As musicians, we all know without knowing that music helps people manage stress, improve mood, and reduce pain. Music is a powerful tool for healing—it’s amazing how it taps into so many aspects of our being. We’ve all seen flutists writing, presenting, and lecturing about their experiences with wellness-focused, integrated approaches to music-making, and it’s true that therapeutic engagement with music directly impacts our emotional and physical states. But the relationship between music and wellness goes far beyond mere anecdotal benefits! I am Dr. Daniel Shineberg, and I am delighted to partner with The Flute Examiner to bring you a series of articles from the perspective of a flutist and board-certified music therapist.
First and foremost, what is music therapy? According to our national licensing body, the American Music Therapy Association, “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.” We are healthcare providers who have earned a therapy degree, finished a clinical internship, and most likely completed advanced clinical work and research in music therapy. We use the modality of music-making to help individuals and build communities.
For me personally, a very special part of being a music therapist is the way that the field encompasses the “total human experience.” My coursework included clinical experience in neonatal intensive care, early childhood development, Alzheimer’s and intergenerational work, palliative care, and hospice care, and my current specialization is in behavioral health, teenagers at risk, sexual abuse (specifically trauma-informed care), substance abuse, neurodivergent populations, intellectual disabilities, and neurologic functioning. Music can help heal and support us through every season and challenge in life, and we therapists have the privilege of connecting all sorts of clients to the benefits that music provides.
When I tell people I am a music therapist, they usually imagine some “Sound of Music” scenario where I smile and play cheery songs on my guitar. In reality, there are four approaches that music therapists use to interact with clients: receptive, re-creational, compositional, and improvisational music therapy. Receptive music therapy involves the client listening and then reacting verbally, silently, or with another modality such as movement or art. Traditionally this approach involves live music, usually on guitar or piano, but the use of recorded music is becoming more and more common. Re-creational music therapy involves activities and interventions that help people improve their emotional regulation, communication, and social skills. Compositional music therapy involves creating music in a way that allows the client to build upon their strengths. Finally, improvisational music therapy uses improvisation to facilitate a response from the client to work on therapeutic goals and objectives. These are the most traditional approaches to music therapy, but these days they represent only a fraction of the work that music therapists do; ongoing research into music therapy is showing incredible amounts of evidence that music therapy can help in more and more populations. Music Therapy now involves specialized certifications in neurologic functioning, neonatal intensive care, and behavioral health work. I specialize in music psychotherapy, which requires training and certifications in cognitive behavioral health (CBT) and dialectic behavioral therapy (DBT). I also hold certifications in crisis care management, therapeutic guided meditation practices (centered in DBT modalities), substance abuse, sexual and physical traumas, mood/personality disorders, and neurodivergence.
How does a typical day in the world of music therapy go? On any given day, I usually have 5-7 individual or group sessions with clients who have been medically diagnosed with cerebral palsy, down syndrome, Alzheimer’s, oppositional defiant disorder, emotional regulation disorder, or any other type of neurodivergence. Each client or group will participate, using music of their preferred genre, in activities or interventions that utilize form, rhythm, pitch, volume, melody, and harmony to facilitate desired behaviors that their medical team has deemed to need improvement. Seeing such a diverse population of clients requires excellent planning and organization skills to make sure that I am not only creating musical experiences that serve my clients’ physical, emotional, cognitive, and psychosocial goals, but I am also allowing time to create essential documentation. When I’m not playing, I am writing. Music therapists are constantly in communication and collaboration with licensed professional counselors, social workers, recreation therapists, physical therapists, occupational therapists, supervisors, parents, state-run facility organizations, psychiatrists, and many other health care providers, and we are always documenting for billing purposes.
The best part of my day is that I am ALWAYS playing music. Even though my DMA is in flute performance, I don’t normally use flute playing in a clinical setting. Instead, I rely on other skills I learned during my education such as music theory, aural skills, piano, and guitar. During a day of client visits, I normally play between 20-25 songs, mostly on guitar or keyboard instruments. Some of these songs come from what we call a “rep book,” which is a collection of songs that I use often and find to be helpful with many clients. However, as a professional music therapist, I am also obliged to treat each client with their own preferred music, and so I learn 10-15 new songs per quarter to meet that objective. It takes a lot of work, but with research showing that live music is more clinically effective than recorded music, it’s worth the effort.
Much of my research has been on incorporating rap and hip-hop music into therapeutic sessions, and I love getting to connect to my clients this way. When my younger clients tell me about their preferred artists, oftentimes they will choose rap and hip-hop musicians. No problem! I learn the chord progression and the rhythm of their favorite song, to the best of my ability. Then, away from the recorded music, I play the song’s beats and chords while the client will write their own lyrics. I get to teach them how to write a song, why certain sounds work the way they do, and why we structure the harmony, melody, and rhythm in a particular fashion. After approximately six weeks of working together most clients have built enough trust and rapport to write openly, and their themes usually include narratives about themselves, their families, their environments, and, most importantly, their trauma. After their song is written, we record and then listen back to their song and talk about it together. Using my knowledge of CBT, DBT, andmetacognition, we examine their songs, find pride and success in having learned new skills, and make a plan for transferring new competencies into their daily lives away from the music-making experience. We do this over and over again until the skill to address their experiences is cemented, replacing past traumatic narratives. These young clients often love to come up with rapper names for themselves, and make me laugh by coming up with names for me, too. So far
my favorite client-given names have been D-Shine, Thug-berg, and D-Static…but after the activity is completed, it’s back to Dr. Shineberg. Outside of my therapeutic practice, I am a busy recitalist and flute teacher. Even though I don’t play flute with clients, my music therapy practice absolutely does benefit my concert work.
For example, most of us have felt some degree of performance anxiety as flutists, right? Let me tell you, playing a client’s favorite song in end-of-life hospice care is a FAR more high-pressure situation than any graded recital or public performance I’ve given. The perspectives gained from my therapeutic experiences have made me a much more balanced and unflappable concert performer. And of course, as a teacher, my training as a therapist has been invaluable in helping me connect responsibly and supportively with my students. I also now run a program called “Inspired Flute,” that combines therapy with flute instruction to help artists develop a healthy and unburdened relationship to their craft.
I engage in music therapy because I believe in my heart that it has the power to help people – I know this both from personal experience and from the ever-growing body of evidence-based research showing its many benefits. I do not particularly consider myself a flutist, music therapist, educator, researcher, businessperson, or otherwise…..I’m just an artist who is finding their own authentic path. I’m grateful that music has given me so many ways to connect with thehumans around me, and I hope it does the same for you.