Culture- Centered Music Therapy

Multicultural community is a product of globalization in 21 century and music therapy is a multicultural activity which deals with people of different cultures. That is why music therapists should equip themselves with necessary skills so that they can work/communicate with clients of different cultures and backgrounds.
Keywords: Music Therapy, Culture-Centered, Acculturation, Globalization

We live in an era of immigration, refuge, marriage between people with different cultures and backgrounds. In such condition communication of individuals and societies are noticeably more than the time of our ancestors. Because of the obvious reasons such as hardness of traveling and rejection of other cultures by the hosts in the past, mixture of cultures was not a common event unless at the war and invasion times.
In 21st century that cultural diversity is a usual incident, Culture-Centered Music Therapy is considerably desired as it can help people with different backgrounds. Brynjulf Stige is one of those who has taken positive steps for Culture-Centered Music Therapy (CCMT).
In this literature review, CCMT, its background, its importance and also its clinical examples will be discussed.

Cultural Music Therapy Framework:

Although the earliest reference about music therapy was written in 1789 with a title of “Music Physically” in America, only after world war 11, music therapy started blooming remarkably in the world as an academic course. Based on different schools, techniques and methods some music therapy models have been built up. For instance, we can mention the following models: Guided Imagery and Music- Bonny model, Analytically Oriented Music Therapy-the Priestly Model, Creative Music Therapy- the Nordoff & Robbins Model and Free Improvisation Therapy-the Alvin model (Wigram, 2002).
Due to vast changes in cultures, economy and politics in the world at the present century, a few topics such as community and culture became important for music therapists, and music therapy developed more than past decades. Based on these changes, Brynjulf Stige established Culture-Centered Music Therapy and Community Music Therapy.

Culture and its essential role in music therapy:

Music therapy and music have close connections to culture. According to ethnomusicologist Bruno Nettl, analyze of each music is connected to the theoretical methods that those cultures offer it (Nettl, 1973). As music therapists and clients have their own cultural backgrounds, it is necessary for the music therapists to attain convenient knowledge of cultural diversity.

There are different descriptions of culture. In brief, culture is tied with shared values, customs, behaviours and norms of a group of people (Sangia, 2014). Dileo and Starr (2005) believe that the different elements of culture have interaction and strong impact on each other. According to Dileo some elements of culture such are age, religion/spiritual orientation, ethnicity, socio-economic status, sexual orientation, indigenous heritage, national origin and genders (cited in Winfield, 2011).

Paying attention to cultural factors that clients have been influenced by, helps music therapist to have a better understanding of his or her client’s needs. This would have noticeable effect on the results of therapeutic sessions.

Because cultural diversity is a rife phenomenon, and it can be seen in the most communities, the need for cultural awareness, sensitivity and responsiveness is more important in comparison with the past, both for the therapists and clients (Forrest, 2014).

Some cultural background factors that can impact the music therapy sessions are the age and gender, where therapist has come from, his/her family’s background and story, beliefs, the experiences of the therapist gain through working with a multi-cultural and acceptance by the clients in therapeutic centers or at their home (Forrest, 2014). Moreover, understanding the background of the client’s family is vital too. Because in some cases, family members participate directly in therapeutic process. However, participation of family in music therapy session can vary from family to family. Some groups of family are passive or only like to observe while many families participate in music therapy programs eagerly.

It is essential to mention that cultural diversity is not only between people of different cultures, but also it can be seen among people with similar background. Moreover, circumstances of migrants, time of being in a new country (or even city) and extent of acculturation are key factors (in) of cultural diversity.

Music therapy and acculturation

For music therapists, in 21st century, being familiar with the term of acculturation and its impacts on their career is very useful and beneficial. It is because these modern concepts considerably affect their relationship and connection with the clients from different cultures (Sangeeta, 2014).
Acculturation is described as a process of understanding health and education system, learning new language, new culture, new lifestyle, social rules and the hardest one; hidden rules such as way of talking, distinguishing of politeness and using humour that form relationship between people. Among them, humour is an important factor in interpersonal relationship, which sometimes, is hard to identify in another culture (Amy, 2014). As Thomas says understanding of hidden rules are more difficult, because we do not know what we do not know. Hidden rules effect therapeutic relationship (Thomas, 2014). Perhaps we can only really absorb those “hidden rules” of another culture when we are living it.

In this process one’s own culture and the host culture negotiate about attitudes and values. Time has an important role in this process. It is possible that the first cultural values being trimmed or the senses of isolation and homesickness appear for people who face the new culture (Swamy, 2001), but generally, acculturation is absorption of the dominant culture while maintaining one’s own culture. Sodowsky (1992) believes acculturation has three steps: level of acceptance of the host culture, fluency in host language, and the concern migrants have about being accepted by the hosts. The process of adaptation is easier for children because they have capacity of creativity and can easily communicate with other cultural groups while older adults are less flexible. According to various studies, this group respond more positively to repertoire that was popular when they were young in comparison to new songs.
It is vital to understand that ambiguity about culture is not only occurs to the clients, but also it can happen for therapist and supervisor as well. It is because of the growing diversity of ethnic, cultural and religious backgrounds of both music therapists and music therapy students in the world.

Globalization and music therapy

Culture and ethnicity affect therapeutic process of music therapy considerably. Because of the global changes, the role of globalization as the other colorful phenomenon of the modern time, should be taken into consideration. Peter Mayer pictured this process beautifully in his pop song, Earth Town Square, from hunter-gatherers to Earth Town Square that we live in it.
Here we can read a part of it:

Now, it’s feeling like a small town
With six billion people downtown
At a little sidewalk fair
In Earth Town Square

In our contemporary communities that are influenced by multimedia and multiculturalism we can exchange information, objects, feelings and cultures that travel rapidly all over the world, without paying attention to distances, time and cultural filters. In this simultaneity, music as a leader can introduce different cultures and social identifications to one other.

As in our era many cultures influence each other. However it is almost impossible for music therapists to know all customs and music of other cultures, researching music and cultures will make a better view about culture-centered music therapy. To attain this goal, studies in ethnomusicology, anthropology, psychology, and cultural can noticeably help music therapy/therapist. As Williams mentioned music therapy has collaborated with other professions from its first steps (Williams, 2014). With help of these sciences, music therapists can learn about the historical, political, social, psychological, geographic, and anthropological context of specific groups of people in the world (Wheeler, 2005).
For example, with the help of musician, ethnographer, researcher and some music therapists, Millicent Mclvor Mercedes Pavlicevic (2004) and Oksara Zharinova-Sanderson (2004) have found a way to integrate context into their clinical work (Sangeeta, 2014).
We are seeing transformation of social context rapidly, thus it is important for therapists to consider the flows and weaving of these sciences between the cultures (Disoteo, 2001). In this way, music as an abstract language with its action as mediators can helps sciences and redesign communication patterns and interactions which should be mentioned by music therapists.
According to Cominardi, music acts as a mirror in our contemporary life, it enhances communication and sensory perception (Cominardy, 2014). We know music as a language, because like other languages it involves body movements, postures and gestures, facial expressions, voice inflections, rhythm and pulse of spoken words, and all the bodily expressions and communication signs active in every human interaction (Watzlawick, Helmick Beavin, & Jackson, 1971).
Therefore, therapists should be careful about all above mentioned factors, which is vary from culture to culture.
As Sangeeta (2014) says in cultural-centered, context, identity and meaning are three main factors. With context, music therapists can understand their clients and their needs. Also, Identity helps therapists to have better connection with clients. Finally, different meanings and different backgrounds are related to each other.

Cross-Cultural Music Therapy:

Cross-cultural music therapy discuses cultural differences that exist between the music therapist and client/s and/or among the clients themselves. Cross-cultural music therapy is when the client and therapist are from different ethnic groups. Cross-cultural music therapy could occur between people of different cultures living in the same country. It is essential for music therapists to realize not only the clients’ background and culture, but also how they think about their music therapists as they can affect the process of therapy. To reach comprehensive understanding, it is recommended that therapist listen to his or her clients carefully to understand how they view their problems and disabilities.
Not only clients travel and migrate, but also it is common that music therapists travel to different parts of the world to offer music therapy. One reason is the number of the countries that train music therapist. According to the World Federation of Music Therapy (2013) music therapy is occurring only in 53 countries of approximately 195 countries in the world (One World-Nations Online, 2014; World Atlas, 2014). Hence, until natives are trained and educated in this field, music therapists are needed in foreign countries. It is obvious that by travelling and moving of music therapist to different countries, we will know more about cross-cultural music therapy. Having said that, it is common that culture becomes a central issue in the process of treatment because the therapist and the client(s) bring their own culture to the therapeutic sessions.
What is the main problem or barrier for therapists in different cultures? What is the best solution for that?
While working with the clients, therapist face issues such as different religious, custom, belief, and language which is the main key of communication. Therefore, it is suggested that music therapist learn some essential and basic words of the client’s language such as numbers, basic body parts and action words to sing and use those during sessions. Moreover, though the therapist does not speak the same language as the client, using nonverbal and musical concepts, are very useful and valuable to have better communication with clients. Also, it is recommended that music therapist uses native musical instruments of clients and Orff instruments especially those that could be played while moving such as maracas. These solutions make music therapy sessions more practical when therapist and client come from different backgrounds.

Multicultural Music Therapy:

It is important for music therapists to know and understand their own background and culture, values and beliefs because they can shape/effect their therapeutic manner (Mahoney, 2015).
Music therapy is inherently multicultural because it deals with people, and each person has his or her culture. Also, usually the function of music is depended on people’s culture.
Multicultural music therapist must increase their knowledge and understanding of the socio-economic background of other cultures. Also they should think about fundamental questions such as who are they? How do they view themselves in the world, and how dose society view them? They should also recognize how their cultures shape their ethics and morals, and how these factors influence their identities. Another essential part is to understand the culture of other ethnical groups, and the role of music in those cultures. With the help of these knowledge, therapists would be able to form cultural relationship with their clients. Consequently, clients will not experience a lack of trust and disconnection.

Therapists morally are responsible about clients who identify themselves with other culture groups. It is not acceptable that principles, beliefs and culture of therapist accidentally disregard clients. To attain efficient relationship with people from other culture, therapist should not behave as a dominant person. By visiting different nationality, race, religion, gender, sexuality, ability, or class, therapists can attain experience and awareness of other people, and behave more efficiently.

Also, we should know that discrimination can affect our clients in some harmful ways, such as suicidal ideation, high risk behaviour, mental health problems, substance abuse, and compromised physical health (Whitehead-Pleaux, 2012). However, according to survey research of Whitehead, clients are not at ease with therapist who has different principles, and fill discrimination. For instance, lesbian and gay people often choose a therapist with the same sexual orientation and gender. Thus, it is important that therapists do not have judgment about gender identity or sexual orientation.


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