Music Therapy & Older Adults

Aging is a universal phenomenon, present in all ages and cultures. It is a continuous process that depends on several factors that are not the same in every human being. Many factors contribute to the type of aging process people have like lifestyles and social and environmental surroundings. 

Diaz Abrahan discusses the psycho-gerontological approach to aging being split into three types of aging: normal, pathological, and active aging. The first one refers to the natural changes occurring as a result of the constant modifications along an individual’s course of life. This can be characterized by the degree of natural decline of cognitive functions like memory, information processing speed, and visual decline. Pathological aging has to do with changes produced by illnesses or bad habits that are not part of normal aging. Sometimes, it can be prevented or controlled, but in some it is irreversible. This can be the case for those diagnosed with dementia, neurodegenerative disorders, Alzheimer’s disease, and Parkinson’s disease, among others. Finally, active aging takes place in the best possible physical, psychological and social conditions, with little loss of the psychosocial, physical, and/or cognitive abilities, resulting in a better quality of life and life expectancy. 

 Diaz wanted to evaluate the effectiveness of music therapy in improving the quality of life of older adults. A program proposal was made by the day center aiming to deal with the psychosocial problems of older persons, encouraging integration among peers, self-management, and social participation with 15 patients for eight months at an average age of 80 years old. The care center used the inventory of quality of life (IQoL) as their pre/post documentation to help validate the need for music therapy with older adults in their facility. By the end of the eight months, the results showed that the benefits of music therapy were reflected in the total quality of life scores, encompassing the final average of all the inventory areas of life. 

Similar to the proposal Diaz conducted, the staff at Cottonwood Retirement wanted to begin to include music therapy sessions into the residents’ schedule. After implementing a music therapy session twice a week the staff found music therapy effective in changing social, physical, emotional, and cognitive functioning. All participants shared observations of the effectiveness of music therapy for older adult consumers at Cottonwood Retirement and reported that consumers were more animated and more likely to participate in movement exercises while engaging in music therapy versus being prompted. More socialization throughout the week if music sessions were held on Mondays. 

Music acts as a complex stimulus, exerting neurophysiological signals that activate brain structures associated with cognition, motor skills, and the regulation of emotions. Evidence of a music therapy intervention has shown an increase in cerebral blood flow and prefrontal cortex activity in older adults with cognitive decline. This suggested the development of new neural networks working to improve executive function. This suggests improvements in the person's ability to concentrate and retain and remember information in both the short and long-term, as well as the ability to organize, plan, and execute actions.

Evidence has shown that music therapy has been effective in reducing symptoms of depression in older adults with different neuropathological states. The nursing staff at Cottonwood Retirement recorded their patients writing songs with music therapists for family members, creating scrapbooks to help process past memories, and use lyric analysis to assist residents remembering experiences from their past and relating them to words from their favorite songs. 

Some music therapy interventions used with older adults focus on body movements generating a positive effect on the motor system. Rhythmic auditory stimulation (RAS) is also used to become a rhythmic signal that is translated into a motor response. Gait parameter improvements are not often reported as outcomes in music therapy interventions in older adults with cognitive decline. The study published in Music Therapy Perspectives found preliminary effects in two gait parameters, gait velocity, and stride length, with higher scores at the end of the music therapy intervention. The effects in terms of cognition, gait parameters, depression symptoms, and flexibility can be attributed to the fact that music acts as a stimulus for cognitive, affective and sensorimotor processes by acting on the brain structures associated with cognitive, emotional, and motor responses (Wells, 2019 pp.52).

References 

Diaz Abrahan, V., Lemos Jaramillo, A., & Justel, N. (2019). Benefits of Music Therapy in the Quality of Life of Older Adults. Revista Ciencias de La Salud, 17(3), 9–19. https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.8349

Domínguez-Chávez, C. J., Murrock, C. J., Guerrero, P. I. C., & Salazar-González, B. C. (2019). Music therapy intervention in community-dwelling older adults with mild cognitive impairment: A pilot study. Geriatric Nursing, 40(6), 614–619. https://doi.org/10.1016/j.gerinurse.2019.06.004

Wells Staab, K., & Dvorak, A. L. (2019). Perception of music therapy by direct care staff of older adults with intellectual disabilities. Music Therapy Perspectives, 37(1), 45–54. https://doi.org/10.1093/mtp/miy021

Welcome, Intern Macy!

My name is Macy Fehl and I am beyond excited to continue my internship journey with those at Therabeat! Before joining the Therabeat team, I began my internship at Arkansas Children’s Hospital in Little Rock, Arkansas. Unfortunately, due to the continual growth of the Coronavirus, I was unable to continue my internship in the hospital, but I am very excited to get the opportunity to complete my internship time closer to home with such an amazing team of people! 

You will find out very quickly I love Disney, all types of music, and being outside whenever I can! After being far away from the area I grew up in, I am very excited to be back investing in this community. I first knew I was interested in Music Therapy as a profession once I had the opportunity to see it in action my junior year of high school. I was so excited to see how music could be used in such a positive way to impact people.

I began my Music Therapy journey at Georgia College where my primary focus was voice, but I also learned to play the guitar, piano, ukulele and fun instruments like the steel drum and accordion. While studying in school, one aspect of treatment I always wanted to experience was getting to work alongside other forms of therapy. This is just one of the many reasons I am so excited to begin working with the Therabeat team to continue to see how important and beneficial co-treating between therapies can be. 

My first week was even better than I could have imagined! I have enjoyed my time getting to meet and work with all the staff at In Harmony Pediatric Therapy. I have never felt so at home so fast. It has been such a blessing to have everyone so willing to help me as I begin on this chapter of my internship. This week has reminded me how sometimes new things can be a little scary and take some getting used to. But, if you have an amazing team behind you, new experiences can be so much fun! I have loved getting to meet all the amazing clients that come in for all different types of therapies and cannot wait to continue to make new friends and fun memories. 

-Macy Fehl, Music Therapy Intern 

Music Therapy and Mental Health: PTSD Edition

Music Therapy and Mental Health: PTSD Edition

For individuals diagnosed with Posttraumatic Stress Disorder, every day may consist of fear, uneasiness, flashbacks, difficulty completing day to day activities, or even emotional numbness. Along with most mental illnesses, there are no cures for PTSD. There are many different treatment options to provide coping skills for those with PTSD — one of those options is Music Therapy. There are therapeutic settings and interventions that are designed to help those with PTSD better adjust to difficult aspects of their everyday lives. By setting goals to decrease a negative behavior or increase a positive with Music Therapy, living with PTSD can become more bearable.

The American Psychiatric Association (2019) defines Posttraumatic Stress Disorder as a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. This type of trauma creates dissonance. Dissonance is created between the magnitude of the threat and the individual’s resources for coping with the rest (Felsenstein, 2013, p. 1). Symptoms of PTSD can be mental, physical, and emotional. Some symptoms of PTSD can include re-experiencing the event, intrusive memories of the event, prolonged emotional distress and psychological reactivity after exposure to trauma-related stimuli, avoidance of trauma-related thoughts and external reminders, negative alterations in mood and cognition, and alterations in arousal and reactivity (Landis-Shack, Heinz, & Bonn-Miller, 2017, p. 2) 

(Oglethorpe Inc., 2020)

There is a three-stage therapeutic process to help those experiencing PTSD stop using unhealthy coping behaviors: sense of safety, building a narrative, and engaging with the community (Story & Beck, 2017, p. 94). Treatment of PTSD can be difficult because it surfaces itself differently in everyone because everyone is different, and everyone experiences different trauma. Many different forms of treatment are being researched and will continue to be researched.

As Ahonen says, “music touches our emotions and triggers our memories on the deepest level. There is something in music that is transformative, making a difference in people’s lives” (2018, p. 26). Music Therapy has many benefits for individuals with PTSD. One benefit of Music Therapy is that music engages people in a universal environment that feels safe and more enjoyable than other verbal processing therapies (Carr, d’Ardenne, Priebe, Scott, & Wang, 2011, p. 180). Music Therapy interventions are used to help a person distinguish the present moment from past traumatic events, an important part of re-experiencing the trauma and staying grounded. Music can elicit traumatic associations, which can be both positive and negative for the individual, and it is important for the individual to understand that they are in a safe space so they can gain that first step of needing a sense of safety (Carr  et al., 2011, p. 196).

One population where PTSD is common is military personnel. Over 15% of people in the military are women and they are the fastest growing demographic among veterans (Story & Beck, 2017, p. 1). Soldiers returning from deployments or active duty status have to readjust to civilian life, which can be very stressful due to what they experienced overseas. Common posttraumatic symptoms that females most commonly identify with in the military stem from combat, sexual trauma or harassment within the military, and family and support separation (Story & Beck, 2017, p. 1).

When it comes to Music Therapy techniques, guided imagery is commonly used with people in the military or veterans. The images used are supposed to be expressions of the inner world of the client (Story & Beck, 2017, p. 3). These images are called resource images and can help the individual face their conflict. Music is the basis of the guided imagery process to help clients deepen their relationship with the music so they are able to connect music to their positive inner resources (Story & Beck, 2017, p. 3). The goals most commonly worked on using guided imagery are resource mobilization, narrative reconstruction, and coping skills. Hyperarousal is also a focus when looking into physical, cognitive, and emotional domains. One example of a goal dealing with hyperarousal is “Poor concentration is addressed through requiring patients to attend to their own sounds and those made by others” (Carr, et al. 2011, p. 181). This will help the group or individual concentrate on the present stimuli instead of the past. An example of an emotional domain would be emotional expression mirrored by instruments. Improvisation is a Music Therapy technique that includes all three domains because it enables arousal regulation by promoting relaxation (Carr, et al. 2011, p. 181).

There are many other Music Therapy techniques that benefit those who have PTSD. One Music Therapy technique is relaxation music listening. Relaxation music listening can be music listening alone, or music listening along with imagery or muscle relaxation (Jespersen & Vuust, 2012, p. 208). Another important difference in techniques is individual versus group work. Individual work with children is most prominent when it comes to Music Therapy and PTSD. On the other hand, most adults work in a group setting. Group Music Therapy is often focused on social aspects and addressing the avoidant behavior of those with PTSD (Carr, et al. 2011, p.189). It is not always easy in the beginning to be social with new peers after traumatic events, but it gets easier over time as engagement increases.

Another technique using guided imagery and music is called the Bonny Method. The Bonny Method typically consists of individualized 90-120 minute Music Therapy sessions where the therapist picks classical music, specifically western art music, to evoke sensory and emotional responses in the listener (Story & Beck, 2017, p. 94). A controlled environment study conducted in 2017 focused on planning effective interventions for women in the military who have experienced sexual trauma (Story & Beck, 2017, p. 96). Overall, the Bonny Method helped the individuals in the study be able to confront the past. One individual said, “it’s just putting it in a positive way, and this has helped associate music with positivity” (Story & Beck, 2017, p. 98).

In conclusion, there are many different Music Therapy interventions that are beneficial to people who have gone through trauma or have been diagnosed with PTSD. Every day is different for individuals who have PTSD. One day could be easy and the next day could consist of fear and then numbness. Although there is no cure for PTSD, different treatments and techniques are available. Music Therapy has such a wide variety of approaches to assist individuals with adjusting to everyday life and increasing positive behaviors or decreasing negative ones. 

-Amanda Brennen, Music Therapy Intern

References

Ahonen, H. (2018). Music medicine’s influence on music psychotherapy practice with traumatized individuals. Music & Medicine, 10(1), 26-38.

Beck, B., Messel, C., Meyer, S., Cordtz, T., Sogaard, U., Simonsen, E., & Moe, T. (2018). Feasibility of trauma-focused guided imagery and music with adult refugees diagnosed with PTSD: A pilot study. Nordic Journal of Music Therapy, 27(1), 67-86. doi: http://dx.doi.org/10.1080/08098131.2017.1286368

Carr, C., d’Ardenne, P., Priebe, S., Scott, C., Sloboda, A., & Wang, D. (2011). Group music therapy for patients with persistent post-traumatic stress disorder-An exploratory randomized controlled trial with mixed methods evaluation. Psychology and Psychotherapy, 85(2), 179-202. doi: 10.1111/j.2044-8341.2011.02026.x

Felsenstein, R. (2013). From uprooting to replanting: on post-trauma group music therapy for pre-school children. Nordic Journal of Music Therapy, 22(1), 69-85. doi: 10.1080/08098131.2012.667824

Jespersen, K., & Vuust, P. (2012). The effect of relaxation music listening on sleep quality in traumatized refugees: A pilot study. Journal of Music Therapy, 49, 205-229. doi: 10.1093/jmt/49.2.205

Landis-Shack, N., Heinz, A., & Bonn-Miller, M. (2017). Music therapy for posttraumatic stress in adults: A theoretical review. Psychomusicology, 27(4), 335-342. doi: 10.1037/pmu0000192

Story, K., & Beck, B. (2017). Guided imagery and music with female military veterans: An intervention development study. The Arts in Psychotherapy, 55, 93-102. doi: 10.1016/j.aip.2017.05.003

Jasmine's Final Blog Post

It’s so hard to believe that my time as a music therapy intern at Therabeat Inc. has come to an end. Time really does fly when you’re having fun! This internship has challenged me in ways that I never knew were possible. However, it has rewarded me in ways that I couldn’t have imagined. I started this internship feeling like a deer caught in the headlights. I’m leaving this internship as a new professional with the skill set to serve as an excellent music therapist.

I have learned so many skills, interventions, and songs throughout my internship experience. However, the most beneficial skill I learned was the ability to be flexible. COVID-19 affected my internship in ways that I couldn’t even have imagined beforehand. A lot of in-person sessions were moved to telehealth sessions, which challenged my session planning abilities. Even though this wasn’t a smooth transition, I believed that these months of telehealth sessions caused me to grow tremendously in so many ways. 

I’m so glad to be wrapping up my internship with the resuming of in-person sessions. Although I am grateful for learning how to navigate music therapy through telehealth options, it truly makes me happy to have the opportunity to see clients in person and continue to address their individualized goals. I’m also grateful for music therapy groups that have resumed at the clinic, such as Little Beats and Harmony Tots. Each individual client and group that I have had the opportunity to make connections with has impacted me for the better. I truly believe that these experiences have caused me to become even more invested in the field of music therapy and caused me to flourish and become a better music therapist.

I cannot thank Therabeat enough for this amazing, surreal internship experience. I plan to spend the next few weeks preparing to take my board certification exam so that I have the opportunity to affect my future clients as my supervisors affect theirs. I am so ready to start my journey as a music therapist and I am excited for what lies ahead!

Yours Truly, 

Jasmine Bailey, Music Therapy Intern

Meet Ms. Amanda

My name is Amanda Brennen and I am so excited to be interning at Therabeat! Serving the community and music have always been two very big passions of mine. Having grown up in Roswell, GA, I’ve been lucky enough to see the positive impact that Music Therapy has made on my hometown. My primary instruments are voice and piano, but I also love to play guitar and ukulele. Sometimes I will even pick up an accordion or keytar and play around! I will be graduating in December 2020 from Georgia College & State University. Go Bobcats! I was very involved on campus, and I loved connecting with so many people and making a difference in Milledgeville.

GCSU provided me with the opportunity to work with many different populations in different settings. One of my favorite experiences was working in a Pre-K class with 20 children between the ages of 3 and 5. Working with this classroom for an entire school year was a treat, and it was so exciting to look at the progress that was made during that time. I was even able to go on a few field trips with them! Another great experience I had was working in a nursing home with a woman who had her own poetry book. Through music therapy interventions, we transformed her beautiful compositions into music! This process was very rewarding. I also was given the opportunity to be a guest lecturer at GCSU and present my research about music therapy and PTSD. GSCU and the Milledgeville community will always have a special place in my heart. My biggest takeaway from my collegiate experience is that we are all “More alike than different”.

My first visit to Therabeat was when the Woodstock location opened and I was very drawn to the welcoming environment. Therabeat is unique because the therapists are able to co-treat with the physical therapists, speech and language pathologists, and occupational therapists. This appeals to me because one day in the future, I would like to open up my own private practice and possibly integrate co-treating. Therabeat also gives me the opportunity to work in different settings with different populations. Therabeat is a place I know I will grow into a well-equipped professional. I am so excited to learn from such a talented group of music therapists.

Sometimes change can be scary, and my first week at Therabeat was definitely not what I expected – it was bigger and better than what I could have imagined! The music therapists are so helpful with any and all questions that pop up. They even come to the rescue when you accidentally set off the building’s alarm! The entire team wants you to succeed, and will make sure you are being pushed to become the best music therapist you can be. This week I helped with summer camp and was able to observe many different sessions. Week one also reminded me that as a music therapist, you have to be very “go with the flow” because things can and do change very often. I know I am going to learn and grow both professionally and personally so much over the next few months. I am so excited for the adventure ahead!

-Be kind to one another. Until next time!

Amanda Brennen, Music Therapy Intern