Music and Movement

Music and movement is one of the most versatile and flexible interventions that we’ve talked about in this blog. It can be used with almost any population you can think of, because it can be adapted to work specifically on the areas of need for your clients.

Music and movements is used very, very frequently when working with children, whether or not the children have physical goals they are working on. As you can imagine, you can’t expect a group of young children to sit and listen to music for 30 to 60 minutes, and that’s where music and movement comes in. Children often get very excited to get up and move to interact with a song. Many very young children may have goals relating to self-regulation skills, such as following directions. Although this isn’t necessarily a physical goal, a music therapist could incorporate movement by choosing songs such as “Old MacDonald,” and asking the children to get up and move like the animals they are singing about. While the emphasis isn’t on the movements themselves, the children are still getting up and moving around the room to work on following directions in the music.

Many adult populations use movement and music as well. Older adults may benefit from stretching along to music in order to maintain the range of motion that they have. While this may seem like a very different intervention than the high-energy dancing and movements done with children, they are both still considered music and movement as there is still some physical response to the music itself. With adults in particular, it can be a bit intimidating if a music therapist introduces movement to music as “dancing,” and in many cases the clients aren’t dancing at all. In this way, music and movement is great descriptor of these very versatile and widely used interventions.

-Maggie

Lyric Analysis

Lyric analysis is one of my favorite interventions to facilitate, because it can be so versatile and lead into all kinds of other interventions later in a music therapy session. In lyric analysis, a music therapist brings in a song for a group to listen to, often asking the group to underline or circle lines of the song that stand out to them, and then discussing the song’s themes afterwards, talking about what stood out to the group and how individuals can connect the song to their own emotions and their own lives.

Lyric analysis is used fairly often in mental health settings, which is where I have personally used it most. I was able to choose songs to listen to that discussed specific themes that we could carry over into other interventions. For example, I have used the song “Under the Bridge” by the Red Hot Chili Peppers, which touches on some themes of loneliness and finding support in others around you. After that, I was able to do a songwriting intervention using the song “Lean on Me” by Bill Withers, so that we could talk where a client find their own personal support in their life, often from family and friends.

Although these themes are pretty set in stone based on the lyrics to the song that the music therapist picks out, there is still a lot of flexibility that this intervention offers the client, as they are able to direct the discussion based on what they want to talk about or what stood out to them. There are never two lyric analysis discussions that are the same!

-Maggie

Therapeutic Singing

Now, I’m going to go on a limb here and say that when most people hear the term “music therapy”, this is what they picture: a therapist with a guitar, sitting next to client X, singing a song together.  In it’s simplest form, this picture isn’t far off the mark from therapeutic singing. However, there are many different things that make therapeutic singing different when implemented by a music therapist.

For starters, every aspect of the music is chosen and tailored based on the client's immediate needs. While various other music professionals (professional musicians, music volunteers, nurses using music, you name it) will either play recorded music to sing with or host a sing-a-long with clients, they may not have the knowledge or understanding of the various musical elements in order to best manipulate them to reach the clients. Or, if they do have the advanced music skills, they may not be trained in observing and assessing the client in order to know what to change.  I’ll provide a clearer example below.

The nice thing about therapeutic singing is that it is very complimentary with many other interventions we use. Music therapists will use singing in conjunction with songwriting, lyric analysis, and instrument play to create more complex interventions, or to provide the client with alternate ways to engage with the therapist. Therapeutic singing is also incredibly versatile, and can be appropriate to use with almost any client. In my experience, it’s also one of the most effective ways to build a relationship with a client.

Since therapeutic singing is so broad and can be applied in so many different contexts, I’m going to give one specific example that I find to be the most fascinating. One of the settings music therapists work in is in the neonatal intensive care unit, or NICU. This is one of the few settings where therapeutic singing is used pretty exclusively. These patients, depending on what developmental stage they were born at, are often unable to handle most kinds of complex stimuli. Although this makes it seem like they would be unfit for music therapy services, this is one of the reasons that therapeutic singing can be so beneficial for them. There are certain sounds and intervals that are innate to the human mind- descending minor thirds, for example (think of the “Rain, rain, go away” song). When sung in a certain range, and with an appropriate level of tactile stimulation, simply repeating this interval over and over again is incredibly beneficial for these patients. It speeds up their brain development, and we begin to see positive behaviors out of the babies, such as an increase in sucking. Even better, we see speedier recovery when we are able to use the mother’s voice. This not only increases their developmental speed, but also increases parent-infant bonding. As the patient’s brain develops, the music therapist will make the music more complex, eventually working towards a full melody line, with words, and a simple harmony. Music therapists see incredible progress while working with infants in the NICU through the simple use of the human voice, trained and manipulated appropriately based on the needs of the client.

In case you’re curious to see what this looks like in person, the New York Times posting a very informative video at the following link: https://www.youtube.com/watch?v=4qjx2BrrQJg

As with before, here is more research speaking more in-depth on this topic. Also as with before, feel free to comment with any questions you may have!

-Alyssa

Belgrave, M. (2011). The effect of a music therapy intergenerational program on children and older adults’ intergenerational interactions, cross-age attitudes, and older adults’ psychological well-being. Journal of Music Therapy, 48(4), 486-508.

Clark, I. & Harding, K. (2012). Psychosocial outcomes of active singing interventions for therapeutic purposes: A systematic review of the literature. Nordic Journal of Music Therapy, 21(1), 80-98.

Kolar-Borsky, A. & Holck, U. (2014). Situation songs- Therapeutic intentions and use in music therapy with children. Voices: A World Forum for Music Therapy, 14(2).

Loewy, J., Stewart, K., Dassler, A., Telsey, A., & Homel, P. (2013). The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics, 131(5), 902-918.

Songwriting

Songwriting is one of my favorite music interventions. I think this is because it challenges my creativity while giving me a glimpse into a client’s personality, interests, and struggles. Songwriting can be a very personal and rewarding experience. For example, someone recently diagnosed with an illness may be struggling to come to terms with the condition, and may be experiencing symptoms of depression. Songwriting allows for verbal processing in a minimally invasive way. The client/patient can share as he/she feels comfortable, and is guided by the structure of the music. This could be with a simple Chorus-Refrain form and a “fill-in-the-blank” style where the patient only responds with a word or phrase. A more complex method of songwriting is "from scratch”. The therapist can play different chord progressions and styles of music and have the patient choose which reflects him/her the best. They can then discuss content. What is most important for the client/patient to portray? A powerful way to work through the patient’s situation is by focusing each verse on a different time in his/her life. The past, present, and future self can be discovered and presented in a unique way. This experience can also be meaningful for the patient’s family members. It can be recorded as a reminder of the emotional, physical, or spiritual journey.

Many different goals can be reached using this intervention in a variety of other settings. In one of my practicums with 4-5 year olds, I used a simple songwriting application to work on impulse control. The music therapist determines the most effective method for an individual and guides the experience with adaptations as needed.

For more information check out:

Baker, F., Wigram, T., Stott, D., & McFerran, K. (2008). Therapeutic songwriting in music therapy. Nordic Journal of Music Therapy, 17(2).

Brunk, B. K. Songwriting for music therapists, Prelude Music Therapy.

http://musictherapyactivities.wikia.com/wiki/Songwriting_and_Lyric_Convergence

Therapeutic Instrument Play

Instruments play (pun intended) a dynamic role in a music therapy session. People of all ages and abilities can benefit from live instrumental experiences. This can look different across sessions, depending on the needs of the client. For example, it could be in the form of a drum circle where a group is interacting non-verbally through improvisation, or in an individual session with set chords, notes, and rhythms. The list of instruments used goes way beyond guitar and piano!

Here are a few that I have used:

Cabasa                Claves

Tambourine        Bells

Egg Shakers       Tone Chimes

Recorders           Boomwhackers

Djembe               Floor Drums

Paddle Drums    Ocean Drums

Q-Chord             Xylophones

The list of functional goals that can be reached using musical instruments is also extensive.

Here are a few examples of the behaviors that can be improved/increased:

Positive coping skills

Emotional expression

Self-regulation

Range of motion

Fine/gross motor skills

Self-esteem

Attention span

Social interaction

Pain management

Audio/visual perception

The fantastic thing about instruments is that they are intrinsically motivating while providing multiple opportunities for choice and autonomy. This means that the client may feel a sense of control when choosing an instrument, and (because it is preferred) is even more likely to actively participate in the session. Another great thing is that instruments are versatile. Adaptive handles and other equipment may be used to allow people with limited motor functioning to be successful.

To see additional goals that can be served in music therapy:

http://www.inmusictherapy.com/vlt12768.htm

For more information on specific populations:

http://www.musictherapy.org/research/factsheets/

Research specific to instrumental play (There is way more out there!):

Best, H. (2014). Group music therapy utilising marimba playing for children with low self-esteem (Order No. 1600914).                   Available from ProQuest Dissertations & Theses Global. (1712633662). Retrieved from                                                             http://search.proquest.com.www2.lib.ku.edu/docview/1712633662?accountid=14556

Case Examples of Improvisational Music Therapy. (2012). Gilsum, NH, USA: Barcelona Publishers. Retrieved from                        http://www.ebrary.com.www2.lib.ku.edu

Lim, H. A., Miller, K., & Fabian, C. (2011). The effects of therapeutic instrumental music performance on endurance                      level, self-perceived fatigue level, and self-perceived exertion of inpatients in physical                                                              rehabilitation. Journal of Music Therapy, 48(2), 124-148. Retrieved from                                                                                   http://search.proquest.com.www2.lib.ku.edu/docview/881979785?accountid=14556

Music-Assisted Relaxation

The first music therapy technique we’ve decided to cover is called music-assisted relaxation. Although the name sounds pretty self-explanatory, music therapists can use this technique in a large variety of ways. For example, music-assisted relaxation may have the music therapist at a piano or guitar playing a simple progression while the patient sits or lies down in a comfortable position. From there, the therapist observes the patient and changes different aspects of the music- such as rhythm, dynamics, harmony, or tempo- based on changes they see in the patient. Or, the therapist may be playing an instrument while speaking from a script, leading the client through a series of muscular relaxations or guided imagery. Another similar modification would have the therapist play a recorded instrumental track in the background while they speak a script.

To me, the most interesting variation of music-assisted relaxation is called “song chaining”. It's a skill I've been working towards the past few weeks. To do song chaining, the therapist will play and sing multiple songs from within a patient-preferred genre without ever stopping the music. I had the opportunity to observe this within a hospital, and the results were incredible- the patients respiratory rate and heart rate, which were elevated at the beginning of the session, were at a normal level after the first two songs. He was sleeping for the entity of the session, but his affect went from strained to neutral, which is an indication of decreased pain and discomfort. All of these changes from a music therapist playing fingerpicked guitar, looping through songs previously identified as pleasant by the patient. It’s really fascinating to see happen in person!

Music-assisted relaxation can be used with many different populations. I’ve seen music therapists use this in hospitals, hospices, mental health facilities, and with individuals with developmental disabilities. Ultimately, the effectiveness of the technique is dependent on the goal and each individual patient. There’s a lot of research out there stating the benefits of music-assisted relaxation, and I’ve provided a few citations of good articles below. If you have any questions, feel free to leave them in the comments and I’ll be sure to get back to you ASAP!

-Alyssa

Enrich, M. (2006). Calm waves: A music-assisted relaxation and imagery experience, including a mental trip to a calm and inviting open beach. Music Therapy Perspectives, 24(1), 54.

Mandel, S. (2010). Effects of a music-assisted relaxation and imagery compact disc recording on health-related outcomes in cardiac rehabilitation. Music Therapy Perspectives, 28(1), 11-21.

Pfaff, V., Smith, K., Gowan, D. (1989). The effects of music-assisted relaxation on the distress of pediatric cancer patients undergoing bone marrow aspirations. Children’s Health Care, 18(4), 232-236.

What is Music Therapy?

Perhaps you’ve heard of music therapy before, but never seen it in action. Well, you’re in luck! This blog has three current music therapy students very excited to tell you all about their future profession! My name is Maggie, and I’m a junior at KU working on applying to internships with a mental health focus.

So, what is a music therapist anyway? Music therapists have completed at least a bachelor’s degree in music therapy, have completed a 6 month internship, and sat for a board exam to earn their MT-BC (music therapist-board certified) credentials. In their training, music therapy students are taught how to assess their client’s strengths and areas of need, and create goals and objectives based off of these assessments. Throughout the treatment process, music therapists take data in each session on how their client progress towards their goals. All of this is supported by research showing how music can impact people’s lives in a positive way.

We will post on this blog daily detailing an intervention or technique used by music therapists to achieve their client’s non-musical goals. Here’s a little bit about our other bloggers:

Hello! My name’s Alyssa. I’m getting ready to finish my coursework at KU and will be shipping off to Phoenix, Arizona! While in Phoenix, I’ll be doing a six-month music therapy internship at Banner University Medical Center. That means my 8-to-5 life will be spent running (supervised) around the hospital, working with clients and learning even more about the profession. I’m incredibly excited to see what this next step has to offer! 

Hi! My name is Bethany. I am a 24 year old undergraduate from Kansas. Although it took me longer to stick with a college (I refer to myself as a seasoned transfer student), I have been sure of my major choice/career path since I heard the words “music therapy”. I am so blessed to be able to use my talents in such a powerful way to help people with many different needs. I graduate next week and get married in July- talk about greatest summer ever. After that, I hope to intern in an adult medical setting. I do not know where life will lead after that, but I know that I couldn’t ask for a more challenging and rewarding profession.