Steve Pretty On The Origin of the Pieces

Music therapy, Swedish standards and clinical improvisation


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This week I speak to Kassandra e’Silva, a saxophonist, improviser and NHS music therapist. We caught up just before a gig at the Edinburgh Jazz Festival to talk about the power of music in care settings — from dementia wards and mental health clinics to the BBQ playlist at home.


We cover:


  • Baby‑wearing during soundcheck 👶
  • Pre‑verbal communication in music
  • Clinical improvisation and jazz
  • Whether all music is a kind of therapy
  • And why rhythm might be the most important bit




⏱️ Highlights


00:00 – Intro – ALSO Festival, Nosferatu live score, and a conch bath update

03:00 – Edinburgh Jazz Festival – A tribute to The Jazz Bar and Bill Kyle

08:30 – Interview with Kassandra e’Silva – Backstage at the Spiegeltent

10:00 – What music therapy is – Presence, trauma, and non-verbal expression

13:30 – Lighting up the brain – Music as reconnection

16:00 – Music at both ends of life – Parenting and dementia

20:00 – Letting go of ‘good’ music – From jazz standards to egg shakers

23:10 – Rhythm as anchor – Repetition, stability, and mental health

25:40 – Creative expression – Instruments, blocks, and tambo-responsiveness

29:40 – Teaching vs therapy – When learning becomes part of healing

31:40 – Improvisation as diagnostic mirror – Sound as resistance

34:40 – Participation matters – Why passive listening isn’t enough

36:10 – What’s the point of music? – A beautiful closing answer



🎶 Check out Resounding, co-written with Nicole Cassandra Smit, on Hackney Colliery Band – Collaborations: Volume Two

👉 Listen on Bandcamp





💬 Resource: Music in Dementia (NHS Lothian)


Kassandra helped develop this practical guide for carers, families and practitioners.

Includes activity ideas, playlists, and real examples from NHS care.


🎵 Explore the guide

Note: Kassandra’s views are her own, not those of NHS Lothian.



🎧 Support the show:

💌 originofthepieces.com

patreon.com/StevePrettyOnTheOriginofthePieces


#musictherapy #jazz #musicanddementia #improvisation #originofthepieces #kassandraesilva #stevepretty

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Steve Pretty On The Origin of the PiecesBy Steve Pretty