March to the tune of a different drummer
Music therapy can be adapted to a variety of issues
When a young man with Parkinson’s disease could no longer take walks in his neighborhood because he would freeze up at major intersections and not be able to cross the street, music therapy gave him back his freedom. He was given tapes of music with a strong rhythmic beat that he would listen to as he approached a street corner. The music would cue the body, and he no longer froze.
"Many times in Parkinson’s disease, the person loses his or her ability to initiate movement. What we found in music therapy is that a certain rhythmic pattern can actually induce movement and maintain that movement at a steady pace, the pace of the rhythm itself for as long as the rhythm is playing," explains Connie Tomaino, DA, MT-BC, director of the department of music therapy at the Institute for Music and Neurologic Functions at Beth Abraham Health Services in New York City.
Patients with memory deficits, depression, balance and gait problems, fine motor skill problems, and acute or chronic pain also benefit from music therapy at the institute. When a patient is not motivated in his or her therapy, the patient is referred to a music therapist in an effort to boost motivation and help the patient pay attention long enough to benefit from other therapies, says Tomaino.
To make sure staff are making the appropriate referrals, the music therapy department frequently conducts inservices to explain what music therapy is and what types of people might benefit from it. (For information on how to include children in music therapy, see article on p. 65.)
Music therapy can complement the traditional medical model, says Brian Abrams, MMT, MT-BC, director of music therapy at the University of Pennsylvania Cancer Center in Philadelphia. "If a patient is given a pain killer, the music therapist might focus their work on enhancing the effects of that pain killer by doing things in music that help to soothe or help to focus on the pain relief centers of the body or to help calm or relax," explains Abrams. (For information on providing tapes to relax patients, see article above.)
While the medical model usually does not address the subjective level, music therapy is used to round out the whole person by looking at the inner self. It is not a cause-and-effect model, but takes into account who the person is — their identity. "I find that my role as a music therapist and the role of creative arts in general is very powerful in this area," says Abrams.
Music therapy usually can reach people whom other therapies cannot reach. For example, it works well with autistic children who have trouble with human contact. Their first connection is with the music and in exploring the sounds. Then they come to the realization that someone is producing that music, and the human relationship starts. A therapist working verbally, however, might unintentionally create a situation an autistic child would find threatening, says Tomaino.
Patients within a medical setting are not the only ones who might benefit from music therapy. Artists or musicians with a creative block often find it helpful. Through improvisation and role playing through music, they often overcome their block. People who can’t find the words to express their feelings will benefit from music therapy, as will those whose feelings are so deep it is hard to explore them. "People often go to a music therapist to find a new aspect of themselves or a new part of their personality or skill they may have," explains Tomaino.
Those who go on their own, however, need to learn how to select a qualified music therapist, experts caution. Abrams recommends looking for a therapist who is board-certified. A board-certified music therapist must complete undergraduate course work, a full course of field work, and a six-month full-time internship in an approved music therapy setting, as well as passing the board certification exam.
Certification also requires that the music therapist have certain basic competencies in keyboard, guitar, and voice, as well as music theory and the different genres of music. Based on the patient group he or she works with, the music can be even more specified. For example, therapists working with children would specialize more in improvisation skills.
"Music therapy is different from putting on a tape and feeling better. There is a whole process that takes place that is based on assessment and the music therapist’s training. The music therapist must gain an understanding of human functioning and then use that with their understanding of music to enhance the functioning," says Tomaino.
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