- In-The-Blank And Song Parody Technique In Music Therapy

2) Improvisation

Music Therapy literature documents the development and value of improvisation in clinical work working with different kind of clinical populations.
Improvisation is a category of Music Therapy often used by therapists Within improvisation, there are many forms, methods and techniques.
Therapists use improvisation in order to allow the clients to improve self-expression, creativity and communication using voice, movement and percussion instruments.
The client makes up his or her own music spontaneously with voice or an instrument. Though most of the time the therapist play exactly the same thing the client which allows the client to can then see their own behaviour in the behaviour of the therapist (Wigram, 2004, mirroring, matching).
Bruscia defined a very similar technique recognised as Reflecting, in which the therapist is sensitive in musical response so that the style of playing ‘matches the mood, attitude or feelings exhibited by the client' (Wigram, 2004). These techniques are very useful when the client cannot picture or phrase what their problem is nor comprehend their mood.
Though not every technique demands the therapist to imitate the client. Some techniques require the clients to imitate after the therapist shows them, for
example, a steady beat or a chord progression. On the assumption that the client will participate therefore it promotes initial musical dialogue. Bruscia (1987) defined this technique Modelling.
Improvisation techniques are more convenient to clients who need to make progress in their communication skills, social relationships, originality and spontaneous reaction. In order to improve in these aspects therapists, plays maintain ‘a rhythmic, harmonic or melodic accompaniment' conducive to a solo played by the client.
That being said music therapists need training quite a lot of training to be able to improvise a wide range of ‘intensity (harmonic, dynamic, rhythmic), contour (melodic shape, harmonic contours), time (tempo changes), motion (the illusion of different tempi through rhythmic subdivisions); and to exercise disciplined and subtle control over these within a highly aesthetic medium - that of music'. Sabbatella (2004).

3) Songwriting

Baker & Wigram (2005) defined Songwriting in Music Therapy as ‘the process of creating, notating and/or recording lyrics and music by the client or clients and therapist within a therapeutic relationship to address psychosocial, emotions, cognitive and communications needs of the client.'
Songwriting in MT might sound old but only in 1965 Ruppenthal would write for the first time about this topic followed by Castelano 1969 and Ficken 1976. Since then songwriting has been used in many different fields for people with different needs. People with reading and writing difficulties (Johnson 1981), chemically dependent adults Free 1987). Furthermore, songwriting has been used in the hospital field for young adults with traumatic injuries (Amir 1990, Hadley 1996), development disable people (Fischer 1991) and children with cancer (O'Callaghan and Jordan 2011).
Songwriting is used because it encourages ‘the expression of thoughts and feelings, problem-solving development, and emotional, spiritual and social support' (Baker & Wigram, 2005).
A survey by Baker et al. (2008) showed that the goal areas most frequently addressed using songwriting included:

(a) experiencing mastery, develop self-confidence, enhance self-esteem;
(b) choice and decision making;
(c) develop a sense of self;
(d) externalising thoughts, fantasies, and emotions;
(e) telling the client's story; and
(f) gaining insight or clarifying thoughts and feelings.

An important component of songwriting is the music vehicle (e.g. melody, tempo, harmony) which contributes to conveying meaning when the message, feelings and emotions may be otherwise unclear. The music process usually starts through improvisation unless the client already has an idea or concept. Though music can be added after writing the lyrics. In general, music is intended to correspond to the mood the message the client is trying to transmit. Felicity Baker, Tony Wigram (2005) stated that ‘many patients feel more conformable starting with the lyric creation.' Many people seeking music therapy are not musicians nor feel too comfortable playing an instrument.

During the Therapeutic Lyric Creation (TLC) the therapist uses different techniques. Though before starting to write any lyrics the therapist and the client brainstorm a few ideas. This process allows the client to generate ideas and concepts which build confidence and aids communication.
Freed (1987), Goldstein (1990) and Robb (1996) provide literature about two techniques commonly use in therapeutic songwriting.
Fill-in-the-Blank (FBT) and Song Parody Technique (SPT). FBT helps clients who have trouble organising ideas, by giving them a structure. Clients will often use this technique to find a direction to the lyrics. Interestingly, sometimes ‘the creation of lyrics does not proceed the composition of the music' (Wigram). SPT requires pre-composed to pre-recorded music in order for the clients to replace the original lyrics of a song with their own words. Furthermore, on occasion, music and lyrics creation merge. At times the therapist will bring pre-recorded material to a therapy
session.
For clients who have difficulty identifying or articulating their emotions therapists usually use Song Collage Technique (SCT). Almost like brainstorming the clients look at music books with lyrics to find lyrics that stand out or have personal significance to them. In the same way, the therapist will help the client to group ideas.
Last but not least, the Use of Rhyme Technique (URT) is used to help to create a structure in a song. URT is frequently used with teenagers as some teenagers enjoy rap music. Songwriting and journaling permit teenagers to express important feelings, emotions, and messages about what is happening in their lives. As therapists work with teenagers, they can use the experience to give pain support and create more extensive grief-related themes that children may express through therapeutically creative interventions. For music therapists working with abused adolescents, songwriting was shown to increase clients' self-esteem, assertiveness, decision-making, and expression of feelings (Lindberg, 1995).

In 2005 Davies, identified appropriate methods and techniques for songwriting with children:

[The] initial stage to writing a song can be to encourage the child to think of a theme. A brainstorming session can provide an opportunity for the children to talk about what is on their mind without being directly asked. When creating lyrics the therapist acts as the scribe, making suggestions and helping with the structuring of the words when necessary, while the children are busy with the thinking. Older children respond very positively to the idea that a song has a chorus and a number of verses, while younger children respond more to improvised storytelling.

Even though it is possible to the older population to get access to individual sessions, most of the time MT will be done in a group setting. The group songwriting process is built on the support and ‘the sharing of ideas, thoughts and feelings, and working through solutions with other group members' (Baker & Wigram). While using music to work on defined goal areas, research highlight that musical preference is an important aspect of therapy. Research has shown good results when using the favourite music of the clients (Clair & Memmott, 2008). Analysis of individual clients' song lyrics can extend therapists' understanding about their lived experiences, which can thereby enhance the therapists' empathy, assessment of clients' conditions (McFerran et al., 2006),

Songwriting is used in many other fields with specific clients such as with adult survivors of childhood abuse (Day 2005) or with clients with mental health problems. (Rolvsjord 2005). Moreover, songwriting is with clients that seek to explore identity change Baker, Kennelly, and Tamplin (2005) described the appropriate songwriting protocol for writing songs with hospitalised patients rehabilitating from impaired physical, cognitive, and communication functioning following Traumatic Brain Injury (TBI). For many people being hospitalised is a very difficult moment in life. At time patients somehow cannot see the seriousness of their problem or simply deny the fact something is wrong with them. Songwriting can create an alternative way to approach reality and may precipitate a change in thinking. (Glassman 1991).

The songwriting process can be impacted by many outside factors. Some outside factors may be environmental, sociocultural, or group-related.
After interviewing 45 subjects Baker wrote about some of the factors a therapist to deal with when having songwriting with any individual or group.
Baker (2013) brings to light the importance of organisational structures, the physical space, the private space, and organisational culture impacted the songwriting environment.
Later Baker (2014) found that sociocultural factors impacting the therapeutic songwriting practice included: (a) music roles in diverse groups, (b) the music therapist's knowledge and skills of multicultural music, (c) cultural diversity of group members, (d) language barriers, (e) social diversity in the therapeutic relationship, (f) religious beliefs, and (g) gender/generational issues.

Summary of the Literature Review

The purpose of this literature review serves to increase the understanding of current music therapy methods and its results in different situations and with different patients.
This literature review examined the latest and most comprehensive literature.
It reviews three methods currently used in music therapy sessions.
1) receptive methods
2) improvisation
3) songwriting