MUSIC THERAPY FOR

BEHAVIORAL DISORDER

KANYARAT KUYSUWAN, PH.D.

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.

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.

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

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

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

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

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.

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.

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"

MUSIC THERAPY APPROACHES USED FOR CHILDREN

Nordoff-Robbins Music Therapy

Orff Music Therapy

Bonny Method of Guided Imagery in

Music (GIM)

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

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

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.

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.

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.

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.

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

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.

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.

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.

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.

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.