Music Heard So Deeply

1. Music therapy is a powerful healthcare profession, distinct from recreational music

Music therapy is the use of music by a certified professional to address specific, personal needs. It is based on assessment and evaluated through data.

Evidence-based practice. Music therapy goes beyond simple enjoyment of music. It involves systematic assessment, data collection, and evaluation of patient responses. Music therapists are board-certified professionals (MT-BC) with extensive training in music, psychology, and healthcare.

Tailored interventions. Unlike general music programs or entertainment, music therapy interventions are designed to address specific goals for each patient. These may include physical rehabilitation, speech recovery, emotional regulation, or cognitive stimulation. Music therapists adapt their approach in real-time based on patient responses, using live music to create a flexible and responsive therapeutic environment.

Holistic approach. Music therapy can impact multiple domains simultaneously, addressing physical, cognitive, emotional, and social needs. This makes it a unique and valuable addition to interdisciplinary healthcare teams, complementing other therapies and treatments.

2. Music therapists use live, adaptive music to address specific patient needs

The music in music therapy is live, flexible, and responsive. Therapists and their clients build relationships through shared music.

Real-time adaptation. Music therapists use their musical skills to adjust tempo, rhythm, harmony, and lyrics in the moment. This allows them to match a patient's energy level, emotional state, or physical capabilities, maximizing therapeutic impact.

Building therapeutic relationships. The shared experience of making music together creates a unique bond between therapist and patient. This can foster trust, encourage communication, and provide a safe space for emotional expression.

Personalized interventions. Music therapists consider factors such as:

• Patient's musical preferences and cultural background
• Current physical and cognitive abilities
• Specific therapeutic goals
• Emotional state and energy level

They then create or adapt music to best serve the patient's needs in that moment, whether it's motivating movement, encouraging speech, or providing emotional support.

3. Neurologic music therapy harnesses rhythm to improve movement and speech

Music provides several forms that work well for this. In a verse and chorus format, I can use a short verse to work with one student, then have everyone sing and/or play for the chorus.

Rhythmic entrainment. The human brain naturally synchronizes to external rhythms. Music therapists use this principle to improve gait, coordination, and speech production in patients with neurological conditions like Parkinson's disease or stroke.

Structured repetition. Musical forms provide a engaging framework for repetitive exercises, crucial for neurological rehabilitation. Examples include:

• Verse-chorus structure for individual and group practice
• Call-and-response patterns to encourage turn-taking and imitation
• Rhythmic chanting to support speech timing and fluency

Multisensory stimulation. Combining auditory (music), visual (gestures/instruments), and kinesthetic (movement) elements enhances neuroplasticity and learning. This multi-modal approach can lead to faster progress and better retention of skills compared to traditional therapies alone.

4. Music can bypass language impairments, aiding communication recovery

Doug could clearly articulate the lyrics of familiar songs. His home town news station came to do a story on his recovery and their video report showed him singing "Slow down…you move too fast….you got to make the morning last -– just kicking down….the cobblestones….lookin' for love and feeling grooooovy!" Each word was pronounced perfectly.

Preserved musical abilities. Many patients with severe language impairments can still sing familiar songs with clear articulation. This is because singing utilizes different neural pathways than speaking, often preserved after brain injury.

Gradual transition to speech. Music therapists use techniques to bridge the gap between singing and functional speech:

• Melodic Intonation Therapy: Gradual fading of melody while maintaining rhythm
• Rhythmic Speech Cueing: Using strong rhythms to support word timing and fluency
• Call-and-response exercises: Building intentional communication through musical dialogue

Emotional connection. Familiar songs can also trigger memories and emotions, potentially aiding in overall recovery and motivation for rehabilitation. Music therapists carefully select repertoire to maximize both technical practice and emotional engagement.

5. Group music therapy fosters social connection and skill development

The cooperation required to produce a single piece of music can create a unique bond between the participants, with the emotion of the music creating memories of support and success.

Shared musical experiences. Group music-making naturally encourages cooperation, turn-taking, and listening skills. This can be especially beneficial for patients with social or behavioral challenges, such as those on the autism spectrum or with dementia.

Inclusive participation. Music therapists can design group activities to accommodate various ability levels, ensuring everyone can contribute meaningfully. Examples include:

• Simple rhythm instruments for those with limited mobility
• Call-and-response songs for those with speech difficulties
• Movement activities synchronized to music for physical rehabilitation

Emotional regulation. Group music experiences can provide a safe space to express and process emotions. The shared nature of music-making can reduce feelings of isolation and build a sense of community among patients facing similar challenges.

6. Music therapy assessment evaluates individual responses, not musical ability

A music therapy eligibility assessment results in data ("the student performed the skill 25% of the time without music and 40% of the time with music"), but it doesn't give scores that can be compared to hundreds or thousands of other students.

Criterion-referenced assessment. Music therapy evaluations focus on how music impacts an individual's ability to achieve specific goals, rather than comparing their musical skills to a general population. This personalized approach allows for tailored interventions.

Functional outcomes. Assessments measure improvements in areas such as:

• Physical functioning (e.g., range of motion, coordination)
• Communication (e.g., speech production, turn-taking)
• Cognitive skills (e.g., attention span, memory recall)
• Emotional regulation (e.g., anxiety reduction, mood elevation)

Ongoing evaluation. Music therapists continually assess patient responses during sessions, making real-time adjustments to interventions. This dynamic process allows for optimal therapeutic impact and documentation of progress over time.

7. Music therapy research spans multiple disciplines, supporting its efficacy

The research we use in music therapy work comes from several fields of study: among them, music cognition, music education, music neuroscience and music therapy itself.

Interdisciplinary foundation. Music therapy draws upon research from diverse fields, including:

• Neuroscience: Understanding how music affects the brain
• Psychology: Exploring music's impact on emotions and behavior
• Rehabilitation medicine: Applying music to physical recovery
• Education: Utilizing music for learning and skill development

Evidence-based practice. Music therapists stay current with research findings to inform their clinical decisions. This includes both quantitative studies (e.g., randomized controlled trials) and qualitative research that captures the nuanced experiences of patients.

Ongoing research. The field of music therapy continues to grow, with new studies exploring its effectiveness in areas such as:

• Pain management
• Autism spectrum disorders
• Dementia care
• Stroke rehabilitation
• Mental health treatment

8. Music therapists must continually adapt and learn to meet diverse patient needs

There is always so much more to learn –- and do!

Lifelong learning. The field of music therapy is constantly evolving. Therapists must stay current with:

• New research findings
• Emerging therapeutic techniques
• Advances in music technology
• Changes in healthcare systems and policies

Diverse skill set. Music therapists need to develop and maintain a wide range of abilities:

• Musical proficiency on multiple instruments
• Knowledge of various musical styles and cultural traditions
• Understanding of medical conditions and therapeutic approaches
• Strong interpersonal and communication skills
• Adaptability to work in various settings (hospitals, schools, private practice)

Professional growth. Music therapists can pursue additional certifications, advanced degrees, and specialized training to expand their expertise. This ongoing development ensures they can provide the best possible care to their diverse patient populations.

Last updated: August 3, 2024