Expressive arts therapy: An alternative to talking

Luke Young


Staff Writer


What do you picture when someone mentions therapy? Do you see yourself lying on a couch, while a therapist with a Freudian beard psychoanalyzes you while he takes notes? While this type of therapy is readily available, other types of therapy are available. One of these alternatives is Creative Arts Therapy, which breaks down into specialties such as Music, Drama, or Dance therapy. Alumni Sarah Smith, a music therapist, answered some questions about expressive arts therapy.

How would you describe music or drama therapy to someone who doesn’t know much about therapy?

Music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Some of the goals we typically try to achieve in creative arts therapy are promoting wellness, managing stress, alleviating pain, expressing your feelings, enhancing memory, improving communication, and so many others. 

What does a typical session look like?

There is no such thing as a ‘typical session,’ because every client is different. Some interventions I typically use involve improvisation, lyric analysis, guided imagery in music, and lots of instrument playing and singing.

Does the genre of the music matter?

No, it mostly depends on the needs of the client. Something that’s interesting to me is that if we were working on finding music to promote relaxation, everyone has a different type of music that they would choose. Music that might sound relaxing to me, might sound different to you, or not promote relaxation. For some people, it’s classical music that helps them feel relaxed, and for other people, it’s hip hop. Other people prefer rock and roll. It really varies person-to-person, because we all have our personal relationships with music.

Does it matter if the music is pre-recorded or made in session?

It depends on what is needed in the session. Some people want to make music and be a participant in the music-making process, whether it’s improvisation or a familiar song that they’ve picked. When we’re doing lyric analysis, typically I’m using recorded music. I’ll pull up the lyric sheet so that both myself and the client have a copy that we can look through and discuss the lyrics. It just depends on what’s needed in the session.

Can anyone of any age benefit from creative arts therapy?

I think anyone can benefit from it, because oftentimes when you’re using a creative-based therapy, it creates a safe container for the session. Most of the time, it helps the person to safely enter and get into their body for the work rather than just talking. Some people just need to talk, and I do that as well because I’m also a licensed mental health counselor. So a lot of times we are talking and that is what’s needed. Using expressive arts therapies is a great way to set up a safety container for a session.

Could someone with a hearing impairment still benefit from music therapy?

Absolutely. There’s a lot of research that’s gone into using music therapy with individuals who have cochlear implants. But also, using music therapy with older adults who either are deaf or have hearing aids or some sort of impaired hearing is very beneficial for those individuals as well. Whether it’s that they can still hear the music a little bit or they can feel the vibrations of the music and absorb it differently. It can be very beneficial.

Is any prior musical experience required or encouraged for musical therapy?

As a client, no. You can just come in and say “I like music” and it’ll still be fine. When I do make music with someone, oftentimes, we’ll take out instruments that I know people might feel a little more comfortable to start out with. To introduce the idea of music therapy to someone, I might start with drums because anyone can play the drums. I might also introduce shakers or other things where you don’t need a lot of training. I have my keyboard set up in my room, and clients will go over to the keyboard and just start messing around with it. I’m able to grab one of my instruments and engage in music that way with them.

How are expressive arts therapy approaches different from regular music listening or theater games?

With both of those, there’s a clinical intent there. While it might even look like we’re just playing or messing around, we are providing interventions that coincide with the goals that we have set for therapy. If we’re working on reducing anxiety, speaking from a music therapy point of view, I might work on some breath support or breath control by having them sing. Through this, we’re working on deep breathing to regulate their emotions, reduce their stress levels, and promote relaxation. It would be the same for a drama therapy approach. When you pick an intervention, there is a clinical intent. When it’s a theater game, it’s usually just “we’re going to warm up” or “we’re just going to have some fun.” Not that we don’t have fun in session, but we picked the intervention or improvisation because there’s a clinical intent.

How does one usually pay for music therapy?

You’re not really paying for a music therapy session. There are music interventions that I’ll do, but I can’t call it music therapy because of insurance companies. They don’t recognize it as a valid form of therapy, so there are other interventions that I do where insurance companies will recognize it. This entails a lot of cognitive behavioral therapy or dialectical behavior therapy, but I also incorporate music into those within the session without saying that I’m incorporating music into it.

How does one find an expressive arts therapist?

For a music therapist, if you google ‘music therapy,’ you can find a board-certified music therapist through the American Music Therapy Association website. They have a list of therapists similar to the other modalities as well. If you were looking for a dance movement therapist, you could google that and it would pull up the American Dance and Movement Therapy association, and you can check by state how many people are licensed there. So if you looked me up, you would see my information along with other music therapists in New Hampshire.

Is there anything else you’d like to say about music therapy?

Anyone can benefit from music therapy or some sort of creative arts therapy. A lot of research dates back to World War Two when people were returning from the war and ending up in hospitals where musicians were coming to perform. They realized that while they were performing, other things were happening with the patients there because the music was helpful. Now we’ve evolved it so there’s training and you learn about the clinical intent and that sort of thing. It is a valid form of therapy and I personally believe it should be valid with insurance companies.

Many types of therapy exist for many different types of people. Music and expressive arts therapies are only a few alternatives to the traditional ‘sit down and talk’ type of therapy. If one kind of therapy doesn’t work for you personally, there may be an alternative that would support you better. Sarah Smith currently works at the Center for Expressive Arts, Therapy, and Education in Manchester, NH, but many other music therapists are located around the globe and are open to receiving new clients.