•Alex Street for helping out with the unexpectedly lengthy process of including note ranges for each of the chapters.
•Sarah Rodgers for writing such an original, thought-provoking and moving foreword at very short notice.
•Phyllis Champion for once again coming to our rescue with her insightful, thorough and always thoughtful editing.
Amelia, Jo and Dawn have thoroughly enjoyed working together. The editing process has been much enhanced by Jo’s delicious wine and cheese.
Amelia is grateful to her colleagues at the Croft Child and Family Unit and at Anglia Ruskin University for their support and patience. She would also like to thank her now grown-up children and her husband, David, for their enduring help and love.
Jo would like to thank her parents for their support and encouragement in all her musical endeavours, her children Charlie and Natasha for their patience and understanding, and her husband, Hugh, for being wonderfully supportive.
Dawn would like to thank her husband David for his love and support – and for his patience as she burned the midnight oil.
Dawn, Amelia and Jo would also like to thank David Loombe for his patience, artistic flair and diplomacy in organising all three of us and our instruments to create our cover photograph.
Introduction
Amelia Oldfield
In 1978 and 1979, when I was looking into the possibility of training as a music therapist, I was fortunate enough to observe some clinical work with a music therapist who was a first-study oboist. She was working with a ten-year-old girl with severe learning disabilities and autism. She played her oboe and the girl was transfixed by the beautiful sound of the instrument, following the therapist around the room and showing great interest in the instrument and the player. This was remarkable because the girl was usually very passive, disengaged and oblivious to people around her. I knew then that I wanted to learn to improvise and play the clarinet in this way and share my passion and love for the sound of my instrument with others, using my playing to attempt to engage or help in some way.
In 1979, I applied to do a one-year postgraduate music therapy training course in the UK. At that time there were only two possible places to train in the UK, the Guildhall School of Music and Drama and the Nordoff-Robbins course. When I was lucky enough to be offered places on both courses, I tried to find out as much as I could about them both, but in the end the decision was easy. If I went to the Nordoff-Robbins course, I would be exclusively focusing on the use of the piano, whereas on the Guildhall course I would be able to develop the use of the clarinet in my clinical work, as well as the piano. As an enthusiastic and dedicated clarinettist, the Guildhall had to be the place for me.
During my training I was never actually taught clinical improvisation skills on the clarinet, although I remember classes where I struggled to improve my keyboard improvisation. However, the head of the course, Juliette Alvin, was a professional cellist and often described case studies where she played the cello. On my placements with music therapists who had all been trained by Juliette, I observed two music therapists who played the violin. Students on the course were encouraged to present case material from their placements where they used their first-study instruments. This was enough to give me the confidence to continue using my clarinet in my clinical practice. However, I was surprised by how few of my colleagues at that time continued to regularly use their first-study orchestral instruments in their work.
In 2015, 35 years later, there are now eight music therapy training courses in the UK. All music therapy students remain proficient musicians, but they will be experts on different instruments. The courses vary in their approaches; the majority emphasise keyboard skills, some will teach guitar accompanying techniques and most encourage students to develop the use of their voice. In recent years there has been a greater emphasis on encouraging music therapy students to develop clinical improvisation skills on their first-study instrument, whether this is a violin, a trumpet or a double bass, for example, or a less well-known instrument such as steel pans, the hang or the Chinese erhu. As a result most music therapy students will now continue to play their first-study instrument and use it at least some of the time in their clinical practice.
As a lecturer on the Anglia Ruskin MA music therapy training course in Cambridge, I teach single-line improvisation, encouraging students to discover their own specific strengths and weaknesses when improvising on their single-line instrument, and exploring with them how each different instrument may be used in a wide range of clinical settings. In recent years many students have become quite passionate about using their own instrument in their work and have chosen, in their second year, to write their MA dissertation specifically about the particular use of that instrument in music therapy. Recent MAs have described the use of the accordion (Loombe 2009), the use of the violin (Roe 2011), the use of the harp (Lo 2011), the use of steel pans (Glynn 2011), the use of the erhu (Tsui 2011) and the use of the hang (Fever 2012).
Given that all the music therapy training courses in the UK have for some years now been actively encouraging students to develop their clinical improvisation skills on all the instruments they are proficient at, it is surprising how little literature there is on the use of orchestral instruments in music therapy clinical work. One of the few people who did write about this was Juliette Alvin, who set up the music therapy training course at the Guildhall School of Music and Drama in 1968. She mentions the use of her cello in several case studies (Alvin 1966).
More recently, Salkeld writes about using her clarinet (2008, p.151) and Haire and Oldfield (2009) refer to the use of the violin. However, very few authors actually reflect on the use of their instrument in music therapy, rather than mentioning the instrument in passing as part of a case study. McTier (2012) gives several examples of how he played the double bass when working with young people with autistic spectrum disorder. He writes that ‘the double bass seems to provide a rhythmic and harmonic framework…which is subtly transparent and hence not overbearing’. In my book Interactive Music Therapy, a Positive Approach, I explore the different ways in which I use the clarinet in my work (Oldfield 2006, pp.33–35). In her MA thesis Loombe (2009) examines the literature of two other accordion-playing music therapists, Bright (1993) and Powell (2004), who have written in some detail about how they use the instrument in their clinical work.
These examples in the literature are relatively rare. In the recent collection of 34 case studies edited by Meadows (2011) there is no mention of orchestral instruments. Many case studies describe various uses of the voice and a number talk about using the piano. The guitar is also used, but mainly as an accompaniment to the voice, although Carpente (2011) does mention using the guitar to improvise. Drums and other percussion instruments are often mentioned, and there is a description by Fouche and Torrance (2011) of a marimba group, which is led by a community musician rather than a music therapist. Erkkilä (2011, p.207) describes a case where he taught an adolescent girl some easy bass lines to songs on the bass guitar. However, the bass guitar was mainly played by the client, although the therapist must have had some knowledge of and ability on the instrument in order to facilitate the work. It is interesting that the only two cases that mention the use of instruments other than the piano, the guitar and general percussion, or the voice, are cases where the clients learnt to play the instruments rather than the therapist using the instrument to interact or communicate with the clients in some way. One explanation could be that some of these authors may play and use single-line instruments in their work, but don’t happen to use the instrument in the case they are writing about in this book. In Chapter 5, for example, I describe a case in child and family psychiatry where I used the piano, my voice, the guitar and percussion, but not my first study, the clarinet (Oldfield 2011). So perhaps instruments such as the piano and the voice are used more frequently in our work and this is one reason the other instruments are not so frequently mentioned.
Elsewhere in the literature, many music therapists describe case studies where they use the piano, percussion, or the voice sometimes supported by guitar playing (Bunt and Hoskyns 2002; Darnley-Smith and Patey 2003; Nordoff and Robbins 1971, 2007; Oldfield and Flower 2008; Tomlinson, Derrington