Music Therapy Final Flashcards
What is music therapy?
disciple in which credentialed professionals (MTA) use music purposefully within therapeutic relationships to support development, health, and well being
CAMT
Canadian Association of Music Therapists
What is CAMT
federally incorporated, self-regulated non-profit professional association
What are the requirements to become a MTA
- completion of a Bachelor/Graduate degree in music therapy
- proficient in guitar, piano, voice
- know psychology and have experience
- must complete a 1000 hr supervised internship
- must write Certification Board of Music Therapists Examination (CBMT)
- every 5 years MTA must maintain their credential through CAMT continuing education process
Personal qualifications of a MT
- musician (excellent musical skills)
- therapist (interest in helping others)
Music therapists using the act of psychotherapy need to become a member of the _________
CRPO (College of Registered Psychotherapists of Ontario)
Only members of ________ can use the protected title “Registered Psychotherapist”
CRPO
With whom does a MT work with? List a few examples
- all ages and diagnosis
- ABI, pain, autism, geriatric care, cancer, neonatal care, mental health difficulties, palliative care, teens at risk, personal growth, substance abuse
Where do MT’s work?
- medical hosiptals
- clinics
- group homes
- prisons
- schools
- mental health facilities
- private practice
What does a session look like?
- Hello song
- Music therapy interventions
- Good bye song
6 different types of music therapy interventions
- pre-composed music
- song-writing
- improvisation
- lyric analysis
- singing
- listening
Precomposed music
- doesn’t always evoke positive memories
- can evoke trauma
Listening
- helps to develop cognitive skills such as attention and memory
In early to mid stage dementia, listening can provide________
a sense of familiarity and increase orientation to reality
Singing
assists in the development of articulation, rhythm, and breath control
Singing in a group setting can improve_______
social skills and foster a greater awareness of others
Singing with those with dementia can encourage_________
reminiscence and discussions of the past, while reducing anxiety and fear
Songwriting
- facilitates the sharing of feelings, ideas, and experiences
Songwriting with hospitalized children
expressing and understanding fears
Songwriting with a patient with a terminal illness
- examines feelings about the meaning of life and death
- opportunity for creating a legacy or a shared experience with a loved one prior to death
Lyric analysis
using existing songs to facilitated meaningful discussion
Improvising
- a creative, nonverbal means of expressing thoughts and feelings
- opportunity to try new instruments and new skills
What is the process to receive music therapy?
- Referral
- Assessment
- Goals
- Treatment plan (interventions)
- Reports and re-assessments
Referral process
- no music prescription
- anyone can make a referall
- all ages and diagnosis
Assessment
1 day, 6 weeks, on going to determine treatment plan
Goals
based on assessments (ex: the client will increase vocabulary)
Treatment plan (interventions)
- pre-composed music
- improvisation
- singing
- songwriting
- lyric analysis
- listening
- instrument playing
Preliterate cultures
- complex languages, no symbol system for communication
- music was a supernatural force that affected mental and physical wellbeing
- music and medicine —–> interchangeable
Medicine men
healing rituals to appease Gods
In which era were the Medicine-men most prevalent?
preliterate cultures
500-6000 years BC
- music played an important role in rational medicine
- music used in magic and religious healing ceremonies
Egyptian priest
music was medicine for the soul and often included chant therapies as part of medical practice
At what time was the Eqyptian priest most prevalent?
500-6000 yrs BC
Ancient Greece 600 BC
- music had force over thought, emotion and physical health
- emotional catharsis
Aristotle
emotional catharsis
Plato
medicine of the soul
In what era, where healing shrines and temples had hymn specialists and music, was prescribed to the mentally disturbed?
Ancient Greece (600 BC)
Hippocratic Oath
doctors must swear by this as Appolo was the god of healing, medicine and music
The Middle Ages (c.476 - 1450 AD)
- medicine influenced by the 4 cardinal humors
What are the 4 cardinal humors
blood, phlegm, yellow bile, black bile
Who claimed that music has the power to degrade or improve human morals?
Boethius in the Middle Ages
Who believed that music was the positive vehicle for sacred emotion?
Saint Basil in the Middle Ages
In what age were hymns considered effective against respiratory diseases?
The Middle Ages
When did physicians prescribe music as a preventive medicine
The Renaissance (1300-1600)
Who matched music to personality characteristics in the Baroque period?
Kircher
When did Physician Louis Roger publish “A treatise on the Effects of Music on the Human Body”?
1748 (Baroque Period)
When was the National Association of Music Therapy (NAMT) established?
1950
Which country is widely recognized as the founder of the MT profession?
USA
When was BAMT recognized by the British government?
1979
When did CAMT establish?
1974
The music itself facilitates change
Music as therapy
Approaches utilize music as a tool to facilitate change
Music in therapy
Form of active music therapy that primarily uses improvisation to reach therapeutic goals. Every individual has an innate musical ability (Music-child) which will lead to personal growth and development
Nordoff Robbins
_________ practitioners believe that music, in association with imagery, can help a client become more self-aware, thereby improving their quality of life
Guided Imagery Method (GIM)
Which music approach do you need a post MTA training of 3 years?
GIM
Who developed GIM?
Helen Bonny
Which approach: The use of music as a contingent reinforcement or stimulus cue to increase or modify behaviour
Behavioural approach
Which approach: providing new experiences, reframing experiences, replace irrational thinking
Cognitive Behavioural Model
What music intervention would be ideal to use in the cognitive behavioural model?
improvisation
Which approach: helping individuals gain insights or increased awareness of unconscious conflicts
Psychotherapy Approach
Which theory: Unconscious thought/connections to childhood/ free association
Freud
Which approach: uses music as a form of stimulation that activates physiological and neurophysiological processes in the body
Biomedical model
Which approach? therapeutic application of music to cognitive, sensory, and motor dysfunction due to the neurological disease of the human nervous system
Neurologic Music Therapy (NMT)
3 rehabilitation methods used in NMT
- sensorimotor
- speech and language
- cognitive
Which approach is a standardized evidence-based approach?
NMT
Which approach: therapists use techniques from all types of therapy without necessarily accepting the theoretical frameworks behind them, client-centred
Eclectic Model
What is an ABI?
Acquired brain injury (all brain injuries)
Traumatic brain injury
a blow to the head
Non-traumatic brain injury
form illness (meningitis)
What does an ABI patient often deal with?
- Loss
- Emotional crisis
- Adjustment
- Rehabilitation
- Identity
Aphasia
aware of what to say but can’t put it in words
Dyspraxia
difficulty articulating speech
Which music approach is used to manage speech symptoms of an ABI?
NMT and song-writing
Song-writing
- creates a tangible product
- identifying and externalizing emotions
- can be frustrating to some
What are the 5 songwriting techniques?
- brain storming
- fill in the blanks
- song parody
- song collage
- rhyming
Brainstorming
thinking about themes and words, picking a melody
Fill in the blanks
using a pre-existing song and changing up some of the words
Song parody
changing all the words to a pre-existing song and using the melody
Song collage
mishmash of songs put together
Rhyming
- brainstorming and just rhyme the lyrics
- don’t have to follow any rules
Chronological age
the number of years
Biological age
ongoing physical process (birth—->death)
- wrinkles, grey hair, loss of stamina
Psychological age
ability to adapt to changing environments
Psychosocial age
different cultural views and expectations
What portrayal does the Western culture have on ageing?
negative
An acquired decline of the cognitive function represented by memory and language impairment
dementia
Is dementia difficult to diagnose?
Yes (normal degeneration vs dementia)
What cognitive test determines cognitive decline?
MMSE (Mini Mental State Examintation)
Dementia class example:
- Listen
- Write down memory evoked
- Music Time line
MT interventions in Dementia Care
- Singing
- Improvisation
- Playing instruments
- Song writing
What is improvisation
- creating something freely in the moment
Free improvisation & playing rules
- playing only on black key of the piano
- easing into it
- feeling comfortable
Mirroring
doing what the client is doing at the same time
- empathic
Matching
- the therapist creates music that is compatible with the client’s
- concept of together yet separate
- same style and quality
Grounding
- creating a musical anchor for the client
- repetitive octaves
- client is musically chaotic
Holding
- strong patterned music which provides a structure for musical chaos
- anchor but with a pattern
- provides structure
Dialoguing
- musical conversation
A condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication
Autism Spectrum Disorder
When is autism typically diagnosed at?
Age 3
Who first noticed austism?
Leo Kanner in 1943
Causes of autsim
unknown
Refrigerator Mother
lack of love which “caused” autism
MT interventions with ASD
repetetive lyrics, live msuic
Benefits of live music (ASD)
- very freeing
- allows clients to feel heard
- some clients have better than normal abilities in music
Mental health can be conceptualized as a ____________ in which the individual realizes their own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community
state of well-being
Is mental health a ‘normalized’ priority?
no, we tend to prioritize physical health
Which music therapy approaches are used with managing mental health?
- CBT (managing symptoms)
- Psychodynamic approach (unconscious thoughts)
- GIM (imagery)
- Nordoff-Robins (non-verbal, more musical)
Which music therapy interventions are used for mental health?
- songwriting
- lyric analysis
- singing
- improvising
- music listening
- end of life care
- team-oriented approach
- enhance comfort and quality of life
- prevent suffering/relieve pain
- guided by wishes of the patient
hospice & palliative care
What does MT in palliative care look like?
- cathartic letting go, MT is focused on living and the person’s needs
- MT interventions are non-invasive
- song writing
- singing
- family + friends also participate
Who benefits from MT in palliative care?
- all ages of people who are terminally ill
- family and friends
- health care team
MT goals in palliative care
- psychosocial (anxiety, loss, spirituality, autonomy, isolation)
- pain management (MOST COMMON SYMPTOM)
- manage dyspnea - entrainment (shortness of breath)
- manage sleep difficulties
Biomedical Theory of Music Therapy
Palliative care
- analgesic effects of music (more difficult to feel pain)
- distraction hypothesis
Music_______endorphin production (enhances, decreases)
enhances
Interventions of MT in palliative care
- music listening
- improvisation
- singing (engaging, enhancing quality of life, connecting with others in a meaningful way)
- songwriting
- music playing
- GIM
- lyric analysis
- iso principle (matching patient’s mood with music)
- MAR (music assisted relaxation) (managing anxiety, working towards sleep goals)
Is music therapy in palliative care flexible?
yes
- singing, music listening, song choice are adaptable to all ages and levels of functioning
- MT needs to adapt in the moment
MT in palliative care, why do they use music to keep patients awake?
to help them back on a healthy sleep schedule
What type of music therapy?
Challenges traditional boundaries and definitions of music therapy. It seeks to develop new perspectives, role identities and ways of doing music therapy. Does not require a referral, assessments or treatment plan
Community music therapy (CMT)
This approach involves an awareness of the system music therapists are working within, to means that music therapy is not only directed towards the individual but often aimed at changing the system
CMT
System theory
- used in CMT
- suggests an alternative to the traditional cause and effect model within science
- not looking at symptoms of mental illness, understanding that their are different layers
Typical CMT goals
- provider of vitality (emotional stimulation and expression)
- tool for developing agency and empowerment
- resource in building social networks
- way of providing meaning and coherence in life
Specializes in the care of ill or premature newborn infants
NICU
Neonatal
first 28 days of life
Is NICU-MT well known in Canada
no, it is well known in the US
Do you have to be trained to be a NICU-MT in the US?
Yes, there are over 300 specially trained Board Certified Music Therapists
How can babies engage in music therapy?
- listening (sucking to turn on music)
- entraining (breathing/heart rate)
- masking noise
Training to work as a MT in NICU
- must take specialized training outside of becoming a MT
- 3 phases and consists of a minimum of eight hours of lecture, 6 hours of hands-on training in an affiliated NICU
Can MT in NICU be dangerous?
Yes, overstimulation can occur
Healthcare goals for MT in NICU?
- physiological measures (heart rate, respiration rate, weight gain etc)
- development/behaviroal milestones (behavior state, ability to transition from state to state)
Live or recorded music?
- research shows that music is effective in multiple ways whether live or recorded
- live music is the preference of the profession
- live music requires an MT
3 stages of developmental care of premature infants
- survival pacification
- cautious stimulation
- tranisition to interactive stimulation
What stage of NICU MT?
- no touching, interacting or disturbance of sleep
- live or recorded music, with the fewest altering stimuli possible (less than 65 dB, C major)
- the therapist’s face should be more than 10 inches from the infant
- use of lullabies in the child’s native language promotes language development
Stage 1 - survival/pacification
What stage of NICU MT?
- touch and interaction is permitted
- music listening during passive touch such as kangaroo care is beneficial
Stage 2 - cautious stimulation
Are methods to elicit infant interaction with the parent or therapist contraindicated until the infant can tolerate minimal stimulation?
Yes
______responds better to a cappella voice if touch is applies while_______ respond better to greater complexity such as guitar accompaniment for voice combined with touch (males/females)
males, females
What stage of NICU MT?
- music listening after distressing medical procedures to return the infant to a sleep state
- music reinforces sucking and facilities oral feeding ability
- systemic multi-modal stimulation is highly effective in promoting neurologic maturation
Stage 3 - transition into interactive stimulation
