Estonia

Translated excerpts from:

THREE SIGNIFICANT STEPS IN THE DEVELOPMENT OF ESTONIAN MUSIC THERAPY
Eve Lukk MA, Marit Mõistlik MA, Alice Pehk MA

Full text available at: muusikateraapia.eu/muusikateraapia/muusikateraapia-eestis
Early 1980s – Mid 1990s:  During this time a group of health researchers and practitioners from the Pedagogical Laboratory of Tallinn Pedagogical University (TPU) gathered at the initiative of Pediatric Professor Saima Tamme, who had a serious interest in the therapeutic effect, meaning and experience of music. With his great enthusiasm and dedication, Saima Tamm invited visiting scientists and therapists in the field to teach from outside Estonia, and he became an ardent initiator and “importer” of the promotion of music therapy.
Since the beginning of the 1980s, Prof. Olav Skille from Norway regularly visited TPU. He introduced the possibilities of the vibroacoustic chair and taught how to make vibroacoustic beds. Prof. Petri Lehikoinen from Finland (Sibelius Academy) joined Skille and together they gave several lectures and seminars on music therapy and vibroacoustic therapy, as well as the Musical Behavior Scale (MUBS). At the same time, Prof. Tamm encouraged students and colleagues to conduct research. Among the first to show interest were psychologists Eha Rüütel, Reet Poom and Ingrid Ojaperv and psychiatrist Erika Saluveer. The effects of music therapy and vibroacoustic therapy in relieving clients’ anxiety and overexertion were mainly studied. In addition, the formal official birth of the Estonian professional music therapy was supported and encouraged by another significant event. Namely, in August 1990, an international seminar on music therapy was held at TPU within the framework of the 19th World Conference of the International Society of Music Education (ISME) in Helsinki. The ISME Committee for Music Therapy and Music in Special Education Education) Petri Lehikoinen and Saima Tamm contributed greatly to the organization of the 3rd research seminar “Music in Education, Therapy and Medicine” in Tallinn. ,
Olav Skille, Petri Lehikoinen and Tony Wigram (Great Britain, Denmark, Aalborg University) were the first key figures in Estonian music therapy to initiate and establish an association of interest with their inspiring introductory lectures and seminars. On December 15, 1990, 37 founding members founded the Estonian Music Therapy Association (EMTÜ). The aim of EMTÜ was to unite music therapy specialists and those interested, to create conditions for the development of music therapy in Estonia, to promote collegial relations, to organize training in music therapy, to disseminate information about music therapy, etc.
Since 1991, EMTÜ, in cooperation with the TPU Health Research Laboratory, has become the cornerstone of the development of music therapy in Estonia. At the same time, the continuous practice of the therapeutic use of music and the study of the psychophysiological effects of music in addition to vibroacoustic therapy also intensified (Tamm, Elenurm, Rüütel, 1992). Music and vibroacoustic therapy sessions were offered mainly to TPU students.
The political turn of independence and secession from the totalitarianism of the Soviet Union opened up many new opportunities for Estonians to expand their international ties in the field of music therapy. In 1991-1992, the first one-year in-service training in music therapy was conducted by Finnish lecturers and music therapists Heidi Ahonen-Eerikäinen, Kimmo Lehtonen, Eila-Sisko Wirzenius and Raisa Saloheimo. Representatives of the Tallinn Psychiatric Hospital (currently the Psychiatric Clinic of the North-Estonian Regional Hospital) also took part in it with great interest and support.

1995-2007: This period began with the resumption of the work of the Estonian Music Therapy Association. One of the goals of the new board was to expand international contacts by joining the European Confederation of Music Therapy in 1995 (Alice Pehk, representing Estonia) and the World Federation of Music Therapy in 1996.
The Board developed the ethical standards of EMTÜ and organized several trainings. One of the most important activities was the establishment of a traditional seminar “Arts for Health”, which was originally organized in cooperation with Tallinn Pedagogical University. Numerous possibilities for the application of various creative therapies in health promotion were discussed at the seminars, both lecturers of Estonian creative therapies and colleagues from abroad spoke as lecturers. During this period, the function of the Music Therapy Development and Research Center was at the TPU Health Research Laboratory. The laboratory worked closely with EMTÜ. Several empirical studies on the effects of music, music therapy and vibroacoustic therapy were conducted by Eha Rüütel (1995, 1996, 1997, 2002), Alice Pehki (1995, 1997), Neeme Kahusk (1997) and others.
In 1995, the first introductory course in Music Therapy started at the Tallinn University Open University, the developer and leader of the training program was Alice Pehk. The annual training provided basic knowledge of the effects of music and the techniques and methods of music therapy, as well as the application of their knowledge and skills in various areas of life outside the therapeutic context in both individual and group work. So far, 10 trainings have taken place. Since 2009, the training has taken place at the Continuing Education Center of the Estonian Academy of Music and Theater. In the autumn of 2010, a new in-service training group was opened.
Since 1995, the master’s degree students of music theory at the Faculty of Culture of the Tallinn University of Technology have been able to listen to the lecture series “Introduction to Music Therapy” as an elective, lecturer Alice Pehk.
From 1996 to 2006, it was possible to complete the additional specialty of Music Therapy at the Department of Psychology at Tallinn University. The leader of the training program was Alice Pehk. It was a 2-year program that provided basic knowledge of music therapy to TU full-time students as well as students from other universities. The program was built on the principles of European and world music therapy trainings, which provided a good basis for further studies in Estonia or abroad if desired. This training was the largest academic music therapy training program in the Baltic States at that time.
In 1996, the first works in Estonian on music therapy were published. Alice Pehk’s monograph “The Art of Muses Helps to Live: The Effects of Music and Its Therapeutic Applications” and the collection of articles “Music Creates an Opportunity… A Selection of Articles on the Therapeutic Use of Music” by Tiiu Arro, Sirje Rass, Ene Järvik, were published by Tallinn Pedagogical University Publishing House. Mölder, Alice Pehk (editor) and others.
In 1998-1999, in cooperation with the Royal Swedish Academy of Music and Tallinn Pedagogical University, a follow-up course to Music Therapy was held, in which 19 people who had previously completed the initial course in Music Therapy had the opportunity to participate. The aim of the course was to deepen the knowledge and skills of the participants in music therapy, focusing on the issues of identity and supervision of a music therapist, as well as to introduce the possibilities of scientific research in music therapy. The main trainers in the course were Ingrid Hammarlund, Petra Werner-Kjällberg, Sören Oscarsson, Dali Kask.
Between 1999 and 2003, it was possible to take part in a number of interesting music therapy trainings conducted by internationally recognized music therapy professionals: Clive Robbins (Nordoff-Robbins method), Gianluigi di Franco (vocal therapy), Joseph Moreno (music and drama therapy), Igor Reznikoff ).
In 2002-2007, the development of Estonian music therapy received strong support from the German patrons Prof Dr Hannelore Greve and Prof Helmut Greve. The project included two 2-year in-service music therapy training programs at Tallinn University, conducted by Hans-Helmut Decker-Voigt, Professor at the Institute of Music Therapy at the University of Music and Theater in Hamburg. 26 music therapists completed the training.
In 2002-2004, the same project carried out research on the possibilities of using music and vibroacoustic therapy with teenage girls. The research group included Eha Rüütel, Alice Pehk, Eve Lukk, Malle Luik, Anne Ojala, Marika Ratnik, Heli Zilensk and others (Rüütel, Ojala, Luik, & Lukk, 2003; Rüütel, Ratnik, Tamm, & Zilensk, 2004).

2007 marks the beginning of the third period in the history of Estonian music therapy.
In 2007, an international conference “Arts in Medical Medicine” was held in Estonia, organized by the Institute of Arts of Tallinn University and the Knowledge Transfer Center SPINNO, where doctors, therapists and researchers discussed creative therapies as opportunities for health promotion. Practitioners of music, art and clay therapy talked about their work in Estonia. In the same year, another important contact was established. Namely, the Paris-based NGO Musique & Santé (French for Music and Health), which promotes and develops the delivery of live music to hospitals and facilities for people with disabilities (Musique & Sante, 2010), has developed a pilot training program called “Music in Healthcare Settings” in the European Union. Within the framework of the Vinci program, in cooperation with the Royal Northern Colleage of Music (Manchester, United Kingdom), Music Network (Ireland) and Musical Academy of Cracow (Poland). Since 2007, several TU students have also participated in this training. The aim of the training is not directly related to music therapy (rather, bringing live music to hospitals); in the long run, music and its positivity will be introduced to patients in hospitals and health care facilities. For music therapists, this opens up job opportunities in health-related institutions.
In September 2007, TU hosted the 9th ECArTE (European Consortium for Arts Therapies Education) International Conference (European Arts, 2010). TU has been a member of ECArTE since 2005.
The third period in the history of music therapy is a constantly evolving and challenging process that takes into account changes and needs in society. The specialization of music therapists is evolving, changing and improving by integrating the possibilities of psychology and art therapies.

Summary
Estonian music therapy has a history of over 30 years. On December 15, 2010, the Estonian Music Therapy Association celebrated its 20th birthday.

Music Therapy in Estonia gained recognition through the following steps:

2011-2012: a working group on professional standards was created, with 7 people: 3 from the Music Therapy Association, 3 from the Creative Arts Therapies association., and one from the umbrella organization, the Estonian Qualification Authority. 

2015: The Estonian Qualification Authority officially recognised two levels of professional qualification in Music Therapy.

Professional Committees were created by the Music Therapy Association and Creative Arts Association and together, they developed the certification process.

2021: The qualification standards were revalidated.

The bachelor’s and master’s degree programs in art therapies were opened at Tallinn University in 2007, which also integrated specialization in music therapy. The curricula were developed by Eha Rüütel, PhD, head of the art therapy curriculum, in cooperation with performers in various fields of art therapy (incl. Music, visual arts, drama therapy and psychodrama, dance and movement therapy).
The art therapy curriculum is interdisciplinary in nature, combining subjects from the fields of health, arts, humanities and social sciences. The bachelor’s curriculum is based on the traditions of creativity research at TU and offers a variety of subjects that enable students to learn about creative thinking and creative self-expression in both theory and practice. Specialization in art therapies (music, visual arts, dance and movement, drama therapy and psychodrama) is flexible. Students have the opportunity to improve their knowledge in other fields of art and art therapies and to experiment with the synthesis of the arts and the integrated use of the arts for therapeutic purposes. The bachelor’s degree in art therapies is a three-year cycle study (180 ECTS). Level studies in art therapies create opportunities for acquiring skills in the therapeutic application of the arts and create preconditions for becoming a professionally mature therapist in the course of further self-improvement and practice. In order to achieve therapeutic skills, students have the opportunity to continue their studies at the master’s level. The art therapy curriculum is also interdisciplinary in nature, placing the field of specialization in a broader health and socio-cultural context. The orientation of the curriculum is creative therapy, application of creative activities and use of art for therapeutic purposes; as well as the principles of arts integration and trust in creative processes. This approach gives students the opportunity to integrate different arts and therapeutic approaches into their personal therapeutic style.
The master’s degree in art therapies is a two-year cycle study (120 ECTS). Master’s studies create prerequisites for professionals to acquire a qualification as a creative therapist. The conditions for professional qualifications for art therapists, as well as music therapists, and their application are being developed in cooperation with the Estonian Chamber of Professions. The professional standard for music therapists is equal to the international standard.

Music Therapy Training Program, postgraduate course, 3 years Estonian Academy of Music and Theatre
Contact person: Alice Pehk, PhD, alice.pehk@muusikateraapiakeskus.ee

Master’s Course in Arts Therapies, specialization in Music Therapy
Tallinn University
Contact person: Eha Rüütel, PhD, eha@tlu.ee

Luik, M. (2014).Music therapy in prison. Group music therapy program : developing emotional skills. Doctoral Thesis. Hochschule für Musik und Theater Hamburg. DIGAR electronic publication: http://digar.nlib.ee/digar/show/?id=197212.

Lukk, E. (2014). Personal Singing Revolution: The experience of individual vocal focused music therapy and significant vocal improvisations for late adolescents in transition. Phenomenological research study. Doctoral Thesis. Hochschule für Musik und Theater Hamburg. DIGAR electronic publication: http://www.ester.ee/record=b3090884~S1.

Lukk, E., Mõistlik, M., Pehk, A. (2011). Three significant steps in the development of music therapy in Estonia. In: Sabatella, P. (Ed.) Evidence for Music Therapy Practice, Research and Education. Selected reedings and Proceedings of the VIII European Music Therapy Congress, May 5-9, 2010, Cadiz, Spain. Granada: Grupo Editorial Universitario. Pp.495-500.

Mardi, R., Pehk, A., Rüütel, E., Vinkel, M. (1995). The Effect of Vibroacoustic Method in Treatment of Stress Related State of Psychosomatic Dyscomfort. In: Abstracts to the Seminar “Man, Environment and Health”, Otepää, Estonia, April 21–22. P. 27.

Metstak, M. (2014). Psühhiaatrilisel ravil viibivate noorukite esmase hindamise meetod muusikateraapias. Tegevusuuring. (The Method of Initial Assessment in Music Therapy for Adolescents in Psychiatric Treatment. Action Research.) Tallinn University. Unpublished Master’s Thesis.

Pehk, A. (2012). Searching for the unknown. Phenomenon-oriented study of music performance anxiety in boundaries of psychodynamic approach. Doctoral Thesis, Hochschule für Musik und Theater Hamburg. Electronic publication, digital archive DIGAR by National Library of Estonia: http://tallinn.ester.ee/record=b2871580~S1. 394 p.

Pehk, A. (2011). Psychodynamic approach to performance anxiety and possible interventions of music therapy. In: Sabatella, P. (Ed.) Evidence for Music Therapy Practice, Research and Education. Selected reedings and Proceedings of the VIII European Music Therapy Congress, May 5-9, 2010, Cadiz, Spain. Granada: Grupo Editorial Universitario. Pp. 227-234.

Pehk, A. (1997). Psychophysiological Influence of Music and Its Therapeutic Use. Unpublished Master’s Thesis.

Pehk, A. (1996–1997). Differences in Influence of Stimulative and Sedative Music Combined With Identical Low Frequency Sound. Tallinn Pedagogical University. Unpublished research.

Rüütel, E., Ratnik, M., Tamm., E., Zilensk, H. (2004). The Experience of Vibroacoustic Therapy in the Therapeutic Intervention of Adolescent Girls. Nordic Journal of Music Therapy, 2004, 13 (1), pp. 33–46.

Rüütel, E. (2002). The Psychophysiological Effects of Music and Vibroacoustic Stimulation. Nordic Journal of Music Therapy, 2002, 11 (1), pp. 16–26.

Rüütel, E. (1997). Psychophysiological Influence of Music and Vibroacoustic Stimulation. Unpublished Master’s Thesis.

BOOKS
Rüütel, E., Elenurm, T., Pehk, A., Tomberg, M., Visnapuu, P. (2001). Loomismäng. Muusika-, sõna-, liikumis-, kunsti- ja värviharjutusi rühmatööks. (Play of creation: Creative activities with music, literature, movement, art and color for group work.) Tallinn: Tallinna Pedagoogikaülikool.

Rüütel, E. (1998). Vibroakustiline teraapia: Teoreetilised lähtekohad ja rakendusvõimalused (Vibroacoustic Therapy: Theory and Practice.). Tallinn: Tallinna Pedagoogikaülikool. 70 p.

Pehk, A. (1996). Muusade kunst aitab elada: Muusika psühhofüsioloogilisest toimest ja selle teraapilistest rakendusvõimalustest (Psychophysiological Influence of Music and Its Therapeutic Use). Tallinn: Tallinna Pedagoogikaülikool. 143 p.

Pehk, A. (Ed.) (1996). Muusika loob võimaluse: Valik artikleid muusika teraapilisest kasutamisest (Music Creates the Chance: Articles from Estonian Music Therapists about Therapeutic Use of Music). Tallinn: Tallinna Pedagoogikaülikool. 138 p.

On December 15, 1990, 37 founding members founded the Estonian Music Therapy Association (EMTÜ). The aim of EMTÜ was to unite music therapy specialists and those interested, to create conditions for the development of music therapy in Estonia, to promote collegial relations, to organize training in music therapy, to disseminate information about music therapy, etc.
Since 1991, EMTÜ, in cooperation with the TPU Health Research Laboratory, has become the cornerstone of the development of music therapy in Estonia.