Compassionate Human First, Music Therapist Second

While keeping an eye on their family’s sheep and alpacas, Aymara boys in the Peruvian Andes play marbles. In their game they need to shoot the marbles over rocks and twigs and through clumps of grass as they aim for a row of small holes they have dug into the ground. The appeal of the game lies in how these rocks, twigs, clumps and holes acts as agents, and in where the marbles will be diverted to. Through this example, Smith (2017) highlights how it is not simply the case that children play with material toys. Toys – including the surface of the ground – also play with children.
 The current issue of Approaches contains articles stretching from music-making programmes to music therapy with groups, individuals, couples, and families, in diverse contexts such as a prison, community settings, an inpatient psychiatric care facility, private practice, and an arts therapies organisation. Rich in their own right, each of these papers also dialogue with one another. Holding While keeping in mind the story of the Peruvian boys and their marbles, we might hear a strand of dialogue emerging in relation to various notions of agency. These notions feed into wider debates about who (or what) the players are when music therapy “works.” Is the music therapist offering an “intervention” or “treatment”? What is role of the client and of musicking in the therapeutic outcome? What is the impact of the interrelations between therapist, client and music? What is the influence of the situated nature of the therapeutic encounter, including its sociocultural context? Alongside these considerations, further questions emerge about how music therapy works (including its spatial and temporal elements – the ‘where’ and ‘when’) and, indeed, about what we actually mean by saying music therapy “works.”
 Individualistic notions of agency champion lone individuals as holding within themselves the capacity to be actors. From this perspective, people are agents when they choose one course of action over another in order to produce a particular effect (Archer, 2003; Giddens, 1984). Various alternative perspectives are available however, some of which have long existed within indigenous knowledge systems (Enfield, 2017) and others that have more recently been integrated within Western critiques of individualised agency. Writing within relational sociology, Burkitt argues that people produce certain effects on each other and in the world “through their relational connections and joint actions, whether or not those effects are reflexively produced. In this relational understanding of agency, individuals are to be thought of as ‘interactants’ rather than as singular agents or actors” (Burkitt, 2016, p. 323). Furthermore, from the perspective of new materialism, the capacity for agency emerges within the intra-action between human and non-human elements (McPhie, 2019). Such notions of distributed agency have informed and continue to inform understandings of music therapy as a situated relational encounter where therapeutic musicking is co-created by human and non-human elements that are reciprocally formed through assemblages of people, places, bodies, musical instruments, institutions, policies, technologies, ideas, and so on. Ansdell (2014), for example, has promoted the concept of musical ecology taking into account the place, time, and people who use certain things, are involved in certain relationships, and who are all becoming part of the music therapy action. Similarly, Flower (2019) has used Ingold’s notion of meshwork to unpack how expertise is formed and enacted in music therapy along the interweaving trails of people, things, and places. In her research work, she endeavoured to navigate “through the ‘unevenness’ of the territory to not only trace the people, places, and activities through which music therapy’s work is achieved, but also to unpick, if possible, the meshwork within which they interweave” (Flower, 2019, p. 155).
 Instead of wondering whether it is the music therapist, the client, or the music that is doing the work, or how to balance the weight of each element most appropriately in the service of therapeutic outcomes, we could look at what is happening in the flow between such agents. Rather than limiting ourselves to asking only how, or where, or when, or with what, or why music therapy works, we could think with and play with how these facets come about through their intra- and inter-action. As you read this journal edition, we invite you to hold these considerations in mind.
 In this issue, Helen Odell-Miller, Jodie Bloska, Clara Browning and Niels Hannibal focus on the process and experience of change in the self-perception of women prisoners attending music therapy sessions in the UK. In this mixed-methods exploratory study, which is based on the doctoral research of the late Helen Leith, we see how agency was distributed (through participants, the music therapist, the song-writing process, entry points into other programmes required for resettlement, to name a few elements) within a care ecology that generated participants’ self-confidence. In a pilot case study, Peter McNamara, Ruyu Wang and Hilary Moss focus on the potential of music therapy to promote positive communication and emotional change for couples. By describing the shared musical space that was created in music therapy with a married couple in Ireland, their study shows how the intermingling of the music therapist, the couple, their memories, the song-writing process, the improvisation and the therapy room formed a care collective that could shift awkward interaction into expressive playfulness and a sense of shared agency. In her article, Rachel Swanick exploresthe impact of trauma on cognitive development in relation to music therapy with children and families. She argues that an important part of the therapist’s role is to reflect on why their work can be effective and on what they do together with the client that helps. This points to an exploration of the factors of effective therapy, and Swanick proposes a pilot project using the Swanick-Chroma Assessment of Supportive Factors (SCAF) questionnaire, which is based on Lambert’s four main factors of effective therapy: relationship/alliance, client characteristics, model of therapy, and expectancy. Kevin Kirkland and Samuel King write about a music therapy process-oriented intervention for adults who live with concurrent disorders. Drawing on their work in Canada with a group called ‘Rap and Recovery’, they explore how rap-based music therapy can create a dynamic space for clients and therapists to “question individual and collective commitments, relationships, and identities in attempts to rethink and re-engage understandings of health and wellness” (p. 70). They outline the intermingling of rap as a catalyst for social reform, the organisational context of the authors’ work, discourses of recovery, people’s own complex histories of wellbeing and struggle, and their sharing of life stories in music therapy. The emerging sense of distributed agency that could come about in this music therapy care collective is linked to participants’ sense of community, personal autonomy, and well-being. Lastly, Katrina Skewes McFerran and Jessica Higgins explore the Just Brass music programme for young people in Australia. With a focus on the role of leadership and facilitation in fostering connectedness and development, the authors interviewed a group of young leaders who had been involved in the programme. The findings show the interconnection between musicianship and wellbeing. The authors challenge methodological assumptions that tend to separate out the influence of leadership from the effect of the music in order to prove the wellbeing benefits of music. 
 Overall, the contents of this issue – taken together with the book reviews and conference reports – offer varied perspectives and questions promoting further our understanding of the human-nonhuman intertwining in music and wellbeing practices. In the opening story, the nature and purpose of the Peruvian boys’ marble game comes about through an assemblage. Indeed, the marbles (and rocks and twigs, grass and holes) play with the boys as they play with these objects and with each other. By acknowledging joint action, distributed agency and the liveliness of matter (Bennett, 2010), we can open a space for the between in our work.
 Closing this editorial, we warmly welcome Lucy Bolger from University of Melbourne, Australia who recently joined our team as associate editor of Approaches. Lucy’s music therapy work with marginalised communities in Australia, Bangladesh and India, and her research interest in how the intersections of power and privilege influence people’s understanding and access to music therapy (Bolger, 2015; Bolger et al., 2018) resonate with the ethos of Approaches and can offer another lens for engaging with notions of agency as these emerge in this issue.
 References
 Ansdell, G. (2014). How music helps in music therapy and everyday life. Ashgate.
 Archer, M. S. (2003). Structure, agency and the internal conversation. Cambridge University Press.
 Bennett, J. (2010). Vibrant matter: A political ecology of things. Duke University Press.
 Bolger, L. (2015). Being a player: Understanding collaboration in participatory music projects with communities supporting marginalised young people. Qualitative Inquiries in Music Therapy, 10(3), 77-126. https://doi.org/10.1093/mtp/miy002
 Bolger, L., McFerran, K. S., & Stige, B. (2018). Hanging out and buying in: Rethinking relationship building to avoid tokenism when striving for collaboration in music therapy. Music Therapy Perspectives, 36(2), 257-266. https://doi.org/10.1093/mtp/miy002
 Burkitt, I. (2016). Relational agency: Relational sociology, agency and interaction. European Journal of Social Theory, 19(3), 322-339. https://doi.o

Music therapy and social justice: A personal journey

Advancing knowledge in music therapy

Societal changes, economic challenges, and multiple global crises require reorienting and repositioning in relation to ethical questions. The need to deal and cope with these challenging circumstances also applies to music therapists and the field of music therapy. To address such ethical issues in music therapy and to provide a forum for exchange and discussion, we started organising online meetings open for music therapists and music therapy students in June 2020. Each meeting is dedicated to a topic or question illustrated by case vignettes. In some cases, experts with specialised knowledge in music therapy or related fields are also invited as discussants to speak on specific topics. So far, the following topics have been covered: (1) ethical issues in times of the pandemic, (2) ethical aspects of listening, (3) facts and opinions: What to do when "conspiracy theories" emerge in music therapy sessions?, (4) the virtuous music therapist, (5) decision-making models, (6) confidentiality, (7) music therapy with people affected by migration or those forced to flee, (8) dealing with the history of colonialism in songs in music therapy, (9) the art of confidence in times of crisis, and (10) ethical implications of the use of artificial intelligence (AI) in music therapy. In this report, we describe the advantages and challenges of this new online format as a case example for developing an open space for ethical discourse. Connecting ethical theories to questions arising from clinical work in music therapy is at the core of this approach. We consider this new format an essential add-on for teaching ethics in music therapy and for continued professional development.

Women form a minority (4.8%) in the UK prison system, which is predominantly designed for men. A high number of women prisoners bring experiences of trauma and abuse with them into the system. The incidence of mental health problems is inordinately high compared to the general population. Whilst an increasing number of UK music therapists work in forensic psychiatry, providing treatment for mental disordered offenders, there is a dearth of music therapists working in UK prisons. There is correspondingly little research into music therapy and women prisoners. The current article presents the qualitative results of a mixed-methods doctoral study carried out by Dr Helen Leith (2014). Using qualitative data, the study investigates whether there is a change in the self-perception of women prisoners attending music therapy and whether, if this is the case, they show an improved ability to engage with prison resettlement interventions. Findings for 10 participants indicated that women prisoners attending music therapy experience a change in self-perception and engagement in music therapy translated into behavioural change outside the music therapy room. Through adaptive interpretative phenomenological analysis of semi-structured interviews, themes indicated that participants showed an increase in self-confidence, self-esteem, self-efficacy, achievement motivation and a number of other areas relevant to successful resettlement. There was a reduction in the number of self-harm or behavioural incidences and attendance of other programmes improved. For severely disaffected prisoners, music therapy provided an appealing and motivating intervention, which served as an entry point to other programmes required for resettlement. Women prisoners not only showed an enhanced ability to attend the programmes required for their successful resettlement; music therapy created aspirations, which is of significance to downstream outcomes. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Note by the first author: This article is based entirely on the original research undertaken by Helen Leith, as published in her PhD, and summarises the study in article form. The authors for this article have had different roles in relation to the original manuscript and the subsequent writing of the article. Helen Odell-Miller and Niels Hannibal were supervisors for Leith’s PhD research and as such helped Leith throughout the whole research process. In that sense, we both feel ownership to Leith’s work, and we are both proud and honoured to be associated with this research. In order to give Leith’s ‘voice’ we have kept to the original text as far as possible. Jodie Bloska and Clara Browning, who have assisted with the manuscript, are from Anglia Ruskin University. The article has added material to the original text and incorporated our views and reflections in order to present the unique work Leith carried out prior to her death in 2014. Leith was aware we would eventually publish some of her work, but she could not be listed as an author as, sadly, we had not started writing the article before she died. I am grateful to Niels Hannibal, the other supervisor of her PhD at Aalborg University, and to Jodie Bloska and Clara Browning from Anglia Ruskin University – where Leith’s mobility PhD Fellowship was also based in the UK – who assisted with the manuscript. Leith’s full thesis is freely accessible through Aalborg University (see Leith, 2014). The late Helen Leith was born in 1958. She studied bassoon and piano at the Musikhochschule Detmold, Germany. She later worked as a youth worker with young German women in France and Great Britain. For 25 years, Helen was a nun in a residential order in London. In 2005, Leith gained her Master in Music Therapy at Nordoff Robbins, London. She worked with women prisoners, from 2008 until her illness took hold, as project manager and delivering music therapist of a ‘through-the-gate’ music therapy project working with female offenders on their pathway through prison and back in to the community. In 2010, she was awarded a Mobility Fellowship by Aalborg University to undertake doctoral research, the qualitative results of which are reported in this article. Sadly, Leith died in 2014, shortly after having delivered her public PhD defence in Cambridge. In a tribute to Leith, it was written that there is ‘no doubt that Helen has made an enormous impact on the prison [in which this research is based], not only in her music therapy work in the room with women, but also within the prison itself’.

This work aims to approaching the role of music therapy in relation to Alzheimer’s disease (AD) within the field of Social Work. In order to do that, a bibliographical revision is carried out and some key concepts, such as music therapy, Alzheimer Disease, or social work intervention, are selected. The information gathered leads to the conclusion that music therapy works as an adjuvant treatment for Alzheimer patients through areas such as social integration, self-esteem, communication, or stress reduction. Thus, it is concluded that musical stimulation improves AD patients’ quality of life.

She serves as associate editor of Approaches.

According to the World Culture Report of UNESCO (2000), cultures are not fixed, bounded and crystallized containers. Instead they are “transboundary creations, exchanged through the world […]. We must now regard culture as a process rather than as a finished product” (UNESCO 2000: 15, as cited in Thomson 2005: 11). A similar view is adopted by Stige (2002) in his seminal book Culture-Centered Music Therapy. Stige writes that culture is not a fixed entity. In contrast, he thinks of culture as something flexible, as “continuously developing ways of life and practices of meaning-making, ranging from the individual to the regional to the global level of social organization” (Stige 2002: 1). From this perspective, the constant flow of culture, as an embodied everyday experience, is made up by the subtleties and complexities of individual and collective life histories. The article and interviews included in this issue of Approaches, illustrate these various levels of ‘cultural stories’, as well as their mutual interaction. In the article Music Therapy and Culture: An Essential Relationship? Daisy Morris explores the role of culture in music therapy practice. Taking Aigen’s (2001) premises on music, culture and therapy as a starting point, Morris discusses how our therapeutic awareness and receptiveness as music therapists interrelates with our cultural awareness. She explores how music therapy work can be affected by both the therapist’s and the client’s cultural backgrounds and histories, as well as the wider cultural framework within which therapy takes place. The interview section of Approaches, which is inaugurated in this issue, starts with an interview of Pauline Etkin who reflects on the development of policies and practices in music therapy. Etkin, whom I had the honour to interview, draws on her rich personal experience in Nordoff Robbins, London. She interweaves creatively historical facts with politico-economic aspects, while she brings in the foreground personal stories which often stay ‘behind the scenes’. Etkin reflects on aspects of the music therapy development in the UK, as well as Nordoff Robbins’ role in this development, while she discusses their potential relevance to the development of music therapy profession in other countries, such as Greece, where music therapy is in its initial stage. The next interview is with Diane Austin who was interviewed by Evangelia Papanikolaou. This interview explores the use and significance of voice in music therapy, and more particularly the pioneering voice-based model of psychotherapy that has been developed by Austin: Vocal Psychotherapy. This exploration reflects on Austin’s (2008) recent book The Theory and Practice of Vocal Psychotherapy: Songs of the Self by drawing on her own personal life history, but also from her extensive clinical experience as a vocal psychotherapist. This issue of Approaches concludes with two new sections: i) New Publications in Greece, and ii) Upcoming Events. Both sections are dedicated to the fields of music therapy and special music education, while they draw from the international community with an emphasis on Greece. These sections aim to provide useful information and raise the readership’s awareness of relevant news and developments. This raise of awareness is linked directly with Approaches’ vision (Tsiris 2009) for advancement of scientific dialogue, for fertile connection of practice, theory and research, as well as for reliable public update through the free dissemination of its articles and resources. Approaches, like many other online peerreviewed journals (e.g. Voices: A World Forum for Music Therapy, see Stige 2009), follows the wider international movement of Open Access publishing. This open access to scholarly journals is vital to research progress and public advancement (COPE 2010), especially during the recent economic downturn that both Greece and other European, but not only, countries face. This downturn has already brought consequent challenges on healthcare and educational services, as well as on the funding resources for research and publishing. Approaches hopes to support effectively the work of practitioners and researchers in the fields of music therapy and special music education by promoting a culture where evidence-based practice is balanced with practice-based evidence.

BackgroundOlder adults often experience changes in health, finances, and social support, which impede community involvement and can be compounded by the onset of cognitive decline. Interprofessional collaboration can help counter such challenges. Here, researchers present a feasibility study, which demonstrated support for a novel social work and music therapy telehealth framework to promote well‐being of older adults with and without dementia. We describe the subsequent pilot study design.MethodDuring the feasibility phase, researchers field‐tested logistics and provided proof‐of‐concept of our novel framework in a randomized cross‐over design. All participants received 6 music therapy sessions via telehealth across 3 weeks (2x/week for 25 minutes) and one 30‐minute social work wellness session with service referral. Quantitative outcomes included self‐reported feelings, anxiety, depression, and loneliness to inform the utility of this framework to improve well‐being of older adults with and without dementia. We conducted semi‐structured interviews with participants and care partners, who offered input about all aspects of the study.ResultsLessons gleaned from the feasibility study, and which informed the pilot, were: 1) participants conveyed that the delivery model was acceptable, interesting, convenient, and helpful; 2) given resources and support using digital technology, older adults found telehealth to be an attractive and feasible delivery mode; 2) older adults and care partners liked music therapy and greatly disliked the recorded music option; 3) music therapists could utilize the “Clinical Practice Model” (Reschke‐Hernández, 2021) to inform provision of appropriate levels of support and challenge to older adults with and without dementia via Zoom; and 4) social workers could leverage the rapport music therapists built with participants and the information they gathered during sessions to link older adults to community resources ‐ a service older adults found more helpful and meaningful than in past social work experiences. Pilot results will be available in December 2023.ConclusionThis project advances a collaborative research partnership to improve research quality and facilitate access to services for older adults with and without dementia. The careful steps of this feasibility and pilot work will inform best practice in an innovative area of music therapy and social work professions.

<p>Music therapy school consultation is positioned to become a significant practice for music therapists. Historically, music therapy work with children who have special education needs in New Zealand has focused on those who attend special schools or units and, according to the published literature, seems to have taken place in clinic settings or withdrawal rooms. The current emphasis on inclusive education demands that music therapists consider other ways of working. Further, a paucity of music therapists and the geographic isolation of many students who attend their local schools suggest that the large majority of students who would benefit are unable to access music therapy services. The aims of the current study therefore were for a music therapist to empower members of special education teams to use music experiences which had been especially planned to assist children to meet individual developmental or academic goals, and to describe how the process was perceived, understood, used, and valued by participants. A further aim was to develop and trial a protocol for music therapists undertaking consultation work. Eight registered music therapists interviewed in stage one of the study, to aid the development of the initial protocol, had differing views and attitudes about consultation, and findings confirmed the need to clearly define the practice. The initial protocol was therefore fragile, based on limited understandings from sparse music therapy consultation literature and the author's previous experience of working with team members in isolated areas. In stage two, four consecutive case studies enabled the protocol to be trialled in the field and, using an action research approach, to be developed further. Accumulated learning outcomes led to the development of a music therapy school consultation protocol based on social learning theory which emphasises the interdependent relationships between the consultant's (music therapist), consultees' (identified team members), and clients' (students) behaviour, their internal personal factors, and environmental factors. The establishment of collaborative relationships, and an ecological assessment which is based on the theory that human development is influenced by environmental systems (Bronfenbrenner, 1989), are critical components of the protocol. Thus the music therapist spends a full week at each student's school. Findings demonstrate that interacting with team members as they went about their daily lives led to deeper understanding of their needs and in turn enabled pragmatic, accessible, and meaningful music activities and strategies to be successfully implemented. A 'clinical' music therapy session remains an important part of the protocol, but findings suggest its primary significance is in highlighting students' strengths so that team members develop fresh understandings and increasingly positive views of students that enhance their mutual relationships. Team members became more motivated, energised, self reflective, and able to support as well as challenge their students' development. They were thus able to continue to use, develop and evaluate their use of music strategies, after the music therapist left the field. Music therapists are currently unprepared for the triadic relationships and the emphasis on adult empowerment that is fundamental to consultation. The findings therefore have significant implications for music therapy practice and training. These implications, including areas for future research, are discussed herein.</p>

<p>Music therapy school consultation is positioned to become a significant practice for music therapists. Historically, music therapy work with children who have special education needs in New Zealand has focused on those who attend special schools or units and, according to the published literature, seems to have taken place in clinic settings or withdrawal rooms. The current emphasis on inclusive education demands that music therapists consider other ways of working. Further, a paucity of music therapists and the geographic isolation of many students who attend their local schools suggest that the large majority of students who would benefit are unable to access music therapy services. The aims of the current study therefore were for a music therapist to empower members of special education teams to use music experiences which had been especially planned to assist children to meet individual developmental or academic goals, and to describe how the process was perceived, understood, used, and valued by participants. A further aim was to develop and trial a protocol for music therapists undertaking consultation work. Eight registered music therapists interviewed in stage one of the study, to aid the development of the initial protocol, had differing views and attitudes about consultation, and findings confirmed the need to clearly define the practice. The initial protocol was therefore fragile, based on limited understandings from sparse music therapy consultation literature and the author's previous experience of working with team members in isolated areas. In stage two, four consecutive case studies enabled the protocol to be trialled in the field and, using an action research approach, to be developed further. Accumulated learning outcomes led to the development of a music therapy school consultation protocol based on social learning theory which emphasises the interdependent relationships between the consultant's (music therapist), consultees' (identified team members), and clients' (students) behaviour, their internal personal factors, and environmental factors. The establishment of collaborative relationships, and an ecological assessment which is based on the theory that human development is influenced by environmental systems (Bronfenbrenner, 1989), are critical components of the protocol. Thus the music therapist spends a full week at each student's school. Findings demonstrate that interacting with team members as they went about their daily lives led to deeper understanding of their needs and in turn enabled pragmatic, accessible, and meaningful music activities and strategies to be successfully implemented. A 'clinical' music therapy session remains an important part of the protocol, but findings suggest its primary significance is in highlighting students' strengths so that team members develop fresh understandings and increasingly positive views of students that enhance their mutual relationships. Team members became more motivated, energised, self reflective, and able to support as well as challenge their students' development. They were thus able to continue to use, develop and evaluate their use of music strategies, after the music therapist left the field. Music therapists are currently unprepared for the triadic relationships and the emphasis on adult empowerment that is fundamental to consultation. The findings therefore have significant implications for music therapy practice and training. These implications, including areas for future research, are discussed herein.</p>

Cultural diversity has become a fact of our reality. To what extent this is considered in music therapy has been little studied. Four German and six English language music therapy journals were selected for a literature review of the period 1990–2019. They were systematically screened for articles with an intercultural context. The 196 articles identified, 138 of which in English, were evaluated using time-series representation and an evaluation matrix with nine categories, including client age groups. Intercultural music therapy articles with case studies appear from the turn of the millennium. With an increase in tendency, they have lately accounted for a fluctuation rate of approximately 4 %. The results show a classification of migration-specific pressures in intercultural music therapy work emphasizing the effects on children and adolescents. Pilot studies in multicultural schools and kindergartens report positive effects of music therapy, but admit insufficient sample size and lack of evidence. The importance of intercultural competency for music therapy work is emphasized, however there is no indication of its integration in music therapy training. Interdisciplinary research projects, together with educational and systemic psychiatric disciplines at schools, could help with difficulties in providing evidence for music therapy. Surveys on teaching intercultural competency at music therapy training-institutions would be useful.

Adult trauma work in music therapy is well established globally, and various approaches presented in the literature reveal the positive impact of using music as part of a therapeutic process. The main music psychotherapy techniques in adult trauma work include improvisation and music listening.Group Analytic Music Therapy(GAMT) was developed by the author. GAMT is a combination of group analysis, interpersonal theories, and intersubjectivity. The therapy group is observed and analyzed from three different perspectives, responding to: (1) The individual in the group (the intersubjective window); (2) the members with one another (the interpersonal window); and (3) the group-as-a-whole (the group matrix window). This chapter presents some of the techniques and methods of the GAMT with the caveat that further training beyond entry level to music therapy is needed to use these techniques and methods.

Wigram, Foreword. Watson, Introduction. Watson, Valuing People: A New Framework. Watson, Music Therapy with Adults with Learning Disabilities: Sharing Stories. Saville, Music Therapy and Autistic Spectrum Disorder. Warner, Challenging Behaviour: Working With the Blindingly Obvious. Richards, 'What Bit of My Head is Talking Now?': Music Therapy with People with Learning Disabilities and Mental Illness. Fillingham, Friendship and Group Work. Watson, Community, Culture and Group Work. Watson, Working with People with Profound and Multiple Learning Disabilities in Music Therapy. Saul, Looking in From the Outside: Communicating Effectively about Music Therapy Work. Twyford, Watson, Multidisciplinary Working and Collaborative Working in Music Therapy. Appendix I: Guidelines for Good Practice for Music Therapists. Appendix II: Useful Organizations and Websites.

In this article, I present a condensed form of research I undertook for a student assignment on how music therapists navigate working in institutions to promote social justice. My literature review highlights approaches in which music therapists integrate social justice into their work. Within the confines of this search, I did not find literature addressing how music therapists navigate a social justice agenda within institutions as their primary focus: this is the gap in the field in which I aimed to position my research. I interviewed five Nordoff and Robbins music therapists, coded my transcriptions, and developed categories and themes. Through the interviews, I found that my participants view allyship through music as valuable social justice promotion, as well as interactions beyond music including presentations, spontaneous conversations, and learning from staff. The extent to which these music therapists felt able to engage in social justice promotion was dependent on relationships within institutions, and they considered when it was less appropriate to speak out, often because of their privilege. I hope this research provides insight for the profession and prompts further exploration of how music therapists can promote social justice within institutions, particularly centring the experiences of those from marginalised groups.