Music Therapists' Perspectives on the Assessment and Clinical Interpretation of Clients' Vocal Parameters

Abstract

The purpose of this study was to investigate North American professional music therapists' perceptions and use of singing voice assessment. The focus was on a general population of music therapists who may or may not specialize in the use of singing as a clinical instrument. The researcher designed an online survey to gather music therapists' perceptions about the frequency with which they use singing voice assessment with clients, the singing voice parameters they assess and the clinical interpretations they make. Participants' demographic information was gathered and analyzed according to their responses. It was expected that these therapists would vary in their training and education, singing background and clinical context. Three hundred and thirty-five North American music therapists with a music therapist-accredited (MTA) or music therapist-board-certified (MT-BC) designation participated in the study, for an overall response rate of 13.9%. Results were analyzed using frequencies, proportions indicating association with Wilson Confidence Limits, Logistic Regression Models, Firth's Estimation, Tukey-Kramer adjusted-p levels and 95% confidence limits. Results indicated that a majority of participants assessed client singing at the beginning of therapy and periodically or regularly afterwards, paying attention to singing voice parameters of breathing and breath-support, freedom versus tension, vocal range, vocal tone quality, and/or pitch control. Results also indicated that a majority of participants used one or more of these parameters as a basis for interpretations about affect, personality characteristics, internal psychological processes, developmental stage, and/or psychopathological states. There were statistically-significant associations between therapists' primary clinical population and frequency of singing voice assessment performed; therapists' primary clinical population and singing voice parameters assessed; and therapists' primary theoretical orientation and singing voice parameters assessed. Results of this study suggest that music therapists in this sample were assessing and interpreting client singing even if some of these therapists had no specialized advanced training in the clinical assessment and interpretation of singing. Furthermore, it appears that music therapists in this study were paying attention to the same kinds of vocal parameters and made the same kinds of clinical interpretations as those featured in the clinical literature. Finally, it appears that voice assessment is not associated with a particular population. Future research should explore the impact of a client and therapist's background with singing on the clinical singing voice assessment. Future research should also explore the role singing voice assessment may play in different clinical contexts and the differential meanings that may be gleaned in these different contexts. There is also evidence within to support future development and validation of a vocal assessment tool.