Trauma & Treatment: Neurologic Music Therapy and Functional Brain Changes Suzanne Oliver, MT-BC, NMT Fellow Ezequiel Bautista, MT-BC, NMT
Music Therapy MT-BC Music Therapist - Board Certified Certification Board for Music Therapists (CBMT) National Certification Program National Examination & Continuing Education Ensuring Protection of the Public
Neurologic Music Therapy NMT & NMT Fellow Music Therapist - Board Certified Professional Designation of Advanced Training University of Toronto, Music and Health Research Collaboratory Fellowship process (initially within first 3 years, then every 5 years afterwards) Ensuring Best Practice Treatment Through an Evidence-Based Treatment Model
Neurologic Music Therapy The therapeutic application of music to cognitive, sensory, and motor dysfunction due to neurologic disease of the human nervous system. Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications (Thaut, 2005) Handbook of Neurologic Music Therapy (Thaut and Hoemberg, 2014)
Neurologic Music Therapy Based on a neuroscience model of music perception and production. Considers the influence of music on non-musical brain function and behavior. Focuses on rehabilitative, developmental and/or adaptive goals.
Neurologic Music Therapy Utilizes a research-based system of standardized clinical techniques in the areas of: Sensorimotor Training Speech & Language Training Cognition Training
Neurologic Music Therapy: Optimizing Neuropathways
Working Mechanisms of Music Rhythmic Stimulation and Entrainment - Provides timing through predictability, immediate effect; can be used for training long-term change. Rhythm is perceived subcortically and bilaterally Rhythm acts as a priming mechanism for the motor system, impacting timing, fluency, output No training period -Change occurs within 3-4 beats Cortical Focus can impede impact (Ex: Heels, Dance Class)
Working Mechanisms of Music Patterned Information Processing - Facilitates cognitive processing, enhanced learning, memory, executive functioning. Temporal templates: processing space and time Rhythm provides time information across the duration of time period/movement, not just at the endpoints. (Ex: ABCs)
Working Mechanisms of Music Differential Neurologic Processing - Activates parallel or shared neural pathways Music is not cortically distinct, but rather shares cortical networks activated in similar non-musical tasks PET studies: music activates many areas of the brain It is now known that music listening, performing, and composing engage regions throughout the brain, bilaterally, and in the cortex, neurocortex, paleo-, and neocerebellum (Levitin & Triovolas, 2009) (Ex: Gabby G., Stroke, Autism Slide)
Working Mechanisms of Music Affective-Aesthetic Response: Arousal, Motivation, Emotion - Effects on arousal, motivation, and emotion which effects learning and behavior The motor system is physiologically very sensitive to arousal by the auditory system Arousal and cognitive processing are primary to effectively processing emotion (Ex: Cleaning vs. Sleeping, Response to Tempo Change)
Key Components to Keep in Mind Optimization and Efficiency Immediate Change rather than through a gradual learning process Drives Cortical Plasticity, effectively changing the brain that is engaged in music (Thaut & McIntosh, 2010)
Plasticity Neuroplasticity: also known as cortical re-mapping, refers to the ability of the human brain to change as a result of one s experience, that the brain is plastic and malleable. From Train you mind, change your brain Sharon Begley
The Brain that engages in music is changes by engaging in music. (Thaut, 2005)
Impacts of Trauma on Self-Regulation/Emotional Regulation Difficulty with: Inhibition Self-Regulation Emotional Regulation, Stability Body Image Boundaries Somatization
Auditory Perception Training (APT)...focuses on auditory perception and sensory integration. APT integrates different sensory modalities (visual, tactile, and kinesthetic) during active musical exercises such as playing from symbolic or graphic notation using tactile sound transmission or integrating movement and music (Thaut, 2005) Participant Experiential
Impacts of Trauma on Executive Functioning Difficulty with: Planning Decision Making Problem Solving Abstract Reasoning
Musical Executive Function Training (MEFT)...exercises presented individually or in groups to practice executive functioning skills such as organization, problem solving, decision making, reasoning, and comprehension. (Thaut, 2005) Participant Experiential
Impacts of Trauma on Psychosocial Health Social Isolation Difficulty Labeling & Expressing Feelings Difficulty Attuning to Others Low Self Esteem
Music in Psychosocial Training and Counseling (MPC) Uses musical performance, guided music listening, musical role playing, and expressive improvisation or composition exercises to address issues of mood control, affective expression, cognitive coherence, reality orientation, and appropriate social interaction to facilitate psychosocial functions. (Thaut, 2005) Participant Experiential
Final Thoughts and Opportunities Increase Your Own Awareness of Music/Rhythm Around You and Its Impact Explore and Discern the use of Live vs. Recorded Music, Benefits and Limitations Seek Out NMT as a Treatment for Complex Trauma When Needed NMTs effectively participate as members of an interdisciplinary team Treatment can be provided individually or within a group process Funding sources include: Private Pay, Insurance, Medicaid, Medicare/Part B
Questions? Email questions & comments to info@nmtsa.org www.nmtsa.org
References Amaya-Jackson, L., & DeRosa, R. R. (2007). Treatment considerations for clinicians in applying evidence-based practice to complex presentations in child trauma. Journal Of Traumatic Stress, 20(4), 379-390. doi:10.1002/jts.20266 Crasta, J.E., Thaut, M.H., Anderson, C.W., Davies, P.L.,Gavin, W.J. (2018). Auditory priming improves neural synchronization in auditory-motor entrainment. Neuropsychologia, 117, 102-112. doi:10.1016/j.neuropsychologia.2018.05.017 Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., &... van der Kolk, B. (2005). Complex Trauma in Children and Adolescents. Psychiatric Annals, 35(5), 390-398. LaGasse, A. B., & Thaut, M. H. (2013). The neurobiological foundation of neurologic music therapy. Music And Medicine, 5(4), 228-233. doi:10.1177/1943862113502547 Marshall, D. F., Passarotti, A. M., Ryan, K. A., Kamali, M., Saunders, E. H., Pester, B., &... Langenecker, S. A. (2016). Deficient inhibitory control as an outcome of childhood trauma. Psychiatry Research, 2357-12. doi:10.1016/j.psychres.2015.12.013 Thaut, M. H. (2005). Rhythm, music, and the brain: Scientific foundations and clinical applications. New York, NY, US: Routledge/Taylor & Francis Group.
References Thaut, M. H., Peterson, D. A., & McIntosh, G. C. (2005). Temporal Entrainment of Cognitive Functions: Musical Mnemonics Induce Brain Plasticity and Oscillatory Synchrony in Neural Networks Underlying Memory. In G. Avanzini, L. Lopez, S. Koelsch, M. Manjno, G. Avanzini, L. Lopez,... M. Manjno (Eds.), The neurosciences and music II: From perception to performance (pp. 243-254). New York, NY, US: New York Academy of Sciences. Thaut, M. H., & Abiru, M. (2010). Rhythmic auditory stimulation in rehabilitation of movement disorders: A review of current research. Music Perception, 27(4), 263-269. doi:10.1525/mp.2010.27.4.263 Thaut, M. H. (2010). Neurologic music therapy in cognitive rehabilitation. Music Perception, 27(4), 281-285. doi:10.1525/mp.2010.27.4.281 Thaut, M. H., & Hoemberg, V. (2014). Handbook of neurologic music therapy. New York, NY, US: Oxford University Press. Thaut, M. H., McIntosh, G. C., & Hoemberg, V. (2015). Neurobiological foundations of neurologic music therapy: Rhythmic entrainment and the motor system. Frontiers In Psychology, 5