there arc common goals for all of the children (18,22). In these situ-
ations, the size and composition of the group are often out of the therapist's
hands. Thus, establishing criteria for group placement is irrelevant, and
greater emphasis is given to accommodating individual differences by adapting
the activities and materials.
Formal music instruction may also be a service offered by a creative music
therapist. It is recommended for the client who has special talents or interests,
r and who has outgrown the need for those kinds of musical interactions and ac-
tivities already received in individual or group therapy ( 16). In such instances,
the main emphasis is on gaining musi~al mastery rather than on removing ob-
stacles to musical communicativeness. Thus, the goal is instructional (though
adaptive) rather than therapeutic in nature.
Rehearsals and performances of musical compositions and dramas com-
prise a type of service which combines music instruction, group therapy, and
educational goals.

MEDIA AND ROLES

originally developed, creative music therapy involves two therapists
work.i~g a team. On~ ther~pist improvises at the piano, working to engage
the ch~d m a ~erap~uuc music experience, while the other works directly with
the child, helping him/her to respond to the improvisation and to the clinical

I
30 lmprooisatumal Modtls of Music Therapy

intentions of the therapist at the piano ( 15, 16). The two work as partners, with
clearly defined roles which have been accepted by both parties and with equal
responsibility for the therapeutic process (16).
The team approach was used by Nordoff and Robbins in both individual
and group settings, and is still used by their followers whenever possible. In
many clinical situations, however, a team approach is not possible economi•
cally, especially for individual therapy. Moreover, in individual therapy for
adults, the need for and appropriateness of a team approach can be questioned.
Many creative music therapists have therefore adapted the approach to work·
ing without a partner. (Thus throughout this unit, "therapist" is used singularly
but may apply to a team as well, unless of course a distinction' is being made
between the therapist and the assistant of a team). -.1~ ·
In individual therapy, the client uses two media predominantly: vocalizing/
singing and playing a drum and cymbal. Any number of other instruments
might be used in addition, and in some instances, the ._client may move or
dance to the therapist's improvisations. '
In group therapy, the clients are engaged in both singin°g and instrumental
activities, involving reed horns (specially adapted for,therapy by Nordoff and
Robbins), bird calls and whistles, various string instruments, and an assort-
ment of pitched and unpitched percussion. An9lher important modality for
group work is the musical drama. ·

THEORETICAL ORIENTATIONS
Because music plays such a central role in creative music therapy, Nordoff
and Robbins' views on the nature of music are of fundamental significance in
understanding their orientation toward particular clinical theories. Put another
way, their theory of music has in large part determined their theory of therapy
or treatment orientation. Hence, most of the relationships drawn between the
Nordoff-Robbins approach and various theoretical orientations can be traced
back to their notions regarding the nature of music and its relationship to hu-
man experience.
In the early years of their work, the ideas of Rudolf Steiner were influential
in shaping Nordoff and Robbins' conception of music therapy. (In fact, their
first book was published by a Steiner press.) Steiner (25) was the founder and
leading exponent of anthroposophy, which can be described as a humanistic
approach to theosophy. As a "science of the spiritt anthroposophy is concerned
with matters such as "the being of man, the nature and purpose of freedom, the
meaning of evolution, man's relation to nature, and the life after death and be-
fore birth" (p. v). Steiner was also the founder of "eurythmy," a concept of
movement which he described as visible speech and visible song, and which has J
become widely accepted (particularly in Europe) as an independent art form.
r
Creative Music Thrrapy
31 I
I
Several aspects of creative music therapy can be related to Steiner and an- •j'
throposophy. In the Nordoff-Robbins approach musical response_s _are viewed 1
.)
t
as a mirror of the person's psychological and developmental cond1t1on, reveal- l
'j

ing both progressive attributes and pathological factors and having diagnostic li
implication (15:34). Steiner said: i

You can never explain the life of feeling and passion by natural laws and so-
called psychological methods. You can understand it only if you consider
man himself in tenns of music.
There will come a time when a diseased condition of the soul life will not
be described as it is today by the psychologists, but it will be spoken of in mu-
sical terms, as one would speak, for instance, of a piano that was out of tune
(26:349).
Nordoff and Robbins advanced the notion that within every human being
there is an innate responsiveness to music and that within every personality
structure there is a "musical self" which they called the "music child" ( 16). This
idea relates to Steinei's concept of the "astral body:' The astral body is that part of
every human being where impulses, drives, passions, and emotions live as expe-
rience. It works within us according to rhythms, and melodies in the cosmos
which are also found in our physical form. In discussing the universality of mu-
sic, Steiner said, "This is the work of the astral body which is a musician in every
human being, and imitates the music of the cosmos" (26:348).

t
I
f
Nordoff and Robbins observed that clients often identify closely with songs
and melodic themes developed in therapy, and that the progressive externaliza-
tion of this identification into various forms of coactivity was a significant pro-
!·. cess in therapy. This appears to be directly related to Steiner's notions on the
origins of melody, rhythm, and harmony. Steiner said:
One cannot speak of a melody of the spheres. One can speak only of a har-
mony of the spheres. Melody exists in the soul of man. The soul is indeed the
harp upon which the musician plays. The whole feeling body of man is a musi-
cal instrument on which the ego resounds and the soul produces melody. It
does not exist in the cosmos. Melody lies within man himself (3:124).
Given the view that melody is a product of the ego resounding in the soul,
and considering th~ importance of intervals within a melody, Nordoff (11)
j\·-
¥

found Steiner's concept of music intervals useful in guiding clinical improvisa-

tions. Stejner (25) believed that each interval carries its own unique kind of liv-
ing experience: with a single tone, one has an inward experience of absolute
rest and inactivity. With the minor second, there is an inward experience, but
with a stirring of movement and activity within the self. With the major sec-
ond, the inward experience becomes more active and searching within the self.
With the minor third, one begins to have inner balance·, which may recede
: ~~,.
back into the major second. With the major third, there is a positive statement
I~ of inner balance and stability. In the state of rest, the major third has no ten-
 ll

32 Improvisalumal Models of Music Therapy

dency to recede inward, and no pressure to move outward. With the perfect
fourth, there is movement away from this security and toward others and the
environment. It is a beginning step outside of the self, an initial reaching out.
With the tritone there is ambiguity and unrest. It poses the possibility for pull-
ing back to the perfect fourth and then withdrawing even further into the self in
the major third, or pushing forward toward the threshold of outer regions en-
countered in the perfect fifth. With the perfect fifth one becomes extroverted,
and has the experience of standing in balance confronting the external world.
With the augmented fifth there is an experience of moving away from self to-
ward the other. With the interval of the sixth, one takes a defini~e step out into
the world, extending beyond oneself and towards others; ·With the minor
seventh, one has the experience of tension between self a~d et:iyironment which
grows even greater with the major seventh where there is an experience of
stretching and quivering outside of the self in unresolved te~sion. The octave is
the ultimate experience of ego finding itself capable of existing comfortably in
relation to the external world. It is not a doubling, or a uAison experience but
an integration with the other. ·
A further aspect of creative music therapy which, can be traced back to
Steiner relates to the process of therapy itself. Steiner taught that learning ta.lees
place from within rather than from without, th~ough experiencing our inner
livingness (i.e., impulses, drives, feelings) rather than through observing our
outward behavior. Similarly, in the Nordoff-Robbins model, the therapist be-
gins with whatever the client is doing impulsively or unconsciously, as a mani-
festation of his/her inner experience. Then, as Steiner advocates, the therapist
explores the client's inner experiences through the senses until they become ex-
ternalized and conscious. Then as the impulses come into the world of con-
sciousness, the client can begin to experience his/her own feelings about them
in terms of pleasures, freedoms, and intentions (4). Likewise, Steiner (26) be-
lieved that through the senses we become conscious of our world, through our
impressions and reactions we reconstruct our world, and by acting upon it in-
tentionally, we learn about the nature of our world.
Inasmuch as Steiner had a humanistic view of theosophy, it is not surprising
to find that Nordoff and Robbins identified with humanistic schools of psychol-
ogy as well. Here however, their work can be related to several different
theorists and systems of psychotherapy.
Ruud (24) identified creative music therapy with "relationship therapy" as
described by Axline (1) and Moustakas (8). Axline developed a method of non-
directive play therapy which employs eight principles that are also found to
some extent in the Nord.off-Robbins approach. They are: a warm, friendly re-
lationship between therapist and client; acceptance of the child exactly as he is;
a permissive relationship which encourages the expression of feelings; alertness
in recognizing and reflecting the child's feelings; deep respect for the child's
ability to make personal choices and solve problems for him/herself; a non-
 F
(

Creative Mu.sic Therapy 33

directive rather than directive approach to therapy, wherein the therapist fol-
lows rather than leads the client; and the establishment of only those bounda-
ries that arc necessary to anchor the therapy to the demands of reality.
In a similar vein, Moustakas (8) defined the therapeutic process as a natural
growing and living together, with the client needing and seeking help, and the
therapist offering it. The therapist se:rves and waits for the client to come to
terms with him/herself, and find various ways of solving problems, relating,
and living.
Robbins and Robbins (22) related their therapeutic goals for personal ma·
turation to the humanistic concepts of Abraham Maslow (6, 7). The following
I' concepts are shared by creative music therapy.
l ... Natural impulses and drives should be used as dynamic forces in therapy
l
rather than undesirable phenomena to be controlled .
. . . Therapy should be growth-motivated rather than deficiency-motivated.
Rather than fulfill needs, therapy should focus and build on what poten-
tials the client already has. Growth is self-gratifying and self-validating
and is therefore motivated intrinsically rather than extrinsically.
. . . Therapy aims at self-actualization which involves: ability to experience
things vividly and fully; ability to make choices; ability to express self;
self-responsibility and honesty; courage of one's own convictions; appre~
ciation for the process of actualization as much as the product; openness
to peak experiences; and self-discovery of strengths and weaknesses .
. . . Learning should have intrinsic rather than extrinsic aims. Intrinsic
learning aims at developing the person's self-actualizing creativeness
whereas extrinsic learning aims at the achievement of specific knowl-
edge, skills, and behaviors .
. . . Having a special creative talent (e.g., musical talent) is not a prerequi-
site for self-actualizing creativeness, and is something quite different.
Self-actualizing creativeness springs from the personality and manifests
itself in many different aspects of living. Its specific achievements are
epiphenomena! and secondary t6 its characterological qualities, such as
courage, boldness, freedom, spontaneity, integration, and self-
acceptance .
. . . Therapy should facilitate peak experiences, those sublime moments
wherein one is able to transcend and integrate splits within the person,
between persons, within the world, and between the person and the
world. Since the arts facilitate the occurrence of peak experiences, es-
thetic endeavors are seen to be a central aspect of life and therefore of
therapy.
 Chapter Two

ASSESSMENT AND EVALUATION

.,.

GENERAL APPROACH

I N TH_E Nordoff-Robbins approach, the client's music;tl, responses serve as

the prunary source of data for assessment and evaluati6n. They found that
the client reveals both healthy and pathological aspects' of his psychological and
devdopmental condition through musical and ~rsonal responses within the
improvisatory situation {15). The musical responses include "to what extent the
child can make music, how he makes it, and what music-making means to him"
(15:61-62), while his personal responses include subjective reactions to the im-
provised music of the therapist.
The improvisatory situation involves the therapist and client in sponta-
neous music-making. Instead of using precomposed or recorded music, the
therapist improvises music to engage the child in either playing a percussive in-
strument or singing. As the child responds to the various elements of impro-
vised music, s/he forms a "musical self-portrait" that reveals the whole
personality (15).
The aim of assessment and evaluation in creative music therapy is to collect
information that will be clinically useful. That is, ·the musical data gathered
about the client is intended to have practical significance in directing the course
of therapy. According to Nordoff and Robbins, observing and recording the
client's responses within the improvisatory situation provides a map of the
client's "musical geography" which enables the therapist to find and open a
channel of communication (15). In addition, the most useful assessment data .
reveals the client's readiness for various musical-therapeutic experiences and
provides practical clues which help the therapist create improvisations that will
evoke therapeutic responses.
Creative music therapy assessment may also provide information which has
diagnostic, etiological, or theoretical significance, however, this is not the pri-
34
 \
Creativt Music Therapy 35

mary aim. For this reason, psychological interpretations and explanations of

the client have been generally avoided and supplanted by purely descriptive
statements regarding his musical communicativeness.
Since musical responses serve not only as an indication of the client's condi-
tion upon entering therapy but also as a gauge of changes made throughout the
course of treatment, the content and format of assessment and evaluation are
the same in creative music therapy. That is, creative music therapists can use
the same clinical procedures and data forms to assess the client's entering con-
dition as they do to evaluate therapeutic progress.
For Nordoff and Robbins, assessment and evaluation involved more than
rating the client on one of their scales. "Any improvised music or songs or any
particular musical techniques that have been important should be transcribed
to a section of manuscript kept for the child, for repetition and possible devel-
opment in succeeding sessions" (16:92). In addition to making quick notes im-
mediately after the session, they also made an index sheet, and upon listening
to the tape, described each significant event against the counter number on the
tape recorder. They also took note of specific musical characteristics of the child
such as tempo range of beating (in beats per minute) and pitch range of vocal
activity. All of the clinical information gleaned from the notes and tapes was
studied before completing the rating scales.
N ordoff and Robbins developed several models for client assessment and
evaluation, all of which were designed for and clinically tested on handicapped
children with various diagnoses. The first model (15) provides "Thirteen Re-
sponse Categories" for characterizing the child's musical and personal reactions
to improvisation. The second modd (16) consists of "Evaluation Scales I and
II," the first dealing with the "Child-Therapist Relationship in Musical Activ-
ity," and the second dealing with "Musical Communicativeness?' The third
model (20) is called "Musical Responses Scale Ill," and deals with musical com-
plexity, expressiveness, and interresponsiveness of instrumental and singing re-
sponses. The last model (16) presented here, "Tempo and Dynamic Schema;
was actually not designed for assessment or evaluation purposes, but provides
useful information for understanding the client's music.

THIRTEEN CATEGORIES OF RESPONSE

The "Thirteen Categories of Response" is based on clinical work and observa-

tions done by Nordoff and Robbins with 145 children with varying diagnoses.
The purpose of this assessment and the evaluation model is to analyze and
classify how the child's music-making relates to the therapist's improvisations
and how the child reacts personally to different musical idioms, clements, and
moods. Thus, the stimuli include musical qualities of the therapist's improvisa-
tions (e.g., scales, intervals, chords, idioms) and the improvisatory situation it-
36 Improvisational Modtls of Music Therapy

self(e.g., the assistant, musical instruments, room). The targets of observation

include the client's musical responses on the drum, piano, and/or voice, and
the client's extramusical responses such as facial expression, body posture and
movement, breathing, etc. Table I gives an edited summary of the "Thirteen
Categories of Response.'.'
Some of the categories require ranking the client according to specific musi•
cal criteria. For example, the first eight categories refer to specific levels of
rhythmic proficiency, and the tenth category deals with different forms of vocal
responsiveness. The remaining categories allow for open-ended, narrative
descriptions of responses in unspecified musical or extramusical areas. None of
the categories specifies particular musical idioms, elements; cir moods to be
presented formally as improvisatory stimuli by the therapist(

EVALUATION SCALES I & II ·'

Nordoff and Robbins began to formulate three rating-'sfales for individual
therapy beginning in the mid 1960s. After clinically testing them in over 1,050
therapy sessions with 52 variously handicapped children, two of the scales were
completed and published in 1977. The first scale deals with the child-therapist
relationship in musical activity, and the second deals with musical communica-
tiveness.
Scale I is comprised of ten levels which describe the child-therapist relation-
ship during musical activity along with two dimensions: the client's level of par-
ticipation, and qualities of his/her resistiveness. Table II presents a summary of
the scale which integrates the two dimensions; however it should be noted that
Nordoff and Robbins rated clients separately on participation and resistiveness
when appropriate.
Scale II is comprised of ten levels which describe the client's musical com-
municativeness in instrumental, vocal, and movement modes of activity. Table
II presents a summary of this scale, however here also, the table combines
modes of activity which Nordoff and Robbins kept separate.
Procedures for using these scales began with tape recording each therapy
session. Upon listening to the tape, the therapist notates every instance of a
particular level of behavior and devises a suitable method for quantifying its
occurrence. Then, based on these observations, the therapist distributes ten
points over as many levels of behavior that occur in the session. Each point or
fraction thereof represents either the percentage of the total session time or the
percentage of the total number of aspects of a particular level observed. Ten
points are apportioned for each scale for each therapy session, and the client's
responses are rated every time a therapy session is .held. A tally sheet or chart
can be made to show the point distributions on both scales over consecutive scs~
sions, thus allowing the therapists to have a graphic means of following the
client's progress.
 37
Creative Music Therapy

TABLE_;
THIRTEEN CATEGORIES OF RESPONSE*

1- COMPLETE Rff'l"r!!!!IC FREEllO~, ~e child bas emotional-motor

coritrol of beatinq, and matches tempi, dynamic•, and rhytbmS of
therapist's improvisation. The child also deaionstrates freedom
and control in musicallY e,cpressing feelinqs and shows coinmitment
to and
2. enjoyment
UNSTABLE in~
the
ICmusical experience•
FRE.EDQM: .
The child has per i o d of
COfflPlete rhythmic freedOlll which are marred by excessive reactions
and loss Psychological
of emotional-motor control. loss has psychological or 7
irype: control . gin
.
-Neurological -rype: control loss has neurological origin
J.LIMITED RHY'l'.HMIC FREEDOM: The child's ability to
control his beating and to match the therapist's improvisation is
sporadic and limited to certain stimulus condition• and/or
response
4. COMPULSIVE BEATING:
ranges. The child's beating is partly
controlled but limited to one tempo and dynamic level. Despite
any apparent awareness of the therapist's improvisations, the
child does not change to synchronize with its tempi or dynamics.
- S. DISORDEREZ2
Impulsive: BEATING:
oue to poor impulse control, the child
- is unable to sustain a steady beat or organized rhythm.
_Para~ytic: Due to lack of muscular coordination, the
child is unable to rhythmically order, control, or
sustain beating.
_compulsive-confused: When beating with two hands, the
child beats at two different speeds,neither of which
relate to the therapist
_EmOtional-Confused: • .
The child's beating is rhythmically
unordered or unresponsive to the therapist, varying
widely according to current feelings.
_6. EVASIVE BEATING: The child avoids synchronizing to the
tempo or dynamic level of the therapist's improvisation.
_7. EMOTIONAL FORCE BEATING: The child beats the drwn to
release energy or make noise, and does not try to order sounds.
_s. CHAOTIC-CREATIVE BEATING: The child's beating is hyperc-
reative but not completely formed. It is unstable and unsustained
yet bears a subtle relationship to the therapist's improvisation.
_9. _PIANO PLAYING: (Optional) The therapist describes how
the client physically relates ~o sounding the piano. Previous
categories may be used for rhythmic aspects.
_10. RESPONSES BY SINGING:
_self-expressive: The child improvises words and melody
of song to express feelings.
_corresponsive: The child sings improvised songs,
completing phrases as directed in lyrics.
L child.re:~:O~~E~i;)'he;I:~INI:
11 The therapist describes how the
12 RE inq ng.
bowl;~e cl~!:;~d~~I~:;~:;~les;1'1nt!~!!i!~•~bo~~=~r!~~
the child's susceptiDility to mus·ica 1 moodThesandtherapist
changes describes
therein.

*Abridged version of Nordoff and Robbins (15)

38
Improvisational Mod.tis of Music Therapy

TABLE II

EVALUATION SCALES I AND II *

I: CHILD-THERAPIST RELATIONSHIP II: MUSICAL COMMUNICATIVENESS
10. Functional independence
inmusical group; cooperative _10. Musical-social intercom-
with therapist's leadership, munication in group activities;
and supportive of other group enjoys and contributes to
members; comfortable in group. musical group.
_9. Self-confidence; trust in ~9. Musical communicativeness
therapist; works toward own 4naependent of the thera-
musical objective; needs to peutic process; realizes own
move beyond therapist-client musicality and apcepts group
relationship but somewhat situation as me~ns of social
uneasy in group; identifies integration,and ,musical growth.
with therapist to avoid _a. Enthusia'sm for musical
regression. creativity; · enjoys working
_a. Intense involvement in towards musical objective with
therapist.
musical activity as means of 7. · Mobility and sensitivity
self-expression; has uniquely
in musical responses; shows
personal, mutual relationship readiness to explore and expand
with therapist; crisis leading musical experiences.
toward resolution or lack of _6. Mµsical involvement
negative resistiveness. develops in individualized
7. Assertive coactivity forms of activity; concen-
In musical interactions with trates·on preferred activities.
therapist; forms working S. ' sustained directed
relationship with therapist to responsiveness. Instrwnental,
achieve musical objectives. vocal, or movement responses
Resistiveness can consist of show control, and beginning
assertiveness, inflexibility, sensitivity to therapist's
rebelliousness, or contests. music. Occasional lapses.
6. Activity relationship 4. Moments of directed
develops through enjoyment of responsiveness and musical
music; recognition and perception. Synchronizes
acceptance of therapist's role; briefly to phrase lengths,
resistiveness is less defensive tempo and dynamics. Wider range
and manifested in perversity or of vocal tones. Movements more
manipulativeness. related to music.
s. Limited responsiveness; 3. Evoked responses are more
willingness to attend therapy; iuitained and musically
evasive defensiveness. formed. Impulsive and compul-
4. Ambivalence; passive sive beating more responsive;
acceptance; intermittent Vocalizations more controlled
involvement; tends to reject. and rhythmically related to
3. Awareness without therapist. Movement influenced
acceptance; negativism; by musical idiom, mood,phrase.
active avoidance. 2. Evoked responses are
2. Fleeting awareness; fragmentary. Discontinuous,
withdrawal; diffuse anxiety. poorly coordinated b!ating;
1. Obliviousness; extreme fleeting relation to music.
ructions when pressed. - 1. Noncommunicative,non-
- active.

*Abridged version
· of Nordoff and Robbins (16)
 Crtativt Music Therapy 39

MUSICAL RESPONSES SCALES III

Scale III was begun in the mid 1960s along with the previous evaluation
scales. It was then reworked in the l 970s, but unfortunately was not completed
prior to Nordofrs death. What is presented here is an abridged version of a
draft recently completed by Clive Robbins (20), and soon to be published.
Nordoff and Robbins found that children's musical responses fall into two
main categories, instrumental rhythmic activity and singing. Thus, the Musi-
cal Responses Scale III contains separate sections on each medium. They also
believed that the clinical significance of a child's musical responses is deter-
mined by structural aspects of the musical forms themselves together with the
child's levd of engagement and responsiveness expressed therein. The scale is
therefore an attempt to indicate not only what a child does musically but also
hows/he does it (20).
Table III presents the "Musical Responses Scale IIIA" for instrumental ac-
tivity. On this scale, rhythmic organization and expressive components are

TABl,,E III
MUSICAL RESPONSE SCALES III (Abridged)
Instrumental Rhythmic Responses
LEVELS OF RHYTHMIC ORGANIZATION LEVELS OF ABILITY/EXPERIENCE
---Developed Levels---
Rhythmic Complexity (Rated _ _ (E) Establishing. Client
according to specific criteria is working to establish percep-
not shown here) . tive and expressive skills with
_complex respect to a particular
Advanced rhythmic component in own and
-Intermediate therapist's playing.
-Simple _ _ ( F) Finding. Client is
_Rudimentary becoming aware of own improvi-
sing in relation to therapist,
Tempo Range (Logged according but beating is not sufficiently
to metronomic speed in beats controlled, stable, or free to
per minute). establish skill.
_Very fast (+240 bpm) ___ (I) Incipient. Client
_Fast (150-239 bpm) has incipient awareness of own
_Moderate (95-149 bpm)• beating in relation to music,
_slow (60-90 bpm) with minimal perception of
_Very slow (-60 bpm) rhythmic structure.
---Undeveloped tevels---
Basic Beating _ _ (P) Perseverative. Child
_ability to maintain a beats unresponsively, fixedly,
steady beat with purpose. and inflexibly.
_ _ (C) Compulsive. Child
beats in an obsessive, driven,
and unresponsive way.
_ _ (R) Reactive. Child
overreacts to stimulation and
loses control and contact •
......,,__CU) Undirected/Unaware .
Child responds reflexively and
sporadically, with no indica-
tion of awareness .
40 lmprooisational Modtls of Music Therapy

TABLE III (continued)

EXPRESSIVE COMPONENTS LEVELS OF RESPONSIVENESS .
___ (M) Musically-expressive
_Tremolo perceptive. Child shows
Dynamic Contrast musical intelligence, sensiti-
-Soft/Diminuendo vity, and expression.
-Accentuation/Punctuation (S) self-expressively
-Loud/Crescendo assertive. Child uses particu-
-Sound of InstrWllent lar component as outlet for
-Accelerando self-expression.
-Ritardando (B) Becoming engaged.
Tempo Contrast ciiI'ra is attracted by particu-
Fermata lar component and begins to use
Rubato it. '
_ _ ( N) Nascent:' Child shows
awareness but n9t perception of
component.

evaluated in tenns of the client's level of ability/experience or responsiveness.

Specifically, rhythmic complexity, tempo range; and beat.ing characteristics of
f

the child's instrument playing (upper left column) are ev~uated according to
the child's awareness and perception of the musical components and their rela-
tionship to the therapist's music (upper right column): 'Letter codes are used as
shown. Similarly, the expressive components in the lower left column are eval-
to
uated ·according levels of responsiveness in the· lower right column-:
Table IV presents the "Musical Responses Scale IIIB" for singing. On this
scale, formal aspects of the child's melodies are evaluated in terms of their vocal
responsiveness and vocal participation. Vocal responsiveness refers to how
much expressive freedom the child exhibits and how sensitive the child is to the
therapist's music. Vocal participation refers to levels and conditions for the
child's involvement in singing activity. On this scale, the left column is evalu-
ated in terms of both the middle and right columns.

'l'ABLE IV

. MUSICAL RESPONSE SCALES III (Abridged)

Singing aesponaea

LEVELS OP MELODIC FORM VOCAL RESPONSIVENESS VOCAL PARTICIPATION

_Extended arias Sustained creative Creative Inter-
-responsiveness
_complex Melodies
Expressive Freedom Expressive Co-
_simple Melodies -and Initiative -activity
_Melodie Phrases _Responsive Expressive _self-confidence
Senaitivity
_Simple Tone Groups Correaponaive
_Directed llesponsivenesa-Involvuent
_single Tones
_Musically evcked Interest but
-IM.bility
_unaware Reflexive
_Insecurity
 Crtative Music Thtrapy 41

TEMPO-DYNAMIC SCHEMA

Though the "Tempo-Dynamic Schema" was not designed as an assessment,

it is useful in understanding expressive components of the child's music making
(16). Originally the schema was intended to guide the therapist in moving the
child away from pathological restrictions into expressive freedom and mobility,
particularly with regard to basic beating.
As shown in Table V, the schema consists of categories of emotions that are
typically expressed through or associated with tempo or dynamic ranges
(15:158-159). A range is considered to be of"pathological" origin when it is ex-
treme and/or inflexible, and therein musically meaningless. The range is con-
sidered "normal" when it falls within the boundaries of common musical
practice. Thus, the extreme, inflexible ranges are determined by a pathology,
and the normal expressive ranges are determined by musical considerations.
Since the tempo and dynamic ranges frequently occur together, often insepara-
bly (i.e., loud and fast, loud and slow, soft and fast, soft and slow), the emo-
tions may be combined accordingly.

TABLE V
TEMPO-DYNAMIC SCHEMA

FAST FAST SLOW SLOW

PATHOLOGICAL NORMAL PATHOLOGICAL NORMAL

nervous activated insecure attentive

tense alert confused calm
hyperactive buoyant despondent serious
overexcited joyful lethargic thoughtful
obsessive gay • vacuous earnest
driven playful weak drive deliberate
running away excited la.eking vigor certain
fervent avoiding affirming
warm

LOUD LOUD S O F T SOFT

PATHOLOGICAL NORMAL PATHOLOGICAL NORMAL

aggressive animated fearful light
frustrated eager inhibited delicate
angry exuberant apathetic gentle
uncontrolled assertive listless careful
impulsive confident remote suspenseful
ventillating climactic unaware intent
shutting-out fulfilled unassertive
over-assertive
 Chapter Three
'
TREATMENT PROCEDURES' ,.
1·

'""PREATMENT procedures in creative music therapy vary according to

.1. whether the sessions are individual or group. Wher~as individual sessions
are almost entirely improvisatory in nature, group session~ ~e largely devoted to
lea.ming, singing, playing, dramatizing, and moving to.various kinds of musical
compositions, with improvisatory activities having a ~condary emphasis.
Since the focus of the present book is on improvisation, and since the
Nordoff-Robbins approach to group work is not' easily condensed, the present
chapter will deal only with individual creative music therapy and those group
techniques which involve improvisation. Aspects of the Nordoff-Robbins ap-
proach pertaining to more performance-oriented group activities are not in-
cluded.

PREPARATION OF SESSION

Nordoff and Robbins described their methodological approach as

"empirically-creatively directed" (16). It is empirical because the therapist's re-
sponses are based on continuous observations of the client's responses; it is
creative because the therapist's responses are musically created or sponta-
neously improvised. Thus, the therapist observes what the client presents and
responds creatively.
Because creative music therapy sessions unfold from moment to moment,
according to the child's musical-emotional responses, the therapists must be
prepared to deal with a variety of situations.
During an active fifteen-minute session, the situation is usually constantly
changing. At any moment the child may make progress or withdraw, become
mechanical in its activity, or have a tantrum and rebel against the entire situa-
tion. The therapist must be constantly on the •qui vive,• ready to lead, to ac-
company, to challenge, to sing, to pause, to change the music in order to '"meet
whatever the child may or may not be doing (12:67).

42
 Crtativt Music TMrapy 43

Given the extemporaneous nature of creative music therapy, only certain

aspects of a session can be planned in advance. Of greatest importance are the
musical environment and the musical materials that will be used during the
session.
Preparing the Environment
Ideally, the therapy room is equipped with high-quality musical instruments
and recording equipment. A good sounding piano which is in tune is essential
for the therapist. Instruments for the client should include: a drum mounted on
a strong, adjustable, floor stand; a small cymbal attached to a drum or
mounted independently on a floor stand; a larger cymbal mounted on a sturdy
floor stand; a single-sided hand drum, a few tambourines, a set of resonator
bells, and various mallets and drumsticks. Additional instruments are also de-
sirable but not essential (16).
The room should be acoustically suitable for making music with the above
instruments and for recording. The drum and cymbal should be placed at the
treble end of the keyboard so that the therapist can observe the client's re-
sponses.
Planning the Music
Developing musical materials to be used in therapy is an individualized
process for each client. It begins with the very first session, and continues
throughout the course of treatment. As mentioned previously, most therapy
sessions are tape-recorded and studied afterwards, and transcriptions are made
of any music which had clinical significance. These transcriptions provide a
wealth of musical materials which can be used as the foundation for improvisa-
tions in subsequent sessions. The materials may include musical fragments or
ideas presented by the client, as well as musical stimuli presented by the thera•
pist which were clinically effective. The tapes also reveal basic information
about the child's musical "geography" which gives valuable clues for working
with him/her. This includes: preferred tempo and dynamic ranges, singing
range, and typical responses to melodic and harmonic elements and to various
idioms and styles. .~
As these musical materials are explored throughout a session, short songs
and themes for instrumental activities are created. The songs and compositions
are then used in subsequent sessions until gradually an individualized reper-
toire of therapy music or songs have been developed for each client. Until such
a repertoire is created, the content and sequence of activities in the session may
remain in flux , depending greatly on matters of musical continuity or the emo-
tional cycles of the child.
Session follows session, the themes and idioms .. .develop and are trans•
formed as the child's activities expand . . . Yet a certain musical structure, un-
premeditated and unforeseeable, evolves through the continuity of the
session, a structure created by the path and the content of the child's progress
(15: 144).
 44 /mp,ovisaJiona/ Models of Music Therapy

Often, efforts to build the repertoire of therapy music begin by developing a

greeting song or similar kind of song which deals directly with the child and the
child's name. Once completed, the song serves as the beginning ritual, and ef-
forts are turned to developing music for other parts of the session, including the
closing or good-bye song. A consistent beginning, middle, and end gradually
emerge so that the form, activities, music, and mood across sessions also re-
mains consistent. Though Nordoff and Robbins felt strongly that consistency is
a condition for effective therapy, they also recognized the pitfalls of routines
and the continual need to adapt the therapy session to situational factors and
significant events or changes (16).

Planning Techniques ·i'.

In addition to helping the therapist plan and prepare musical materials,
tapes of previous sessions reveal many subtle aspects of the child's responses
which may have been missed, while also pointmg out ep-ors in technique or
perception made by the therapist (16). This infonnatio:p provides valuable
clues for what to observe in subsequent sessions, and what strategies or tech-
niques might be effective. •1
A creative music therapist should be prepared to use various clinical tech-
niques which have been developed by Nordoff and Robbins. Because therapy
is empirically-creatively directed however, their many methodological princi-
ples and techniques should be used only as general guidelines, not as prescrip-
tions or recipes (23).
Nordoff and Robbins (16) found that techniques are most effective when
they are explorative, consistent, and flexible. In being explorative, the tech-
nique should lead to a discovery of the child's capabilities, limitations, and sen-
sitivities, while also revealing the conditions under which the child is
responsive. In being consistent, the technique should sustain and secure the
child's progress by conveying that the music therapy situation is predictable,
coherent, dependably supportive, and reliable. In being flexible, the technique ·
should allow for adapting to variability in the child's responses and the emer-
gence of new possibilities, obstacles, and moods.

PROCEDURAL PHASES

Creative music therapy can be analyzed in terms of progressive work in

three main areas: meeting the child musically, evoking sound or music-making
responses, and developing musical skills, expressive freedom and interrcspon-
siveness. Each work phase is characterized by its own objectives and tech-
niques, and each phase is at a different level of development or readiness.
Thus, with some clients, an entire session or period of therapy may be devoted
 45
Creative Music Therapy

one or two phases; with others, a single improvisation ma~ in_volve three
10
phases. For example, with a more reticent or lo':er functlonmg ch1~d who
makes no sounds or music, the therapist's efforts might be devoted entire:Y to
meeting the child musically and/or evoking some kind of respons~. ~1th a
more assertive or higher functioning child who already presents_mus1cal 1de~s,
the therapist's efforts might be devoted entirely to deve]opmg expressive
freedom and interresponsiveness.
As shown in Figure 1, the therapist follows certain sequence~ to ~chieve
each phase. The figure also shows how work in every phase begms with the
first phase, meeting the child musically.

EVOKE MUSICAL RESPONSE

MEET CHILD MUSICALLY

DEVELOP MUSICAL SKILLS,

EXPRESSIVE FREEDOM, AND
INTERRESPONSIVENESS

Figure 1. J>rocedural phase~ in creative music therapy.

Meeting the Child Musically

In creative music therapy, communicative contact always begins by match-
ing the child's inner condition with the music ( 15). The therapist docs this by
improvising music which accepts and meets the child's emotional state, while
also matching, accompanying, and enhancing its expression (16). The thera-
pist improvises empirically, responding to how the client responds from mo-
ment to moment, while also exploring various expressive possibilities and
providing the necessary musical support. The aim is to open a channel of com·
munication, and trial and error are valid aspects of the procedure (15).
 46 Improvisational Models of Music Therapy

This phase serves severaJ important functions. First and foremost, by com-
municating with the child as he is (16), the therapist creates an accepting, re-
sponsive atmosphere. Then by proceeding gently and respectfully, the therapist
works to make musical contact with the child, thereby establishing whatever
level ofrapport the child accepts (5). This not only serves to build trust but also
to lessen any resistiveness the child may have at this stage.
By stimulating the child musically and then observing closely, the therapist
is also working in this phase to discover the child's inherent musicality, or the
"music child" that lies within him/her. In order to establish a working musical
relationship, the therapist must discover the child's musical resources, limita-
tions, sensitivities, reaction patterns, and any cause/effect cel'ationships that
1
are revealed within the improvisatory situation. .1·
Crucial to establishing rapport and developing a working· ;elationship is the
child's enjoyment. Aside from conveying acceptance and stimulating the child,
the music must therefore bring pleasure and. entice tlje child to become
engaged (5). Whenever necessary, the therapist must ~so lend support and
help the child's improvising become musically meaningful;'
Levin (5) suggests that the music for this phase be ~pimposing, and capable
of being withdrawn at any time. In many instances, musical tension or urgency
is avoided. Dynamics and speed are kept moderate, rhythms are kept simple
and closely related to the beat, and harmonies are kept open but tonally cen-
tered. Meanwhile, all of these musical components are kept consistent with the
child's emotional state. Nordoff and Robbins (15) pointed out that more capa-
ble children may need more diverse musical experiences, whereas less capable
children may prefer limited idioms, qualities, or forms because of their special
significance for them.
A major technique used in this phase is usually referred to as "reflection:'
Though Nordoff and Robbins did not use this term, they described several
ways to "match" what the child is feeling and doing. These include: improvis-
ing a musical portrait of his personality; musically depicting the mood of the
moment; matching the child's facial expression and physical bearing in the
mood of the improvisation; setting the child's movements to descriptive music;
singing a song which describes the child's actions, mood, or experience; and
musically imitating any sounds the child makes (15,16).
The therapist should use his/her voice almost immediately with the piano
(16), because it is a human sound which is often associated with maternal nur-
turing (5). It is best to begin with vowels or neutral syllables rather than words,
because many children have been confronted through conventional language
(5). When indicated, simple word phrases such as "Good morning; or "Hello
_ _ _ ,, should be used ( 16). When words arc used, they are often sung re-
peatedly. The style is variable, depending upon the therapist's response to the
mood of the child. For example, the therapist may sing in short melodic
phrases simply built on the buic beat, or conversely in recitative style with