This article is the result of questions and reflections on improvisation in music therapy. The purpose of this study was to provide a review of literature through electronic search in the publications of the Journal of Music Therapy since its beginning (1964) until the present day. A systematic review was conducted in order to analyze what improvisation is in music therapy and its role in the clinical setting. Twelve articles were selected and analyzed in order to identify the served population, setting, instruments, types of analysis, objectives and results of improvisation in music therapy. Among the findings, this study has demonstrated that there is a gap between the creation of improvisational music therapy (1959) and the initial publications about the topic on the JMT (1988), that improvisation was used with a small variety of population with a broad diversity of objectives and that there is a focus on behavior and not on the analysis of the creative musical material produced by the therapeutic relationship.
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