Improvisation in music therapy allows for clients to make up, or alter, music as they see fit. While improvisation is an intervention in a methodical practice, it does allow for some freedom of expression, which is what it is often used for. Improvisation has several other clinical goals as well, which can also be found on the Improvisation in music therapy page, such as: facilitating verbal and nonverbal communication, self-exploration, creating intimacy, teamwork, developing creativity, and improving cognitive skills (Bruscia, 1998). Building on these goals, R. Keith Botello and Dr. Robert E. Krout (2008) took steps to design a cognitive behavioral application of improvisation to assess and improve communication in couples. Further research is needed before the use of improvisation is conclusively proven to be effective in this application, but there were positive signs in this study of its use.