Intervention Inspiration Series: Instrumental Improvisation

As a new initiative for MTSA this summer, we are choosing to share different ideas for Music Therapy practice in the hopes that this will provide a valuable resource for beginning music therapists and as inspiration for practicing therapists. Every Monday, a different intervention idea will be presented. They will be very basic and will be best as beginning inspiration to be varied and adapted for different clinical settings. They may include specific music, but will typically only indicate the style of music to be incorporated.
The following basic format will be given for each intervention: 1) Activity, the type of intervention; 2) Target population, the intended client population for the intervention; 3) Materials, the instruments and supplies required; 4) Goals/Aims, ideas for goals or aims that could be addressed in the intervention; 5) Method, a detailed description of what would occur during the intervention; 6) Comments, an explanation of why this intervention is applicable for the given client population and how the goals/aims are addressed; and 7) Evaluation, questions to allow for reflection on whether or not the intervention was effective for a particular client or clients.

Printable Version (PDF File)

Instrumental Improvisation

by Victoria Rondinelli

Intervention Series - Instrumental Improvisation

Photo Source:


Referential Improvisation on the theme “rain”

Target Population:

Pediatric Oncology (Ages 8-12)


A variety of relaxing instruments: chimes, rain sticks, ocean drum



  • To encourage interaction with children of a similar age and diagnosis
  • To address isolation issues
  • To foster the expression of feelings
  • To engage the clients in collaborative and active music making
  • To assess the ability to follow visual and musical cues
  • To engage in a musical dialogue
  • To reduce feelings of stress associated with hospitalization
  • To increase socialization in the hospital setting (with other patients and the music therapist)


The music therapist will begin by giving the children a choice of instrument (choosing from relaxing percussive instruments). The music therapist will show and play for the children a rain stick and provide probing questions such as “What feelings are associated with the rain?” The therapist will encourage the children to close their eyes and think about what sounds, images and ideas they hear, see and feel. The therapist will ask the children “What do you feel like when you are stuck inside when it’s raining?”

The music therapist will explain that the group will have a referential improvisation based on the image of the rain. The children will use their instruments to express the images, feelings an ideas associated with the rain.

The music therapist will explain that just like the rain, the improvisation will begin quietly. Whoever feels ready to start can begin (if no one feels comfortable, the therapist will begin the improvisation). The other clients are invited to join in one by one when they feel ready. The therapist will explain that that the improvisation will work towards a buildup like when the rain builds up, and then see where the rain takes the group. The therapist will pose the question “Will we end with a rainstorm or will the rain slow back down to just small drops of rain?”

After the improvisation, the therapist will ask if the children can share a little bit about their experience. The music therapist will use questions to probe the children such as: “What did they see during the improvisation?” What did they notice in the group? What did they feel when they were playing?”


Children in pediatric oncology may struggle with numerous emotional issues, regressed development, difficult pain and other adverse side effects (Hilliard, 2006). Their world has been changed, and this affects their sense of control, their quality of life and their sense of “normalcy”. Helping children and families cope effectively with the many challenges that come along with the diagnosis and treatment of a life-threatening disease like cancer is a major challenge for health care professionals (Barrera et al., 2002, p. 379). In this intervention, the focus is on the child individually and helping them cope with their disease, treatment and the emotions associated with hospitalization.

Through music interventions such as improvisation, music can maintain the client’s connectedness with a “normal” part of their life, and a “normal” part of themselves as an individual (O’Callaghan, 2013, p. 137). The use of referential improvisation will be helpful for the age group, who may feel timid or frightened to improvise freely. With an image in mind, the improvisation will facilitate the exploration of emotions associated with the rain and being stuck inside, which relates to feelings of being stuck in the hospital. Improvisation may allow children a safe way to explore and express difficult emotions of their illness and hospitalization in a nonverbal way. Through the use of a group improvisation, children may feel supported by others who are experiencing similar feelings. The music therapist will also use a similar instrument to allow for a deeper connection and the facilitation of the match, grounding and mirroring, as this will be one of their first experiences with improvisation.


Did all children participate in the improvisation?

Did the use of referential improvisation encourage or limit emotional expression?

Did the improvisation lead to an open discussion?

Did children appear comfortable in the improvisation?

What types of reactions did the children have to the improvisation?

How could the music therapist build on this improvisation?


Barrera, M.E., Rykov, M.H. & Doyle, S.L. The effects of interactive therapy on hospitalized children with cancer: A Pilot Study. Psych-Oncology, 11, 379-388.

Hilliard, R.E. (2006). Music therapy in pediatric oncology: a review of the literature. Journal of the Society for Integrated Oncology, 4, 75-78.

O’Callaghan, Clare. (2013). Music’s relevance for children with cancer: Music therapists’ qualitative clinical data-mining research. Social Work in Health Care, 52(2), 125-143.


About Laurier MTSA

We are a student association at Wilfrid Laurier University and most of our members are students in the Music Therapy program. We exist to educate about, promote, and support the work of music therapy, and to support the academic, career, and personal needs of the Music Therapy Students. Our mandate is to unite prospective, current and alumni students while promoting our profession in the larger community.
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