Including the Excluded

Music therapy with adolescents with social, emotional

and behavioural difficulties

Steve Cobbett

Abstract

This paper describes the use of music therapy in supporting adolescents from a deprived, inner-city
background with social, emotional and behavioural difficulties (SEBD) and draws on the author's work
with adolescents in SEBD schools and pupil referral units (PRUs). The complex needs of this client group
are outlined in terms of social, cultural, developmental and organic factors. The difficulties they face in
accessing traditional National Health Service-based psychotherapy are described and ways of providing a
more inclusive therapy service are suggested including the use of music therapy, providing therapy in
schools rather than in mental health clinics and thinking about the nature of the therapeutic relationship
being offered. The need to ensure that music therapy practice adapts to the cultural needs of such clients
is also explored with a focus on the use of music technology and rap. A case study is used to illustrate the
approach used by the author.

Keywords: adolescents, music therapy, grime, exclusion, social, emotional, behavioural

Background (Croll 2002) and exclusion from school (OFSTED

1996). There are also high incidences of other
The young people that are referred to SEBD schools factors linked to the stresses of experiencing social
and PRUs have usually been excluded from deprivation: criminal involvement, living in care and
mainstream school either because their behaviour experiences of abuse or domestic violence (Berridge
was continuously unmanageable within a et at 2001). In addition there are other issues such as
mainstream setting or because of a serious isolated parents with mental health difficulties, addictions or
incident (e.g. an assault on a member of staff). offending histories, absent fathers and migration.
However, there are also many pupils with SEBD Many excluded pupils are looked-after children and
(either with or without a formal statement of special have experienced passing through several foster
educational needs) who are educated in mainstream placements and children's homes. All of these
schools. factors impact on the children's experience of
attachment to caregivers and most have not
There is a high correlation between social experienced the kind of consistent, nurturing and
deprivation and both under-achievement at school responsive attachments that are necessary for their

Including the Excluded: Music Therapy with Adolescents 15

 social and emotional development (Geddes 2006). 1990). In addition, adolescents with SEBD often lead
Most excluded pupils are boys: 83% in 2000/2001 chaotic lives and may be unable to organise
(Department for Education and Skills 2002). There themselves sufficiently to attend clinic-based
appears to be a lack of research on the reasons for appointments. Their parents are often struggling
this but there is research evidence for various with their own difficulties and may also be unable to
differences between boys and girls that may be bring their children to appointments (Camilleri
behind the figures. These include hormonal 2007). Other difficulties include young people acting
differences (Susman et at 1987), differences in out and not being able to manage session
responses to trauma (Dulmus et at 2004, Kitzmann boundaries.
et at 2003) and differences in how boys and girls
communicate aggression (Moretti et at 2001). There Locating therapy in school may offer several
may also be differences in the cultural expectations advantages. Pettitt (2003) highlights the reduced
of boys and girls; for example, Kane (2006) suggests sense of stigma felt by both young people and
that there are particular cultural pressures on parents, the sense of safety created by a familiar
working-class boys to establish their male identities environment and improved communication
that encourage them to act confrontationally at between professionals as advantages of providing
school. There is also an ethnic bias with black pupils therapeutic services in schools. It also makes it more
being more likely to be excluded than white pupils likely that young people will actually attend their
and there is evidence that this may be partly due to sessions as they do not have to make a special
racist attitudes rather than simply reflecting ethnic journey to a clinic.
socio-economic inequalities (Department for
Education and Skills 2006). Evans (2006) also In terms of the nature of the therapy offered, I
questions a bias towards middle-class values in would argue that music therapy (along with other
schools that alienates working-class pupils and arts therapies) has real potential with these clients.
contributes to behavioural difficulties. Music therapy offers them a safe way of expressing
and processing difficult experiences without
Thus, there are a number of interrelated factors necessarily having to rely on words which may feel
associated with excluded pupils and pupils with too intrusive in their specificity and / or may not
SEBD. An underlying pattern of social deprivation, capture the quality of their experience. Joint musical
experience of trauma, cultural issues, organic and improvisation also mimics those infant-caregiver
psychological conditions and attachment difficulties interactions involved in a secure responsive
may all contribute to their complex needs and this attachment (Trevarthen 2005) and these young
needs to be borne in mind when providing people need reparative attachment experiences in
interventions which are intended to support them. order to develop socially and emotionally
(Batmanghelidjh 2009). Music plays an important
role in adolescents' identity formation (North 1999)
The potential for school-based music therapy and culture (Epstein 1994) and the musical element
of music therapy may help motivate them to
Adolescents with SEBD face a number of obstacles engage in their therapy (Gold et at 2004). In
that make it difficult for them to access addition, music therapy can offer adolescents
psychotherapeutic support through Child and physical forms of release that can help them stay
Adolescent Mental Health Services (CAMHS). Massie within session boundaries and cope with attention
(2008) cites the difficulties associated with having to or hyperactivity difficulties.
attend a mental health clinic and services that do
not match the cultural needs of young people as A number of authors describe music therapy being
key reasons why CAMHS often fail to engage young successfully used with adolescents whose need
people generally: I would suggest that these reasons might be said to be primarily of an SEBD nature
are particularly acute for young people with SEBD. including McIntryre (2007), Tervo (2001), Derrington
Part of the problem is that verbal psychotherapy is (2005), Baker & Jones (2006), De Backer (1993),
generally the only therapy on offer and adolescents Mark (1988), Aigen (1997), Haines (1989) and Flower
are often resistant to this (Berkovitz 1995; Frisch (1993). These authors have reported benefits to

16 British Journal of Music Therapy Volume 23 • No 2 • 2009

clients in terms of socialisation, self-esteem and have no choice but to practise in a culturally-
emotional well-being, emotional expression and sensitive way. Adolescents bring many different
behavioural targets. It is also worth citing the recent cultural aspects to the therapeutic relationship that
meta-analysis by Gold et at (2004) which concludes need to be thought about, both in terms of the
that music therapy clearly leads to positive music-making and also in terms of general relating
outcomes with children and adolescents with and verbal communication.
"psychopathology".
A significant cultural element that might be
Procter (2006) argues the case for music therapy overlooked is the culture of adolescence. Geldard
provision in schools, highlighting the benefits for and Geldard (2004) talk of the need to understand
pupil's educational achievement, the contribution to adolescent forms of communication and to try to
staff's understanding of pupils, supporting school enter that linguistic culture in order to help them
relationships in general and contributing to the engage in a therapeutic process. This includes the
requirements of the Every Child Matters agenda. My selective use of self-disclosure, positive connotation,
clinical work (and the clinical work of other arts being direct about opinions and matching and
therapists practising at my workplaces) has been exaggerating the client's emotional expressions
evaluated using Strengths and Difficulties when s/he is story-telling. I have found this
Questionnaires (Goodman 1997) and has shown approach to be effective with adolescents but,
clear progress for the young people in terms of their having been initially trained in psychodynamic
level of SEBD. I have not included this data due to music therapy, I have had to re-evaluate my
the absence of a reliable control group but there is theoretical stance as a result. Although I still find
clearly a need for more quantitative research on the psychodynamic concepts invaluable in terms of
effects of music therapy with this client group. In understanding what is happening in sessions, I have
terms of engagement, 80% of referrals for music found that it is more helpful to my clients if I
therapy have managed to attend more than 10 present myself to them in person-centred (Rogers
sessions at my current workplace (over a period of 3 1967) terms. Rogers described the need for the
years) and most of that 80% have actually managed therapist to be genuine, warm, and honest and to
many more sessions than 10. I have found it display a congruence between the therapist's inner
impossible to obtain figures for engagement of thoughts and feelings and what is expressed to the
SEBD adolescents with CAMHS psychotherapy in my client. I have found that adolescents respect this
local area but my observations of children being genuineness and that this allows them to develop a
referred to CAMHS and the testimonials of school sense of trust and to engage in the risky business of
staff and pupils themselves suggests that the exploring difficult experiences and experimenting
engagement rate for school-based music therapy is with new behaviours.
much higher. Again, there needs to be more
quantitative research into this. Class, gender and racial differences between
therapist and client are also important. Concepts
commonly used in systemic therapy but applicable
Ensuring that music therapy meets the clients' to all forms of therapy can be useful here. Burnham
needs and Harris (1996) describe how curiosity can be
helpful in exploring these issues sensitively and how
Although music therapy may have much potential risking being clumsy is important and being open
with these clients, it needs to be presented in a way about this with clients. McCarthy (2001) describes
that avoids replicating the barriers that can prevent how the experience of therapy is mutually created in
them accessing CAMHS psychotherapy. Much of relationship and through the shared language used
what needs to be adapted can be thought of in (and I would extend this to the musical language in
cultural terms. The cultural aspect of music therapy music therapy). Jones (1993) warns of the potential
has received much attention recently, particularly abuse of power by therapists from the dominant
with the growing influence of community music culture and the benefits of deconstructing dominant
therapy. Stige (2002) describes how music therapy is narratives prevalent in society with clients. For me as
culturally constructed and how music therapists a male, white and (in financial terms at least)

Including the Excluded: Music Therapy with Adolescents 17

 middle-class therapist, this has meant keeping in clumsy in our musical offerings in a context of
mind what I may represent to my clients and respect for the client's greater knowledge of their
sometimes acknowledging and exploring the issue culture can help bridge cultural gaps and construct
openly with them. an experience of therapy for the client that is
empowering.
As a music therapist, it is also important for me to
consider the musical culture of my clients, which I When I started working with this client group, I felt
feel is influenced by a number of factors including that it would be important to use music technology
class, gender, ethnic origin and the environment in in order that they could create music using the
which they live. The young people I work with listen musical forms and sounds that they were familiar
primarily to electronic dance and rap music. The with. The equipment I use is based around a
most popular genre (certainly with boys) in recent computer with three kinds of music software: music
years has been grime - a form of rap that emerged composition software (Cubase), sequencing
from the estates of East London at the beginning of software (FL Studio) and sample-based OJ software
the decade. Very much a music of its environment, (Ableton Live). A USB music keyboard is connected
the grime culture has been about empowerment to the computer and can be used either as an
and giving a voice to the voiceless (Wheatley 2010). instrument in its own right (triggering digital sounds
MCs "spit" their aggressive, confident lyrics over in the computer) or to input note information into
harsh electronic beats that were initially created on Cubase. I also supplement traditional acoustic
PlayStations and the music spread by word of instruments with electric guitar, electric bass, a full
mouth, assisted by pirate radio stations. MCs drum-kit and a microphone. The technology helps
perform at "clashes" where rivals spar with each the clients access music therapy in a number of
other using lyrical dexterity as their weapon and ways and also opens up various therapeutic
distribute homemade OVOs of their performances possibilities that would not otherwise be possible:
to promote themselves (Frere-Jones 2005).
Teenagers download the music for free from file- Computer composition allows them to create
sharing websites and transfer them to their mobiles the electronic beat-based music that they are
or mp3 players. It has been a very community- familiar with from their own musical culture.
based, democratic culture that has largely bypassed This has the dual effect of helping them build
big corporations (Campion 2004) and many an alliance with me because they feel that
disadvantaged young people identify with its values. their culture is being acknowledged and also
They also identify with the anger inherent in the making it easier to for them to find a musical
music and the defiant lyrics that both express a language with which they can express
refusal to be oppressed or disrespected and reflect themselves.
the violent realities of their lives. Most young people are confident using
computers - this reduces anxiety for clients
For adolescents with families who have ties to other with low self-esteem who are afraid of
countries, there is also the influence of that making mistakes or being ridiculed. In
country's musical heritage. I have found that this addition, they are often able to show me new
heritage is often important to my clients although it ways of using the computer. This allows them
is also often an area that feels very personal to them to experience an empowering way of relating
and takes a while to emerge. Expressing curiosity positively to an adult.
about the music and allowing the client to be the Music software is intuitive and with a little
expert is often effective but this can be aided by instruction is easy to grasp for most young
some awareness of different ethnic musical forms. In people. Music that is aesthetically satisfying
working with Sudanese refugee teenagers, Baker et can be quickly created thus opening up music
at (2004) noticed that incorporating elements of therapy to clients with little traditional
African musical forms into the therapist's playing musical technique.
helped their clients engage and fostered a greater The task-oriented nature of using computer
degree of communication between therapist and software can be a safer way of interacting
clients. As with verbal communication, risking being with the therapist for adolescents who may

18 British Journal of Music Therapy Volume 23 • No 2 • 2009

 find a completely non-directive / improvised feelings. I do however balance this with allowing the
approach too anxiety-provoking. possibility of alternative narratives to emerge and, in
• Music can be stored on the computer and time, encouraging the client to explore these
may be worked on over several sessions. This through their lyrics. Clients use rap in different ways:
is a useful way of working therapeutically with sometimes they "freestyle" (i.e, improvise lyrics) over
clients who are often impulsive and find it a beat. This can be useful therapeutically in that it
hard to plan over the next few hours, let becomes a form of free association that is aided by
alone weeks. It also allows the clients to make the combined meditative and energising effects of
choices which can be thought about in a powerful repetitive beats. Often, there are "Freudian
therapeutic context such as returning to old slips" in their improvised lyrics and unconscious!
ideas, changing a piece of music over time unexpressed elements emerge that it can be useful
and erasing material. to reflect on afterwards. Some young people like to
write lyrics in a prepared way in their sessions and
Although I still offer improvisation with instruments sometimes we do this as a joint venture which can
in sessions, and some young people do interact with again be useful, allowing me to help them think
me in this way, it has been helpful for my clients to about the issues involved. Usually there is a strong
have a range of musical options on offer that they element of performance, sometimes involving
can chose from. Often, a client will experiment with dancing, and this helps them to get in touch
improvisation once s/he has worked in a physically with the feelings they are expressing. This
technology-based way for a while and has reached a element of performance in front of me can also be
point of feeling safe enough to take that risk. For valuable in terms of developing their self-esteem in
other clients, improvisation seems safer and the that mastering their anxiety about it can be an
reverse is the case. achievable goal that we can celebrate together.

The use of rap is also a major element in sessions The approach used with my clients has necessitated
with these clients and again this has involved some a consideration of how I generally "do therapy" with
thinking around how to work therapeutically with them. Batmanghelidjh (2009) describes the informal
this medium. There is already a developing practice use of what she describes as "corridor therapy" by
of using rap therapeutically with inner-city youths in therapists working at the drop-in centre run by her
the USA pioneered by Elligan (2000, 2004) and charity Kids' Company. Therapy is practised in a way
Tyson (2002). Tyson argues that cultural sensitivity is that meets the needs of the young people and this
essential in engaging at-risk youth in therapy and often means re-examining traditional therapy
that the use of rap can facilitate this. Kobin and boundaries. Therapists of all persuasions still use
Tyson (2006) emphasise the usefulness of rap in many of the 'rules' developed by Freud who was
aiding the formation of a productive therapeutic working with a white! middle-class clientele with all
alliance! in particular through bridging cultural gaps sorts of cultural differences from 21st century clients
and helping to forge 'empathic connections'. This is (Sue and Sue, 2008). Some of those rules may be
especially useful with disadvantaged young people inappropriate when working with contemporary
where the therapist is from the dominant culture. working-class clients from different ethnic
Tillie Allen (2005) recognises that the use of rap in backgrounds. Pavlicevic and Ansdell (2004) make a
therapy may be understood as a response to similar case for an approach in music therapy that
traditional forms of therapy that are ineffective with challenges assumptions about what is 'right' or
high-risk clients because they were not developed 'proper' practice! for example recognising that
to meet the unique needs of such clients. The learning an instrument and composition may be
American model uses rap in a directive, cognitive- beneficial activities for our clients in music therapy.
behavioural based way but it is also possible to use This can also extend beyond how we make music
rap within a more client-led approach. For example, together. With one client for example, I agreed to
I might initially accept and work with the violence his request to help him fill out college application
and anti-social sentiments often expressed in their forms in a session. I knew this was a risky activity for
lyrics and acknowledge that these communications him and that he had been unable to engage with
may be valid expressions of their experiences and the school's careers officer. If he felt that he needed

Including the Excluded: Music Therapy with Adolescents 19

 my support in that way, and that music therapy was music therapy. He said he liked grime and rap and
a safe place for him to take the necessary risks, it that lyrics should be "about your life" but didn't
seemed unhelpful for me to question the think held be able to do a rap in front of me. He
'appropriateness' of such support. With another said it would also be good to have someone to talk
client, we spent several sessions playing football to if he got upset. We tried improvising on the
together before he felt safe enough to come into instruments but he found it difficult and laughed at
the music therapy room with me. Obviously, himself, saying he was "crap". I tried encouraging
boundaries are extremely important to people who him but he refused to continue. I suggested we had
have experienced traumas such as abuse and I am a go on the computer and directed him to make a
not advocating a cavalier approach. However, a beat on FL Studio which I felt would be the least
dogmatic application of rigid boundaries is also threatening option for him. He again ridiculed
unhelpful and many young people with SEBD will himself and needed a great deal of encouragement
simply not engage with us if we expect them to but managed to persevere and made a beat that he
conform to how we think music therapy should be was eventually happy with. I felt he had managed a
done. I agree with Stewart (2004) who argues that considerable amount in his first session: he had
boundaries are more meaningful if therapists and taken a few risks and allowed me to co-regulate his
clients collaborate in their creation rather than the anxiety with him. I was looking forward to the next
therapist imposing 'pre-ordained' boundaries session.
through adherence to therapeutic doctrine.
Over the next few sessions we continued to work on
the computer and spent a lot of time talking. I
Case Studyl continued to offer the possibility of improvising on
the instruments but he always refused and after a
Jake was white, working class and fifteen years old while I accepted that this was not an option he was
when I started working with him at a secondary interested in. Jake gradually became more confident
school for pupils with SEBD. He had had a difficult at composing his music and making creative
start in life: his mother was addicted to crack and decisions. He started adding melodic synthesizer
had significant mental health difficulties and Jake melodies to his beats and I was struck by the
was eventually taken into care because of neglect melancholic quality to his melodies and the 'soft
and abuse. He never knew his father and was strings' timbres that he preferred which contrasted
separated from his siblings when he was removed with the aggressive, fast-paced grime beats. I
from his mother. He had ended up at the school hesitated to verbalise my thoughts but then he
after having been excluded from a mainstream confirmed my impression by asking if there were
school and passing through a PRU. He was often any more "sad sounds" on the computer. I reflected
aggressive and violent, particularly towards adults, how the different sounds made me feel and
and was habitually verbally abusive. He also wondered if Jake was showing me his tough side
occasionally self-harmed by cutting his arms, and his soft side as well. He laughed and said he
smoked skunk cannabis and was involved in street was always tough and being soft got you nowhere.
crime. He had been referred to CAMHS for He also wanted me to teach him how to play piano
psychotherapy but had refused to engage. so, over the weeks, I taught him how to play Fur
Elise. He concentrated very hard on this and often
When I took Jake to the room for his first session, he became anxious and angry when he made mistakes
described himself as thick and the school as a and would swear and give up. As the weeks went by,
school for thick kids, instantly revealing his however, he became increasingly able to let me
interpretation of his exclusion from mainstream soothe his anxiety during those moments and used
school. We sat and chatted for a while and I asked my containment to help him persevere. Eventually
him some gentle questions about himself and what he mastered the tune and even managed to add
he liked to do. We discussed what we could do in some bass notes with his left hand, and his pride at
his accomplishment was really moving. He even
recorded himself so that he could play it to his mum
I Names have been changed to protect confidentiality. when he next saw her. After a six-week assessment

20 British Journal of Music Therapy Volume 23 • No 2 • 2009

period, he decided he wanted to continue with his Around this time, a major change occurred in Jake's
music therapy "because it helps me express myself". life: his elder sister, Laura, had moved to London
and was living in her own flat. They were spending
Jake became increasingly confident in his ability to substantial amounts of time together and Jake was
talk about emotional issues with me, albeit in short excited about being reunited with her after such a
bursts. He told me about his foster placements and long time. There were concerns in Jake's
how "they like me to start with and then it always professional network, however, about their
goes wrong". He hated his social workers because relationship which was extremely volatile and
they never listened to his complaints. He told me sometimes violent. Laura self-harmed and the
how he used to run away for days and then they'd school had concerns about groups of boys going to
listen to him. I reflected that he was very clever at her flat with Jake and drinking and taking drugs.
finding ways to make people listen. From time to Jake talked about his sister in his sessions and
time, I would gently bring up the option of making a expressed his anger at "posh people" trying to
rap as I felt that lyric-writing would be a useful and minimise his contact with her. We thought together
safe way for him to process some of the feelings he about his experience of middle-class professionals
had about his experiences. Eventually, we controlling his life and what that meant for him. I
transferred some instrumentals/ from the computer wondered aloud whether Jake perceived me as
to his mobile and he took them home with him to another "posh person" interfering in his life and we
inspire him to write some lyrics. A couple of weeks talked about this. I also explored with him how he
later, he shyly announced that he had some bars must be experiencing really strong feelings after not
(lyrics). He managed to perform them in front of me seeing Laura for a long time and how those feelings
to an instrumental backing track and was pleased might be hard to control. He found this hard to talk
with how his voice sounded through the about and I asked him if he might be able to
microphone, saying it was deeper than he had express some of those feelings in his lyrics. He said
thought. The lyrics were typical of the posturing it would be hard and I agreed it might. I suggested
gangsta rap lyrics that many of the boys I work with we listen to some artists he liked to get some
write and although there seemed to be an element inspiration. He played me some raps by OJ lronik
of artifice involved in the lyrics, I felt there was also which reflected on the struggles in his life. I
a connection to his experiences of violence, both in enthused about his choice of music, telling him that
his family and on the streets. Osofsky et al (1993) OJ lronik was really clever at finding ways to show
describe how children who have been exposed to people his feelings without hurting anyone. The
violence "act tough" in order to distance themselves next week, he wrote a rap in his session about his
from difficult emotions and "untrustworthy" people girlfriend expressing his love for her. I congratulated
and I felt Jake also used his aggression as a form of him on being able to show me his loving side and
protective armour. We explored his lyrics and he then wrote a violent gangsta rap, possibly
thought together about the pressures on the streets threatened by my perhaps over-enthusiastic
that forced young people to turn to violence and recognition of his capacity for affection. Later,
how hard that must be. He showed me a stab however, we managed to talk about the way that
wound on his hand that he had received in a street males are expected to behave and where these
fight a couple of days earlier and said that it stung. expectations come from. This was the start of a
After the session, we went to first aid and put a period of writing lyrics in his sessions which he
plaster on it. I felt this was a useful concrete would perform over instrumental backing beats. He
demonstration of my desire to think about his needs usually asked for my help in the lyric-writing and we
and also modelled a different kind of male evolved a way of working where I would suggest
behaviour from what he was used to. I was also, ideas if he became stuck. I would also usually playa
however, struck by the symbolism of how futile my djembe drum with the backing track to provide
attempts to help him seemed against the chaos of some additional musical containment. The content
his life. of the lyrics varied and included elements of anger,
love, violence, fear, hope, help and humour. One
day he came over to see me early, clearly agitated,
2 Instrumentals are instrumental versions of commercial raps / and said he needed to write a lyric. He showed me
songs with the vocal part removed.

Including the Excluded: Music Therapy with Adolescents 21

 marks on his wrist and said he'd cut himself after were continuing. Things came to a head when he
"losing it" with his sister. He proceeded to write a finally took an overdose at his sister's flat after an
lyric that powerfully expressed how his anger and argument and ended up in hospital. In the session
despair sometimes led him to self-harm and self- following the overdose, he was unable to talk about
medicate with drugs. He wrote the lyric in the form what had led up to the situation but managed to
of a conversation with a friend but I felt it was a write another lyric that expressed both some of his
metaphor for a conversation between different parts confusion and also some hopes for the future:
of himself:
When the pressure's building up inside your mind
Touch the love when there's no meaning Think about life cos you're not so blind
Jammin in your house with your wrists bleeding When you're confused in your mind, beat the hard times
Fix up Bruv cos I know how you're feeling Everyone gets stressed, everyone gets depressed
Why cut your wrists when you know you're squealing Think about where you're going in this life
Sit down Blood and take a pill You might wanna have kids, you might wanna have a wife
As I said you gotta think about your life
Talk to me Bruv cos I know how you feel
Life's too soon, don't wish your life away
Deep down in your heart you want to be killed
Cos if you wish it too soon you might pass away
When there's anger in your veins blood will be spilled
You must have dreams there's no need to betray
(extract) One more year - it's your birthday

In working with these themes, I attempted to strike The theme of hope continued with Jake showing me
a balance between allowing space for the "difficult pictures on a website of a motorbike he wanted to
stuff" while also allowing space for what Stewart buy. We thought about how he could get the
(2004) terms 'acts of transformation' - the way our money and he suggested a plan of charging staff at
co-created music could enable Jake to develop school to clean their cars. I asked him some
positive aspects of himself. I felt that both aspects questions about motorbikes, allowing him the
were equally as important for him. opportunity to be the "expert" and he responded
enthusiastically. The session ended in comical
Our relationship was also developing as he came to fashion with Jake teaching me how to ride a
trust me. He still had the need to project difficult motorbike with both of us miming the actions,
feelings into me on occasion and make me feel pretending our chairs were motorbikes and Jake
threatened, useless, angry etc. but there were many humorously expressing frustration at my
times when he also managed to hold onto those incompetence ("No! Look, the gears are here...!")
feelings. He became interested in me and my life
and asked questions about the music I liked, my That was six months ago and at the time of writing
family, my childhood. I spoke honestly but carefully this article, there have been no further overdose
about my own experiences with him and felt that attempts. In his last session before the summer
this genuineness in our relationship was something holidays, Jake created a rap about his early
that he required from me. He was interested in my childhood in which he revealed how his mother had
own transgressions from socially-accepted norms. been selling crack while he was in her care, how
For example, he asked me about my own scared he had been and how angry he was with her
experiences of taking drugs as a young adult and for letting him down. I felt privileged that he had
my honest replies helped him think in a balanced trusted me enough to share such personal
way about his own drug use. There was also a lot of experiences and I reflected with him how far he'd
humour in the sessions and I felt this was an come from thinking that he wouldn't be able to
important part of our work together and helped him perform a rap in front of me. The rap was delivered
to remain engaged. freestyle and Jake performed it with his eyes closed,
his body swaying in time to the beat, utterly lost in
Jake was starting to show improvements in his his music. I was struck by a sense of grace and was
ability to control his temper at school and his carer deeply moved by how he had drawn on such
and school staff noticed that he was more confident. traumatic experiences and used them to reach a
However, there were still major concerns about his state of genuine artistry. I feel a sense of hope for
relationship with his sister and his criminal activities Jake's future (maybe holding on to that has been

22 British Journal of Music Therapy Volume 23 • No 2 • 2009

part of my role) but I know that there are no quick construct a therapy experience together that was
fixes for young people like him and that it will be a perhaps different enough from other oppressive
long journey which will probably involve many steps and excluding narratives in his life to allow for the
backwards as well as steps forwards. possibility of change.

Discussion and Conclusions Steve Cobbett is a registered music therapist and systemic
practitioner working with children and adolescents with
A number of factors seemed to enable Jake to social, emotional and behavioural difficulties at a school in
engage in his therapy and to use it successfully in South London.
terms of expressing, processing and understanding
his feelings and experiences. Locating his therapy in
References
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24 British Journal of Music Therapy Volume 23 • No 2 • 2009