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From Community Music Therapy – edited by Mercedes Pavlicevic and Gary Ansdell

Josie arrives at music therapy at the suggestion of the computer class facilitator. She seems ill at ease and unwilling to play, so we talk about music instead: the solos she sang in church as a child, the pieces she learned in piano lessons and the music she enjoyed with friends as a teenager before her breakdown at college. I remark that her musical biography seems to stop with that breakdown. 'Yes,' she replies, 'there hasn't been much music  lately.'

Over the next few weeks we start playing together. At first she is dismissive of her own playing, as if whatever she does can have no value. And if I suggest otherwise, she is dismissive of me too, using the kind of formal, critical language used in music journalism to rubbish performances or recordings. It is as though the whole world of music, once a gateway to social interaction, has become her isolating oppression.

For a while, deterred by her reluctance to play and her continual trashing of our music, I am tempted to try to engage with her verbally rather than musically and find that I am spending almost half the session talking rather than playing.

But perhaps I am being drawn into her belief that music can only be a bad thing when what she needs is the experience of successful music-making with me, not my collusion in avoiding it. So I suggest to Josie that for the next ten sessions we just play, without necessarily talking about it. Then we can review our work to date. Seeming a little reluctant, she agrees.

Our music-making begins to develop. Our improvisations get longer.

Josie's playing seems to become less dependent on mine for its content and structure. After ten sessions, I ask Josie how she feels things are going. She says she enjoys coming 'in a weird sort of way', even though she considers herself a far from ideal candidate for music therapy.

We agree to continue. In all we work together in one-to-one sessions for nearly two years. As I listen back each week to the recordings of our sessions, I note the development of her spontaneity, her expressiveness, her sheer revelling in music-making. One day, after a lively and protracted improvisation in which both of us move freely between many instruments and she also sings, she spontaneously exclaims, 'wow that was amazing!’

This feels like a real change: Josie is beginning to be able to take pleasure in our music-making. This pleasure encourages greater freedom, which in turn leads to greater pleasure. The role of music in Josie's life, formerly a force for failure, seems to be changing and allowing her to be more fully herself. She is taking pleasure in being herself, and in being herself with me. Towards the end of our work, we talk about what she will do after-wards. I suggest joining a choir, but she is cautious about such an organised way of making music.

Then a few weeks later she arrives at the session, clearly very pleased with herself, and tells me that she has joined a theatre group where she will be able to sing and dance as well as try out acting forthe first time. A year later, she invites me to watch her in performance. 'l enjoy myself with other people,' she said. 'I'm not ashamed of myself anymore.'