Music Therapy and Brain Injury
Katherine Wright, BMT, MTA
Brain Injury refers to damage to the brain resulting from a number of causes. This damage to the brain results in a noticeable impairment in one’s cognitive, physical, behavioural, or psychosocial functioning such that the individual’s or the family’s life is adversely affected.
Brain Injury Rehabilitation strives to reduce the functional deficits caused by the brain injury by maximizing the person’s functional abilities and quality of life. (Taken from Alberta Hospital Ponoka – Brain Injury Rehabilitation Program pamphlet).
For further information or for detailed descriptions of some of the terms used here please go to www.braininjuryresources.org
Disclaimer: The information contained herein is based on my own experience with adults and adolescents with acute traumatic brain injury. Acute traumatic brain injury in this context refers to clients who receive inpatient rehabilitation within approximately two months following their traumatic brain injury.
Music Therapy and Brain Injury: General Tips
All clients with brain injuries need structure to their day. This structure helps them with memory, sequencing, and concentration. Most clients respond best to structured music — music with a definite beginning and ending– with predictable chord progressions. In my own experience, I have found that clients experience a loosely structured improvisation as an unsettling and insecure experience.
Most people who have brain injuries process information a little more slowly than the general population. In music therapy, you may have to ask questions more slowly, sing songs at a slower tempo, and use gestures to help yourself be understood.
Music therapy can benefit clients with brain injury in the following areas:
Language and speech: When the language centre of the brain is damaged, the music section may or may not be damaged. What this means is that although a client may not be able to talk, s/he may still be able to sing. Singing also works on breath control and timing of speech — skills that are essential when working on verbal communication. Give non-verbal clients a chance for self-expression by playing simple percussion instruments. This type of structured improvisation is an excellent way to provide clients with an expressive outlet for any feelings/frustrations they may be experiencing.
Memory/Cognitive Issues: Music Therapy can help with sequencing and concentration. Clients often struggle with being easily distracted, but are able to focus on a song for 2-3 minutes. In the majority of brain injuries, long term memory remains intact; music enables a person to reminisce and to reconnect with their own sense of identity. Song writing is an excellent tool to use when working on concentration and other cognitive issues (like generating ideas and initiation).
Physical Issues: Physiotherapy focuses on regaining strength and movement in affected limbs. Music can help with stretching and strengthening muscles. Some clients may benefit from using music to enhance their physiotherapy times, or using music to extend their physiotherapy goals. For example, using music therapy to work on arm strengthening and eye-hand coordination complements the physiotherapy goals.
Emotional Issues: Many clients are labile after a brain injury. A brain injury can change the chemical balance of the brain, so it’s very common for clients to experience depression or intense anger in the months following a brain injury. Combine that with communication problems, and it’s easy to see how songs can speak volumes for these clients. Providing clients with positive, successful experiences that focus on their abilities (and NOT their disabilities) can improve self-esteem and motivation, which in turn will enhance their performance in rehabilitation. Rehab, by necessity, at first must focus on a person’s disabilities in order to determine a client’s goals. Music therapy has the wonderful and unique opportunity to focus on the client as a whole person with many abilities and strengths.
The most important thing to remember is:
No brain injury is the same; just as personalities are different,
so too are the manifestations of a brain injury.