How Music Therapy Can Support Connection, Expression and Participation for Young People
For some young people, disengaging from school is part of a much bigger picture.
Mental health challenges, neurodivergence, difficult life experiences, social isolation or prolonged periods away from education can all affect a young person’s capacity to participate – not only at school, but socially and therapeutically as well.
Re-engagement doesn’t always begin with returning to a classroom.
Sometimes, it begins with finding something worth engaging with.
A conversation. A shared interest. An opportunity to create. A place where there isn’t necessarily a right answer.
For some young people, music therapy can provide that starting point.
Welcome to Beyond the Notes, a QPAH series exploring what music therapy actually looks like in practice – and the clinical thinking happening behind the music.
In this first article, we’re looking at how Registered Music Therapists (RMTs) can use music within therapeutic programs for adolescents experiencing mental health challenges or disengagement from education.
When music becomes the meeting place
Imagine a small group of teenagers arriving at a music therapy session.
They have different backgrounds, different strengths and different reasons for being there. Some are comfortable talking. Others aren’t. One might head straight for the instruments. Another might be much happier sitting back and observing.
The music therapist might begin with a very simple question:
“What have you been listening to this week?”
On the surface, they’re talking about music.
But a song can be connected to a friendship, a memory, an experience, an emotion or an important part of someone’s identity.
Talking about the song can actually create opportunities to talk about something bigger.
Rather than asking a young person to begin by describing how they’re feeling, music can provide a shared focus from which conversation and interaction can develop.
And that’s where we start moving beyond the notes.
What’s actually happening therapeutically?
Music therapy isn’t a music lesson, and participants don’t need to be musicians.
A Registered Music Therapist uses music purposefully within a therapeutic relationship to work towards identified goals.
That distinction matters.
Consider collaborative songwriting.
A group might decide to write a song about friendship, happiness or something completely ridiculous.
Before they’ve even finished a verse, participants may be generating ideas, communicating preferences, listening to other perspectives, making decisions together and finding ways to express something of themselves.
The finished song isn’t necessarily the therapeutic goal.
The process of creating it is where the therapeutic opportunities lie.
The same applies to making music as a group.
Playing drums, ukuleles or percussion together can require participants to listen, wait, respond, sustain attention, coordinate their actions and adjust what they’re doing in response to other people.
From the outside, it looks like a group of teenagers making music.
From the therapist’s perspective, there may be multiple therapeutic processes occurring within that musical experience.
Why use music?
Music is a complex human activity involving processes associated with attention, movement, memory, emotion, perception and social interaction.
That gives a music therapist a flexible medium through which different therapeutic goals can be explored.
For example, an RMT might use:
Song discussion to create opportunities for emotional exploration, communication and connection.
Songwriting as a structured way to explore ideas, identity and self-expression.
Collaborative music-making to create opportunities for listening, shared attention, cooperation and social interaction.
Instrument playing to incorporate motor planning, coordination, attention and participation within a motivating activity.
Importantly, the same musical activity may be used very differently depending on the person, the context and their therapeutic goals.
Music therapy for young people isn’t about choosing a song or instrument that somehow “treats” a particular diagnosis.
It is about how a qualified registered music therapist uses musical experiences intentionally within a therapeutic process.
What could this look like in practice?
Consider a music therapy group designed for adolescents experiencing mental health challenges or disengagement from education.
Sessions might follow a predictable structure while allowing flexibility for creativity, choice and self-expression.
A session could begin by sharing music participants have been listening to recently. From there, the group might discuss what they notice about a song, why particular music matters to them or the ideas and experiences represented within it.
The group might then work together on an original song.
One week the theme could be friendship. Another group might decide to explore happiness: what makes us happy, what happiness feels like and how that could be represented through words and music.
Or the idea might be completely silly.
That’s okay too.
The therapeutic value isn’t determined by whether the finished song is profound.
The process can create opportunities for participants to contribute ideas, make choices, negotiate with peers, communicate preferences, listen to other perspectives and create something collectively.
Later, the group might accompany familiar songs or their own compositions using instruments such as ukuleles, drums or percussion.
Again, becoming a better musician isn’t necessarily the goal.
The musical activity provides a context in which participants can practise skills relevant to their individual and group therapeutic goals.
What does the research tell us?
Research into music therapy and child and adolescent mental health is encouraging, but it is important not to overstate what we know.
A meta-analysis examining music therapy for children and adolescents with a range of psychological, behavioural and developmental difficulties reported positive effects across clinically relevant outcomes. However, the authors also identified variation according to the population, therapeutic approach and outcomes being measured.
Research since then has continued to demonstrate a complex picture. A large, randomised, controlled trial involving children and adolescents receiving mental health services, for example, did not find a significant improvement in its primary communication outcome following twelve weeks of music therapy plus usual care, compared with usual care alone.
More broadly, systematic review evidence has found potential benefits of music therapy alongside usual treatment for people experiencing depression; while also highlighting limitations in the available evidence and the need for further high-quality research – particularly involving children and adolescents.
So, we shouldn’t say:
“Music therapy will re-engage a disengaged teenager.”
The evidence doesn’t support a promise like that.
What we can say is that music therapy provides a therapeutic medium through which goals involving communication, emotional expression, social interaction, participation and other areas of functioning may be explored – with the approach tailored to the individual and their circumstances.
Sometimes participation itself matters
For a young person who has become disconnected from school, peers or other activities, therapeutic work doesn’t always look dramatic.
It might look like choosing a song.
Offering an idea.
Joining a rhythm.
Writing a lyric.
Listening to another person’s contribution.
Or choosing to participate in something as part of a group.
Within music therapy, these moments can provide meaningful opportunities to work towards broader therapeutic goals.
The music isn’t the outcome.
It’s the medium through which therapeutic work can happen.
And that’s what Beyond the Notes is all about.
Could music therapy complement your program?
Music therapy may be incorporated within multidisciplinary approaches in schools, community organisations, health services and other programs supporting young people.
QPAH’s Registered Music Therapists work with organisations to develop programs based on the needs, context and identified therapeutic goals of the people they support.
To learn more about music therapy at QPAH or discuss whether it may be appropriate for your organisation, contact our team on 07 5647 6120 or [email protected].
Evidence & further reading
Gold, C., Voracek, M., & Wigram, T. (2004). Effects of music therapy for children and adolescents with psychopathology: A meta-analysis. Journal of Child Psychology and Psychiatry, 45(6), 1054–1063.
Porter, S., McConnell, T., McLaughlin, K., Lynn, F., Cardwell, C., Braiden, H. J., Boylan, J., & Holmes, V. (2017). Music therapy for children and adolescents with behavioural and emotional problems: A randomised controlled trial. Journal of Child Psychology and Psychiatry, 58(5), 586–594.
Aalbers, S., Fusar-Poli, L., Freeman, R. E., et al. (2017). Music therapy for depression. Cochrane Database of Systematic Reviews, Issue 11, CD004517.
This article provides general information about music therapy practice and is not individual clinical advice. Examples are illustrative and do not describe an individual QPAH client. Music therapy is individualised, and approaches and outcomes vary according to each person’s needs, goals and circumstances.