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IT鈥橲 1944 in a veterans鈥� hospital in Nowheresville, USA. After losing half his comrades in a raid while fighting in Europe, private John Doe is so badly traumatised that he cannot speak. A musician arrives to entertain the vets. Private Doe starts to cry, his first response to anything in months. As the musician leaves, a nurse jokes: 鈥淧erhaps we should hire you 鈥� you seem to be doing as much good as us.鈥� Meanwhile, inspired by such insights, Michigan State University is at work on the world鈥檚 first music therapy degree programme.

Of course, music therapy has a much longer and broader history than traumatised vets and a degree course. The idea has been with us for a couple of thousand years, but many people still class it as a Cinderella discipline. It has, however, achieved government recognition through the Health Professions Council of the UK and other parallel bodies worldwide, though it remains underfunded. One of the leading groups in the UK is the Nordoff-Robbins Music Therapy Centre, a nationwide charity based in north London and mainly paid for by the music industry.

What exactly is music therapy? It is based on the idea that responding to music is an innate human capacity, unimpaired by injury, handicap or trauma. Therapists 鈥� though not clients 鈥� must have high-level improvising skills. Their work is to match their music to the needs of their clients. This initial matching or imitation is the bridge between client and therapist. Once this vital communication is established, therapy can begin. Nordoff-Robbins treats more than 700 children and adults nationally each week. Clients choose an instrument to play, from maracas and drums to pianos. Initially, therapists focus on musical elements such as tempo or volume that match a client鈥檚 way of playing or just of 鈥渂eing in the room鈥�. Clients can be anybody: a child with delayed development, a stroke victim, someone with Parkinson鈥檚 or Alzheimer鈥檚 or a stressed-out executive. Music is improvised for each client in the hope that these joint musical excursions will expand their musical experience and expression.

So does it work? Music therapists are convinced: they have seen the small and painful improvements in behaviour, concentration and movement, even occasional 鈥渕iracles鈥� when someone regains speech. But can they prove it? Hundreds of strands of research have embraced everything from the relationship between music and emotion to musical hot spots in the brain, biochemical markers of music-making鈥檚 effects, and the 鈥渕usic鈥� of the communication between mother and baby. But if you want to use science to prove the case for music therapy, you will have to wait a while.

IMPROVISING A BREAKTHROUGH

PENNY^* discovered two years ago that she was HIV-positive. She was devastated and retreated into herself, lost her friends and left her job. Her first session of music therapy exhausted the therapist. Penny鈥檚 inner chaos and depression tumbled out in crashing of drums and cymbals. The therapist tried to match this chaotic playing on the piano. Then he worked with her on alternatives to her thunderous playing.

Penny鈥檚 music gradually became quieter and more structured. She was more 鈥渆ngaged鈥�. By the end of her therapy, Penny was working as a volunteer helping other people with HIV. She was also enjoying a far broader range of music than her previous staple 鈥� loud rock 鈥榥鈥� roll.

BEN^* is 5 years old and has an autistic disorder. He is a dreamy loner, frightened and angry when he feels under pressure or cannot understand. He doesn鈥檛 like eye contact, and rarely speaks. He was nervous when he began his therapy, running up and down the room. The therapist played the piano in a way that echoed his restlessness, but also created a safe atmosphere. Ben began to move towards the instruments placed in the room. He played for a few seconds and ran off. In his third session, he played a little longer. The therapist鈥檚 music followed Ben鈥檚 patterns of excitement, music-making and flight. Towards the end of that session. Ben stayed at one instrument for a whole 10 minutes as the music 鈥渉eld鈥� him, helping him contain his anxiety about contact with another person. The music slowed down: soon Ben was playing more and more, until the music finished and a long silence fell. Ben looked directly at the therapist, surprise and pleasure on his face. He broke the silence with a sigh. The therapy had begun.

SUSAN^* was 34 when she suffered a major stroke. Brain damage deprived her of speech. She was left with a tiny bit of movement in her left arm. Staff at her residential centre felt there was someone 鈥渋n there鈥� to work with, so she was referred for music therapy. Getting a response was difficult. The therapist played all the instruments in the room in turn without any perceptible reaction. He talked to Susan鈥檚 family and found out that she loved to sing. When he played one of her favourite songs 鈥� Angels by Robbie Williams 鈥� he noticed that Susan was more attentive. One day her lips moved: she was mouthing the words and 鈥渟inging鈥� again.