Preventive-community music therapy (Pellizzari)

1. Introduction

Version followed: the preventive-community model of Patricia Pellizzari and the ICMus team (Buenos Aires), as reported in ICMus team publications (Basutto, Pellizzari & Smith 2021; Barbaresco et al. 2017) and in Argentine papers that cite Pellizzari's books (1993, 2003, 2005 with Rodríguez, 2006, 2011). The founding books themselves (Salud, escucha y creatividad: musicoterapia preventiva psicosocial, Pellizzari & Rodríguez, Ediciones Universidad del Salvador, 2005, re-edited 2019 per one citation; Crear Salud: aportes de la musicoterapia preventiva-comunitaria, 2011) are not drawn on; everything attributed to them here comes through citing authors [uncertain where marked].

What it is. An Argentine approach to music therapy, developed by Patricia Pellizzari, that applies music therapy to health promotion and prevention with groups and communities rather than to treating individual illness. It is a framework and a team practice (ICMus, active since 1998 under Pellizzari's direction, starting from the research project Música y Psiquismo), not a single manualised therapy [source: Basutto, Pellizzari & Smith 2021]. ICMus describes its aims as an "expanded and community" music-therapy clinic and as building support devices from a gender and human-rights perspective [source: Basutto, Pellizzari & Smith 2021]. The same team also runs clinical/rehabilitation groups with its own assessment tools [source: Barbaresco et al. 2017].

How change is thought to happen. Health is treated as a social construction in permanent transformation, moving between the individual and the collective, and inseparable from rights; illness is linked to a "fatalism" of passivity, conformity and lack of projects [source: Ciancio et al. 2023, summarising Pellizzari 2011]. Vulnerability is located at the border between health and illness [source: Benzacar 2025, citing Pellizzari & Rodríguez 2005]. Change comes from activating what is healthy: the creative act brings out fluency, flexibility and originality, and creativity is itself a health-giving capacity [source: Pereyra & Rueda Tolava 2018, citing Pellizzari & Rodríguez 2005]. In groups, shared music-making, situated listening and collective reflection build ties, participation and networks, and let people express social suffering and build joint projects [source: Fideleff et al. 2020, citing Pellizzari & Rodríguez 2019; Echezuri et al. 2023, citing Pellizzari 2003].

Professional frame. This is a music therapy approach. In Argentina it is practised by graduates of university music-therapy degrees (licenciatura, e.g. UBA, Universidad del Salvador) [source: Fideleff et al. 2020; Bárcena & Castello 2026 record]; Argentina regulates music-therapy practice by national law (Ley 27.153) [uncertain]. Elsewhere the equivalent credential applies (UK: HCPC registration, BAMT; US: MT-BC via CBMT, AMTA) [uncertain: general knowledge, not from the sources]. A psychotherapist without music-therapy training should not present this as music therapy or run the clinical-assessment tools (sound profiles, Toma Sonora); they can refer into an ICMus-style group, co-facilitate alongside a qualified music therapist, or use non-clinical community singing/music activities while being clear these are arts activities, not therapy [synthesis].

2. Framework

No staged protocol with fixed session counts is described in the sources; the published examples below are the versions available. Movement criteria between phases are not published in the sources and are given as [synthesis].

Overall arc of a preventive-community intervention [synthesis, assembled from the reported devices below]:

Entry and co-design. Contact the community, institution or network; identify referents; agree aims with participants, who are treated as valid decision-makers [source: Echezuri et al. 2023, citing Pellizzari 2003]. Move on when there is an agreed space, time, population and a co-coordination arrangement [synthesis].
Opening of the workshop (taller). The workshop is the privileged form of preventive group work; it creates trust, creativity, affective ties, mutual respect and group agreements [source: Pereyra & Rueda Tolava 2018, citing Pellizzari 2003]. Move on when agreements are in place and participants begin to propose content [synthesis].
Group process. Recurring sessions using musical, multi-arts and conversational resources chosen from the session's emergentes [source: Barbaresco et al. 2017; Basutto, Pellizzari & Smith 2021].
Amplification and closure. Productions (songs, poems, recordings) are shared outward with the community, and the cycle is reviewed with participants [source: Fideleff et al. 2020; Echezuri et al. 2023 ("Amplificación" in community MT, not attributed specifically to Pellizzari)].

Published device 1: online "Musicoterapia Social" for women (ICMus, 2020 onward) [source: Basutto, Pellizzari & Smith 2021]

Format: monthly, about 2 hours, on Zoom, free and open; not recorded or shared on social media, to protect privacy. About 300 women took part from May 2020, roughly 20% regularly.
Five moments per meeting: (1) welcome with visual contact and sharing of sensations; (2) the main theme, approached through a performance or a playful, expressive, receptive or participatory activity; (3) open conversation (conversatorio); (4) a poetic/aesthetic synthesis of the experience; (5) closure with spontaneous movement or dance as farewell.
Coordination rotates among therapists, neighbourhood referents and participants. The team warns the method can become rigid and keeps it flexible to manage time, rhythms, energies, roles and changes of coordinator.
Stated objectives: accompany feelings around isolation; horizontal listening to life experiences; encourage expressive interaction; recognise personal limits and self-protection against violence; build significant ties among women through digital means.

Published device 2: ICMus group in adult psychiatric rehabilitation (Italy, 2016) [source: Barbaresco et al. 2017; Pellizzari supervised for ICMus]

Preliminary individual phase: individual interviews including a sound intake ("Toma Sonora"), a verbal interview and a written questionnaire adapted from Pellizzari et al. 2006, with the therapist improvising with each participant.
Group phase: weekly 75-minute sessions for about five months, average ~13 participants, sessions recorded for review; a group data matrix (from "Equipo ICMus Comunitario Argentina") tracked the group's sound organisation through aesthetic stages named Aleatoriedad (randomness), Estancamiento (stagnation), Embrionaria (embryonic) and Estable (stable).
Final individual phase: re-assessment from three sources (user, psychiatrist, music therapist), including a participatory music-therapy self-evaluation (EMPI) alongside standard psychiatric scales.
Exclusion: acute or crisis phase; absence from 60% of workshops.

Other reported formats [source: Fideleff et al. 2020; Millanao 2015 record]

School health promotion (UBA team, Buenos Aires public primary schools, citing Pellizzari & Rodríguez): sound explorations, free and guided improvisation with critical reflection, song questionnaires with group listening, creating a song or sound product, and amplification to the school community; moved to WhatsApp in 2020 with three moments per session (preparation, development, closing/reflection), which the authors present as their own organisation.
Workplace prevention (Chile, drawing on Pellizzari's preventive music therapy): 13 sessions with 9 female hospital staff over three months, aimed at stress and recovering psychosocial skills.

Typical dose [synthesis from the above]: a closed group of 10–20 weekly sessions of 60–90 minutes for institutional groups; open monthly meetings for community networks; 8–15 participants for active instrumental work.

3. Guiding principles

Horizontality and participation [source: Echezuri et al. 2023, citing Pellizzari 2003; Basutto, Pellizzari & Smith 2021]: participants are valid decision-makers whose knowledge shapes the intervention. In practice: ask the group what to work on and share coordination; do not arrive with a fixed programme you impose.
Strengthen social networks [source: Echezuri et al. 2023, citing Pellizzari 2003]: the work should multiply experiences, knowledge and proposals in the community. In practice: link the group to local organisations and plan how it continues without you.
Collective construction of meanings about health, risk and illness [source: Echezuri et al. 2023, citing Pellizzari 2003]: health is defined with the group, not for it. In practice: include reflection on what "being well" means here, in this neighbourhood.
Health as a right and a social construction; counter fatalism [source: Ciancio et al. 2023, citing Pellizzari 2011]: passivity and lack of projects are targets. In practice: every cycle should end with something the group decides and does.
Work with the healthy traits [source: Pereyra & Rueda Tolava 2018]: the preventive music therapist strengthens what is healthy and promotes participants' own musicality. In practice: build on songs, rhythms and skills people bring rather than on deficits.
Creativity as health [source: Pereyra & Rueda Tolava 2018, citing Pellizzari & Rodríguez 2005]: fluency, flexibility and originality emerge in the creative act. In practice: prefer making and transforming music over consuming it.
Vulnerability as a border zone [source: Benzacar 2025, citing Pellizzari & Rodríguez 2005]: prevention works where people are neither well nor ill. In practice: screen for people who need clinical care and refer, rather than treating disorder in a prevention group [synthesis].
Situated listening (escucha situada) [source: Basutto, Pellizzari & Smith 2021]: listening is the core method. In practice: attend to sound, silence, voice and the context that produced them before interpreting.
Listening to emergentes; the therapist as spokesperson [source: Pereyra & Rueda Tolava 2018]: requests, songs, body sounds, comments and sensations are material; the therapist voices what participants want to express. In practice: name back what you heard, in the group's terms.
A poetics of resonance [source: Basutto, Pellizzari & Smith 2021, citing Pellizzari 1993]: opening one's gaze and listening to resonance produces significant events. In practice: leave room for what resonates rather than steering to a planned outcome.
Ethics of not knowing and of uncertainty [source: Basutto, Pellizzari & Smith 2021, citing Najmanovich and Morin]: the therapist does not hold finished answers; the authors write "No hay objetivos, no hay expectativas" about the moment of meeting. In practice: hold session aims loosely and follow what arises.
Spontaneity as strategy and presence [source: Basutto, Pellizzari & Smith 2021]: availability in the present is part of the intervention. In practice: improvise your coordination as well as the music.
Relationship over product [source: Barbaresco et al. 2017]: what is created in the shared activity matters more than musical quality. In practice: never correct or grade musical output.
Reflect with, not about, participants; avoid absolutist readings [source: Barbaresco et al. 2017, drawing on Pellizzari 2011]. In practice: offer readings of the group's music as questions.
Gender, human-rights and decolonial perspective [source: Basutto, Pellizzari & Smith 2021]: normalising categories of health, risk and suffering can colonise. In practice: avoid diagnostic labels in community spaces; respect local music and meanings.
Aesthetics, history and politics are knotted together [source: Basutto, Pellizzari & Smith 2021]: group art-making is also social and historical. In practice: allow songs that carry protest, memory or identity.
Flexible method, team contrast [source: Basutto, Pellizzari & Smith 2021]: keep structure from becoming rigid, and test convictions against other teams and institutions. In practice: hold regular team supervision and peer review of recordings or notes.
Privacy [source: Basutto, Pellizzari & Smith 2021]: the online device is not recorded or posted. In practice: get explicit consent before any recording, and agree what can be shared in amplification [synthesis].

4. Intervention inventory

The sources name the resources and devices below but give little step-by-step detail; steps are therefore largely [synthesis] built around each named resource, and the source tag says only that the resource itself is part of the ICMus/Pellizzari repertoire. All example language is illustrative.

Safety for every musical activity [synthesis]:

Hearing: keep group volume at a level where people can talk over it; offer foam earplugs; use soft beaters and hand-played drums; no amplified playback at high volume; give drummers and singers breaks; seat people with hearing aids, tinnitus or hyperacusis away from loud instruments and let them choose quieter ones.
Musical trauma triggers: songs, genres, national or religious music, military-style rhythms, sudden loud sounds or a particular voice can evoke violence, war, migration, bereavement or abuse. Ask at intake about music to avoid; agree a stop signal; never insist on a song; allow stepping out.
Physical: check instruments for sharp edges and small parts; clean shared wind instruments and microphones or avoid them; clear space before movement; offer chairs.

4.1 Setting up the workshop (taller) and its agreements

Purpose: create the privileged frame of preventive group work: trust, creativity, affective ties, mutual respect and group decisions [source: Pereyra & Rueda Tolava 2018, citing Pellizzari 2003].
Steps [synthesis]: (1) agree time, place, frequency and who coordinates with the host institution and referents; (2) in the first meeting, invite the group to set its own agreements (confidentiality, phones, how to say "stop", respect for each person's sound and silence, recording rules); (3) write them in the group's words and revisit them when breached; (4) agree how decisions about content will be taken.
Example language (illustrative): "This space is ours. Before we play, let's decide together what we need so that everyone can make sound here, or stay quiet, without being judged."
Watch for: agreements that only the coordinator proposes (horizontality not yet real); silence from some members during agreements. It is working when participants refer back to the agreements themselves.

4.2 Preliminary individual intake: sound intake (Toma Sonora), verbal interview, written questionnaire

Purpose: in clinical/rehabilitation groups, get to know each participant's musical history and relational way of sounding before the group starts [source: Barbaresco et al. 2017, citing Pellizzari et al. 2006].
Steps: the published device used an individual verbal interview, a written questionnaire adapted from Pellizzari et al. 2006, and a sound intake in which the therapist improvises with the participant [source: Barbaresco et al. 2017]. The content and scoring of the Toma Sonora and questionnaire are not available in the sources [uncertain]. Add [synthesis]: ask about music to avoid, hearing problems, current crises and supports; screen out acute or crisis states (as the published device did).
Example language (illustrative): "Which music has been with you at important moments? Is there any music you would rather not hear here?"
Watch for: distress on recalling music tied to losses or violence. Do not use the intake as a diagnostic test; it is a starting point for the work [synthesis].

4.3 Sound profiles: Modalidad de Enlace, Perfil Sonoro Individual, Perfil Sonoro Vincular

Purpose: ICMus tools for describing a person's mode of linking through sound and their individual and relational sound profiles [source: Barbaresco et al. 2017, citing Pellizzari et al. 2006, Música y Psiquismo: Lo Psicosonoro]. A related technique named ISI-V is also cited there; its content was not described in the sources [uncertain].
Steps: not reproducible from the sources; obtain the ICMus training and manual before use [uncertain]. These are music-therapy tools for qualified music therapists; no validity or reliability data were reported in the sources, so do not treat profiles as diagnostic evidence.
Watch for: over-reading a single improvisation as a personality or psychopathology finding [synthesis].

4.4 Group sound-organisation tracking (aesthetic stages)

Purpose: follow how the group's joint sound organises over time, using a group data matrix from the ICMus Argentine community team; stages named Aleatoriedad, Estancamiento, Embrionaria, Estable [source: Barbaresco et al. 2017].
Steps [synthesis]: record or note each group improvisation; after the session, note whether the sound was random and unconnected, stuck in repetition, showing first shared patterns, or stably co-organised; compare across sessions in team review.
Watch for: a stagnation stage is information, not failure; it often calls for a change of resource (see 4.6, 4.11) [synthesis].

4.5 Free and guided improvisation (vocal and instrumental, individual and group) with critical reflection

Purpose: core expressive resource; brings out creativity and lets the group discover its own way of sounding; guided versions focus on a theme [source: Basutto, Pellizzari & Smith 2021; Barbaresco et al. 2017; Fideleff et al. 2020].
Steps [synthesis]: (1) lay out simple instruments (hand drums, shakers, xylophones, voice); (2) free version: invite everyone to choose an instrument and play when they want, stop when they want; (3) guided version: give a theme from the group (e.g. "the neighbourhood at night", "what isolation sounds like"); (4) play 3–10 minutes; (5) silence; (6) ask what each heard and felt, then what it says about the group's situation (the critical-reflection step).
Example language (illustrative): "No one can play wrong here. Let's listen to how we sound together." Afterwards: "What did you hear? Did anything in our music sound like what we are living?"
Watch for: one person dominating volume; people not playing at all (offer a quieter role, not pressure); loud chaotic playing that escalates arousal (lower the volume, slow the pulse, move to voice). Working when people link the sound to their lives in their own words.

4.6 Spontaneous improvisation games and free or structured musical games

Purpose: playful entry, warm-up and ice-breaking; reduce performance fear [source: Basutto, Pellizzari & Smith 2021; Barbaresco et al. 2017].
Steps [synthesis]: use simple rule-based games: passing a rhythm round the circle, call-and-response, a conductor role that rotates, sound guessing; keep rules short; hand the conductor role to participants.
Example language (illustrative): "Whoever holds the drum leads; the rest of us follow. When you're done, pass it on."
Watch for: competitive dynamics or shaming of "mistakes"; it is working when participants invent new rules.

4.7 Group singing

Purpose: shared voice builds ties and releases held tension [source: Basutto, Pellizzari & Smith 2021; Ciancio et al. 2023].
Steps [synthesis]: let the group choose songs; print or share lyrics; start in a comfortable key; allow humming or listening; follow with conversation about why the song was chosen.
Example language (illustrative): "Who has a song that our group could sing today? Tell us why you chose it."
Watch for: songs that trigger grief or traumatic memory (pause, acknowledge, offer choice to continue); voice strain.

4.8 Song recreation, reinvention and composition (songwriting)

Purpose: turn familiar songs or the group's own words into a collective product that voices its situation [source: Basutto, Pellizzari & Smith 2021; Barbaresco et al. 2017; Fideleff et al. 2020].
Steps [synthesis]: (1) choose a known melody or create a simple pulse; (2) collect phrases from the conversation; (3) fit them to the melody line by line, with the group deciding words; (4) sing it through; (5) decide whether and how to share it (see 4.17).
Example language (illustrative): "Of everything we said today, which phrases do you want in our song?"
Watch for: the coordinator writing the song for the group; personal disclosures entering lyrics that will be shared publicly (check consent line by line).

4.9 Song questionnaires with group listening

Purpose: use recorded or chosen songs to open reflection on a theme [source: Fideleff et al. 2020, school device].
Steps [synthesis]: play a song chosen by the group or linked to the theme; offer a few open questions (what it tells, who it speaks for, what you would change); discuss in pairs then the whole group.
Example language (illustrative): "What is this song saying about people like us? Is there anything you'd answer back to it?"
Watch for: volume of playback; lyrics containing violence or self-harm content (pre-listen and decide with care).

4.10 Sound exploration and body percussion (body drum)

Purpose: discover instruments, objects and the body as sound sources; low-threshold entry [source: Fideleff et al. 2020; Barbaresco et al. 2017].
Steps [synthesis]: invite exploration of each instrument or everyday objects for a few minutes; share one discovered sound each; build a short piece; for body percussion, use clapping, chest, thighs and stamping, with seated options.
Example language (illustrative): "Find one sound in this object that surprises you and show it to us."
Watch for: body-percussion on the body of others (do not), people with pain or limited mobility (offer alternatives), and touch sensitivity after trauma.

4.11 Sonorisation of scenes (sonodramatisation), psychodrama elements and free dramatisation

Purpose: give sound and action to a situation the group brings, so it can be seen, felt and transformed [source: Basutto, Pellizzari & Smith 2021 (sonodramatisation, free dramatisations); Barbaresco et al. 2017 (sonorisation of scenes, psychodrama)].
Steps [synthesis]: (1) the group names an everyday scene (e.g. a waiting room, a family dinner); (2) volunteers enact it briefly while others give it sound; (3) replay with a changed soundtrack or ending the group chooses; (4) step out of roles explicitly (each says their own name and one thing about today); (5) discuss.
Example language (illustrative): "Let's give this scene its sound. Now, if we could change the music of it, what would we change?"
Watch for: this is enactment; screen out acute crisis, keep scenes everyday rather than traumatic, never re-enact violence or abuse in a prevention group, always de-role and close, and stop if anyone shows signs of overwhelm (see section 5). Psychodrama proper requires psychodrama training [synthesis].

4.12 Receptive work: guided imagery with music, relaxation induction, listening activities, active group relaxation

Purpose: regulate arousal, open inner imagery, close sessions calmly [source: Barbaresco et al. 2017].
Steps [synthesis]: choose calm instrumental music at low volume; invite a comfortable posture with eyes open or closed by choice; give a brief, neutral invitation to notice breath and images; 3–10 minutes; return slowly; share only what people choose to share.
Example language (illustrative): "Let the music carry you somewhere safe; you can open your eyes at any time."
Watch for: dissociation, panic or intrusive images, especially with trauma histories; keep eyes-open options and grounding. The Bonny Method of Guided Imagery and Music (GIM) is a distinct method requiring AMI-recognised training; ICMus "guided imagery with music" in the source is not described as the Bonny Method [uncertain].

4.13 Multi-arts resources: stories, poetry, masks, puppets, drawing, digital design, free movement and dance

Purpose: widen expression beyond music, especially online and with mixed groups [source: Basutto, Pellizzari & Smith 2021].
Steps [synthesis]: pair a short musical moment with one other medium (e.g. draw while listening; write a line of poetry after an improvisation; a puppet speaks for a sound); bring the product back into the conversation.
Watch for: drawings or stories are not diagnostic evidence; do not interpret them as signs of abuse or disorder [synthesis]. Movement: clear space, seated options, no touch unless explicitly invited and freely declinable.

4.14 Conversation circle (conversatorio, "mateada")

Purpose: open, horizontal dialogue; in the women's device, a shared "mate" circle is described as a territory of subjectivity on the border of public and private [source: Basutto, Pellizzari & Smith 2021].
Steps [synthesis]: after the main activity, open with a question about what was lived; let participants respond to each other, not only to the coordinator; the coordinator summarises themes and returns them to the group.
Example language (illustrative): "What did today's music bring up for you? Does anyone recognise themselves in what was just said?"
Watch for: disclosures of violence or risk (follow safeguarding, see 5); one voice dominating.

4.15 Listening to emergentes and acting as spokesperson (portavoz)

Purpose: take what arises (song requests, sounds, comments, sensations) as the material and voice what participants want to express [source: Pereyra & Rueda Tolava 2018].
Steps [synthesis]: keep a running note of emergentes; choose the next resource from them (as the ICMus rehab device did) [source: Barbaresco et al. 2017]; reflect them back as a question.
Example language (illustrative): "Several of you asked for songs from your youth today. Shall we follow that?"
Watch for: imposing your interpretation; it is working when the group corrects or extends your reading.

4.16 Poetic or aesthetic synthesis and collective "gifts" (regalos)

Purpose: gather the experience into a short shared aesthetic form; products (shared poems, digital compositions) are offered as gifts carried into later sessions [source: Basutto, Pellizzari & Smith 2021].
Steps [synthesis]: before closing, invite each person to give one word, sound or line; assemble them into a short poem or sound piece; repeat it together; bring it back next time.
Example language (illustrative): "Give us one word to take away from today; together they'll make our poem."
Watch for: pressure to contribute; allow a pass or a silent gesture.

4.17 Amplification (sharing productions with the community)

Purpose: move the group's production outward (to the school, neighbourhood, public space or media), strengthening networks and voice [source: Fideleff et al. 2020; Echezuri et al. 2023; not explicitly attributed to Pellizzari in the sources].
Steps [synthesis]: the group decides what, where and how to share; get individual written consent for any recording, image or name; for children, also from parents or carers; rehearse; debrief afterwards.
Watch for: exposure of identities of people at risk of violence; performance pressure. Working when participants own the event.

4.18 Rotating co-coordination and network-building

Purpose: horizontality in practice; build continuity through neighbourhood networks and social organisations [source: Basutto, Pellizzari & Smith 2021; Echezuri et al. 2023, citing Pellizzari 2003].
Steps [synthesis]: share each meeting's coordination between a therapist and a participant or referent; prepare it together; map local organisations with the group; invite one to a session.
Watch for: referents asked to hold clinical responsibility they are not trained for; keep risk management with the professional team.

4.19 Closing with spontaneous movement or dance

Purpose: bodily farewell that ends the meeting [source: Basutto, Pellizzari & Smith 2021].
Steps [synthesis]: play a short, chosen piece; invite any movement, seated or standing, cameras on or off online; end with a shared gesture or word.
Watch for: body-image discomfort; always offer a non-moving option.

4.20 Online adaptation

Purpose: keep the device running when people cannot meet [source: Basutto, Pellizzari & Smith 2021 (Zoom, monthly, not recorded); Fideleff et al. 2020 (WhatsApp, audios, short videos, flyers, Padlet, a trivia game, short "adjustment signals" to create shared time; the authors' own design)].
Steps [synthesis]: choose the platform participants already use; send a short audio invitation beforehand; keep latency in mind (avoid playing in time together; use call-and-response, turn-taking and listening); agree that sessions are not recorded; have a private channel for anyone who becomes distressed.
Watch for: privacy at home (someone overhearing, including a violent partner); offer text or camera-off participation.

4.21 Participatory evaluation

Purpose: participants take part in evaluating the process [source: Ciancio et al. 2023]; the ICMus rehab device combined participant self-evaluation (EMPI), psychiatrist and music-therapist views [source: Barbaresco et al. 2017].
Steps [synthesis]: at mid-point and end, ask the group what has changed, what to keep and what to drop; record their words; review with the team; feed back to the host institution with the group's consent.
Watch for: evaluations that only measure attendance; it is working when the group changes the device as a result.

5. Handling problems

The sources name two difficulties directly: a method that becomes rigid, and irregular attendance (about 20% regular in the open online device; exclusion after 60% absence in the rehab device) [source: Basutto, Pellizzari & Smith 2021; Barbaresco et al. 2017]. Everything else below is [synthesis].

Rigidity of the device [source: Basutto, Pellizzari & Smith 2021]: when the five moments start to feel like a checklist, shorten or drop one, hand coordination to a participant, or let the main theme come from the opening round.
Irregular attendance / non-adherence: in open community devices, design every meeting to stand alone (welcome, one activity, synthesis, closure); send a short audio or message before each meeting; ask leavers, without pressure, what would make it easier to come; in closed clinical groups agree an attendance rule at the start, as the rehab device did [synthesis; attendance figures from sources above].
Stuck group (stagnation, repetitive or flat sound): name it as part of the process (the ICMus matrix includes a stagnation stage) [source: Barbaresco et al. 2017]; change medium (voice instead of drums, poetry, movement), change scale (pairs instead of whole group) or ask the group what it wants to change [synthesis].
Silence, refusal to play, "I'm not musical": offer listening, choosing music, or conducting as full forms of participation; use objects or body sounds before instruments; never single people out [synthesis].
Resistance to horizontality (group waits for the coordinator to decide; or an institution wants a fixed programme): offer limited choices first, then open ones; explain to the host institution that participation is the method, and agree a few shared aims you can report on [synthesis].
Dominant members, loud volume and escalating arousal: introduce turn-taking games, a conductor role and a volume agreement; move to softer instruments or voice; end with a calming listening piece [synthesis]. Re-check hearing safety (earplugs, breaks).
Overwhelm or retraumatisation (tearfulness that escalates, panic, dissociation, sudden withdrawal, triggered by a song, scene or sound): stop or lower the music; ground with eyes open, feet on floor, slow breathing, naming objects in the room; offer a co-coordinator to sit with the person outside the group; never push to continue an enactment; follow up individually and refer to individual therapy if needed [synthesis]. Prevention groups are not the place to process trauma memories.
Disclosure of violence, abuse or risk (common in groups on gender and isolation) [synthesis]: acknowledge without probing in the group; speak with the person privately; follow local safeguarding and mandatory-reporting rules; give information on local services; in online work, check whether it is safe to talk where they are.
Suicide or self-harm risk [synthesis]: conduct or arrange a standard risk assessment by a qualified clinician the same day; agree a safety plan, including lethal-means counselling (safe storage and removal); inform the host service according to policy.
Ruptures with the coordinator (feeling judged, a song dismissed, a rule imposed): name it in the group or privately, own your part, and return the decision to the group; repair is part of the horizontal stance [synthesis].
Conflict between participants (musical or political taste, identity songs): use the agreements; frame differences as material for reflection; allow songs that carry memory or protest but not ones used to attack someone present [synthesis].
Confusing prevention with treatment: if a participant shows a disorder that needs care (psychosis in crisis, severe depression, substance dependence), refer to clinical services while keeping them welcome in the group if appropriate; the rehab device excluded acute or crisis phases [source: Barbaresco et al. 2017; synthesis for referral steps].
Over-reading music or art as diagnosis: do not infer abuse, trauma or disorder from improvisations, sound profiles, drawings or song choices; no validity data for the ICMus tools are reported in the sources [synthesis; uncertain].
Children and young people (school devices) [synthesis]: obtain school and parent/carer consent and the child's own assent; explain that what is shared stays in the group except when someone is at risk; know the school's safeguarding lead; keep activities short, playful and movement-friendly; avoid personal-disclosure tasks in whole-class settings; never post images without written consent.
Touch: body percussion is on one's own body; any partner movement needs explicit invitation and an easy opt-out; consider cultural and trauma sensitivities; never sexual or genital touch [synthesis].
Recording and privacy: the online women's device is deliberately not recorded or posted [source: Basutto, Pellizzari & Smith 2021]; clinical devices recorded sessions for review [source: Barbaresco et al. 2017]. Decide case by case with written consent, secure storage and a deletion date [synthesis].
Working outside your training: a psychotherapist without music-therapy credentials should co-lead with a qualified music therapist or present the activity as community music rather than music therapy, and should not use ICMus assessment tools [synthesis].
Sources thin: steps for most interventions are not published in the material opened. Before using this approach clinically, read Pellizzari & Rodríguez 2005/2019 and Pellizzari 2011, or train with ICMus [uncertain].

Sources

Sources:

Books cited through the papers above (further reading, not drawn on):

Pellizzari, P. (1993). El malestar en la voz. Resio Editor.
Pellizzari, P. (2003). Cited in text by Pereyra & Rueda Tolava and Echezuri et al.; full reference not given [uncertain].
Pellizzari, P. & Rodríguez, R. (2005). Salud, escucha y creatividad: musicoterapia preventiva psicosocial. Buenos Aires: Ediciones Universidad del Salvador (cited as 2019 edition by Fideleff et al.).
Pellizzari, P. et al. (2006). Música y Psiquismo: Lo Psicosonoro. Buenos Aires: ICMus.
Pellizzari, P. et al. (2011). Crear Salud: aportes de la musicoterapia preventiva-comunitaria. Buenos Aires: Patricia Pellizzari Editora / ICMus.

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