Adapting Electric Guitar in Music Therapy

One of the keys to the music aspect of my music therapy sessions over the past 4-plus decades has been teaching my friends to play real instruments. Nearly every person seems to enjoy playing a real violin, piano, drum, banjo, guitar, harmonica, or other instrument. And, if I adapt the music and instrument just right, nearly every person succeeds, no matter the level of their abilities or the nature of their disabilities. One of the most popular instruments for all ages has been the electric guitar.

For a variety of reasons, most of the individuals in my music therapy practice over the years have had significant limitations in their motor skills that prevent their playing electric guitar in a typical manner. Few have been able to conquer all the aspects of playing chords or lead guitar,  playing rhythms or finger-picking patterns, maintaining an even rhythm, or learning melodies and riffs by rote or by written music. It is my job as a music therapist to develop a customized program for making electric guitar as accessible to each individual as possible. I take a look at a person’s cooperativeness, motivation to learn, and functioning level in areas of cognition, motor skills, ability to communicate as well as their music interests and abilities. Then we dive into our electric guitar jam.

Please allow me to share the stories of five music therapy friends who have enjoyed learning to play electric guitar.

My buddy CH began participating in music therapy when he was 3-years-old and in an early childhood intervention (ECI) class in our public schools. He was nonverbal, easily agitated, and had many repetitive and ritualistic actions. He was eventually diagnosed with autism, and was enrolled in individual music therapy sessions in addition to his weekly school groups. Over time, CH became somewhat more tolerant of changes in routine, used some pointing to communicate, and began to take care of his own personal needs. He seemed to enjoy sitting quietly while listening and watching others made music, sometimes looking at the therapist, smiling, and flapping his hands close to his face. Eventually CH reached out to hold an acoustic guitar, hold it in front of him, and pluck one string over and over. Needless to say, we were all thrilled when he unexpectedly began singing “Happy Birthday” to another student along with the therapist one day in music therapy. As he entered his teen years, CH began holding the acoustic guitar correctly and strum his thumb VERY quietly over the strings while singing a growing repertoire of songs. Because CH showed no interest in learning to form chords while strumming, the guitar was open-tuned to a C chord. One day he allowed the music therapist to put an electric guitar in his lap. He didn’t play it for a few weeks, but finally began strumming when the therapist unplugged the guitar from the amplifier. Over time, CH allowed the open-tuned electric guitar to be plugged into the amplifier and he learned to play partial barre chords. He would only place his barre finger across three strings, but his willingness to follow color cues allowed him to play 3-chord songs in the keys of C and G. He really prefers to just sing and strum and open C chord, but, because he has a musical ear, he plays the barre chords to keep the songs in tune. Because of his rather obsessive interest with trains, CH’s favorite songs are “I’ve Been Working on the Railroad” and an adaptation of Johnny Cash’s “Folsom Prison Blues” with these customized lyrics: Hear that train a’coming, coming ‘round the bend. Hear that whistle blowing back behind the bend. Cameron hears that train a’coming, coming down the track. Cameron hears those wheels a rolling, they go clickity-clack!

This youngster, DL, recently joined the one of the elementary classes receiving music therapy services in a neighboring town. He is friendly and cheerful, is able to speak somewhat fluently, and interacts well with others. DL has very limited reading and math skills and his fine motor skills are lacking, so academics are challenging for this third grader. But he has top-notch teachers who encourage him, and he really enjoys weekly music therapy with his class as well as some specialized therapy during the year. DL enjoys playing all instruments, and especially the electric guitar. Using a guitar with standard tuning, he has learned a few familiar lead and bass riffs as well as partial C and G chords, using just the first 3 strings of the guitar. DL plays slowly and needs to see the therapist play several notes before he plays, but he is patient and making tiny steps of progress every week. He has not yet memorized more than three notes in a pattern, and he has not yet learned to play following written music with letter or color cues. But we will keep working, and, meanwhile, he seems to be happy to just hold the electric guitar.

When he first began participating in music therapy group in his public school ECI class, this non-verbal youngster with down syndrome stayed rolled up in a ball on the floor, ignoring the world around him. Over the years, CK began coming to the music therapy group sessions, string in his chair with arms and legs folded, and looking up occasionally when a song started or stopped. As a teenager, he now follows his the lead of his classmates, participates to some extent in group activities, and takes care of his personal needs with fewer reminders. Despite work in therapy, at home, and in class, he speaks very few words very quietly, and his only interaction with peers is to touch them on top of their heads and laugh. CK will now come into music therapy group, select an instrument without prompt, and sit down waiting for the music to start. He will also give the therapist a handshake at the beginning of class as a greeting, and at the end of class when leaving the room. In the past three years, he has shown a great deal of interest in the electric guitar. He has learned to hold the guitar correctly without turning the tuning pegs randomly, and to hold the guitar pick rather than throw it or bite it into two pieces. He plays open-tuned guitar and particularly enjoys playing bass guitar. CK starts when the music starts, keeps a relatively rhythmic beat, and often looks up with a smile at the end of the song. He particularly lights up when we play some of his favorite, classic Chuck Berry rock’n’roll such as Johnnie B. Good, Sweet Little Sixteen, Rock & Roll Music, and Maybelline. We are hoping he will get his own electric guitar at home and play along with Chuck in his free time.

These identical twins diagnosed with autism and developmental delays approach life and music in different ways. Both are non-verbal and have cognitive and motor delays. During the past school year, they have begun taking care of personal needs, noticing people around them, and participating in group activities when prompted. Although he is beginning to settle down, one of the boys, JM, is easily agitated, often screaming, biting or scratching his hand, and striking out at others. The other twin, KM, is more calm and is more interested in books, objects and people. KM seems to enjoy playing repetitive patterns on the keyboard, will indicate a song preference by choosing a song booklet and giving it to the therapist, and will play drums or strum guitar along with other musicians. This snapshot captures his reaction the first time he held an electric guitar. He wanted to hold it on his knees in front of him so he could feel the weight on his legs and see the strings vibrate as he picked individual strings, particularly the bass strings. You can see him looking toward the amplifier, seemingly interested in the fact the sound from the strings was coming from across the room. He kept looking at the strings, plucking a string, then looking toward the amplifier. His twin brother is sitting calmly next to him in the black shirt, and also seems interested in this new instrument.

The music therapist has Plan A, Plan B, and Plan C ready for the young lady in photos #5 and #6. Sometimes she is calm, interactive with the therapist and her peers, and focused on making music. During these times, as depicted in photo #6, she selects a favorite song and sings beautifully along with the therapist while strumming along on an open-tuned guitar. She encourages her peers to play along and sometimes asks them what song they want to play. At other times, she is agitated, repeats sentences or phrases over and over, and seems unaware of people around her. Sometimes she will calm down a bit when the therapist lays an acoustic or electric guitar across the arms of a chair in front of her, and rhythmically plays just one string or two while quietly singing one of her favorite songs. Sometimes, as in photos #5, she calms down a bit and begins playing the strings while looking and listening with great interest.

These five music therapy friends are just some of the many dozens who enjoy playing the electric guitar. Each student has unique needs, but all enjoy playing rock’n’roll music in their own way.

The diversity in our clinical settings and the unique needs of each of our clients makes our daily work in music therapy quite challenging. At, we offer a number of self-study professional e-courses – 3 of which are FREE!  The topics of these practical e-courses cover a wealth of clinical and professional issues to help our MT colleagues meet these challenges. Check them out here –