Building the bridge: clinical applications of improvisation in music therapy with severely and profoundly retarded adults

Abstract: This thesis addresses the clinical application of improvisation in music therapy with profoundly retarded, multiply handicapped adults and severely retarded adults with some degree of accompanying psychopathology. Chapter one presents the basic assumptions and core beliefs of the author's model of music therapy as well as the rationale for including clinical improvisation in a humanistic and holistic treatment approach. Following a general description of the mentally retarded adult population, chapter two outlines overall treatment goals in music therapy for this population and why improvisation is an effective clinical procedure. Chapter three surveys the entire treatment process inclusing assessment/evaluation, treatment planning, length of treatment and stages of therapy and conducting therapy sessions. Comments are made about the implications for improvisation during each component (i.e., choosing group or individual sessions, structure of sessions, selection of and purpose of techniques, materials). In chapter four, a closer examination of clinical process is provided by exploring how music improvisation is utilized in the clinical setting. Work with the profoundly retarded, multiply handicapped client and the severely retarded, emotionally disturbed are considered separately. Methods of working with a range of responses are offered and exemplified through case examples. Conclusions on a humanistic music therapy practice and improvisation and areas for further exploration are presented in the final chapter.

Keyword(s): Improvisation, psychopathology, severe-mental-retardation, profound-menatl-retardation.

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