In its more than 60 years, music therapy has grown and evolved as a profession, especially over the past few decades. It is becoming more commonplace for music therapists to utilize electronic devices, programs and instruments. They serve as tools to provide access to active music making to increase personal expression, communication, independence, motivation, enhance physical rehabilitation and more. Like other health and educational professionals, music therapists now often use technology within therapeutic relationships and milieus to meet the challenges of assisting people with highly complex needs, such as John.
John was diagnosed with terminal cancer. In his final months he resided at a hospice, where he looked forward to his music therapy sessions. For several weeks, he and his music therapist were engaged in producing a recording of his favorite songs, including "The Eye of the Tiger" and "I Feel Good," to name only a few. John joined in the singing when he was able, and the therapist accompanied him on her electronic keyboard, all the while recording their performances on her laptop computer.
Each session they recorded additional songs, until their entire set list was complete. The original plan had been to complete the recording and then invite family, friends and hospice staff to a "CD release party." Unfortunately, John's disease progressed more quickly than expected, and when he took a turn for the worse, the party had not yet taken place. Plans were changed to schedule the CD release party following his death, thereby providing a powerful venue in which to honor his life and provide a legacy gift and closure for friends, family and staff.
John's story is one example of how music therapists can utilize technology. Electronic music technologies might also be effective in addressing mild to moderate pain for medical patients. Music composing programs, music-based video games, music "apps" and/or electronic instruments require the patient to focus. This focus on sounds, sights, touch and movement can reduce the amount of pain information that the brain pays attention to. There is actually a pain management concept called the neuromatrix theory, maintaining that the brain chooses to attend to sensory information rather than pain information.
Electronic music technologies may also help a child deal with feelings of helplessness following a trauma or injury. A young girl was alone in a different section of a burn hospital after a house fire because her mother and sister were more seriously injured than she was. Her music therapist suggested she create personalized recordings for her mom and sister, using messages of encouragement, their favorite songs and even a song she composed herself through computer software. She was thus able to meet goals such as connecting to her loved ones, becoming empowered, gaining control and experiencing success, without requiring prior training to play instruments.
Technology plays a large role in music therapy in educational settings as well. A young boy with quadriplegia could only move with a slight turn of his head. But a voice output communication aid, or VOCA, allowed him to participate in the opening song in his music therapy group. He activated his VOCA via a switch with his head to "sing" hello. Later, he used a multistep VOCA to sequence recorded phrases of a song, and to play music with other group members.
The experience of using his switch to participate led to his understanding of cause and effect, in turn leading to the start of purposeful communication with others. He is now able to participate independently in the group, without hand-over-hand assistance, and to actively respond to others music.
Adolescent students with complex cognitive and physical disabilities have become a part of their school band through "Switchintime," a group of "switch accessible music software programs for playing music using assistive devices." Nonmusical goals in the band include team building, peer support and self-expression, while musical goals might be reading adapted notation, exposure to repertoire, following musical cues and performing with a group.
Technology allows the students who are not able to play traditional band instruments the opportunity to play chords, sound effects or melodies with a section of the school band. Students have expressed "feelings of accomplishment, contributing to a group, validation and praise from family and friends."
At an after-school program for children who are "at-risk," five kids aged 7-11 gathered around the table as their music therapist explained they were going to do a group project with Garage Band, the computer program. Every decision involved a vote from all group members: choosing the picture to correspond with the music, selecting instruments, picking which sounds to start with, which to be played the longest and which to layer in, deciding on their favorite "riffs" and a beat.
The next step in the process involved copying and pasting the riffs the kids had chosen into the song structure on the computer. The kids then listened to their composition -- they liked it! Their last vote ("It's about everybody having a little bit of a choice," the music therapist reminded them) was for a song title.
What the kids may not have realized was that while they were having fun, they were being creative, too. They were also practicing group cohesion skills, learning to express their own opinions and allow others to express theirs, follow directions, listen to an adult and their peers and make decisions as a group, lessons they can carry into other aspects of their lives.
Recently Baker and Krout (2009) compared online music therapy intervention via Skype videoconferencing, facilitating face-to-face sessions with an adolescent diagnosed with Asperger's syndrome. Prior to the online sessions, the client had already established a therapeutic relationship and rapport with the clinician. Songwriting was the chosen intervention in both settings. Not only was the teen highly engaged in his Skype session, but he made more eye contact, was more creative with the creation of lyrics and more confident, in regard to offering disagreeing statements.
While other research using online approaches is definitely warranted, particularly to ensure that music therapy practices are aligned with other advances in medicine, psychiatry, nursing and allied health, this case study suggests possibilities for music therapy services to be provided online. Increasing access or frequency of services for those who are unable to attend music therapy clinics due to barriers such as distance, lack of transportation, susceptibility to infection and more, would be among the goals for this type of service provision in the future.
If you want to know more about music therapy, please visit the American Music Therapy Association's (AMTA) newly redesigned website. Here you can find music therapy news stories and videos, fact sheets, bibliographies, music therapy publications and other products in our online store, and information on how to find your very own music therapist.
References:
Baker, F. & Krout, R. (2009). Songwriting via Skype: An online music therapy intervention to enhance social skills in an adolescent diagnosed with Asperger's Syndrome. "British Journal of Music Therapy," 23 (2), 3-14.
Magee, W. L. (2011). Music technology for health and well-being: The bridge between the arts and science. "Music and Medicine," 3 (3), 143-145.
Magee, W. L., Bertolami, M., Kubicek, L., LaJoie, M., Martino, L., Sankowski, A., Townsend, J., Whitehead-Pleaux, A. M. & Zigo, J. B. (2011). Using music technology in music therapy with populations across the life span in medical and educational programs. "Music and Medicine," 3 (3), 146-153.
Whitehead-Pleaux, A. M., Clark, S. L. & Spall, L. E. (2011). Indications and counterindications for electronic music technologies in a pediatric medical setting. "Music and Medicine," 3 (3), 154-162.