Onwards and upwards!?

So I’ve finally passed MSc music therapy – after a couple of years study, and a couple of years planning before that. It’s been a lot of work, it’s changed my way of thinking (and making music), and it’s developed me personally too…

The qualification is just the start of the next part of this journey, setting off into the world and working with people for real – helping people through music – what brought me to music therapy in the first place.

So it’s time to face the music – the name I’ll use for musical endeavours going forward – drawn from a community music group a couple of years ago where f.a.c.e. stood for “fun all-age community ensemble” – and it also brings a catchy tune to mind ;)

face the music

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Music therapy, what’s that?

(Back to Blog after summer break – none for months, then two posts in a day!)

As I begin second year of university training in music therapy, I often find myself explaining the subject to people I meet – it still seems to be a little-known field… here are snippets from conversations:

it’s like using music as a tool to help people

it helps folk connect in different ways

music can communicate more than talking

I suppose it’s easier to understand the music part of the equation, compared with the therapy part.  The theory behind the practice and the clinical approach have been big things to learn for me – and it’s great to have music as a vehicle for the work.

Reading more around the subject, and re-reading books I’d previously read, I have more questions and deeper thoughts about how music impacts people.

So, this blog will see more posts on #MusicTherapy and related thoughts – meantime here’s a portrait of Amy I spotted in Amsterdam this summer…

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Back to Black, Street Portrait of Amy, Amsterdam

Conclusions changed for music therapy – Cochrane Review

Having heard about Cochrane reviews, and knowing how respected they are, I was intrigued to see a Cochrane Review tagged “Conclusions changed” and entitled Music interventions for improving psychological and physical outcomes in cancer patients.

With the growing body of research, it appears music therapy is now recommended for inclusion in cancer care, compared to a few years ago.

From 2016:

We conclude that music interventions may have beneficial effects on anxiety, pain, fatigue and quality of life (QoL) in people with cancer. Furthermore, music may have a small positive effect on heart rate, respiratory rate and blood pressure. Reduction of anxiety, fatigue and pain are important outcomes for people with cancer, as they have an impact on health and overall QoL. Therefore, we recommend considering the inclusion of music therapy and music medicine interventions in psychosocial cancer care.

From 2011:

This systematic review indicates that music interventions may have beneficial effects on anxiety, pain, mood, and QoL in people with cancer. Furthermore, music may have a small effect on heart rate, respiratory rate, and blood pressure. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution.

Interestingly, the review also compared “music therapy” with “music medicine”, their term for listening to pre-recorded music, offered by medical staff:

A comparison between music therapy and music medicine interventions suggests a moderate effect of music therapy interventions for patients’ quality of life (QoL), but we found no evidence of an effect for music medicine interventions.

So, plenty to think about here, and plenty to read further online

Playin’ in the band…

A few months ago I read this book “Playin’ in the Band” (Kenneth Aigen), with accompanying DVD, it’s a detailed case-study from the 90’s featuring Lloyd and his music with two music therapists at Nordoff-Robbins New York.  In the DVD excerpts from sessions spanning several years you can see relationships develop between Lloyd and the music therapists as they play a range of rock, blues, country and more. It’s highly recommended if you can get access to a copy.

This book came to mind today as I was talking to someone who asked what music genres appear in therapy – in the literature it stands out as a contemporary or ‘pop’ example among the classical and traditional music usually mentioned. For example, in Healing Heritage by Nordoff & Robbins, “During his lectures, Nordoff illustrated points with live musical examples, many from the classical repertoire”.

In the past, music therapists were typically classically trained, and this would influence the music they played in sessions. These days, music therapists come from a wider range of backgrounds, and that is bound to have an impact on the music used. Clearly there’s no limit to what styles or genres may appear in music therapy – particularly in sessions where the client brings their own music – and the therapist works with what they bring.

The BAMT website states “Music therapists work with the natural musicality styles and genres including free improvisation to offer appropriate, sensitive and meaningful musical interaction with their clients”.

This could take many forms, so every little bit of music may have potential – and it’s a reminder to me to open up and absorb as much music as I can :)

Music therapy in context – book recommendation

Here’s a great book I’ve been reading recently, particularly the last three chapters about Winnicott, psychodynamic meaning and why people choose to become a therapist.

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Mercedes Pavlicevic writes with clarity and passion, bringing the subject to life with fresh thinking and real-life examples. Here’s a couple of excerpts to whet your appetite…

In music therapy, it is the ’emotional’ creativity – or the individual’s capacity for autonomy – rather than ‘artistic’ creativity, that is being tapped in improvisation, despite the artistic or aesthetic medium being used. (p153)

This comes during a chapter about playing, art and emotion, and shows that music therapy is beyond simply playing music: it can reach an emotional level, connecting with people in ways that speech or other modes do not.

Perhaps, within this passionate discourse, rather than seeing music therapy as ‘alleviating symptoms’, we need to think in terms of intensifying them: invoking and evoking our passions, our rages and excitement, our madness; we need to think in terms of animating our total being, of quickening our spirit. (p182)

Here’s a hint of the passion behind the pen, the knowledge that music is powerful stuff, coming from experience of work with people who have changed during music therapy – leading the author to state that music therapists “need to feel confident in the legitimacy of music as itself; of music as therapy; in the legitimacy of an intuition that is deliberate…”

TIME-A: trial of music therapy with autism

Exciting times, right now there’s a global randomised controlled trial of music therapy with children on the autism spectrum – known as TIME-A (Trial of Improvisational Music therapy’s Effectiveness for children with Autism)

More than 360 children aged 4-7 are involved already, and the first results will be available in mid-2016 – the largest research of non-pharmacological therapy for autism yet.

The study protocol is also available online.

More posts soon on autism & more.

Books books books

Here’s a few of the books I’ve been reading: some are specifically about music therapy, others are about related subjects. They’re listed in the order I came to them – and many more will join the list, perhaps in a future post…

 

Music Therapy: Intimate Notes – Pavlicevic
This was recommended to me when I first began looking into music therapy, and provides a lot of insight – get a copy if you’re at all interested in the subject!

Key Concepts in Psychoanalysis – Frosch
A run-down of many topics in this area, eg: unconscious, transference, etc…

The Divided Self – Laing
Came across this in the library, a riveting read about psychotherapy and more.

A Secure Base – Bowlby
Attachment, parenting and more topics which can come into play during music therapy.

Musicophilia – Sacks
Tales of music and the brain from a neuroscientist, a powerful book written in everyday language.

Flute, Accordion or Clarinet? – Oldfield, Tomlinson, Loombe
Discusses a range of musical instruments and how they can be used in music therapy.

Presenting the Evidence – Ansdell, Pavlicevic, Procter
A practical down-to-earth guide to music therapy research.

How Music Helps – Ansdell
A wide-ranging summary of all kinds of music therapy information, case studies and further details.

Creative Music in Groupwork – Achenbach
Practical guidance for music with groups, from warm-ups to full activities.

Music Therapy with Children and their Families – Oldfield, Flower
Examples from a range of settings, vivid portraits of music therapy with family groups.

Dementia and music therapy

There are many documented cases where music impacts people with dementia, somehow re-awakening long lost memories.  It appears speech and music are handled by different areas of the brain, and songs learned early in life will be retained when other faculties have gone.  Here are just a few quotes from articles around this subject – and there’s much more to discover!

“I’ve seen many music therapy sessions where people who can’t speak still sing, or respond to a musical cue. The research we carried out in our homes along with Anglia Ruskin University showed music therapy bringing demonstrable wellbeing benefits for people with dementia. There’s even some suggestion that music therapy could reduce the need for medication.” – Ming Hung Hsu, MHA – Stimulating minds with music and memory

“It made me realise that people with dementia had a special ability to remember songs. Even if people with dementia can’t talk, they may be able to sing, whistle, clap or tap their feet. It helps them, and their carers, to feel life is worthwhile.” Quote on Age UK: Dementia and music

“The aim is to use interactive music and music therapy on dementia sufferers in order to help them maintain function, access memory and connect with those around them.” – article on New Zealand Herald

“My Mum’s communication improved around the time music therapy started. When she had had music therapy, she was different. She was lighter, she was engaged, she was doing something in life that she really enjoyed. She was just a different person, because she had had the therapy. She’s not agitated when she’s in therapy.” – Kathryne Cowhig, quoted on MHA Stimulating Minds campaign

What, no speech? How about music instead?

Imagine you can’t talk, you have no words to say, you don’t know if you could say them even if you were able.

But you can hear, you can feel, you can make sense of a happy tune, you can tap a rhythm and hear it echoed back to you.

In this way, you can communicate, you can influence someone else, and respond to them as they respond to you.

You can be loud and angry, or quiet and gentle, whatever you feel at that moment.  And then you can travel on a journey of sound as you play together, rising and falling in melody and tempo.

Music to help carers

Here’s something I hadn’t thought about very much before – how can music help the people who care for someone close to them?

Staff at Nordoff-Robbins recently studied this in relation to dementia, read further in the links below.  Stating the phrase “music therapy contributes to the support of carers’ needs”63% of family members agreed, with lower figures for staff and managers (much higher for music therapists).  This compares to 100% who agreed “music therapy is part of treatment and support” for their family member with dementia.

Depending how you view 63%, you may think:

A – it’s great that the majority of people think music therapy helps support carers!

B – why is the figure not higher, and why is it different between carers and therapists?

Music offers potential to move beyond awkward silences, to breathe new life into regular routines, and to give people a different way to relate to each other.

Imagine bringing together people with their partners or children in a fun informal music group, where they are each involved in making the music, singing the songs, beating the rhythm – so everyone has their part to play…

Links

Music therapy – Caring for Carers – Nordoff-Robbins

Between practice, policy and politics: Music therapy and the Dementia Strategy

The ‘ripple effect’: Towards researching improvisational music therapy in dementia care homes

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