What's it really like?
Andy Lale, 47, has been a music therapist for 14 years. He works in adult psychiatry within the NHS.Were you a musician or a therapist first?
I was a musician, then a community musician, then a music therapist, then a psychoanalytically informed psychodynamic music therapist.
What do you do in a working typical day?
I work for the NHS in adult psychiatry in an inpatient unit but also see people straight from the community. I see on average 5 to 7 patients a day - one group (of 4) and 3 individuals. As I now have a more senior role, I line-manage a Band 7 arts therapist and provide clinical supervision for a Band 7 music therapist and several honorary music therapists and trainees.
During the sessions, do you sometimes end up doing a more traditional counselling session when you are working with an individual?
Music therapy is client centred in its philosophy so the interaction will change depending on the client group (learning disabilities, child autism and delusional ideas create problems for verbal interaction for example). In adult psychology there is usually a verbal component but in my work this is usually psychoanalytic and interpretive rather than psychological - i.e. rather than counselling the patient we are reflecting on unconscious themes or motivations. Most of the time we use music as the means to communicate and to manage the distress that can’t be expressed in words.
Have you worked with clients experiencing a wide range of difficulties?
In my current role, two thirds of the patients I see are suffering from psychotic conditions; another third are mainly diagnosed with personality issues, depression and generalised anxiety.
What do you like about the job?
I love playing and I'm always amazed by what happens when we improvise music together.
What do you dislike about the job?
The NHS is a very large and blunt instrument that is over-managed from the top down and full of anachronisms that are hard to shift, while at the same time there is a manic drive for modernisation that adds to the problems rather than solving them.
What advice would you give to someone thinking of doing this job?
It’s a great job. Take care of your own health and have a good support structure.
What are your qualifications?
I hold a postgraduate diploma in Music Therapy from Roehampton University and a further MA in Psychoanalytic Psychotherapy from the University of Essex. I am HPC registered (Health Professions Council) and I am a registered and approved clinical supervisor by the British Association of Music Therapists.
What job(s) do you think you might do after this role?
Retire to my shed!
What other inside-information can you give to help people considering this career?
Make sure you can play an instrument well, can improvise freely and have an interest in psychology, culture, politics and most importantly hang on to your compassion.
Do you mind us publishing your salary / rate per hour - this is very helpful for job seekers?
A private rate for a music therapy session would be £50 per hour. In the NHS, at band 8 my salary is £45,000 pro rata.
Also known as...
- Art Therapist
- Dance Movement Therapist
- Play Therapist
- Drama Therapist
Music therapists are healthcare professionals who use music to help individuals suffering from physical, emotional or mental issues.
Music therapy has been practised in the UK for nearly 60 years. For the last 10 years practitioners have been required to be registered with the Health Professions Council.
Music therapy is a means of working with music to overcome the limitations of a disability or health problem, or to resolve personal issues. Music therapists work in group or individual sessions with a broad range of clients, including adults, teenagers and children with learning disabilities, mental health problems and physical issues. Music therapy can be an alternative to psychotherapy when people are finding verbal communication difficult or inadequate, or are having problems relating to others.
The music therapist and client make music together, often through improvisation. Music therapists do not teach how to sing or play an instrument but develop a relationship through music-making with clients. The aims are to increase wellbeing, alleviate pain, improve communication and relationships with others, express feelings, increase concentration span and facilitate emotional development.
Music therapists also support recovery and management of physical impairments: playing with instruments helps to improve muscle coordination, balance and strength as well as to develop motor skills needed for holding and making use of objects.
A music therapy session will usually have a variety of percussion instruments available, so the client does not have to have musical skills to be able to participate. The musical sessions may involve:
- Playing different instruments
- Playing and listening to music that clients know and enjoy
- Writing songs
- Creating music-based stories
Music therapists support people with a wide range of issues, including:
- Emotional issues: eating disorders, anxiety, behavioural difficulties, bereavement, post-traumatic stress disorder, abuse, etc
- Communication issues: autism, learning disorders, dementia, brain injury, neurological disorders, memory loss, etc
- Physical issues: paralysis, physical disability, lack of coordination, Parkinson’s disease, addiction, terminal illness, breathing disorders, etc
Some clients do not have serious disabilities or issues; they simply wish to discover more about themselves and how they relate to the world through musical therapy.
Clients usually have a weekly session which ranges from half an hour to over an hour. The minimum length generally recommended for music therapy treatment is 10 sessions. Clients with complex needs might come for several years, in order to put long-term changes in place. The average length of therapy is 1 year.
The NHS pay varies between £25,528 per year for newly qualified therapists to £46,621 per year for senior practitioners.
- Assess clients' pathology and needs
- Agree therapy objectives with clients
- Design music sessions for individuals and groups
- Take an active role in sessions by playing, improvising, singing and listening
- Encourage clients to take part and express themselves in the session
- Observe and analyse clients during music sessions
- Evaluate sessions to monitor effectiveness
- Support clients’ creative development
- Promote the development of social skills and relationships
- Help clients to increase physical and mental well-being
- Record therapy sessions
- Write up case studies and reports
- Consult with other healthcare professionals to evaluate treatment plans
- Conduct research in the field of music therapy
The music therapy training is a 2-year postgraduate course, leading to an MA or MSc in Music Therapy, recognised as leading to registration with the Health Professions Council (HPC). There are currently 6 training programmes at British universities and colleges:
- Anglia Ruskin University
- Guildhall School of Music and Drama
- Nordoff Robbins
- Roehampton University
- Queen Margaret University, Edinburgh
- University of the West of England, Bristol
Universities require students to hold an honours degree (2:1) in Music. Applicants with a background in psychology, medicine or education might be accepted, but they need to demonstrate a professional level of musical competence in at least one instrument. Applicants need to be CRB-checked.
During their training, students attend lectures on psychiatry, psychology, psychoanalysis and music therapy theory. They take part in music improvisation workshops and undertake placements in various clinical settings.
- High level of musical ability
- Improvisation skills
- Excellent listening skills
- Personal skills suited to working as a therapist
- Reliability, responsibility and empathy
- Mature personality
- Lateral thinking
- Ability to provide a safe environment for clients
Music therapists work in a variety of settings including schools, hospitals, care homes, day centres, community settings, workplaces and within the prison service. Sessions usually take place indoors in a music room.
Therapists working in the public service tend to have a standard 8-hour working day. In private practice they may also work during evenings.
Experience is paramount to enter a course in Music Therapy. Applicants need to have a high standard of musicianship and a mature personality. Most universities also require students to have personal psychotherapy prior to and during the training, in order to know themselves well and understand their own emotional reactions, to be able to help clients.
The majority of employers are public bodies such as the NHS, schools and social services.
Many music therapists start their careers as music teachers or musicians. Teachers who have seen the benefits of music in schools may want to shift their career towards a more therapeutic or clinical approach.
An experienced music therapist can go on to train and supervise other practitioners or start a PhD to become a researcher.