As if by magic, I have the privilege of getting to see the best in people in music therapy. I see the joy, the creativity, the humor, the passion, and the quirks that make people who they are. But it isn’t magic- it’s MUSIC. The glorious connection that occurs within the music, whether it’s spiritual, interpersonal, interpersonal, or any combination thereof, is palpable, purposeful, powerful, potent. It is the essence of the human potential – to express one’s true self, and to experience the range of human emotion and human expression; to feel alive.
Although people come to music therapy to feel or function better due to a struggle in life such as dementia, brain injury, depression, or anxiety, these difficulties do not define the individual. I do not look at people and see their problems; in music, I get to see their potential. They are still in there – the beautiful, unique soul rising to the occasion of personal growth, rehabilitation, or transformation. Even at the end of life or at the rock bottom of suffering – the intangible essence of music reaches deep into the person, and reveals their strengths and potential.
Within music therapy, indescribable moments of connectedness occur between the music therapist, the client, and the music. The music and the relationship developed within the music facilitate the growth, transformation, and rebuilding the client seeks and needs. These moments of attunement are a peak experience for me as a music therapist – they feed my soul, and help me to get through the more difficult aspects of my work (after all, I am often seeing people during some of their greatest struggles).
The magic of these moments of connectedness is eclipsed only by the results of the work (see the rest of this blog for the science behind the magic of music therapy). I am humbled to serve as a music therapist; I am in awe of the potency of music and the power of the human spirit.
March 1st is International Music Therapy Day! What a great day for a blog post!
A few months ago, I posted about music therapy in stroke rehabilitation in general. Since there are so many ways music therapy can help people recover from a stroke, I thought it might be useful to dive in to each topic in-depth, individually. Today’s focus is on the rehabilitation of Upper Extremity Hemiparesis.
What is Hemiparesis and Why Does it Matter?
Hemiparesis is weakness or inability to move (paralysis) on one side of the body, resulting from an injury to the opposite side (hemisphere) of the brain. In layman’s terms, “upper extremity” basically refers to arms.
Musical tasks provide “anticipation and timing structure for movement from the external rhythmic cue and from integrating the external cue (feedforward) with the patient produced sound patterns (feedback),” (Thaut, 2014).
What does music therapy in stroke rehabilitation look like?
Imagine your physical therapy exercises to improve flexion, extension, range of motion, etc. Now imagine having the sensory feedback that playing musical instruments provides and the rhythmic cueing that is so essential in a good work-out session.
To your brain, this multisensory feedback enriches the motor experience; anytime you are having fun and enjoying something, the event is more significant neurologically. New neural pathways are built more quickly, and with less effort. This is how all humans naturally learn and re-learn. You are getting “more bang for your buck,” basically!
Utilizing musical cueing via dynamic, temporal, and rhythmic changes is known as Patterned Sensory Enhancement, or PSE. Just as music cues a dancer’s moves, music may also cue gross and fine movements for functional gain.
Music therapists are trained in choosing and adapting musical instruments and mallets to stimulate functional gains; we will find *something* to suit your gripping needs and capabilities, or an instrument that is the right height, or provides the right amount of feedback.
How Do I Get Started with Music Therapy for Stroke Rehabilitation?
When you’re ready to try music therapy, give us a call to schedule your assessment session. After your assessment, your board-certified music therapist will determine a treatment plan to meet your rehabilitation goals.
Pre-registration is now open for MindSteady, a live virtual music-based depression & anxiety-reduction group music therapy program. The program will offer adults of all ages an opportunity to practice music and mindfulness techniques and learn to use rhythm & music to regulate emotions and induce a physiological state of calmness. Participants will experience both passive and active techniques.
No experience necessary! There are absolutely no musical pre-requisites- all levels of musician are welcome; degree of musicianship is not an indicator of anticipated benefits from participating.
The program will require pre-registration and pre-payment. Thanks to an anonymous donor, the total cost of the program for each participant will be reduced to $100, to include all 6 group sessions.
This article offers an overview on the basics of music therapy and depression.
Please contact firstname.lastname@example.org for more information.
My first exposure to music therapy was in a day program for individuals with dementia. I had never imagined that I would someday become a music therapist; I thought I would play flute in a world-class symphony orchestra, but once I witnessed the power of music therapy, there was no going back.
Durin my first semester at Berklee College Music, I spent long hours in the practice rooms rehearsing flute and perfecting my technique. I loved performing, but I started to feel a calling to become a helper and to do something thatt involved more daily interaction with people. After meeting a music therapis by chance, I was invited to observe a group music therapy session in a day program for older adults witht dementia. I arrived to the day program during their lunch hour, and I felt sad to see how much support the once vibrant and capable participants needed. They required assistance with feeding, mobility, and all basic activities of daily living (ADLs). Some had lost all ability to verbally communicate or ambulate independently.
The music therapist and day program staff helped the participants over to an area with comfortable seating arranged in a semi-circle, and once everyone was in place, the magic began: people who could no longer walk were dancing, people who could no longer speak were joyfully singing songs of their youth. Bright smiles and laughter lit up dim, expressionless faces. In that moment I felt a renewed clarity of purpose and knew my fate was to recreate that moment.
After the program, I signed up to volunteer with the music therapist who worked full-time in the assisted living in the same building, then I went back to Berklee and applied to the music therapy program.
While volunteering, I observed music therapy groups and individual sessions on both the high-functioning and low-functioning dementia units. My favorite group was the songwriting group on the high-functioning unit, where the music therapist used humor, joy, structure, and acceptance to support residents in confronting the harsh realities of dementia, such as becoming increasingly forgetful and dependent upon others for basic ADLs (activities of daily living).
Music makes everything easier. I say it all the time, but it’s true: exercise, eliciting verbal phrases, memory recall, interacting with others positively, confronting difficult and painful emotions . . . the list goes on. There are a million and one ways people with dementia can benefit from music therapy, and the concept seems so obvious for me, initially it didn’t occur to me to write a blog post about it! Music therapy should be a staple in every nursing home and assisted living. Indeed, there are not enough music therapists to go around: music therapists can also serve as consultants in developing supportive music programs, or train caregivers in the safe integration of music into daily support tasks. (Care must be taken to reduce the risk of harm when providng music interventions).
Each time I hear a story of someone’s beloved family member or friend who suffered a stroke, and never spoke again, I am left wondering if music therapy could have made a difference. I think of all the lives affected by the tragedy, loss, heartache, and the frustration of losing the ability to communicate effectively, perhaps on top of hemiplegia or hemiparesis, or cognitive deficits. Music therapy has become standard care in many of the world’s leading rehabilitation hospitals, is reimbursable through insurance, and stands firmly on the foundation of a substantial body of research and clinical experience. Every stroke survivor should have access to music therapy, when clinically indicated.
When you hear a song you like, you might feel like you’ve just got to get up and dance, or you just have to sing along. You may notice that your mood shifts, or you feel more motivated. Maybe you use music when you’re cleaning, exercising, or to help young children follow instructions. The pull and power of music is what makes it a potent and transformational tool in neurorehabilitation, and the global processing of music throughout all areas of the brain provides unmatched flexibility as a therapeutic mechanism.
Nearly 30% of stroke survivors experience symptoms of depression, which can hinder functional gains and contribute to social isolation, and may be masked by sleep disturbances or aphasia. Music therapy can be a focused or multi-tasking modality, working in multiple domains simultaneously or sequentially, (Clements-Cortes & Haire, 2019). For example, the act of expressing oneself vocally in service of improving speech may also improve mood. Similarly, a focus on improving emotional symptoms may yield increased motivation and desire to engage in the potentially daunting task of physical rehabilitation, increasing treatment adherence. Additionally, music therapy techniques can decrease perceived exertion when compared to traditional occupational therapy, (Lim, H. et al 2011).
Moving beyond standard MIT, or Melodic Intonation Therapy, as is common in speech therapy, music therapy provides the opportunity for creative self-expression through improvisation within the context of a developing interpersonal relationship, creating additional motivating factors for the patient/client. When the music therapist validates the musical and emotional expressions of the client, the client feels more invested in the session, and the positive feedback from the therapist drives the client to continue on in the work. Rather than superfluous, the emotional component moves forward the rehabilitative aims of the session, and solidifies the gains made by activating more areas of the brain, making the experience more neurologically meaningful.
While researchers are still working to determine if there is a “golden period” for the use of music therapy in stroke rehabilitation, it is well-known that neuroplasticity, or the ability of the brain to adapt to change through reorganization and the formation of new neuronal connections, persists into adulthood. Therefore, stroke rehabilitation can still be effective many months or years after the injury.
Subscribe to this blog to learn more about how music therapy can help stroke survivors, and stay tuned: in the coming months, we’ll be taking a deep dive in to music therapy for:
Do you know someone whose life has been impacted by a stroke? Contact Bloomsburg Music Therapy for a 30-minute consultation.
Clements-Cortes, A., and Haire, C. (2019). Individuals with acquired brain injury (ABI): implications for music therapy in the treatment of depression. Music & Medicine, 11(2), 108-114.
Lim, H.A., Miller, K., Fabian, C. (2011). The effects of therapeutic instrumental music performance on endurance level, self-preceieved fatigue level, and self-perceived exertion of inpatients in physical rehabilitaiton. Journal of Music Therapy, 48(2), 124-148.