“Listening to the Unheard: Finding a Way to the Child with Musicality” How do Child and Adolescent Psychotherapists Understand Children’s Unconscious Communications Through Music?

Free association is a fundamental method in psychoanalysis. In the context of child psychotherapy, the play and drawings of children and young people serve as ways of expressing their unconscious emotions and thoughts. Notably, Waddell (2019) argues that music shares characteristics with role-play and dreams, which are integral to free association; yet, it has not received commensurate attention from child psychotherapists. This qualitative research endeavour aims to explore child and adolescent psychotherapists' understanding of children's unconscious communications through music in psychotherapy sessions. The term "music" encompasses a range of activities, including children's improvisations, singing, rapping, beatboxing, tapping, and drumming, collectively referred to as "musicality." Furthermore, a secondary objective of this study is to investigate the usefulness of music in working with traumatised children. The research employs Constructivist Grounded Theory as its methodology. Data collection is based on semi-structured interviews with five qualified child and adolescent psychotherapists. The study’s findings reveal a lack of clarity regarding what is considered music by CAPTs in psychotherapy sessions; the majority of young people they describe used music during the ending phase of therapy, and music is not only used in positive ways but can also be used as a defence. The detailed interviews with the participants demonstrate that the unique properties of music foster young people’s engagement in therapy, allowing patients to re-work their internal conflicts and supporting children’s meaning-making to conceptualise their experiences, which might not be possible without musicality. The conclusions and recommendations highlight a notable gap in the current literature and child psychotherapy training, emphasising the potential contribution that a focus on musicality can make to helping children who might be traumatised or who experience other barriers in therapy, such as neurodivergence, as their voices may go unheard.