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Exploring the power of play, voice, and connection through music

A small wooden figurine taps the surface of a gathering drum. A child is lost in the moment of play. He reaches to take the figurine’s out of the hands of his music therapist. She prompts him to say before handing them over to him, “May I have the person, please?” repeats the ask. In that moment, music therapy becomes more than a modality—it becomes connection.

How is music therapy progress tracked?
After every session, I write a case note—a snapshot of what happened—so I can track progress over time. I often use the SOAP note format, a concise and widely used method among therapists that highlights the most meaningful actions a client took toward their goals.

📝 What Is a SOAP Note?
A SOAP note is a structured method used by healthcare professionals to document client encounters. Here’s how I apply it in music therapy:

• S – Subjective: The client’s words, communication, and responses during the session (e.g., “May I have a turn?”).
• O – Objective: Observable and measurable behaviors witnessed by the therapist.
• A – Assessment: Interpretation of the client’s mood, emotional expression, and progress toward goals.
• P – Plan: Notes on the next session, any tasks between sessions, and reminders for future interventions.
  This format ensures clear, consistent, and comprehensive documentation across medical, therapeutic, and counseling settings.

🎶 A Session Snapshot
Recently, I found myself writing a more detailed note in the “Plan” section than usual. I was working with a 7-year-old diagnosed with Autism, who also presents with attention deficit and hyperactivity—though not formally diagnosed to my knowledge. (Music therapists do not diagnose clients; we work with individuals referred by diagnostic professionals.)
I’ve worked with this child for some time, and each week is different. His choices are guided by what interests him most in the therapy room. Because of his age, I follow a child-directed play approach, offering music-based activities such as drumming, piano playing, sing-reading books, and interactive folders.
To encourage focus, I set boundaries: if an item is chosen—a drum, a book, a folder, or the piano—it must have a beginning, middle, and end.

🧸 Music, Figurines, and Social Play
The week prior, he discovered a basket of small wooden figurines I rarely use. Both weeks, he engaged in lining them up and creating pretend scenarios. We added music to enhance the play and encourage back-and-forth interaction. One of his goals is to engage in three verbal exchanges during a music-based play activity.
Here’s the SOAP note from the second session (*name changed for privacy):

SOAP Note
Subjective
“May I have the person, please?” “I would like that person too, please.” “Thank you.”
Objective
Jim* and the music therapist (MT) engaged in child-directed play using wooden figurines and a floor gathering drum. When Jim attempted to pull the figures from the MT’s hands, he was prompted to ask appropriately. He complied and engaged in three verbal exchanges related to the play.
Assessment
Mood: Good. Focused on pretend play. Demonstrated goal-related behavior by making requests and engaging in three verbal exchanges.
Plan
Continue with a session in one week.

🌟 Extended Reflections I included in the note:
Jim directed the play, which fostered social communication and verbal requests. He began by setting up the toys on the floor, then pulled the bass gathering drum over and beside them. I played developmentally appropriate music over a speaker to encourage rhythm and non-verbal singing, using the figurines to “jump” on the drum to the beat.
At first, Jim said “Stop,” signaling that he wanted to lead the play. He then tried to take the figures from my hands, and I prompted him to make appropriate requests. He responded by handing me another figurine and saying, “This one is Ms. Carrie.” I used it to jump on the drum.
We transitioned to a 6/8 time beat with lyrics repeating “Up and Down and Around” as directional cues. Jim and I engaged in this song for two to three repetitions, using the figurines to move accordingly. He didn’t always mirror my actions—sometimes walking around the room—but he returned to the activity and mirrored motions two or three times before disengaging.
At the end of the session, I sang the Goodbye song. Jim took over, using playful, nonsensical vocalizations on the word “bye,” singing loudly enough for his mother to hear outside the door. This was a meaningful moment: he used his voice to be heard. Though he may have been testing boundaries, I didn’t admonish him. Instead, I reinforced his expressive play and vocalization by saying, “You have a beautiful singing voice!”

💬 Final Thoughts
In this moment, music therapy naturally created space for dramatic play and spontaneous conversation. Other developmental areas were also engaged—fine motor skills, imagination, and social-emotional growth—all within a safe, supportive environment.

Did this post inspire you? Take the next step and sign up for a FREE Consultation Session to find out more how Music Therapy can benefit you and/or your loved one!

Musically yours,

Ms. Carrie

Carrie Friddell, MT-BC, NMT

Owner and Music Therapist for In Harmony Music of Middle Tennessee

Tom* began individual music therapy teletherapy sessions this past December because he has had Parkinson’s Disease (PD) for 10 years and now his spouse says she can’t hear him speak and continually asks him to, “Speak Up!” I also knew Tom before the pandemic lockdown of 2020 as he attended an in person music therapy group for people with PD. After attending the in person singing sessions Tom realized the strong effect singing at least once a week, and going through specific research based vocal warm-ups, helped preserve and often allowed him to speak louder when in conversation with others. After a break in sessions due to the COVID-19 pandemic, he reached out to me to begin twice weekly teletherapy sessions to begin to increase his vocal volume once again. He often self reports, “This is really helping! My spouse doesn’t complain as often about my soft speaking voice. I also love singing the songs we sing together! I’ve even sung with my grandchildren!” (*Tom’s name and case details have been changed slightly for privacy)

On other occasions over the past few months, parents have reported that they could see their children physically relax when the music therapy session began over teletherapy. The pandemic has brought on a larger sense of anxiety in children and adults and these days, much of the goals of music therapy is to provide a sense of safety, familiarity, and support.

Music can bring out our “superpowers”. There is a relationship one has with the music that helps meet an individual goal, such as to increase feelings of wellbeing, to relax, to speak up, and increase confidence.  Perhaps someone mentioned the practice of music therapy to you, or you saw a post on social media spotlighting the benefits of music therapy.  Music Therapy has increasingly gained more attention in the 15 years I have been in practice.  Alternative health care practices as a whole has increased as a way to often complement and enhance traditional health care practices.  Music therapy does not replaces doctor’s visits, other important prescriptive therapies, but it can complement other other therapies as well as stand on it’s own as an effective therapeutic intervention. 

Once, I was talking to someone I met at the park while with my kids and I told her I was a music therapist.  She wanted to know more about music therapy which sparked a conversation with her.  This kind of conversation is not uncommon for me.  At this particular instance, one of my kids remarked, “Mommy, you can talk about your job any where!”  Yes, I can.  Yes. I can. 

The common definition for Music Therapy is that it is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.  Music therapy is often individualized to individual needs and musical preferences. 

A good website to find out more and gain much of the same information is the website for the American Music Therapy Associaiton www.musictherapy.org there is a great slide show on the home page that gives a great overview of music therapy.  I encourage you to check it out. 

What does music therapy look like at In Harmony Music Therapy of Middle Tennessee? I serve a variety of ages with a variety of needs through music therapy services.  Here is the break down of my current work:

Ages 0-6: Music Together within Therapy curriculum includes a songbook and a CD of songs that are used within a developmental model of growth.  Music Therapy techniques help address global developmental delays, including social, communication, movement, social-emotional, health challenges, as well as developmental and intellectual disabilities.    This family centered music therapy helps foster bonding and communication between parent and child in an enjoyable and engaging activity. Diagnosis includes but not limited to developmental delays, premature birth, cancer, challenging behaviors, Cerebral Palsy, Down Syndrome, Autism Spectrum Disorder (ASD), Rhett Syndrome, Angelman Syndrome

Ages 7-21 Both individual and seasonal group sessions are offered for kids and youth with continued delays, diagnosis, and physical and/or cognitive impairment can continue to benefit from social interaction, social-emotional well being, and learning communication skills.  Music pared with movement engages kids and youth with varied abilities. This includes both verbal and nonverbal communicators which can increase confidence in a growth mindset of personal agency.  Therapy helps build skills and self-confidence in a fun interactive music making setting.  It can also work on relaxation and coping strategies to calm and regulate the nervous system and help increase focus. Diagnosis includes but not limited to developmental delays, cancer or other health challenges, trauma, challenging behavior, Cerebral Palsy, Down Syndrome, Autism Spectrum Disorder (ASD), Rhett Syndrome, Angelman Syndrome

Adults with Intellectual and Developmental Disabilities.  Currently, individual music therapy is offered for adults with cognitive impairments but wish to engage in active music making and setting goals for themselves such as to improve self-confidence, learn a leisure skill, and process more complex feelings and emotions as adults.  Through music therapy services, they can learn to sing songs, play piano, or use rhythm instruments for musical and self expression.

 
Adults with Parkinson’s Disease.  Music and active music making through singing and rhythmic movement is utilized to help strengthen, preserve and slow the progression of loss of voice volume, teach supported breathing, encourage physical movement and to help lift feelings of apathy and depression. I offer both individual and group sessions.

Memory Care for Dementia diagnosis. Music therapy can help support adults diagnosed with dementia to enhance memory recall which contributes to reminiscence and satisfaction with life. Music making, especially to a person’s preferred musical preferences of favorite songs can cause positive changes in mood and emotional states associated with memory loss. I also offer both individual and group sessions.

Do you know someone who might benefit from one of these music therapy services offered through In Harmony Music Therapy of Middle Tennessee? I LOVE and appreciate word of mouth referrals! I encourage you to tell your friend and/or loved one about music therapy today. Please do me a favor and share this post with someone you love. I offer a free 30 minute consultation either over Zoom, over the phone, or scheduled in person. Click the button below to find out more and get started.

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All the best, Ms. Carrie