Audible Gestures: From Clinical Improvisation to Community Music Therapy

Abstract

Clinical improvisation, or Creative Music Therapy (CMT) has come a long way since its original conception in the sixties by Paul Nordoff and Clive Robbins both in terms of expanded musical and instrumental resources, new areas of practices including adult mental health, and new theoretical perspectives. Theoretically, CMT now draws from a whole range of discourses, from those inspired by recent approaches within relational psychotherapy, to performance theory and resource–oriented thinking, as well as from the field of community music therapy. A multidimensional perspective on the improvisational approach seems to fit well with the recent development within community mental health thinking about psychiatric rehabilitation. These multidimensional approaches within this field now require several theoretical perspectives, ranging from empowerment theory to social cognitive approaches. The following (instrumental) case study presents the results of music therapy with a woman born in 1953. Listening to live music, improvisation, and teaching keyboard skills were the basic music therapeutical approaches chosen over a period of nearly three years with almost weekly sessions. Within this improvisational approach, four theoretical perspectives are taken into consideration when we explain the changes that have occurred in behaviour: Relational music therapy, resource–oriented music therapy, performance–oriented music therapy and community music therapy. However, we will focus especiaily on the relational aspect of the music therapy sessions concerning a) recognition and attunement by the therapist, b) nurturing through singing and playing, c) musical flow created through improvisation and groove–based play, and especially the sharing of time through gestural attunement and identification.