To practice music therapy, a master’s degree in healthcare and a professional qualification (with specialization) in music therapy are required.

In Latvia, the British model has been chosen for the establishment and development of art therapy.

Since 1997, art therapy has been included among the 13 health professions in the UK, whose activities are supervised by the British Health Professions Council (HPC), which approves and regulates curricula and determines the registration required for practice.

In the UK, the Art Therapy Practice Research Network (ATPRN) has begun significant work. In 2005, it won the prestigious Awards for Allied Health Practitioners and Healthcare Scientists, which are awarded for innovations in patient care. This award was in recognition of the MTPPT’s contribution to the development of research-informed practice, as well as to the promotion and integration of practice-based evidence with evidence-based practice. This achievement and the assessment of professionals confirm the successful development of the research field.

Music therapy can be used in preventive (preventive curative medicine, palliative, rehabilitative) medicine, both outpatient and inpatient, for people of all age groups with health and developmental risk factors.

The goals of music therapy are closely related and depend on the patient’s needs, desires, capabilities, health status, age, etc. The goals can be short-term or long-term, suitable for individual music therapy or music therapy in a group, they can be directed towards change and growth or personal and social integration, however, therapeutic goals are always primary and not accidental or related only to the current activity. The specific goals of music therapy are related to the relevant areas of the client/patient’s illness:

• physical – development of gross and fine motor movements, hand/eye coordination, organized rhythmic movement, head movement, etc.;
• communicative – development of listening skills, development of conscious heart, development of vocal verbalization, promotion and development of language understanding, articulation, understanding of imitation gestures;
• social – understanding of relationships, interaction with the therapist, staff and other patients, development of several skills (e.g., give and take, listen, not get confused, etc., development of play skills, sense of independence, motivation);
• emotional – reduction of aggression, fear, anxiety, obsessive behavior, promotion of expression and control of feelings.

World and European experience and practice indicate the successful use of music therapy in neurology, neuropediatrics and includes developmental delay disorders, early (childhood) cerebral disorders, hemi-, para- and tetraplegia, speech and motor disorders after stroke, hyperkinetic syndrome, neuromuscular diseases, post-traumatic rehabilitation, autism. For example, using the methods of sensory and sound integration and perceptual functions, the music therapist uses light synchronous sensory stimulation (e.g., tactile with a touch on the patient’s hand or face) together with sound (singing, playing instruments). Intensive combination of these two perceptual abilities contributes to increased attention, as well as subsequent better responsiveness. But, for example, in the method of motor and sound integration and perceptual functions, the music therapist uses guided / passive, supported or independent movement of the patient together with sound (singing, instrumental playing). The combination of these two perceptual abilities leads to increased attention and improved movement/motor planning.

In audiology, music therapy is used in cases of hearing loss, sound processing disorders, receptive and expressive speech disorders, speech development delays, and in rehabilitation after a cochlear implant.

In oncology, in cases of leukemia and other oncological diseases, nonverbal creative music therapy provides an opportunity to learn new life experiences and develop musical activities in the process.

In neonatology, in cases of premature births and respiratory adaptation disorders, in individual therapy, a music therapist performs sensory auditory stimulation (to reduce skin sensitivity disorders) for rhythmic stabilization.

In psychosomatic medicine, in cases of asthma, anorexia nervosa, bulimia, digestive diseases (Colitis Ulcerosa, Morbus Crohn), abdominal pain and enuresis, a music therapist, individually and in a group, through music making (free instrumental and vocal improvisation), promotes the stabilization of a positive emotional state, psychocorrection, improvement of body perception and relationship behavior, and helps in the formation of new experiences.

In psychiatric practice, a music therapist helps in cases of mental developmental disorders, depression, exogenous and endogenous psychoses, phobias and fear disorders. – For example, free instrumental improvisation promotes the development of musical activity in the emotional and intellectual spheres of the personality. The music therapist integrates the quality of the patient’s musical playing into his or her piano and vocal improvisation, thus offering the patient’s emotional state to be embodied in sounds and/or the integration of a positive experience with associative improvisation and vocalization.

Music therapy is successfully used in geriatrics in cases of vision and hearing disorders, after a stroke, dementia, Parkinson’s disease, multiple sclerosis, depression, psychosis, etc., depending on the patient’s illness. The music therapist strives to realize the general goals of the field of care for the sick: maintaining, improving or restoring physical and mental independence; reintegration of the patient into his or her social environment.

Technologies of music therapist for the assessment and analysis of the patient’s current physical, psychological state and social situation:

1.1. Obtaining initial information (establishing contact and interviewing the patient) (30 – 90 min);

1.2. Analysis of the patient’s difficulties and situation, obtaining additional information from relatives, medical staff (60 min);

1.3. Patient self-assessment surveys (30 – 60 min);

1.4. Objective assessment tests (30 – 60 min);

1.5. Music-based assessment in music therapy: (30 – 90 min):

1.5.1. Nordoff & Robbins/ Plahl/ Wigram’s relationship, behavioral, developmental and musical profiles (90 min);

1.5.2. audio/videography analysis for the evaluation of behavior, musical activity, vocal/instrumental improvisation, communication, movement areas, cognitive processes (90 min);

1.6. creation of a general overview (summarization of information obtained during the evaluation, analysis of examination results of the members of the multiprofessional team and analysis of the patient’s medical history) and the establishment and formulation of the art therapist’s work hypothesis, formulation of music therapy goals and tasks, planning for the evaluation of music therapy results; if the music therapist works as part of a multiprofessional rehabilitation team – integration of music therapy goals into the overall team work plan (60 – 90 min).

Music therapist work technologies:

2.1 music therapy session (individually or in a group), using introductory and/or warm-up techniques, action techniques and closing techniques, including specific music therapy methods or their elements in the overall process (improvisation on musical instruments and/or with voice, active and passive listening to music, composing compositions/songs, working with song lyrics) (30 – 120 min):

2.3.1. warm-up techniques – individualized active exercises individually or in a group to activate the patient for the music therapy process (activation, attention, musical greetings, body warming-up and breathing techniques);

2.3.2. action techniques – individualized directive tasks to achieve therapeutic goals (sensory/motor function and sound integration techniques, cognitive ability development techniques, emotional contact building techniques, breathing regulation techniques);

2.3.3. performance techniques – individualized active and non-directive tasks to achieve therapeutic goals (vocal and/or instrumental improvisation; metaphor creation and symbolization);

2.3.4. performance techniques – individualized tasks, including multimodal techniques (drawing to music, movement guidance techniques);

2.3.5. performance techniques – individualized receptivmūe music therapy tasks (music listening techniques and relaxation; listening and/or observing musical actions in audio/videography);

2.3.6. closing techniques for integrating each music therapy session (verbalization, dialogue formation and feedback; specific regulatory (active and passive) unifying music therapy techniques);

3. Evaluation of music therapy results, in accordance with point 1.5. (60 min).

4. Development of conclusions and recommendations (30 min).

5.  Supervision of one’s own practice individually or in a group (60 – 90 min).

6. A music therapist, using the technologies mentioned in paragraphs 1 and 2, participates in the treatment process of patients as part of an independent practice (monoprofessional service provider) or a multiprofessional rehabilitation team.

7. A music therapist, using the mentioned technologies, performs the rehabilitation of a maximum of five patients individually per day or works with a maximum of two groups, or individually and in a group, but not more than one group and three individual patients per day.

8. The music therapist conducts regular supervision of their practice.

The music therapy room should be large enough to work with the patient(s) individually or in a group. A sink with water, soap, and paper towels is desirable in the music therapy room.

The music therapy room should be arranged so that the patient feels physically comfortable while doing creative work, and so that he has the choice of working in the room in a place and manner that suits him (sitting, standing, on a trampoline, in a hammock, etc.).

During music therapy, the patient should be provided with the necessary specific musical instruments intended for music therapy, which should be visible and accessible to patients (including children) independently during the session.

Specific instruments needed for music therapy: [1]

• Stand drums (4-5)
• Congas (4-5 drums)
• Drum set with cymbals and bass drum
• Table bells (tuned 10 tones)
• Metallaphone
• Xylophone
• Split tones 2 octaves
• Small hand and lap drums (several, different diameters)
• Sea (Oceandram) drum with beads
• Rainwood
• Castanets
• Triangles (different heights)
• Tambourines (2)
• Wind chimes
• Stand drums, metallaphone. and xylophone, cymbal
• Recorder
• Trumpets (in different tones)
• Piano
• Guitar (1-2)
• Kokle (s)
• Maracas (2-3 different sizes)
• Wood tones (large divided, tuned)
• Tone metal drums (steeldrum)
• Gong
• Trumpets + mallets
• Other specific instruments, mallets (rattles, scrapers, etc.)

Music therapy requires special additional equipment, the use of which is appropriate for the specifics of the disease (movement disorders, autism, neuropediatrics) and/or the use of receptive music therapy techniques (sleeping mats for listening to music).

Inventory

• Children’s table, 2-4 chairs
• Trampoline
• Hammock
• Sleeping mats (individual), etc.

The independent practice of music therapists is also documented and, in coordination with the patient or his/her parents, guardians, recorded on audio and/or videotape in order to follow the dynamics of therapy and successfully carry out the evaluation process. The recorded materials serve to improve the teaching process and research.

Required technical equipment:

• CD player and recorder
• Video camera – mobile or static (preferred)
• TV and/or video, DVD player (preferred).

[1] The number and variety of the specified instruments give options for free assembly