Glimpses into Music Therapy from Down Under – Lauren Stewart

Now we have our blog set up (thanks Amy), I can use it to check in with you all from down under – g’day! This morning I spoke at the annual meeting of the Australian Music Therapy Association – definitely not my usual crowd but a fantastic group of highly committed and passionate music therapists.  This year’s theme was ‘Music in Mind’, highlighting a commitment of this community to understanding the neuroscientific mechanisms through which music may exert its effects in a wide range of contexts. This was the biggest ever meeting of the association with several hundred registered music therapists in attendance and many additional music therapists in training.  The three parallel sessions included presentations on the use of music in trauma, rehabilitation, palliative care and community settings, and a panel on altered states of consciousness, a few snippets of which follow:

Matthew Huckel, from the Disability South Australia Music Therapy Unit, spoke on ‘strengthening what remains’, relating to the use of music with patients who are severely brain injured following hypoxic or traumatic brain injury.  Patients may be in persistent vegetative or minimally conscious states, and music can be used both diagnostically (to assess what functions are intact) as well as therapeutically.  Matthew pointed out the difficulty inherent in knowing whether observed behavioural responses to music are really purposeful or are simply non-conscious reflexes due to arousal of the limbic system. He gave a fascinating personal perspective on the job –  pointing out that there may be a complete lack of response from the client for many months making it difficult but integral to remain open to the possibility of a future change.  Compassion, commitment and patience are clearly high on this job spec. The students on the MSc in Music, Mind and Brain will here more about this from our guest lecturer, Wendy Magee (Royal Hospital for Neurodisability) later in the year.

Kate Teggelove from the Sing and Grow project, Melbourne, spoke about the neurological effects of trauma in the developing brain of children.  She highlighted the damaging effects that traumatic situations such as extreme neglect can have on the development of structures such as the hippocampus, orbitofrontal cortex and the amygdala. Such situations, especially when prolonged, can result in hyper-arousal of the limbic system so that danger is anticipated long after any threat has dissipated, resulting in long lasting physical and emotional repercussions.  In such cases, music therapy can be used to modulate arousal levels (eg by matching tempo of the music to the child’s heart rate) and, subsequently, to build motor co-ordination, social skills and regulate emotional processing.

Trish Dearn (Mercy Hospital for Women) and Helen Shoemark (The Royal Children’s Hospital, Melbourne) opened my ears to the auditory environment of the neonatal intensive care unit (NICU).  Their study investigated the effect of music on the behaviour and physiological responses of premature infants, as a function of the presence or absence of the mother. They failed to find any main effect of music on behaviour or physiology, possibly because the music they used was played at a very low volume, in order to satisfy published safety guidelines.  Infact, these guidelines were stipulated in order to preserve clarity of spoken communication between nurses on the wards, though Helen pointed out that little is known about the effect of high levels of ambient sound on the premature developing brain: the noisy environment of the machinery on NICU wards may already be too high. I have it on good authority that this question is being investigated using a sheep model but unfortunately I couldn’t find any photos of lambs in NICU wards with a brief google search!

Imogen Clark (registered music therapist, Eastern Health and Austin Health) presented the results of a project carried out in collaboration with an occupational therapist to look at the potential of music making as a means of rehabilitating upper-limb movements, such as following stroke.  With a range of instruments to choose from, and some flexibility in how they can be played, making music can bring about specific spatial, timing and force components of desired movements.  The sensory outcomes achieved by playing a musical instrument bring rewards that are rarely experienced through the use of more traditional rehabilitation devices, and patient compliance is therefore high. The presentation reminded me of a talk I saw a few years ago in which a patient with visual neglect was prompted to strike some chime bars positioned in her neglected field, in order to finish off the ending to a well-known tune.  The desire to resolve the incomplete tune was sufficiently strong to over-ride  the attentional spatial bias that characterizes visual neglect, indicating the potential benefits of using music for cognitive, as well as motor rehabilitation.

Finally, Jacques Launay (PhD student at MARCS auditory laboratories, University of Western Sydney) considered whether tapping in synchrony to a beat can impact upon subsequent feelings of affiliation.  Participants engaged in a tapping paradigm, followed by an economic game of trust.  Both the tapping part and the economic game involved interacting with a computer, but half the participants believed they were interacting with another person. For these individuals, there was a significant correlation between degree of synchronization and the amount of trust displayed during the economic game.  This was one of only a few presentations given by non music-therapists but the discussion that followed showed that these findings were deemed to be of high importance for issues of rapport building during music therapy.

The above snippets are just a few of a large number of excellent talks I was able to attend. I was genuinely impressed with the breadth of approaches and applications on the programme and by the genuine openness and interest of this community in understanding findings from neuroscience and music psychology.  The organizers, Drs Helen Shoemark and Karen Bolger and their team did a remarkable job with the programming and organization and I am very grateful to them for introducing me to their world and opening the door to future collaboration – and, not least, for the Ugg boots 😉 Now please excuse me, I’ve got a date with some penguins….

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