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What is music therapy?

Find out what music therapy is, what a music therapist does and how to get a degree in music therapy.

Music therapist plays guitar with young girl during music therapy session

Music therapy, far from being “unscientific”, is in fact a recognised health and therapeutic intervention with the potential to change lives. It can be used to help people manage neurological conditions like autism spectrum disorder (ASD) and Alzheimer’s, mental health issues like depression and anxiety, as well as physical injury and disabilities.

In this blog, we’ll cover what music therapy is and what it’s used for. We’ll also provide information on what a music therapist’s job involves and how to get a degree in it. We’ve included expert insight from Alison Hornblower, Head of Training at music therapy charity Nordoff Robbins, Abby Klemm, a licenced music therapist specialising in adolescent mental health and neurodiversity, and Dr Frank Russo, neuroscientist and Chief Scientific Officer at LUCID – a digital innovator in the field. 

What is music therapy?

Music affects multiple areas of the brain simultaneously, making it a powerful therapeutic tool. Music therapy uses the process of interacting with music to help people engage with others, cope with mental health challenges and reach their potential.

“Music reaches our emotions and allows us to express ourselves in ways that words often do not,” says Abby Klemm.

“A steady rhythm can slow our heart when it’s racing. A child with a speech delay might be able to sing a sound when they have difficulty producing the sound in everyday speech.” 

And as well as its direct cognitive effect on the brain, music also gives us opportunity for connection – with an audience or fellow musicians

Communal music making comes with social, emotional and even physical health benefits. And group sessions are particularly useful where people naturally congregate, such as in schools and care homes.

“Music making naturally occurs in a range of group formats – duets, trios, bands, choirs – and any of these can be used in music therapy,” says Alison Hornblower. 

What’s the difference between learning music and music therapy?

It’s important to make the distinction between studying and teaching music itself – where there is an emphasis on one’s technical skill level – and music therapy, which focuses on our visceral relationship with music. 

In a music therapy session such as those offered by the Nordoff Robbins charity, everyone is considered a musician with potential for expression, communication and imagination. 

“People who come to music therapy don’t need to have had any musical training at all,” says Hornblower. “It is the music therapist’s responsibility to use their training to offer these experiences.”

“We usually have a range of instruments in the room and we don’t generally tell people what to play or how to play it. Rather, we draw on an ‘improvisational attitude’ that embraces people’s enthusiasm, abilities and aspirations.”

Why does music therapy work?

Music engages many areas of the brain – particularly its reward, cognitive and emotional systems. One person who understands this better than most is Dr Frank Russo – neuroscientist and chief scientific officer at LUCID, a digital therapeutics company. LUCID uses artificial intelligence (AI) to create personalised soundscapes aimed at specific emotional outcomes – feelings of calm, joy or tenderness, for example.

“Over the course of a music therapy intervention, a piece may develop increased capacity to engage the reward system,” says Russo. 

“It often involves the release of dopamine to the reward system – this is particularly important in older adults as the activity in the reward system and its connectivity to other systems in the brain typically declines as we age.”

What is a music therapist?

Like any professional therapist, music therapists are trained to a high standard – but in this case, they’re also skilled musicians. They engage the unique musicality of their client, even if that client has never played an instrument before. 

“As music therapists, we have a responsibility to listen and attend really carefully to each person’s musicality and to engage with their musicianship, their aspirations and their identity so that we can offer them meaningful, powerful experiences of music making,” says Alison Hornblower.

Those who aspire to a music therapy job in the UK can get a Masters degree in music therapy, such as the internationally-renowned two-year Master of Music Therapy programme taught by Nordoff Robbins and validated by Goldsmiths University. You can learn more about the Nordoff Robbins approach through our two courses: An Introduction to the Nordoff Robbins approach to Music Therapy and Caring with Music: Can Music Do More In Adult Care Settings?

The average starting salary for a music therapist in the UK is £32,305, and the average salary for a principal music therapist is £45,838 (source: National Careers Service). Music therapy jobs in the UK are mostly found within the NHS and through charities such as Nordoff Robbins, or you can offer music therapy privately.

Music therapist conducts music therapy session with young boy with Down's syndrome

What does a music therapy session involve?

Abby Klemm identifies four main methods of music therapy: Improvisation, Re-creation, Composition and Receptive. Although certain methods more naturally lend themselves to certain needs, Klemm cautions against adopting a prescriptive approach. 

“Each method can treat most conditions. The best indicator of effectiveness is a client’s interest,” she says.

The four methods are briefly explained here:

Improvisation

Improvisation is the creation of music in the moment, whether vocal, instrumental or a combination of the two. It requires little pre-planning and allows patients to connect with their emotions as they are.

“If someone is having difficulty expressing their emotions using words, improvisation with instruments could be useful, as it is ‘in the moment,’” says Klemm. 

Re-creation

With re-creation, clients learn to play or sing music that has already been written by someone else. 

“Vocal re-creation could assist with speech needs, while instrumental re-creation could support physical movements – for example, increasing arm strength through playing the drum to a steady beat. And a group re-creation experience can give people a sense of community and combat feelings of loneliness,” says Klemm.

Composition

The best-known form of composition is songwriting. Clients write a song from scratch or change parts of a pre-written song. Composition can assist in language skills, or in self-expression. 

“Many individuals, especially teenagers, write songs and raps as a way to express difficult feelings they didn’t feel they could talk about,” says Klemm.

Receptive

The receptive method involves the client listening to music and reacting in some way – be that musical or non-musical. Like composition, receptive methods can be used for self-expression but also for relaxation. Music can provide the backdrop for guided breathwork or lead to a productive discussion about a song’s themes. 

“People will often identify themes that are relevant to their own life because it feels more ‘distant’. They can say that the singer is feeling these things rather than admitting that they feel them,” says Klemm.

What is music therapy used for?

While music therapy has the potential to help almost anyone, there are certain groups of people and certain conditions for which music therapy has been particularly beneficial.

Autism spectrum disorder (ASD)

People with ASD often struggle to communicate with others. Music gives them the chance to bypass that and express their emotions in a non-verbal way. Music therapy for autism focuses on developing social skills and emotional awareness. 

Alzheimer’s and dementia

Because music taps into so many areas of our consciousness, it often forms our first memories and our last ones. Music also offers dementia patients the potential for non-verbal communication, giving vital chances to connect with others when ordinary conversation is a challenge.

“Individuals with late-stage dementia or Alzheimer’s can recall and sing favourite songs of their youth when other memories and communication have otherwise left them,” says Klemm.

“Someone living with dementia may be losing their capacity to communicate verbally, but in music they can feel a sense of flow and connection that doesn’t require words – music therapy gives people opportunities to celebrate their sense of self,” says Alison Hornblower. 

Care home residents

Music therapy helps care home residents to build a sense of community

“Carefully facilitated opportunities for communal music making may be particularly important in order to help people in care homes feel connected to others around them,” says Hornblower.

School students

Music therapy can benefit school pupils of all ages, particularly those with additional needs or who have experienced trauma or neglect. 

“Individual sessions offer students a rare opportunity for their own needs to be the focus and for them to try out new ways of relating,” says Hornblower.

Hospice care

Music can be a source of comfort to someone entering their final days. Abby Klemm recounts one experience with a hospice patient: 

“The patient’s face appeared as if she were in pain, and her breathing was shallow. I began playing my guitar in a soothing pattern to match her breathing. I then gradually slowed the tempo, incorporating longer-held notes, and her breathing slowed down with me as she began to physically relax. I then continued playing as I sang a song I had learned in her native language. I saw her mouth move ever so slightly as I sang. At the end of the song, she opened her eyes, smiled at her daughter, and squeezed her hand. The daughter told me, with tears in her eyes, that the song I played and sang was a lullaby her mother sang to her as a child.”

Mental health issues

Music therapy can be beneficial for people suffering from a wide range of mental health conditions, including depression, anxiety and post-traumatic stress disorder (PTSD). Klemm used music therapy to create a safe space for one teenage client, a survivor of abuse who had developed PTSD, substance abuse and other mental health disorders. 

“At the beginning of our therapeutic relationship, she would often play me songs that meant a lot to her. Over the weeks and months, she began identifying themes that related to her own life.”

She would eventually open up about experiences that she had never told anyone, and she and Klemm continued to work through her trauma therapeutically.

One day she asked Klemm if she could learn the piano – one of the first times she had ever requested to engage in a healthy activity. She chose songs that were meaningful to her and Klemm created piano arrangements that were easy to learn. By the time they finished working together she had learned five songs and would often play them while Klemm sang along. They recorded a CD of their performance that she used whenever she began to feel overwhelmed.

Who are Nordoff Robbins?

Nordoff Robbins is the UK’s largest music therapy charity. Their therapists use the power of music to enrich the lives of people affected by life-limiting physical and mental illness, disabilities or feelings of isolation. Nordoff Robbins music therapists work in a variety of contexts: schools, care homes, hospitals and community mental health projects around England, Scotland and Wales.

The Nordoff-Robbins approach was developed in 1959 by Paul Nordoff, an American composer and pianist, and Clive Robbins, a British teacher of children with additional needs.

How has the Nordoff-Robbins approach changed over the years?

The core aim of Nordoff Robbins – to encourage people to realise their potential and engage with others through music – remains unchanged, but its music therapists have become more diverse. 

“Paul Nordoff was a classical pianist and composer but now, our therapists and trainee therapists come from a much wider range of musical traditions and we no longer prioritise skills associated primarily with classical music, such as being able to read traditional musical notation,” says Alison Hornblower. 

“We should be able to engage with anyone musically, so it’s important that we expose ourselves to a wide variety of music. We hugely value both musical and personal diversity in our student cohorts.”

How can anyone benefit from the therapeutic power of music?

There are ways in which all of us can benefit from music in our personal and professional lives. Music can energise us, help us focus, or help us relax

“Music can give us a sense of safety or the feeling that we’re not alone, especially when the world feels overwhelming,” says Klemm.

She adds that an easy practice could be to create a playlist of songs that give you a feeling of comfort – this can be a go-to coping mechanism when you’re having a bad day. 

“Pay attention to the emotions that stir in you while you listen to music and allow yourself to express them,” she says.

“If it makes you laugh, laugh, if it makes you cry, cry. Music can help us tune into our own bodies and recognise what we need in the moment.”

For those who prefer a tech-driven approach to musical self-care, there is a raft of new applications claiming to act as “digital drugs,” delivering relief to anxiety sufferers, insomniacs and distracted workers through tracks curated specifically to their needs.

Services such as LUCID and Endel – an app that automatically crafts personalised tracks based on your heart rate and circadian rhythm – take “biohacking” to a whole new level and offer a glimpse into the potential future of music-based healthcare. However, it’s likely that face-to-face therapy with a real human will remain the gold standard for those in greatest need.

Final thoughts

Music helps us to communicate and bond where words fail, making the work of music therapists and charities such as Nordoff Robbins life-changing for thousands of people around the world.

At the core of music therapy is the belief that everyone is musical and that everyone can be a musician.

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