Life is Better When You Improvise

“The thing about improvisation is that it’s not about what you say. It’s listening to what other people say. It’s about what you hear.”

-Paul Merton


Music therapists employ all kinds of methods in their work. Whether their method is to play a song or to let the patient/client play an instrument, music therapists know how to use music to achieve a goal. An important method that music therapists use is improvisation. Music therapists use improvisation to engage with clients in a process that can be transformative and full of meaning.


Improvisation in a Music Therapy Context

As a music therapy process, clinical improvisation is the free or guided extemporaneous use of music, undertaken by the therapist and/or client, using a range of tuned and untuned instruments and voice, to maintain or improve health (Bruscia, 1987). The goal of musical improvisation in this context is to help a client be more aware of himself or herself and others. It also helps them gain personal insight. Improvisation can hold the client’s attention, help manage pain, promote well-being, enhance self-expression and creativity, and improve interpersonal relationships. The opportunities for improving health are many.


The act of improvising is more simple than most people think. We all improvise in our day-to-day. We encounter unexpected circumstances every day and as we adjust to them, we improvise. Improvisation in music therapy is about letting patients explore this simplicity of their inner state through music. Yet for the music therapist, it can also be a complex process between him/her, the patient, the desired outcome, and the actual improvisation. This duality can also represent the duality present in anyone’s inner state of being. The music then helps bring this to the forefront of the therapy as the therapist helps the client or patient through their journey.


Improvisation in Different Settings

Clinical improvisation can be used along with a wide variety of settings and populations, from children to older adults and anything in between, with any kind of condition. Improvisation in music therapy may look different in relation to the population and setting. Therefore, a music therapist is an expert in creating a space to improvise with the client reaching towards a certain therapeutic goal. The therapist approaches the client with empathy and is always attentive to the needs of the client or patient. Through this communication, patients/clients can reach into a part of themselves that is inaccessible through words. This is particularly true when there is an insufficiency of language or because of a disability that renders all verbal communication impossible.


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Why Improvisation?

The therapist uses techniques to engage, evoke responses, and support the client. Music becomes a co-created space where the known and unknown can happen. The client/patient and the therapist are then engaged in meaning-making through the music. These meanings can give rise to hidden or unconscious concerns in the client/patient’s world. The client/patient can express their everyday struggles through the improvisation.


In music therapy, the therapist attempts to enter the world of the client/patient through improvisation. And in this process, the music emerges. The therapist’s approach is influenced by his or her beliefs and opinions about the world and music therapy in specific.


Just as there is the potential for change in the music, there is potential for change in the client. The everyday struggles of a client can be expressed in the music and as the music has the potential for change, the client may find the agency for change as well.


Different Approaches

Without going in-depth into the topic, I would just like to point out that generally there are two approaches to improvisation in music therapy. The first is an approach that considers styles and common melodic, rhythmic and harmonic elements as important. I refer to the Nordoff-Robbins approach here. The other approach is that of Juliette Alvin and Mary Priestley, which generally is based upon non-stylistic considerations.


Music therapists discuss and disagree on whether the use of styles or “correct” musical idioms is important for music therapy. Is creating “beautiful” music with the client/patient important? Or is it more important to let them express themselves without any constraints or considerations? I will not take a side here, but I think it is important to consider this, as music therapists you might encounter might lean in one direction or another.



Here is an example of a therapist improvising the feeling of “anger” with a client:


And in another example, Turry (2010) describes a significant moment in his work with Gloria, a woman diagnosed with non-Hodgkin’s lymphoma. In this musical exchange, which represents a key moment in their therapeutic work:


Client sings:

You listen to me deeply

Therapist plays:

Single tones from the piano gently, slowly, sounds sustained to create harmony which contextualizes the client’s melody, creating momentum and leaving space for the voice to continue

And that makes me cry

A new minor harmony from the piano supports the sentiment of the words

Just when I got used to not ever being heard

The tender accompaniment pauses, then comes to a temporary resting place

I stopped talking

A countermelody from the piano gently echoes the melody

Oh I seem to talk

A pulse generated from the melody is now present in the harmony

People thought I talked

There is a rhythmic quality that now creates a gentle swing

But I didn’t speak from my heart

A song form with pulse and phrase structure emerges

Music goes to places that words can never go

The intensity builds

Music goes to places that words can never go

The lyric repetition solidifies the song form

Finding my true voice

The music begins to cadence, slowing down and clearly heading for the tonic

Not being afraid

The music and words slow down

You listen to me deeply

A final harmonic cadence

And that makes me whole

The music and words come to a place of completion (Turry, 2010, pp. 116–17)


Thanks for reading!


Meadows, A., & Wimpenny, K. (2017). Core Themes in Music Therapy Clinical Improvisation: An Arts-Informed Qualitative Research Synthesis. Journal of Music Therapy,54(2), 161-195.

Aigen, K. Social interaction in jazz: Implications for music therapy. Nordic Journal of Music Therapy, 22(3), 180-209.

L. Samuel Gracida

L. Samuel Gracida

Samuel is Sam's Fans Operating Director and our primary blogger!

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