Music Therapy with Military Populations

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Motivating Development Through Intentional Music Therapy Services!

Researched Backed – Evidenced Based

Click here to read more about the history of music therapy with the military population and to find out more about Captain Luis Avila's experience with music therapy.

What is Music Therapy?

               Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music Therapists use music within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. After assessing the strengths and needs of each client, the qualified music therapist provides the indicated treatment including creating, singing, moving to, playing, and/or listening to music. Through musical involvement in the therapeutic context, clients' abilities are strengthened and transferred to other areas of their lives. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words. Research in music therapy supports its effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people's motivation to become engaged in their treatment, providing emotional support for clients and their families, and providing an outlet for expression of feelings. (American Music Therapy Association, 2005)

Music Therapy with Military Populations

            Music interventions as a form of therapy was founded in treatment of veterans of World Wars I and II. Due to the observed effect music had on morale, physical and emotional rehabilitation, and psychological functioning, research was conducted to find out more about music used in a therapeutic environment. Out of this research, the music therapy profession was established and grew to be used with a variety of populations. After WWII in 1950, the National Association for Music Therapy was formed, and in 1971 the American Association for Music Therapy was founded. These two organizations merged in 1998 to form the American Music Therapy Association (AMTA) and the profession developed standardized curriculums, standardized codes and conducts of practice, and conducted evidenced-based research. “Music therapy meets the recognized hallmarks of a profession identified by sociologists including a body of knowledge, autonomy, authority, and altruism (Hodson & Sullivan, 2012) […] Music therapists provide services to military personnel, their families, service members in transition, and veterans nationwide. These music therapy programs are on bases, in military treatment facilities, and VA healthcare facilities, in communities, and elsewhere.” (American Music Therapy Association, 2014).

Why Music?

  • Music is an effective tool for therapy due to, but not limited to the following reasons:
  • Music creates a non-threatening environment: Music is a form of nonverbal communication, and allows the patient to express themselves through interventions such as drumming, movement, and improvisational music making.
  • Music provides a structure for self-expression: Through interventions such as songwriting, lyric analysis, and therapeutic singing, patients have a schema in which to express inner thoughts and engage in self-disclosure. Music inherently involves tension and release, allowing patients to experience catharsis when appropriate patient-preferred music is chosen for therapeutic interventions.
  • Music increases reality orientation: Rhythm is organized, structured, and occurs in time. This allows patients to experience and engage in the “here and now.”
  • Music engages the whole brain: When engaging in music-making (playing an instrument, singing, dancing) both hemispheres of the brain to function together. This quality of music allows the music therapist to work on a variety goals such as memory, attention span, or helping the brain to make new pathways to relearn functional skills.
  • Music is inherently emotional: Music creates a safe space in which for patients to experience and express strong emotions. Memory is often associated with a strong emotional response, therefore this quality of music allows patients to learn skills more effectively when there is a strong emotional connection to the music therapy process.

 

Music Therapy Research

           Music Therapists use evidence-based research on clinical techniques with Military Populations to support the holistic treatment of patients on a group and individual level. Music therapy can be used to address the physical, cognitive, mental, and emotional rehabilitation of populations including, but not limited to patients with traumatic brain injury, post-traumatic stress disorder, substance abuse disorder, and other mental health diagnoses. A selected list of related research studies outcomes is listed below.

  • Music therapy resulted in observed reduction of PTSD symptoms following drumming especially increased sense of openness, togetherness, belonging, sharing, closeness, connectedness and intimacy, as well as achieving a non-intimidating access to traumatic memories, facilitating an outlet for rage and regaining self control (Amir, Bensimon, & Wolf, 2007).
  • Patients with persistent post-traumatic stress disorder experienced a significant reduction in PTSD symptoms, and a marginally significant reduction in depression compared to the control group that received just cognitive behavioral therapy (Carr et al., 2012).
  • Active engagement in improvisational music therapy showed a significant improvement of the collaboration of the severe brain-injured patients and a reduction of undesired behaviors such as psychomotor agitation (Formisano et al., 2001).
  • Rhythmic auditory stimulation (RAS a neurologic music therapy technique) may be beneficial for improving gait parameters for patients with acquired brain injury including gait velocity, cadence, stride length and gait symmetry (Bradt, Magee, Wheeler, & McGilloway, 2010).
  • Stroke patients that received RAS showed statistically significant improvement in one limb stance, cadence, velocity, stride length, and posture head tilt (Hayden, Clair, Johnson, & Otto, 2009).
  • Various benefits with use of therapeutic singing with patients with nonfluent aphasia have been identified including: strengthened breathing and vocal ability, improved articulation and prosody of speech, and increased verbal and nonverbal communicative behaviors (Tamaino, 2012).
  • Long term improvements in affective intonation, vocal range, and improved moods were found when therapeutic singing was used with patients with traumatic brain injury (Baker, Wigram,& Gold, 2005).
  • Patients with traumatic brain injury that received neurologic music therapy showed improvement in executive function and overall emotional adjustment, lessening of depression, sensation seeking, and anxiety (Thaut, et al., 2009).
  • TBI and stroke patients that received music therapy compared to standard rehabilitation were reported to be more actively involved and cooperative in the treatment groups, mood improvement, and social functioning (Nayak, Wheeler, Shiflett, & Agostinelli, 2000).
  • Patients with substance abuse disorder that received music therapy experienced positive emotions to a moderate to high degree without the need for a substance (Baker, Gleadhill, & Dingle 2007).

Music Therapy Methods

         “Music therapy services are delivered as part of an individualized treatment plan. Specific interventions may address cognitive, physical, communication, emotional, and social needs of individuals across the life span. After assessing the strengths and needs of each client, the qualified music therapist designs and implements individualized treatment protocols. Music therapy interventions include creating music, singing, moving to, and/or listening to music. In the context of certain types of conditions, such as those that involve brain injury, the music therapist is trained to provide specific evidence-based interventions that build life skills to improve independence and promote adjustment to the individual’s “new normal.” Through musical involvement in the therapeutic context, clients’ skills are strengthened and transferred to real-life situations.” (American Music Therapy Association, 2014).

References
American Music Therapy Association (2014). Music Therapy and Military Populations: A Status Report
            and Recommendations on Music Therapy Treatment, Programs, Research, and Practice Policy.
Amir, D., Bensimon, M., & Wolf, Y. (2008). Drumming through trauma: Music Therapy with post-
            traumatic soldiers. The Arts in Psychotherapy, 35(1), 34-48.
Baker, F., Gleadhill, L., Dingle, G. (2007). Music Therapy and emotional exploration: Exposing substance
            abuse clients to the experiences of non-drug induced-emotions. The Arts in Psychotherapy,
            34(4), 321-330.
Baker, F., Wigram, T., & Gold, C. (2005). The effects of song-singing programme on the affective
            speaking intonation of people with traumatic brain injury. Brain Injury, 19(7), 519-528.
Bradt, J., Magee, W.L., Dileo, C., Wheeler, B.L., & McGilloway, E. (2010). Music therapy for acquired
            brain injury. Cochrane Database of Systematic Reviews, 2010(7).
Carr, C., d’Ardenne, P., Sloboda, A., Scott, C., Wang, D., & Priebe, S. (2012). Group music therapy for
            patients with persistent post-traumatic stress disorder: An exploratory randomized controlled
            trail with mixed methods evaluation. Psychology and Psychotherapy: Theory, Research and
            Practice, 85(2), 179-202.
Formisano, R. Vinicola, V., Penta, F., Matteis, M., Brunelli, S., & Weckel, J.W. (2001). Active music
            therapy in the rehabilitation of severe brain injured patients during coma recovery. Annali
            dellIstituto Superiore di Sanita, 37(4), 627-630.
Hayden, R., Clair, A. A., Johnson, G., & Otto, D. (2009). The effect of rhythmic auditory stimulation
            (RAS) on physical therapy outcomes for patients in gait training following stroke: A feasibility
            study. International Journal of Neuroscience, 119(12), 2183-2195.
Nayak, S., Wheeler, B., Shiflett, S.C. & Agostinelli, S. (2000). Music therapy in the rehabilitation of TBI
            and stroke patients. Rehabilitation Psychology, 45, 274-283.
Thaut, M. H., Gardiner, J.C., Holmberg, D., Horwitz, J., Kent, L., Andrews, G., … McIntosh, G.C. (2009).
            Neurologic music therapy executive function and emotional adjustment in traumatic brain
            injury rehabilition. Annals of New York Academy of Sciences, 1169, 406-416.
Tomaino, C.M. (2012). Effective music therapy techniques in the treatment of nonfluent aphasia.
            Annals of the New York Academy of Sciences, 1252(1), 312-317.