This article explores public creative expression as an intervention of Community Music Therapy (Stige, 2002, Pavlicevic & Ansdel, 2005, Turry, 2005) for adult clients with long-term disabilities accessing supportive services such as post-acute rehabilitation, day treatment, and residential programs. Involving clients in situations that seem to blur the lines between music therapy and mainstream music activities such as recording songs, doing concert performances, releasing CDs, and producing music videos, extends the role, aim, and possible working environments for music therapists. Such endeavors offer potent opportunities for positive psychosocial outcomes but may also introduce complex dynamics that could compromise their integrity as a legitimate form of therapy. In-depth discussion and case studies examine the issues involved in assisting clients in moving outside of traditional therapy settings and into the wider social contexts typically involved in music.
For most of human history, music was an essential aspect of communication and sense of connection within a tribe or village and was deeply integrated into the rituals, ceremonies, and celebrations that related to the deepest needs of the community (Netti, 1956). The current belief that music is primarily entertainment to be enjoyed separately from life's more serious obligations dominates contemporary culture with musical "products" such as CDs, DVDs, and concert performances produced by professionals within the highly lucrative entertainment industry. (Lieberman & Estgate, 2002, Negrus, 1 996). This perception of music as basically a form of recreation permeates our society right through to our health and rehabilitation institutions. According to Anthony Salerno, founder of numerous residential rehabilitation centers:
The fact is, the vast majority of people who work in our profession, not to mention the clients, families, advocates, regulators, policy makers, legislators, elected and appointed officials, and the community at large - too often think of music therapy as only a recreational activity and they regard recreational activity as a method of residents keeping occupied. The fact that this belief is endemic is disturbing, but factual (personal communication, October 24, 2007).
Many music therapists work within recreation departments of institutions and are often expected to facilitate large groups, making it challenging to establish an authentic alliance with many, if not most, clients. It is possible the music therapist may consciously or unconsciously align more with needs of the institution than the needs of the client by seeing a lot of clients, increasing the visibility of music in the facility, attempting to generate an appearance of "fun," and generally making things "look good" from an outward perception.
One problem in determining what is, and is not, music therapy is that music lends itself to these types of activities. Concerts, festivals, parties, living room sing-alongs and similar enjoyable social gatherings are familiar aspects of most people's musical lives. In my experience, even under the worst conditions from a traditional therapy perspective, music is still a generally positive and uplifting experience for most clients in rehabilitation programs and institutional settings. Music makes people feel good. We play music. As such, it may appear inconsistent with the principles of serious work.
Pinker (1 997) dubbed music "auditory cheesecake" because he could discern no evolutionary benefit to mankind's universal and enduring practice of it. That our prehistoric ancestors made music is clear as evidenced by the discovery of bone flutes more than 50,000 years old (Tramo, 2001 ) and the fact that the limbic system, an ancient part of the brain in evolutionary terms, has been demonstrated to be strongly responsive to music has led some researchers to conclude that music predates spoken language (Menon & Levitin, 2005). …