POLYPHONYJournal of the Irish Association of Creative Arts Therapists
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Practice paper: Incorporating a Music Therapy Practice Within a Conservatoire Setting

Published on Sep 08, 2024 by Jessica Harris

I offer this practice paper with the aim of opening a window into my role within the Royal Irish Academy of Music (RIAM) and the unique perspective of developing a professional, clinical framework within an academic, conservatoire setting. Through this paper, I will explore the process of establishing the music therapy department, reflect on the challenges and opportunities encountered along the way, and consider the broader implications of integrating therapeutic practices into a traditionally performance-focused environment. This reflection seeks to illuminate how such a framework can contribute to the wider goals of inclusivity, collaboration, and innovation in music education.

Background and Theoretical Foundations

In 2017, I was offered the opportunity to pioneer the development of the music therapy department at the Royal Irish Academy of Music (RIAM). Prior to this appointment I have been, and continue to be, privileged to work with a diverse range of clients across various settings. This diverse practice continually broadens my theoretical foundation and informs my reflection and approach. With parallels within an educational setting and as the majority of clients attending at RIAM are parent referred/carer referred autistic children and young adults, I considered my previous experience of work with children in school settings particularly relevant when developing a new theoretical framework in this innovative setting.

As an avid collaborator, part of my initial method of practice is to endeavour to seek out a multi-disciplinary team as a basis for enhancing partnerships. In schools, these include the teachers and principals, thus facilitating reflective and evaluative discussions and observations. This collaboration, which involves teachers in the therapeutic process, has opened a window into the outcomes of music therapy and seemed to help the children develop new ways of understanding and interacting with their environment. As one principal noted relative to my practice in a Dublin school in 2019:  "It was wonderful to see this capability and transference of learning and confidence to the world outside the therapy room".

McFerran (2014) succinctly supports an eclectic approach:

"In the most common forms of practice … music therapists draw on multiple theoretical perspectives, with an integrated blend of analysis, goal setting and encouraging creative expression being a popular approach".

I found that I had organically developed an orientation that blends various approaches. Aspects of humanistic and community therapeutic values became intertwined with psychodynamic practice, each influencing and in reflexive dialogue with the other.

From my earliest practice, I also recognise the influence of developmental psychology and "communicative musicality" (Malloch & Trevarthen, 2009) as being a foundation for the reshaping and repairing of communication pathways.  The theory of communicative musicality suggests that the foundation of all communication lies in musical engagement. Through our musical interactions, I aim to model a framework of musical and interpersonal interaction. As Jacobsen (2016) similarly reflected: "I try to match and attune myself … and I try to be very clear in my communication and signals" (Jacobsen, 2016). This has become central to my practice and here I offer a brief vignette in illustration.

Vignette

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Still image from Anam Beo project, 'Music on Our Doorstep' supported by Creative Ireland. 2023

My vignette is of a seven year old girl I met through my practice in a special school prior to my appointment at RIAM. Her diagnosis included a combination of life limiting conditions and severe communication disability.  At the time I met her, she had no contact or visitations from her family. To establish a connection with her and with the aim of offering comfort I communicated with her in improvised song using primary vowel sounds and perfect intervals, with our goal being to return to earliest musical development and relational patterns.  Nursing staff and I initially noted small movements at the corner of her mouth, which appeared to be a smile, which was a unique response to music therapy and we were able to continue to develop our relationship and communication from this foundation. Nurses, carers and support staff observed the impact of musical interactions with this young girl and began to sing to her throughout the day and at moments of transition. From returning to the inherent foundational basis of communication sought and found within music, this girl was offered channels of relationship and comfort during her time in care.

Royal Irish Academy of Music

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Royal Irish Academy of Music

My work in educational environments is guided by an instinctive awareness of the unique dynamics within each setting, as well as the distinctive personal and communal responses they evoke. This is to say the organic melding of music therapy within the unique community environment and systems as supported by psychodynamic therapeutic theory (Midgley et al., 2021). I had been very familiar with the environment of the RIAM from the perspective of a student, having studied there throughout my BA in Music Performance some years prior. The perspective of staff member and sole developer of a clinical department was, however, new to me.

The formation of a music therapy department within the environment of the RIAM was envisioned and spearheaded by Deborah Kelleher, RIAM Director.

Deborah established inclusion and accessibility as a foundational pillar of practice at RIAM as evidenced by the current strategic plan. This plan places inclusion and a full spectrum of music engagement, appreciation and experience as integral to providing excellence within a music conservatoire.

Deborah Kelleher

Deborah Kelleher

Thompson, de Bruin and Skinner (2023) surmise that the area of research surrounding inclusive higher music education in the U.K., particularly pertaining to the needs of students with disabilities, is under-served.  However, research in other areas of inclusivity practice, such as with regard to gender, race and class. are more extensive. This points towards the innovation of the RIAM in founding a music therapy department amidst a recent but growing collective consciousness for the need for inclusivity in music education settings (Thompson, de Bruin & Skinner, 2023).

Ginwright (2018) supports the pivotal placement of environment and community as central to the foundation for wellbeing (Ginwright, 2018). Therefore, I find it of interest that part of the question and challenge I have faced is the establishing of a music therapy department in an environment in which inclusive representation is highly valued, yet in a foundational era. This has been reflected through the benefits and challenges uncovered through the formation of the department.

Forming a Department

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Music Therapy at RIAM

The pioneering establishment of a music therapy department within an academic music institution therefore has potential for recognition as a new framework within higher music education settings.

In establishing the department, I researched existing frameworks and best practice for introducing music therapy (Kobus S, Felderhoff-Mueser U, Lainka E, Fandrey J, & Benson S., 2024).  Furthermore, I considered a number of key work strands as most applicable to the existing academic structure for the establishment and integration of a department.

These included:

- The development of a music therapy clinic within RIAM on a self- referral basis.

- The facilitation workshops for teachers within the RIAM network on therapeutically based, inclusive education practices.

- The establishment of research originating from the department.

Music Therapy Clinic

My first point of call was to establish the music therapy clinic. This clinic now operates within RIAM, and those seeking to attend contact either myself or the RIAM administration department to set up the initial intake process. While the clinic is set up in a teaching room at the RIAM, the new build completed in 2023 ensures that the room is soundproof, and some funds were allocated to
purchase a range of percussion instruments when we first set up.

Through effective partnership with the RIAM junior department, we have now established a referral process within the preschool early musicianship groups. This ensures that children who are referred through these preschool groups have opportunities to engage in early intervention music therapy. The importance of early intervention is widely understood in every clinical field as critical to enhanced development outcomes.

Music Therapy Courses for Teachers

With my further aim of offering workshops and information to colleagues at RIAM, I have been met by great interest by professors and teachers on site and within the RIAM teaching network. I have held workshops around the country focused on therapeutically based educational practices. Third level students have also approached with curiosity and great interest, and last year I partnered with Adam Buttimer, third year undergrad student of tuba, to present a concert series
for neurodivergent children. This was a resounding success, with feedback requesting more of these engaging, compassionate and welcoming performances, and indeed more are now planned for September/October 2024.

Importantly, I hope that through visibility of the department, more pathways towards music therapy will become visible to third level students. This year, in partnership with RIAM outreach, I hope to release an online course designed to introduce the profession of music therapy to students, teachers, parents and all to whom it may be of interest.

Erasmus Research

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European University of Cyprus

I am delighted to be an RIAM research partner within an Erasmus funded inclusive music project. The project aims to develop and communicate enhanced strategies for inclusive music education in third level institutions. It is a partnership amongst several European universities and conservatoires for a range of professional aligned disciplines. Our partnered universities include Academia Națională de Muzică Gheorghe Dima (AMGD), Università LUMSA, European University Cyprus, Conservatorio di Musica Statale “Alessandro Scarlatti”, and RIAM.

Through this research, we are developing an online course and manual, which we hope to disseminate among our partnership countries. The course will be designed to provide a learning platform promoting inclusive educational and administrative practices in university and conservatoire settings. Through this project I have had the opportunity to network and partner with European colleagues, and the experience of international teamwork and shared learning is a true joy!

The Challenges

The pioneering nature of this work has included the introduction and upholding of clinical concepts and frameworks within an academic setting as outlined by the HSE in their clinical governance leaflet. As recognised above, I have found inclusive representation to be highly valued, yet in its early days of process and establishment. This comes with both opportunities and challenges, as I have enjoyed being a key contributor to the development of inclusion at RIAM. The challenge continues to be pioneering such pillars of inclusion and establishing a parallel clinical governance framework for the music therapy department. While music therapy indeed requires allied health clinical governance, within the RIAM it is required to dovetail seamlessly with the purpose of the institutional governance framework.

Clinical governance framework provides assurance to those receiving services and also to RIAM that the music therapy department holds accountability for providing high quality safe services which operate in line with best practice and that we continually strive for excellence in clinical practice.

The elements of this framework include:

- The development of a range of clinical policies covering all areas of the service.

- Clinical audit/evaluation

- Clinical supervision

- Continuous professional development

The work on the governance framework is an ongoing developmental process as the music therapy department continues to grow roots within the organisation.

Music therapists in their typical alignment within healthcare settings thrive through collaboration with other professionals, working together to ensure the best outcomes for their patient/client.

In my unique position at the RIAM, I continue to work on building this and feel very fortunate to collaborate with some of the finest music educators in the country.

Founded in 1848, RIAM’s current commitment to inclusivity requires visionary educators. The understanding that excellence requires inclusivity as opposed to exclusivity is led by Deborah Kelleher, who continues to be single-minded in her manifesto of inclusion. However, this is an ambitious commitment which requires significant time, collaboration, investment and strong governance.

The positive impact of the establishment of a music therapy department has been evident from the outset as teachers and students at the RIAM have expressed support, curiosity and a desire forcollaboration and further knowledge.

These positive relationships are the engine of achieving the goal of being a truly inclusive organisation.
 
While the development of the music therapy department at RIAM has been met with enthusiasm, the process remains one of collective effort and continuous growth. Deborah Kelleher, Director of RIAM, reflects on the early progress of the department and its potential for future impact:

"By appointing Jessica Harris as the first music therapist not only at RIAM, but in any conservatoire on the island of Ireland, we were re-defining Access and Inclusion for the RIAM. Her work with clients onsite, in workshops for music professionals, and in early interventions for our pre-school division has inspired and delighted me. This has been one of the most positive moments of RIAM's evolution in recent times and I look forward to seeing its contribution to our community grow over time."

This recognition highlights the collaborative nature of the department’s growth, with its ongoing evolution rooted in shared learning and partnerships.

References

Bruin, L. de, Skinner, A., & Thompson, G. (2023). "Making Higher Education in Music More Accessible:Exploring Barriers and Enablers for Students who are Deaf, Disabled, Neurodivergent or have Chronic Physical or Mental Health Conditions". Final Report.pdf. https://doi.org/10.26188/24173565 
 
Ginwright, S. (2018). "The Future of Healing: Shifting from Trauma Informed Care to Healing Centered Engagement." Occasional Paper, 25, 25-32.

Health Service Executive (HSE). (n.d.). Clinical Governance: Development of a National Clinical Governance Framework [PDF]. HSE. https://www.hse.ie/eng/about/who/qid/governancequality/clinical-governance.pdf 
 
Jacobsen, S. L. (2016). "Child Protection: Music Therapy with Emotionally Neglected Children."  In Jacobsen & Thompson (Eds.) Music Therapy with Families: Therapeutic Approaches and Theoretical Perspectives. Jessica Kingsley Publishers.
 
Kobus S, Felderhoff-Mueser U, Lainka E, Fandrey J, & Benson S. (2024). "Music Therapy as a Topic in Medical Education: Course Concept and Student Evaluation of an Elective Course for Medical Students". J Med Educ Curric Dev. 22(11), 23821205241234537. doi: 10.1177/23821205241234537. PMID: 38405366; PMCID: PMC10894546.
 
Malloch, S., & Trevarthen, C. (2009). Communicative Musicality: Exploring the Basis of Human Companionship. Oxford University Press.
 
McFerran, K. S., & Rickson, D. (2014). "Community Music Therapy in Schools: Realigning with the Needs of Contemporary Students, Staff and Systems". International Journal of Community Music, 7(1), 75-92.
 
McFerran, K. (2018). Music Therapy in Schools: An Expansion of Traditional Practice. In G. E. McPherson & G. F. Welch (Eds.), Music and Music Education in People's Lives: An Oxford Handbook of Music Education (Vol. 1, p. 308). Oxford University Press.

McFerran, K. S., Lai, H. I. C., Chang, W. H., Acquaro, D., Chin, T. C., Stokes, H., & Crooke, A. H. D. (2020). "Music, Rhythm and Trauma: A Critical Interpretive Synthesis of Research Literature. Frontiers in Psychology, 324.
 
Midgley, N., Mortimer, R., Cirasola, A., Batra, P., & Kennedy, E. (2021). "The Evidence-Base for Psychodynamic Psychotherapy with Children and Adolescents: A Narrative Synthesis". Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.662671 
 
Royal Irish Academy of Music (RIAM). (2021). RIAM 175: A New Model for Music Education [PDF]. https://www.riam.ie/sites/default/files/media/file-uploads/2021-02/RIAM-175-Strategy-January-2021-v2.pdf 

Jessica Harris

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Jessica Harris is a leading senior music therapist and alumnus of the Royal Irish Academy of Music (RIAM), Dublin, the Royal College of Music, London (MMUS) and the University of Limerick (MMT).

As a performer she has shared the stage with the National Symphony Orchestra of Ireland, the National Concert Orchestra of Ireland and soloists including Maxim Vengerov and Placido Domingo.

She has over 10 years of extensive experience in the practice and research of music therapy and is founder of the Music Therapy Department at the Royal Irish Academy of Music. In partnership with the RIAM Jessica has created an Introduction to Music Therapy course (accessed online) aiming to introduce the profession of music therapy around the globe. Jessica has engaged as a Council Member on the board of the Irish Association of Creative Arts Therapists and has presented at conferences including the IACAT AGM. Through her experience with clients and work groups she has witnessed first hand the far reaching impact of musical engagement.