Written by Katelyn Lee, CEO
In 2012, a clip of an elderly man named Henry shot across the internet like wildfire. In the video, he is slumping in his wheelchair, largely unresponsive. Then, a nurse gently places headphones on his ears. Almost immediately, Henry’s face lights up. His eyes widen. He begins to hum. Then he sings. Then he speaks. It was a miraculous moment—a man who seemed lost to dementia briefly returned, all because of a playlist.
That clip, taken from the 2014 documentary Alive Inside, has now been viewed over 18 million times on YouTube. The documentary, which follows the work of the “Music and Memory” program, won the Audience Award at the Sundance Film Festival in 2014 and sparked a global interest in using music to help people with dementia (American Music Therapy Association). Personally, this film sparks tears every time I watch it, whether it’s my first or fifth viewing. As someone who runs Healing with Music, a nonprofit that brings live performances to nursing homes and hospitals, watching Henry transform from a shell of a man into a vibrant individual with stories to share about his childhood, religion, and even his love of jazz is a beautiful confirmation of everything I’ve worked toward: music has the profound power to awaken something essential in all of us.
But as I began researching for this paper, I encountered a shocking perspective — one that challenged my assumptions.
Many music therapists were critical of the film or even angry. Some felt that the film blurred the line between music therapy and passive music listening. Others were worried that it could be harmful. The American Music Therapy Association (AMTA) even released a public denouncement of the film for its misleading content and misrepresentation of music therapy. I wondered, why would a film that demonstrates music’s healing potential face backlash from the very people most invested in music as a tool for healing? I found myself in an uncomfortable space: emotionally moved by the film, yet logically challenged by its critics. It was in this tension that a real question began to form for me: Can a documentary that spreads joy and awareness also inadvertently cause damage? And if so…what is the best way forward?
This essay is my attempt to submerge myself in that tension—to weave together my lived experience with the insights of accredited music therapists and to contribute a voice to a conversation that, it turns out, is far more layered than a viral clip might suggest.
Let’s begin with what’s undeniable: Alive Inside is powerful. Music, in its purest form, has an uncanny and irreplicable ability to uplift, to reach into places untouched by language. The scenes of nursing home residents singing again, remembering again, being again—they don’t just move us; they remind us of what it means to be human. A widely circulated 2021 New York Times article, “The Healing Power of Music,” echoes this truth, documenting powerful examples and the expanding role of music in hospice care, chemotherapy suites, and hospital wards. Music can transform a room, and even further, can transform a person. It can soften fear, summon joy, and, in some cases, restore a fragile sense of self (Schiffman).
However, the emotional impact and clinical accuracy are not the same, and this is where the documentary falters.
At the heart of the critique is the film’s casual and misleading use of the term “music therapy”. It refers to the passive act of just playing music on iPods for the nursing home residents as “music therapy,” despite the absence of any active management by credentialed therapists (Murakami). The film consistently cites music therapy research and includes interviews of music therapists to explain or support the work they are conducting, even though the work being depicted is not actually music therapy (American Music Therapy Association). Music therapy is a “research-based discipline that actively applies supportive science to the creative, emotional, and energizing experiences of music” (Cleveland Clinic). That means assessments, goal-setting, and real-time responsiveness. It’s not just pressing play on a playlist.
It’s not just the documentary that blurs this important distinction; The Times article profiles reputable board-certified therapists like Andrew Rossetti but also includes non-clinical musicians, lumping their distinctly separate roles under the same headline. Both are meaningful, but they’re not interchangeable (Schiffman).
Out of curiosity, I reached out to Andrew Rossetti himself. Rossetti didn’t just voice concern about the confusion surrounding music therapy—he was deeply frustrated by the way Alive Inside presents its message. In his view, the film glosses over the training, assessment, and ethics that define music therapy as a clinical discipline. To illustrate the issue, he offered a vivid medical analogy: “I’ve watched hundreds of people get injections. I could probably do one, not badly. But would you want me to inject you?”. The comparison is pointed—and effective. Just because someone has seen a medical act performed, or in this case, witnessed the emotional power of music, doesn’t mean they’re qualified to administer it safely. His message was clear: music used in a medical context needs to be applied with care, intention, and training.
This brings me to Rossetti’s biggest fear: Inspired musicians, moved by Alive Inside, might slap on the title “music practitioner” after a weekend course and start working with vulnerable patients, with no real training, no supervision, and no understanding of the risks (Rossetti). He’s not alone in his concerns. Dr. Brea Murakami, director of music therapy at Pacific University, worries that the film’s imprecise language and generalized examples might encourage volunteers to misrepresent themselves and misuse research to legitimize their incorrect and even ignorant claims that they are providing music therapy.
The AMTA agrees. The “Music and Memory” certification program featured in the film consists of just three online videos that total 4.5 hours of instruction. There is no clinical practice, no ethics training, and no real assessment. Yet, participants walk away with a fictitious title and a toolkit they are not equipped to use safely (American Music Therapy Association).
And here’s why that matters: music isn’t always benign.
Dr. Kathleen Howland, a prominent music therapist, puts it plainly in her own response to “Alive Inside” in 2016: “Music can do harm”. There is a risk of “the emotional distress that can come when music awakens certain memories”, especially in patients with PTSD. Dr. Murakami echoes the concern in a blog on “Alive Inside” as well, noting that “Music can stir up unexpected or bad memories, and these reactions were not seen by viewers. The film did not appear to acknowledge music’s power for negative rumination or over-stimulation”. Rossetti told me a story of a patient with past trauma being triggered by a song played by an untrained musician. The patient started sobbing. The musician, unprepared, had to go find a nurse. These instances are not just awkward—they are potentially dangerous.
As someone who has played music in hospitals countless times over the past four years, this made my stomach twist. Have I been that musician? I’ve definitely had moments where a song I chose sparked tears in the audience. I always assumed those tears were healing. But now I wonder: had I inadvertently opened wounds I didn’t know how to tend to?
Still, I can’t ignore the sting in some of the AMTA’s language discussing non-clinical music interventions. According to the AMTA, “The fact of the matter is that almost anything a board-certified music therapist would do using clinical music therapy techniques would have an even more profound effect than passively listening to music”. “Almost anything”. That phrase hurt. Not because I doubt the skill of music therapists, but because I worry it erases the value of what we do. It feels dismissive of organizations like mine. And here’s where I want to push back a little. While acknowledging the crucial distinctions, I argue that these musical interactions, though not clinically therapeutic, still matter deeply. Because at the end of the day, I show up for residents and patients. I try. I care.
Dr. Murakami, to her credit, offers a more balanced view: “As awareness grows, so must the public’s understanding of the music therapy profession”. To me, that means we don’t need to dim the light that Alive Inside sparked—we need to channel it. Use it to educate. Use it to elevate.
Dr. Howland draws an insightful parallel between Alive Inside and the “Mozart Effect”. The “Mozart Effect” was a 1993 study that found listening to Mozart temporarily improved spatial reasoning, which was blown out of proportion by the media and turned that into a sweeping, inaccurate claim: Music makes you smarter (Jenkins 170). “It got a lot of media coverage,” Howland writes, “and was accompanied by a remarkable surge in subscriptions to symphony orchestras and purchases of classical music recordings.” Even though the science was shaky, the result was a net win for music (Howland). Maybe we can find the same opportunity with Alive Inside; We can leverage the wonderfully warm interest of the general public in the power of music toward a deeper understanding and utilization of music therapy.
But I remain cautious. While media attention can open doors, it can also cement misunderstandings. Once someone believes that an iPod is therapy, it’s hard to walk that back.
In that light, using Alive Inside as an educational tool can feel risky. Yes, it’s a conversation starter. But what if the conversation never goes deeper? Even worse, what if some people don’t want the conversation to go further?
Before the film’s release, the AMTA officials met with the director, offered detailed edits to correct misleading claims, and recommended re-filming certain segments. Their concerns were heard…and ultimately ignored. The film went forward unchanged. The story, it seemed, was too compelling to complicate with more nuanced information (American Music Therapy Association).
That decision wasn’t just frustrating—it was telling. It revealed a deeper problem: the ease with which music therapy can be misunderstood, rebranded, or overlooked entirely. And that’s not just a media problem. It’s a structural one.
Part of this problem, I believe, lies within the field itself. Music therapy is still relatively young, and it lacks a clear, universally accepted vocabulary to define and defend its boundaries. Rossetti even brought this up during our interview, admitting “We don’t have a lexicon of terminology for ourselves. We borrow from medical lexicon, from psychological lexicon”. This patchwork language makes the field vulnerable—easily conflated with adjacent practices and difficult to explain without being misunderstood. A recent study by Rodríguez-Rodríguez et al. revealed just how widespread this confusion is: many healthcare professionals remain unfamiliar with what music therapy actually entails and when asked, were unable to accurately define music therapy (70). Moreover, the majority of existing literature and public discourse on music therapy has emerged primarily in the last decade, underscoring the field’s youth and vulnerability.
My concern is that without robust, established foundations, using Alive Inside as an educational tool poses both opportunities and risks. It can raise awareness and spark public interest, yes—but it also risks cementing misconceptions that threaten the credibility and future of music therapy as a clinical discipline.
And yet, my own work exists in the heart of that very gray area. Running Healing with Music has placed me squarely at the intersection of two worlds: the emotional and the clinical. On one side, I witness the joy and human connection that live music can bring—moments that feel nothing short of magic. I’ve watched Dorene, in the dementia unit, clutch her well-loved stuffed bunny like a child clutching a favorite toy for comfort, her eyes shining with a kind of delighted wonder. Every time we played “You Are My Sunshine,” she would sway softly, her smile open and giddy. When the last note faded, she’d tug at my sleeve with urgency and a mischievous sparkle in her eye: “Again? Just once more?” And so we’d play it again—and again. Each repetition felt like a quiet act of anchoring her to joy. But on the other side, I hear the concerns of music therapists who are working tirelessly to protect the integrity of their field. I’ve seen how casually people toss around the term “music therapy” on social media, often with good intentions but little understanding. Heck, I wouldn’t be surprised if our own PR team has unknowingly posted a few misleading statistics or blurbs. And I’m coming to see just how easily those small slips may erode the careful boundaries that music therapists have worked so hard to build.
Perhaps a fresh, philosophical perspective can shed additional light on this predicament. Philosopher Harold N. Lee, in a 1942 article titled “The Use and Abuse of Words,” emphasized the importance of clear language to prevent confusion and misrepresentation. Applied here, his argument suggests we must develop a precise vocabulary to delineate various forms of musical engagement in healthcare clearly and respectfully. Lee humorously warns, “When words can cause confusion and error in our thought, they have established themselves as masters” (627). His observations resonate powerfully today—particularly in the context of music therapy. Lee asserts, “Words must be transparent symbols. To forget this is to let them obstruct or divert the knowledge process” (628). Hyperfixating on semantic debates rather than focusing on music’s genuine potential for good may inadvertently empower confusion rather than clarity. Over 80 years ago, philosophers wrestled with these same linguistic complications, ultimately reminding us that words are simply “tools of thought.” As we build this conversation around music therapy, perhaps the most productive approach is to remember Lee’s insight: clear, transparent language helps us use music responsibly and meaningfully rather than allowing semantics to undermine its value (630).
Lars Ole Bonde, associate professor of the music therapy program at Aalborg University, seems to agree with this as well. He writes, “I think we need some orientation tools, as the field of music, culture and health is rapidly growing and becoming potentially confusing. Music therapists have fine qualifications to work in the field,…but the field…is notoriously open to anyone who wants to contribute to musicing for health purposes” (133).
As the field matures, I am hopeful that clearer distinctions and vocabulary will emerge, helping clarify different levels of musical engagement in healthcare, without diminishing the value of each contribution. But as of right now, I also strongly believe that all music deserves to be valued for what it is, not mistaken for what it’s not.
So here is where I land. Maybe the future isn’t about drawing a hard line between therapy and non-therapy. Maybe the way forward is a kind of partnership. Volunteers and musicians can bring warmth and connection. Therapists can bring depth and clinical skill. We don’t need to compete —we can collaborate.
Alive Inside gave the world a powerful story. It reminded us that music reaches places words cannot. But it also raised a question we still haven’t answered: when we conflate emotional power with therapeutic practice, do we risk diminishing both? As someone who works in this space, I now feel a responsibility—not just to play music, but to listen more deeply: to patients, to therapists, and to the ethics of care. We don’t need to discredit Alive Inside to see its limitations. We need to deepen the dialogue it began. And that conversation shouldn’t end on the screen—or on this page.
Healing with Music is ready to take that next step. I’ve always believed in music’s power, that’s never been in question. But power without responsibility is just noise, and I didn’t get into this to make noise.
I got into this to make music.