What is music therapy, what happens in sessions and who is it for? Learn how music affects emotions, how to use it day to day and where its limits lie.
Picture an elderly woman in a care home who has barely spoken for months and even mixes up her grandchildren's names. When someone plays an old Turkish classical song from her youth, one that was often on the radio back then, her lips begin to move; by the second line she is murmuring the words one by one, and her eyes fill with tears. This scene is one of the everyday examples showing that music can reach memory and emotion along paths that words cannot. Music therapy aims to use this effect not by chance, but within a therapeutic relationship and with specific goals. In this article we look at what music therapy is, what is done in sessions, in which situations it is used, how you can draw on music in your own daily life, and what the method's limits are.
What Is Music Therapy?
Music therapy is an approach in which a practitioner trained in this field uses music and musical experiences, that is listening, singing, keeping rhythm, improvising or songwriting, in a planned way to address a person's emotional, cognitive, social or physical needs. The key words here are "planned" and "relationship". Listening to your favourite songs after a bad day may do you good; but that is not music therapy. In therapy, music is a tool that serves a defined purpose and takes shape within the interaction between the therapist and the person.
Applications are generally grouped into two main categories:
- Active methods: The person makes the music themselves. Improvising on easy-to-play instruments such as drums, cymbals or a xylophone, singing, keeping rhythm with the therapist or writing their own song fall into this group. No musical training is needed.
- Receptive methods: The person listens to music; afterwards the emotions, images and memories evoked by the piece are discussed. In some approaches music accompanies relaxation or imagery exercises.
The tradition of healing through music in Turkey
The idea that music is good for the soul is nothing new in this part of the world. It is known that in some Ottoman-era darüşşifas, that is hospitals, music was used as part of treatment; the darüşşifa of the Sultan Bayezid II Complex in Edirne can be visited today as a museum telling this history. Historical sources also contain views that different makams (the melodic modes of Turkish classical music) are good for different states of mind. This tradition is culturally valuable; however, it is not possible to say that claims such as "this makam cures that illness" are supported by today's scientific knowledge.
Today in Turkey, treatment practices using music fall within the scope of the Ministry of Health's regulation on traditional and complementary medicine practices. Who may carry out this practice, in what settings and under what conditions is determined by legislation. It is therefore sensible for anyone seeking a service offered under the name of music therapy to ask about the practitioner's training and the place where the practice takes place.
How Is Music Therapy Applied?
A music therapy process usually begins with an initial assessment. The practitioner learns about the person's needs, their relationship with music, the genres they like and dislike, and any physical or cognitive limitations. Then the goals to be reached are set: for a child, eye contact and turn-taking; for an adult who has had a stroke, regaining the rhythm of speech; for an anxious young person, being able to calm their body.
Some of the techniques used in sessions are:
- Improvisation: The person and the therapist build a musical "conversation" with instruments. If the person is playing fast and hard, the therapist first accompanies them, then gradually changes tempo, inviting the person into a different emotional space.
- Singing and breathing work: Holding long notes regulates the breath and calms the body. For people who find it hard to speak, completing the words of a familiar song can be a bridge to expression.
- Songwriting: The person writes lyrics about their experiences together with the therapist. Turning a feeling into a chorus both expresses it and gives it a structure.
- Reminiscence work: Songs from different periods of the person's life are listened to and the memories they evoke are discussed. This is often used with older people.
- Relaxation with music: Chosen music accompanies breathing and muscle relaxation exercises.
Individually or in a group?
Work with music can be carried out in individual sessions or in small groups. Individual work leaves more room for the person's own particular goals and feelings. Group work, meanwhile, supports communication, sharing and a sense of belonging through experiences such as keeping rhythm together, taking turns to play or creating a shared song. In group sessions held in care homes or hospital rehabilitation units, for example, singing the same folk song together can create closeness even among people who hardly say a word to one another. Which format is suitable is decided according to the person's needs.
Let's imagine an eleven-year-old who struggles to control their anger coming to a session. In the first few minutes they hit the drum with all their might. The therapist does not stop them; they accompany the child on their own drum with the same intensity. After a few minutes the therapist slightly slows the rhythm; the child resists for a while, then, without realising it, falls in with it. At the end of the session what is discussed is not the drum, but what happens in the child's body when they get angry and how that anger can slow down.
Who Is Music Therapy For?
Music therapy is used across very different age groups and settings. Research shows that music-based interventions may be helpful as a complement to other treatments in the following areas:
- Children on the autism spectrum: Music offers a structured, predictable setting for supporting social communication skills such as joint attention, turn-taking and eye contact. If you are curious about the early signs of autism, you can take a look at the article on signs of autism.
- People living with dementia: Familiar songs can revive memories, reduce restlessness and agitation, and help people reconnect with their families. The article on being a relative of someone with dementia, about what carers go through, may also interest you.
- Stroke and neurological rehabilitation: Rhythm and melody are used as support in speech and walking rehabilitation.
- Low and anxious mood: Music can be a tool for noticing and expressing emotions, calming the body and taking steps back towards enjoyable activities.
- Hospital and palliative care settings: At times when pain and anxiety are intense, music can help a person feel less helpless.
In none of these areas is music therapy considered a treatment on its own; it is regarded as a complementary approach alongside medical treatment, rehabilitation or psychotherapy.
How Does Music Affect the Brain and Emotions?
There are several reasons why music can have such a powerful effect.
Rhythm captures the body. The human body is drawn to rhythm; while listening to a slow tempo, breathing and heart rate may gradually begin to fall into step with it. This is why a lullaby calms the singer as much as the baby.
Music activates the reward system. The shiver we feel at our favourite moment of a song we love is a sign that areas of the brain linked to pleasure and motivation have come into play. For someone in a depressive period who can enjoy nothing, even a small moment of musical pleasure matters.
Music and memories are tightly bound together. The songs we listen to in adolescence and young adulthood are remembered strongly even in later years. This partly explains why some songs stay in place even when memory weakens.
Music connects people. Joining the halay (a traditional Turkish line dance) at a wedding, breathing at the same moment in a choir or singing the same anthem in a stadium creates a sense of belonging to a community. For people experiencing loneliness and withdrawal, this shared experience can be valuable.
Regulating Emotions With Music in Daily Life: What You Can Try on Your Own
Music therapy is carried out by a specialist; but using music more consciously for your own emotional well-being is within reach for all of us.
- Start from your feeling, then change direction. When you are very tense or sad, putting on a cheerful song straight away often feels jarring. Prepare a playlist that begins with a piece matching your current mood and gradually changes tempo and tone over several songs.
- Create different playlists for different needs. Separate lists that help you wake up on the school or work minibus or in traffic in the morning, make it easier to focus in the afternoon, and slow your body down before bed in the evening may be useful.
- Sing out loud. Singing in the kitchen, in the shower or in the car lengthens the breath and can reduce tension. Your voice does not need to be beautiful.
- Watch out for the sad-song loop. Listening to sad songs when you are down can help you recognise the feeling and find relief. But if you are listening to the same song for hours and going round in circles with the same thoughts, the music may now be feeding that loop rather than soothing it.
- Leave room for silence too. Walking around with headphones all day can make it harder to hear your own inner voice.
- Protect your ears. Listening at high volume for long periods can damage hearing; keep the volume at a level that does not cause discomfort.
Music hears a feeling before it changes it; a good musical experience first comes to where you are, and then takes you somewhere else.
The Limits of Music Therapy and Points to Watch
The fact that music does you good does not mean that every music-based practice is effective. It is worth paying attention to the following points:
- Be cautious about exaggerated claims. Claims circulate online that sounds at particular frequencies, special recordings or "brainwave music" listened to through headphones treat anxiety, depression or attention problems. Most of these claims are not based on strong scientific evidence.
- Music can be a trigger. A song may unexpectedly revive a memory linked to loss or trauma. A trained practitioner notices such reactions and handles them safely.
- It does not replace psychotherapy or medical treatment. Severe depression, psychotic symptoms or life-threatening situations should be addressed not with music but with a comprehensive assessment.
What can you ask a practitioner before you start?
Asking a few questions before approaching someone who works with music helps you understand whether you are in the right place. You can ask what training the practitioner has had in this field, in which institution and under what supervision the practice takes place, which goals will be set for you and how progress will be evaluated. Be wary of practices that promise a definite recovery after a set number of sessions, steer you towards stopping your medical treatment or psychotherapy, or rely solely on sound recordings you have to buy.
When Should You Seek Professional Support?
Even if music does you or a loved one good for a while, it is necessary to talk to a mental health specialist in the following situations:
- If for a long time you have been unable to enjoy anything, not even the music you used to love,
- If your anxiety, anger or sadness is markedly affecting your work, school or relationships,
- If you notice worrying differences in your child's communication, play or development,
- If you are having thoughts of harming yourself or ending your life. In such a situation, do not wait for it to pass by listening to music; in an emergency, call 112 (emergency services).
You can find general information about the psychotherapy process with adults on the individual therapy page.
How Is Music Used in Therapy?
A psychologist, even if not a music therapist, may at times make room for music within psychotherapy. In cognitive behavioural therapy, in behavioural activation work that aims to add small, enjoyable activities to a person's daily life during a depressive period, picking up an instrument they used to play or joining a choir can be a meaningful step. When working with anxiety, physical relaxation exercises can be supported with calm music. Asking a client who struggles to name their emotions "If what you're feeling right now had a song, which one would it be?" can open the door to conversation.
In play therapy with children, simple rhythm instruments in the playroom make room for the child to express their anger, joy or restlessness safely. The therapist accompanies this expression and names the child's feeling.
If you are thinking of turning to a music-based practice, you can discuss with your specialist whether it suits your needs, what goals it will be carried out with and, if necessary, how it can proceed alongside psychotherapy.
Frequently Asked Questions
Do I need to know how to play an instrument for music therapy?
No. The instruments used in sessions are usually tools such as drums, cymbals and maracas that require no training at all. The aim is not to make beautiful music but to express yourself through music and to reach the goals that have been set.
What is the difference between music therapy and a music lesson?
In a music lesson the goal is to learn an instrument or a musical skill; success is measured by performance. In therapy, music is a tool; there are no right or wrong notes, and the focus is on the person's emotional, social or physical needs.
Will listening to sad songs make my mood even worse?
Not always. A sad song can help you recognise your feeling and sense that you are not alone. However, if after listening you feel increasingly hopeless or find yourself stuck in the same thoughts, it is worth reviewing your listening habits and, if necessary, seeking support.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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