Communication: Functional, cognitive and emotional difficulties in verbalising thoughts, intentions and feelings, or the use of words might be used as a well-established defence. Music can provide a non/pre-verbal means of communication.
Relationship: Difficulties in self-other awareness and may struggle to manage relational proximity where the experience of the ‘other’ is too intimate, direct or distant. The music can provide a relational buffer between the patient and therapist, another space in which interactions, thoughts and feelings can be worked with more flexibly.
Social Skills: Struggles to listen, share and negotiate with others. Musical shapes and structures can help motivate and organise social interaction
Emotional Regulation: Dis-regulation in affect and impulsivity due to difficulties in mentalising and/or sensory needs, which may also be exacerbated by interactions with others or when forming an attachment. Music is primarily a sensory experience and the affect attunement that can take place within clinical improvisation can accommodate a wide range of intense feeling states.