Rebecca O’Connor, Creative Arts Therapy Leads at the National Rehabilitation Hospital and Associate Professor of Music Therapy, University of Limerick, explains how music therapy supports neurorehabilitation.
Music therapists are evidence-based health and social care professionals practicing in more than 40 countries around the world. Music therapy is a dynamic intervention in neurorehabilitation settings that utilises prescribed music-based methods to target specific identified clinical goals.
Music is intrinsically rewarding and motivating and engages neural networks that are shared with ‘non-musical’ functions (cognitive, memory, emotional, language, motor) resulting in changes to brain structures. Incorporating live music delivered by trained and qualified professionals ensures interventions are tailored to patients’ needs and goals, assisting with engagement and adherence to treatment.
At the National Rehabilitation Hospital, Dublin (NRH), music therapists work as an integral part of the interdisciplinary team, using music-based methods to facilitate paediatric and adult rehabilitation goals. This has led to numerous research studies, and the NRH is a centre of excellence and research.
Music therapy is highly valued within the context of interdisciplinary assessment of children with an acquired brain injury as important and detailed information is gained through observation and interpretation of their musical and non-musical behaviours during interactive music-making. At the NRH, the Music Therapy Lead and Senior Clinical Psychologist have developed the O’Doherty, O’Connor Music Therapy Psychology Assessment. This tool is utilised and applied to assess cognitive and developmental functioning of children with complex needs following an ABI.
Because of speech and music’s similarities, communication goals are frequently targeted in joint sessions with speech and language therapists. Melodic Intonation Therapy is a technique applied to address language production and fluency with people with severe non-fluent aphasia. It emphasises the use of melodic and rhythmic elements to engage language-capable regions of the undamaged right hemisphere and results in changes in neuroplasticity. In physical rehabilitation goals, musical components provide structure, stimulation and motivation. A PhD study undertaken at the NRH, demonstrated how Neurologic Music Therapy enhanced gait speed and velocity and increased positive mood, motivation and engagement levels in paediatric and adult patients with an ABI.
For patients with prolonged disorders of consciousness (PDOC), salient music, promotes behaviours indicative of arousal, selective attention, and increase behavioural responses that indicate discrimination and levels of awareness. A four-year study at the NRH for patients with PDOC indicated that music therapy was specifically beneficial in enhancing assessment with the inclusion of the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness and played a valuable role in maximising arousal, eliciting emotional responses and in supporting family members.
While music therapy in neurorehabilitation often focuses on behavioural and rehabilitation goals, it most importantly offers a whole person approach supporting emotional adjustment and assisting in the rebuilding of self-identity.
The National Institute for Health and Care Excellence (NICE) carried out a review in 2023 of the clinical and cost effectiveness of music therapy for adults following a stroke. This review highlighted benefits of music therapy for several reported outcome measures including health related quality of life and psychological distress. The Association of Professional Music Therapists position statement for the UK Department of Health Stroke Strategy states, “Rehabilitation services have identified the need for the inclusion of music therapy in treatment programmes. Where integrated into neurological rehabilitation teams’, music therapy has a role in rehabilitating communication, social, emotional and behavioural functioning”.