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Nordic Journal of Music Therapy 15(2), 2006
69
PERSPECTIVES ON PRACTICE
Introduction
The music therapy profession is continuing to
develop more rened and specic techniques
of therapeutic intervention (Thaut, 2005). The
literature reports the use of a range of methods
used in music therapy including: improvisation
(Bruscia, 1987), songwriting (Baker & Wigram,
2005), singing (Cohen, 1994), music listening
and discussion, and so on. Within each of these
methods are subcategories of intervention
designed to address specic therapeutic goals or
client circumstances. Detailed descriptions of
Song Collage Technique:
A New Approach to
Songwriting
Jeanette Tamplin
Abstract
Song Collage Technique is a therapeutic songwriting intervention. The presentation and discussion of
this technique provides music therapy clinicians with detailed resources, consistent terminology with
which to describe treatment, and therapeutic applications for clients who have cognitive impairments,
difculty articulating feelings due to cultural or gender issues, or time restrictions in therapy. A
discussion of traditional therapeutic songwriting techniques provides a foundation for the evolution
of Song Collage Technique. Trauma, disability and the need for emotional expression in rehabilitation
are presented to provide a clinical context for the use of Song Collage Technique. Case examples and
contraindications are offered to highlight clinical application of the technique with clients undergoing
rehabilitation for spinal cord injury and traumatic brain injury.
Keywords: songwriting, song collage, lyrics, rehabilitation, spinal cord injury, traumatic brain injury,
adjustment, emotional expression.
Nordic Journal of Music Therapy, 15(2) 2006, pp. 69-82.
JEANETTE TAMPLIN B.Mus (Hons), M.Mus,
RMT, is Senior Music Therapist at Royal Talbot
Rehabilitation Centre and Ivanhoe Private
Rehabilitation Hospital, Melbourne, Australia.
She recently completed her Master’s research
on the effects of music therapy in dysarthria
rehabilitation. Her clinical and research interests
include neurological disorders, rehabilitation,
coping, and adjustment following traumatic injury
or illness. Jeanette has also co-authored a book
with Dr. Felicity Baker entitled “Music Therapy
Methods in Neurorehabilitation: A Clinician’s
Manual.”
Email: jeanette.tamplin@austin.org.au
Nordic Journal of Music Therapy 15(2), 2006
70
these subcategories of intervention in relation to
treatment not only enables music therapy service
provision to be more transparent to clients and
employers, but also ensures the use of the same
terminology amongst practitioners to discuss
specic techniques employed in therapy.
Clinicians have been writing songs with
clients in therapy for many years; however, it is
really only in the last decade that this technique
has been explored signicantly in the literature.
In addition, most clinicians who publish on
their songwriting work tend to focus on clinical
examples and therapeutic outcomes rather than
explicitly describe method (Wigram & Baker,
2005). Baker and Wigram (2005) edited a book
on songwriting methods, techniques, and clinical
applications specically to address this gap in the
literature. It was through co-authoring a chapter
in this book with two fellow clinicians that I
became aware that ‘song collage’, a songwriting
technique that I often use, has rarely been reported
in the literature. Therefore, the purpose of this
paper is to describe Song Collage Technique
(SCT) and its clinical applications. To provide
some context for the development of SCT a
brief review of the songwriting literature will be
presented. The clinical populations with which
I use this technique and issues specic to these
clients will also be discussed and a series of case
examples and contraindications will highlight the
clinical applications of this technique.
Songwriting
Songwriting in music therapy has been dened
as “the process of creating, notating and/or
recording lyrics and music by the client or clients
and therapist within a therapeutic relationship to
address psychosocial, emotional, cognitive and
communication needs of the client” (Wigram &
Baker, 2005, p. 16). The experience of writing
a song in therapy is a process. The creation of
lyrics reects the journey towards identifying
and expressing emotions. The composition of
the music supports and validates the emotions
expressed in the lyrics. The completed song
becomes a record of the process, providing
opportunities for revisiting experiences and
emotions and sharing these with others (Baker
& Tamplin, 2006). Songwriting is a dynamic and
empowering therapeutic medium through which
to process thoughts and emotions, particularly in
relation to trauma, grief, identity, and disability.
Songs can “assist people to reect on their past,
present or future, to make contact with unconscious
thought processes, to confront difculties
within their intrapersonal experiences and their
interpersonal relationships, and to project their
feelings into music” (Wigram & Baker, 2005, p.
11). The process of writing a song in therapy may
facilitate the identication and self-disclosure of
emotions and subsequently impact on issues of
self-esteem and insight (Glassman, 1991). Clients
receive validation for their feelings when these
are expressed and incorporated into original song
lyrics (Freed, 1987). Songwriting in therapy may
also teach clients coping strategies by promoting
self-expression and decreasing feelings of
helplessness (Edgerton, 1990; Ficken, 1976;
Freed, 1987; Goldstein, 1990; Robb, 1996). In
group settings, songwriting is reported to promote
group cohesiveness, communication, self-esteem
and appropriate behaviour (Cordobes, 1997; Day,
2005; Edgerton, 1990; Ficken, 1976; Robb, 1996;
Schmidt, 1983; Silber & Hes, 1995).
A ‘Working Model’ of Songwriting
(Wigram, 2005)
It is essential when using songwriting as a
therapeutic intervention that the therapist
recognizes the clients’ need to value the song
as something that they themselves have created
(or collaborated in creating). This encourages a
sense of ownership of the song and its content or
message.
Often songwriting in therapy begins with
lyric creation, as this can be a more tangible
aspect of songwriting for non-musicians.
A range of therapeutic techniques for lyric
development is presented in Table 1. This review
of the songwriting literature suggests that the
most common lyric writing techniques used in
therapy are word substitution and song parody
JEANETTE TAMPLIN
Nordic Journal of Music Therapy 15(2), 2006
71
(working within existing musical structures), and
brainstorming on themes to generate lyrics.
There are a variety of ways in which music
therapists facilitate the composition of music for
song lyrics. Techniques for music creation include:
improvisation with the client, presenting ideas
for the client to accept or reject, asking the client
questions about genre, style, instrumentation,
accompaniment, tonality, etc., using material
from known songs, or music created completely
by the therapist for the client (Wigram, 2005).
Song Collage Technique
Songs are an important part of today’s popular
culture and are an accepted means of emotional
expression for people of all ages. Songwriting
in particular is a more socially acceptable and
perhaps less threatening way to channel emotions
(Davies, 2005). For many people the lyrics of
well-loved or familiar songs hold particular
signicance. Song Collage Technique (SCT)
involves the use of words or phrases from existing
songs as a part of the lyric formation process in
creating therapeutically oriented songs. The
formation of a verbal collage that is meaningful
to the client forms the basis of this technique and
aims to stimulate the client’s creative expression
and maximise independence and ownership of
the created song.
Little has been written about the use of SCT.
Vocal improvisation (Davies, 2005; Derrington, 2005; Dileo & Magill,
2005; Oldeld & Frank, 2005; Robb, 1996; Schmidt,
1983)
Client pre-composed lyrics (Aasgaard, 2005; Davies, 2005; Derrington, 2005;
Glassman, 1991; Lindberg, 1995; O’Callaghan,
1996; Rolvsjord, 2005)
Brainstorming and reframing ideas (Baker, 2005; Baker, Kennelly, & Tamplin,
2005; Cordobes, 1997; Davies, 2005; Day, 2005;
Derrington, 2005; Edgerton, 1990; Ficken, 1976;
Lindberg, 1995; O’Brien, 2005; O’Callaghan, 1996;
Schmidt, 1983)
Selecting words from a list (Rolvsjord, 2005)
Use of open-ended or direct questions (Baker et al., 2005; Freed, 1987; O’Callaghan, 1990,
1996) Schmidt, 1983)
Therapist-developed lyrics based on
client-generated themes and ideas
(Dileo & Magill, 2005; Krout, 2005; Lindberg, 1995;
Rolvsjord, 2005)
Client-developed lyrics for therapist-
composed melody
(Silber & Hes, 1995)
Song parody/Changing words to existing
songs
(Baker et al., 2005; Ficken, 1976; Freed, 1987;
Glassman, 1991; O’Callaghan, 1990; Robb, 1996;
Schmidt, 1983; Silber & Hes, 1995)
Fill-in-the-blank/word substitution
technique
(Baker et al., 2005; Dileo & Magill, 2005; Ficken,
1976; Freed, 1987; Glassman, 1991; Goldstein,
1990; O’Callaghan, 1996; Robb, 1996; Schmidt,
1983)
Use of rhyming patterns (Aasgaard, 2005; Baker et al., 2005)
Song collage/Using words from existing
songs
(Baker et al., 2005; Derrington, 2005; Ficken, 1976;
Schmidt, 1983)
Table 1: Therapeutic techniques for lyric development
SONG COLLAGE TECHNIQUE: A NEW APPROACH TO SONGWRITING
Nordic Journal of Music Therapy 15(2), 2006
72
Ficken (1976) reports the use of fragments
of existing songs to “form a collage with a
central theme” (p165). Similarly, Derrington
(2005) suggests that when songwriting with
teenagers their inspiration may be drawn from
pre-composed lyrics. In a group therapy setting,
Schmidt (1983) states that songs can be created
by having each group member select a phrase on
a particular theme from a favourite song and then
working as a group to combine these fragments
into a new song. Although these references each
allude to a form of song collage, in each case
further elaboration on the implementation of this
technique was not provided.
The benets of songwriting in facilitating
the expression, containment, and processing
of emotions and thoughts are clear. However,
for some clients lyric creation is difcult for a
variety of reasons. In my experience there are
three key clinical scenarios in which SCT may be
an appropriate choice of therapeutic songwriting
intervention.
Difculty articulating feelings or fear of
emotional expression based on cultural
or gender issues
Cognitive difculties - poor initiation/
memory/idea generation and
development
Time restrictions – not enough time
between referral and admission to
music therapy and discharge to employ
traditional songwriting approaches
Typical stages in the SCT lyric development
process are as follows: 1) collation of lyrical
fragments, 2) grouping of collated lyrics into
thematic ideas, 3) reworking of lyrics, adjustment
to t rhyming/rhythmic patterns, possible addition
of original ideas, and 4) music creation. Clients
are encouraged to look through CD covers, lyric
sheets, and/or music books and select words and
phrases that stand out to them. These existing
lyrics may have particular meaning for the client
and SCT can be very powerful for this reason.
These words and phrases can be scribed by
therapist or client (depending on client ability and
preference). The collated lyrics are then grouped
1.
2.
3.
together so that they make sense to the client. The
theme and structure of the song begins to evolve
at this point. The nal created song lyrics may
appear as simply a collage of these words and
phrases or this collage may serve primarily as a
means of idea generation. The client and therapist
can then rework the lyrical ideas collected into
original lyrics. Keeping the client in total control
of the lyric selection maintains the client’s
autonomy and allows a strong sense of ownership
of the newly created song to develop.
Trauma and Adjustment
As known phrases are reworked into a new song,
they are imbued with added meaning and personal
signicance. SCT is therefore an ideal music
therapy intervention to employ in rehabilitation,
in terms of its therapeutic applications as well
as its social and cultural relevance. Signicant
injury or illness is a traumatic experience for most
people. The experience can be traumatic in terms
of physical outcomes and emotional reactions,
as well as social responses, or perceived social
responses to the event. Loss and grief issues may
arise surrounding the loss of physical function and
independence, appearance, nancial security, and
professional, social and family roles (Ponsford,
Sloan, & Snow, 1995). The aftermath of trauma
may also stimulate feelings of guilt, self-blame,
anger, and frustration (Baker & Tamplin, 2006).
Dealing with these emotions is particularly
important in a rehabilitation setting as unvoiced
or unresolved emotions may lead to mood and
behaviour disturbances and impact on a client’s
ability to participate in rehabilitation (Wheeler,
Shiett, & Nayak, 2003).
Adjustment to disability involves a combination
of factors, including self-acceptance, emotional
maturity, and mental health status (Olney & Kim,
2001). A person must adapt to a new condition
under unplanned circumstances. Self-expression
can assist in processing the impact of trauma
and subsequent identity changes. Song listening
and songwriting can be used to assist clients to
identify and express emotions spontaneously,
thus bypassing concrete thought processes and
JEANETTE TAMPLIN
Nordic Journal of Music Therapy 15(2), 2006
73
defense mechanisms (Baker & Tamplin, 2006).
By providing a musical medium through which
to express difcult emotions it is possible to lift
mood, encourage hope for the future and manage
depression, which can subsequently increase a
client’s motivation to participate in other therapies
(Tamplin, 2006). Traumatic brain injury and
spinal cord injury each represent an experience
of signicant trauma, often requiring lengthy
periods of rehabilitation and hospitalization.
These injuries will each be briey outlined in the
following sections.
Traumatic Brain Injury
Traumatic brain injury (TBI) results from an
insult to the brain from an external force (such
as a severe blow to the head) and can cause
signicant impairments in physical, cognitive
and communicative function. The incidence of
people with traumatic brain injury who experience
disturbances of mood and affect ranges from 26%
to 77% (Bowen, Neumann, Conner, Tennant, &
Chamberlain, 1998; Prigatano, 1999; Schramke,
Stowe, Ratcliff, Goldstein, & Condray, 1998).
These disturbances may appear in the form
of anger, restlessness, frustration, irritability,
agitation, anxiety, sadness, or loss of motivation
(Prigatano, 1999).
Spinal Cord Injury
Spinal cord injury (SCI) results in the loss of
movement and sensation in the limbs and trunk
of the body (Zedjlik, 1992). A SCI may be
caused by trauma (motor vehicle accidents/falls)
or illness (infection/tumor) and the effects of
the injury can vary greatly from one person to
another. Physical changes are often considerable
and include paralysis of limbs, loss of sensation,
balance difculties and the inability to control
the function of bladder, bowel, and sexual
organs (Nielson, 2003). Following SCI 25-40%
of people experience depression and anxiety
disorders and the suicide rate is up to six times
higher than that of the general community (Galvin
& Godfrey, 2001). A study by De Carvalho and
colleagues (1998) found that effective coping
mechanisms used by SCI clients included
protective strategies of emotional self-control,
acceptance, positive re-evaluation, and ignoring
the problem and living as before. Conversely,
clients using coping mechanisms of escape or
avoidance, confrontation, and self-blame were
more vulnerable to psychological distress or
depression.
The Need for Emotional Expression in
Rehabilitation
The physical stressors associated with SCI
and TBI are sudden and traumatic (unlike
the slow onset of chronic illness) often
resulting in permanent lifestyle changes. The
expression and processing of feelings following
a traumatic event is necessary for healthy
emotional well-being. It can also assist in the
rehabilitation process (Wheeler et al., 2003).
More importantly, the blocking or suppressing
of emotions following traumatic injury or illness
may negatively impact on a person’s ability to
cope with new issues that may arise during the
rehabilitation process (De Carvalho et al., 1998).
Given the higher percentages of males in the
TBI and SCI population,
1
it is also important to
recognise gender differences in coping styles
and expression of emotion. Research has shown
that emotion-focused coping strategies are more
effective when dealing with situations over
which a person has no control, however, in
general men tend to use problem-focused coping
strategies (de Ridder, 2000; Folkman, 1992).
Western culture discourages men from open
emotional expression and promotes qualities of
strength and independence, both of which are
challenged following TBI or SCI. However,
although men may be less inclined to express
their emotions verbally, they can experience the
same emotional intensity as those who are able
1
Most estimates indicate that two to three males sustain TBI for every female (Ponsford et al., 1995).
SONG COLLAGE TECHNIQUE: A NEW APPROACH TO SONGWRITING
Nordic Journal of Music Therapy 15(2), 2006
74
to verbalise their feelings. By assisting male
clients to identify and express their feelings,
use of more effective emotion-focused coping
strategies may be facilitated (Baker, Kennelly, &
Tamplin, 2005a).
A number of studies have shown that music
and music therapy can facilitate expression of
feelings and positive mood change for clients
with TBI (Baker, Kennelly, & Tamplin, 2005b;
Baker & Wigram, 2004; Magee & Davidson,
2002; Nayak, Wheeler, Shiett, & Agostinelli,
2000; Wheeler et al., 2003) and SCI (Amir,
1990). Collectively, these studies have used a
variety of music therapy interventions to attain
similar results (see Table 2).
The only publications in the literature reporting
songwriting in the rehabilitation setting examined
song themes in relation to adjustment and coping
styles of TBI clients (Baker et al., 2005a, 2005b,
2005c). Themes that emerged from a lyric
analysis of 82 client songs included descriptions
of distress, physical and emotional pain, and
feelings of isolation, dependency, helplessness,
and anger. Positive themes included memories
and reections upon signicant others and the
communication of messages to loved ones. These
themes clearly exemplify the depth of emotion
that patients in rehabilitation are able to express
through songwriting.
Choice of Specic Music Therapy
Technique - “The Right Approach at
the Right Time”
In order to facilitate the best therapeutic outcome,
it is important for the clinician to identify suitable
interventions for each patient for whom emotional
expression and/or adjustment are identied as
key goals. For example, music improvisation as a
means of expression is often not possible for TBI
and SCI patients due to physical impairments and
limitations. Where songwriting is determined to
be an appropriate technique for a patient, the
specic songwriting technique to implement also
needs to be assessed. When the patient is having
difculty initiating ideas for lyrics independently,
SCT offers an alternative to the therapist
suggesting words or themes and thus risking
guesswork, projection, or ‘putting words into
the patient’s mouth’. Instead, the patient looks
through music books, lyric sheets, and/or CD
sleeves and identies words or phrases that stand
out to him or that he can relate to. Therapeutic
benet is gained through providing choice and
maximum control over the creative process in
a rehabilitation setting where patients have so
little control over anything else. The therapist
may assist the patient to alter or add words
or rework the lyrics in any way, but the key to
this patient-focused technique is empowerment.
The patient provides himself with a palette of
phrases and lyrical ideas with which to work.
This collection of phrases from other songs may
be used as a springboard for discussion in therapy
sessions, which can trigger new lyrical ideas.
Existing words are shaped together with new
ideas, modied and molded into something new
– a song that expresses the patient’s own feelings
and identity.
Case Examples
Three case examples are presented to illustrate
clinical situations in which it may be appropriate
to use SCT: 1) difculty expressing feelings, 2)
cognitive difculties, and 3) time restrictions.
Patients provided written consent for the
inclusion of their song lyrics and case material in
this paper. Names have been altered to preserve
condentiality.
SCT for Clients Who Have Difculty
Articulating Feelings
Cultural norms may prevent some people,
particularly males, from being comfortable
talking about their feelings. This fear of
emotional expression may relate to perceived
societal expectations or gender issues and is often
exacerbated by a lack of modeling and experience
in articulating feelings.
JEANETTE TAMPLIN
Nordic Journal of Music Therapy 15(2), 2006
75
Case Example 1 – Difculty Articulating
Feelings
‘Jim’, a nineteen year old young man who had
received a SCI and TBI following a motorcycle
accident used SCT in music therapy to facilitate
emotional expression. Jim was a high level
quadriplegic (C5), which meant that he had no
movement or sensation below his chest and limited
ability to use his hands. Cognitive issues including
decreased inhibition and anger management,
poor problem solving, and rigid thinking patterns
resulted from his brain injury. He was referred
to music therapy to encourage him to engage
with his emotions and express how he was feeling
in a constructive way. Jim was typical of many
young Australian males in that he liked listening
to loud music, taking risks, driving fast and found
it difcult to talk about his feelings. The latter
may have been exacerbated by his brain injury
but was primarily due to culture and premorbid
personality traits. Jim’s SCI meant that music
improvisation was physically not achievable for
him. The rst few music therapy sessions were
spent developing rapport, establishing Jim’s
music tastes, and discussing issues that he raised.
He enjoyed selecting popular songs from books
for me to sing, and with directive questions was
able to identify with some concepts raised in the
lyrics of some songs. I introduced the concept of
writing a song to Jim after a month of therapy.
He agreed to try this but had great difculty
initiating any ideas or even identifying a theme
for his song. As the songbooks were familiar
territory for Jim, I suggested that he look through
the books and collect phrases that he related to
from other songs. He was able to do this quite
easily, perhaps because it placed a step between
him and his emotions and therefore was not as
confronting or challenging. That is, he wasn’t
required to state directly how he was feeling or
put this into words; rather, he was able to use the
words of various other lyricists to get his message
across. So Jim icked through the books and read
out phrases or parts of phrases that he liked and
I wrote these down for him. As we went along
it became clear from the content of the lyrics he
was collating that the song was a song to his
girlfriend. This was signicant as a rst step in
communicating his feelings. Jim perceived that,
based on his experience of popular music culture,
it was socially acceptable for a man to express
emotion in the context of a love song. In addition,
of all the important things in life for a nineteen-
year-old man – girls, cars, drinking, working,
all but his girlfriend had been taken from him
as a result of his injury and hospitalization, so it
made sense for him to focus on his girlfriend at
this time. The completed lyrics of Jim’s song are
presented below.
Improvisation (Magee & Davidson, 2002; Nayak et al., 2000; Wheeler et al.,
2003)
Song singing (Baker & Wigram, 2004; Nayak et al., 2000; Wheeler et al.,
2003)
Songwriting (Baker et al., 2005a, 2005b; Baker, Kennelly, & Tamplin,
2005c; Wheeler et al., 2003)
Music listening (Magee & Davidson, 2002; Nayak et al., 2000; Wheeler et al.,
2003)
Composition (Nayak et al., 2000; Wheeler et al., 2003)
Performance
(Nayak et al., 2000)
Improvised songs (Amir, 1990)
Table 2: Music therapy interventions for emotional expression and mood change with TBI/SCI
clients.
SONG COLLAGE TECHNIQUE: A NEW APPROACH TO SONGWRITING
Nordic Journal of Music Therapy 15(2), 2006
76
You’re My Shining Star
Since I met you, babe you should know
That I could never go on without you
I love the way you think, and I love the
way you look
You’re just like an angel
Chorus:
My care for you is from the ground up to
the sky
And I never want to say goodbye
‘Cause your love for me is gold, and I
wanna treat you right
You’re my shining star at night
Bridge:
Maybe I’m too young to keep good love
from going wrong
I don’t want the things I say to push you
away
I need you so much where are you now?
Babe you should know, that you’re the one
for me
You’re the only one I see
No one else compares to you, thanks for
sticking by me
…Through everything
Chorus:
My care for you is from the ground up to
the sky
And I never want to say goodbye
‘Cause your love for me is gold, and I
wanna treat you right
You’re my shining star at night
The lyrics in the bridge particularly highlight
Jim’s fear of alienating his girlfriend because of
the anger and frustration he was experiencing
following his accident. In the completed song
Jim communicates love, fear, commitment, and
gratitude to his girlfriend. After he completed
the lyrics I asked Jim about how he wanted
the music to sound. He suggested music in the
style of Ben Harper/John Butler with blues slide
guitar accompaniment. After listening to some
music from these artists that Jim liked, I began to
improvise some chord progressions using a slide
and open guitar tuning. I then presented him with a
range of options for melodic lines that he selected
from. Although it may be challenging at times for
music therapists to meet the differing musical
styles and preferences of individual patients in
this way, this method facilitates a strong sense
of ownership and connection with the music for
Jim. This method of music creation for patient
songs may also stimulate music therapists to play
in musical styles other than those that they would
usually present to patients.
The completion of this song was an important
step in Jim’s rehabilitation journey. It provided
him with renewed condence and a sense of
achievement. It also allowed him to experience
positive emotional expression in a culturally
acceptable way. Following this, Jim went on
to write another song in which he expressed
his frustration and anger about his accident
and disability. He generated the lyrics for this
song independently. SCT was for Jim a more
manageable way to approach songwriting and
emotional expression. It provided him with
condence to continue to explore his feelings
and later he began to express these in his own
words.
SCT for Working with Cognitive
Difculties
When working with people who have sustained
neurological damage, cognitive difculties can
impact on their ability to process situations
emotionally. For example, memory impairments
make it difcult to remember, from session to
session, the issues that have been raised and
discussed. Other cognitive impairments may
include difculty initiating ideas or being able to
communicate abstract concepts such as emotions.
By using a technique such as SCT, patients may
identify and relate emotionally to concepts that
they read in lines of other artists’ songs. By
capturing these in the context of a new song, a
JEANETTE TAMPLIN
Nordic Journal of Music Therapy 15(2), 2006
77
record of the experience is made and can be used
as a memory aid to facilitate moving through the
staged process of emotional adjustment.
Case Example 2 – Cognitive Difculties
Mark, a 27-year-old young man with severe
cognitive difculties following a TBI, was referred
for music therapy to assist emotional expression.
Mark had a strong relationship with the music
that he listened to and initially music therapy
involved concrete tasks such as singing songs of
Mark’s choice. Later it became more important
for Mark to identify his own emotions and be able
to express these, as he was becoming depressed
and apathetic about his situation and refusing to
attend therapy sessions. Similarly to Jim in the
rst case example, Mark was already familiar
with the songbooks, but had difculty putting
his own feelings into words. Using phrases from
other songs to express these feelings was therefore
an ideal approach to songwriting. Mark’s song
lyrics are presented below.
Things Change
Try to see it my way
My life is changing every day
My identity, has it been taken?
I’m not half the man I used to be
All my plans fell through my hands
These days turned out nothing like I’d
planned
It’s been a long hard year
And people, they don’t understand
Chorus:
There’s no one here to blame
And nothing stays the same
I’d like to dream my troubles all away
There are many things that I would like to
say
…But I don’t know how
I open up and see
The person falling here is me
Never needed anyone’s help before
But now I need you so much more
Bridge:
I’m sad but I’m laughing
I’m brave but I’m chickenshit
I’m weak, but I’m strong
I try, but it’s tearing me apart
Chorus:
There’s no one here to blame
And nothing stays the same
I’d like to dream my troubles all away
There are many things that I would like to
say
…But I don’t know how
Memories seep from my veins
And nothing is the same
The damage has been done
My independence, it has gone
Mark’s completed song was a powerful expression
of his fear, confusion, and grief relating to
his accident and particularly in reference
to perception of identity change. The whole
songwriting process took about four weeks to
complete. We composed the music after only two
verses had been created. This was important, as
singing the ‘song in progress’ at the start of each
session was an important memory prompt for
Mark. When asked, he was unable to remember
what had happened in previous sessions, but he
remembered the music when I played it and could
sing and thus reconnect with his song in this way.
SCT was a very ‘immediate’ construct for Mark
as he was able to identify lyrical phases ‘in the
moment’ that he related to. Although he needed
signicant assistance to organize these and
structure them into a new song format, Mark’s
deep connection to the emotions expressed meant
that he felt a strong sense of ownership over
the completed song. He played the recording to
family, friends and hospital staff and proudly
displayed the lyrics on the wall in his room.
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Nordic Journal of Music Therapy 15(2), 2006
78
SCT When Scope for Songwriting is
Limited by Time Restrictions
On some occasions where songwriting is indicated
in music therapy assessment, a limited amount
of time available prior to discharge may impact
on the practicality of this intervention. Usually
a period of time needs to be spent developing
rapport between therapist and client before the
client feels safe to disclose and explore their
feelings in therapy. In addition, the generation
and expression of ideas for lyrics often takes
some time, particularly in the early stages of
writing a song.
Case Example 3 – Time Restrictions
‘Sharon’, a 32-year-old woman, presented with
mild cognitive impairments following a TBI
resulting from a skiing accident. She was referred
to music therapy to work through grief and loss
issues as her insight into the full extent of her injury
increased. After an initial assessment session, we
agreed that songwriting would be an appropriate
way for Sharon to process the experience of her
injury. I suggested SCT, as Sharon was due to
be discharged not long after she was referred to
music therapy and we were only able to schedule
four sessions before she left the hospital. Sharon
was a fan of the band Radiohead and was able to
read much of her experience into the esoteric and
often obscure lyrics of Radiohead songs.
Over the course of two sessions, Sharon
collated various phrases and sampled sections
of Radiohead songs that she felt described her
experience. During this collation process, Sharon
was able to identify feelings that were aroused by
the lyrics she was writing down. She talked about
these feelings and was able to begin to process the
experience during the actual composition of the
song. In the fourth and nal session I composed
music for the song in the style of Radiohead, with
feedback and suggestions from Sharon. We then
recorded the song for her to keep as a record of
the process.
‘Sharon’s’ Radiohead Song Collage
I jumped in the river what did I see?
Black-eyed angels swam with me
I was dropped from the moonbeam
And sailed on shooting stars
Chorus:
A full moon of stars and astral cars
All the things I used to see
All my past and futures
And we all went to heaven in a little row
boat
There was nothing to fear and nothing to
doubt
Blame it on the black star
Blame it on the falling sky
Blame it on the satellite that beams me
home
Sometimes I get overcharged
That’s when you see sparks
Limb by limb and tooth by tooth
Tearing up inside of me
Everyday, every hour
Wish that I was... bullet proof... bullet
proof...
Chorus:
A full moon of stars and astral cars
All the things I used to see
All my past and futures
And we all went to heaven in a little row
boat
There was nothing to fear and nothing to
doubt
You ask me where the hell I’m going
At a thousand feet per second
I feel my luck could change
Hey man, slow down, slow down
Idiot slow down, slow down
Sharon only became aware of how serious
her injury was and how close to death she had
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Nordic Journal of Music Therapy 15(2), 2006
79
come following a conversation with her partner
several weeks after her accident. Her partner
had described the scene of the accident to her
and his fear that she was dead when he saw her
lying sprawled unconscious on the snow with
blood coming from her head. Sharon used this
image to paint a picture of the accident scene
and referred to herself in the picture as a ‘black-
eyed angel’. She used the references to stars,
space, and heaven in the song to depict her view
of herself in that unconscious state. She referred
to it as an out-of-body experience, discussed the
concept of past and future in relation to life, and
talked about the experience of having been so
close to death. The phrase “wish that I was bullet
proof” she also used to refer to her near-death
experience and her new sense of the fragility
of life. Sharon used the nal verse to convey
her experience of rehabilitation, where she
felt people were constantly telling her to ‘slow
down’, but her mind was racing ‘at a thousand
feet per second’. Sharon’s feedback about her
use of SCT suggested that it helped her to express
and contain the emotional responses evoked by
her trauma experience at a time when she was
not able to do this verbally.
Contraindications
The use of SCT in situations where other
songwriting techniques are appropriate may limit
the creative expression of the client. That is, for
a client who is cognitively and emotionally able
to identify and express his feelings (and where
time is not an issue) the use of only lyrics from
other songs may limit the full expression and
originality of his own song. For such a client
it may be more therapeutic for him to nd his
own words to express his feelings. Alternately,
for a client with initiation difculties it may
be important to work on improving this skill
through traditional songwriting methods. In a
rehabilitation setting particularly, the choice
of therapeutic intervention should be based on
challenging the client to address appropriately
staged rehabilitation goals. In addition, for a
client with severe cognitive impairments it may
be over-stimulating to look through pages and
pages of pre-composed lyrics and the task of
associating particular lines with his own feelings
may be too abstract. In such cases, it may be
more appropriate to use directive questions and
considerable guidance and assistance from the
clinician to facilitate traditional techniques for
therapeutic songwriting.
Use of SCT in Other Clinical
Populations
The use of SCT is not limited to use with TBI
and SCI populations. Although my use of SCT
developed out of clinical experience with
these populations, the potential for therapeutic
application of the technique is much more wide-
ranging. Cognitive issues that prevent initiation,
articulation, or development of ideas may be
present for children with learning difculties,
stroke patients, and people with intellectual
impairments or people who have a degenerative
neurological condition. Thus, SCT may open the
door to therapeutic songwriting for people with
cognitive impairments originating from causes
other than TBI. Likewise, SCT may be used
with any clients who have difculty putting their
feelings into words independently. These clients
could be cancer patients, victims of abuse, grieving
adolescents or adults, people with substance
abuse issues or mental health problems. One
of the primary benets of SCT for clients who
struggle to articulate feelings or ideas verbally is
the reliability and accuracy of expression. With
SCT the onus for idea generation originates from
client identication with pre-existing lyrics rather
than from the therapist trying to put the client’s
feelings into words. Similarly, time constraints
in therapy are an issue for music therapists in a
variety of clinical settings, particularly in acute
health care, where SCT may ‘fast-track’ the lyric
creation process.
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Nordic Journal of Music Therapy 15(2), 2006
80
Conclusion
SCT is only one approach to therapeutic
songwriting. Use of this technique may be
indicated when other customary songwriting
techniques involving the creation of original
lyrics are not possible for cognitive, emotional,
or logistical reasons. It can be seen from the
case examples presented above, that SCT has
particular therapeutic application for clients who
have cognitive impairments, difculty articulating
feelings due to cultural or gender issues, or
time restrictions in therapy. SCT empowers the
client to take maximum creative control over
the songwriting process. The clinician supports
the independence of the client and provides
assistance where appropriate.
The description of SCT as a particular
subcategory of songwriting intervention, together
with discussion of the clinical indicators and
contraindications for use of this intervention
contributes to the development of a more
comprehensive and transparent catalogue of
effective music therapy techniques. It is my hope
that music therapy clinicians will be inspired to
trial the use of SCT, particularly in circumstances
where traditional approaches to songwriting in
therapy have failed or are not appropriate.
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