Guided Imagery and Music (Bonny) and music-and-imagery adaptations

1. Introduction

Version followed: the Bonny Method of Guided Imagery and Music (BMGIM) as taught in AMI-endorsed training (Appalachian GIM Institute; Atlantis Institute) and summarised by Bonde (2015) and O'Farrell (2010); the music-and-imagery (MI) adaptations as named by Grocke & Moe (2015) and described by Summer (interview 2012), Paik-Maier (2010, Supportive MI) and Bonde (2015, MI/group MI). Moe's group model is Torben Moe's modified group GIM for psychiatric patients (PhD, Aalborg 2000). Note: the spelling "Moe" refers to Torben Moe, not "Tor" Moe. [source: Appalachian State; Atlantis curriculum; Bonde 2015; Grocke & Moe 2015 contents]

The Bonny Method is "a music-centered depth approach to transformational therapy" in which a client (the "traveller") lies relaxed and listens to a sequenced programme of mostly classical music while describing spontaneous imagery (visual, bodily, emotional, memory) to a guide who stays with them in continuous, non-directive dialogue. Helen Bonny developed it in the US in the 1970s and founded the Institute for Consciousness and Music (1973); since 1988 the Association for Music and Imagery (AMI) has overseen training and endorsement. [source: Appalachian State; O'Farrell 2010]

Core idea of change: music acts as "co-therapist", catalyst and container. In a relaxed, expanded (non-ordinary) state of consciousness reached through relaxation and music alone (no drugs are part of the method), the music evokes, elaborates, holds and transforms the client's experience; imagery is then linked to life material in verbal processing and drawing. The training tradition frames this within Jungian, humanistic and transpersonal psychology (self-actualisation, the "guiding wisdom of the Psyche"); these are the tradition's own theory, not established fact. [source: Appalachian State; Abbott (c. 2002); Atlantis curriculum]

The adaptations form a spectrum. Summer and Goldberg named three levels of practice: supportive (resource-oriented) MI, re-educative (symptom-oriented) MI and reconstructive work (full BMGIM). MI narrows the client to one image and usually one short piece of music, whereas BMGIM stimulates many images over a 30–50 minute programme. Group Music and Imagery (GrpMI) and Group GIM apply this to groups. [source: Summer interview 2012; Paik-Maier 2010; Bonde 2015; Grocke & Moe 2015 contents]

Professional frame. Full BMGIM is a post-qualifying specialism. AMI-endorsed training runs in three levels: Level I (about 35–36 h, introductory, open to personal or professional development), Level II (about 50–56 h, guiding skills, music programmes, group format) and Level III (two years or more, at least 100 instructional hours, 15 personal sessions, 75 supervised guiding sessions, 15 supervisions, case studies, music analyses and a final project). It leads to Fellow of the Association for Music and Imagery (FAMI). Fellows must also hold registration to practise as a therapist in their own country, for example HCPC in the UK, MT-BC (CBMT) in the US, MTA in Canada, or an equivalent psychotherapy or counselling licence. In Europe, EAMI is developing training standards. A bachelor's degree or equivalent is the usual entry requirement. Do not run full BMGIM sessions (induction into expanded states, a 30–50 minute programme, guided dialogue) without Level III training or supervised trainee status. Since the early 2000s Summer and Goldberg have taught MI first, at Levels I–II, so these trainees learn supportive MI first. A psychotherapist with no GIM training should treat everything in Section 4 as a description of what trained guides do, and should refer clients on rather than improvise. [source: Atlantis; Appalachian State; Bonde 2015; Bonde 2017; Summer interview 2012] [synthesis: the scope advice for untrained psychotherapists]

Materials and physical safety [synthesis unless tagged]:

Hearing. Play music at comfortable listening levels, well below loud, through good speakers or headphones. Check the volume before the induction and during crescendos, which are built into many programmes. Never use maximum headphone volume. Ask clients with hearing loss, tinnitus or hyperacusis about volume and loudspeaker placement first. Give a clear signal (a raised hand or saying "stop") that halts the music at once.
Musical trauma triggers. Some music may be tied to trauma: music used during abuse, torture, war or captivity, coercive religious settings, funerals, or a perpetrator's favourite music. Before choosing a programme, ask which music, genres, instruments and sacred or choral pieces the client links with distress. Ahonen's trauma chapter advises assessing a client's responses to different musical styles beforehand and not assuming how a client will hear a piece [source: Chang 2020 review of Grocke 2019]. Keep a non-classical or culturally familiar alternative ready.
Physical setting. The client lies on a mat or couch, with blankets and cushions. Make sure getting up afterwards is safe: allow grounding time, rise slowly, and watch for dizziness after long reclining. Art materials for mandalas (pastels, crayons, paper) should be non-toxic. The client must be grounded and alert before leaving, especially if driving. [source: O'Farrell 2010 for the mat/couch, blankets and grounding; rest synthesis]
Online sessions. Sanfi's chapter covers devices, software and ethics for online GIM [source: Samara 2023 review; chapter uncertain]. Check sound quality, the client's physical safety and privacy, and an emergency contact before working online. [synthesis]

2. Framework

Individual BMGIM session (90–120 min). Phases and timings as given by Bonde (2015); Abbott, O'Farrell and Appalachian State give the same sequence with small differences:

Prelude or preliminary conversation (15–25 min). Review the client's current state and life, then agree a focus for the session and often a starting image. In first sessions, explain the process and take a biographical and musical history. The guide also chooses the music programme here, based on the client's mood and energy.
Induction or relaxation (5–10 min). The client reclines, and the guide gives body relaxation and focusing suggestions that lead into the starting image.
Music travel or music imaging (25–50 min; Appalachian State gives 35–45 min). The client reports imagery aloud as it unfolds, with ongoing non-directive dialogue. The guide witnesses, supports and takes notes.
Return. The guide gently brings the client back to ordinary alertness as the programme ends.
Transition with mandala drawing (5–10 min).
Postlude (20–30 min). Talk through the meaning of the experience and how it relates to the focus, the prelude and the client's life. The client receives a transcript, and must be grounded before leaving. [source: Bonde 2015; Abbott c. 2002; O'Farrell 2010; Appalachian State]

Music and Imagery (MI) session, individual or group (60–90 min): prelude (15–60 min; in groups this means finding a common focus), induction (3–5 min), unguided music listening with no dialogue (4–10 min), mandala drawing (5–7 min), and postlude (10–20 min). [source: Bonde 2015]

Supportive MI session (Paik-Maier's account of Summer's level): prelude with gentle exploration of positive experiences, then choice of one resource image and of a piece of music matching its quality, then a brief focusing induction, then repeated listening while the client expresses the image in drawing or clay, then a postlude that internalises the inner quality, then home listening. [source: Paik-Maier 2010]

Course length. BMGIM is described as long-term, exploratory and reconstructive. The sources give no fixed number of sessions [uncertain]. Supportive MI is short-term; Paik-Maier saw most clients make small but significant changes within about six sessions, a supervisory observation rather than a trial result. In Summer's inpatient setting, re-educative MI was fitted to 30-day admissions. Moe's group ran inside a psychiatric hospital programme at Sct. Hans Hospital, Copenhagen, with clinical work ending in 1997; its group size, number of sessions and session length were not available in the excerpt opened [uncertain]. [source: Paik-Maier 2010; Summer interview 2012; Moe 2000 thesis excerpt]

Levels and moving between them. No formal phase model for a whole course of BMGIM is described in the sources [uncertain]. What the sources do give:

Music programmes are graded. Beginner programmes are gentler. Positive Affect suits reasonably experienced travellers. Death and Rebirth and Mostly Bach are for experienced travellers. Bonny designed 18 programmes, and others have added more. [source: O'Farrell 2010; Chang 2020]
Summer's continuum. Supportive, re-educative and reconstructive levels are matched to client capacity. The supportive level can stand alone or run alongside deeper work. [source: Summer interview 2012; Paik-Maier 2010]
Criteria for full BMGIM. The client can think symbolically, tell symbol from reality, report the experience verbally, and use it for growth (O'Farrell, citing Summer 1988), and has adequate ego strength. [source: O'Farrell 2010]

Practical progression rule [synthesis]: start with assessment and supportive MI or a short, gentle programme. Move to full sessions, and then to more demanding programmes, only when the client:

returns from the music reliably and stays oriented,
can stay with difficult imagery without fragmenting,
links imagery to life in the postlude.

Step back down the spectrum, to shorter music, a single image, more structure or supportive MI, if any of the following appear:

disorganisation or confusion between imagery and reality,
persistent overwhelm,
dissociation that does not resolve at the return,
a crisis in the client's life.

Suitability and contraindications. Clients with psychosis should not receive full BMGIM; O'Farrell gives the reason that it can reinforce psychotic thinking. Weak ego strength and fragile defences argue against it. In palliative care, clients need to be:

free of confusion, dementia or impaired cognition,
free of active psychosis,
able to concentrate and engage emotionally,
able to report the experience verbally,
not actively dying.

Adapted MI formats are what was developed for psychiatric, addicted, depressed and anxious clients. Examples are Goldberg's simplified non-classical approach for psychosis and Moe's group modification for schizophrenia and schizotypal disorder. They should be run only by GIM-trained music therapists working within the treating team. Grocke (2010) is cited for the contraindication of severe psychiatric illness and fragile ego boundaries; that text is not drawn on [uncertain]. [source: O'Farrell 2010; Covenant Health 2026 (citing Marr 1999, Burns 2001, Martin 1993, Cadrin 2006); Summer interview 2012; Moe 2000]

3. Guiding principles

Music as co-therapist. The music does much of the therapeutic work. In practice, choose and adjust the music carefully, and do not fill the space with your own words. [source: Atlantis; Abbott]
Non-directive, client-centred guiding. Follow the client's imagery; don't suggest content or steer it toward your own hypotheses. [source: O'Farrell 2010; Bonde 2015; Appalachian State]
Non-analytical during the music. Interpretation waits for the postlude, and even then it is shared meaning-making. During the music, reflect and support rather than explain. [source: O'Farrell 2010; Paik-Maier 2010 for MI]
Guide as witness and facilitator. The guide stays present, empathic and attuned throughout the music. Your steady attention is part of the holding: never leave the room or turn to other tasks. [source: Appalachian State; O'Farrell 2010]
The music holds and contains. Music's structure contains the client and can lower anxiety (Moe), but it can also tip into regression. Match how structured the music is to the client's fragility; De Backer, cited by Moe, warns that monotonous music may hold a patient in a ritual or psychotic pattern. [source: Abbott; Moe 2000 citing De Backer]
Fit the level of practice to the client. Use the supportive, re-educative or reconstructive level that suits the client's ego strength, setting and time available. Choose the format by capacity, not by the therapist's preference. [source: Summer interview 2012]
Resources before depth (supportive level). Build on what nourishes the client, focusing on the inner quality the client feels rather than the external object. In MI, deepen felt positive qualities before any exploration of problems. [source: Paik-Maier 2010]
Narrow the focus for vulnerable clients. MI works with one image and short, predictable music, whereas BMGIM opens many images. The more fragile the client, the narrower the focus, the shorter the music and the plainer its structure. [source: Summer interview 2012; Paik-Maier 2010]
Assess the traveller's style. Notice how this client images (visual, bodily, emotional or memory-based) and fit your interventions to it. Don't expect visual pictures from everyone. [source: Atlantis Level II content; detail synthesis]
Know the music intimately. The guide needs detailed knowledge of the programmes, including their shape, climaxes and the transference they may draw. Anticipate peaks so that you can support the client through them. [source: O'Farrell 2010; Grocke 2002 cited there]
Every reaction to the music is valid material. Clients may fight, ignore, reject or find the music incongruent. Not all negative experiences are resistance, and resistance may be active or passive. Explore these reactions; don't fight them. [source: Abbott c. 2002]
Avoid rescue-driven intervening. Abbott warns that rescue- or countertransference-driven interventions can foster dependence. Before stepping in, ask yourself whose discomfort you would be relieving. [source: Abbott c. 2002]
Grounding and integration. No client leaves ungrounded. Mandala, transcript and postlude dialogue all serve integration. [source: O'Farrell 2010; Bonde 2015]
Ethics of non-ordinary states. Clients in expanded states are more suggestible and more open to transference, which raises the duty of care and the need for consent. Get explicit consent for the method and for any touch, and avoid suggestion. [source: Atlantis curriculum topics; detail synthesis]
Cultural fit of music. Classical European programmes are the tradition's default, but culturally specific programmes exist, for example Chinese programmes built on the Yin-Yang principle, and non-classical programmes are increasingly used. Ask about musical culture and heritage before assuming classical music suits the client. [source: Samara 2023; Chang 2020; Covenant Health 2026]
Attribute spiritual content. The tradition includes transpersonal, archetypal and sacred dimensions (Level III modules on myth, ritual and transpersonal consciousness). Present these as the tradition's framework. Follow the client's own spiritual meanings and never impose them. [source: Atlantis; synthesis]

4. Intervention inventory

Scope note: the AMI training curricula list the guiding skills taught: guiding interventions, session set-up and intention, assessing the traveller's style, physical interventions, levels of imagery, music programmes, post-session processing and the group format. They do not publish the content of these skills. The detailed taxonomy of guide interventions in Bonny's 1978 monographs and in Grocke (2019, ed.) is not drawn on. The steps below are therefore built from the session phases and practices the sources describe. Wording is illustrative, and finer technical detail is marked [synthesis]. Items A1–A12 make up full BMGIM; B1–B10 are the MI and group adaptations. [source: Atlantis; Appalachian State; uncertain where noted]

A1. Prelude (preliminary conversation) and session focus

Purpose / when: At the start of every session, to assess the client's mood, energy and current life material, to agree a focus, and to give the guide what is needed to choose a programme. In first sessions it also covers an explanation of the method and a biographical and musical history. O'Farrell stresses that the prelude is integral to the session but is not counselling. [source: O'Farrell 2010; Appalachian State; Bonde 2015]
Steps: (1) Review the previous session, the transcript and any mandala, and what has happened since. (2) Listen for the most alive theme, feeling or body sensation. (3) Agree a focus together, as an intention, question, feeling or image. (4) In the first session, take a musical history: what music the client loves and hates, and what music is linked with trauma or loss (see Section 1). (5) Note the client's energy and ego state, which guide the programme choice (A4). (6) Keep it to about 15–25 minutes so that there is time for the music. [steps 1–2 and 4 detail synthesis]
Example language (illustrative): "Of everything you've told me, what feels most important to take into the music today?" "Is there a feeling or a place in your body that wants attention?" "Is there any music or kind of sound that's hard for you to hear, that I should avoid?"
Watch for: A prelude that turns into a full verbal therapy session and leaves no time for the music. A focus that is too intellectual. Signs that the client is too depleted, agitated or disorganised today for a full session (switch to MI or a supportive format). Working: a clear, felt focus the client owns. [synthesis]

A2. Choosing a starting image

Purpose / when: To give the music travel a launch point. The usual choice is a neutral, agreed image such as a garden or beach, or an image drawn from the prelude focus. [source: O'Farrell 2010]
Steps: (1) Offer or elicit an image linked to the focus, or a neutral one. (2) Check that the client accepts it and feels safe in it. (3) Avoid images tied to known trauma sites unless the work is deliberately aimed there and the client has the capacity for it. (4) Keep the image open-ended so that the music can develop it. [steps 3–4 synthesis]
Example language (illustrative): "Would a meadow be a good place to start, or does another place come to mind?"
Watch for: Hesitation or a flat response, which may mean the image doesn't fit, so offer alternatives. Working: the client can sense the image a little before the music begins. [synthesis]

A3. Relaxation induction

Purpose / when: To relax the body and focus attention so that defences soften and the client moves toward an expanded state that is still connected to the guide. O'Farrell notes that relaxation and concentration support each other. [source: O'Farrell 2010; Appalachian State; Bonde 2015]
Steps: (1) The client lies on a couch or mat with blankets and cushions, eyes closed if comfortable. (2) The guide sits near the client's head without touching. (3) Give relaxation suggestions for about 5–10 minutes, for example breath, progressive body awareness or a sense of heaviness or warmth. Fit the length and depth to the client: shorter and lighter for anxious, dissociative or medically ill clients. (4) Narrow attention to the focus or starting image. (5) Start the music. Palliative adaptations: in place of breath instructions (for breathless patients), use an image such as a breeze blowing; offer a warm blanket; use language that suits the patient; avoid tense-and-release (Jacobson-style) methods where they are contraindicated. [source: O'Farrell 2010; Bonde 2015; Covenant Health 2026; specific relaxation forms synthesis]
Example language (illustrative): "Let the couch take your weight… notice your breathing, without changing it… and now let yourself become aware of the garden we spoke of, and let the music take you there."
Watch for: Breathlessness or panic when attention goes to the breath. Trauma-linked fear of lying down or closing the eyes (offer eyes open, sitting, or a lighter induction). Falling asleep. Working: visible softening, slower breathing, and the client beginning to sense the image. [synthesis]

A4. Selecting the music programme (or spontaneously linked music)

Purpose / when: To match the music to the client's state, focus and experience level. This is the guide's main clinical decision in the prelude. [source: Appalachian State; Atlantis]
Steps: (1) Choose from Bonny's 18 programmes or later programmes, graded from gentle beginner programmes to demanding ones (Positive Affect for reasonably experienced travellers; Death and Rebirth and Mostly Bach for experienced travellers). (2) Consider each programme's shape: where it builds to a climax and where it resolves. O'Farrell gives the example of Positive Affect, built around Barber's Adagio for Strings as its central climax. (3) Consider culturally specific or contemporary programmes (Chinese Yin-Yang programmes; the Uplifting, Present Moments, Awakenings, Earth Spirit and Facing the Shadow programmes in Grocke & Moe 2015). (4) Advanced alternative: Summer reports that in 85–90% of her own sessions she links pieces spontaneously, choosing each to mirror the client's present state, instead of running a predesigned programme. This takes extensive repertoire knowledge and Level III-plus skill. [source: O'Farrell 2010; Chang 2020; Samara 2023; Grocke & Moe 2015 contents; Summer interview 2012]
Example language (illustrative): (to self, in notes) "low energy, grief focus, first session: gentle programme, no big climax."
Watch for: A programme too intense for the client's ego strength, a peak that arrives when the client is already flooded, and music that is culturally alien or linked with trauma. Working: the client's imagery moves with the music rather than against it. [synthesis]

A5. Guiding dialogue during the music travel

Purpose / when: Throughout the 25–50 minutes of music, to contain, facilitate and deepen the experience. The client narrates, and the guide responds with verbal and non-verbal interventions and reflections. The guide is non-directive and non-analytical, music-based and client-centred. [source: O'Farrell 2010; Bonde 2015; Appalachian State]
Steps (intervention types inferred from the sources' descriptions of reflecting, supporting and deepening; the formal taxonomy is not drawn on [uncertain]): (1) Open-ended invitations to describe what is happening. (2) Brief reflections of the client's words and feelings. (3) Sensory deepening, asking about colour, texture, sound, temperature or body sensation. (4) Directing attention to the music itself when imagery stalls. (5) Encouraging the client to stay with an experience, a guide response Abbott documents. (6) Support and empathy at intense moments. (7) Keeping your interventions short, and timing them to musical phrases and quiet passages, not to climaxes. (8) Taking running notes on the music, your interventions, the client's words and their body movements. [source: O'Farrell 2010; Abbott; items 3, 4 and 7 synthesis]
Example language (illustrative): "What are you aware of now?" "You're at the edge of the water…" "What's it like underfoot?" "Let the music be with you there." "Can you stay with that a little longer?" "Where do you feel that in your body?" Abbott's interviewee recalls the guide saying "stay with it" when the client asked for the music to change [source: Abbott].
Watch for: Over-talking, leading questions that plant content (for example, "Is there a door?" when none was mentioned), interpretations made during the music, and silence that leaves the client feeling abandoned. Working: imagery that unfolds, changes and is felt in the body and emotions, rather than staying static or narrated from a distance. [synthesis]

A6. Contained Spontaneous Imaging (for clients who struggle to image)

Purpose / when: When the client finds open imaging hard, the guide offers a contained image to explore. O'Farrell's example is the family home, where the client explores the rooms one by one. [source: O'Farrell 2010]
Steps: (1) In the prelude, agree a bounded, familiar setting. (2) During the music, invite exploration within its limits: rooms, objects, who is there. (3) Let the music colour the experience. (4) Return to the frame if the imagery scatters. [steps 2–4 synthesis]
Example language (illustrative): "You're standing at the front door of the house you grew up in… which room would you like to go into first?"
Watch for: A home linked with abuse. Check in the prelude that the image is safe, and offer a neutral alternative. Working: the client can sense and describe the image with growing detail. [synthesis]

A7. Physical interventions (only with explicit consent)

Purpose / when: Taught in Level II and supervised in Level III. Abbott documents a guide applying light pressure to a client's clavicles to help release built-up tension, which the client experienced as releasing stored hurt. [source: Atlantis; Abbott]
Steps [synthesis, following Domain VIII touch rules]: (1) Agree in the prelude, before the induction, whether any touch may happen, where (for example hand, shoulder, upper chest above the clavicle) and how the client will say no in the moment. Never touch genital, breast or other intimate areas, and never touch sexually. (2) During the music, ask again before each touch: "Would it help if I put my hand on your shoulder?" (3) Wait for a clear yes. (4) Use light, still contact, and remove it at once if the client tenses or says no. (5) Use non-touch options first: a cushion under the hands, a blanket, inviting the client to place their own hand. (6) Record the consent and the touch in your notes. (7) Take extra care with trauma survivors, and attend to culture and gender.
Example language (illustrative): "You've mentioned pressure in your chest. Would you like me to rest my hand lightly on your shoulder, or would you rather put your own hand there?"
Watch for: Freezing, compliance without real consent (clients in expanded states are more suggestible), and transference reactions. Working: the client reports feeling supported and the tension shifts. [synthesis]

A8. Changing the music or staying with it

Purpose / when: When the client fights, rejects or ignores the music, or finds it incongruent. Abbott documents guides doing two different things: encouraging the client to stay with the experience, and changing the piece when it really was not what the client needed. [source: Abbott]
Steps: (1) Explore the reaction ("What's the music doing to you right now?"). (2) Decide: if the reaction is resistance to material that the client has the capacity to meet, support them in staying with it; if the music is incongruent or the client is overwhelmed beyond tolerance, change to gentler music or begin a return. (3) Afterwards, process the reaction in the postlude. [step 2 decision rule synthesis]
Example language (illustrative): "The music feels like it's pushing you… what do you want to do with it?" "I'm going to change the music to something gentler."
Watch for: Rescuing too early (Abbott raises a dependency risk) and insisting on staying while the client is flooded. Working: the client's relationship to the music shifts, for example from fighting it to engaging with it. [source: Abbott; synthesis]

A9. Return

Purpose / when: As the programme ends, to bring the client back gently to ordinary alertness. [source: Abbott; O'Farrell 2010]
Steps: (1) As the final piece fades, invite the client to say goodbye to the imagery or bring something back from it. (2) Bring attention to the body, the couch, the room and the sounds in it. (3) Invite movement, stretching and opening the eyes. (4) Check orientation before the client sits up. [steps synthesis]
Example language (illustrative): "As the music finishes, take a last look around… is there anything you'd like to bring back with you?… Now feel the weight of your body on the couch… when you're ready, open your eyes."
Watch for: Lingering dissociation, disorientation or dizziness. Lengthen the return and use orienting questions about the date, the room and the plan for the rest of the day. [synthesis]

A10. Mandala drawing (transition)

Purpose / when: Straight after the return, for about 5–10 minutes, to give the experience a form, bridge back to verbal awareness and help integrate symbols. In MI, the drawing is done after the listening. [source: Bonde 2015; O'Farrell 2010]
Steps: (1) Offer a large paper circle (the mandala format) and pastels or crayons. (2) Invite the client to draw whatever comes, without planning, artistic judgement or explaining. (3) Then use the drawing in the postlude. [step 1 specifics and step 2 synthesis]
Example language (illustrative): "Take a few minutes to draw something of your experience inside the circle: colours, shapes, anything."
Watch for: Mandalas are a processing tool, not a diagnostic test. Do not read the drawing as evidence of abuse or of a disorder. [synthesis; Domain VIII rule]

A11. Postlude processing and the transcript

Purpose / when: For 20–30 minutes, to talk through the meaning of the experience, link the images to the prelude focus and to the client's life, and ground the client. [source: Bonde 2015; O'Farrell 2010]
Steps: (1) Invite the client to tell you what stands out first. (2) Use the mandala. (3) Follow the client's own meanings before offering any connections tentatively. (4) Link the experience back to the focus. (5) Give the client the transcript or session notes. (6) Agree what to take away. (7) Check grounding before the client leaves. [source: O'Farrell 2010 for transcript and grounding; ordering synthesis]
Example language (illustrative): "What stays with you most?" "How does that image sit with what you brought in today?" "I'm wondering if… does that fit, or not?"
Watch for: Over-interpretation by the guide, and a client who cannot make sense of the experience (Abbott found some clients could not, even later). Hold such material lightly and return to it next session. [source: Abbott; synthesis]

A12. Session notes and music-programme records

Purpose / when: Throughout. The guide records music, interventions, client responses and body movement. Level III trainees also write reports and analyse music, and supervisors observe music matching, guiding and processing. [source: O'Farrell 2010; Atlantis; Bonde 2015]
Steps: Note the time code against the music, your intervention, and the client's words and movement. File these with the mandala, and review them before the next prelude. [synthesis]
Watch for: Patterns across sessions, such as recurring images, and reactions to particular pieces. [synthesis]

B1. Shortened BMGIM sessions and short music travels

Purpose / when: The full BMGIM structure compressed for time limits, fatigue, or a standard therapy hour, for example with adolescents with eating disorders or adults in the therapeutic hour. Grocke & Moe's nomenclature distinguishes MI, GIM and shortened BMGIM sessions. [source: Bonde 2015, 2017; Grocke & Moe 2015 contents (Papanikolaou; Heiderscheidt; Beck); chapters uncertain]
Steps [synthesis based on the full structure]: (1) Brief prelude, about 10 minutes. (2) Short induction, 2–3 minutes. (3) One to three pieces of music, about 10–20 minutes, with guiding dialogue. (4) Brief return and drawing. (5) Short postlude. Keep every phase, so that the client still enters and leaves the experience in a contained way.
Example language (illustrative): "Today we'll use just a short piece, about ten minutes, and I'll stay with you through it as usual."
Watch for: Opening up material that the shorter postlude cannot process. Choose music without a large climax. [synthesis]

B2. Music and Imagery (MI), individual

Purpose / when: A shorter, non-dialogue format for clients who are not suited to or not ready for full BMGIM, or where time is short. The client listens to one short piece without guiding and then draws. Summer and Goldberg coined "music and imagery" to distinguish these methods from GIM; Goldberg later used the term "music imagery". [source: Bonde 2015; Summer interview 2012]
Steps: (1) Prelude, 15–60 minutes, including choosing a focus. (2) Induction, 3–5 minutes. (3) Unguided listening to a piece of 4–10 minutes, with no dialogue. (4) Mandala or free drawing, 5–7 minutes. (5) Postlude, 10–20 minutes, linking the drawing to the focus. [source: Bonde 2015]
Example language (illustrative): "I'll play one piece of music, about six minutes. I won't talk during it. Just let the image of the tree be there with the music, and afterwards we'll draw."
Watch for: Unguided listening still evokes material. Choose music whose structure contains it, and keep your attention on the client the whole time. Working: the drawing and the conversation show a felt link to the focus. [synthesis]

B3. Supportive (resource-oriented) Music and Imagery

Purpose / when: At Summer's supportive level, to build positive internal resources and strengthen the ego. It is short-term, more directive and more contained than GIM. Suitable as an entry point for clients with little experience of psychotherapy, as a stand-alone short intervention, or alongside deeper work. [source: Paik-Maier 2010; Summer interview 2012]
Steps: (1) Prelude: brief intake, review of the previous session, then gentle exploration of nourishing or positive experiences. (2) Choose the image: the client picks the most meaningful positive experience, and you help elaborate its felt inner quality (for example safety, warmth, strength) rather than its external details. (3) Choose the music together: offer a few pieces that match the image's quality. Paik-Maier's criteria are simple musical elements, a clear and predictable structure, a steady beat and tempo, a gentle and followable melody, no sudden surprises, often non-classical. (4) Induction: brief, only helping the client focus on the feeling of the image, with eyes open or closed. It does not condition an altered state as the Bonny induction does. (5) Music and imagery: soon after the music starts, the client expresses the image in drawing or clay while the same piece repeats. Keep dialogue minimal, only helping the client feel the image more fully. (6) Postlude: explore and internalise the inner quality ("what is it like to feel this?") rather than describing the image. Avoid cognitive analysis. (7) Encourage the client to keep listening to the same music at home (B4). [source: Paik-Maier 2010]
Example language (illustrative): "When you remember sitting with your grandmother, what's the feeling inside you?… Let's find music that has that same warmth." "As you draw, let yourself feel that steadiness in your body." Verbatim aim: the power of the work comes "from deepening the feeling and experience of the positive imagery" (Paik-Maier 2010).
Watch for: A positive image that turns negative, for example a grandmother who has died, bringing grief. Acknowledge this and, at this level, gently help the client back to the resource quality, or choose another image. Working: the client reports self-acceptance, confidence and inner strength, and uses the music between sessions. Paik-Maier observed small but significant changes within about six sessions. [source: Paik-Maier 2010; handling of a negative turn is synthesis]

B4. Home listening with the supportive piece

Purpose / when: After supportive MI, to carry the resource into daily life. [source: Paik-Maier 2010]
Steps [synthesis]: Give the client the piece through a legitimate recording or streaming link. Agree when and how to listen: seated, safe, not while driving, at a comfortable volume. Suggest recalling the felt quality of the image while listening, and ask about it at the next prelude.
Example language (illustrative): "When you need some of that steadiness this week, put this piece on and let the feeling come back."
Watch for: The music becoming linked to distress if it is used during crises, and isolated listening replacing other support. [synthesis]

B5. Re-educative (symptom-oriented) Music and Imagery

Purpose / when: Developed by Summer in an inpatient psychiatric setting for depression and drug and alcohol addiction, where full GIM was too exploratory for 30-day stays. It aims to help clients face specific symptoms directly and "be honest with themselves". [source: Summer interview 2012]
Steps: (1) Agree a symptom-related focus (Summer's early example: dependence). (2) Choose a short, evocative piece of about 3–10 minutes. Summer used tension-filled Romantic-era classical music. (3) Brief induction, then listening. (4) Draw or write to bring the image forward and make the inner experience visible. (5) Discuss it in relation to the symptom. Usable in groups or individually. [source: Summer interview 2012; steps 3 and 5 are ordering synthesis]
Example language (illustrative): "While you listen, let an image come for how the drinking has a hold on you. Afterwards, draw it."
Watch for: Shame and overwhelm. Tension-filled music heightens affect, so keep pieces short and the postlude structured. Working: clients put symptom-related insight into their own words. [synthesis]

B6. Supportive MI with a therapist "talkover" (Goldberg)

Purpose / when: Fran Goldberg independently adapted GIM for psychotic patients in San Francisco. She simplified sessions and used non-classical music so as not to raise psychotic symptoms. During the music she led a "talkover" to stimulate positive resources. [source: Summer interview 2012]
Steps: The sources give no step-by-step account [uncertain]. A cautious approach [synthesis]: use short, simple, familiar non-classical music. Keep eyes open or offer a light induction. During the music, speak quietly and steadily about a concrete, positive and reality-based image or resource, and keep the client oriented. Follow with brief, concrete discussion. This is only for GIM- or MI-trained music therapists working within the psychiatric team.
Example language (illustrative): "As the music plays, notice your feet on the floor… and remember the walk by the river you enjoyed… the fresh air… the steady path."
Watch for: Increased hallucinations or delusional content woven into the music, and loss of contact. Stop the music and orient the client. [synthesis]

B7. Group Music and Imagery (GrpMI)

Purpose / when: A group format first described by Bonny. The group listens together without individual guiding, then each member draws and the group shares. Used in psychiatric outpatient rehabilitation (Bonde & Pedersen), with women with cancer (Hertrampf), in cancer survivor groups (Dimiceli-Mitran) and elsewhere. [source: Bonde 2017; Bonde 2015; Grocke & Moe 2015 contents]
Steps (Bonde's MI phases applied to a group): (1) Prelude of 15–60 minutes: a check-in, then finding a common focus for the group. (2) Induction of 3–5 minutes for the whole group, seated or lying. (3) Unguided listening to one piece of 4–10 minutes, with no dialogue. (4) Drawing, individual mandalas, 5–7 minutes. (5) Postlude of 10–20 minutes: each member shares their image and drawing as they choose, and the group responds. [source: Bonde 2015] Add a clear closing round in which each member names how they are leaving and something to take away. [synthesis]
Example language (illustrative): "From what everyone has said, a shared theme seems to be 'finding rest'. Shall we take that into the music?" "Would anyone like to show their drawing? You can also just pass."
Watch for: Members who are flooded but silent (scan the group during the music), pressure to share, and one member's disturbing imagery affecting others. Working: members link their imagery to the shared focus and to their own lives. [synthesis]

B8. Group GIM (guided group journeys)

Purpose / when: Group formats in which some guiding happens during the music, for example Torres's fibromyalgia groups. Bonde (2017) reports that it is used only occasionally in Danish therapy practice. [source: Bonde 2017; Grocke & Moe 2015 contents; procedures uncertain]
Steps: Not available in the sources [uncertain]. A cautious approach [synthesis]: give the group brief, general verbal prompts during the music ("notice where the music takes you") rather than individual dialogue, and keep the length of the music limited. Process in turn afterwards.
Watch for: Individual guiding cannot be given in a group, so screen out clients who need it. [synthesis]

B9. Moe's modified group GIM for psychiatric patients

Purpose / when: Torben Moe developed a modification of group GIM for patients with schizophrenia, schizoaffective disorder and schizotypal disorder at Sct. Hans Hospital, Copenhagen. His thesis (2000) studied its restitutive factors. The theoretical frame is object relations, Kohut's self psychology (music and group as selfobjects), Winnicott's transitional space and Stern's developmental model. Music is treated as a structuring, containing element that may reduce anxiety. Assessment used the GAF, a post-therapy questionnaire and interviews, and a Hevner mood wheel appears among the appendices. [source: Moe 2000 thesis excerpt]
Steps: The thesis chapters on session anatomy, music selection and inclusion and exclusion criteria were not available in the excerpt opened [uncertain]. A later case chapter ("Peter's Story", Grocke & Moe 2015) is not drawn on. Do not reconstruct the protocol from this guide. If you work alongside a music therapist delivering it, the principles that can be drawn from the thesis frame are: carefully chosen, structured music; attention to containment; and awareness of the risk of regression. [synthesis]
Example language: Not available; none offered.
Watch for (from De Backer, cited by Moe): receptive music can tip a patient into regression, dissolving into the music and losing contact with the surroundings. Monotonous music may hold a patient in a ritual or psychotic pattern. A patient may regress toward a comforting or a frightening experience. [source: Moe 2000]

B10. Palliative, medical and other named adaptations

Imagery over music (palliative): Use either a pre-written script or the patient's own image, retold by the patient, over pleasant music with gentle movement. Avoid overly relaxing "spa" music. Sounds can be matched to the scene, for example ocean waves with an ocean image. In grief work, follow the patient's cues. Adapt the induction (see A3). Shorten elements, schedule around fatigue, and if needed hold the postlude at the next session or leave art materials for later. Bonde (2017) mentions a palliative adaptation pairing a single piece of music with mandala drawing. [source: Covenant Health 2026; Bonde 2017] Example language (illustrative): "Tell me again about the beach you love… and let the music bring it closer." Watch for fatigue, drowsiness and medical changes, and coordinate with the palliative team.
Named adaptations [uncertain: chapter titles only, Grocke & Moe 2015]: MED-GIM for medical patients (Gimeno); TEAM-GIM for team building (Pehk); KMR "short music journeys" (Warja); Music Based Mindfulness for substance addiction (Van Dort); Guided Music Imaging for performance anxiety (Martin); a mentalisation-based approach (Frohne-Hagemann); GIM with fairytales in psychiatry (Brink-Jensen); trauma adaptations (Maack). Also Music Breathing, described as widening the window of tolerance (Körlin, in Grocke 2019, reported via review). Consult the original chapters before using any of these.
Children and young people: Adaptations exist for children with loss (Reher), complex trauma (Fugle), eating disorders (Papanikolaou; Noer), improvisation combined with GIM and mandala (Vila), youth (Band) and public-school classrooms (Powell). Their procedures are not drawn on [uncertain]. General requirements [synthesis]: get the young person's own assent and the consent of a parent or carer, and involve carers as appropriate. Use shorter music, eyes open if preferred, concrete images and plenty of drawing or play. Follow your jurisdiction's safeguarding and mandatory-reporting duties for anything disclosed in imagery or talk. Never treat a child's imagery or drawing as evidence of abuse; respond to disclosures through safeguarding procedures.

5. Handling problems

Abbott's study of client experiences with the music is the main primary source here. Most other guidance is marked [synthesis].

Active resistance to the music (fighting it, asking it to stop, shouting at it) [source: Abbott]: Explore the reaction rather than override it ("What is the music doing?"). If the client has the capacity, support staying with it: Abbott records a guide saying "stay with it". If the client is overwhelmed, change the music or begin the return (A8). Process the reaction in the postlude as meaningful material. [synthesis for the decision rule]
Passive resistance (ignoring the music, flat narration, long silences) [source: Abbott]: Direct attention to the music itself or to the body. Make the format more contained, using Contained Spontaneous Imaging (A6) or MI with drawing (B2). Ask about the experience in the postlude without judging it. [synthesis]
Music experienced as incongruent [source: Abbott]: Change the piece if it truly doesn't fit, and note this for future programme choices. Ask about the client's musical preferences and culture. [source: Abbott; synthesis]
Client feels stuck or trapped in an image [source: Abbott reports clients feeling stuck, trapped or exhausted]: Invite sensory detail or curiosity about what the image needs. Ask what or who could help. Wait for the music to shift, since programmes are designed to move on. If the client is still stuck, offer a gentle option or begin the return. Abbott found that guides helped clients engage with the imagery when they were reluctant to move on. [source: Abbott; other steps synthesis]
Overwhelm or flooding during the music: Slow down and use fewer words. Orient the client to their breath, their body and your voice. Lower the volume. Switch to gentler music. If needed, stop the music, have the client sit up with eyes open, and ground them through the senses (naming objects in the room, feeling the feet on the floor). Afterwards, reduce intensity in future sessions by moving down the spectrum (Section 2). Abbott warns that unresolved outcomes may reflect too little therapist support, and recommends actively monitoring clients through difficult material. [source: Abbott; grounding steps synthesis]
Traumatic memories emerging: Ahonen's chapter covers contraindications and adaptations for traumatised clients and advises checking music responses in advance [source: Chang 2020; chapter uncertain]. Practical response [synthesis]: in the prelude, agree a stop signal and a safe image. During the music, keep a dual awareness of the trauma material and the present, with your voice as an anchor. Avoid long, climactic programmes until the client is stabilised. Use supportive MI (B3) as a resource phase first. Coordinate with any trauma-focused treatment.
Dissociation or poor return: Lengthen the return and use orienting questions about the date, place and plan. Have the client sit up, drink water and move about. Do not let them leave or drive until they are oriented. For later sessions, choose shorter music, eyes-open formats and a lighter induction, and reassess suitability. [synthesis; O'Farrell 2010 on grounding before leaving]
Psychotic or disorganised content appears: Stop the full session, orient the client, and inform the treating team. Full BMGIM is not suitable for psychosis (O'Farrell). Any further work should use a contained adaptation (B6 or B9) delivered by GIM- or MI-trained music therapists within psychiatric care, mindful of Moe and De Backer's warning about regression and monotonous music. [source: O'Farrell 2010; Moe 2000; Summer interview 2012]
Client cannot image or says "nothing is happening": Normalise this, since imagery can be bodily, emotional, a memory, or the music itself. Use sensory questions, Contained Spontaneous Imaging (A6), or MI with drawing, which gives the experience a concrete form. [source: O'Farrell 2010 for CSI; rest synthesis]
Client falls asleep: Check the client's fatigue and medication with them; don't ask for drug details beyond what is needed for the schedule. Use a lighter induction, sit the client up a little, keep dialogue more active, or shorten the format. [synthesis]
Rupture or negative transference to the guide or the music: Name it in the postlude, explore what the client experienced as intrusive (leading questions, touch, a choice of music) or as abandonment (silence), and acknowledge your part. O'Farrell notes that the guide must be aware of positive and negative transferences. Abbott raises the risk that rescue- or countertransference-driven interventions can foster dependence; take this to supervision. [source: O'Farrell 2010; Abbott; repair steps synthesis]
Unwanted touch or a boundary breach: Stop at once and acknowledge it. Re-establish the consent agreement, and record and supervise the incident. Use no further touch unless it has been explicitly re-agreed (A7). [synthesis]
Non-adherence (missed sessions, not doing home listening): Explore ambivalence about the depth of the experiences. Offer shorter or supportive formats. Agree a realistic home-listening plan, or drop it. [synthesis]
Client cannot make sense of the experience afterwards [source: Abbott found this in some clients even after reflection]: Don't force an interpretation. Return to the transcript and mandala in later sessions, and accept that meaning may come later. [synthesis]
Spiritual or transpersonal experiences: Receive them respectfully within the client's own belief framework. Don't validate or impose metaphysical claims, and attribute transpersonal theory to the GIM tradition. If an experience is destabilising, ground the client and consider whether it is a spiritual emergency or a mental-health crisis, and refer if appropriate. [synthesis; Atlantis Level III covers ethics of transpersonal states]
Hearing problems (a client reports pain, ringing or distress from loudness): Lower the volume at once. Check speaker placement and use no headphones if they are uncomfortable. Ask about tinnitus or hyperacusis, and adjust future programmes to avoid sudden loud peaks. [synthesis]
Musical trauma triggers: If a piece, genre, instrument, voice type or sacred text triggers distress, stop or change it. Explore the association in the postlude, record it, and exclude it from future programmes. Ask about such links routinely at intake (see Section 1). [synthesis; Ahonen via Chang 2020]
Group-specific problems: One member's distress dominates the group, so offer that person brief individual grounding and follow-up. A member is under pressure to share, so restate the right to pass. Members are mismatched in capacity, so screen in advance and use unguided MI rather than guided group GIM for mixed groups. [synthesis]
Suicidal ideation or self-harm surfacing in imagery: Assess risk using standard practice in the postlude or at once, follow your service's risk protocol, and involve the treating team. Images of death or dying are common in GIM and are not in themselves evidence of risk, so ask directly about intent and plans. [synthesis]
Untrained use: A psychotherapist without GIM training should not run full GIM sessions. Refer to a FAMI, or use only generic relaxation and music listening within your own competence, without the BMGIM structure or guided imaging in expanded states. [synthesis; based on Atlantis and Appalachian State credential statements]

Sources

Sources:

Further reading (not drawn on) [uncertain where relied on]:

Bonny, H. L. (1978). GIM Monographs #1–3 (including Facilitating GIM Sessions). Baltimore: ICM Books.
Grocke, D. E. & Moe, T. (Eds.) (2015). Guided Imagery & Music (GIM) and Music Imagery Methods for Individual and Group Therapy. London: Jessica Kingsley.
Grocke, D. E. (Ed.) (2019). Guided Imagery and Music: The Bonny Method and Beyond (2nd ed.). Dallas: Barcelona Publishers (chapters by Abbott, Ahonen, Summer, Grocke, Körlin, Sanfi).
Grocke, D. (2010), cited for contraindications (not drawn on).
Bruscia, K. & Grocke, D. (Eds.) (2002). Guided Imagery and Music: The Bonny Method and Beyond. Gilsum, NH: Barcelona (Bruscia's nine components of a Bonny Method session, cited via O'Farrell 2010).
Summer, L. (1988). Guided Imagery and Music in the Institutional Setting. St Louis: MMB (suitability criteria cited via O'Farrell 2010).

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