Exploring the potential of music therapy for a group often overlooked

In the autumn of 2021 a project in Specialist Area Autism became the starting point of our experiences with the use of music therapy. The purpose was to gain experiences that can help us decide the role of music therapy in Specialist Area Autism in the future. The framework of the project was:

  • Six autistic adults with intellectual disability, minimal verbal language and possibly other behavioural issues such as self harm or challenging behaviour
  • Three sheltered housing facilities from Specialist Area Autism and the two heads of department
  • 10 employees who took part in workshops and music therapy sessions
  • Cooperation with an outside music therapist who held weekly individual music therapy sessions
  • A pilot test of the VR-app for music therapy developed by the Multisensory Experience Lab at the University of Aalborg, Copenhagen

We gathered the experiences and the reactions of the employees and the music therapist in focus group-interviews and interviews respectively. The motivation of the participants, what they gained from the project and specific strategies in the project is specifically in focus in this evaluation.

The purpose of the evaluation is to create learning and reflection through insight into what the music therapy meant to the participants - and to gather the experiences of the employees and the music therapist.

 

What is music therapy?

Music therapy is a method that uses singing and playing musical instruments as a method to create contact with the individuals and to develop the interaction between the individuals and their surroundings. Thus, the goal of music therapy is to create contact and communication with people trough musical activities and experiences. In music therapy music is used to create safe relationships, generating an interest in social relations and breaking social isolation, relieving stress and pain, strengthening identity, creating better coping strategies, managing emotional trauma and so forth.

Summary

In this project six autistic adults have experienced music therapy with and without VR. For all six music therapy has proven to be a highly motivating activity. This fact in itself is a good starting point for the use of music therapy with autistic people. According to the employees the reasons for the high degree of motivation are:

  • The joy of taking part in musical activities
  • An experience of connectedness
  • An experience of taking the lead in an activity and that lead being followed
  • Sensory needs being met
  • The framework of each session being recognisable

Prior to the start of the project the employees expected that the participants would react to the changes – due to the new routine of attending music therapy in a new location and with a person they did not know beforehand. However, the employees were surprised to see how easily the participants adapted to these changes. This realization meant that employees have had to reconsider the ability of the participants to accept changes in their everyday schedules. Some of the participants have even asked to go to the music therapy room between sessions – which shows that it has been a good experience.

The ability of the music therapist to use his/her expertise and to scale the activities individually and react to the input of the participants is of great importance to the sessions being relevant and interesting to the participants. The experiences from the project also show that the employees from the sheltered housing, where the participants live, are of great importance to the initiative – especially when it comes to recruiting participants and - on the day of the sessions - to judge whether they are capable of joining the music therapy and for how long on that specific day. It is our assumption that if the project had lasted more than three months and that the music therapist thus had been able to get to know the participants better the dynamics between the therapist, the participants and the employees would have changed. But no matter the length of a music therapy initiative at a sheltered housing facility for autistic adults, it is necessary to be conscious of the importance of the collaboration between the music therapist and the employees.

An important experience that is highlighted by both the music therapist and by some of the employees is that the participants benefit from participating even on days when they have only little energy. We speculate that it is possible that they benefit even more from participating on such days because of the sense of connectedness and the help they get from the music therapy when it comes to regulating their emotions.

According to the employees the participants have benefitted from partaking in the musical therapy especially in these areas:

• When it comes to regulating arousal
• Helping to stay focussed and taking initiatives
• Experiences of being in new settings
• Feeling connected and being seen
• The joy of taking part in a highly motivating activity

The above list is meant to serve as inspiration and is to be considered as an example of the outcome of music therapy based on the six cases. Thus, it is in no way an exhaustive list or a guiding principle for what benefits one can expect from similar, future music therapy initiatives for similar target groups. The benefit for the individual participants hinges on a combination of several elements – among them the goal of the music therapy combined with the qualifications, wishes and interests of the participants.

Another insight from the project is the importance of being aware of the criteria based on which the participants are invited to join the music therapy initiative. There is not necessarily any connection between how interested a participant is in music and the outcome of the participation. The project has rendered more knowledge about music therapy as a method among both employees and leadership in the organization and it will serve to give us a better starting point in future projects when it comes to deciding what participants should be part of the initiative.

Employees that took part in the initiative have been introduced to how musical activities can be used for pedagogical purposes on a daily basis. However, the project has not lead to any such specific initiatives in the daily routines. A few employees report that they have started using music and singing as a means to creating motivation and joy and to creating recognizable settings for the residents. However, only few new musical activities were started by the employees during the project period. The possible reason for this is that it takes some time to learn and that the project period has coincided with a high degree of employee turnover – and resulting pressure for the remaining staff. The employees and the music therapist point to the fact that a resident music therapist could help support the ongoing efforts in more flexible ways – e.g. by being offering both individual and common musical activities and musical therapy sessions.

The project gave us some tentative experiences when it comes to using VR for music therapy. We used a very early version of the app that is meant for users with a very low cognitive level. Hence, regular music therapy was not carried out by means of the VR-app. Some of the residents tried staying in the virtual music room for a short while. On the positive side, they accepted wearing the VR-headset, were curious when it came to exploring the opportunities in the virtual room and to interacting with a virtual instrument. However, the employees concluded that the participants probably had a cognitive level that was too low for them to benefit from the VR-part of the music therapy session. Both employees and the music therapist see the potential of this technology – especially if the app is changed so that it becomes easier for the employees and music therapist to join the participant in the VR-room.