Recently I watched an interview with the comedian Stewart Lee in which he discussed the economic difficulties faced by small theatres and music venues. The interviewer made the point that it was important to keep these venues open because they often provide a starting place for material that might go on to become successful in the West End. Without these small venues providing a space for new material, commercial opportunities would be lost. A similar argument has been made, for example, about the now defunct UK Film Council, which funded, for example, the highly commercially (and artistically) successful The King’s Speech. Stewart Lee, instead of agreeing, as perhaps the interviewer expected him to do, made what I think is a compelling counter-argument. If we argue for the funding of small venues on this basis, then we are implicitly conceding an argument about the true purpose behind art. We are saying that ultimately, it is only commercial worth that counts. In fact the real reason that small venues should be funded is because they provide a forum for material which has no further commercial potential whatsoever, but is nevertheless artistically worthwhile. He gave an amusing example of an avant-garde balloon act at Bush Hall which had no chance of ever “transferring to the West End”.
Music therapy, along with other therapies, faces a similar dilemma. It’s not a perfect analogy but it has similarities. Do we argue an outcomes-based case for our service that says that ‘evidence shows that clients coming to music therapy often make progress in these areas: behaviour, social communication, affect regulation etc. etc.’ or do we ‘come clean’. By this I mean that we admit that we cannot establish any clear causal link between music therapy and generalised outcomes. Music therapy is so individualised an activity that to suggest it might achieve this or that for a certain client group is at best speculation. If we try to base the case for music therapy on this type of medical-model evaluation of efficacy then are we on shaky ground? Are we, stretching the analogy, focusing too hard on the ‘West End transfer’ when we should be concentrating our efforts on the artistic content of the show?
Some time ago, in an instrumental teaching job I do, I was asked to produce a set of targets, including week-to-week planned activities for the term. To me, along with other members of the teaching team, this was patently absurd. How can you plan a set of activities when what you do is entirely dependent on what your pupil is capable of? Not only what they are capable of, but how much practise they are able, or feel motivated to do, which tunes it turns out they like, what other musical experiences inspire them in the meantime, and so on? Of course we did it. We all fudged it, producing sets of fictional planned outcomes which we secretly knew would have little bearing on or relation to real events as they were to unfold. I suppose we felt our jobs might be at stake.
How much less predictable is music therapy? With instrumental teaching there are in fact broadly definable and measurable aims. We can test students on their knowledge of scales or their developing sense of rhythm, for example (although how far you can really test musicality is also open to debate). Planning a term of lessons in advance might be pointless, but we can assess in retrospect whether a student has made good progress, and indeed, over time, whether a teacher is doing a good job. With music therapy, even when outcomes are excellent, there’s actually no way of demonstrating with certainty that this is a result of therapy. Fortunately, we are not yet being asked to ‘plan’ sessions, although we might outline aims.
However, let’s say a child starts behaving better in class after twenty music therapy sessions. Does this mean the therapy is helping? We all know that as therapists we can make no such claim. However what do we say to the SENCo? We accept credit when it is afforded us, perhaps, taking a “You win some, you lose some” approach. Or perhaps, being conscientious we say something like “That’s good to hear, and it may be that music therapy has contributed to this, but of course we can’t be certain”. The important question is, if we can’t confidently make direct causal links between music therapy and ‘good’ outcomes, what can we do to justify our interventions? What place does music therapy have in (to coin Lord Sugar’s phrase) ‘the current climate’? What ‘good’ does it do?
The answer to this question perhaps lies in that currently much ignored and discredited area – human experience. Everyone has a relationship to music. This is a fundamental tenet of music therapy, that we all innately musical. Ask any human being what they think life would be like if they had to do without music and they would nearly all say that it would be worse, and not just a bit worse. Intuitively we know that those that said otherwise would be (to coin another phrase) ‘in denial’. Listening to music makes you feel good, in a good way, in a way that feels healthy and nurturing. Playing music involves people in a beneficial creative process that connects them to their fellow human beings on a deep level of shared experience. It involves giving and receiving at the same time and is an expression of our humanity which, while we may not be able to put it into words very effectively, we all understand. There is no culture on earth that has no music. It’s a universal human activity.
Where people are in emotional distress of one kind or another music therapy can help them to reconnect with this shared experience of humanity. Music therapists are trained to facilitate this in various ways. We’re trained to attune to each person. We don’t respond to diagnosis, because we’re not doctors. We’re not even a bit like doctors, despite our use of the word ‘clinical’. But we are trained to understand the needs of the individual (and we don’t ignore diagnosis).
The auditors of our society are in the ascendant in the ‘current climate’, with its emphasis on ‘outcomes’ and numerical data. Unfortunately for us, you can’t measure the outcomes of musical interaction in any way that does justice to the actual experience. There may be some benefit from before-and-after studies, questionnaires, client feedback scores and so on, after all, if 50 clients attend music therapy and 45 of them show marked improvements in some aspect of their lives then this need not be ignored, but if we base our case for music therapy too strongly on data we may be missing the point. I don’t think many people would find this a controversial statement, but I think it’s worth reminding ourselves of this when we feel the pressure to come up with ‘good numbers’.
Because musical experience is so hard to put into words, even subjective accounts are unreliable. But is there more scope for appealing to the humanity of the decision makers, because a lot of them have an iPod, go to concerts, listen to the radio, play in a rock band, or sing in choirs? They know what music means to them. Human beings are all musicians, but some can forget sometimes.
(Leading Note - October 2011)
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