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Abstract

Sustainable behaviours, in particular environmental sustainability, are a key theme across the healthcare landscape and are increasingly discussed in the field of music therapy. This article is a position piece exploring different perspectives in the area, aiming to raise the profile of the topic for Music Therapists. Three areas of sustainable behaviour are used as a framework for the article, first through the presentation of a literature review and then examples of music therapy practice. The three areas are: work with people with climate anxiety (care for others), reflective practice and sustainable careers (self-care), and prevention in work with service users and the practicalities of environmental sustainability (caring for the environment).

Keywords

climate anxiety environmental sustainability reflective practice and sustainable careers sustainability sustainable behaviours

Introduction

Sustainable behaviours have become a central issue for Music Therapists to address in training and in professional practice (Coombes, 2023; McLaughlin and Seabrook, 2025; Seabrook, 2020). The Pan-European Commission on Climate and Health (2025) stated in 2021 that ‘the climate crisis is a health crisis, and climate action is therefore health action’ and in 2025 that ‘the growing health and economic toll of climate inaction – and the multiple benefits of action – demand a far more ambitious climate agenda’. In addition, Juniper (2025) considers that fairness is essential for achieving lasting ecological progress. Therefore, sustainability and the environmental emergency will demand action and engagement from all health and care professionals. Drawing upon existing literature and initiatives, this position piece will explore three different areas, setting out some of the issues and some of the ways in which Music Therapists in the United Kingdom are thinking and working on these topics. The writing of Corral-Verdugo et al (2021) will be used as a framework to consider these areas of sustainable behaviour in music therapy. The three areas are: work with people with climate anxiety (care for others), reflective practice and sustainable careers (self-care), and prevention in work with service users and the practicalities of environmental sustainability (caring for the environment) (Corral-Verdugo et al. 2021). This article aims to raise the profile of the topic, the three different areas and the need for action for all Music Therapists and to encourage changes to practice. The authors begin by introducing themselves in order to position themselves in relation to this topic.

Prompted by her mother’s passion for gardening, Tessa spent much time outdoors as a child, digging, planting and nurturing plants and generally appreciating nature and the seasons. This led to much time spent outside as a young adult; holidays were spent camping and walking, and in the 1990s, Tessa gained an allotment plot, which continues to form part of her own self-care. This connection with nature has led to concern for and commitment to action relating to environmental sustainability. Tessa sets herself challenges to take steps towards a zero-waste lifestyle at home and work, including minimising waste and consumption and recycling or reusing. In recent years, Tessa has also become interested in how this can be modelled in her music therapy trainer role, and in April 2025, she was recognised as an energy pledge leader at the University of Roehampton.

Since childhood, Jim has been interested in the impacts of the climate crisis and what can be done to reduce its effects on the planet. As he’s grown older, this has turned into shock at the denial and lack of change that is happening and what this is clearly leading to around the world. During Covid and being on furlough, he had the opportunity to create an Environment & Sustainability Lead position at Chiltern Music Therapy, which has been funded for 2 hours per week since. Initially, Jim had to teach himself everything he thought was necessary to assess and reduce the impact Chiltern had as an organisation, and ever since, he has wanted to widen the areas of influence that he can achieve. Jim has been working with British Association for Music Therapy (BAMT) to support them in addressing this subject on a professional level, which has included creating relevant Continuing Professional Development (CPD) opportunities and linking in with the Climate Minds Coalition. Jim represents Music Therapy at meetings of the Greener AHP Partnership, where he’s been able to learn from other AHPs and refine what he believes our role can be in a more sustainable model of healthcare. Jim coleads the Art, Drama and Music Therapies Sustainability Network, which aims to share best practice between the three professions. He is also a member of the Climate Psychology Alliance and is currently developing a new Climate Café Listening and Music Circle as a means of exploring how music therapy might be used to help people suffering from climate distress.

Literature review

A brief literature review relating to three areas of sustainable behaviour within music therapy practice is included here to contextualise this article. Corral-Verdugo et al. (2021), writing about a model of sustainable behaviour, suggest that ‘environmental problems cannot be solved without solving social problems (and vice versa)’ (2021, 12868). These authors write about sustainable behaviours, including the premise that self-care behaviour is a fundamental component of sustainable behaviour that has been omitted from some frameworks. They set out a three-dimensional model of sustainable behaviour, with the three aspects being caring for others, self-care and caring for the environment. This brief literature review follows the structure of this three-dimensional model.

Clements-Cortés et al. (2024) note that these three areas are important throughout the career of a Music Therapist, both in training and practice. Leal Filho et al. (2025) cover issues relating to sustainability and sustainability teaching at higher education institutions, and useful resources can be found for practice at webpages of the Centre for Sustainable Healthcare (n.d.a, n.d.b, n.d.c). Seabrook’s (2020) valuable article describes both the professional and personal imperative to consider this issue.

Care for others

In Corral-Verdugo et al.’s model of sustainable behaviour, care for others is one of the necessary components, and one that is clearly intrinsic to music therapy. This section of the literature review will focus on a form of caring for others that is most relevant to the climate emergency, which is working with people with climate anxiety or eco-distress.

Eco-distress (Calabria and Marks, 2024) is a term used to encompass the wide range of psychological responses people may experience when thinking about the climate emergency, which includes (but is not limited to) fear, anxiety, grief, anger and a sense of injustice. The climate crisis itself is extremely complex to understand and address, and therefore, the feelings it evokes can themselves be complex. Facing the reality of an existential crisis can be overwhelming, leading to avoidance and denial, and an understandable desire to psychologically protect oneself. Calabria and Marks (2024) argue that the broad range of eco-emotions may have ‘distinct differences from the distress described in traditional models of psychopathology’, and therefore eco-distress ‘presents a unique form of distress to therapists’.

The emotional impacts of eco-distress are being increasingly studied and understood (Pihkala, 2020; Stanley et al., 2021; Verplanken et al., 2020, World Health Organisation (WHO) 2025). A study by Hickman et al. (2021) demonstrated that 83% of 10,000 children and young people from across the world report concerns about climate change, and we can predict that this is only likely to increase as the effects become more and more obvious and devastating. In fact, a 2016 study showed that 37.6% of therapists were increasingly encountering eco-emotions in therapy (Seaman, 2016), and a more recent survey of mental health professionals showed that only 15% of respondents were aware of specific resources or interventions to use (Hoppe et al., 2023).

Linked to this work, there is a growing body of literature that evidences how nature and music therapy can be used together, not only to enhance outcomes for service users but also to provide links to the world and to nature, resulting in more compassion towards the planet (Hand et al., 2025; Lindvang and Daniels Beck, 2024; Pfeifer et al., 2019). The idea of reconnecting with nature is understood by related disciplines as being one way to ‘address the systemic structures and paradigms that underpin the actions and behaviours contributing to the current global environmental crisis’ (Ives et al., 2018: 1390). Pfeifer, (2017) who has written much about eco-music therapy, writes that some music therapists work secretly in this way, doubting the validity of their work, and explains how this work can ‘promote nature connectedness, pro-ecological and environmentally conscious behavior and reduce eco-anxiety’ (Pfeifer, 2024: 39). Musicians, as North Yorkshire Music Therapy Centre’s (2022) blog notes, rely on nature in some ways (natural material form the basis for many musical instruments) and can act to draw others into recognition of and connection with the environment.

Self-care

Self-care for health professionals as a response to the climate crisis

In the three-dimensional model proposed by Corral-Verdugo et al. (2021), the area of self-care is considered necessary in order to allow for the two other aspects. The authors note the reciprocity involved in all three aspects. Seabrook (2020) refers to a similar idea, writing about the ‘deeply personal’ nature of this topic and their own cognitive dissonance (p. 1). Cronin et al. (2023) provide a useful systematic review of the characteristics of highly resilient therapists, including ideas about self-care.

Some health professions (particularly those which experience high levels of stress and burnout) have considered self-care as part of a response to the climate crisis. Powers and Engstrom (2020) write about radical self-care in social work in response to the global stressors of climate change, modern technology and the political landscape. These authors write about the centrality of self-care as part of sustainable practice, referring to the pace model as supporting sustainable and life-enhancing practice. Their article refers to traditional self-care and to activism for social and ecological care as both having importance, explaining their idea that working for the collective good is a type of environmental activism, allowing healthcare professionals to contribute to solutions and change (Powers and Engstrom, 2020). Authors also consider the fact that sustainable practice is enhanced by self-care because healthcare professionals can remain working in attached relationships with service users, which they note are disrupted by high turnover of practitioners (Motani, 2023; Powers and Engstrom, 2020).

Challenges to self-care

Self-care is a central aspect of music therapy practice and may be more necessary given the context of climate change. Challenges to self-care are set out in several pieces of literature, with Cech (2021) and Egan et al. (2019) noting that health and social care professionals may feel that self-care is a diversion from work or should not be needed, citing the passion principle. The digital world may engender a sense in professionals that they should be available at all times (Rose et al., 2025) and, additionally, that they do not have the time (Motani, 2023). There can also be organisational barriers to self-care, with individual, rather than organisational, action being encouraged (Rose et al., 2025, writing about social work). Some organisations use self-care to manage work stress and increase productivity (Riccitelli, 2025; Rose et al., 2025: 1459); these authors note that stress is a work issue and self-care should be built into regular work practice (Rose et al., 2025).

Professional guidance relating to self-care

Regulatory standards for music therapy in the United Kingdom include self-care. This Health and Care Professions Council (HCPC) requirement for reflection upon health and well-being is framed from the primary perspective and role of HCPC to protect the public and ensure the provision of a high standard of professional practice (HCPC, 2023). Self-care is now included in the updated HCPC standards of proficiency (2023). Proficiency 3 states that at the point of registration, Art, Drama and Music Therapists must be able to

look after their health and well-being, seeking appropriate support where necessary;

identify anxiety and stress in themselves and recognise the potential impact on their practice;

understand the importance of their own mental and physical health and well-being strategies in maintaining fitness to practise;

understand how to take appropriate action if their health may affect their ability to practise safely and effectively, including seeking help and support when necessary; and

develop and adopt clear strategies for physical and mental self-care and self-awareness to maintain a high standard of professional effectiveness and a safe working environment (HCPC, 2023, n.p.).

Self-care in training

The preceding literature points to the importance of self-care being developed as a central pillar of practice during training (Campoli and Cummings, 2024; Watson and Warner, 2025). Watson and Warner underline the importance of embedding secure understanding and performance of reflective practice and self-care within a music therapy qualifying training, including where and how to seek help when needed. Failing to attend to challenging aspects of the work and to self-care can lead to low job satisfaction and to Music Therapists leaving the profession, as Eyre notes (Eyre et al., 2023 and see Branson, 2023).

Some specific self-care areas for Music Therapists

Trondalen (2015) writes of self-care as being ‘giving to yourself and also receiving care and support from others, not least through the means of music’ (p. 937). Aspects of self-care that are important to attend to for sustainable practice include both physical aspects and emotional well-being. Care for hearing (Cole and Warner, 2022; Musicians Union, 2023) and safe moving and handling may support more sustainable careers. Music is not surprisingly a central aspect of self-care for Music Therapists, as one of Watson and Warner’s (2005) graduate interviewees states: ‘Improvising is central to my self-care and emotional regulation as a practising music therapist’ (p. 124); also see (Wilhelm and Moore, 2023). This is also emphasised by HCPC Standard of Proficiency 2.13, which states that registrants should ‘recognise that the obligation to maintain fitness to practice includes engagement in their own arts-based process’ (HCPC, 2023). Wilhelm and Moore’s (2023) research in the United States draws upon the voices of students to articulate their self-care practices. One music therapy trainee describes self-care as ‘being able to know what you need, when you need it, and how to make sure you’re doing what is right for you’ (p. 351).

Caring for the environment

The world is experiencing a climate and health emergency. Climate change has been described in The Lancet as ‘the greatest threat to global health of the 21st century’ (Costello et al., 2009: 1693), with the World Health Organisation predicting that on our current trajectory, climate change will cause an additional 250,000 deaths per year between 2030 and 2050 (World Health Organisation (WHO), 2023). These health impacts are not felt equally, with those least responsible for greenhouse gas emissions often most at risk of their effects. Healthcare systems themselves contribute to climate change (Romanello et al., 2023; Sherman et al., 2021), undermining their efforts to improve and maintain the health of the populations they serve.

A model of Sustainable Healthcare was developed by Mortimer (2010), which is still the dominant framework used in the United Kingdom (Braithwaite et al., 2024; Heath et al., 2024; Naughton et al., 2025; Walsh et al., 2024; Yassaie and Brooes, 2025). She specified four principles that are necessary to minimise the environmental impact of the health service while continuing to provide the necessary care to those who need it. In decreasing order of importance, these principles are as follows:

Prevention of illness and disease, reducing the overall need for healthcare.

Patient empowerment and self-care.

Providing the right care at the right time and the right place.

Reducing the carbon in care delivery.

The most impactful of these principles is the first, which ‘requires tackling drivers of poor health’ (Sherman et al., 2021: 4) by providing preventive healthcare. Music Therapists are often already working in this way (de Witte et al., 2020; Wang, 2025); by providing services in settings or the community, we aim to increase the well-being of our clients, which in turn reduces their need for reliance on other services. This has the triple benefit of better outcomes for the client, cost savings from not needing perhaps more expensive interventions later on, and reduced carbon emissions from not requiring more carbon-intensive healthcare in the future (Stancliffe, 2020).

Although the literature on reducing carbon in the delivery of music therapy is minimal, substantial work has been done in other Allied Health Professions, with much of it accessible on the Greener Allied Health Professional hub (NHS England, n.d.). This valuable resource provides information on the importance of environmental sustainability for both population health and the environment, as well as examples of what AHPs are already doing and suggestions for other ways to contribute.

Leal Filho et al. write about the importance of education in sustainability behaviours, suggesting that sustainability education ‘should focus upon imparting action-oriented knowledge’, with academic staff considered role models and agents of change in driving student understanding of interconnected systems and the need for transformative action (Leal Filho et al., 2025: 10). The curriculum guidance of BAMT (2025) requires that there is a consideration of ‘social, economic and environmental sustainability’ (BAMT, 2025: 9). Goditsch et al. (2025a) ran a workshop at the European Music Therapy Conference 2025 which asked which climate crisis-associated topics are music therapists confronted with and how can music therapy contribute to the issues on a therapeutic and societal level (p. 76). At the same conference, Goditsch et al. (2025b) ran a session about therapy in times of global crises, exploring issues related to the relationship between global crises and therapy, Music Therapists’ contributions and roles.

This brief literature review has set out some of the concepts and scholarship related to the three sustainable behaviours that are now explored through examples in relation to music therapy training and practice.

Three areas of sustainable behaviour

Examples are now presented from each of the three areas of sustainable behaviour. These examples explore work with people with climate anxiety (care for others), reflective practice and sustainable careers (self-care), and prevention in work with service users and the practicalities of environmental sustainability (caring for the environment).

Care for others in music therapy

Work with people with climate anxiety

As eco-distress becomes more present in therapy, it is important that music therapists are trained and prepared to respond. McLaughlin and Seabrook (2025) have offered a framework for creative arts therapists to begin to engage with the climate crisis, inviting intentional reflection and suggesting wide-ranging, appropriate action.

One recent response to the need for support for those with eco-distress was a ‘Climate Café Listening and Music Circle’, cofacilitated by music therapist Jim Davey-Hewins (Nestor and Davey-Hewins, 2025). The concept of a Climate Café was developed as an ‘empathetic space where fears and uncertainties about our climate and ecological crisis can be safely expressed’ (Climate Psychology Alliance, 2022: n.p.). It was based on the Death Café model, with both approaches offering a facilitated space for people to come together to discuss something that is surrounded by a ‘socially constructed silence’ (Calabria and Marks, 2024: n.p.). Climate Cafes have been designed as a place to process the sense of loss associated with the climate crisis, which can then be assimilated into a new sense of self and place in the world (Atkinson, 2020). In this new model, two opportunities to improvise were included after periods of verbal reflection on eco-emotions. The intention was to help group participants to deepen and connect to their feelings beyond words and to hold a space for these to emerge. The first of these groups had a positive response from attendees and is currently being developed for further use.

Ames (2023) provides another example of music therapy addressing the psychological impact of the climate crisis, through a one-off workshop in a community mental health setting called ‘Songs for a Crying Earth’. Ames aimed to ‘create a space where people of all ages could explore their evolving relationship with the natural world through group singing’ (p. 3) and also involved improvisation, pre-composed and collaborative music. Although again this is a limited example of this kind of work, she argues that the experience of the group can be transformative and support people to overcome any fears related to the climate crisis, as well as increase agency to make change.

Nature-connecting work in music therapy

Another strand of work is music therapy within nature. Pfeifer et al. (2025) conducted a survey in Austria and Germany that showed that while most music therapists had not worked in nature, a high percentage considered that it would benefit their work. Pfeifer (2017, 2019) has written extensively about this work. He notes that in ancient days, music and the environment would have been interconnected and considers that outdoor music therapy can provide a ‘valuable contribution to a therapeutic community that is rediscovering nature’ (Pfeifer, 2017: n.p.). In his music therapy work, Pfeifer (2017) considers nature as an active partner, writing about the role of nature as cotherapist. In this 2017 text, Pfeifer presents seven case examples, including that of Mr Hillman, included here as an illustration of outdoor music therapy work. Mr Hillman had a stroke, which impacted his cognitive skills and behaviour, and reached a plateau in his treatment with his team. Pfeifer describes how Mr Hillman suggested ‘we could go outside!’ and a short ‘listening walk’ was undertaken, with the idea of collecting natural sounds and storing them in an imaginary bag for further usage. This had a great impact on Mr Hillman and the music therapy group. Mr Hillman remembered the idea and was able to initiate it in future sessions, suggesting ‘we could go outside and collect some sounds!’ (Pfeifer, 2017: n.p.).

Self-care

The theme of self-care has developed in recent years with writing and researching about practice across a range of disciplines, including psychotherapy and counselling and the Arts Therapies (Bleuer et al., 2025; Cronin et al., 2023; Guerrero and Bräuninger, 2025; McLaughlin and Seabrook, 2025; Moula et al., 2025; Ranasina, 2025; Watson and Warner, 2025). The idea of self-care and reflective practice is now a central principle of music therapy training and practice (Trondalen, 2015; Watson and Warner, 2025); however, there is little published literature about how Music Therapists carry out this self-care.

Self-care practice of the authors

The authors have discussed their own self-care practices. For Tessa, two central self-care activities are music and nature. This involves activities such as music-making (weekly orchestra and choir rehearsals) and being in nature (running, gardening at home, on the allotment and in a local community garden). Alongside this are the supportive and social peer networks at work that provide great support. Jim also plays music for self-care, currently in a big band and local orchestra, as well as going on walks with his family whenever possible. He also attends online Climate Cafes to connect with others and help to stay in touch with his feelings about the climate crisis.

Self-care in training

On UK qualifying training programmes, self-care is embedded within the curriculum and trainees are encouraged to develop their own self-care practice. Self-care is drawn into learning and teaching about all aspects of the role. This includes physical body, hearing and voice care, and mental health well-being. A couple of examples are included here. At the University of Roehampton, teaching about neuroscience and trauma includes consideration of self-care during learning, with self-care resources being provided for students, including the idea of completing a trauma map and using reflective spaces for support. Specific seminars about self-care are also delivered, with linked independent learning that requires students to reflect upon their self-care and begin to develop resources and practices for their future practice (University of Roehampton, 2024). At Anglia Ruskin University, there is teaching about self-care in both years of the training, with learning drawn into assessments and a development plan (Molyneux, Personal communication between Claire Molyneux and Tessa Watson, 19 December 2025). The valuing of lived experience is important to note here; trainees and Music Therapists with lived experience have much to offer regarding self-care.

At the University of Roehampton, the development of ideas relating to sustainability has been supported by discussions within the School of Psychology Service User and Carer group (SUCG). The SUCG supports service users/carers’ involvement in the programmes (as required by the HCPC, 2017). The SUCG group’s recommendations relating to trainee understanding and development of sustainable practice and self-care include the following:

Recent graduates talking to student cohorts about their understanding of the importance of self-care and sustainability in practice, particularly during the early years.

Staff teams to model ways of performing self-care and reflective practice.

Learning and teaching to include the topic of boundaries and allow deep reflection upon the development of personal and professional boundaries.

Openness to the idea that self-care is different for everyone and encouragement for trainees to use contemporary/innovative approaches to self-care.

Provision and exploration of the sources of support available to graduates once in practice, both in work and personal spheres.

Employability sessions to include encouragement for trainees to ask questions about work/life balance and expectations of employees during interview processes.

Inclusion of the topic of financial well-being.

The provision (where possible) for recent graduates of alumni events, a supportive network to access and an invitation to keep in touch with trainers. (School of Psychology Service User and Carer Group (SUCG), 2025)

Self-care in practice

It is also important to note possible negative effects of music therapy work, which may include burnout, compassion fatigue and secondary trauma. These can lead to emotional and physical exhaustion. Working to attend to these experiences before they become overwhelming can allow Music Therapists to adjust their work and enable sustainable practice (Watson and Warner, 2025). Building a varied caseload with a range of work, perhaps including working with colleagues, delivering training and the provision of different types of therapeutic work or projects, can support breaks from the need to be constantly emotionally available.

Caring for the environment

Prevention in work with service users

A study by Lale and Ntourntoufis (2020) measured the effectiveness of individual music psychotherapy in patients with psychosis by comparing rates of hospital readmission between those who received weekly 1:1 sessions and those who received treatment as usual. This study demonstrated how patients who received weekly 1:1 sessions while an acute inpatient, which then continued for 3 years in the community after discharge, had, on average, 60 fewer days in hospital per patient per year, which equates to a potential reduction in cost of £25,740 per patient per year. This interesting study has not been followed by similar research in the United Kingdom, and it is noted that it was a small study of an unusual level of provision and may not be representative of other MT services.

The Royal College of Psychiatrists (2023) article ‘Delivering greener, more sustainable mental healthcare guidance’ states that one inpatient mental health bed day has a carbon footprint of 97 kg CO2e. Alongside Lale and Ntourntoufis (2020), this suggests that by providing long-term individual music psychotherapy in this context, a carbon saving of 5.82 tonnes CO2e per patient per year can be achieved. For context, this is roughly the equivalent of more than 10,000 miles driven in an average car.

It is perhaps counterintuitive to think that providing more music therapy might be better for the environment, when we tend to think of the need to reduce what we are doing. Often this will not be the case, however. There are many other contexts where Music Therapists are providing preventive care (de Witte et al., 2020; Haugwitz, 2021; Patch and Short, 2022; Suh, 2023; Sun et al., 2021; Wang, 2025), and it would be valuable for us as a profession, as well as for those we try and help, to frame our services in this way when appropriate, and perhaps begin to prioritise those that have the most positive impact on health outcomes, cost and environmental impact.

Reducing the carbon of care delivery

Referring back to the four principles of Sustainable Healthcare (Mortimer, 2010), it is also incumbent on us as clinicians to do all we can to reduce the carbon emissions related to our delivery of music therapy. While music therapy has a comparatively small impact on the environment, there are still areas that can be addressed. In 2025, BAMT were involved in a project run by the Chief Allied Health Professions Officer (CAHPO, NHS England) to establish the top 5 sustainability priorities in each of the allied health professions. The agreed priorities for music therapy were:

Training on sustainability for preregistered students

Improving the efficiency of travel for case work

Promoting good mental health and active strategies for service users, trainees and in professional practice

Research and promote how Music Therapy can be used as part of preventive care

Ethical finances

These five areas are being addressed as part of BAMT’s (n.d.) current Strategic Plan, which has sustainability as one of its values and includes aims and key performance indicators.

Chiltern Music Therapy, a UK-based music therapy organisation, has been working to minimise its carbon footprint since publishing its original Environmental Policy in 2021, which was followed by a first Environmental Report covering 2022–2023 and subsequent annual reports. It established the following key areas of environmental impact:

travel to and from sessions

office-related energy, water use and waste

purchase of instruments and office supplies

finance-related (bank and pension investment)

digital (cloud storage and website)

Staff travel is by far and away the largest aspect of this, with related emissions making up around 99% of the organisation’s carbon footprint in its latest report (Chiltern Music Therapy, 2025). By implementing driving reduction strategies, it was possible to reduce travel-related emissions by 25% between 2022–2023 and 2024–2025. These strategies included reorganising clinicians’ schedules to make driving between sessions more efficient; being more considerate in allocating clients to the most local therapist; signposting referrals to other music therapy organisations if a local therapist is not available; incentivising staff to use public transport or active travel where possible, by changing the way travel expenses are reimbursed. The need to transport instruments between settings is seen as a barrier to public transport or active travel, although sets of secondhand instruments could be left at settings to combat this.

Another area music therapists are thinking about is their use of instruments (Coombes, 2023). Chiltern Music Therapy has implemented a ‘secondhand first’ policy for the purchase of instruments, reducing the need for resources and energy to be consumed in the manufacture of new ones. They also have a register of instruments not currently in use, so that instruments can be moved around the organisation between therapists when they are needed, again reducing the need to buy more.

Although not directly related to the work, where organisations hold their money or invest in pensions can have a huge impact, as finance plays a massive part in contributing to the climate emergency. The UK Health Alliance on Climate Change (2020) has produced a resource to help individuals and organisations understand the need to divest in fossil fuels and steps to do this.

In Chiltern Music Therapy’s model of bringing music therapy to wherever people are, energy-related emissions are not within the direct control of the clinician. However, settings can be encouraged to think about energy use, perhaps by including something within a service agreement that offers support and guidance to make positive changes.

Diamond (2022) demonstrated how a hybrid way of working during the COVID-19 pandemic ‘led to a significant reduction in carbon footprint’ due to a reduction in travel emissions, while also benefiting the participants. Music therapists may wish to consider when they can work online when appropriate, but it is recognised that the majority of sessions will need to be face-to-face to most benefit our clients. The service users who form the Chiltern Insights Group were consulted about their views on digital versus face-to-face sessions and unanimously preferred the latter.

Conclusion

This position article has drawn together ideas from three areas relating to music therapy and sustainability: climate anxiety and eco-distress (care for others), self-care and sustainable practice (care for self), and prevention and the practicalities of environmental sustainability (care for the environment). We hope that this will prompt thought and action from the music therapy community in the United Kingdom and internationally, and we hope to continue this dialogue – perhaps at the BAMT conference in November 2026.

The idea of a sustainable career is central to the profession. And the profession is essential for the planet, something that Juniper’s recently published book urges us to understand. Juniper (2025) considers that fairness is essential for achieving lasting ecological progress – social inequalities are the greatest environmental threat, and Music Therapists’ role in providing sustainable work in centralising and supporting minoritised groups is therefore essential.

Footnotes

ORCID iD

Tessa Watson

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Author biographies

Tessa Watson is a Music Therapist and Educator working at the University of Roehampton, United Kingdom, as Associate Professor/Programme Leader for the MA Music Therapy. Tessa has worked as a Music Therapist and in a variety of other roles in a range of mental health and learning disability settings, and her current therapeutic work is with the children and families who use Alexander Devine Hospice. She is passionate about advocacy for marginalised groups and considers her music therapy work to be creative activism. Tessa works for HCPC on CPD and FTP schemes, has an interest in coproduction and is one of the founders of HENCoP (The Health Education Network for Co-Production). She has published on topics such as music therapy work, interdisciplinary work and training. Tessa’s most recent book, written with Cathy Warner, is Contemporary Issues in Music Therapy Training, A Resource for Trainees, Trainers and Practitioners (Routledge 2025).

Jim Davey-Hewins is a Music Therapist who trained at the University of Roehampton, United Kingdom, and has experience working with children and adults with learning disabilities and in mental health settings. Jim is currently the Environment & Sustainability Lead at Chiltern Music Therapy, as well as colead of the Art, Drama & Music Therapies Sustainability Network, which is hosted by the Centre for Sustainable Healthcare. He is also a member of the Climate Psychology Alliance and the Greener AHP Partnership Group.

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Sustainable behaviours within music therapy: A view from the United Kingdom

Abstract

Keywords

Introduction

Literature review

Care for others

Self-care

Self-care for health professionals as a response to the climate crisis

Challenges to self-care

Professional guidance relating to self-care

Self-care in training

Some specific self-care areas for Music Therapists

Caring for the environment

Three areas of sustainable behaviour

Care for others in music therapy

Work with people with climate anxiety

Nature-connecting work in music therapy

Self-care

Self-care practice of the authors

Self-care in training

Self-care in practice

Caring for the environment

Prevention in work with service users

Reducing the carbon of care delivery

Conclusion

Footnotes

ORCID iD

Funding

Declaration of conflicting interests

Author biographies

References