Music Therapy in Mental Health

Music therapy is a form of sensory stimulation for clients with mental health impairments which uses musical interaction as a means of communication and expression. Music therapy can be a form of treatment for persons who have psychosocial, affective, cognitive and communicative needs.

Research shows that music therapy can be effective even in those clients who find other treatment approaches non effective.

The aim of therapy is to help individuals develop relationships and address issues they may not be able to address using words alone. Music therapy sessions include the use of music making, music listening, and discussion.

According to the American Music Therapy Association (2011) music as an intervention provides opportunities to:

• Make positive changes in mood and emotional states
• Have a sense of control over life through successful experiences
• Enhance awareness of self and environment
• Express oneself both verbally and non-verbally
• Develop coping and relaxation skills
• Support healthy feelings and thoughts
• Improve reality testing and problem solving skills
• Interact socially with others
• Develop independence and decision making skills
• Improve concentration and attention span
• Adopt positive forms of behaviour
• Resolve conflicts leading to stronger family and peer relationships
• Explore personal feelings and therapeutic issues such as self-esteem or personal insight

Personal Experiences

At the start of the year I had a placement on an in-patient mental health ward. A client, who we'll call John, experiences Paranoid Schizophrenia and was having problems with getting out of bed, engaging in occupation,  blunted affect and avolition. I saw he had a guitar and suggested we have a jam, as I also play. After a couple of relaxed jams sessions John was back into a daily routine, was engaging in activties on the ward and he appeared to have a more elevated affect. The M.D.T couldn't believe the change in John and were keen to hire someone to take my place once my placement finished to keep playing with John.

References

American Music Therapy Association. (2011). Music Therapy and Mental Health. Retrieved from http://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf

 

Music Radar. (2012).10 killer audition tips. Retrieved from http://www.musicradar.com/tuition/guitars/10-killer-audition-tips-530771/10

Music Therapy in Palliative Care

“By stimulating creative participation through familiar music, the patient’s senses of self-worth and purpose are enhanced. Stimulating creative participation through familiar music provides them with an incentive and motivation to actively live while dying” (Aldridge, 1999, p. 17).

                                                                    


Music can be put in the same category as religion or meditation,  experiencing a spiritual being and finding peace with one’s self.Working with a patient in a creative way can enhance the quality of living, but can also make sense of dying. Music in death can help to give hope to the individual and  give them a sense of purpose. The musician or therapist uses music to bond with the patient on a creative intimate level. Music therapy is about finding acceptance and preparing to die.

Music helps to relive favourite memory’s, most of us can link a favourite song to a certain time in our life. Through listening to songs, one can know what is important in their life which can lead onto reminiscing about ones life on what they have  achieved or not achieved.

According to Hilliard (2005) reasons for music in palliative care could include:

·         Coping difficulties

·         Social (isolation, loneliness, boredom, stress)

·         Emotional (depression, withdrawal, anxiety, anger, fear, frustration. Difficulty expressing thoughts, feelings, needs and desires)

·         Cognitive (neurological impairments, disorientation, confusion)

·         Physical (pain, nausea, shortness of breath)

·         Spiritual (lack of spiritual connection)

·         Cultural language barriers.

·         Provides comfort, relaxation and support to cope with the difficult path ahead.

Music and song choice is used with patients who may not be able to express emotions verbally due to neurological difficulties or choose to keep these feelings from others. Music is used as a tool to provide a creative means to express their emotions. One can pick a song that expresses the mood he/she is in or wants to feel. The lyrics and the instruments used can be played to express to family, friends or the therapist what the patient is feeling if they are unable to do so themselves verbally. Songs can also be chosen because they offer comfort or past memories that one has experienced.

Music has been a part of ones life the whole time even if they don’t recognise it. The music one listens/plays to can reflect what life stage they are in, the sort of person they are, their behaviours and who they want to be.

 References

Aldridge, D. (1999). Music Therapy in Palliative Care: New Voices. Great Britain: Jessica Kingsley   publishers.

Hilliard, R.E. (2005). Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data. Journal of Evidence-Based Complementary and Alternative Medicine, 2 (2), 173-178. Doi: 10.1093/ecam/neh076.

The New York Times. (2011). Relaxing, touching the memory, music helps with the final transition. Retrieved from http://www.nytimes.com/2011/07/04/nyregion/music-therapy-helps-the-dying.html?_r=1

Music Therapy for Dementia

"Music is used as a means to an end rather than an end in itself. it is used to improve awareness of other people and of the surroundings, to improve self-esteem, give an opportunity for decision making and freedom of choice, the expression of feelings of joy or sadness, opportunity for reminiscence, and enhancing physical mobility" (Bright, 1997, p. 17).

                                                                

Music is becoming more popular in dementia care as a tool for engaging clients in meaningful occupation but also as a method of utilising what memory one has left. Music is great with clients who experience some level of dementia because long term memory is genrally still available. Music can be used as an indivdual tool or part of group therapy.


Music for dementia could include:

• Listening to the radio
• Listening to records/CD's/MP3
• Talking about music
• Singing
• Using music as a distraction for those who are angry or upset
• Music to enhance exercise
• Playing instruments
• Dancing

Benefits of music could include improved:

• Quality of life
• Self esteem and decreasing depression
• Decreasing aggression and stress
• Decreasing wandering
• Mobility
• Socialisation and communication
• Identity
• Happiness
• Awareness
• Decision making

Cuing is used in retrieval of past preferences of music tastes. This can be done by verbal or auditory cues. Other cues could include objects that relate to a favorite songs title or lyrics. For example, seeing a picture of a road drifting in to the sunset could be a cue to the song "country roads" by John Denver.

There are some important aspects to consider when choosing music as an intervention tool:

• The activity needs to be modified for the client to gain some level of success
• Importance of finding the specific songs that were special to your client to gain their interest and attention.
• Expression of self: music is a great means of putting emotions into sound or lyrics if one cant do this verbally.
• Level of dementia
• Age
• Language/visual/auditory deficits
• Neurological deficits

Oliver Sacks, a well known neurologist, psychologist and writer published an article in Oprah's magazine titled "wired for sound". Here Sacks talks about music and how even in the most severe forms of dementia and memory loss, music, is one of the last remaining memory's to disappear. The article provides a real example of a man called Woody who struggles with everyday ADL's and expresses how music can improve ones performance and happiness.


Wired for sound


Below are some YouTube videos that you can watch if you choose to. The first one is about a man called Henry who is often non-responsive and once music is in the picture he almost comes alive, starts singing, swaying and engages in conversation. The next video is Oliver Sacks talking about music and Alzheimer's.

References: 

Bright, R. (1997). Music Therapy and the Dementias: Improving the quality of life (2nd ed). United States of America: Walsworth Publishing. Knopfgroup.

“Oliver Sacks - Musicophilia - Alzheimer's/The Power of Music." YouTube. YouTube, 22 Sept. 2008. Web. 22 July 2012. <http://www.youtube.com/watch?v=MdYplKQ4JBc>. MusicandMemory1.

"(original) Man In Nursing Home Reacts To Hearing Music From His Era." YouTube. YouTube, 18 Nov. 2011. Web. 22 July 2012. <http://www.youtube.com/watch?v=fyZQf0p73QM>.

Nordoff Robbins. (2011). Dementia and difficulties for the elderly. Retrieved from http://www.nordoff-robbins.org.uk/content/what-we-do/who-can-music-help/dementia-and-difficulties-elderly

Oprah. (2008). Wired for sound. Retrieved from http://www.oprah.com/health/Oliver-Sacks-Finds-the-Bond-Between-Music-and-Our-Brains/1