Behavioural music therapy

Domain VIII · Creative & expressive arts therapies · Clifford K. Madsen, Vance A. Cotter, Clifford H. Madsen Jr. · 1968 · United States

What it is

Behavioural music therapy is applied behaviour analysis that uses music. Madsen calls it the use of music and of the therapist's own self to change behaviour, built on learning principles and on control of the client's environment. Other names he gives for it are "applied behavior analysis" and…

Format

• Madsen's framework is a set of principles applied through a data cycle, not a fixed number of sessions. The six phases below are the writer's arrangement. They combine Madsen's elements (explicit goals, consequences, shaping, data, generalisation) with the stages of a case run on Hanser's…
• What to gather: records; reports from carers or teachers; direct observation in the natural setting (for example a class or the home); a first individual music session; a music-preference questionnaire (listening habits, preferred genres, musical activities); and a written client profile.

Who practises it, and how they are trained or regulated

• Sources support: the 1968 paper's citation (Journal of Music Therapy 5(3), 69–71, doi 10.1093/jmt/5.3.69) and Madsen's account of it as the origin of the approach; the four functions of music (cue, time and body-movement structure, focus of attention, reward) as stated in Madsen's 1999 address; the Madsen & Alley (1979) findings (abstract); and the US MT-BC credential rules (CBMT). Unverified: the content of the…
• Who may practise. This is a music therapy method. Use it only as a credentialled music therapist, or jointly with one. In the US the credential is the MT-BC (Music Therapist-Board Certified), awarded by the Certification Board for Music Therapists (CBMT). Candidates must complete the academic and clinical training requirements of an AMTA-approved music therapy programme, or their equivalent, including a supervised…
• Training. Madsen says the principles are few but applying them is complex. It needs extensive training, a solid grounding in behavioural principles, and analytical and creative skill.

Evidence status, as the guide reports it

• Version followed: Clifford K. Madsen's behavioural (applied-behaviour-analysis) approach as restated in his 1999 address to the 9th World Congress of Music Therapy, which names the 1968 Journal of Music Therapy paper with Vance Cotter (Madsen, Cotter & Madsen, 1968) as its starting point; with…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• relapse when the contingencies stop. Reinstate them briefly, then fade them more slowly.
• steps that are too big (errors, avoidance) or too small (boredom). It is working when the client meets each criterion within a few sessions.
• storing video without consent or securely; self-criticism without a concrete next step. It is working when your ratios hold steady across weeks.
• tempos that over-arouse; rigid structure for clients who need flexibility. It is working when time on task or movement accuracy improves inside the musical frame.
• music that the dyad associates with past conflict; one party using the music to avoid talking altogether. It is working when calm talk lengthens and blow-ups fall.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.