Music Therapy Isn't New
Music therapy as a profession seems relatively new, but the practice of using music as therapy is ancient. It's been practiced in various forms throughout history. Even in ancient preliterate cultures relationships between music and medicine are found. In such societies, it was thought that someone who got sick had offended the gods or was under a magical curse. Music was used as part of the rituals performed by “medicine men,” or shamans, to appease the offended god or drive away the evil spirits to effect a cure.
As civilization developed, the relationship between music and healing complemented the theories of disease used at the time. As societies moved away from magico-religious theories and toward rational interpretations of disease, musical interventions changed along with them. In the 6th century BC Greece, for example, the study of medicine was almost completely based on empirical evidence. However, the underpinning theory of the body still relied on the idea of the Four Humors developed during the time of Hippocrates.
During the Middle Ages in Europe (about 500 – 1500 AD), Christianity influenced the attitudes society had toward sick people. The Four Humors were still used as the main theory behind disease, but the afflicted were no longer viewed as inferior beings or having committed sin. More humanitarian practices were put into place, with mental illness being an exception. Here there was still a great deal of gross mistreatment, by today's standards.
The Renaissance (about the 15th - 16th centuries) is where we start to see the development of the scientific approach to medicine, although the Four Humors are still around. At this time, music and art were often used in combination with medicines to treat medical conditions, but also in the prevention of mental and physical illness.
As Europe moved into the Baroque era (about the 17th and 18th centuries), we still find the Four Humors dominating illness theories, but Kirchner's theories of temperaments and affections, which grew out of the Four Humors theory, get thrown into the mix. Music becomes more prominent in the treatment of mental health disorders, particularly depression. On a side note (pun intended), several composers, including C.P.E. Bach and Paul Hindemith, have used the four temperament theory as inspiration for composition.
Music remains popular in the treatment of disease through the last few decades of the 18th century. It is late in this period that we find the first accounts of music therapy in the United States where various physicians, psychiatrists, and musicians were supporting its use in treating mental and physical disorders.
The 19th and first half of the 20th centuries saw music therapy being regularly used in hospitals, but almost always at the same time as other therapies. At that time, its therapeutic use began to decline. Several early practitioners and pioneers continued to promote music therapy, but their efforts were short-lived. Researchers attempted to study the reasons why music was effective in the treatment of certain physical and mental disorders, but the lack of trained music therapists and unsubstantiated claims of its effectiveness stunted the growth of the profession, and the use of music therapy in healthcare settings. This began to change with collective research efforts and the establishment of undergraduate and graduate training programs began during the 1940's.
During World War II, there was an uptick in the therapeutic use of music, primarily to boost the morale of returning veterans and in the rehabilitation of leisure skills and socialization, as well as physical and emotional function. Most music therapists at the time served as volunteers under the supervision of doctors and other hospital staff.
In 1950 the National Association of Music Therapy (NAMT) was formed, a professional organization for music therapists. In 1972 a second group, the American Association of Music Therapy (AAMT) followed in 1971. Long-awaited professional recognition was finally approaching. The creation of standardization in curriculum, regular research publication, and standards of practice helped lead to the formation of the Certification Board for Music Therapists (CBMT) in 1983. The NAMT and AAMT merged into the American Music Therapy Association (AMTA) in 1998. All of this has contributed to the growth of music therapy as an accepted and viable profession.
A lot of work remains, however. Advanced training and degree programs (including PhD. programs) have expanded, as well as a growing body of research that continues to support and inform music therapy practice. However many music therapists still face the difficulty of reimbursement when it comes to billing insurance companies, as well as Medicaid and Medicare. This sometimes makes it difficult for music therapists to provide services for lower-income populations, despite having gone through a great deal of time and training in the most effective practices, working in often unpaid internships, and being required to demonstrate their skills as other health professionals do.
