Annotated Bibliography

Guitar as a tool for music therapy

Chronological order

Anthony A. Decuir, Vocal Responses of Mentally Retarded Subjects to Four

Musical Instruments, Journal of Music Therapy, Volume 12, Issue 1, Spring
1975, Pages 40–
43, https://doi-org.ezproxy3.library.arizona.edu/10.1093/jmt/12.1.40

This remarkable study reaches the goal to discover which instrument is the most effective when
it comes to stimulate responses from patient with a mental retard. The instruments most
commonly used and therefore brought into the study are Piano, guitar, organ pipes and electronic
pipe. The starting point in the study was to determine which instrument would satisfy the
rhythmic part more than the others because in a study conducted in 1968 it has been found that
retarded patient respond more to rhythmic impulses than to melodies. Guitar turned out to be the
preferred instrument also because of his portability and the tight visual contact that there is
between therapist and patients. Probably a great help was given by the familiarity with guitar
sound. Perhaps a more thorough comparison between the rhythmic side of the instruments would
have brought a different outcome for there is no way to perform a strumming chord on the organ.
The latter will be discussed later in the following studies.

Susan Rachel Eisenstein, Effect of Contingent Guitar Lessons on Reading

Behavior, Journal of Music Therapy, Volume 11, Issue 3, Fall 1974, Pages 138–
146, https://doi-org.ezproxy3.library.arizona.edu/10.1093/jmt/11.3.138

With this study, The author brilliantly demonstrates an improvement on the baseline reading
behavior of 3rd grades kids through the aid of guitar lessons as well as implementing the theory
of Michael and Farrell (1973) according to which “contingencies as candies, guitar lessons, and
other social reinforces.. attempt to modify students’ self esteem”. The effectiveness of the study
is achieved by a 4 steps method where learning guitar chords (step. 2 and 4) was used as a
reward for getting as many right answers as possible (step 1 and 3). This procedure resulted to be
so efficient that the children asked about the guitar in step 3 and were able to focus better when
quizzed. At the end of the sessions the subjects were more determined in learning how to read
and they caught up with the rest of the classroom as well as gaining more self esteem and social
skills due to socializing because of playing together. However, some discrepancies have been
registered and are accounted for many factors some of which are: different time in which
sessions happened, the extent of words difficulty, interruption of the study due to holidays, and
unpredictable variables within the classroom that will surely be the object of further studies.

April Batson Malone, M.M., RMT-BC, The Effects of Live Music on the
Distress of Pediatric Patients Receiving Intravenous Starts, Venipunctures,
Injections, and Heel Sticks, Journal of Music Therapy, Volume 33, Issue 1,
Spring 1996, Pages 19–
33, https://doi-org.ezproxy3.library.arizona.edu/10.1093/jmt/33.1.19

The study shows how helpful is employing guitar music as a “non-invasive methods of pain
management” when needle insertions becomes source of distress for infants and young children.
The author decided to have two groups analyzed: the one without music soothing procedure and
the other with the help of guitar strumming and singing. The study demonstrates that employing
music in a pre needle insertion, during insertion and after post insertion, it really takes a lot of
stress off of children and lower the anxiety before the puncture. There are some instances though
where the study proved music therapy wrong and even that it maximized the pain at the moment
of the needle insertion. Some parents disagreed with the intervention of music therapy stating
that if it is true that distracted the patient before the puncture it intensified the pain as the patient
was not ready for it. For them it is better longer anxiety period than intensified pain all at once.

Robert Groene, PhD, MT-BC, The Effect of Presentation and

Accompaniment Styles on Attentional and Responsive Behaviors of
Participants with Dementia Diagnoses, Journal of Music Therapy, Volume 38,
Issue 1, Spring 2001, Pages 36–50, https://doi-
org.ezproxy3.library.arizona.edu/10.1093/jmt/38.1.36

The following study is impressive in his findings: Alzheimer’s disease patients react far more
actively during live performance than with recorded tapes for many reasons. The author outlines
the most important as “the flexibility of tempo change that match client response” and the
“visual cue of therapist mouth for lyric imitation”. In a world where mental illnesses advance for
the old generations, music therapy turns out to be the most suitable remedy for containing the
advancement thereof. Once more the usefulness of guitar comes in handy because of the
sweetness of the tone and the ductility of the instrument capable of reproducing melodies,
different harmonic rearrangements, percussive effects and so far. The study assessed every
patient behaviors by 4 steps: leaving the room before the therapy session ended, engagement
with the lyrics, attention with the music and attention revealed by compliments. There has been
some confusing data for the study evaluates behaviors based on 4 different modality: simple live
music, complex live music, simple recorded music and complex recorded music. The confusing
data sprang by the singular different preferences and not by a general scheme. This will lead to
further research. The study nevertheless resulted in being very helpful for the treatment of
Alzheimer.

Krout, Robert E. “The attraction of the guitar as an instrument of motivation,

preference, and choice for use with clients in music therapy: A review of the
literature” The Arts in Psychotherapy 34 (2007) 36–52

In this publication Krout offers an exhaustive compendium of hospitalized clients that benefitted
from playing classical guitar. He gathers over one hundred studies that observed clients from
different perspectives, ages, illness and brilliantly associated them with the same healing process:
Guitar as a tool of Music Therapy. He is capable of understanding the magic that lays behind
guitar and why it has proved to be so successful. By analyzing the literature in the
aforementioned publication, the author points out the cross-cultural trait of the instrument as
being the main factor for which it is the first instrument preference for the clients. Since guitar is
a mainstream instrument and it is the main “character” in every music genre, and provided that
every human being consumes music to some degree, This instrument is the main candidate to
serve as healing tool in music therapy. However, the author focus the attention chiefly on kids
and adolescents illnesses leaving out seniors. If it is true that old people face more obstacles due
to loss of ear and poor hand mobility, in the other hand other sources witness how the desire of
playing guitar doesn’t die out in old people, and success in healing pathologies also proves to be
right.

Bell, A. P. “Guitars have disabilities: Exploring guitar adaptations for an

adolescent with down syndrome”. British Journal of Music Education, 31(3),
(2014) 343-357.
doi:http://dx.doi.org/10.1017/S026505171400028X

This innovative and inspiring study demonstrates that guitar can be the most suitable instrument
for people affected by the down syndrome, provided that the instrument is adapted to the subject.
The author embraces the social model of disability by virtue of which “when a difficulty is
encountered, instead of focusing on the individual’s limitations, one man should focus on the
limitations of the situation”. Hence, he cunningly devises different prototypes of guitars (two
strings guitar, open tuning in D, plastic molds that simulate chords shapes) to match his client’s
limitations. The adolescent affected by this illness is naturally drawn by the beauty of the guitar
sound that reminds him of his preferred band Green Day and that enables him to express his
emotions through music, something that was thought to be unreachable. Besides, he develops
rhythmic abilities that allow him to keep a steady tempo as well as motivating and entertaining
him through music therapy. As far as the change of chords are concerned, He does not manage to
physically hold the neck of the guitar with his left hand. This will prompt further studies to find
more suitable solution like perhaps decreasing the width of the fretboard.

Neal, Nicole. “Learning Classical Guitar and The Mental Approach You Need
for Success.” CLASSICAL GUITAR N STUFF, June 19, 2014.
https://classicalguitarnstuff.com/tag/psychology/.

The main emphasis of this study is that your mindset highly influences skills like learning and
playing a classical instrument, in this case guitar. Talent, brain, and discipline are affected by
engaging with classical music, and unfortunately they may become enemies of the mind if
involved in an unhealthy way. There may be psychological changes in learning a new piece of
music, and with time it is evident “how these changes will have a negative impact on your
learning". The key to master classical guitar is concentration. Being Talented surely helps, but
the essential part is the effort you put in and the quality and strategy of the practicing, and
obviously the process of learning an instrument “can also have a subtle effect on our minds”.

Keller, Joshua Robert, "Perceptions of Guitar Use and Training in Music

Therapy: A Survey of Clinicians" (2015). Master's Theses. 604.
https://scholarworks.wmich.edu/masters_theses/604

Due to its proximity with any client and to its intimate tone, guitar is the most used instrument in
music therapy and it is a mandatory course in the undergraduate studies for the ones pursing the
carrier of music therapy. This detailed study documents the difficulties that clinicians face once
in touch with patients and the improvements that they have to take in order to meet supervisors’
demands. The author clearly reports therapists’ complaints about not being adequately prepared
by the guitar training received in university programs for the clinical practice, that in most cases
it is only about one semester. The strength of the study is proving that playing guitar help to
improve physical issues such as hands strengths as well as psychological such as increasing self
esteem, attention, conveying emotions and so forth. Yet, it suggests that guitar courses should
implement further learning objectives: “playing in a variety of styles, improvisation, basic
maintenance, and adaptive techniques”.
A Robertson, PhD, MT-BC, “Results of Medical and Hospice Music Therapy
Internship Directors’ Views of Advanced Guitar Skills Needed for
Interviews” Music Therapy Perspectives, Volume 38, Issue 2, Fall 2020, Pages
205–209, https://doi.org/10.1093/mtp/miz022

This remarkable study allows us to learn which advanced guitar skills a music therapy intern is
recommended to earn in order to successfully deal with clients: since the diversity of clients is
wide and their genre preferences goes along, a broader range of guitar techniques need to be
acquired. The author, based on the extended research across the states, denotes that guitar is the
most suitable instrument for music therapy due to 1) ductility to adapt to every style , 2) its
portability and usability in every circumstance and 3) to its soothing tone. The usefulness of the
study lays in determining that Fingerstyle patterns, different genre’s rhythmic patterns and
performing familiar songs transposed in many keys need to be learned , although the
requirements of the American Music Therapy Association don’t implement them. However, the
author doesn’t mention that in order to acquire this fluency with the instrument, undergrads
studies need to increase the amount of guitar courses since most of the interns show a lack of
competencies in this regard.

Kory Antonacci, MS Ed, LPC, MT-BC, Nicole Steele, MS, MT-BC, Jacob
Wheatley, PhD, LPC, NCC, CCLS, Donna M Weyant, MSN, RN, CPN,
Beverly Brozanski, MD, Brittany Stone, MM, MT-BC, Teresa Mingrone,
MSN, RN, CCRN, “Effects of Guitar Accompaniment Patterns on
Hospitalized Infants: A Randomized Controlled Trial” Music Therapy
Perspectives, Volume 39, Issue 2, Fall 2021, Pages 172–
183, https://doi.org/10.1093/mtp/miab013

While it was already documented that music stimulates physical and psychological responses to
infants, this detailed study aims to determine whether certain guitar accompanying patterns have
different effect on patients and to point out which one can be of a better use in the field of music
therapy. Although the authors fail to achieve a significant difference between arpeggiated
accompaniment and bass/chordal accompaniment, it surely launches a challenge to future studies
about other guitar accompaniment patterns. The study was properly conducted, with the utmost
care to the minimum detail providing equity with analyzing 180 infants. With regard to the
methodology in the music therapy session, humming along the accompaniment is employed and
this may have caused a slight outcome since the 2 investigators have different voices and
performing style. The strength of the study proves that guitar foster a status of relaxation and
comfort, a decreased heart beat and a regulation in breathing.