Music Therapy Explained

Music Therapy Explained

by Arash Bazrafshan

I approach an elderly gentleman with progressed Alzheimer’s disease and I had been told by the care assistant that he has limited mobility. The gentleman’s upper body is slumped forward, his eyes are closed and his hands are laying motionless on his lap. I greet him by name to no response and hold out a small drum. After a few moments of silence, I softly start to sing ‘They’ll be bluebirds over, the white cliffs of Dover…’. After a few seconds I notice the gentleman’s head move and start to hear a quiet and tuneful humming. I watch him become animated and his eyes open as he starts to sing along. I reflect that whilst we are both playing the music, the music, in a way, is playing us; the music is activating parts of our brain and body, generating movement and producing sound. I offer him a drum beater and we begin to tap the drum in time with the music. The music is now stimulating the gentlemen’s physical co-ordination, memories and emotions, and the rhythm provides a safe and familiar structure. I approach an elderly gentleman with progressed Alzheimer’s disease and I had been told by the care assistant that he has limited mobility. The gentleman’s upper body is slumped forward, his eyes are closed and his hands are laying motionless on his lap. I greet him by name to no response and hold out a small drum. After a few moments of silence, I softly start to sing ‘They’ll be bluebirds over, the white cliffs of Dover…’. After a few seconds I notice the gentleman’s head move and start to hear a quiet and tuneful humming. I watch him become animated and his eyes open as he starts to sing along. I reflect that whilst we are both playing the music, the music, in a way, is playing us; the music is activating parts of our brain and body, generating movement and producing sound. I offer him a drum beater and we begin to tap the drum in time with the music. The music is now stimulating the gentlemen’s physical co-ordination, memories and emotions, and the rhythm provides a safe and familiar structure.
Music therapy is a relatively new profession and, as it is not widely renowned, it can be misconstrued as a singing group, a performance or other musical activity. Unlike these other activities, Music Therapy is a professional service regulated by the Health and Care Professions Council (HCPC). To practice under the title of ‘Music Therapist’ one must be qualified and registered with the HCPC. Music therapy is a relatively new profession and, as it is not widely renowned, it can be misconstrued as a singing group, a performance or other musical activity. Unlike these other activities, Music Therapy is a professional service regulated by the Health and Care Professions Council (HCPC). To practice under the title of ‘Music Therapist’ one must be qualified and registered with the HCPC.
Music Therapists have worked with people of all ages, from young children living with autism, to adults with complex mental health issues and more recently with elderly people, including those with dementia. To borrow a definition from British Association for Music Therapy, music therapy is ‘a psychological therapy which uses the unique qualities of music as a means of interaction between therapist and client’. As a recently qualified and registered Music Therapist, I recognise that there is a need to increase awareness and understanding of the service. Music Therapists have worked with people of all ages, from young children living with autism, to adults with complex mental health issues and more recently with elderly people, including those with dementia. To borrow a definition from British Association for Music Therapy, music therapy is ‘a psychological therapy which uses the unique qualities of music as a means of interaction between therapist and client’. As a recently qualified and registered Music Therapist, I recognise that there is a need to increase awareness and understanding of the service.
One of the key challenges of introducing music therapy to care homes with no history of music therapy, is neither the staff nor residents necessarily know what to expect or how to distinguish it from other musical activities. One care home that I currently work at shows how the service can grow when people start to see its purpose and worth. They had not had a Music Therapist work there before and so I arranged a short series of trial sessions. During the early sessions members of staff observed, and as a result of their support and interest there are now several separate groups receiving music therapy at the home. One of the key challenges of introducing music therapy to care homes with no history of music therapy, is neither the staff nor residents necessarily know what to expect or how to distinguish it from other musical activities. One care home that I currently work at shows how the service can grow when people start to see its purpose and worth. They had not had a Music Therapist work there before and so I arranged a short series of trial sessions. During the early sessions members of staff observed, and as a result of their support and interest there are now several separate groups receiving music therapy at the home.
Whilst an individual with Alzheimer’s disease sometimes may not be able to remember things they said a minute after they say it, that same individual may be able to remember all the words and the tune to a song they used to sing 60 years ago. So music can be a powerful communication tool when working with people with dementia. A client may choose to or only be able to say one word, and that word may not have any obvious context. A Music Therapist can use this word, draw out its melody and rhythm and sing it back with supporting music, giving the client a sense of being heard. This opens a channel in which both the client and therapist can communicate meaning beyond language. Whilst an individual with Alzheimer’s disease sometimes may not be able to remember things they said a minute after they say it, that same individual may be able to remember all the words and the tune to a song they used to sing 60 years ago. So music can be a powerful communication tool when working with people with dementia. A client may choose to or only be able to say one word, and that word may not have any obvious context. A Music Therapist can use this word, draw out its melody and rhythm and sing it back with supporting music, giving the client a sense of being heard. This opens a channel in which both the client and therapist can communicate meaning beyond language.
I often encourage music that is spontaneously created by clients. I wait to listen to the clients’ responses and base my music on their rhythms, melodies and movements. Clients that choose not to, or cannot play an instrument often vocalise or become an active listener. I often encourage music that is spontaneously created by clients. I wait to listen to the clients’ responses and base my music on their rhythms, melodies and movements. Clients that choose not to, or cannot play an instrument often vocalise or become an active listener.
The title of this article makes reference to a comment a client with dementia made after we had been playing rhythmic music in a group music therapy session. The music had just finished and we shared a few moments of silence. We had all been closely playing the same rhythm and even though the music had stopped, the feeling of being connected to each other seemed to remain. The client sitting nearest to me said, ‘it’s good to be in time, isn’t it?’. The title of this article makes reference to a comment a client with dementia made after we had been playing rhythmic music in a group music therapy session. The music had just finished and we shared a few moments of silence. We had all been closely playing the same rhythm and even though the music had stopped, the feeling of being connected to each other seemed to remain. The client sitting nearest to me said, ‘it’s good to be in time, isn’t it?’.
I have reflected on this comment a number of times since. Short term memory is crucial to our experience of time. It allows us to organise events we experience so that we can tell what was past, what is now and what may be future. By having this structure and reference we can normally return to ‘the now’ and find our self again. As short term memory becomes impaired, people with progressed dementia are vulnerable to losing this ability. Music, especially rhythmic or familiar music, can provide a structure in time that can be absorbed, even if a person is only listening. I have reflected on this comment a number of times since. Short term memory is crucial to our experience of time. It allows us to organise events we experience so that we can tell what was past, what is now and what may be future. By having this structure and reference we can normally return to ‘the now’ and find our self again. As short term memory becomes impaired, people with progressed dementia are vulnerable to losing this ability. Music, especially rhythmic or familiar music, can provide a structure in time that can be absorbed, even if a person is only listening.
As the population of the UK is ageing, it is realistic to expect the amount of people requiring support for dementia to increase. As care homes grow and expand, the need for individualised attention and support may also grow, as depression and feelings of loss and isolation are common for those living with dementia. A Music Therapist’s job is learning how best to use music to improve the quality of a person’s life and then putting it into practice within a safe and caring environment. As the population of the UK is ageing, it is realistic to expect the amount of people requiring support for dementia to increase. As care homes grow and expand, the need for individualised attention and support may also grow, as depression and feelings of loss and isolation are common for those living with dementia. A Music Therapist’s job is learning how best to use music to improve the quality of a person’s life and then putting it into practice within a safe and caring environment.
Whether it involves singing ‘The White Cliffs of Dover’ in a duet, drumming in a loud and chaotic fashion, or supporting someone’s arm as they beat a drum softly, music therapy offers an opportunity for people with dementia to reconnect with their identity. Whether it involves singing ‘The White Cliffs of Dover’ in a duet, drumming in a loud and chaotic fashion, or supporting someone’s arm as they beat a drum softly, music therapy offers an opportunity for people with dementia to reconnect with their identity.