Music therapy is an evidence-based expressive arts intervention that is increasingly being integrated in health care centers throughout the country to aid in treating a variety of medical conditions: developmental disabilities, Alzheimer's disease, substance-abuse disorders, brain injuries, physical disabilities and chronic pain. The emphasis in music therapy is not on musical ability or mastery, but rather engaging in the sensory experience of sound, performance, movement, instrumentation or voice to affect change in the patient's well being.
Model of Wellness
Daniel's Music Foundation (DMF) is an innovative, non-profit, volunteer-run organization providing free music programs for people with disabilities from age three to adulthood in the New York City area. Its members have a range of disabilities, including Down syndrome, autism, cerebral palsy, sensory processing disorders and paraplegia, to name a few. DMF aims to enable its members to benefit from training in musical instruments, voice, rhythm, song writing and more to experience emotional expression, community bonding, and the joy that music can provide. DMF members undergo 5- to 10-week classes in musical training and have a public recital twice a year. Staff includes a gifted group of volunteers, many of whom are music therapists, musicologists, college professors and performing musicians.
DMF seeks to build a community of people of all different abilities through music. "For the members and the caregivers who bring them to sessions, I believe they immediately get the sense that no one is judging them that regardless of their diagnosis, music is for all and they are not alone," explained musicologist Stephanie Jensen-Moulton, PhD. "Often medical intervention is about overcoming disability versus [simply] claiming who you are. Of course, it is beneficial to strive and work on getting from point A to point B. But an important alternative is often overlooked: living in your body. and finding joy and expression now, here in the present," Jensen-Moulton continued. "It is amazing to see the non-verbal members respond to music with some kind of phonation and then form words. There are connections being made."
Daniel's Music Foundation is the result of one personal journey of music and recovery. Daniel Trush, now 25, suffered a rupture of one of his five brain aneurysms while playing basketball at 12 years old. He was in a coma for a month and hospitalized for 341 days, then underwent years of rehabilitation. Music played a key role in helping him restore his life. "When Daniel was in a coma, he was connected to 16 IV lines beeping constantly," recalled Daniel's father, Ken. "I started playing music as a way to comfort myself and to communicate to Daniel." At first Ken played songs that communicated his feelings, like "I'm Not Giving You Up" by Gloria Estefan. "Then I made up my own song: 'I believe in you. no matter how long it takes. I would be with you.'" His father sang these words to Daniel nightly.Though Daniel did not speak for six months after awakening from the coma, his family and caregivers observed him mouthing the words to the song. "He retained the music and [we knew] that communication was going on," his father said. As Daniel recovered, he added words to the song that Ken had composed.
"Music was our common language," Ken stated. "I saw how music became the vehicle for Daniel to express himself, to gain self-esteem, build confidence and be creative." Ken noted the importance of balancing corrective goals with expressive goals. Daniel, for example, struggled significantly with mobility issues. "If you are constantly doing something that is wrong, it is easy to feel, 'I am wrong.'
Through music, Daniel had the experience of doing something right." After three years of active rehabilitation, Daniel stopped all therapies but continued with music. After discharge from rehabilitation, Daniel has continued music therapy weekly for the past 9 years. He has learned to play the keyboard and has written original songs. After graduating from high school, Daniel started non-matriculated classes at Hunter College in New York City, where he took classes with Jensen-Moulton. "She helped me to find my passion for music," Daniel explained. Daniel also expressed interest in using music to connect with and help others, especially children. "I found that Daniel had a good ear for music, and then we started ear training," Jensen-Moulton said. "When I met Daniel, he changed my perspective on people with brain trauma, his spirit and enthusiasm for learning was infectious. We have been taught to view people with disabilities through a pre-assumed lens, despite who the person is as an individual.. and what their capabilities are." Today, as the co-founder of DMF, Daniel is actively involved in all areas of the foundation. One day a week he also volunteers at the pediatric unit of the Rusk Institute of Rehabilitation Medicine in New York, where he spent close to nine months in 1997 and 1998 during his recovery.
Music & Medical Recovery
Integrating Music Therapy Into Rehab OT's can explore integrating music therapy interventions on two levels. Individually, therapists can identify a client's specific treatment needs and then work with a music therapist to integrate this in sessions. When OT practitioners are formulating treatment plans with patients, it can be helpful to note the following benefits of music interventions that parallel common rehabilitation goals. Sensory stimulation. Music can provide both sensory and intellectual stimulation to patients. Music can stimulate the imagination, and can be energizing or distracting when one is fatigued, for example. Relaxation. Music can have a calming effect and can provide a patient with an "emotional break," either actively by engaging in playing an instrument or passively by listening to pleasurable music. Stress relief. Music is used in hospitals for a wide variety of treatment situations: producing calm to induce sleep, or lessening muscle tension for the purpose of relaxation. Self-expression. Music intervention can allow for creative ways to respond to mental health needs. It can elicit new feelings, lift mood or stimulate emotional release.
Engaging in music can also strengthen non-musical areas such as communication skills and social functioning. It can sharpen cognitive functioning through eliciting musical responses. On a programmatic level, currently there are promising protocols for adapting music therapy interventions in rehab settings. Dr. Barry Bittman, consulting neurologist to DMF and director of the Yamaha Music and Wellness Institute, conducts research on the therapeutic effects of music. One model, Recreational Music Making (RMM), is an approach to guide patients through the process of playing a musical instrument without the goals of mastery or performance. The organization Health Rhythms has music intervention protocols that have been applied to cancer patients, at-risk youth and the elderly. "Musical interventions can become an enabling strategy," explains Bittman.
"Despite the challenges a patient may face, you can engage them at any level with music, through sound, movement, listening; and this aids in a patient achieving wellness. In addition, for progressive disabilities, music can alter pain perception and has the ability to improve quality of life regardless of the progression of a medical condition." Reflecting back on the journey through Daniel's rehabilitation, Ken and Daniel emphasize that music therapy and organizations like DMF can facilitate growth and healing in part through the communities they build. When Daniel was in acute rehab he underwent five interventions a day. "I would have a lot of one-on-one, and it would be just me. I had little opportunity for group interaction," Daniel explained.
After seeing the amazing progress Daniel has made through music, the Trush family hopes that Daniel's Music Foundation can be replicated in other communities. "We believe that every community could benefit from having a music program," Ken Trush said.
David Milarch, a fourth generation tree farmer in Northern Michigan with a bent for rugged living, had a near death experience in the hospital, after refusing dialysis and facing liver failure. He had died, left his body and returned, but with a message from spirit guides telling him his work was not done yet. The earth’s trees were in trouble, and he needed to clone Champion trees to protect their genetics for the future of the planet.
Milarch, fueled by the message from the angels, co-founded The Champion Tree Project. Twenty years later, with a modest staff, he has accomplished what skeptics and scientists said could not be done: cloned the earth’s biggest and oldest trees – among them Sequoias and Redwoods - that have stood the test of time and are the most resilient to climate change.
Each time I attend a live musical performance, I am always awed by the soul-piercing effect of music on the audience, be it jazz, blues, gospel, rock, or classical. I witness how music moves the listener spurring relief, joy, play, or an escape into imagination.
Earlier this summer, I visited the Nordoff-Robbins Center for Music Therapy and spoke with director,
Dr. Alan Turry, on the healing aspects of music and the unique treatment approach of the center.
“Pull on a single thread in nature, and you will find it
attached to everything in the universe,” says the naturalist John Muir. These words came to mind when I recently discovered the cinematic artwork of mouth painter, Moses Hamilton, 37, who lives in Kauai, Hawaii.
Capturing subjects ranging from the mundane to the transcendent, Hamilton’s paintings draw the viewer into the breathtaking landscapes of Hawaii and tell a moving visual story of the island’s people.
Mindfulness, the practice of bringing our attention purposefully to the present moment, is taught widely in healthcare treatment as a tool to aid in stress relief and coping.
I recently spoke with Ashley Mask, Manager of Visitor Experience and Access Programs at the Rubin Museum of Art in New York about Mindful Connections, a guided monthly 90-minute art tour of the museum for persons with dementia and their caregivers.
Spit it Out, an award-winning documentary codirected by Jeff Shames and Jonathan Skurnik, follows the poignant journey of Jeff Shames in his efforts to find self-acceptance as a stutterer.
In one of the delightful opening scenes, Shames is attending a workshop at a conference held by Friends, a support organization for children who stutter and their families. The children are outdoors ready with their speech monsters in hand, an art exercise depicting their struggles with stuttering. “We need to show them who is the boss of our talking!” says the group leader. “Put your speech monster inside the rocket!” The kids crumple up their speech monsters, dump them into a rocket, and blast it off into space, giving back the power to the children.
Are you a sensation seeker, or do you prefer a low key evening with quiet music playing in the background? Decoding our sensory style is the subject of a fascinating book, Living Sensationally: Understanding Your Senses, by Dr. Winnie Dunn, Chair and Professor of Occupational Therapy at University of Kansas Medical Center. Dunn's research on sensory processing disorders indicates that people fall into four categories of sensory styles: seekers, sensors, by-standers, and avoiders. In a recent conversation, I spoke with Dr. Dunn about the broad applications of her work.
“People with sensory processing disorders may be more sensitive to sensory input, but we are all wired to have idiosyncratic reactions to sensory experiences - sound, touch, taste or smell,” notes Dunn. In families, finding creative ways to respond to such needs of children can alleviate unneeded emotional suffering. Dunn provides the following example, “At a family gathering, a child with autism may want some time away from the group due to over-stimulation of social energy. Guests present can understand this as a sensory need versus another thing wrong with the child," she advises.
Each day, we humans participate in a common activity—the ancient craft of storytelling. Reading the daily paper, watching movies, or catching up with friends—sharing or listening to stories is at the heart of our nature. But can telling your story have benefits for your health? “Yes, most definitely,” says Paul Browde, actor, psychiatrist, and narrative therapist, “it made all the difference to my health and life."
Sharing the healing power of storytelling is a narrative exercise that Browde and his fellow actor Murray Nossel, an academy-nominated documentary filmmaker, have engaged audiences in for the last 14 years through Two Men Talking, a live unscripted performance that has been showcased to acclaim in New York, London, and South Africa. On stage, the two men explore a variety of stories: growing up white, Jewish, and gay under apartheid in South Africa; homophobia; racism; AIDS; and most importantly, their friendship and the passage of time.
The outpouring of emotion for the recent passing of tech genius, Steve Jobs, is validation of how much the magic of digital devices has become a central part of our daily lives. Phones and tablets are lifestyle managers, offering apps that help with organization, planning for dinner or checking one's budget. Jobs will be remembered as a central inspiration for the digital age, but how people continue to make creative use of digital technologies is the post-Jobs story.
Bridging Apps is a innovative web community of parents and professionals who seek to share information on ways to use educational/therapy apps on the latest technology devices—iPad, iPhone, iPod, Android and others—to support developmental learning goals for people with disabilities.
From the moment of birth children process the world through their senses. Through discovering taste, touch, sound, and movement, each child develops unique likes and dislikes. For some children, however, sensory processing can be painful or disorganizing.
Raising a Sensory Smart Child, by Lindsey Biel, M.A., OTR/L, and Nancy Peske, is a resource-rich, practical handbook for parents and caregivers of children with Sensory Processing Disorder (SPD) as they work to help kids find their daily balance.
Each year in the U.S., 765,000 American youths, about one every 40 seconds, visit an emergency room for a traumatic brain injury (TBI). Compounding this complex diagnosis, families have to navigate an
often-frustrating maze to access health care or discover the lack thereof. “Whether you are prince or a pauper, you face the same struggle across the U.S.,” says Patrick Donohue, founder of The Sarah Jane Brain Project (SJBP).
Donahue knows the challenges parents face firsthand. The Sara Jane Brain Project is named after his daughter, Sarah Jane, who at 5 days old was shaken by her baby nurse, breaking four ribs and both collarbones and resulting in severe pediatric acquired brain injury (PABI). From the outset, Donahue became harshly aware of what families of children with brain injuries contend with—an uncoordinated system of care, a medical issue with minimal research dollars, and haphazard treatment options.
Blissful Bedrooms is a one-of-a-kind nonprofit organization seeking to transform the bedrooms of young individuals with significant disabilities into spaces where they can experience peace, comfort, and joy. The idea was born from a special bond between Martha Gold- Dvoryadkin, physical therapist/yoga instructor at New York's PS 118 and a former student,Tamisha.
"My partner Alex and I brainstormed one day on how we could bring more happiness into her life. We decided to paint and decorate her bedroom. We were amazed at the impact on her and us," said Gold-Dvoryadkin.
“I wish to be, I wish to go, I wish to meet, I wish to have.” These are the magical questions in the wish-making process that have guided the granting of more than 1,700 wishes of children with progressive, degenerative, or malignant life-threatening medical conditions by Hudson Valley Chapter of the Make-a-Wish Foundation . I recently had the privilege of attending the annual Wish Gala, and took few moments to speak with Denise D'Amico, Vice President of Program services, on the work of the Foundation.
How people cope and subsequently learn to live well while dealing with a progressive medical condition is a central theme in my health
advocacy writing. Later this year, I will be interviewing Deshae Lott, PhD, a prolific writer and health care advocate. She has written widely on subjects related to ventilator dependent living, spirituality, and health care access for persons with disabilities.
In the following essay, "No Way Out But In: Responding to Chaos Positively with Forgiveness and Grief", Deshae walks the reader through the challenges of a week in her life of living with Limb Girdle Muscular Dystrophy. In this piece, Deshae shares her own acquired model of coping, “Whether much is going awry or right, I restore my inner serenity and well-being each day by using prayer and meditation, and processing grief and forgiving.
No day seems to pass without my using these mental resources,” she states. Her mission is to offer encouragement to those who struggle with the emotional stresses of complex health concerns.
Janne Kouri, President and Founder of NextStep Fitness, a state-of-the-art specialized gym facility in Lawndale, California, is an advocate with a focused dream: “…to expand NextStep Fitness in communities of
need throughout the U.S., so people living with paralysis or disability would have access to community-based fitness options. This is a nationwide problem, and it needs to be addressed,” he says.
This mission is inspired by Kouri’s own journey. In 2006, while playing beach volleyball with friends, Kouri took a break and dove into the water to cool off; he hit his head on a sandbar and was instantly paralyzed from the neck down. He then began a challenging rehabilitation for his spinal cord injury at Fraizer Rehab Institute in Louisville, Kentucky. His background as an avid exerciser and former college football athlete at Georgetown University equipped him with a unique sensibility for tackling the demands of his recovery.
Claudia Glaser-Mussen, the sassy singer-accordionist of the Grammy- nominated children's rock band, Brady Rymer and The Little Band That Could, has a lot to say about her muse, “I can feel my mother's presence on stage, when I perform; she inspires me and I'm able to convey that energy to the audience.” A thread of music runs through Glaser-Mussen’s life, "I grew up in a home where music was a part of our experience,” she says. Music never became more important for Glaser-Mussen than it did in the final stages of her mother’s life, when she was coping with Alzheimer’s disease. In this telling, WNYC radio interview, Opera Mom, Glaser-Mussen and her brother, violinist Matt Glaser, reflected on the role that music had in the care of their mother, Jeanette Glaser-Taubin, a professional opera singer.
One of the most memorable people I've interviewed in my travels is Ken Kunken, Deputy Bureau Chief of the Nassau County District Attorney's office. Over 30 years ago, Kunken suffered a spinal cord injury at age 20 while playing football at Cornell University, paralyzing him from the neck down. Despite his life-altering injury, Kunken's gifted intellect and perseverance afforded him an impressive string of academic and professional achievements. Ken would be the first to say these pale in comparison to becoming a Dad. "Being a father is my proudest accomplishment", says Kunken. When Kunken and his wife, Anna, decided to have a family, they sought help from The Miami Project- an organization specializing in fertility issues for paralyzed males.
An interview with Brooke Ellison, March 2010:
What is the role of hope in medical care? It is a complex and vital one, and it will soon be the focus of a six week elective course, The Ethics of Hope. The course will be taught to second year medical students at Stony Brook University Medical center this coming March.
The instructors are Brooke Ellison, 31, a doctoral candidate in sociology, and Steven G. Post, Director of Medical Humanities and Compassionate Care at Stony Brook University. They make a strong case for examining the role of hope in medical care, a perspective that is not commonly a part of the training for medical students. “I want to take the subject of hope out of the philosophical realm and provide students a structured way of thinking about it,” Ellison states.