Music Therapy

1992,Vol. 11,No. 1, 120-141

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A Phenomenological Analysis
of Nordoff-Robbins Approach
to Music Therapy: The Lived Experience
of Clinical Improvisation
MICHELE FORINASH
RESEARCH CONSULTANT,
NORDOFF-ROBBINS MUSIC THERAPY CLINIC,
NEW YORK UNIVERSITY; MUSIC THERAPIST,
HEBREW REHABILITATION CENTER, BOSTON

This study attempts to shed light on the therapist’s experi­

ence of Nordoff-Robbins Clinical Improvisation. Eight cli­
nicians and two directors at the Nordoff-Robbins Music
Therapy Clinic at New York University in 1991 were inter­
viewed about their lived experience of Clinical Improvisa­
tion. The data generated by the interviews were subjected
to phenomenological analysis. Results of the research are
presented and discussed. Interviewees were presented
with the results and discussion, and their responses are
incorporated in the Conclusion.

Introduction
Clinical Improvisation is the basis of the Nordoff-Robbins ap­
proach to music therapy and rests on the assumption that in every
child, regardless of ability or disability, lives an inborn musicality
and musical sensitivity. This inherent musicality is referred to by
Nordoff and Robbins (1977) as the “Music Child”:
. . . the term has reference to the universality of musical
sensitivity--the heritage of complex sensitivity to the
ordering and relationship of tonal and rhythmic move­

120
 A Phenomenological Analysis of Nordoff-Robbins Approach 121

ment; it also points to the distinctly personal signifi­

cance of each child’s musical responsiveness. (p. 1)

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Clinical Improvisation is the technique of engaging a child
through the therapist’s creation of a musical-emotional environ­
ment, thus accessing the “Music Child.” In this environment the
child’s responses and expressions, however restricted, are ac­
cepted as meaningful and used to facilitate further contact and
communication. The therapist’s role in this process is to improvise
clinically significant music, music that will reach the child and
provide the possibility for a relationship in which the child can
grow and develop. The improvisations are usually conducted at
the piano, and the ability of the therapist to clinically improvise
resides at the core of this approach.
While the therapist’s technical ability to improvise has been
discussed, and techniques developed for expanding it have been
explored (Nordoff & Robbins, 1977), the therapist’s complete
experience of Clinical Improvisation has not been addressed in
music therapy theory or research.
Technical ability as a music therapist is an essential skill, yet the
assumption of this research study is that the process of Clinical
Improvisation is more than merely utilizing one’s musical exper­
tise. The complex nature of Clinical Improvisation was observed
by Aigen (1991), who cites both the need for exploration of this
phenomenon and the difficulty in doing so:
Any model which purports to represent clinical im­
provisation must account for the contribution of in­
volvement in the creative process, a notoriously difficult
area to define and research. But these difficulties are no
reason to avoid exploration here as clinicians function in
this realm on a daily basis. (Aigen, 1991, p. 239)

Continuing, Aigen (1991) points the direction for research:

If one accepts that research in Music Therapy should be
oriented towards explaining meanings and phenome­
nal experience. . then it is this experience which must
be the source of the explanatory mechanisms, and to
which such explanations must be adequate. (p. 260)
122 Forinash

Following Aigen’s reasoning, in order to investigate the com­

plex phenomenon of Clinical Improvisation, the researcher
turned to the experience of improvisation among clinical practi­

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tioners as the source of data for this project. This study was
conducted by actively seeking descriptions of the experience of
Clinical Improvisation from music therapists who practice this
technique at the Nordoff-Robbins Clinic at New York University.
It is hoped that the results of this investigation will increase our
understanding of the therapist’s experience of Clinical Improvisa­
tion in the therapy context, and that further understanding of this
experience will impact on our ability to teach the concept of
Clinical Improvisation to therapists in training.

Method
The research was conducted by asking music therapists for a
retrospective account of their experience of Clinical Improvisa­
tion in a music therapy session. The researcher conducted one
interview on the subject of Clinical Improvisation with each of
eight therapists participating in a one-year training program at
the Nordoff-Robbins Music Therapy Clinic at New York Univer­
sity, and with the Co-Directors of the Clinic, Dr. Clive and Carol
Robbins. Dr. Clive Robbins, who along with the late Dr. Paul
Nordoff originated the technique of Clinical Improvisation, has
been practicing Clinical Improvisation since 1959. Carol Robbins
studied with Drs. Nordoff and Robbins and has been working
with Dr. Robbins since 1968.
The therapists at the clinic represent a range of experience and
backgrounds. At the time of the interview, one therapist held a
bachelor’s degree in music therapy, six held masters’ degrees in
music therapy; one held a doctorate in educational psychology in
addition to a master’s in music therapy. All were Certified or
Registered Music Therapists. Their clinical experience ranged
from 2 to 17 years and covered a variety of populations: learning­
disabled children, multiply-handicapped children, emotionally­
disturbed adolescents, adult psychiatric patients, cerebral-palsied
adults, and geriatric clients.
 A Phenomenological Analysis of Nordoff-Robbins Approach 123

Since each therapy session conducted at the Nordoff-Robbins

Music Therapy Clinic is videotaped, the eight therapists were
each asked to choose a videotape of a music therapy session in

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which they had clinically improvised. The videotape was then
viewed by the therapist and the researcher simultaneously; ques­
tions regarding the experience of Clinical Improvisation were
asked by the researcher. Each interview was transcribed, and this
transcription served as the data base. The data collected was
treated by phenomenological analysis, asapplied by Giorgi (1984)
and Forinash (1990), in the the following sequence:
1) The researcher reviewed each interview transcript to
get an overall senseof the lived experience of Clinical
Improvisation.
2) Each interview was then reviewed more slowly, with
the researcher assuming a “bracketing critical con­
sciousness,” that is, suspending previous beliefs or
opinions about the phenomenon in question and
directing consciousness to the phenomenon as it ap­
pears. In this step the researcher transformed the
descriptive data from the interview into “meaning
units” (Giorgi, 1984, p. 19) that indicate where a
transition in meaning occurred in the data.
3) The meaning units formed the basis for the transla­
tion of descriptive material into psychological lan­
guage in which the researcher searched for the
“invariants of the phenomenon,” those events that
are necessary for the constitution of the meaning of
the phenomenon as experienced.
4) The researcher again assumed the bracketing critical
consciousness, while reflecting on the meaning units,
in order to provide a description of the structure of
the lived experience of Clinical Improvisation
(Giorgi, 1984):
5) The researcher submitted the written results of the
study to the eight therapists for their validation that
their experience of Clinical Improvisation was in­
deed described in these written results. Their re­
sponses were incorporated in the Conclusion section.
124 Forinash

Results
After each interview transcript was synthesized, the following
meaning units emerged: Natural Ability; Musical Biography; The

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Unknown; Vulnerability; Pressure; Hard to Define; Spontaneity,
Creativity, and Intuition; Interplay of Intuition and Rationality;
Rational, Conscious Choice; Self; Music; and The Child. In the
following examination of the results, each meaning unit is identi­
fied; therapists’ statements are included to clarify how these
concepts were experienced by the therapists.
The results are presented chronologically: experiences from the
therapists’ pasts that had direct bearing on their experiences in
the moment of Clinical Improvisation; their experiences in the
actual improvisation; and their experiences in the post-session
analysis.
Supporting quotations taken directly from the audio-taped
interviews with the therapists are presented for each of the mean­
ing units discussed. In keeping with the phenomenological ideal
to study experience in its lived form, the interview material is
included as it transpired. The therapists and researcher were
responding spontaneously as the research situation unfolded.
Therefore, some of the quotations may have a rough, process­
oriented quality to them rather than the more finished phrasing
usually given to one’s thoughts when they are allowed to develop
over an extended period of time. Consequently, the reader is
encouraged to read through quotations several times to allow for
a full comprehension of the meaning.

Natural Ability
Three of the eight therapists and both of the Co-Directors
interviewed stated their awareness of bringing a natural, inborn
ability to their Clinical Improvisations. They described this natu­
ral ability as being twofold in nature, referring both to their own
innate relationship to music, and to their natural affinity for
relating to and working with people.
Natural musical ability was viewed as an inner quality that
enabled the therapist to spontaneously and fully feel and exist in
the music-making process. Those interviewed stated that a thera-
 A Phenomenological Analysis of Nordoff-Robbins Approach 125

pist’s musical affinity could be heard in improvisation as a “natu­

ral feel” for music:

Co-Director 2: Improvisation comes from someone who

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lives music and from someone for whom music is a life
force, someone who sees a situation and can put it into
music.
Therapist 6: You hear their natural feel for phrasing. It is
an inborn musicality. You hear what risks they are
willing to take, and in what area: melody, harmony,
dynamics, rhythm, or tempo.

While acknowledging that natural ability in music is necessary,

the interviewees recognized an equal demand for a natural clini­
cal awareness or an empathic perception of the needs of others.
This was summarized by one of the Co-Directors:

Co-Director 2: Sometimes people will realize that, al­

though they may be really good musicians, they may
not make good therapists because they cannot put
themselves into another being. They are in themselves.
Performers are trained to be this way. You have to be if
you are going to make it in a performance world. You
may also have people who have very, very, very warm
hearts, but have very little musical training. While they
have the feeling, they don’t have the musical skill to
bring out their feelings musically. You can work a tre­
mendous amount just through improving your skills if
you have the innate feeling for it. What we really try for
is a balance of the two.

While natural musical ability was seen to be necessary to the

process of improvisation, one therapist mentioned the problem of
sometimes “getting carried away” in the music making because
it was so natural and instinctive:

Therapist 2: I have to be careful about what I play be­

cause I can very easily get carried away in the music. I
can loose my focus when I get so immersed in the music.
126 Forinash

These results suggest that the natural ability needed for Clinical
Improvisation includes an innate feeling for the music and the
needs of people, as well as the ability to bring that feeling into the

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clinical session. A clinical improviser must be able to be fully
expressive in the music-making process, while maintaining a
sound clinical awareness of the clients, and have the ability to
relate to clients in a meaningful manner.

Musical Biography
Five of the therapists and both of the Co-Directors interviewed
spoke of the significance of their own unique musical background
in Clinical Improvisation, their “musical biography”: their history
as a musician, which encompasses their musical preferences,
training, and personality. One of the Co-Directors summarized
the contribution of musical biography as an awareness of one’s
musical background and an ability to use one’s natural resources
to build from these assets.

Co-Director 1: Musical biography is not only your gifts

but what you have been exposed to, what you have
acquired, your tastes and prejudices.

The therapists interviewed represented a diversity of musical

biographies. Some of them learned to play music by ear and grew
up playing primarily popular music. One therapist related an
early musical memory of hearing and imitating music. He spoke
of the subsequent connections that he made between emotions
and music and how this affected his present improvisations:

Therapist 2: I remember watching TV as a child and

connecting certain scenes to emotions, certain kinds of
music with certain emotions. Like on “Star Trek” when
Kirk saw his love. [Therapist plays music from that
scene.] Those things stick with me. It becomes part of
my history. What happened in my musical history has
shaped why I play what I play.
 A Phenomenological Analysis of Nordoff-Robbins Approach 127

Other therapists grew up with classical training and technique.

In describing an improvisation from a particular session, one
therapist spoke of the influence of her classical training:

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Therapist I: I didn’t grown up with that [improvisation].
I tend to play in a more classical style. Even this theme
[referring to the videotape] is more “Bachian” because
I have been listening to that music all my life. The styles
of Schumann and Copland, these are the names that I
have lived with.

Although the interviewees saw musical history as essential,

they assumed that no one particular musical biography was cor­
rect for pursuing Clinical Improvisation. They saw the therapist’s
personal musical biography as an important part of preparation
for improvisation and as a strength in improvisation. They did not
view it as a limitation to be overcome, but as a building block from
which to grow.

Co-Director 2: Therapists have to be willing to realize

that there is a big world of music out there to be ex­
plored.

The Unknown
When asked to describe the experience of improvising, six of
the eight therapists interviewed and both Co-Directors spoke of
improvisation as facing the unknown, which they recognized as
a very powerful force:

Therapist 1: It is like a mystery story where the end is

unknown. It has yet to happen. The only way to find out
is to do it.
Therapist 5: There is a lot of living in the moment to see
what will happen and not even knowing what I will be
playing.
Therapist 8: I think for me in doing this I suspend some­
thing. I don’t know what exactly that is. It puts me in
the moment with this child, and I have no idea what is
going to come out.
128 Forinash

Therapist 2: I have a sense of preparation and direction,

but I do not know what will happen. I must be open to
that.

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Both Co-Directors stressed the reality of facing the unknown in
this clinical work:

Co-Director 1: It is a stepping into the unknown. It is a

mysterious thing about the creative process.
Co-Director 2: You don’t ever reach the point where you
feel that you know what to do all of the time. It just
doesn’t happen. There isn’t any formula.

These statements indicate that Clinical Improvisation involves

a necessary willingness on the part of the therapist to step into the
unknown, to enter into a relationship in the moment that pre­
cludes a known outcome.

Vulnerability
Three therapists and both Co-Directors spoke of the feeling of
vulnerability that accompanies stepping into the unknown:

Therapist 5: It is a vulnerable situation because defenses

are stripped away. It is really letting yourself go and it
is a vulnerable place to be in.
Therapist 8: You are vulnerable in that you don’t have a
plan. Even if you do have a plan, it might be totally not
what is needed at the moment. You have to be vulner­
able. If you were controlling and rigid, I don’t think you
could do this kind of work.

Perhaps this therapist sums it up most clearly:

Therapist 2: You can’t hide. It comes out in the music.

While the therapists interviewed felt this sense of vulnerability

was uncomfortable to some degree, they saw their discomfort as
unavoidable and something to be accepted as part of the improvi-
 A Phenomenological Analysis of Nordoff-Robbins Approach 129

sation experience. The experience of these therapists suggests that

permitting and accepting the feelings of vulnerability are critical
to the therapist’s ability to participate in Clinical Improvisation.

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Pressure
A possible unique aspect relevant to the clinical work at the
Nordoff-Robbins Clinic is that every session is videotaped and
reviewed at a later time by the therapist. The therapist’s aware­
ness of being videotaped and having to analyze the tapes often
adds to the stress. This sense of pressure was mentioned by five
therapists and one Co-Director:

Therapist 4: It is the moments before the improvisation,

it is a pre-performance anxiety. People will say “Who is
on next?” meaning who is on stage next.
Therapist 8: The anxiety is much more when the camera
is on and there are people watching.
Therapist 2: I am aware of wanting to play a pretty chord
because everyone is watching.

It will be important in future research to examine this experi­

ence of pressure and to determine whether the experience is
different in improvised sessions that are not videotaped. It will
also be important to explore other factors that create pressure,
such as supervisory review and peer review.

Hard to Define
As each interview progressed, and the therapists set about
describing the actual moments at the keyboard, clinically impro­
vising with a client, the difficulty of putting this experience of
improvisation into words became apparent. The complexity of the
phenomenon was evident in all of the interviews conducted. It
was specifically mentioned by four of the therapists and one of
the Co-Directors:

Therapist 6: The experience is very hard to capture, there

are so many different levels to it. It is hard to
verbalize this.
130 Forinash

Therapist 8: It is really hard to talk about because it is

essentially something that happens on a nonverbal
level.

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Therapist 3: This feels very vague. It is really hard to
talk about.

Comments made by Therapist 8 accurately summed up a basic

difficulty that is significant for those practicing Clinical Improvi­
sation: Improvisation is a process that happens on a nonverbal
level, and this is what gives it a unique strength. This research
recognizes that improvisation can accessexperience on a nonver­
bal level and can afford a means of communication to those either
emotionally or physically unable to utilize spoken or written
language.
At the same time, the nonverbal quality of improvisationmakes
it difficult to put the experience into words.

Spontaneity, Creativity, and Intuition

In Clinical Improvisation, therapists experience moments of
spontaneity, creativity, and intuition; spontaneous, indicating the
therapists’ ability to freely respond to the therapy situation; crea­
tive, suggesting therapists’ ability to develop and expand both
their own and their clients’ responses; and intuitive, implying
therapists’ sense of knowing in what direction to proceed without
any apparent external reason. The combination of these three
words suggest one aspect of the total experience.
All of the eight therapists and both of the Co-Directors de­
scribed moments when both musical and verbal ideas spontane­
ously emerged, when they were able to create a musical
environment out of a child’s responses. All struggled with the
explanation of the origin of their intuitions.

Co-Director 1: I don’t know where it comes from. I have

a hunch, gut feeling, intuition, perception that says to
do it, or has me doing it and then realizing it.
Co-Director 2: A great deal of the time I can’t explain my
interventions; I can’t say why. It was the intuition at the
moment.
 Analysisof Nordoff-RobbinsApproach 131
A Phenomenological

One of the therapists spoke of intuition as a type of musical

instinct:

Therapist 6: When I am improvising, it feels like the

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music or the instinct for music comes from a place in me
that is so deep.

Another spoke of intuition as feeling like magic:

Therapist 8: To me it feels like magic. I don’t know how

this happens. I don’t understand it. It is magic. It is
not a logical, verbal process. It is a very different kind
of process. It is another state of consciousness.

The fifth therapist also spoke of the creative aspect as existing

in another dimension:

Therapist 5: In the creation I am unaware on some level.

It is not really conscious at that point. After the improvi­
sation is over it is a sense that you have been someplace
else. It is a feeling of being transported to some other
dimension. It is a sense of timelessness. I get lost in time.

These observations indicate that, during the process of Clinical

Improvisation, there is movement from the more spontaneous,
intuitive aspects to the more rational and planned. Improvising is
not simply creating; it is also analytically examining what one has
created musically as therapist and making intentional therapeutic
decisions.

Interplay of Intuition and Rationality

At times in the Clinical Improvisation experience, both intui­
tion and rationality are working together in a balance. Five of the
therapists and both Co-Directors articulated this interrelation­
ship, the constant interactionbetween their spontaneous, intuitive
choices and their conscious attitudes and choices. They suggested
that a therapist might instinctively begin the music in a session
but once started the music can become more conscious and clini­
cally directed.
132 Forinash

Co-Director 1: You see the child, get to know him, a

musical idea comes up and even as you think it, you
play it and as you play it you think it.
Therapist 4: The music comes out, you are hearing it, and

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then you catch up to your fingers. It is a split. After you
start improvising, then your mind is listening and de­
velops it. You have to become conscious of what you
are playing. It may come from an unknown place, but
you have to know it and be aware of it to bring it back
to the child even as it is happening.
Therapist 3: [Referring to the videotape] This improvisa­
tion became very conscious. In order to stay in that
musical structure, I had to know what I was doing.

The transformation, then, is from the spontaneous, creative

impulse to deliberate, clinically significant intentionality.
The reverse may also happen. A therapist may decide to play
a certain musical style but, once begun, the development may
occur spontaneously.

Therapist 5: For this improvisation I had picked a mode

based on one instrument the child was playing, though
when I played it he was actually on a different instru­
ment. But I decided to stay with the music because, I
don’t know, it just felt right to stay with it. I don’t know
what gave me the idea.
Therapist 4: When I improvise, I am thinking of setting
an initial mood in the room, and then the fingers take
over.

It is apparent that there is a flow that occurs during the sessions

from pure intuition to rational choices and from rational choices
to intuitive choices.

Rational, Conscious Choice

In the experience of Clinical Improvisation, there are moments
when rational, conscious choices are made and enacted in the
session. These can be decisions based on goals and objectives set
for the child during long-range planning, or they can be decisions
 A Phenomenological Analysis of Nordoff-Robbins Approach 133

made in the moment based on the child’s reaction and response

in the session. All of the therapists and both Co-Directors men­
tioned this level of conscious choice:

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Therapist 7: There is something intellectual that goes on
[in improvisation] that says, “Oh, you should do some­
thing with this” [the child’s response].
Therapist 6: We [the clinical staff] had been talking a lot
about it: “Give these children songs.” So I went into this
session thinking, “Get a song.” It was on my mind.
Therapist 4: The mood change [in the music] was con­
scious. I wanted to bring in something lyrical and gen­
tle. I wanted to change the mood at that point.

There is a multidirectional flow in Clinical Improvisation

among the experiences of spontaneity, creativity, and intuition;
the interplay of intuition and rationality; and rational, conscious
choice. One therapist and one Co-Director spontaneously
summed up these relationships during the interviews:

Therapist 2: I think there are probably three levels. One,

where I am really, really connecting to what’s happen­
ing, to the situation. I am not thinking about what I am
doing, and I am totally focused on the child. Then there
is the middle part where I am somewhat consciously
thinking that I want a particular sound or I want some­
thing that will kind of pick upon what the child isdoing.
Then there is the third part when I am thinking, “Okay,
what am I going to do now?”

Co-Director 1: There is a magic to it [improvisation], but

there is also a painstaking carefulness. There is also trial
and error. It is all of these things.

The aspect of conscious, rational choice also applies to the

analysis that occurs after the session. For these therapists, the
experience of Clinical Improvisation does not end the moment the
actual session is over. After each session they go through a process
of indexing the videotape of the session. This involves watching
the videotape, notating significant events that occurred during the
134 Forinash

session, and transcribing important musical improvisations that

occurred during the session. In this way therapists reexperience
the improvisation from a more analytical perspective.

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This reexperience of improvisation, though noted by several of
the therapists to be quite difficult and uncomfortable at times,
affords them with increased opportunities to learn. This learning
comes in the form of a deeper understanding of self, of music, and
of the child in the session. It affects the therapists’ ideas about
music and therapy, and directly influences their future Clinical
Improvisations.

Self
This post-session analysis of Clinical Improvisation also in­
cludes the therapists’ understanding of themselves. This review
experience can provide them with insight into their own personal
feelings and issues, and increased understanding of how these
affect their improvisations.

Therapist 3: I need to first get in touch with where I am

musically and emotionally.
Therapist 2: I have to trust and accept that what I do will
be okay. I have to have a belief in myself.
Therapist 5: A lot of it for me is anxiety. Questions flow
through my mind. The thoughts go so fast, they are not
even clear.
Therapist 7: I was thinking that it [the improvisation]
wasn’t going anywhere. Whether it was or not, that was
what was going on in my head.
Therapist 8: [Referring to the videotape] That improvi­
sation came from my own anxiety that I wasn’t able to
plug into where the child was.

These statements indicate that an awareness of the self plays a

significant role in the improvisation experience, that acknow­
ledging and allowing one’s own feelings and trusting in oneself
is vital for those who practice Clinical Improvisation.
 A Phenomenological Analysis of Nordoff-Robbins Approach 135

Music
Clinically-improvised music is at the center of the clinical
work studied in this project. In addition to discussing their

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individual musical biographies, all of the therapists and both
of the Co-Directors spoke of experiencing insight into their indi­
vidual relationships to music from the post-session analyses. At
times they experienced an increased awareness of their own
specific musical preferences:

Therapist 3: I like to play a lot with very open fifths and

sixths. There is something so supporting in itself-it is
going to feel integrated.
Therapist 7: [Referring to the videotape] That [the music]
just came out. I always play fourths.

They also had experiences of increased awareness of the con­

ceptual ideas about the kind of music that might work in future
sessions and new understandings of what kind of emotional
feeling they would like to put into the music:

Therapist 4: I would like to be able to put the feeling from

a “romantic period” piece of music into the music I
improvise.
Therapist 2: I cannot hear exactly what I want to play.
But I can hear more of the feeling I want to give. [Refer­
ring to the video-tape] It took about four times for me
to get the sound that I heard in my head onto the
keyboard. I knew that I wanted to do it [this theme]
again, and I wanted to develop it.

The therapists also spoke of their awareness of moments of

frustration with their music, with their own musical limitations,
pointing toward their need for continued musical growth and
development:

Therapist 7: I have felt frustrated in that I haven’t been

able to bring into the sessions what I musically planned
to do. In one session in particular, I couldn’t get into any
of the chord inversions I had practiced, I couldn’t re-
136 Forinash

member any of the seventh chords one of the other

therapists had taught me. I just was stuck.
Therapist 5: When Iam trying anew mode, Iworry about

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which notes I can play and which not. A lot of it is just
having the chords, getting to know the scales, so I can
forget about the notes.

The therapists spoke, too, of their beliefs about improvisation

in music therapy and the intentions they brought to the session:

Therapist 2: There are certain things that I may have

done in a session that portray . . . who that person is in
the session with the music that I have created. A certain
harmonic portrait, I would say, and even melodic
phrases that might describe that person.
Therapist 4: The music is a reflection of the attitude of
the therapists, their acceptance, and their expectations.
Therapist 8: To me, music therapy isn’t just about mak­
ing music; it is about making music on the surface level,
but what it is really about is expressing a very deep part
of yourself.

Thus, the aspect of music is quite complex. It includes the

therapists’ own musical history, conceptual ideas, abilities and
limitations, and philosophical beliefs.

The Child
All of the therapists and both Co-Directors mentioned their
experience of multileveled awareness and learning that takes
place in their relationship to the child in the session. This aware­
ness has to do with the therapist’s ideas about how to relate to the
child in the session and their purpose in relating to the child.

Therapist 7: I have to be aware of the child, and trying to

match what I am doing with what will help the child.
That has to do with knowing where he is and where he
is going to go. I have to be aware of what he is doing
musically and nonmusically, how I feel about him, and
what he might do.
 A Phenomenological Analysis of Nordoff-Robbins Approach 137

The skill of observing and listening to the child was stressed by

the therapists and Co-Directors:

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Co-Director 2: In doing this you are closely observing
what the person is doing, trying to read them, not
always getting it right, but being willing to admit that
you don’t have it all the way right.

Another therapist described a way of focusing on a child:

Therapist 2: I focus on the child as much as I can. [Refer­

ring to a particular session] I am thinking about the
tunes that her mother told me she likes and incorporat­
ing her inquisitiveness. I am watching and capturing
her qualities.

The therapist’s focus on the child is multilevel in that it encom­

passes a relationship in the moment while maintaining an open­
ness to future potentialities. In addition, the therapist must
consistently verify their reading of the child through observing
and listening.

Discussion
The results of this research indicate that, for those interviewed,
the experience of Clinical Improvisation encompasses more than
the mere interaction that occurs between the children and the
therapists during the session. While interaction in the session is
important, the experience also extends back in time to the thera­
pists’ individual and complex musical histories, which are
brought to life in the session. In the same way, the experience also
reaches forward in time to encompass the therapists’ learning and
growth, which occurs as they reexperience the improvisation
during the post-session analysis.
When the therapists were interviewed, there was an anticipa­
tion on the part of the researcher (author) that they would focus
exclusively on the moments during the sessions, yet clearly each
person’s experience of the event encompasses much more than
the 20-35 minute session times when they are improvising with
138 Forinash

the child. Since the therapists’ histories and musical biographies

live in the therapy sessions, an awareness and exploration of these
aspects of the experience cannot be overlooked.

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Additionally, from the therapists’ perspectives, the learning
that takes place in the post-session analysis is a vital component
of the experience of Clinical Improvisation. For the therapists
interviewed, the improvisation experience was complex and in­
tricate.
The therapists also conveyed that there is a profound sense of
facing the unknown in Clinical Improvisation. As both researcher
and music therapist, the author has experienced this sense of the
unknown and the accompanying vulnerability, yet rarely for­
mally identified it and discussed it withcolleagues. Hearing these
therapists discuss their willingness and openness in this experi­
ence brought home the realization that this is an experience that
must be addressed more directly and fully in our attempts to teach
and train therapists.
Another insight into the experience of Clinical Improvisation
came in the therapists’ discussions of the aspects of spontaneity,
creativity, and intuition; the interplay of intuitionand rationality;
and rational, conscious choice: There is a place--and a necessity-­
for all three of these aspects of the experience. While it is probably
easier to teach the more rational and intellectual aspects of Clinical
Improvisation, the experience of these therapists suggests that the
creative, intuitive aspects are significant and viable parts of the
experience. Formally acknowledging this complexity of experi­
ence, allowing and in fact encouraging therapists to practice using
their intuition and developing their creativity, would then be vital
to a comprehensive training of therapists.

Conclusion
In summary, the therapists interviewed described the experi­
ence of Clinical Improvisation as bringing personal, unique mu­
sical ability and history to life in the present moment of
improvisation. They experienced it as stepping into the unknown
moment of clinical interaction with a child and meeting that
moment with musical and therapeutic creativity and rationality.
 A Phenomenological Analysis of Nordoff-Robbins Approach 139

They saw the need for awareness and acceptance of the event and
a necessary sense of trust and ability to “let go” into the process.
And they concurred on the importance of an essential willingness

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to be open and vulnerable to the experience, and to the self­
scrutiny that will result in the therapist’s continued growth and
development.
In qualitative research the validity of the results of a project are
often measured by the meaning it has for those who are most
intimately familiar with the experience being studied. For that
reason, the results from this research were submitted to those
interviewed at the Nordoff-Robbins Music Therapy Clinic, and
their responses to the portrait of the experience are offered here.
The most pervasive response was each therapist’s discomfort
at reading their sometimes searching and faltering process asthey
explored the experience in Clinical Improvisation during the
interview process. When given their interviews to review, almost
all wanted to refine their sentences and perfect their thoughts. As
researcher, I made the decision to share the thoughts and explo­
rations of the therapists as they occurred in the interview process.
The hope is that this honest portrayal of Clinical Improvisation­
and the difficulty in sometimes finding the words to describe the
experience-will ring true for readers who practice some form of
improvisation and will encourage them to continue to struggle
with articulating this complex process.
Additional comments from the therapists indicated that they
were pleased and somewhat surprised that their experiences were
paralleled by other therapists. It seems that, while an individual
therapist may not have been able to verbalize an aspect of the
experience clearly, they all gained deeper understanding by read­
ing someone else’s attempt to describe the experience.

Therapist 1: I found the comments from my colleagues

to be insightful and interesting. Especially one [Thera­
pist 2] in particular saying, “You can’t hide. It comes out
in the music.”
Therapist 4: While I couldn’t verbalize it myself, the
words “facing the unknown” with their accompanying
feeling of vulnerability rang true for me. These elements
make the work so challenging and a bit scary at times,
140 Forinash

but I can say now that, with time, it is a little easier to

make the leap! Once we feel more confident about what
can come from the unknown, the vulnerability lessens.

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This research is only a beginning, yet it points the way for
several possible avenues of continued exploration. One such rec­
ommendation is to focus a study on a more in-depth description
in one of the areas that emerged from this research. A further
exploration of the experience of creativity seems especially
needed at this time, as it is one of the least articulated and
understood aspects of clinical work, yet one of the most impor­
tant. Other areas for possible exploration include therapists’ rela­
tionships to the music; their personal processes in dealing with
issues, such as facing the unknown and feelings of vulnerability;
and the learning that occurs in the post-session analysis.
This research was conducted in the Spring of 1991 when all of
the therapists interviewed were completing their first year of
Clinical Improvisation study with the Robbins. In talking infor­
mally to the therapists and Co-Directors in more recent months,
it has become clear that the experience of Clinical Improvisation
changes over time. The results discussed in this article reflect the
experience of therapists in their first year at the Nordoff-Robbins
Clinic. It would be important to do a follow-up study with the
therapists at a later point in their work at the clinic to determine
if and how this experience changes.
It is hoped that these results may help lay the groundwork for
a deeper understanding of the therapist’s experience of Clinical
Improvisation and for clearer ideas of how this skill might be
taught to therapists in training.
 A Phenomenological Analysis of Nordoff-Robbins Approach 141

REFERENCES
Aigen, K. (1991). The roots of music therapy: Towardsan indigenous researchpara­
digm. Doctoral Dissertation, New York University. Ann Arbor, MI: UMI order
91-34717.

Downloaded from https://academic.oup.com/musictherapy/article-abstract/11/1/120/2757087 by guest on 16 April 2020

Forinash, M. (1990). A phenomenolgy of music therapy with the terminally ill.
Doctoral Dissertation, New York University. Am Arbor, MI: UMI order
91-02617.
Giorgi, A. (1984). A phenomenological psychological analysis of the artistic
process. In J.G. Gilbert (Ed.), Qualitative evaluation in the arts: II (pp. 10-37).
New York: New York University SEHNAP.
Nordoff, P., & Robbins, C. (1977).Creativemusic therapy.New York: Samuel Day
Publishing.

Michele Forinash, D.A., ACMT-BC, served as the Research Director

of the Nordoff-Robbins Music Therapy Clinic, New York University,
during the writing of this article. She now resides in Concord, Massa­
chusetts, and is a music therapist at the Hebrew Rehabilitation Center
for the Aged in Boston.

The author would like to thank Clive and Carol Robbins and the Therapists at
the Nordoff-Robbins Music Therapy Clinic at New York University for their
willingness to participate in this study. Their openness and honesty are very
much appreciated. Thanks also to Barbara Hesser and the NYU community for
their support.