Music Therapy in Recovery

You liked the idea of music in treatment, and then you could not tell whether the hour was therapy or a speaker in the corner. That confusion is worth settling before you travel. A song you choose, time in a choir, and music therapy are three different things. Music therapy is a clinical service: an assessment, goals, and a credentialed music therapist.

If thoughts of suicide are tangled up with a song, call or text 988. If someone may be overdosing or will not wake, call 911.

Who may use the title

The American Music Therapy Association defines music therapy as the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship, by a credentialed professional who has completed an approved music therapy program. The goals it lists include wellness, stress, pain, feelings, memory, communication, and physical rehabilitation, and it adds more. That list describes the field. It is not a set of results promised to you, and the words "evidence-based" inside a definition are not a success rate you can take home.

The scope statement, written with the Certification Board for Music Therapists, says a music therapist has completed the education and clinical training the association requires and holds current board certification from that board. The credential is MT-BC, music therapist-board certified, granted after the approved training and an exam. Anyone who represents themselves as board certified must hold it. State law may also require the credential. Ask what the letters are, and ask who checks them. A recreation therapist, a guitar teacher, or a peer who leads singing can do real work. They are not music therapists because the activity used music.

A counseling group has its own training questions, covered in group therapy. Cognitive behavioral therapy works by a different method. A program can offer all three. It should not use one name for all three hours.

What has to happen before the music starts

The association's standards for addictive disorders describe music therapy as the specialized use of music to restore, maintain, and improve mental, physical, and social-emotional functioning. A music therapist accepts someone for assessment. The assessment looks at psychological, cognitive, communicative, social, and physiological functioning, and at how the person responds to music. For this population it also includes substance use, emotional status, and vocational status, among other areas. Those results are supposed to become part of the file and the basis of that person's music therapy program.

Referral can come from you, from family, or from the treatment team. The decision to accept someone for assessment belongs to the music therapist. When the assessment shows a need for another service, the therapist is supposed to refer. That line is the opposite of a studio that claims to replace the rest of the team. The standards are professional rules for people who already hold the credential. They are not a living-room method, and they do not say every program must employ a music therapist. A missing hour is not something you fill by guessing.

What the research note covers

TIP 65 tells counselors that many aspects of music have been studied for a healing effect, and that evidence shows group music therapy can reduce pain in people with opioid use disorder and cravings in people with a substance use disorder. Hold that as a note about a led clinical group. It does not name a genre, a volume, or a number of sessions, and it does not say the effect replaces medication or counseling. A song that pulls you back toward use is a cue, which triggers and cravings treats more fully.

NIDA says no single treatment is appropriate for everyone. Behavioral therapies may include skills to resist drug use and replacing drug-using activities with constructive ones. Music can sit inside a clinical plan. That is not a finding that music is the plan. Medicines are an important element of treatment for many patients, especially combined with counseling. A music therapy hour does not cancel a medicine a prescriber started.

Keeping a satisfying interest after discharge is a separate suggestion in TIP 65, about hobbies. Satisfying is not a discharge rule.

What to ask before you count on the hour

Ask whether the person leading the hour is a board-certified music therapist, and whether you can see the credential. Ask whether there was an assessment, and whether music therapy is written into the treatment plan with a goal. Ask if the hour is therapy, an individual session, or recreation that uses songs. If the assessment says you need counseling, medication, or withdrawal care, ask who provides that.

A music group is not a place to ride out withdrawal. If you have been drinking heavily for a long stretch, NIAAA says withdrawal after a sudden stop can be life-threatening. The FDA says an abrupt benzodiazepine stop can cause seizures. If either emergency is underway, call for help before you go looking for a credential.

Search FindTreatment.gov and ask who holds the credential. Call or text (800) 653-9376 if you want help asking whether "music" on a schedule is therapy or an activity.

Additional Resources

Sources cited on this page:

• American Music Therapy Association: What is music therapy?
• American Music Therapy Association: Scope of music therapy practice
• American Music Therapy Association: Standards of clinical practice, including addictive disorders
• SAMHSA TIP 65, Chapter 4 (NCBI Bookshelf)
• NIDA: Principles of Drug Addiction Treatment, third edition (revised January 2018)
• NIAAA Core Resource: Alcohol Use Disorder, From Risk to Diagnosis to Recovery
• FDA: Boxed warning update for benzodiazepines
• 988 Suicide & Crisis Lifeline
• SAMHSA FindTreatment.gov

Common Questions