In 2014, the music therapy journal Voices: A World Forum for Music Therapy published a special issue which focused on establishing a dialogue between music therapy and disability studies. This seminal publication brought together scholars and practitioners from a variety of different fields to debate “the role of a disability studies perspective within music therapy” and “the role of music therapy from a disability studies perspective” (Honisch, 2014, para. 1). Prior to this, the fields of disability studies and music therapy had taken up residence in largely separate camps. Straus (2011, pp. 157-158) perhaps best outlines the reasons for this when he explains:
Until the present moment, the music-making of people with disabilities (including people with physical, cognitive, or intellectual impairments or psychological disorders) has been largely confined to two intellectual ghettos. The first ghetto is that of “abnormal psychology” […]. Within musical scholarship, disabled listeners are relegated to a second intellectual ghetto: music therapy. According to the goal statement of the American Music Therapy Association, music therapy “is an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of children and adults with disabilities or illness”. In other words, music therapy is a normalizing [sic] enterprise, bound up with the medicalization [sic] and attempted remediation of disability. Of course, there is a long history stretching back to classical antiquity of accounts of the power of music to cure or disable. What’s new in the field of music therapy is the full impact of the medical model of disability: its practitioners are medical
professionals who offer therapy to patients and write up their findings in the form of case studies. They seek to cure, remediate, or normalize [sic] their patients, and music is their therapeutic tool.
For the non-disabled reader interested in music, education and disability but unfamiliar with disability studies, the positioning of music therapy and music psychology as “intellectual ghettos” may seem a little extreme. However, when viewing these research fields from a critical disability studies perspective, the meaning of Straus’ words
becomes clear.
The academic field of disability studies emerged in the latter decades of the twentieth century and is rooted in the activism of the disability rights movement
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disability as a social issue rather than simply a medical issue. As Mallett and Runswick Cole (2014) explain:
What unites most approaches within contemporary Disability Studies is the rejection of any model of disability that locates (the problem of) disability within the person […] Disability is instead seen as a social issue: (the problem of) disability is firmly positioned in terms of barriers in the social world, not
‘problems’ within the individual. The idea that disability should be understood as a sociological concept, rather than as a biological difficulty for tragic, isolated individuals, is key to understanding the discipline of Disability Studies in the United Kingdom. (p. 5, emphasis in original)
There are many models of disability that are used as heuristic devices to facilitate an alternative understanding of disability, most of which stem from the lived experiences of disabled people themselves. The two most commonly juxtaposed models when introducing newcomers to disability studies are the medical/individual models of disability and the social model of disability.
Mallett and Runswick Cole (2014) describe the medical model of disability as follows:
The medical model deems disability to be a functional limitation that is biologically or physiologically determined. The medical model emphasises individual pathology, individual (personal) deficit and individual medical treatment. (pp. 3-4)
Morris (1991) further explains that:
Within this model, disabled people are reduced to the medical condition which accounts for their physical and/or intellectual characteristics and there is little or no account taken of the social and economic context in which people experience such medical conditions (pp. 9-10).
The medical model is closely aligned with the individual model of disability (Oliver, 1990) which views disability as “a tragic problem for isolated, unfortunate individuals” (Mallett & Runswick Cole, 2014, p. 3). The individual model therefore sees disability primarily through the lens of what a person “cannot do or what is wrong with them” (Mallett & Runswick Cole, 2014, p. 3).
In contrast, the social model – developed by the Union of the Physically Impaired Against Segregation (UPIAS) in 1975 (Oliver, 1996) – draws a distinction
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between impairment and disability. Impairment is referred to as any neurological, sensory, intellectual, physical and/or psychological difference that deviates from a socially-constructed ‘norm’. Within the social model, impairment is not seen as the cause of disability. Instead, disability is caused by environmental, attitudinal and/or organisational barriers that prevent people with impairments from participating in society. A common illustration of this viewpoint is that “it is not the inability walk which disables someone but the steps into the building” (Morris, 1991, p. 10). L. Davis (2002, p. 41) further explains:
An impairment involves a loss or diminution of sight, hearing, mobility, mental ability, and so on. But an impairment only becomes a disability when the ambient society creates environments with barriers.
As such, whilst those approaching disability from a medical/individual model
perspective seek to change the individual to fit societal ‘norms’ – often referred to as a process of ‘remediation’ (Schalkwijk, 1994) or ‘normalisation’ (Straus, 2006) – those approaching disability from a social model perspective accept and value difference and seek instead to remove the social barriers that serve to disable people.
It is therefore unsurprising that, when viewed through a social model lens, music therapy becomes a problematic area of practice. Liz Crow (1992) illustrates the reasons for this in her acknowledgement that:
There is a joke amongst Disabled people that non-Disabled people listen to music, do the gardening, hold down jobs, but Disabled people do music therapy,
horticultural therapy, occupational therapy. Where Disabled people are involved, almost every activity of life seems to have to be justified in terms of its medical and therapeutic benefits. (p. 1)
The aim of the Voices special issue on music therapy and disability studies was
therefore to begin to openly and honestly discuss how music therapy might be reframed and reimagined through constructive dialogue with scholars from disability studies.
In her editorial introduction to the issue, Hadley (2014) explains that, as a non- disabled music therapist, the more she read and engaged with the ideas and activism of disabled scholars, activists and self-advocates, the more her identity as a therapist was called into question. She was forced to consider how her practice, however well-
intentioned, may reinforce the stigmatised view that disabled people are best served via the framing of disability as an individual deficit that is best overcome by bringing the
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person “closer to the ‘ruling norms’” (para. 9). Indeed, in his contribution to the same volume, Cameron (2014) cautions that music therapists may be doing more harm than good for disabled people. He outlines the history of 'the disability business' – which he describes as "a vast army of workers employed in rehabilitation industries to manage the lives of disabled people" (para. 17) – and argues that "[f]rom a disability studies perspective, the keenness of music therapists for acceptance, recognition and respect from the medical profession and its spin offs is intensely problematic" (para. 22). For Cameron, the alignment of music therapy with the medical profession perpetuates the stigmatised view that disabled people need to be fixed or cured in order to meet the 'normal' standards of living that enable their full participation in society. The impetus to change lies with the disabled person, not the therapist. Therefore, traditionally
oppressive power-imbalances between “the therapist as an expert with power, and the client as weak and pathological” (Rolvsjord, 2014, para. 4) are reconstructed within the therapeutic relationship.
Many critiques of music therapy from a disability studies perspective begin from the assumption that music therapy is inextricably linked to problematic
pathological paradigms of disability (Tsiris, 2013). However, as Rickson (2014) notes, not all approaches to music therapy are aligned with a medical model. Culture-Centred Music Therapy (Stige, 2002), Community Music Therapy (Ansdell, 2002, 2014; Pavlicevic & Ansdell, 2004; Stige & Aaro, 2012), Resource Oriented Music Therapy (Rolvsjord, 2010) and anti-oppressive music therapy (Baines, 2013) are all approaches that align with an affirmative model of disability which Rickson describes as follows:
[T]he affirmative model is about validating the lives and experiences of people with impairments and enabling them to make sense of themselves as actors in their own cultural worlds. (Rickson, 2014, para. 8)
In this way, there is potential to reimagine and redefine the practice of music therapy (as it relates to disability) in ways that cease to reinforce oppressive social and medical practices. This reimagining, however, comes with the difficult task of un-picking some of the fundamental assumptions inherent in medicalised music therapy practice. As Honisch (2014, para. 7) contends:
What if music therapists were to align with disability studies in receiving disabled people differently? Such a move requires engaging a different set of critical concerns, beginning not with medical or clinical diagnosis, but rather with
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reflexivity, digging at the methodological foundations of both scholarly research, and the philosophical assumptions of therapeutic practice.
These emerging conversations in music therapy and disability studies are important considerations when examining the place of music therapy in special
education. When taking into account the cautions and criticisms of those writing from a disability studies perspective, the most pertinent questions for researchers in music, disability and education is perhaps not ‘where do the boundaries lie between education and therapy?’ but rather, ‘what is music for in special education?’ and ‘where does music therapy fit?’