“Sarah” was a 9-year-old African-American female with a history of sexual abuse, neglect and abandonment. The focus of her music therapy treatment addressed self-regulation and prosocial skill development. Music therapy sessions included improvisation, lyric analysis, live music production and songwriting. The structure of the sessions was activity-based and included use of visual aids to create a concrete and multisensory process.

The “Feelings Faces’ ‘ improvisation activity used with Sarah explores musical expression of feeling states to encourage development of a feelings vocabulary. Pictures of actual people, each with a different effect (e.g., happy, sad, mad, scared), were first viewed and discussed. Then, Sarah and the music therapist took turns selecting a “feelings face ” and improvising music on the piano that matched that feeling state. Each took turns guessing what feeling was being musically expressed. Sarah played loudly and aggressively to portray a mad feeling and softly to portray a sad feeling. The therapist encouraged Sarah to discuss and process circumstances and events in her life that contributed to these different feeling states.

“Helping Hands” is a more advanced lyric analysis activity that helped Sarah decrease her aggressive behavior and increase prosocial behavior. Printed lyric sheets of the song “Hands” by the recording artist Jewel were distributed, along with blank sheets of paper. Sarah was encouraged to follow the lyrics and actively listen to the meaning of the song. The recording was then played a second time (at a lower dynamic level), and Sarah was directed to trace around each of her hands on the blank sheets of paper. She was then asked to write or draw on each finger of her left hand one way in which she could use her hands to help others (e.g., handshake, kind touch, wave hello, help with chores). She was asked to write or draw on each finger of her right hand one way in which hands could be used to hurt others (e.g., hit, push, grab). Sarah and the therapist examined ways to use hands to help others and how to avoid using hands for hurtful behaviors. Sarah’s foster mother used a sticker token economy to reinforce the times when Sarah used her hands in helpful ways.

Future Directions 

As the evidence supporting the utility and effectiveness of music therapy continues to accumulate, stronger research designs are needed to directly compare music therapy with other child therapies. The rigor of this type of testing is at the core of the evidence-based practice movement. In addition, the next generation of music therapists will pioneer the integration of music with multimedia treatment methods and computer-assisted technologies. These emerging technological capacities will provide new and innovative instruments for music therapists to use in modern psychiatry’s struggle to “heal the soul in the age of the brain.”