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 Best Practices, Practical Techniques, and Trending Research  Best Practices, Practical Techniques, and Trending Research

Best Practices, Practical Techniques, and Trending Research - PowerPoint Presentation

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Best Practices, Practical Techniques, and Trending Research - PPT Presentation

in Music Therapy Hannah Bronson MTBC Rebecca Vaudreuil EdM MTBC 29 th Annual Brain Injury Association of Maryland 23 March 2017 Presenters Hannah Bronson MTBC BoardCertified Neurologic Music Therapist ID: 774672

music therapy health amp music therapy health amp musical training care telehealth www arts interventions speech center trauma neurologic

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Slide1

Best Practices, Practical Techniques, and Trending Research in Music Therapy

Hannah Bronson, MT-BCRebecca Vaudreuil, EdM, MT-BC29th Annual Brain Injury Association of Maryland 23 March 2017

Slide2

Presenters

Hannah Bronson, MT-BC Board-Certified Neurologic Music TherapistContractor, Americans For The Arts, in support of Intrepid Spirit One, National Intrepid Center of Excellence Satellite, Fort Belvoir Community HospitalRebecca Vaudreuil, EdM, MT-BC Board-Certified Music Therapist, Neurologic Music Therapy FellowNeonatal Intensive Care Unit/Music-Assisted Child Birthing Certified, Contractor, Americans For The Arts, in support of the National Intrepid Center of Excellence, Walter Reed National Military Medical Center & Creative Forces Tele-rehabilitation Initiative

Slide3

Learning Objectives

At the conclusion of this presentation the participants will be able to:

Recognize the evolution of music therapy, from historic scope and purpose to current clinical application, innovative interventions, and treatment trends.

Identify music therapy interventions and the applicable context for utilization in an interdisciplinary or co-treatment setting.

Demonstrate knowledge of neurologic music therapy (NMT) interventions and interpret the need and use of music therapy in allied health care on a national scale through real-time experiential examples.

Slide4

Opening Experiential ~Breathing to Music

Featured instruments

Reverie harp, guitar, HAPI drum, viola

Instruments selected specifically for abilities to be rhythmic and incorporate soothing melody

Goals

Facilitation of breath-connection to induce relaxation response

Internal entrainment of respiratory rate (55-70 breaths per minute), blood pressure, heart rate to external auditory stimuli

Intentional listening for enjoyment

Slide5

Presentation Outline

Section 1: Emerging trends in health care utilizing creative arts therapies as adjunctive treatment and standard of care

Section 2: Current clinical implications from neurologic music therapy interventions across multiple patient populations and platforms of care

Section 3: Intervention experiential and research questions

Slide6

History of Music Therapy

World Wars I and IIVeteran clinicsCombat fatigue, shell shockResponse to volunteer musiciansPhysician, nurse, mental health referralsFirst music therapy course at Columbia in 191972 accredited colleges and universities 49% offer graduate degreesCertification Board for music therapistsBoard Certified Music Therapist (MT-BC)

Image source: Resounding Joy, Inc.

Image source: The Oakland Press

http://

www.theoaklandpress.com

/article/OP/20160119/NEWS/160119471

Slide7

Where do Music Therapists Work?

Hospitals Neurorehabilitation ProgramsMilitary Treatment Facilities Schools (Special Education)Older Adult EstablishmentsCenters for Developmental Disorders

http://

www.wellspringeducation.org

/music-therapy/

Slide8

Music Therapy Treatment Goals

SOCIOBEHAVIORALPain/anxiety managementRelaxation/stabilization of vital signsSelf-awareness/expressionEmotional regulationAppropriate communicationLearning coping strategiesSocial engagement/group cohesionPositive sense of self/accomplishment(Re)integration to self/family/community/country

REHABILITATION (PHYSICAL, NEUROLOGICAL)

Speech and language

Sensorimotor

Cognition/Memory

Social engagement/group cohesion

Positive sense of self/accomplishment

(Re)integration to self/family/community/country

Slide9

Rationale for Music

100+ billion neurons in the brainScientists in recent years have found that listening to music activates neurons in nearly every region of the brain. (Levitin, 2006)Effective throughout the lifespan

Slide10

Rationale Continued…

Bodies entrain to rhythm due to the natural response and entrainment of motor system. Humans physiologically respond to music.Music “taps” into emotions. Music helps improve attention/executive function. Music shares neural circuitry with speech. Music is a social experience. Music is non-invasive, safe and motivating.

Image source: http://www.androidwallpapercentral.com/downloads/AndroidWallpaperMusicLifeline.jpg

Slide11

Slide12

Contexts of Music Therapy Facilitation

Individual vs. Group Dynamics

Self insight

 Social engagement

Inpatient vs. Outpatient Rehabilitation Setting

Maintaining engagement of both mandatory and volunteer participation in music therapy programming

Acute vs. Long-term Care

Improvisation, adapted instruction, songwriting, performance

Stages of Trauma Awareness

Kübler

-Ross model (the five stages of grief)

(

Kubler

-Ross, 1969)

Denial, anger, bargaining, depression, and acceptance

Entry at all levels

Different mus

ical interventions to accompany different stage/progression through processes

Slide13

4-Week Acute Intensive Outpatient Program Model at the National Intrepid Center of Excellence

Slide14

Long-Term Progressive Program Model at Intrepid Spirit Center Fort Belvoir

Slide15

Neurologic Music Therapy

“A Brain that is engaged by music, is changed by engaging in music…In Neurologic music therapy, music as a therapeutic agent does not operate as a cultural artifact, but rather it operates as core language of the human brain…music engages widely distributed neural networks that are shared with general “non-musical” cognitive, motor, and language function” (Thaut, 2014)

Slide16

Rational Scientific Mediating Model

Slide17

Common NMT Interventions:

CognitiveAssociative Mood and Memory training (AMMT)Auditory Perception Training (APT)Echoic Memory in Music (EMM)Music Attention Control Training (MACT)Music Executive Function Training (MEFT)Music Psychosocial Training and Counseling (MPC)Musical Mnemonic Training (MNT)

Motor

Musical Neglect Training

Patterned Sensory Enhancement (PSE

)

Rhythmic Auditory Stimulation (RAS)

Therapeutic Instrumental Music Performance (TIMP)

Speech

Melodic Intonation Therapy (MIT)

Oral Motor and Respiratory Exercises (OMREX)

Rhythmic Speech Cuing (RSC)

Therapeutic Singing (TS)

Slide18

The Intersection of Goals & Intervention to Inform Function

Slide19

Cognitive: Auditory Perception Training (APT)

(Central) Auditory Processing Disorder – Developmental, common in military blast TBIFocused on auditory perception and sensory integrationDeveloping treatment program with Speech and Language Pathologists

Slide20

Cognitive: Musical Mnemonic Training (MMT)

Uses music as a mnemonic Device to sequence and organize information enhancing persona ability to recall informationFunctional Example: “ABC” song, School House Rock

Something patients often can relate to…

Slide21

Remembering morning routine…

WalletIDCell phoneCoffeeBreakfast

Medication

Brush teeth

Shower

Pack lunch

Backpack

Slide22

To the tune of “Smooth Criminal”

“Wake up brush my teeth, take a shower, eat some breakfast. Pack a lunch, make coffee, take my medication.

Gotta

grab my wallet, my ID and my cell phone. Put them all in my backpack, out the door, and I’m ready to go!”

Slide23

Speech and Language: Oral Motor and Respiratory Exercises

OMREX involves the use of musical materials and exercises, mainly through sound vocalization and wind instrument playing, to enhance articulatory control and respiratory strength and function of the speech apparatusCommonly used for people with dysarthria, and muscular dystrophyFunctional Example: Video

Play Video

Slide24

Patient Testimonial:“For me it is a time where I can get out of my pain, grief, and some of my darkest thoughts in almost a cryptic manner without being judged by others. It’s like I open myself up to explore my thoughts, put them in a bottle, and seal it up as a finished project allowing me to let go of some things and reflect on others.” (Davis, B., verbal communication, 4/6/14)

PLAY NEWS FEATURE

PLAY NEWS FEATURE

PLAY NEWS FEATURE

PLAY NEWS FEATURE

Music Therapy News Feature

Slide25

Songwriting in Music Therapy

Songwriting in Music Therapy“Songwriting in therapy consists of a process of creating the song and all the musical, verbal, and bodily communication involved in that process.” (Baker & Wigram, 2005, p 98). Ethical obligation of clinician to ensure that the client can further process experiences of residual effects, be they positive or negative.Strong emphasis on expression, communication, agency.

http://

www.wellspringeducation.org

/music-therapy/

Slide26

Tele-Music Therapy Using Cyberspace to Connect

Slide27

Defining TeleHealth

Interest peak of telehealth in public and private sectors since 1996

Use of telecommunication technologies to disseminate electronic information to support long-distance clinical health care, patient and professional health-related education, public health, health administration, etc...

Technologies include videoconferencing, the internet, terrestrial and wireless communications.

Increase/improvement of telehealth to meet needs of underserved people by:

Fostering partnerships within HRSA, federal, state and private sector groups.

Providing technical assistance.

Evaluating the use of telehealth technologies and programs.

Developing telehealth policy initiatives to improve access to quality health services.

Promoting knowledge exchange about "best telehealth practices.”

~

US

Dept

Health & Human Services, 2012

Health Resources and Service Administration (HRSA)

http://www.hrsa.gov/ruralhealth/about/telehealth/glossary.html

Slide28

Grounded in TeleMedicine

Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status.” (American Telemedicine Association, www.americantelemed.org)Telemental Health (TMH) is a subset of telehealth that uses technology to provide mental health services from a distance. Telepsychology, telepsychiatry, telebehavioral health. Ensures that clinical care, medical education and monitoring, and provider consultations are available anytime, anywhere.How are you integrating tele-music therapy into your practice?

National Center for

Telehealth

& Technology, 2012

Defense Center of Excellence,

www.dcoe.mil

Slide29

Telemusic Therapy (TMT)

Provide music therapy interventions remotely for pts that are either homebound due to illness or live in rural areas. Common TMT interventions: personal music inventory creation, lyric analysis, songwriting, relaxation, therapeutic singing, instrument performance, recording, producing, meditation & relaxationLocate music-based services in pts communities that are accessible and in proximity to TMT pts.Individual, Group, Families

Slide30

Example:

https://www.arts.gov/art-works/2017/music-saved-my-life-how-arts-therapy-helped-master-sergeant-recover-wounds-war

Slide31

Music Therapy Research Initiatives

Grammy Foundation - Supported research project exploring emotional regulation

using music listening for service members with PTSD. This neuroimaging study will use the

magnetoencephalograph

(MEG) to show brain activity while listening to specific music.

Case Study to show the gains that this patient continues to make in a rehabilitation process involving an interdisciplinary team approach

from inpatient (acute) to outpatient (long-term) settings. Through sharing this case example, we aim to demonstrate the benefit of multiple disciplines individually and highlight points of collaboration to provide total patient-centered care. This patient has selected music therapy as a modality that bridges his treatments together with consideration to speech, PT, and assistive technology.

Slide32

Presenter Contacts

Hannah Bronson, MT-BC

Hannah.e.bronson.ctr@mail.mil

Rebecca Vaudreuil,

EdM

, MT-BC

rebeccamusictherapy@gmail.com

Slide33

References

American Music Therapy Association (2002).

Using music therapy in response to crisis and trauma.

Silver Springs, MD: Author.

Baker, F. (2001). The effects of live, taped, and no music on people experiencing post-traumatic amnesia.

Journal of Music Therapy,

38(3), 170-192.

Baker, F. & Wigram, T. (Eds.). (2005). Songwriting: Methods, Techniques and Clinical Applications for Music Therapy Clinicians, Educators and Students. Philadelphia: Jessica Kingsley Publishers.

Bensimon

, M., Amir, D., & Wolf, Y. (2008). Drumming through trauma:

Music

therapy with post-traumatic soldiers.

Arts in Psychotherapy

, 35(1), 34-48.

Carey, L. (2006) (ed.)

Expressive and Creative Arts Methods for Trauma Survivors.

Philadelphia, PA: Jessica Kingsley Publishers.

Thaut

, Michael.,

Hoemberg

, Volker. Handbook of Neurologic Music Therapy. Oxford University Press (2014)., New York, NY.

Taylor, D.,

Biomedical Foundations of Music as Therapy

(2

nd

edition). Barton Publications (2010). Eau Claire, WI.

Gabrielsson

, A., “The relationship between musical structure and perceived expression”, Chapter13.

Oxford Handbook For Musical Psychology.

Oxford University Press (2009), New York, New York. pp. 141- 150.

Slide34

References Cont..

Gabrielsson

, A., “The relationship between musical structure and perceived expression”, Chapter13.

Oxford Handbook For Musical Psychology.

Oxford University Press (2009), New York, New York. pp. 141- 150.

Kubler

-Ross, Elisabeth. (1969). On Death and Dying. New York, NY: The Macmillan Company.

Levitin, D. (2006). This is your brain on music: The Science of a human obsession. USA: Penguin.

Ng, Wang Feng (2005). Music Therapy, War Trauma, and Peace: A Singaporean Perspective.

Voices: A World Forum for Music Therapy.

Retrieved June 19, 2010, from

http://www.voices.no/mainissues/mi40005000191.html

Sutton, J. (2002.) (ed.)

Music, Music Therapy and Trauma; International Perspectives.

Philadelphia, PA: Jessica Kingsley Publishers.

Sutton, J., & De Backer, J. (2009). Music

,

trauma and silence: The state of the art.

Arts in Psychotherapy

, 36(2), 75-83.

Vaudreuil, R. &

Reuer

, B. [ed.] (2011).

MusicWorx

Toolbox: Music Therapy Progressive Curriculum; Working With Active Service Members

. San Diego, CA:

MusicWorx

Inc.