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Official Musical Therapy Presentation

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Chelsea Emrit

on 12 February 2013

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Transcript of Official Musical Therapy Presentation

Chelsea, Holly, Kate, Nicole, & Tahara Musical Therapy Music therapy is the clinical and evidence-based use of musical interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.
(musictherapy.org) What is Music Therapy? The American Music Therapy Association (AMTA) defines music therapy as "an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals of all ages. Music therapy improves the quality of life for persons who are well and meets the needs of children and adults with disabilities or illnesses." Goals of Musical Therapy Promotes wellness
Manages stress
Provides distraction
Enhances expression of feelings
Stimulates memory
Improves communication
Promotes physical rehabilitation Types of Music Therapy Active Therapy: Based on improvisation between the therapist & the patient or group of patients. Requires direct participation. Passive Therapy: Patients, individually or in a group, listen to recorded music or to sounds made with musical instruments by a therapist. Individual Group Founded in 1971, they are an association whose purpose is the progressive development of the therapeutic use of music in rehabilitation, special education, and community settings. What is the American Music Therapy Association? Risks Benefits Certain music can elicit sad or traumatic memories
It can increase hostility, tension, fatigue, and decrease mental relaxation and clarity Eases anxiety, decreases stress
Form of self-expression
Healthy distraction during medical procedures
Can be relaxing and soothing
Can increase cognitive & creative abilities
Social Experience Who can benefit from music therapy? Children Adolescents Adults Elderly
Pregnant Moms Those with: Alzheimer's Disease Brain Injuries Sensory Impairments Autism Spectrum Disorders Mental Challenge Learning Difficulties Behavioral Disorders Anxiety Isolation Acute & Chronic Pain Education: Earn a bachelor's degree or higher in music therapy from 1 or more than 70 AMTA- approved college and university programs. Becoming a Musical Therapist Complete at least 160 hrs of clinical experience with a board-certified music therapist. Sit for the independently administered national examination, offered by the Certification Board for Music Therapists. Complete a supervised internship of 1,040 hours. Renew the certification credential every five years. Complete 100 hours of recertification credits or retake the examination in the 4th years of a five-year cycle. Examples of mental health illness: Schizophrenia, depression, bipolar disorder, personality disorders, ADHD, eating disorders, substance abuse disorders
Increase quality of life
Music helps orient the person: to place, time, event, person, “organization of sound in time and space.”
Is a universal language: beating a drum, don’t have to use words, form of expression
Social activity Music and Mental Health Are any of you musically inclined? If so, what instrument do you play? Or do you sing?
If you listen to music, when do you listen to music during your day?
Do you use music as a form of therapy?
What types of music do you listen to?
After this presentation, did you know about any of these benefits before? Some things to think about... Decreases distress
Decreases anxiety
Reduces fear, worry, and fatigue
Improves level of comfort
Provides distraction from pain, distress, nausea Music Therapy in the Oncology Setting Music Therapy With the Elderly 2 Studies Done Palliative care patients
Music used in pain management palliative care to help patients regain self-control and become actively involved in managing their pain
Dementia patients
Music therapy used to enhance communication, emotional, cognitive, and behavior skills with elderly patients Study was done to determine the efficacy of a single music therapy session to reduce pain in palliative care patients
200 patients over 2 year span
2 groups: one that received standard care, and one that received standard care with music therapy
Intervention incorporated music therapist-guided autogenic relaxation and live music Palliative Care Patients Research Significantly greater decrease in Numeric Rating Scale in the music group
Effective in lowering pain Results Kathy Jo Gutgsell, Mark Schluchter, Seunghee Margevicius, Peter A. DeGolia, Beth McLaughlin, Mariel Harris, Janice Mecklenburg, Clareen Wiencek, Music Therapy Reduces Pain in Palliative Care Patients: A Randomized Controlled Trial, Journal of Pain and Symptom Management, Available online 24 September 2012, ISSN 0885-3924, 10.1016/j.jpainsymman.2012.05.008.
(http://www.sciencedirect.com/science/article/pii/S0885392412003302) This was a literature review of 13 studies that were reviewed and reported results of music therapy influencing the behavior of patients with dementia in a positive way Dementia Study Music therapy was effective directly after it was given, but not long term
Reduced symptoms of aggressive behavior, anxiety, irritability, and restlessness
Not only does it benefit the patients, but also the caregiver
playing background music led to positive social interactions such as smiling, talking and eye contact

Wall, M., & Duffy, A. (2010). The effects of music therapy for older people with dementia. British Journal Of Nursing, 19(2), 108-113. Results Where a Music Therapist May Work Psychiatric hospitals
Medical Hospitals
Rehabilitation Facilities
Outpatient Clinics
Day Care Treatment Centers
Drug and Alcohol Programs
Senior Centers Nursing Homes
Hospice Programs
Correctional Facilities
Halfway Houses
Private Practices How Does Music Affect the Brain? Music can cause an increase in serotonin levels
Approximately 50 million brain cells are influenced by serotonin
Positive changes are triggered in cells that control memory power, learning, mood, sleep functions, body temperature regulation mechanisms, sexual desires, and other processes Music and Endorphin Levels •Studies suggest music also helps in the release of endorphins that aid in speeding up the body’s healing process
•Music is thought to distract the body from suffering and pain
•Music also simultaneously triggers certain chemical activities that affect healing, such as prostaglandins Music Helps Improve Memory • Research suggests that the silence between two musical notes can trigger the neurons and brain cells which are required for healthy memory
• Music from flute, sarod, and santoor, are ideal for the improvement of memory and concentration
• Music with stronger beats causes brain waves to resonate in such a way that is in sync with the music, creating higher levels of alertness and concentration
• Music also enhances creativity because it has a stimulating effect on the right side of the brain Neurogenesis • It has been proposed that listening to music facilitates neurogenesis, the regeneration and repair of cerebral nerves
• Thought to be accomplished by adjusting the secretion of steroid hormones leading to cerebral plasticity
• Music affects levels of steroids such as cortisol, testosterone, and estrogen, and it is believed that music also affects the receptor genes related to these substances Study Related to Brain Plasticity Musicians were studied to better understand the brain and how it is influenced by specialized sensorimotor skills
Musicians learn and repeatedly practice the association of motor actions with specific sound and visual patterns
This association learning can strengthen connections between auditory and motor regions while activating multimodal integration regions
Plasticity in this network may explain some of the sensorimotor and cognitive enhancements that have been associated with music training and therapy
These enhancements suggest the potential for music making as an interactive treatment or intervention for neurological and developmental disorders, as well as those associated with normal aging Music Therapy and the Patient with a TBI This study examined the immediate effects of neurologic music therapy on cognitive functioning and emotional adjustment with brain-injured patients

Four treatment sessions were held, during which participants were given a pre-test, participated in 30 min of NMT that focused on one aspect of rehabilitation (attention, memory, executive function, or emotional adjustment), which was followed by post-testing

Control participants engaged in a pre-test, 30 min of rest, and then a post-test

Treatment participants showed improvement in executive function and overall emotional adjustment, and lessening of depression, sensation seeking, and anxiety

Control participants improved in emotional adjustment and lessening of hostility, but showed decreases in measures of memory, positive affect, and sensation seeking Music and Emotion Emotional response has to do with:

1) Personal preference

2) Connection to past memory, person, or place the listener is fond of

3) The element of surprise
- There are unexpected deviations from the melody, such as through ornamental notes like an appoggiatura
-The music is soft, then abruptly becomes loud
-There is an abrupt entrance of a new tone or voice, such as a different harmony or a new instrument
-The pitches being played expand, as when you move to an octave Music Therapy for Stroke Recovery Blind, Randomized, and controlled trial-designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke

In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery stroke were randomly assigned to a music group, a language group, or a control group

During the following two months, the music and language groups listened daily to self-selected music or audio books while the control group received no listening material

All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires one week, 3 months, and 6 months after the stroke

Fifty-four patients completed the study

Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups

The music group also experienced less depressed and confused mood than the control group Application to Nursing and Healthcare ~Used to decrease pain so that less pain medication has to be used
~Used to help with rehabilitation for walking and other skills
~Used to increase ease and effectiveness of procedures with children
~Used to decrease anxiety so energy and physical reserves can be used for healing Examples of Therapies Used ~Playing an instrument to the beat of a song to encourage the mind to focus on the tempo of the song rather than pain

~Playing music of increasing tempos for patients relearning to walk to encourage movement

~Guided imagery to music for children

~encouraging musical composition to vent emotions and concerns

~Learning to play an instrument as a means of distraction and therapy Palliative Care Study done to determine the efficacy of a single music therapy session to reduce pain in palliative care patients.
200 patients enrolled in study for 2 years
2 Groups: One that received standard care, one that received standard with music therapy.
Pre and post tests to assess level of pain using a Numeric Rating Scale
Intervention incorporated music therapist- guided autogenic relaxation and live music.
Results: significantly greater decrease in Numeric Rating Scale in the music group.
Music therapy was effective in lowering pain. Dementia Music Therapy in the Oncology Setting Music & Pregnancy Research Purpose: Investigate the effects of music on pain reaction & anxiety during pregnancy and labor.

Conclusions: Music therapy does in fact provide quantifiable psychological benefits. Proven to be effective during the latent phase of labor.

Relevance to clinical practice: Results support that music listening is an acceptable and non-medical coping strategy, as well as cost effective. Further research is needed to test long-term benefits. Clinical Practice Mothers can be encouraged to make a "labor playlist". The songs that are chosen can elicit some calmness and relaxation during the early stages of labor. Music therapy seems to be most effective when the body & the brain have time to develop a conditioned response to the music, rather than spontaneously listening.
Some moms have reported that listening to music regularly during pregnancy enables them to visualize a successful birth.
Music can help establish a new rhythm in labor, since our body tends to mimic the beat of music. More Milk Please! Music therapy during the postpartum period in relation to breastfeeding:
1. Keep mother calm which thus allows for a better physical and emotional connection with baby.
2. Research has shown that music can increase milk flow. A study done in 1989, found that when mothers of premature babies listened to a relaxation & visualization audiotape, they produced 63% more milk than those who did not. Ex: Cathro, M., & Devine, A. (2012). Music therapy and social inclusion. Mental Health Practice, 16(1), 33-36
Percussion based group called “Drumdee”
94% felt relaxed, 98% could learn at their own pace, 94% had enough choice
65% more active outside of the group since attending
60% reached goals “social confidence, mastery, developing an interest”
Facilitators: Increased eye contact and communication within group
Interest in person hygiene and appearance Ex: Grocke, D., Bloch, S., & Castle, D. (2009). The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness. Journal Of Music Therapy, 46(2), 90-104.
10 week group music therapy session of song singing, song writing, improvisation
Increased quality of life
Less physical pain, more leisure activities, more friendships made
Increased eye contact
Focus groups states: involvement gave pleasure and joy, was relaxing, were surprised in their productivity in creating songs
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