Abstract
Music therapy in India is an evolving and multifaceted discipline that taps into the country’s wellness & clinical fields through its rich musical heritage to enhance physical, social, emotional, and mental well-being. Historically, music has been an integral part of Indian culture, used in rituals, religious ceremonies, and healing practices. The concept of music as a therapeutic tool is deeply rooted in ancient Indian traditions, with references to its healing properties found in scriptures and folklore. It is also emphasised in Ayurveda and Acharya Charaka Sahita and Vedas. Today, music therapy in India is trying to combine these traditional practices with modern scientific research-based clinical approaches, creating a unique and effective form of therapy that is gaining increasing recognition and acceptance.
The practice of music therapy in India is approached using a variety of terms, reflecting the diverse nature of this healing art. The terms used to describe music therapy in India include musical therapy, therapeutic use of music, musical healing, Nada Chikitsa, Nada Yoga, Raga Chikitsa, Raga Therapy, Sangeet Upchaaar, and Sangeet chiktisa, among others (S. Priyanka, 2021)
This rich tapestry of terminology signifies the widespread use and acknowledgement of music therapy throughout the country.
Furthermore, individuals involved in the practice of music therapy in India are referred to by different titles, including music therapists, music healers, Sangget Chiktisak, and Naad chikitsak. These varied designations reflect the diverse cultural and linguistic background from which practitioners of music therapy emerge, underscoring the widespread adoption of music therapy across different communities in India. This leads to a variety of ways of practices within the country which may lead confusion in clinical settings.
To ensure the recognition and relevance of trials and their outcomes while pursuing music therapy in India, the country needs to draft policies promoting education, certification, and regulation. These foundational elements ensure the efficacy and integrity of the practice in clinical and general settings. This paper will emphasise upon comprehensive educational programs established in India which can equip aspiring music therapists with the necessary knowledge and skills, encompassing musical proficiency and therapeutic techniques. This paper will also emphasise Certification, typically through recognised global bodies such as the Certification Board for Music Therapists (CBMT), which can validate a practitioner’s competence and adherence to professional standards. This certification process often includes rigorous examinations and continuing educational and professional requirements to maintain credentials. This paper will also emphasise the regulation of the field through licensure and professional guidelines, which will provide a framework for consistent practice standards and protect the welfare of clients. These regulatory measures can also help to establish the credibility of the profession in India, which can foster public trust and ensure that all practitioners are held to high ethical and professional standards. This will mean music therapy practitioners can be well-prepared to deliver high-quality, effective care to various clients through global standards through these structured educational pathways, certifications and regulatory mechanisms.
Introduction
Psychiatric epidemiology lags behind other branches of epidemiology due to difficulties encountered in conceptualizing, defining a case and diagnosing, sampling technique, lack of trained manpower, poor knowledge, data collection from a single informant, systematic under – reporting, stigma, lack of adequate funding and low priority of mental health in the health policy.[3–4] which means there is a lot of scope of developement in the system for psychaty and alternative medicine. India is developing and enhancing yoga, meditation styles, Ayurveda, Unani, Siddha, Homeopathy and other menans and tools throuh ministry of Aayush for alternative medicine. Although music therapy has been developing and gaining recognition in the fields of mental health and psychology, the concept of using music as a healing tool is not new to the generations who pioneered music in the country. Music is an ancient form of expression through its time duration seasons moods and emotions which existed since the beginning of time.
In India, mental health disorders have a high prevalence, impacting a considerable proportion of the population. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370 per 1000 people in India [8].The prevalence rates of mental health disorders in India highlight the need for effective interventions and support systems to address the mental well-being of the population. Conditions such as depression, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders are commonly observed mental health disorders in India [8].
Mental illness also carries a significant social stigma in Indian society, leading to discrimination and social exclusion for individuals with mental health problems. [14].
Alternative medicine such as music therapy increases the participation, appriciates the acceptance, finds out detailed personal experience and works deeply over emotions.
While visiting mental healt organisations, The stigma creates barriers to seeking help and support, as individuals may fear judgment, rejection, or negative consequences. Consequently, individuals may delay or avoid seeking treatment, resulting in inadequate or delayed care and further exacerbating their condition [14]. Whereas study reveals listening or playing music engages the brain and activates all parts of the brain, equivalent to full body workout. Brain strats processing different information in intricate, interrelated and astonishingly fast sequences, which lit up visual auditory and motor cortices with linguistic and mathematical precision which brings confidence and boost self esteem generates happy hormones, for quickly braking the taboo and seelk support and identifying the concerns.
This needs supportive, knowledgable, well prepared alternative healthcare professionals. To prepare these professionals we need proper education and systems in place. To develop strong structured music therapy interventions in India, we need Consistency and Quality of Care
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Professional Recognition and Credibility
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Portability of Credentials
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Ethical Practice
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Advancement of the Profession
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Client Safety and Protection
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Cultural Sensitivity and Competence
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Accountability
For achieving all these we need to put our efforts into building education, certification and regulation for practicing
Education
The availability of mental health professionals, including psychiatrists, psychologists, and psychiatric nurses, is insufficient to meet the growing demand for mental healthcare in India. The shortage is particularly prominent in rural areas, where access to mental health professionals is limited. This uneven distribution of services creates a significant barrier for individuals seeking timely and appropriate mental healthcare [22–23]. The same is the case with music therapy professionals Music Therapy is in the early stages of development in India. Therefore there is an evolving need in the country to develop and provide structured and quality-based academic education and training programs and to create a framework for developing competencies which form a part of every academic and clinical program. These educational programs and competencies can help to: a) develop music therapy as an applied field and as a discipline; b) bring to the global forefront the therapeutic components of Indian music through research; c) meet the increasing interest amidst students to take up MT as a profession; and 4) meet the demands of health care teams in clinical settings to introduce complementary therapies into the context of integrated health care and holistic approaches in the treatment the disease.(S Sumathy, 2006)
Education
This journey of combining the therapeutic use of music as clinical practice in India started when Ms Margret Lobo introduced India to Western practices. Lobo conceived the idea of The Music Therapy Trust during her visit to India to give talks on music therapy in New Delhi and Mumbai. The trust was established in 2004 as a registered Indian society and became the first to introduce a clinical music therapy network in India.
The Music Therapy Trust India was started through the tireless and spirited efforts of Dr. Margaret Lobo SRAsT(M), FRSA,Founder and Director of the Otakar Kraus Music Trust. The initial work began in 2004 through a series of talks and partnership events, and as a response to the overwhelming response the trust was set up in 2005. In the years that followed the institution has been working to conform to international standards yet rooted in Indian contexts and culture.
Besides introducing Clinical Music therapy as an academic discipline and a career option the centre has been spearheading the awareness about music therapy in Delhi and other parts of the country.
It then continued with Dr Sumathi Sundar’s enthusiasm for using standardised therapeutic tools from the West and classical way of using music from India by creating the Chennai School of Music Therapy (CSMT)in 2011.
Chennai School of Music Therapy Pvt. Ltd. is a Corporate entity committed to taking Music Therapy practice, education and research to modern health care delivery system. Providing through professional training, consultancy services and therapeutic care, the school aims to advocate music therapy as an allied health care profession. The School is committed to introducing Music Therapy education and research to Universities and Consultancy and Clinical Services to hospitals, clinics, Non-Governmental Organisations and Special Schools providing health care services.
The Corporate entity provides state-of-the-art training online programmes with distinguished faculty assisting the Programme Director. The courses are developed by Chennai School of Music Therapy to impart music therapy learning programmes with interactive platforms. Further, keen on identifying cultural sensitivities, the School focuses on integrating Western music therapy and the more cultural, traditional and spiritual Indian music healing tradtions to suit local needs.https://www.chennaimusictherapy.org/
Ashwaas offers post graduate diplomaand creates accessible and effective form of teaching and learning therapeutic styles. We aim to ensure to keep up to date with latest research findings in the field of arts therapies, as well as conducting our own research, to ensure that the most effective therapeutic music techniques are used in all clinical work undertaken. All our music therapists are trained to internationally recognised standards and receive regular supervision. https://apply.ashwaas.com/
Nada Centre for Music Therapy is a nonprofit, public, charitable organization, founded and registered on 12th May, 2004 by a few enthusiastic individuals under the guidance of Dr T V Sairam. Ever since its inception, the Centre has been popularizing the healing concepts and practices of music in general and raga therapy in particular. Dr Sairam, the President of the Centre has introduced the increasing relevance of ancient concepts of Nada Yoga and Raga Chikitsa as essential ingredients in the ever- growing discipline music therapy to the West (USA, UK, Greece, France, South Korea etc ) The Distance Learning Program started for the first time in India in the year 2009 has produced hundreds of professional music therapists who have come from various discipline such as: music, medicine, psychology, lifestyle management etc.
Yenepoya Medical College A Certificate Course in Music Therapy for Health Professionals from the department of Otorhinolaryngology and Geriatric Medicine is a short-term program at Yenepoya Medical College, Mangalore. The program provides healthcare professionals with specialized knowledge and skills in the use of music therapy as a complementary treatment option for patients with physical, emotional, and cognitive challenges.
The course is recognized by the Yenepoya Medical College, Mangalore.https://www.ymc.yenepoya.edu.in/programs-cerificate-music-therapy.php#:~:text=A%20Certificate%20Course%20in%20Music,at%20Yenepoya%20Medical%20College%2C%20Mangalore.
MSc medical music therapy Music Therapy is a growing allied health care profession in its nascent stage of development
in India as music has been well researched to have profound effect on the body, mind and
the soul. Treating the person as a whole instead of just the symptoms (integrative
medicine) is an approach gaining popularity to achieve optimal health and healing and music
therapy fits in as a perfect complementary therapy along main stream medicine. There is a
very good scope of professionally qualified music therapists finding placements in hospitals,
special education and rehabilitation settings and NGOs working on disabilities and assisted
living. The sity developed the first professional Post Graduate Diploma Program through
Center for Music Therapy Education and Research, in a pioneering effort to prepare aspiring
music therapists in the country. The objective of this music therapy program was to offer
professional training to the students to begin their clinical practice in hospital settings both
in music medicine and music therapy areas. The program was very well received by the
students and also the program gained visibility across the globe which ended up in an
overseas collaboration with the Department of Music Therapy at the IMC University of
Applied Sciences, Krems, Austria. More so, as it is unique program offered from a health
sciences university with the strong emphasis on both the art and science and not just the
art side of music therapy. As the program was successful, the university has decided to
further offer an accredited, credit and choice based Master’s degree in Medical Music
Therapy also aiming to prepare the students to pursue a Ph.D. program after completing
the Master’s program
India also has other schools and universities such as, Santosh Ghatpande, TV Sairam Foundation, Sri Balaji Vidyapeeth for giving diplomas and degrees with global standards and indian concepts. In this journey,
The Indian Association of Music Therapy (IAMT), in 2010, also played a pivotal role in this development. IAMT made their mission to promote the research on Music therapy and community building of the people who are interested in this field. Through this association, India is trying to establish standardised education and clinical training, certification regulation and a sustainable way of practising music therapy in India and neighbouring countries.
To become a certified music therapist in India, one typically needs to pursue formal education in music therapy. Various universities and institutions offer courses ranging from diploma programs to master’s degrees in music therapy. For instance, the Chennai School of Music Therapy offers a Post Graduate Diploma in Music Therapy (PGDMT), while the Sri Balaji Vidyapeeth University provides a Master of Science (M.Sc.) in Medical Music Therapy. These programs cover theoretical knowledge, practical skills, and clinical training.
The Indian Association of Music Therapy is the association which represents researcher, bio-musicologist, scientist, music therapists, corporate members and related associations worldwide to promote the use of music not only in the cure of various diseases but also for the healthy life.
IAMT founded in 2010 with a mission of establish music as a drug and progressive development of the therapeutic use of music in the cure of disorders and in rehabilitation, special education, and community settings. IAMT sets the education and clinical training standards for music therapists.
The main object of IAMT is-
• to protect our national heritage of music therapy available in our mythological literature and tribal areas
• to promote the scientific research in music therapy in zoology, botany, microbiology, medicine and other areas of life sciences.
• to set up the guidelines in the area of Music therapy.
• to start certificate, diploma, and advance diploma training
• to set up a chain of music therapy centres and music therapy spa
• to start annual awards for the music therapist
• to start publication of the journal of international repute so the work carried in the area of bio-musicology will be recognized at international platform
• take the initiative in music therapy and opened a new era of bio-musical research which minimize the use of drug in form of chemicals.
• to establish bio-musicology as a source of employment-For college students with a special, aptitude for music, but no desire for the bright lights of a performance carrier, music therapy is a field that offers opportunities and rewards. So it may become a tool of self-employment for college students of science and music.
• to organize seminar, conferences, workshops time to time
The association and practitioners aim to protect India’s national heritage of music while developing an understanding of evidence-based therapeutic global interventions through indian music methodology.
This will allow scholars to promote scientific research and work towards setting guidelines for its practice.
One of the most distinctive aspects of music therapy in India is using ragas, specific melodic frameworks from Indian classical music. Each raga is believed to affect the listener’s mind and body in unique ways. But, in the modern world where exposure to global music and integration of local melodies are deeply rooted in Indian societies, only stating that classical ways of using ragas will help the brain stimulation, will not make it correct. We need a cultural center, age appropriate, demographically inclined music for our clients. We also need clinical interventions and a result-oriented approach in clinical settings which needs to be worked upon within India as a teaching learning aspect.
WFMT points out the correct way of teaching practices
The following guidelines should be applied within the context of the culture of the country.
The practice of music therapy requires an intensive program of study and supervised clinical training through an institution of higher education over an extended period of time.
Intensive studies shall consist of:
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! Musical skills and knowledge
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! Biological, psychological, and social studies
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! Music therapy knowledge and skills
Clinical training shall consist of
! Supervised field experiences in various areas of music therapy
Guidelines for Music Therapy Education & Training.
Certification
Music therapy is beginning to be applied in various clinical settings across India, including hospitals, rehabilitation centres, care homes and special education institutions. Clinical settings review the trials and the results/ outcomes pre and post-intervention. For instance, some hospitals are running clinical trials on receptive music, and others are looking at active music therapy interventions. Receptive music users use classical music or familiar songs to help manage conditions such as hospic, depression, dementia, and anxiety, with assessing outcomes reported by patients and healthcare providers, whereas in active form of therapy is used by oncology, neonatel, special need, neurological setting where they are assessed and measured upon scales, tools and active participation while or after the intervention.
Prominent practitioners in the field, such as Dr. Sumathy Sundar once in an interview with Michael G McGuire said that Music Therapy is in the early stages of development in India. Therefore there is an evolving need in the country to develop and provide structured and quality- based academic education and training programs and to create a framework for developing competencies which form a part of every educational and clinical program (Michael G McGuire, 2006).
The international board that is been recognised by many countries is CBMT. CBMT is a member of the Institute for Credentialing Excellence. Our Music Therapist-Board Certification (MT-BC) program has been fully accredited by the National Commission for Certifying Agencies since 1986. As the only certifying board for music therapy, we are committed to rigorous competency testing. Our accreditation ensures our unconditional compliance with stringent testing and measurement standards.
Board Certification in Music Therapy (MT-BC) signifies higher learning and a deeper commitment to excellence in the profession. It also underscores your dedication to evidence-based therapeutic practices that improve lives.
At CBMT, we share and support your goal of enhancing the
lives of patients. The core purpose of board certification is to provide an objective standard ensuring that all certificants are prepared to practice music therapy at the highest level. Board certification also assists the public by identifying standards
for the professional practice of music therapy. By ensuring comprehensive competency testing, we emphasize the importance and impact of what you do.
The CBMT Board Certification program consists of a computerized multiple-choice examination with 150 questions, developed by a committee of music therapists from diverse backgrounds. Exam questions are based on the Board Certification Domains, which are informed by the results of a national Practice Analysis Study. The examination defines the body of knowledge that represents competent practice in the profession of music therapy and identifies what a credentialed therapist may do in practice.
This Candidate Handbook offers extensive support and guidance on preparing for the exam and achieving your board certification.
We are in your corner on your journey to success as a board-certified music therapist. Our commitment to you begins long before you take the certification exam, and it continues throughout your career.
They train and look upon therapists readiness about Referral, Assessment, Interpretation of
Assessment and Treatment Planning
Treatment Implementation and Documentation:
68 items
A. Implementation
1. Develop a therapeutic relationship by:
a. being fully present, authentic, and respectful.
b. building trust and rapport.
c. establishing roles, boundaries, and expectations.
d. providing ongoing acknowledgement of progress
and reflection.
e. providing a safe and contained environment.
f. recognizing and managing aspects of one’s own
professional and personal biases, feelings, and
behaviors that affect the therapeutic process (e.g.,
transference and countertransference).
g. understanding group dynamics and processes.
2. Provide individualized music therapy experiences to
address client’s:
a. ability to empathize.
b. ability to use music independently for self-care.
c. abuse and trauma.
d. activities of daily living.
e. adjustment to life changes or temporary or
permanent changes in ability.
f. aesthetic sensitivity.
g. affect, emotions and moods.
h. agitation.
i. aggression.
j. anticipatory grief.
k. anxiety.
l. attention (i.e., focused, sustained, selective,
alternating, divided).
m. auditory perception.
n. autonomy.
o. bereavement.
p. coping skills.
q. danger to self or others (e.g., suicidality,
self-injurious behavior).
r. depression.
s. family dynamics.
t. enunciation and vocal production.
u. executive functions (e.g., decision making,
problem solving).
v. functional independence.
w. generalization of skills.
x. grief and loss.
y. group cohesion and/or a feeling of group
membership.
z. impulse control.
aa. initiation.
bb. interactive response.
cc. language skills.
dd. memory.
ee. motor skills.
ff. musical and other creative responses.
gg. neurological and cognitive function.
hh. on-task behavior.
ii. oral motor control.
jj. pain (e.g., physical, psychological).
kk. participation/engagement.
ll. physiological symptoms.
mm. quality of life.
nn. range of motion.
oo. reality orientation.
pp. relaxation.
qq. respiratory function.
rr. responsibility for self.
ss. self-awareness and insight.
tt. self-esteem.
uu. self-motivation.
vv. sense of self with others.
ww. sensorimotor skills.
xx. sensory orientation (e.g., maintenance attention,
vigilance).
yy. sensory perception.
zz. sensory processing.
aaa. social skills and interactions.
bbb. spirituality.
ccc. strength and endurance.
ddd. stress management.
eee. support systems.
fff. verbal and nonverbal-communication.
ggg. wellness.
3. Recognize how the following theoretical frameworks
inform music therapy practice:
a. behavioral.
b. biopsychosocial.
c. cognitive.
d. holistic.
e. humanistic/existential.
f. neuroscience.
g. psychodynamic.
4. Utilize the following music therapy approaches to inform
clinical practice:
a. behavioral.
b. community music therapy.
c. culture-centered.
d. developmental.
e. health and wellness.
f. humanistic.
g. improvisational.
h. medical.
i. neurological.
j. psychodynamic.
5. To achieve therapeutic goals:
a. apply a variety of scales, modes, and
harmonic progressions.
b. apply standard and alternate tunings.
c. apply the elements of music (e.g., melody,
harmony, rhythm).
d. arrange, transpose, or adapt music.
e. compose vocal, instrumental, and digital music.
f. employ functional skills with:
1. digital instruments.
2. guitar.
3. Keyboard.
4. percussion instruments.
5. ukulele.
6. voice.
g. improvise using instruments, voice, or movement.
h. sight-read music.
i. utilize a varied music repertoire (e.g., blues,
pop, metal, hip-hop) from a variety of cultures
and eras.
j. utilize music and movement.
k. utilize music to communicate with client.
l. utilize song and lyric analysis.
m. utilize songwriting.
n. mediate interpersonal problems within the
session.
o. provide musical cues.
p. utilize leadership and/or group management skills.
q. utilize prompting hierarchy (i.e., verbal, gestural,
model, visual, physical, auditory, or tactile).
r. employ active listening.
s. employ mindfulness techniques with music.
t. employ music relaxation and/or stress
reduction techniques.
u. facilitate community-building activities.
v. facilitate generalization of therapeutic progress
into everyday life.
w. identify and respond to significant events.
x. integrate current technology and
interactive media.
y. observe client responses.
z. offer coaching to family, caregivers, and peers
to maintain and support the client’s therapeutic
progress.
aa. provide receptive music experiences.
bb. share musical experience and expression with
clients.
cc. utilize adaptive materials, equipment, and assistive
technology.
dd. utilize breathwork.
ee. utilize creativity and flexibility in meeting client’s
changing needs.
ff. utilize imagery.
gg. utilize relaxation techniques.
hh. validate client’s musical experience.
India yet do not have any