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Book Review of The Study of Music Therapy: Current Issues and Concepts by
Kenneth Aigen

Article · January 2014

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Lisa Summer
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AIP-1254; No. of Pages 2 ARTICLE IN PRESS
The Arts in Psychotherapy xxx (2014) xxx–xxx
Contents lists available at ScienceDirect
The Arts in Psychotherapy
Book review
The Study of Music Therapy: Current Issues and Concepts, K.
Aigen. Routledge, New York (2014)262. $48.95
The Study of Music Therapy: Current Issues and Concepts is a
groundbreaking publication from Ken Aigen, one of the most pro-
lific scholars in our field. His 250 page tome poses the most essential
questions music therapists should be asking individually and col-
lectively in order to understand the state of the music therapy
profession. The book is thoughtfully organized around six ques-
tions whose answers yield a compelling history and contemporary
portrait of the field.
Part I asks: “What is Music Therapy?” Ancillary questions
include: Are we “therapists who use music” or “musicians who do
therapy”? Should clinical approaches be divided by areas of dis-
ability or approach? (For example, should music psychotherapy
be considered population-specific, hence used only for psychiatric
clients; or should it be applied with any populations who experi-
ence ancillary psychological issues)? And one question that recurs
throughout the book gets its initial presentation in this chapter:
Should music therapy assimilate to a medical model, evidence-
based treatment paradigm in order to be considered a “real”
therapy if this assimilation marginalizes the subjective, esthetic
aspects, the “real” nature of music itself?
Part II: “How is Music Considered in Music Therapy?” challenges
music therapists to reflect upon how we think about the music we
make with our clients. Aigen articulates a conventional music ther-
apy stance in which “the nonmusical goal is the real therapy and
the involvement in music is merely an inducement to the client
to do something that is challenging and that may otherwise be
resisted. . .The client is fooled into thinking the therapy is in the
music when it is really in the nonmusical achievement” (p. 67). The
author’s contention is that a goal-oriented focus considers music
simply as a means to an end, and it puts clients in the position of
being acted upon by the music as if it were medicine. This view of
music is not only aligned with a medical model, but it also carries
with it the objectification of the patient and a dehumanizing of the
music experience.
Aigen asks pointedly: Is music simply a tool that we bend to non-
musical ends? When we consider music as a means to an end, then
how the client experiences the music internally becomes essentially
irrelevant. The author challenges us to consider whether the central
locus of clinical practice should be in our goals or in the music we
make, inviting us to consider more deeply the internal experience
that our music brings to the client. Underlying Aigen’s perspective is
the idea that the most fundamental goal of music therapy should be
provide clients with an internally driven meaningful music experi-
ence, not an externally driven goal-oriented one. This chapter posed
an especially haunting question to me: Does the traditional focus
upon nonmusical goals have a negative impact upon the quality of
our music making?
http://dx.doi.org/10.1016/j.aip.2014.06.001
0197-4556/
Please cite this article in press as: Summer, L. Book review. The Arts in Psychotherapy (2014), http://dx.doi.org/10.1016/j.aip.2014.06.001
Part III: “How are the Nonmusical Aspects of Music Therapy
Considered?” examines the client/therapist relationship with an
emphasis upon the role of verbalization. Aigen delves into the inter-
personal nature and current controversies regarding a “talking”
relationship versus musical relatedness.
Part IV: “How does Music Therapy Relate to other Uses of Music
in Society?” focuses on two areas of practice outside the field
of music therapy: music healing and community music. Aigen
explores perspective regarding the question: Should music the-
rapists embrace current music healing practitioners? He draws
his conclusion: the practice of music healing – in which music
is thought to have specific healing effects – is a reductionistic
approach that should not be “mined” to discover potentially valu-
able music interventions, nor should the music therapy profession
expand its boundaries to embrace this type of simplistic, medical
model approach.
Regarding community music, Aigen aligns himself closely with
the community music therapy perspective that has forged a broad-
ened definition of the client-therapist relationship with a heavy
emphasis on performing. Traditional music therapy takes place
within a confidential and narrowly defined therapeutic relationship
in which clinical and nonclinical experiences are clearly separated.
But Aigen, taking a community music viewpoint advocates for a
continuum of music experiences that can include nonclinical sit-
uations (such as public performances or recording sessions) along
with clinical ones.
This chapter cleverly juxtaposes culturally sensitive commu-
nity music therapy – a practice that has emerged organically from
within the field – with culturally insensitive music healing prac-
tices. He clearly warns us not to loosen the boundaries of music
therapy unthinkingly; rather, to allow for the cautious expansion of
our identity only through theories that have arisen from culturally
sensitive and ethical practice.
Part V moves away from socially based music therapy perspec-
tive to a serious critique of music therapy theories that are based
on brain science and early childhood interaction including Daniel
Stern’s concepts of cross-modality empathy. Like Part IV, these
theories are creatively grouped as Aigen articulates an underly-
ing position taken by their proponents: that clinical music therapy
processes can be explained by nonmusical process(es), i.e., early
child development, brain function, and/or biological survival. These
theories, when taken as the sole explanation for music therapy pro-
cesses contain the fatal flaw of reducing the experience of music to
something that is not recognizable as the “artistic-cultural artifact
that we acknowledge music to be.” “Taking this extreme position
invites a complete rejection and dismissal” of “music as music” (p.
186). Part V: “How are Psycho-Biological Concerns Addressed in
Music Therapy?” completes Aigen’s critique of theories by challeng-
ing us to resist the temptation to simplify clinical music experiences
using reductionistic mechanisms devoid of artistic considerations.
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2 Book review
Part VI: “How is Music Therapy Theory Developing?” begins
with an historical perspective in which three stages of music ther-
apy history are identified. During 1945–1964, ideas were imported
primarily from psychology with no emphasis upon developing
an indigenous theory to explain clinical music experiences. From
1965 to 1981 the field experienced a rapid expansion of clinical
practice and with it, music therapy theory was initiated. Stage
three, beginning in 1982 is heralded by the work of William Sears
and Carolyn Kenny’s development of the first indigenous theory of
music therapy. Within the third stage, Aigen identifies the following
contemporary theories: Field of Play (Kenny), Biomedical (Tay-
lor), Neurological (Thaut), Culture-Centered (Stige), Esthetic (Lee),
Community (Pavlicvic/Ansdell), Complexity-Based (Crowe), Music-
Centered (Aigen), Analogy-Based (Smeijsters), Dialogical (Garred),
Feminist (Hadley), Resource-Oriented (Rolsvjord), and Humanities-
Oriented (Ruud). The bulk of this chapter, and the conclusion of this
book, is devoted to an exciting comparative analysis of these cur-
rent music therapy orientations with special attention to how each
orientation defines health and wellbeing, and the role of music and
culture.
Ken Aigen has been a major contributor to the music therapy
field and this book is his highest achievement to date. This book
challenges music therapists individually to examine our own the-
oretical position, and it asks us collectively to contemplate the
direction of our profession. Aigen’s theoretical acumen is clearly
evident in his selection of contemporary music therapy theorists,
in his articulation of the most important elements of each theory,
and in his ability to pinpoint its problems or insufficiencies.
There is no hidden agenda in this book. Aigen openly acknowl-
edges his personal biases, and they are evident in his selection of the
crucial areas of debate within contemporary music therapy profes-
sion: the role of music, the definition of health and wellbeing, and
the significance of culture. Once these areas of debate are estab-
lished, most of the book is devoted to identifying the arguments
among the thirteen identified theoretical positions (he calls them
“orientations”) in relation to these issues. This is a captivating ele-
ment of the book because Aigen describes the argument using a
direct, matter of fact attitude akin to a family member who – with
the wise perspective of an elder – gives his views on the intri-
cate and complex dynamics between each member of his family.
It is as if Aigen says to the reader: “All families have differences
of opinions, and this is healthy. But let’s look beyond the surface
arguments. Try to fully examine and understand what is meant
by each person’s perspective. This is the way you can find a posi-
tion for yourself within the pluralistic viewpoints of our family.
Please cite this article in press as: Summer, L. Book review. The Arts in Psychotherapy (2014), http://dx.doi.org/10.1016/j.aip.2014.06.001
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“His writing includes detailed descriptions of the most polarized
viewpoints; sometimes a negotiated middle ground in a debate is
offered, but often Aigen does not resolve the debate at hand. He
includes extensive primary quotes to illustrate each theory, and he
offers his analysis of the perspectives as well.
Some aspects of Aigen’s writing were especially enjoyable for
me. For example each chapter is filled with clever juxtapositions,
by which I mean that he clusters together theories whose overt
positions seem contradictory yet, upon further examination, their
underlying assumptions are the same. In addition, the author writes
with a refreshing emphasis on the importance of music. Music
in healthcare can easily become relegated to a tool designed for
a therapeutic end, the therapist paying less and less attention to
music as an esthetic experience. When music becomes marginal-
ized, we lose our connection to the esthetic core of our work and
we become unbalanced in the direction of clinical processes over
musical ones. Whether we are singing Beyonce or Beethoven or the
Good Bye Song, the music itself matters. I found Aigen’s emphasis
on music as the central element of our profession revitalizing and
essential in regard the direction of our field. For me, personally,
this book was an opportunity to reassess the theoretical conflicts
within music therapy. It gave me a clear picture of a contemporary
identity for music therapy, as well as renewed hope for our future
direction.
This book is invaluable for practicing music therapists and for
professionals outside the field who have a scholarly interest in
music therapy. As an educational textbook, the author has recom-
mended it for graduate study, but I utilized Chapters I and VI (along
with supplemental reading) with success for senior level under-
graduates. I found it to be a perfect textbook for teaching because
it models for the student reader how to debate the many opposing
viewpoints within music therapy in a scholarly way.
I strongly recommend this book. The Study of Music Therapy is
the first critical survey of the music therapy profession and without
a doubt it will advance theoretical analysis and constructive debate
in the field.
Lisa Summer, PhD, LMHC, MT-BC ∗
Music Therapy, Anna Maria College, 50 Sunset Lane,
Paxton, MA 01612-1198, USA
∗ Tel.: +1 508 363 4460.
E-mail address: lsummer@annamaria.edu
Available online xxx