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Hip Hop in Music Therapy

Josh Kuhl
Rap music is a prominent aspect of today’s society that engages people from many walks of life.
It is a music that expresses the desires, wants, and emotions of a large group of people. This aspect makes
it a great tool for music therapists. Music therapy, in the terms of the articles presented, works to create
discussions on self-disclosure through lyric analysis and participation in music creation.
Although they are used interchangeably, the term “Hip Hop” is used by its researchers to describe
a cultural arts movement compared to a genre of music. Hip Hop culture was initially developed in the
1970’s by urban African American youths as an almost countercultural movement (Lightstone, 2011, a p.
41), and Hip-Hop culture can be expressed in many ways. The primary modes of expression are dance,
visual art, fashion, and music. These modes are expressed in break dancing, graffiti, oversized clothing,
outdoor/wilderness accessories, prominent displays of large jewelry, and rap. Rap music is closely
associated with DJ-ing and MC-ing (Lightstone, 2011, a p. 41-42). DJs and MCs work very closely
together; DJs provide and create beats from various tracks while the MC raps (Hadley, & Veltre, 2011, p.
87-88). Rap music has since changed the labels of the individuals involved from its early beginning in the
Bronx, but the functions stay the same. The producer creates the beat and mixes the final track, while the
rapper raps the lyrics.
Hip Hop culture is expressed by three defining characteristics present throughout forms of art in
Hip Hop: flow, layering and rupture in line. These characteristics are seen in rap through the flow of the
beat and lyrics, the layering of drums, bass line, vocal line, and the rupture of the flow by breaks, fills,
and scratching (Rose as cited in Lightstone, 2011, a p.43). “One factor that distinguishes hip-hop from
other genres of music is its primary focus on the spoken word” (Kobin, & Tyson, 2006, p. 344). The
content of the vocal line is typically heavily laden with slang or “street speech” (Lightstone, 2011, a p.
43). Common themes expressed in rap music are that of boasting of achievements; primarily drug
use/dealing or sexual exploits, signifying (an African American oral tradition of verbally attacking
oppressive social structures), spirituality, and violence (Lightstone, 2011, b). The lyrical content defines
the genre of the rap.
Between Tyson and Elligan, there are ten potential genres. Each proposed six genres and agreed
on two, those of political and gangsta rap. These focus on themes of social change/justice, and that of
living a gangsta life respectively. Other genres mentioned are commercial rap (Tyson, 2003), which
shows similarities to materialistic rap (Elligan, 2011) which focuses on boasting about the individual's
wealth, success, and possessions, coining the phrase “ghetto fabulous.” Hip Hop rap (Tyson, 2003)
references to rap’s early beginning in the Bronx, commonly known as “battlin’” or “rap battles”. Poetry
rap (Tyson, 2003) can be identified as more commonly as spoken word while reality rap¹ tends to be a
more serious version of gangsta rap, where instead of boasting and making threats, it discusses the
hardships of life. The counter to reality rap is positive rap. Positive rap² bleeds into spiritual/gospel
(Elligan, 2011) rap where focus themes are positive messages relating to the betterment of oneself in the
former, and themes pertaining to God, the afterlife, and faith in the latter. “Other” as described by Elligan
(2011) is music and genres the incorporate rap style and lyrics, but rap is not the primary focus or genre
of the music. An example of such being popular music that contains a rap verse by a featured artist
(Tyson, 2003, as cited in Kobin, & Tyson, 2006, p. 349) (Elligan, 2011). Being that Hip Hop and rap are
the culture and music embraced by many youths, particularly in urban environments, opportunities for
therapists to connect to and understand this group increases.
Tyson (2002) uses the widespread popularity of rap music as a rationale for its inclusion in
therapy. He cites the “social, cultural, and political lyrical content and underlying themes” as useful
therapeutic tools. His findings demonstrate that by utilizing the clients’ strengths and interests, he was
able to engage a challenging client population in a therapeutic process (Tyson, 2002, as quoted in
Lightstone, 2011, a p. 46). The inclusion of rap music in music therapy is featured in two ways: the
analysis and discussion of themes of pre-existing and commercial rap music, and self-disclosure through
participating in musicing.
Statistically, the most difficult clientele population for any and all therapists to work with is that
of urban minority youth, primarily of African American or Latino heritage. The challenge is creating a
safe environment for them to express their emotions and cope with the challenges of life (Kobin, &
Tyson, 2006). One aspect that can greatly hinder creating a safe environment is the formation of
perceived and real authority of the therapist, creating a hierarchy in the client-therapist relationship. This
barrier can become especially prominent if the therapist is not of a minority population. The inclusion and
discussion of rap music, particularly that of the client’s picking, can increase the perception of the
professional’s empathy and relatability (Kobin, & Tyson, 2006, p. 343-344). In a study conducted by
Olsen-McBride and Page at an alternative school, three groups of participants used a “theme song”
approach where they selected a song containing the specified theme and then participated in a group
discussion about that theme. The data shows that all three groups had high ratings of self-disclosure
during these sessions. By engaging a culturally relevant medium, a very deep class and cultural divide
was bridged between the facilitator and the participants. The facilitator was a middle class, white female
from a rural town in the Midwest, and the participants were primarily African American adolescents from
an impoverished urban area in the deep south. The participants over time referred to “the white lady,” as
“the rap lady”, showing a clear change of perception of the facilitator (Olsen-McBride, & Page, 2012).
The same study focused on the use of a group poetry therapy called the R.E.S model. R.E.S
(receptive/prescriptive, expressive/creative, and symbolic/ceremonial) utilizes three components: the
introduction and discussion of literature to a group, the writing of original content, and the involvement of
metaphors and storytelling. The poetry and “hook” for this study was that of rap music. By listening and
discussing rap music, the participants created conversation by using the lyrics as a “springboard” to help
them find topics and interrelated topics to express their thoughts and disclose personal information or
beliefs. The process of song to self was the measurement by which the process would prove successful.
Although the groups each displayed different percentages of willingness to self-disclosure, they all
followed the same trend. As the sessions went on, the percentage of self-disclosing statements increased,
and the content of comments moved from being solely about the lyrics to being about the thoughts,
feelings, and experiences of the individual (Olsen-McBride, & Page, 2012). The discussion of lyrics
provides therapists with an arsenal of topics to discuss. Some common topics found within rap music are
those of empowerment, racial identity and pride, drugs, and feminism.
Empowerment themes encompass both individual empowerment and community empowerment.
Individual empowerment focuses on developing esteem, resilience, and growth, while community
empowerment focuses on community and change (Lightstone, 2011, b). Four steps in empowering ethnic
minorities are: reducing self-blame (esteem), increasing self-efficacy (change and growth), developing
group consciousness (community), and assuming personal responsibility (resilience) (Gutierrez in Kobin,
& Tyson, 2006, p. 347). Kobin and Tyson proceed to provide examples of lyrics that demonstrate
Gutierrez’s themes, but later they state some limitations to the inclusion of rap in a music therapy session,
one of them being that the lyrics only have power if the therapist and client both agree on the meaning of
a particular set of lyrics.
Since rappers are often considered celebrities, they tend to become iconic figures within their
communities that help promote social change and racial awareness. Racial awareness is developed in two
models, Cross’ Nigrescence model and Sue’s Racial Cultural Identity Model (RCID). Cross’ model
follows the steps of pre-encounter, encounter, immersion-emersion, internalization, and internalization-
commitment. RCID follows a similar five step model of conformity, dissonance and appreciating,
resistance and immersion, introspection, and integrative awareness. Each of these steps can be loosely
aligned with different genres of rap to help explore the emotions and ideas contained in each step. Step 3
(Resistance and immersion) from both models presents self-appreciation themes and themes of
deprecation towards a dominant group. This is commonly displayed in gangsta rap. Nonconformity and
rage directed at an oppressive society to which one used to conform is common. Deviancy from this
culture typically takes the form of “thug life” which raises self-efficacy by showing others that your
actions have a direct impact on your environment, regardless of if it legal or not. It is a means to an end to
get by. As stated in Selling D.O.P.E by Dead Prez, “I ain’t plan to get rich from selling that shit it was
survival. “Stage 4 is characterized by introspection, questioning one’s place in society and previous anger
towards the dominant race. This stage works towards the development of a self-identity and works to
move from group values and group hate. Animosity in this stage shifts from being a group hatred to focus
on those who impose oppression, one such example being hatred toward police. Gangsta rap can still be
connected to this stage, but the themes tend to be more common with those in reality rap. Stage 5 is
integrative awareness. This is coming to accept one’s past culture with their newly identified self. There is
acceptance and freedom from traditionally held views of a culture, and knowledge that it is okay to
disagree with your culture. Feeling empowered and having esteem lead to a feeling of being an active
ingredient in shaping their future, and their community. Individuals are better suited to working for social
change by helping to de-construct preconceived notions about race and equality (Kobin, & Tyson, 2006,
p. 348-351).
Another common theme within rap music is that of drug use and dealing. Drug use, violence,
crime, and sexist themes are risky behaviors, and rather than labeling them as good, bad, positive, or
negative, they are given the term “risky” as they are subjective. Risky is defined as increasing the
likelihood of harm to oneself or others. (Travis, 2013, p. 150). When asked about engagement with rap
music and the increased desire to participate in empowering and risky behavior, 36.7% -61.7% of
participants said that listening to rap increased their desire to engage in empowering behaviors, while
9.4% - 20.4% reported feeling more comfortable with engaging in risky behavior after listening to rap
music (the variation in percentages is associated with different action and ideas). Alcohol consumption
and marijuana usage held the highest percentage of risky behaviors that participants felt more comfortable
with doing (Travis, 2013, p. 152, table 2). In Lightstone’s initial study, participants wrote their own rap
lyrics to express their thoughts, ideas, and the reality of their lives. Within their music, there was 28
musical excerpts that refer to drugs. The fact that there are so many references to drugs in the data is
reflective of the role that drug use (especially marijuana) plays in the lives of many of these participants
(2011, p.232). However, given the abundance of references in both commercially and therapy created rap,
analysis of the lyrics can be used effectively in help both adult and youth clients with substance abuse
issues. Analysis of lyrics of Talib Kweli’s Broken Glass could be used in a form of Motivational
Interviewing where clients compare the lyrics to their current life, and then compare their currently life to
one that is drug free, and by helping clients recognize triggers and explore positive coping strategies, such
helping a “friend,” or “artist” with their drug problem (Kobin, & Tyson, 2006, p. 351-352).
Rap is often criticized for its sexist and misogynistic language and depictions of women (Hadley,
& Veltre, 2011, p. 86). Analyzing the lyrics of prominent women in Hip Hop and creating a space place
of discussion for both the praise and critique of the culture is imperative (Hadley, & Veltre, 2011).
Historically, Hip-Hop has provided a space for disenfranchised youth, including young women, to resist
oppression (Rose, 1994, as cited in Hadley, & Veltre, 2011, p. 86). In helping young black women, Hip
Hop feminism looks to address four main goals in lyrical analysis of major female rap icons such as:
Sistah Soujah, Salt-n-Pepa, Queen Latifah, Eve, and Missy Elliot. The main goals are that of community,
identity formation/gender-role socialization, empowerment and equality, and social transformation. The
intent is to help create strong women who work together to fight for equality and social justice through
the discourse and creation of rap music (Hadley, & Veltre, 2011).
Rap and music therapy do not have to be limited to any group of individuals. Male, female;
young, old; Caucasian, minority, Hip Hop/rap therapy should be considered and used with anyone who
identifies and connects the music and the culture (Kobin, & Tyson, 2006, p. 347).
Another method of using Hip-Hop in music therapy is participating in creating and making music
to express and self-disclose. The use of musicing in group Hip Hop therapy was spearheaded by Aaron
Lightstone in his research with homeless youth in a residential youth. “Forty-seven percent of street youth
report a background of physical or sexual abuse (Delivering Health Care to the Homeless, 2003).
Engagement in group music experiences can be one means of learning to trust others and coming to feel a
sense of mastery, particularly when this occurs within a genre to which the participant feels a connection.
Furthermore, rap music can act as an empowering transformative agent by offering challenges to the
politics and ideology of the dominant culture” (Lightstone, 2011, a p.46).
Rap music is very highly groove focused. The flow plays an important part in not only the
musical structure, but also in creating a sense of comfort that invites movement, dancing, and other forms
of participation (Aigen, 2002, as cited in Lightstone, 2011, a p.47). The main challenge with this form of
Hip-Hop therapy is the demand on the therapist to create beats and bass lines using technology such as
drum machines and samplers. The therapist must be proficient enough to create simple grooves. The
presence of a drum machine does present some limitations regarding its ability to change the musical
structure on a moment’s notice. Therapists working in a music-centered theoretical framework frequently
engage clients in instrumental improvisations, acknowledging that these experiences can be therapeutic
when there is representational meaning behind the music and when there is not (Lightstone, 2011, b p.
247). The concept of musicing can also apply to words, where participants can make music with words
and vocal sounds in a nonrepresentational and potentially therapeutic way. When music therapy clients
engage in rap music improvisations, their voices and the microphones are the instruments. Alternatively,
some participants were very willing and able to pre-compose rap but were less able in the improvisation
of rap music. Numerous clients kept journals and wrote down their original rap songs. These clients
tended to be more musically able when working with precomposed material (Lightstone, 2011, a pg. 49).
The contents of these improvisations and the written journal focused on nine different themes that
are present throughout Hip-Hop culture. The intent of Lightstone’s research was to test the validity and
effectiveness of using rap music in music-center therapy session with improvisation. Each of the
discussed themes is subjected to scrutiny of if it contains therapeutic value. The first theme was that of
authenticity and emotional expression. Authenticity or “keepin’ it real” as a cultural value in Hip-Hop
culture. It is of great importance for expression in rap songs to be “real” and to reflect the lived
experiences or direct observations and thoughts of the rappers. This makes rap music a compelling
therapeutic tool (Lightstone, 2011, b p. 216). Music therapists generally hope to engage participants in
authentic, self-reflective self-expression to express and connect with their emotional states and triggers,
they will develop greater insight into their own human condition and become better able to develop
creative ways of improving their circumstances (Yalom, 1995, as cited in Lightstone, 2011, b p.216).
The idea of a rapper as a critical theorist is a rapper who performs lyrics that critique social
institutions and structures. A primary tool for this theme is the use of language to attack oppressive social
structures based off the African American oral tradition of Signifying. When rappers identify, name, and
critique the instruments of their oppression and marginalization, they are engaging in an empowering
experience. “As individuals who identify with Hip-Hop culture, the participants know that signifyin’ is a
frequent theme in commercially produced and available rap music. I suggest that they often come ready to
engage in this type of critical dialogue because it is a cultural norm” (Lightstone, 2011, b p. 221). One of
the often-criticized themes and subjects of concern for therapists is that of battles. Rap battles are a well-
known event within Hip Hop culture where two participants compete in a battle of the mind and tongue
where they tear each other down with threats and insults. These usually contain violent imagery, verbal
treats, or attacks on various aspects of one’s character, musical ability, or verbal expression (Lightstone,
2011, b p. 226). Lightstone’s participants often challenged each other to battle at the end of the session,
but not all of them were accepted due to a lack of confidence by one individual, or they simply did not
want to, critiquing this tradition to be contrary to Hip Hop’s goal of community building and
empowerment. Lightstone justifies the therapeutic value of battles as such,
“Battles were difficult to come to terms with as a therapist. I wanted to be sensitive to the musico-
cultural norms and practices of my participants’ cultural group. Yet I initially felt that as a
therapist there could be clinical and ethical issues around encouraging expression that is
potentially hurtful. Even when the battles were consensual and clearly in jest… Groups or
individuals living in socially difficult and oppressive conditions have many real and symbolic
battles to fight daily. Surviving these battles requires a certain degree of psychological armor.
Though it may seem controversial and counter-therapeutic to expose participants to ritualized
insults, this may in fact be quite therapeutic as it allows participants to sublimate aggression into
a creative ritual and build their emotional and psychological armor.” (2011, p. 228).

Boasting is interrelated with two other themes, those of drug use/deal and violence through the
character of the badman. Boasting is just that, boasting about one’s abilities in rapping or athletics, sexual
exploits, or the themes drugs and violence.
“Twenty-eight musical excerpts in the transcripts make references to drugs—17 references were
to cannabis, five to crack cocaine, two to alcohol, while mushrooms, crystal methamphetamine,
and heroin each receive one reference. There is one nonspecific reference to drugs. (See
Table 12.4.) The fact that there are so many references to drugs in the data is reflective of the role
that drug use (especially marijuana) plays in the lives of many of these participants” (Lightstone,
2011, b p. 232).
The character of the badman is present in many African American folktales. He is the trickster hero who
directly defies power structures through direct opposition while at the same harms his own (Pinn, 1999, as
cited in Lightstone, 2011, b p. 230). According to some theorists (Rose, Perkins, Stephen & Wright), the
violence in rap music is not always gratuitous. It is reflective of the harsh realities that many rappers have
experienced during their upbringing in the urban ghettos of America; 2Pac Shakur being one such rapper
whose violent lyrics were meant as an example of this (Lightstone, 2011, b p. 243). While 2Pac may be
functioning as critical theorist whose goal is to upset the status quo with the reality of street life, the lyrics
of Lightstone’s participants did not serve that function when they rapped about violent themes. This seem
to be what they know, the “authenticity” of shelter life, that of playing the badman, putting up a facade to
survive and not show weakness. Themes of violence seem to be connected to feelings of vulnerability; the
witnessing, imagining, or experience of trauma; the expression of anger; expression of existential angst
and feelings related to guilt, remorse, and meaninglessness; and some aspects of African American oral
culture such as boasts, the badman, and verbal sparring (Lightstone, 2011, b p. 243, 245).
All sessions were held in a group therapy setting and evidence of the group process is seen
through verbal encouragement (typically off mic), lyrical interplay from listening and responding to the
rapper before or quoting their lines, and lyrical encouragement where one rapper would provide brief
interjection to help keep the verse of another rapper going. Lightstone recalls a fascinating interaction
between two members that demonstrates lyrical interplay. Two participants were rapping, who he calls
Sam and Tami. Sam kept trying to egg Tami into battle through dissing on her voice and lyric choices.
Tami responds with a rejection to his proposal by reminding him that he must be in deep emotional pain if
he felt the need to attack another and she understood him. She went on to continue singing about her own
pains with return to the line “we’re all hurting deep inside,” which was her response to Sam. Sam tried to
leave the session after this, but Tami convinced him to stay which allowed for the both of the to engage in
a lesson about how one’s words and actions can affect another (Lightstone, 2011, b p. 235-37).
Spirituality emerged from the data frequently as an important theme. Arguably, people need
religion or spiritual experiences even more when their lives seem meaningless or when they are in
difficult life situations. Detachment from family, education, and work can create a sense of
meaninglessness in life (Lightstone, 2011, b p. 238). Conditions that are typically described as giving
meaning to life tend to be absent or diminished in the lives of individuals living in a shelter. A wide
variety of themes emerged during the analysis of the Spirituality category, which suggested that the
involvement in Hip-Hop culture and the enactment of its artistic expression may provide important
opportunities for shelter residents to experience and express their spirituality. Spirituality emerged as a
theme that not only was rich in data but also revealed complex and interesting connections to other theme
areas such as drugs, violence, boasting, and expression of emotions (Lightstone, 2011, b p. 238,243). The
last theme apparent was that of word play. This consisted of musical word play, that of rhyming to rhyme,
shout outs to groups of people, and play by plays which depicted the happenings around the rapper when
they were just trying to fill space and come up with a line.
Travis (2013) does a great job of summarizing the findings within the main two methods of Hip
Hop in music therapy discussed in this article championed by Tyson for lyrical analysis and Lightstone
for musicing in therapy sessions. Travis in his earlier work created a framework for determining if
musical engagement was empowering to urban youth in the contexts of music therapy. The framework
looked at both Individual empowerment through developing esteem, resilience, and growth; and
Community empowerment through developing a sense of community and change for better conditions.
Travis took both Tyson’s and Lightstone’s data to answer three prior research questions and three
main questions. Prior research A asked if Individual and Community empowerment dimensions were
valid and reliable constructs for music engagement. Indicators of individual and community
empowerment suggested that participants’ engagement of rap music was associated with emotional
regulation and additional functional relationships (Travis and Bowman, 2012, as cited in Travis, 2013, p.
151). Prior Research Question B asks: “does empowering music engagement benefit ethnic identity and
self-esteem in contributing to variability in depressive symptoms?” Research suggested that individual
and community empowerment constructs were also significantly associated with developmentally
relevant concepts such as ethnic identity (Travis and Bowman, 2012, as cited in Travis, 2013, p. 153).
These results supported prior research demonstrating the contributions of positive ethnic identity and
positive self-esteem on reduced depressive symptoms (Mandara et al., 2009, as cited in Travis, 2013, p.
153). Prior Research Question C: “What role does risky music engagement play amongst empowerment,
and other well-being indicators?” Prior research examining perceptions of music engagement found
listeners taking away both empowering and risky messages. The theoretical distinction between the
constructs suggests that they can both be present for listeners/engagers at the same time and that they
should not be consistently statistically associated, either negatively or positively (Travis and Bowman,
2012, as cited in Travis, 2013, p. 154).
Research questions 1 and 2 focus on the same principle, each from a different outlet. Research
question 1 looks at youth self-expression in music created in therapy sessions and whether or it reflects
the framework dimensions, while research question 2 focuses on content in commercially recognizable
rap music and its ability to reflect framework dimensions.
“Only the results of Lightstone (2012b) reflected themes obvious to the esteem dimension… Both
studies found resilience themes prominent. Further, the nuances of the dimension were outlined.
First, was cathartic expression of one’s ‘‘story’’ and challenges (e.g., loneliness and pain). Next,
were methods of overcoming these adversities, followed by perspective on and commentaries
linked to overcoming adversities (e.g., survival of the fittest; I ain’t never gonna retire). The
growth dimension featured prominently in the themes found within both research studies. Similar
to resilience, all sub themes existed, including maturity in competence, greater relationships,
decision-making and care… The two studies found relevant themes that linked to the community
dimension, especially the collective lived experience of communities and pride in aspects of the
community.” (Travis, 2013, p. 155).
The final research question asks how well the framework aligns with a model of empowerment-based
positive youth development. The framework consisting of Esteem, Resilience, Growth, Community, and
Change; Connects perfectly with aspects of the Empowerment-based positive youth development as seen
in table 4 (Travis, 2013, p. 159).
In therapy with urban youth, the goal and challenge are to help the individual create a sense of
empowerment to help reduce self-blame, increase self-efficacy, develop a group consciousness, and
assume personal responsibility (Gutierrez, 1990, in Kobin, & Tyson, 2006, p. 347). All of these develop
the voice and influence of a very often oppressed group.
Consideration for future research would be to critically analyze the use of Hip Hop and rap music
in other methods of music therapy. Since music, like all art, is constantly changing and as genres are
always evolving, how has recent changes to rap music and Hip-Hop culture affected the process and
content of lyric analysis, and how have new genres and styles affected technology required for group
musical expression through musicing?
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