When we think about it we all respond to music and are surrounded by it in our daily living. From birth, through adolescence and adulthood we use music to soothe, stimulate, connect with others and give’ voice’ to our feelings sometimes without using any words. Everyone can participate in music making regardless of disability, ethnicity or age and this is what makes music therapy an effective intervention for people of all ages and abilities.
Everyone can participate in music therapy sessions; clients do not need to have any previous musical training or experience. In a typical music therapy session the music therapist and client create music together using voice, a range of accessible percussion instruments and IT equipment. They establish a relationship through which the individual can communicate thoughts and feelings in a way they have perhaps never previously been able to in a safe and supported environment. Through this they have a new experience of communicating and relating, and as a result may come to regard themselves in a different way. The therapist’s role is to facilitate this expression and communication.
Styles and models of working vary depending on the setting and the needs of each client group e.g. a therapist may well adopt a very different approach when working with pre-school children as opposed to adults in a mental health setting. However, there are some general principles which are at the centre of music therapy practice.
A guide to the use of music therapy with a range of communication difficulties and disorders. It should be noted that the following are general examples of how music therapy is used to support and develop particular groups of clients. The specific aims and objectives of therapy programmes are individual to each client.
A pre-school child with significant speech and language delay and associated behavioural problems.
Music Therapy sessions provide a boundaried structure which encourages appropriate behaviour and leads to increased vocal use. Through rhythmic play, the intonation of sounds and mirroring of vocal ideas, children working at a pre-communication level are encouraged to ‘play’ with their voices. This prepares them to be more open to speech and language therapy interventions.
A child with autistic spectrum disorder, who has severe difficulties in a number of areas including deficits in their ability to communicate, tolerate sounds and concentrate.
Music Therapy sessions provide a secure structure for the child on the autistic spectrum. Through the non-verbal medium of music their playing and vocal sounds are mirrored. Perhaps for the first time these innate sounds are given meaning. Communication, cognitive, sensory and behavioural skills can be developed as the client begins to interact using this less ‘threatening’ language. The clients acquire new skills and develop an increased sense of self at their own pace.
An adolescent in a psychiatric setting who may have a depressive illness, self- harming behaviour or expressing suicidal ideation.
Music Therapy sessions provide a space for self-expression and for enhanced self-esteem. Music plays a significant role in the lives of most adolescents as they explore genres which appeal to them and which express their emotions and feelings.Through song-writing, creating their own music, the use of music information technology, listening and discussion clients are provided with an empathic, supported therapy space where they can explore difficult issues.
An adult with acquired brain injury as the result of a stroke or physical injury who has lost movement and has significant speech impairment.
Music Therapy sessions provide a space where the client can express their feelings through the non-verbal language of music. Through instrumental and vocal exercises they can explore the grief and frustration at their loss of movement and speech. Music which was important to them prior to their brain injury can also be used in sessions and clients can create their own ‘new’ music through the use of specific information technology. Clients become re-empowered as they begin to exercise control over aspects of communication, enhancing self-esteem. Joint work with physiotherapists can develop fine and gross motor control through the use of instruments.
A child, young person or adult with a terminal illness.
For the client with a terminal illness music therapy sessions provide a space for self-expression and communication. This occurs through listening to music which has significance to clients, discussion around this significance can lead to the creation of an individual's own music. Through song-writing and information technology the therapist can offer the opportunity to express how one is feeling. This may also provide the opportunity to create a musical legacy for their families to have a piece of music as a memory of them. Music therapy in this context provides a creative response in the midst of all the medical interventions where a person can lose their sense of self.
An adult with dementia or Alzheimers disease.
For these clients music therapy has a role in decreasing agitated behaviours, in promoting feelings of acceptance and belonging. Even though clients may exhibit deteriorating levels of functioning they may be able to retain musical perception, and learn new information when presented in a musical context. The use of familiar songs and music can be used to assess the level of functioning, to provide a relaxing environment for clients and to offer an alternative way of communicating when their ability to express and interpret language has significantly declined.
There is no prescribed type of sound or style of music required for a certain client or group of clients. Instead, the therapist intuitively uses whatever musical sounds/instruments that seem to be appropriate for that particular session and individual. The music used may be pre-composed, improvised or songs/music written by clients with the therapist.
Music therapy sessions provide a space where vocal activity, instrumental play and spontaneous interaction are encouraged. For example, when working with an autistic child, the therapist can pick up on and incorporate into musical expression the sounds and even small gestures the autistic child brings to the session – interpreting these sounds and movements as the child’s ‘music’.
Children, young people and adults with:
In common with all other Allied Health Professionals music therapists work by accepting referrals and undertake a minimum of three individual assessment sessions to determine firstly if music therapy will be an appropriate intervention and secondly if individual or group therapy would be most appropriate to their needs. A programme of therapy sessions is then put in place.
The goals and aims in music therapy are individual to each client and common goals in music therapy may include development in:
There may be more specific aims identified for clients and over time as the therapeutic relationship evolves and clients meet therapy goals new aims are established or if it is deemed suitable the therapy ended.