Music therapy
Music therapy is the use of music in a clinical setting to accomplish therapeutic goals. " Music therapists are generally trained musicians who have completed an accredited music therapy program. Although music therapy has been established as a profession only relatively recently, the connection between music and therapy is not new.
Music therapy is a broad field. Music therapists use music-based experiences to address client needs in one or more domains of human functioning: cognitive, academic, emotional/psychological; behavioral; communication; social; physiological, spiritual, or aesthetics. Music experiences are strategically designed to use the elements of music for therapeutic effects, including melody, harmony, key, mode, meter, rhythm, pitch/range, duration, timbre, form, texture, and instrumentation.
Some common music therapy practices include developmental work with individuals with special needs, songwriting and listening in reminiscence, orientation work with the elderly, processing and relaxation work, and rhythmic entrainment for physical rehabilitation in stroke survivors. Music therapy is used in medical hospitals, cancer centers, schools, alcohol and drug recovery programs, psychiatric hospitals, nursing homes, and correctional facilities.
Music therapy is distinctive from musopathy, which relies on a more generic and non-cultural approach based on neural, physical, and other responses to the fundamental aspects of sound.
Music therapy might also incorporate practices from sound healing, also known as sound immersion or sound therapy, which focuses on sound rather than song. Sound healing describes the use of vibrations and frequencies for relaxation, meditation, and other claimed healing benefits. Unlike music therapy, sound healing is unregulated and an alternative therapy.
Music therapy aims to provide physical and mental benefit. Music therapists use their techniques to help their patients in many areas, ranging from stress relief before and after surgeries to neuropathologies such as Alzheimer's disease. Studies on people diagnosed with mental health disorders such as anxiety, depression, and schizophrenia have associated some improvements in mental health with music therapy. However, in many countries, including the United States, music therapists do not diagnose, so diagnosing mental disorders would not be within their scope of practice.The National Institute for Health and Care Excellence has claimed that music therapy is an effective method in helping people with mental health issues, and more should be done to offer those in need of this type of help.
Uses
Children and adolescents
Music therapy may be suggested for adolescent populations to help manage disorders usually diagnosed in adolescence, such as mood and anxiety disorders and eating disorders, or inappropriate behaviors, including suicide attempts, withdrawal from family, social isolation from peers, aggression, running away, and substance abuse. Goals in treating adolescents with music therapy, especially for those at high risk, often include increased recognition and awareness of emotions and moods, improved decision-making skills, opportunities for creative self expression, decreased anxiety, increased self-confidence, improved self-esteem, and better listening skills.There is some evidence that, when combined with other types of rehabilitation, music therapy may contribute to the success rate of sensorimotor, cognitive, and communicative rehabilitation. For children and adolescents with major depressive or anxiety disorders, there is moderate to low quality evidence that music therapy added to the standard treatment, may reduce internalizing symptoms, and may be more effective than treatment without music therapy.
Premature infants
are those born at 37 weeks after conception or earlier. They are subject to numerous health risks, such as abnormal breathing patterns, decreased body fat and muscle tissue, as well as feeding issues. The coordination for sucking and breathing is often not fully developed, making feeding a challenge. Offering musical therapy to premature infants while they are in the neonatal intensive care unit aims to both mask unwanted auditory stimuli, stimulate infant development, and promote a calm environment for families. While there are no reported adverse effects from music therapy, the evidence supporting music therapy's beneficial effects for infants is weak as many of the clinical trials that have been performed either had mixed results or were poorly designed. There is no strong evidence to suggest that music therapy improves an infant's oxygen therapy, improves sucking, or improves development when compared to usual care. There is some weaker evidence that music therapy may decrease an infants' heart rate. There is no evidence to indicate that music therapy reduces anxiety in parents of preterm infants in the NICU or information to understand what type of music therapy may be more beneficial or how for how long.Medical disorders
Music may both motivate and provide a sense of distraction. Rhythmic stimuli has been found to help balance training for those with a brain injury.Singing is a form of rehabilitation for neurological impairments. Neurological impairments following a brain injury can be in the form of apraxia – loss to perform purposeful movements, dysarthria, muscle control disturbances, aphasia, or language comprehension. It is shown that patients with schizophrenia have altered feeling on major and minor chord. Singing training has been found to improve lung, speech clarity, and coordination of speech muscles, thus, accelerating rehabilitation of such neurological impairments. For example, melodic intonation therapy is the practice of communicating with others by singing to enhance speech or increase speech production by promoting socialization, and emotional expression. After a stroke, music therapy may be a useful tool for the recovery of motor skills. Listening to music may improve heart rate, respiratory rate, and blood pressure in those with coronary heart disease. In addition, there is tentative evidence that music interventions led by a trained music therapist may have positive effects on psychological and physical outcomes in adults with cancer. The effectiveness of music therapy for children with cancer is not known.
Autism
Music may help people with autism hone their motor and attention skills as well as healthy neurodevelopment of socio-communication and interaction skills. Music therapy may also contribute to improved selective attention, speech production, and language processing and acquisition in people with autism. Music therapy may benefit the family as a whole. Some family members of children with autism claim that music therapy sessions have allowed their child to interact more with the family and the world. Music therapy is also beneficial in that it gives children an outlet to use outside of the sessions. Some children after participating in music therapy may want to keep making music long after the sessions end.Dementia
Like many of the other disorders mentioned, some of the most common significant effects of dementia can be seen in social behaviors, leading to improvements in interaction, conversation, and other such skills. A study of over 330 subjects showed that music therapy produces highly significant improvements in social behaviors, overt behaviors like wandering and restlessness, reductions in agitated behaviors, and improvements to cognitive defects, measured with reality orientation and face recognition tests. The effectiveness of the treatment seems to be strongly dependent on the patient and the quality and length of treatment.A meta-study examined the proposed neurological mechanisms behind music therapy's effects on these patients. Many authors suspect that music has a soothing effect on the patient by affecting how noise is perceived: music renders noise familiar, or buffers the patient from overwhelming or extraneous noise in their environment. Others suggest that music acts like a mediator for social interactions, providing a vessel through which to interact with others without requiring much cognitive load.
Aphasia
Broca's aphasia, or non-fluent aphasia, is a language disorder caused by damage to Broca's area and surrounding regions in the left frontal lobe. Those with non-fluent aphasia are able to understand language fairly well, they struggle with language production and syntax.Neurologist Oliver Sacks studied neurological oddities in people, trying to understand how the brain works. He concluded that people with some type of frontal lobe damage often "produced not only severe difficulties with expressive language but a strange access of musicality with incessant whistling, singing and a passionate interest in music. For him, this was an example of normally suppressed brain functions being released by damage to others". Sacks had a genuine interest in trying to help people affected with neurological disorders and other phenomena associated with music, and how it can provide access to otherwise unreachable emotional states, revivify neurological avenues that have been frozen, evoke memories of earlier, lost events or states of being and attempts to bring those with neurological disorders back to a time when the world was much richer for them. He was a firm believer that music has the power to heal.
Melodic intonation therapy, developed in 1973 by neurological researchers Sparks, Helm and Albert, is a method used by music therapists and speech–language pathologists to help people with communication disorders caused by damage to the left hemisphere of the brain by engaging the singing abilities and possibly engaging language-capable regions in the undamaged right hemisphere.
While unable to speak fluently, patients with non-fluent aphasia are often able to sing words, phrases, and even sentences they cannot express otherwise. MIT harnesses the singing ability of patients with non-fluent aphasia as a means to improve their communication. Although its exact nature depends on the therapist, in general MIT relies on the use of intonation and rhythm to train patients to produce phrases verbally. In MIT, common words and phrases are turned into melodic phrases, generally starting with two step sing-song patterns and eventually emulating typical speech intonation and rhythmic patterns. A therapist will usually begin by introducing an intonation to their patient through humming. They will accompany this humming with a rhythm produced by the tapping of the left hand. At the same time, the therapist will introduce a visual stimuli of the written phrase to be learned. The therapist then sings the phrase with the patient, and ideally the patient is eventually able to sing the phrase on their own. With much repetition and through a process of "inner-rehearsal", a patient may eventually be able to produce the phrase verbally without singing. As the patient advances in therapy, the procedure can be adapted to give them more autonomy and to teach them more complex phrases. Through the use of MIT, a non-fluent aphasic patient can be taught numerous phrases which aid them to communicate and function during daily life.
The mechanisms of this success are yet to be fully understood. It is commonly agreed that while speech is lateralized mostly to the left hemisphere, some speech functionality is also distributed in the right hemisphere. MIT is thought to stimulate these right language areas through the activation of music processing areas also in the right hemisphere Similarly, the rhythmic tapping of the left hand stimulates the right sensorimotor cortex to further engage the right hemisphere in language production. Overall, by stimulating the right hemisphere during language tasks, therapists hope to decrease dependence on the left hemisphere for language production.
While results are somewhat contradictory, studies have in fact found increased right hemispheric activation in non-fluent aphasic patients after MIT. This change in activation has been interpreted as evidence of decreased dependence on the left hemisphere. There is debate, however, as to whether changes in right hemispheric activation are part of the therapeutic process during/after MIT, or are simply a side effect of non-fluent aphasia. In hopes of making MIT more effective, researchers are continually studying the mechanisms of MIT and non-fluent aphasia.