4 Counseling Skills to Know As A Music Therapist

Jun 17

As part of the plan of study of the music therapy master’s degree program I attended several years ago, we had the opportunity to take various elective classes outside of the music department, but preferably related to the therapy realm. The class selection process was dictated entirely by personal preference, which meant that we were able to broaden our knowledge about topics we had grown interested in and substantiated other concepts that required deeper understanding prior to embarking our journey as professional music therapists.

Encouraged by the experience and self-awareness gained during my music therapy internship placement at a behavioral health hospital, I knew that the topic of counseling skills was one that needed further exploration and training. At that point in time, I envisioned myself solely in “mental health settings” because of my interest in mental health, later on realizing that counseling and supporting our client’s mental health goes beyond a specific setting. Many of my years as a music therapist have been devoted to end-of-life and grief work, and as you can imagine, a solid basis of interpersonal and communication skills is necessary to provide supportive and exceptional music therapy services to tend to the needs of our clients.

If you are a music therapists interested in learning about basic counseling skills, below you will find 4 counseling skills that I think every music therapist should know & use in their music therapy sessions (regardless of where they work!):

1. Active Listening

Listening “involves trying to hear and understand what clients are saying” by becoming attuned to the messages clients communicate. It includes giving our clients aural attention, but it also includes observing our client’s behavior and identifying incongruities or needs in the client’s body language, words, tone of voice, and facial expressions. Active Listening can be outlined in two ways:
- Attending: Attending has to do with the way we orient ourselves physically and in non-verbal ways toward our clients. It’s the way that we utilize our body language, positioning and gestures to encourage clients to share with us, and to communicate that we are interested in what they feel safe to share with us. Attending involves our presence, the way we show attentive body language and is giving the client undivided attention. It’s mostly communicated through how we communicate our words (i.e. tone) and through non-verbal behaviors. Self-awareness is necessary to make sure we are conveying what we are trying to communicate. Behaviors such as sighting, yawning, foot tapping, etc. may communicate to our client that we are not interested or present with them in the session.
- Observing: Observing involves noticing what client communicate (knowingly or not) with their body language, gestures and other non-verbal behaviors. Observing is important because often the majority of what it is communicated by the client is via their body language. If we are aware of our client’s behavioral cues, we can point out discrepancies or nuances in what they say or do not say with words, supporting the client in gaining insight.

This video provides great guidance about active listening and attending behaviors in 60 seconds or less.

2. Reflection

The skill of reflection is used to describe the client’s affective state with verbal or non-verbal cues. Instead of responding to the content of the client’s statement (paraphrasing or restating what the client has said), the music therapist responds to the feelings that appear to be behind or underneath what the client is communicating.
Example:
Client: “Now I mostly stay on this chair and it’s a big deal to even go to the bathroom ‘cause I can’t breathe.”
Music Therapist: “It makes you frustrated that you can’t even walk to the bathroom without getting out breath.”
Client: “Yes, frustrated and sad.”

Notice that in this example, the client makes a statement about their current state. Even though the client did not communicate how they are feeling with specific words, the music therapist made an inference about what the client might be communicating “between the lines” and with their body language about their affective state. This helps the client move toward greater self-awareness and self-understanding while we validate and recognize the world as they are perceiving it. In addition to validating the client’s feelings, the process of reflection helps in establishing rapport in the therapeutic relationship and conveys understanding.
Additionally, engaging in reflection as music therapists allows us to gain insight about the client’s emotional responses to triggers or events and provides clarification among various feelings. What this means is that, sometimes our perception of our client’s feelings will be accurate but sometimes it will not. Utilizing reflective skills can allow the client elucidate on what they’re actually feeling. Let’s expand on the previous example:
Client: “Now I mostly stay on this chair and it’s a big deal to even go to the bathroom ‘cause I can’t breathe.”
Music Therapist: “It makes you frustrated that you can’t even walk to the bathroom without getting out breath.”
Client: “No, not sad or frustrated. It actually makes me feel scared about what is happening to my body.”

When a music therapist utilizes the skill of reflection of feelings, it supports the client in discriminating among different feelings and sort through multiple meanings. Our goal is to understand the client and what they’re experiencing. Even when we “make a mistake” in identifying and verbalizing what our client might be feeling, it is still a valuable opportunity for the client to rectify what they’re actually experiencing knowing that we are actively attempting to understand them.

3. Asking questions

Asking questions, specifically open-ended questions, is one of my favorite skills to use in my music therapy sessions because it allows me to approach and build rapport with the client in a curious, intentional manner. Asking questions allows us to get to know the client in a deeper way. In this process, we engage clients in exploration of feelings and thoughts to support them toward greater self-awareness and understanding. Questions are also used to clarify what a client has said to us and are provided with intention and therapeutic purpose.
Upon establishing rapport and a solid foundation of the therapeutic relationship, open-ended questions can serve as an invitation for clients to deeply ponder about the meaning and possible explanations for what they’re thinking, feeling, or for a particular behavior. Lastly, asking questions is a skill that can be use to convey action, particularly helpful to engage the client in problem-solving, and discuss about the client’s readiness for change.
Some examples of the use of open-ended questions may be:
- “What have you tried in the past?”
- What would that be like for you?”
- “What is your understanding about what might be going on with ________?”
- “What are your thoughts/feelings about ________?”
- “Tell me more about ________.”
- “Can you give me an example of that?”

4. Challenging

Challenging is a skill utilized to bring up incongruences, discrepancies, and ambivalence about the client’s thoughts, actions, or feelings. It is employed to support the client in gaining self-awareness and clarify any mismatches in the clients verbal and non-verbal communication. It might be difficult for us as music therapist to challenge our clients as it can feel uncomfortable to use any type of confrontation, but when done with empathy, respect and intentionality, we can support our clients to move a step forward in their healing journey. Challenges can also be utilized to identify resistance, hesitancy and to promote insight.
When we let curiosity guide us, we can utilize challenges in an authentic and genuine way. To do so, we must be aware of our tone of voice, our body positioning, and our words, avoiding judgements and demonstrating respect.
Something to be mindful of is that, even when we lead with curiosity and respect, our clients might react with resistance, defensiveness, fear, and confusion. Ultimately, it can be hard for anyone to be confronted!

Some examples of challenges:
- “On the one hand you say ______ but on the other hand ______.”
- “I’m hearing _______ but I’m also hearing __________.”
- “You say you want to get good grades but you also say that you spent most of your time ________.”
- “What would be the worst thing that could happen if _________.”