What is Music Therapy?
As a music therapist, I use music as my tool to help clients and patients improve. I use music to help them think, move and communicate better as well as socialize more appropriately. Music is effective because it stimulates multiple parts of the brain simultaneously, stimulates the production of endorphins and is highly engaging.
Let me correct one myth right away: Music therapists do not try to improve a person’s ability to sing or play an instrument — that is the job of a music educator.
Who benefits from music therapy?
Music therapy is used with a wide spectrum of people. For instance, it is used with people with neurologic conditions such as stroke, but also with infants in the neo-natal intensive care unit, children with autism, people with behavioral and psychiatric disorders, intellectual and physical disabilities, Alzheimer’s disease and those in hospice care.
How might stroke survivors benefit from music therapy?
Music therapy is used to improve three areas of functioning with survivors: motor, speech and cognitive.
Because there is a strong connection between what we hear and movement (try dancing without music), and because music is an organized and predictable stimulus, it is effective at improving motor deficits caused by stroke.
A survivor can have a more regular gait by walking to the beat of a familiar song. And playing instruments such as drums, piano or a triangle can encourage movement and improve strength and coordination in an affected arm.
If a patient is working on walking because their gait is uneven or they shuffle their steps, I provide a steady, strong beat, usually played on a drum, to help the patient entrain their steps. I also sing a familiar song (e.g., The Battle Hymn of the Republic) with a strong beat for motivation. Often the person will not only be walking with even steps, he may also be singing along.
Because singing and speaking use several similar processes such as respiration, making speech-like sounds and articulation, singing may improve speaking skills for some. Many times a person with aphasia may not be able to speak but can sing. This is because speech is processed and produced primarily in the left side of the brain.
On the other hand, music is processed and produced in multiple parts of the brain. Some of these overlap with speech centers and some do not. A therapist can stimulate and strengthen injured speech centers, or create new connections around injured areas to potentially help people speak again.
When working with survivors with aphasia, I like to incorporate singing to improve expression. I might start by having them play a harmonica to work on air production, then do vocal warm-ups similar to those done in choirs.
I may then have them sing a single word at the end of a familiar lyric (e.g., “My bonnie lies over the ______”). We will progress to longer and longer phrases, moving toward the survivor singing an entire song. These exercises improve word retrieval, articulation, volume and prosody — the rhythm and intonation of spoken language.
Music is highly engaging and activates multiple parts of the brain simultaneously, the way the sky lights up during a fireworks display. This makes it a perfect medium for helping people with left-side neglect and difficulty with attention. Music can be used to capture someone’s attention (focused attention), hold it for a period of time (sustained attention) and get the survivor to switch back and forth between two things (alternating attention).
If a patient has left neglect, I might use the playing of instruments to help with this. I would place one drum in front of the survivor and another to her left. Using a drumstick, she strikes both drums one time alternatively. Back and forth, like a tennis match. I move the drum on the left to various locations encouraging her to hunt for the drum. I also provide a familiar song for motivation and a strong beat for entrainment to help organize the movements.
I have been practicing music therapy for nearly 20 years, and I still am amazed at the power of music when my stroke clients are able to walk with even steps, or when someone who can’t talk is able to sing for the first time. It is a rewarding job, and I am grateful for the opportunity.
About the author...
Kyle Wilhelm has provided music therapy services since 1998. He has worked with a variety of people — children with autism, hospice patients as well as people who have had a stroke or traumatic brain injury. He has served as music therapist at more than 25 Refresh & Retreat Stroke Camps.
For more information, visit the American Music Therapy Association.
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