1. MUSIC THERAPY FOR
BEHAVIORAL DISORDER
KANYARAT KUYSUWAN, PH.D.

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. 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. 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. 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

8. 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

9. 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

10. 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.

11. 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.

13. 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"

14. MUSIC THERAPY APPROACHES USED FOR CHILDREN
Nordoff-Robbins Music Therapy
Orff Music Therapy
Bonny Method of Guided Imagery in
Music (GIM)

15. 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

16. 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

17. 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.

18. 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.

19. 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.

20. 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.

21. 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

22.  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.

23. 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.

24. 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.

25. 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.

26. 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.