Blending Music and Talk for Therapy With Kids and Teens

Source: Courtesy of Dan Schteingart / Used With Permission

Music Therapy for Young People

Children and teens have not yet fully developed the skills needed to identify, understand, and cope with stressors. As a result, they may experience unease, emotional distress, or a diminished sense of well-being without understanding why. Feelings of loss, anxiety, or sadness may be present- sometimes tied to specific experiences, but often vague or difficult to articulate.

For young people, music therapy can be an especially effective form of treatment. Music therapy—an evidence-based treatment provided by trained and licensed music therapists—is used in a variety of settings, including hospitals, schools, mental health facilities, and private practice, and can be offered in individual or group therapy sessions, either in-person or via telehealth. The goals of music therapy include healing, communication, emotional expression, psychological growth, stress reduction, and increased self-esteem.

Music plays a central role in youth culture, and as adolescents in particular may be reluctant to engage in traditional talk therapy; music therapy can seem to them more acceptable and less intimidating. Through music, young people can express and then better understand emotions such as anger, sadness, or fear—feelings that might otherwise be suppressed or expressed in unhealthy ways.

Specialized approaches of music therapy are also used in young people with special needs. For example, for children with autism or speech delays, music therapy offers an alternative pathway for communication. Structured musical activities can improve attention, support social engagement, and strengthen communication skills. Singing, for example, provides opportunities to practice language use and social interaction within a supportive therapeutic relationship.

What Is a Music Therapy Session Like?

Music therapy encompasses a wide range of approaches, techniques, and interventions. A qualified music therapist can best explain and demonstrate these methods. Dan Schteingart, a board-certified music therapist and licensed creative arts therapist, provides explanations and clinical examples here. (These credentials are important indicators of proper training and accreditation.) With over a decade of experience in educational and medical settings, he currently works within the New York City mental health system and in private practice.

“No two sessions are ever the same,” he notes. Each session is shaped by the individual’s therapeutic needs, treatment goals, and moment-to-moment emotional state. Music therapy sessions are interactive, and—as with all forms of psychotherapy—the therapeutic relationship and rapport between therapist and client are essential components of the healing process.

Sessions may begin with music or talk therapy. Musical interventions can include drumming, singing, playing instruments, songwriting, or listening to familiar music. Instruments such as drums, guitars, xylophones, shakers, and piano are commonly used, and no musical ability is necessary. Encouragement for nonverbal self-expression, as well as accompaniment by the therapist, is given. This collaborative process—a journey together, he notes—strengthens the therapeutic alliance and often leads naturally into discussion and verbal processing aligned with the goals of the session.

Schteingart frequently incorporates mindfulness, meditation, progressive muscle relaxation, and coping skills into sessions. A young person is guided through visualization and positive imagery while the therapist provides musical support using gentle guitar accompaniment and verbal prompts. They are also taught to use these relaxation and breathing techniques independently, allowing them to access these skills whenever needed.

Songwriting as a Therapeutic Tool

Songwriting is an especially effective technique in music therapy. “Writing lyrics helps people identify, express, and understand their thoughts and feelings,” says Schteingart. “There is often less resistance to exposing and sharing troubling feelings. Once vague emotions become clearer when put into words. It may seem indirect, but it’s actually more direct,” he says.

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Writing lyrics can provide immediate opportunities for deeper exploration. The therapist might ask questions such as: What are these words saying? Why do you think this came up just now? Who in your life is connected to these feelings?

From there, the focus can shift toward coping and growth: How might you experience these feelings with less intensity? What strengths or positive themes appear in your lyrics? How can you bring more of that into your life?

Using the melody of a familiar song or collaborating with the therapist to create something new, lyrics and music come together. This creative process itself fosters agency, confidence, and increased self-esteem.

Music Therapy in Groups

Group settings are particularly well-suited for music therapy. Young people are often more receptive to therapy when it is offered in age-specific groups.

Listening to music together allows participants to share emotional reactions in a supportive environment, fostering self-expression, empathy, and mutual understanding. Group music-making—through singing, composing, or improvisation—encourages collaboration and social connection, and reduces feelings of isolation.

Throughout the session, the therapist facilitates discussion, supports insight, and guides interaction. Importantly, group members themselves often become sources of support for one another. In this way, each participant can function as a “co-therapist,” offering feedback and encouragement. This opportunity to positively affect others is rare for many young people and can significantly enhance self-esteem.

Examples of Healing Through Music Therapy

Here are clinical vignettes provided by Schteingart.

“Rachel” was experiencing deep depression following a major personal setback. She felt trapped in rigid patterns of obsessive behavior and disordered eating and struggled to break free from them.

During a group music therapy session, the therapist introduced a short musical phrase on guitar, repeated steadily with a metronomic beat. Group members were invited to choose instruments and contribute their own musical ideas. Rachel sat at the piano and began playing the opening notes of Für Elise, a piece she had once studied. She repeated the phrase again and again, and then again.

Schteingart responded by improvising on guitar—first harmonizing with her melody, then introducing variations. Other group members joined on xylophones and drums. Gradually, supported by the musical structure and encouragement of both therapist and peers, Rachel began to improvise, moving beyond repetition and creating something new.

When the group reflected afterwards, someone suggested naming the shared musical experience Recess—a fitting title that captured the sense of freedom and play Rachel experienced as she broke out of rigidity.

“Emma” described herself as feeling depressed and numb. During a songwriting session, she wrote the following lyrics:

Do I matter?

Yes or no

If I give up

Will anyone know?

It hurts too much

To be alone

Better to be unknown

Leave me alone

As the lyrics were explored, Emma reflected, "For the last couple of years, I’ve had no friends. That’s the root of it—not wanting to be alone."

Schteingart gently highlighted a contradiction in her words: “You wrote, It hurts to be alone, but also, leave me alone. What do you think that’s about?” Emma responded, “Sometimes I feel overwhelmed by other people’s problems.” This insight led to a discussion about developing coping skills that allowed for connection without emotional overload—alternatives to isolating herself that could better meet her needs.

In these ways, music therapy offers children and teens opportunities to express emotions safely, develop self-understanding, build social and communication skills, and acquire practical coping tools that support ongoing emotional growth and mental health. Through creativity, connection, and structure, music becomes both a language and a pathway toward healing.