The American Music Therapy Association presented Kenneth E. Bruscia, PhD, MT-BC as The William W. Sears Distinguished Lecture Series Speaker at the annual AMTA conference in Atlanta, Georgia in November, 2011. Dr. Bruscia’s lecture, “Ways of Thinking in Music Therapy,” is an analysis of various ways of thinking about the respective roles of music, therapist, and client, and how these roles are configured in different models and styles of music therapy practice. Dr. Bruscia specifically addresses the implications of the question he posed during his lecture: Can we better serve our clients by moving from “one-way” thinking to more “integral” thinking? This AMTA-Pro podcast includes both the audio and video versions of Dr. Bruscia’s lecture as well as a detailed discussion outline. Keep in mind the hour-long video takes a bit of time to download. Please note that Dr. Bruscia’s final comments are not included in the audio and video segments because technical difficulties during the original recording in Atlanta cut the recordings short.



The 2011 William W. Sears Distinguished Lecture

Ways of Thinking in Music Therapy
Kenneth E. Bruscia, PhD, MT-BC

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Dr. Bruscia is Professor Emeritus of Music Therapy at Temple University (Philadelphia, PA – USA), where he taught undergraduate and graduate students for 37 years. Board-certified as a music therapist, and Fellow of the Association for Music and Imagery, he worked clinically with diverse clientele, and authored and edited numerous books, clinical articles, and research studies.

The William W. Sears Memorial Fund was established in memory of Bill Sears, a National Association for Music Therapy leader whose membership dated back to the Association’s formative years in the early 1950s. The mission of the Fund is to advance the knowledge of music therapy through distinguished speakers who are authorities in a field of interest to music therapy.

Discussion Outline


1. Outcome-oriented: induce predictable, specific, observable changes

2. Experience-oriented: present therapeutic alternatives

3. Context-oriented: induce change and present alternatives to client and context


1. Basic music strategies of outcome-oriented thinking

  • Use music as stimulus or reinforcer to elicit specifically targeted nonmusical responses, operationally defined as therapeutic.
  • Use music therapy sessions to effect measurable nonmusical therapeutic change.
  • Engage client in music activity that requires specifically targeted musical behavior or skill, operationally defined as therapeutic.

2. Characteristics of outcome-oriented thinking

  • Basis for Practice: Empirical evidence of cause-effect relationships between music and target response, previous clinical evidence
  • Outcomes are pre-determined, specific, and observable changes that are operationally defined as therapeutic.
  • Treatment is problem-oriented.
  • Efficacy depends on predictability and control of relevant variables.
  • Evaluation of efficacy depends on objective evidence of predicted change.
  • Orientations: Medical, Behavioral, Educational, Cognitive-behavioral.
  • Music Therapy is a science.

3. Roles in outcome-oriented thinking

  • Therapist:  Expert, treatment planner, supportive professional, scientific.
  • Music:  Used as tool to achieve nonmusical goals. Means to an end.
  • Client:  Recipient or consumer with varying degrees of involvement.


1. Basic music strategies of experience-oriented thinking

  • Engage client in music experience that provides opportunities for client, therapist, and music to address therapeutic issues as they manifest in the music-making or listening “process.”
  • Assist client in creating music “product” that represents the client or client’s world, or that documents the process and outcome of therapy.
  • Engage client in music experience that is intrinsically pleasurable, uplifting, empowering, or meaningful.

2. Characteristics of experience-oriented thinking

  • Basis for Practice: Interactions with client, experience with other clients, clinical models, theory, and research.
  • Therapeutic alternatives emerge from engagement in musical process or product.
  • Therapy may be problem-oriented or resource-oriented.
  • Efficacy depends on relevance of music experience to client and therapeutic issue.
  • Efficacy evaluated through subjective or objective evidence of change.
  • Orientations:  Psychodynamic, Humanistic, Gestalt.
  • Music Therapy is an Art.

3. Roles in experience-oriented thinking.

  • Therapist: Expert, musician, empath, surrogate
  • Music: Medium in which therapy takes place. Presents analogy, metaphor, symbol, meanings, and emotions for life experiences.
  • Client: Explores self in relation to music and therapist as simulation of own life circumstances.


1. Basic strategies of context-oriented thinking

  • Situate client, therapist, music and health concern in respective interpersonal social, political, cultural, environmental, and global contexts.
  • Based on above contextualizations, design and apply music interactions that address the health concern as it evolves (Stige, 2002)
  • Arena: What setting is best suited?
  • Agenda: Is focus of therapy: client, context or both? Health or disease? Problem or resource-oriented?
  • Agents: Who should be involved?
  • Activities: Which musical processes are most relevant to health concern?
  • Artifacts: What kinds of musical products reflect client in context?

2. Characteristics of context-oriented thinking

  • Basis for Practice: How client, therapist, music, and health are contextualized in relation to one another, and to larger contexts (social, cultural, political, environmental, global)
  • Outcomes are pre-set or emergent in client and/or context.
  • Therapy is more resource-oriented than problem oriented.
  • Efficacy depends on reflexivity of therapist.
  • Efficacy evaluated from intersubjective evidence of observable change and adoption of therapeutic alternatives.
  • Orientations: Cultural Psychology, Sociology, Anthropology, etc.
  • Music Therapy is a Humanity.

3. Roles in context-oriented thinking

  • Therapist:  More experienced co-learner, co-participant, advocate, project coordinator
  • Music:  Health “affordances;” cultural resource.
  • Client:  Co-learner, co-participant, apprentice
  • Others in Community as needed


1. Each way responds to different need.

2. Each way uses same musical and nonmusical resources in different ways.

3. Each way gives therapist, client, and music different roles.

4. Each way relies upon different types of evidence. Impossible to determine which is “better.”

5. One way cannot replace the other.


Can we better serve our clients by moving from “one-way” thinking to more “integral” thinking?


1. Use different ways of thinking  with clients who have different needs.

2. Focus on “Outcome” when observable change is clearly recognized as priority need or pre-requisite. Therapeutic alternatives or contextual change may or may not be as relevant.

3. Focus on “Experience” when specific change is not entirely predictable, and the priority need or pre-requisite for change is for the client to experience therapeutic alternatives in self or context.

4. Focus on “Context” when individual and contextual change are interdependent.


1. Use different ways of thinking during and between sessions, based on what client needs in the moment, in the short term, and in the long term.

2. When pursuing specific outcome, also consider client’s need for open-ended experience and attention to context.

3. When presenting an experience, consider client’s need to exhibit specific responses and to address contextual factors.

4. When approaching context, consider whether the individual or context need to make specific or find their own alternatives.


1. Open yourself to using music as fully as possible

2. Consider music in the outcome, experience, and context.

3. Consider music as a stimulus or reinforcer, as a target response, as a change process, as a representative product, as an aesthetic experience, and/or as a cultural resource.


1. Open yourself to taking different roles as needed.

2. The music therapist may be in the role of expert, scientist, musician, professional, empath, surrogate, advocate, more-experienced learner, and/or fellow citizen.

3. Open yourself to leading, co-leading, and following.


1. Consider all aspects of evidence, including external, internal, and both.

2. Consider musical and non-musical evidence, objective and subjective evidence, the short-term and long-term effects in and out of session, and consider the client and the context.


1. Clients

2. Music therapists

3. Leadership

4. Education and training

Note about Dr. Bruscia’s lecture in audio or video format as well as the discussion outline:
(c) 2011 by author
Not for duplication or dissemination.

To cite the material, please use the following reference:
Bruscia, K. (2011). Ways of Thinking in Music Therapy [The William W. Sears
Distinguished Lecture Series, American Music Therapy Association 13th Annual Conference, Atlanta, Georgia].  Podcast retrieved from[insert link]. [Date retrieved]