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Music therapy for behaviotal disorder

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Music therapy for behaviotal disorder

  1. 1. MUSIC THERAPY FOR BEHAVIORAL DISORDER KANYARAT KUYSUWAN, PH.D.
  2. 2. HISTORY OF MUSIC THERAPY Music has been used as a healing implement for centuries.  Apollo is the ancient Greek god of music and of medicine.  Aesculapius was said to cure diseases of the mind by using song and music, and music therapy was used in Egyptian temples.  Plato said that music affected the emotions and could influence the character of an individual.  Aristotle taught that music affects the soul and described music as a force that purified the emotions.  Aulus Cornelius Celsus advocated the sound of cymbals and running water for the treatment of mental disorders.  Music therapy was practiced in biblical times, when David played the harp to rid King Saul of a bad spirit.  As early as 400 B.C., Hippocrates played music for mental patients.  In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the patients.
  3. 3. WHAT IS THE MUSIC THERAPY? Music therapy is defined by the Canadian Association for Music Therapy (CAMT, 1994) as the skillful use of music and musical elements by an accredited music therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health. Music has nonverbal, creative, structural, and emotional qualities. These are used in the therapeutic relationship to facilitate contact, interaction, self-awareness, learning, self-expression, communication, and personal development. American Music Therapy Association (AMTA) defined that Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.
  4. 4. A letter written by the artist to William Walters dated July 20, 1860 illuminates the subject of this painting. It shows a brother and sister resting before an old tomb. The brother is attempting to comfort his sibling by playing the violin, and she has fallen into a deep sleep, "oblivious of all grief, mental and physical." This composition exists in at least one other version, now preserved at the Hermitage Museum in St. Petersburg. A closely related reduced replica was given to the Musées royaux des Beaux-Arts de Belgique by a descendant of the artist. The melancholic subject's popularity is attested by its reproduction on a porcelain plaque manufactured by the Royal Porcelain Factory, Berlin
  5. 5. HOW DOSE MUSIC THERAPY WORK? Music therapy interventions can be designed to: Promote Wellness Manage Stress Alleviate Pain Express Feelings Enhance Memory Improve Communication Promote Physical Rehabilitation
  6. 6. HOW DOSE MUSIC THERAPY WORK? Music therapy research and clinical practice have proven to be effective with people of all ages and abilities. Whether a person's challenges are physical, emotional, spiritual or psychological, music therapy can address a person's needs. At its core, music therapy is the interaction between a therapist, a client (or clients) and the use of music. A music therapist assesses the client(s) and creates a clinical plan for treatment in conjunction with team and client goals, which in turn determines the course of clinical sessions. A music therapist works within a client-centered, goal- directed framework
  7. 7. Various client populations that music therapists work with:  Alzheimer's Disease  Autism Spectrum Disorders  Brain Injury  Childbirth and Neonatal Care  Children with Emotional Disorders  Community Mental Health  Dementia Care  Developmental Delay  Geriatrics  Hearing Impaired  Mental Health  Mentally Challenged  Pain  Palliative Care  Personal Growth  Pervasive Developmental Disorder  Physical Disabilities  Schizophrenia  Stress Management  Substance Abuse  Voice
  8. 8. TYPE OF MUSIC THERAPY There are a few different philosophies of thought regarding the foundations of music therapy.  One is based on education and two are based on music therapy itself,  In addition, there are philosophies based on psychology, and one based on neuroscience.  Approaches from education are Orff-Schulwerk (Orff), Dalcroze Eurhythmics, and Kodaly.  The two different philosophies that developed directly out of music therapy are Nordoff-Robbins and the Bonny Method of Guided Imagery and Music.
  9. 9. MUSIC THERAPY MODEL music therapy have emerged from the field of education include Orff-Schulwerk (Orff), Dalcroze Eurhythmics, and Kodaly. Models that developed directly out of music therapy are Neurologic Music Therapy (NMT), Nordoff-Robbins and the Bonny Method of Guided Imagery and Music. Music therapists may work with individuals who have behavioral-emotional disorders. To meet the needs of this population, music therapists have taken current psychological theories and used them as a basis for different types of music therapy. Different models include behavioral therapy, cognitive behavioral therapy, and psychodynamic therapy.
  10. 10. NEUROLOGICAL MUSIC THERAPY (NMT) One therapy model based on neuroscience, called "neurological music therapy" (NMT), is "based on a neuroscience model of music perception and production, and the influence of music on functional changes in non-musical brain and behavior functions.” In other words, NMT studies how the brain is without music, how the brain is with music, measures the differences, and uses these differences to cause changes in the brain through music that will eventually affect the client non-musically. As one researcher, Dr. Thaut, said: "The brain that engages in music is changed by engaging in music.” NMT trains motor responses (i.e. tapping foot or fingers, head movement, etc.) to better help clients develop motor skills that help "entrain the timing of muscle activation patterns"
  11. 11. MUSIC THERAPY APPROACHES USED FOR CHILDREN Nordoff-Robbins Music Therapy Orff Music Therapy Bonny Method of Guided Imagery in Music (GIM)
  12. 12. NORDOFF-ROBBINS MUSIC THERAPY Nordoff-Robbins music therapy is grounded in the belief that everyone can respond to music, no matter how ill or disabled. It holds that the unique qualities of music as therapy can enhance communication, support change, and enable people to live more resourcefully and creatively, also known as creative music therapy
  13. 13. ORFF MUSIC THERAPY  The Orff Approach of music education uses very rudimentary forms of everyday activity for the purpose of music creation by music students.  The Orff Approach is a "child-centered way of learning" music education that treats music as a basic system like language and believes that just as every child can learn language without formal instruction so can every child learn music by a gentle and friendly approach.  It is often called "Elemental Music making" because the materials needed to teach students are "simple, basic, natural, and close to a child’s world of thought and fantasy”.  the Orff Approach "all concepts are learned by ‘doing’” Students of the Orff Approach learn music by experiencing and participating in the different musical lessons and activities.  Orff activities awaken the child’s total awareness” and “sensitize the child’s awareness of space, time, form, line, color, design, and mood- aesthetic data that musicians are acutely aware of, yet find hard to explain to musical novices
  14. 14. APPLICATION OF ORFF MUSIC THERAPY The Orff Approach was originally intended to teach music to children but because of the different benefits that it offers with coordination, dexterity, and concentration the technique is often used to teach individuals with special needs. The simplicity of the technique allows all ranges of handicapped students to participate in the learning process. Mentally handicapped students can easily perform the tasks without fear of being ridiculed or being left behind. The visually impaired/blind who tend to have "hesitant, jerky, and over controlled" movements because they "often breathe quite shallowly" can use the different breathing and movement exercises to relax their body and breathing. Students with a hearing impairment can use the Orff Approach by feeling the vibrations that are created by different instruments. Since music is mostly resilient students who have had injuries that have mentally impaired them can use the Approach as a form of therapy. Even elderly individuals who often become weak with old age can use the Orff Approach to help with memory, dexterity, and agility.
  15. 15. BONNY METHOD OF GUIDED IMAGERY IN MUSIC Bonny Method of Guided Imagery in Music (GIM) Music educator and therapist Helen Lindquist Bonny (1921 - May 25, 2010) developed an approach influenced by humanistic and transpersonal psychological views, known as the Bonny Method of Guided Imagery in Music, or GIM.  Guided imagery refers to a technique used in natural and alternative medicine that involves using mental imagery to help with the physiological and psychological ailments of patients.  The practitioner often suggests a relaxing and focusing image and through the use of imagination and discussion, aims to find constructive solutions to manage their problems.
  16. 16. BONNY METHOD OF GUIDED IMAGERY IN MUSIC  Bonny applied this psychotherapeutic method to the field of music therapy by using music as the means of guiding the patient to a higher state of consciousness where healing and constructive self- awareness can take place. Music is considered a "co-therapist" because of its importance.  GIM with children can be used in one-on-one or group settings, and involves relaxation techniques, identification and sharing of personal feeling states, and improvisation to discover the self, and foster growth.  The choice of music is carefully selected for the client based on their musical preferences and the goals of the session.  Usually a classical piece, it must reflect the age and attentional abilities of the child in length and genre, and a full explanation of the exercises must be offered at their level of understanding.  The use of guided imagery with autistic children has been found to decrease stereotypical behaviors and hyperactivity, increase attention and the ability to follow instructions, as well as increase self-initiated communication, both verbal and non-verbal.
  17. 17. ASSESSMENT AND INTERVENTION As with any type of therapy, the practice of Music Therapy with children must uphold standards of conduct and ethics, agreed upon by national and provincial associations such as the Canadian Association for Music Therapy. In part with this, formal assessment is crucial for understanding the child – their background, limitations and needs, as well as to create appropriate goals for the process and select the means of achieving them. This serves as the starting point from which to measure the client’s progression throughout the therapeutic process and to make adjustments later, if necessary. Similarly to how assessments are conducted with adults, the music therapist obtains extensive data on the client including their full medical history, musical (ability to duplicate a melody or identify changes in rhythm, etc.) and nonmusical functioning (social, physical/motor, emotional, etc.). The assessment process is then carried out in formal, informal, and standardized ways.
  18. 18. Interviews with Clients and/or Family Members Structured or Unstructured Observation Reviewing of Client Records Standardized Assessment Tests THE FOLLOWING ARE THE MOST COMMON METHODS OF ASSESSMENT
  19. 19.  Information gathered at the music therapy assessment is then used to determine if music therapy is indicated for the child.  The therapist then formulates a music therapy treatment plan, which includes specific short-term objectives, long-term goals, and an expected timeline for therapy Music therapy interventions used with children can fall into two categories. The first, Supportive active therapy, is product- oriented and can included rhythm activities such as body percussion (stomping feet, clapping hands, etc.), singing songs which re-inforce nonmusical skills, awareness and expression, or movement to music (as simple as marching to the beat, as complex as structured dances). The second area is called Insight music therapy which is process-oriented. Activities could include song-writing, active listening and reacting, or auditory discrimination activities for sensory skill development. Music therapy for children is conducted either in a one-on-one session or in a group session.
  20. 20. The therapist typically plays either a piano or a guitar, which allows for a wide variety of musical styles to suit the client's preferences. The child is usually encouraged to play an instrument adapted to his or her unique abilities and needs. These elements are designed to improve the experience and outcome of the therapy.
  21. 21. MUSIC THERAPY RESEARCH 1). Daphne J. Rickson. (2006). Instructional and Improvisational Models of Music Therapy with Adolescents Who Have Attention Deficit Hyperactivity Disorder (ADHD): A Comparison of the Effects on Motor Impulsivity. Journal of Music Therapy , 43 (1): 39-62. 2). Daphne J. Rickson and William G. Watkins. (2003). Music Therapy to Promote Prosocial Behaviors in Aggressive Adolescent Boys: A Pilot Study. Journal of Music Therapy, 40 (4): 283-301. 3). Carme Solé, Melissa Mercadal-Brotons, Adrián Galati, and Mónica De Castro. (2014). Effects of Group Music Therapy on Quality of Life, Affect, and Participation in People with Varying Levels of Dementia. Journal of Music Therapy, 51 (1): 103-125. 4). Carme Solé, Melissa Mercadal-Brotons, Sofia Gallego, and Mariangels Riera. (2010).Contributions of Music to Aging Adults' Quality of Life. Journal of Music Therapy, 47 (3): 264-281. 5). Wendy E. J. Knight and Nikki S. Rickard. (2001). Relaxing Music Prevents Stress-Induced Increases in Subjective Anxiety, Systolic Blood Pressure, and Heart Rate in Healthy Males and Females. Journal of Music Therapy, 38 (4): 254-272.
  22. 22. MUSIC THERAPY RESEARCH 6). Hayoung A. Lim. (2010). Effect of “Developmental Speech and Language Training Through Music” on Speech Production in Children with Autism Spectrum Disorders. Journal of Music Therapy, 47 (1): 2-26. 7). Hayoung A. Lim. (2008). The Effect of Personality Type and Musical Task on Self-Perceived Arousal. Journal of Music Therapy, 45 (2): 147- 164. 8). Varvara Pasiali. (2012). Supporting Parent-Child Interactions: Music Therapy as an Intervention for Promoting Mutually Responsive Orientation. Journal of Music Therapy, 49 (3): 303-334. 9). A. Blythe LaGasse. (2014). Effects of a Music Therapy Group Intervention on Enhancing Social Skills in Children with Autism. Journal of Music Therapy, 51 (3): 250-275 first published online July 22, 2014. 10). Jennifer Whipple. (2004). Music in Intervention for Children and Adolescents with Autism: A Meta-Analysis. Journal of Music Therapy, 41 (2): 90-106. 11). Lori F. Gooding. (2011). The Effect of a Music Therapy Social Skills Training Program on Improving Social Competence in Children and Adolescents with Social Skills Deficits. Journal of Music Therapy, 48 (4): 440-462.
  23. 23. MUSIC THERAPY RESEARCH 12). Ayelet Dassa and Dorit Amir. (2014). The Role of Singing Familiar Songs in Encouraging Conversation Among People with Middle to Late Stage Alzheimer’s Disease. Journal of Music Therapy 51 (2): 131- 153, first published online June 19, 2014. 13). Dena Register, Alice-Ann Darrow, Olivia Swedberg, and Jayne Standley. (2007). The Use of Music to Enhance Reading Skills of Second Grade Students and Students with Reading Disabilities. Journal of Music Therapy, 44 (1): 23-37. 14). Michael J. Silverman (2014). Effects of a Live Educational Music Therapy Intervention on Acute Psychiatric Inpatients’ Perceived Social Support and Trust in the Therapist: A Four-Group Randomized Effectiveness Study. Journal of Music Therapy, 51 (3): 228-249 first published online July 23, 2014. 15). Eri Haneishi. (2001). Effects of a Music Therapy Voice Protocol on Speech Intelligibility, Vocal Acoustic Measures, and Mood of Individuals with Parkinson's Disease. Journal of Music Therapy, (2001) 38 (4): 273-290.

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