A couple of years have passed since I last wrote about music therapy in our country. At that point we were living in exciting times waiting for the 6th European Music Therapy Congress which was held in Finland, in June 2004. Now, almost four years later, the congress is a warm, yet still exciting memory. Over 350 people, representing some 30 nationalities, found their way to Finland. The congress was undoubtedly one of the biggest highlights in the history of Finnish music therapy. To me, the congress symbolizes a change in our community's orientation to music therapy. During the first decades of the profession's development the field maintained a mostly national focus. However, in the mid 1990's the focus began to broaden - first in terms of Nordic, then European, and finally to the current state of international music therapy relations.
When I started as a professor of music therapy at the University of Jyväskylä 1997, I was told that it takes at least 10 years of preliminary work for a professor to really benefit from the fruits of his/her work. At that time I thought well, perhaps for some, but. couldn't I do it faster? Now, after 11 years I can only agree with those wise words and would even add more years to the notion. When I look back at the history of Finnish music therapy - I see that at least 30 years (possibly more) are needed until such a profession is strong and established enough to stand on its own two feet. Thus, we should never underestimate the importance of the preliminary, pioneering work that paves the way for future reforms. In this regard I see how the current generation owes a lot to the older one for the development of Finnish music therapy.
I am not sure if music therapy in Finland is currently doing as well as the state itself currently. Since the deep economic recession at the turn of 1990's Finland has rapidly improved its situation by joining the group of the richest countries in the world. However, this has not necessarily meant that the fruits of the success have been shared equally to everyone, or to every societal field. Moreover, many Finns are thinking the success has made decision makers greedy. Increasingly demands are made to "tighten the belt" in order to achieve more efficiency. This concerns municipalities, municipal organizations such as schools and hospitals, and even Universities. Although part of this can be seen as preparation for the future (an increase of senior citizens and decrease of working-age and young people) many are thinking that much of these reforms are unnecessary and based on exaggeration. In terms of music therapy, this development meant the end of a grace period, and we are expected to fulfil the same criterions as more established disciplines in order to survive. Of course, this makes daily life for the music therapy community sometimes rather tricky.
After many years of effort, we now have a rather stable training system based on Bachelor and Masters levels. We have two polytechnic schools (Pirkanmaa Polytechnic and North Carelia Polytechnic) with bachelor level training, and one University (University of Jyväskylä) with a master's program. In addition, there is one private bachelor level training program (Eino Roiha Institute). The training programs maintain a high level of collaboration and the Master's training is open for qualified music therapists regardless of which of the above training they have. These programs only intake new students every second year. This is due to the limited availability of resources (mainly teachers and funding) but also involves an effort to avoid over-education and saturation of the work force.
The majority of our clinical training is eclectic; many methods and models are taught and that the instruction does not advocate any particular approach. After some years' clinical experience music therapists may concentrate on a particular model or method appropriate to their needs and working context. However, if one model and method should be highlighted, I would say that the psychodynamic approach and improvisational method are the most common.
In 2004, a music therapy research and training clinic was established at the University of Jyväskylä. This is a significant development to Finnish music therapy in that both research and clinical method development are mostly centralised in Jyväskylä. The clinic there is well equipped for training and research purposes. Due to active collaboration between the training programs, new ideas and practices have developed quickly in the clinic and have become part of the programs curriculum. Collaboration with local health care organizations enables the students and the research projects use real clients, who represent a variety of diagnostic categories.
During the last few years, training in GIM (levels I and II) has been arranged by the Eino Roiha Institute. The head trainers have been doctors Thorben Moe (DK) and Dag Körlin (SWE). Some Finnish music therapy clinicians have now started level III training that takes place in Stockholm, Sweden. In general, teachers from abroad visit Finland more frequently nowadays. This is because of increasing international collaboration in general, but also due to international research projects.
Research is perhaps the fastest developing area of Finnish music therapy. Due to a fortunate sequence of events, and several years of a strong Finnish economy, music therapy research has taken some big steps forward. These activities mostly come from the University of Jyväskylä because of its Chair in music therapy.
In 2003 The Finnish Academy allocated money for a research project entitled "Intelligent Music Systems in Music Therapy" (project number 102253). This project was based on the collaboration between the Music Cognition Group at the University of Jyväskylä and the music therapy unit. The aim of this project was to develop a computational analysis tool for music therapy improvisation analysis (Erkkilä, 2007) as well as to empirically test it (Luck et al., 2006). In 2007 the International Network of Music Researchers was given funding by the European Union framework 6. The title of this project, conducted together with the University of Helsinki, Cognitive Brain Research Unit (principal responsibility) and Univ. of Jyväskylä, Department of Music, is "Tuning the Brain for Music" (Contract No 028570 (NEST)). Within this large project there are many su s b-studies, one of which has a focus on music therapy (the project's web site is: http://www.braintuning.fi). That ongoing study is a randomized controlled trail on music therapy for people with depression (the design can be found on the web-site: http://www.controlled-trials.com/ISRCTN84185937). Since the beginning of the year 2008 the Academy of Finland granted the status of "Centre of Excellence in Interdisciplinary Music Research" (project code SA 20/510/2007) for the group consisting of the researchers from the University of Jyväskylä, department of Music (principal responsibility), and from the University of Helsinki (Cognitive Brain Research Unit). Music therapy is involved in this project as well, which means some more resources for the Depression study, and then a new RCT trial, this time on active music therapy with people with stroke. Recently, one of the collaborative studies between the Helsinki and Jyväskylä Universities received remarkable attention when the journal Brain published our article on the effect of music listening on recovering from stroke (Särkämö et al., 2008).
We have about 150 music therapy clinicians working full-time in various fields of the health care system, and perhaps an additional 50 as part-timers. Music therapy is closely linked to the health care system and music therapists are typically collaborating with other professionals such as physicians, psychologists, psychotherapists, occupational therapists, etc. It has been a trend for several years that the majority of music therapists work as independent entrepreneurs serving several organizations. Perhaps the biggest sponsor of music therapy is the Social Insurance Institution of Finland. But there are other employers such as various municipal institutions. In some institutions there are also full-time positions for music therapists.
The traditional clients of Finnish music therapy are people with psychiatric disorders and mentally and/or multiply disabled people. With increased clinical experience and research based knowledge there is also increasing specialization with particular diagnostic groups such as people with stroke, learning disabilities, chronic pain, etc.
I would say that the last 15 years have been a time of relatively quick professional development. At its best music therapists can be compared to any other health care professionals with shared responsibilities and obligations. Music therapists are often members of multi-disciplinary teams having their share of a client's assessment and treatment. However, it would be too optimistic to say that music therapists are fully equal to other health care professionals. Even though their status is better and more established than in previous years, there are still prejudices and obstacles to overcome.
In summary, the profession of music therapy in our country is located in the context of the health care system. Most often a music therapy clinician's work is based on the principles closely associated with the tradition of individual psychotherapy. My guess is that in near future music therapy work with groups will also increase. For instance, there is currently an emerging interest in group analytic music therapy as a Finn (who currently lives and works in Canada) has recently written a book on the topic (Ahonen-Eerikäinen, 2007).
When looking back to the early years of Finnish music therapy compared to today's situation, one can undoubtedly see quite a difference. Many things have improved and many dreams have come true. However, one can also see that despite the positive developments, there are always new obstacles on the way towards becoming a fully accredited profession.
In 1970's and 1980's our society was not so wealthy and progressive as it is now, but there are things from then that we are missing now. For instance, it was possible for music therapy to grow and develop even though the basis of the profession was not so strong in those days. There was a kind of balance and peace in the health care system and no obvious reason to change the traditions at every turn. Competition between the professions was minimal and it was relatively easy to establish a new position if wanted. There was also a confidence in one's work. I can well remember the times when nobody would question a psychoanalyst's work, to say nothing of requiring objective evidence of such work. Similarly, music therapists in those times perhaps felt that they had a kind of mystical weapon - music - in their use and there is no need to "open it up" or "uncover" the mystical power of it. In this sense there was "peace in the valley" and no obvious threat on the way towards professionalism.
Then everything changed. Finland is well known for its ability to quickly adapt to new situations. And it did. Finland is also well known for its humility in front of the authorities, such as the European Union. We are perhaps the only members of the EU to immediately follow the new regulations - even though they are often paradoxical and not fully thought through, and most of the other members would resist them. Sometimes this kind of national "identity" makes life rather tricky, even unfair. Those in power may ruthlessly use their might without much willingness to check whether objectivity has been followed. For instance, there are no obvious reasons why music therapy is not on the official list of the recognized health care professions. The grounds of the decision makers to not recognize us have been paradoxical, illogical and indifferent. Perhaps this is the price we have to pay for success?
Ahonen-Eerikäinen, H. (2007). Group Analytic Music Therapy. Gilsum, NH: Barcelona Publishers.
Erkkilä, J. (2007). Music Therapy Toolbox (MTTB) - An Improvisation Analysis Tool for Clinicians and Researchers. In T. Wosch & T. Wigram (Eds.), Microanalysis in Music Therapy (pp. 134-148). London and Philadelphia: Jessica Kingsley Publishers.
Luck, G., Riikkilä, K., Lartillot, O., Erkkilä, J., Toiviainen, P., Mäkelä, A., et al. (2006). Exploring Relationships between Level of Mental Retardation and Features of Music Therapy Improvisations: A Computational Approach. Nordic Journal of Music Therapy, 15(1), 30-48.
Särkämö, T., Tervaniemi, M., Laitinen, S., Forsblom, A., Soinila, S., Mikkonen, M., et al. (2008). Music listening enchances cognitive recovery and mood after middle cerebral artery stroke. Brain, 131(March), 866-876.
Erkkilä, Jaakko (2008). The State of Music Therapy in Finland. Voices: A World Forum for Music Therapy. Retrieved June 12, 2013, from http://testvoices.uib.no/?q=country-of-the-month/2008-state-music-therapy-finland