Music therapy with Jack
- Clara Browning
- Nov 8, 2019
- 6 min read
Here is the first of hopefully a few short case studies about children and young people I work with at a special school. I am hoping to raise awareness of what music therapy is and why I believe it is an invaluable tool for the students I work with by writing about different individuals, with consent from their parents, and showing some video clips of their music therapy.
Jack (not his real name) was 17 years old when I started working with him in music therapy in May 2018. He had arrived at the school the previous September and soon began music therapy with the therapist who worked at the school previously. Jack has autism spectrum disorder and although he has limited verbal expressive communication, he has a good understanding of speech. When Jack first arrived at our school, he suffered from anxiety and as a result there were periods of time when his emotions become overwhelming for him and would manifest in agitated outbursts. At these times, Jack was required to leave the classroom in order to calm down and keep himself and others safe. These outbursts have become far less frequent in recent months.
Music therapy is a psychological therapy that provides opportunities for self-expression and social interaction using an expressive medium other than words. It is based on the principle that all humans respond to music, regardless of disability or illness. Evidence shows that many people with special needs, such as autism spectrum disorder, have a special affinity to music due to the way in which they process sound (Ockelford 2013). I have certainly found this to be the case with Jack, who responds extremely positively to music.
Jack was referred to music therapy by his class teacher to help him manage his emotions and to support the development of his communication skills. Following his sessions with the previous music therapist, I started working with Jack at a time when he was still settling into the school; his emotions fluctuated greatly within the school day and his timetable mostly involved one-to-one time away from his classmates. In music therapy sessions, Jack has access to a wide range of percussion instruments that he is free to explore. As the music therapist, I attempt to build a relationship with Jack by ‘joining in’ and supporting his music, either improvising or using familiar songs.
Having minimal resources to express himself verbally, music therapy is an important time for Jack to think, reflect and express his emotions through music, body language, movement or silence. As a music therapist, I attempt to use my improvised music to highlight the content and emotional quality of Jack’s music and actions, acknowledging his emotions and reflecting these back to him in a way that he can begin to make sense of his experience. When difficult or sad feelings arise, the music that I improvise, or that we co-improvise, may not sound ‘nice’. However, as a therapist I feel that it is important to sit with difficult feelings and process them together. Naturally, at other times during music therapy sessions, positive feelings are expressed. I have chosen to show a video clip here that demonstrates Jack’s expression of happiness, playfulness and excitement:
Reflecting on this video clip and other similar clips, Jack’s mother stated, “As a parent of a severely autistic child/adult I would very much recommend this kind of therapy. Jack started mainly with small percussion but then went on to enjoy guitar, ukulele, piano and the best bit, drums. Jack can articulate himself and his actions when playing the drums.”
Jack sometimes appears to be in his ‘own world’, however he has always shown a great desire to interact through music in music therapy. His engagement in shared musical interaction is often prolonged and in quite close proximity with me. I try to meet with Jack’s mother every term to discuss his music therapy sessions and show her some video material from the sessions; she has been moved by his consistent engagement in interaction through music as she has told me that this level of interaction is unusual other contexts.
Here is a video clip that demonstrates Jack’s capacity to engage in face-to-face musical interaction:
Hopefully it is clear that I try to follow what Jack is doing whilst also extending and expanding his ideas: creating a connection with him, then continuing and developing the interaction. I was inspired to start singing the nursery rhyme 'Incy Wincy Spider' by the way Jack was moving his fingers, which reminded me of a spider; knowing that he had enjoyed this song in the past, it was one that came to mind with the movements he had initiated. I do use nursery rhymes occasionally with adolescents who are functioning at a younger age than their chronological age; I find that the familiarity and predictability of nursery rhymes are engaging and are experienced as safe.
Bearing in mind that Jack does not maintain extended conversations and seldom sits face-to-face with someone for this length of time, this clip is one example of Jack’s motivation for interaction through music, which enables him to experience human connection, being heard, responded to, leading, following and initiating within a therapeutic relationship. Each of these abilities is necessary for social interaction and communication. By using and growing in these skills within music therapy, alongside the support he is receiving at school and at home, Jack has become more confident to engage in social interaction both within music therapy and in other social situations. To feel and be connected with others is an innate human need that Jack has accessed through musical interaction.
Jack has become increasingly independent and autonomous in music therapy. He has become more confident playing various instruments, such as the drum kit and piano, and he enjoys leading the music we make together by playing a short musical phrase and waiting for me to respond. He also leads the style of music that we play by initiating an improvisation, which I often support and follow on the piano. Jack’s mother commented, “It’s become very interesting that he has chosen to lead the sessions as this seems to give him the control over the type of beat, instrument or music he wants. This in itself supports Jack making a decision, taking that decision and enjoying the rewards of the decision. And enjoying the one-on-one relationship with his therapist.” Here is a clip of Jack confidently leading our improvised music on the piano:
Supporting Jack’s style of playing, and therefore his autonomy and self-confidence, has been a key aim of music therapy thus far.
I’d like to finish with a quote from Jack’s school teacher from 2018-2019:
Jack came to [our school] from another special school due to a move in location. Jack originally found the transition very difficult and was struggling to manage his emotions. We think music therapy has been a bit of an outlet for him. It has helped to improve his concentration, when first attending school Jack’s concentration was approximately 5-10 minutes which, with the help of music therapy, has now increased massively and he is able to participate in a full lesson without needing to come out of class. Jack enjoys his music therapy and often we witness him sitting and really thinking for a long period of time while listening to the music which is something we very rarely see in the classroom. Jack has on occasion experienced emotional outbursts during music therapy where he has gotten cross, upset or extremely happy but the next week is able recover from these and attend music therapy again. Jack has made huge progress in communicating and his social skills and we feel this has been supported in music therapy from observing taking turns. Jack loves intensive interaction activities and is able to do this in music by having his music copied and copying the music played. I have seen Jack for short snippets of music therapy and feel that even on days where he is not very engaged in class that music helps to bring him back to engagement. Jack generally comes back to class either relaxed and calm or very happy after music therapy now and we feel music therapy has helped him to manage his behaviour – especially as Friday was often a day that he found more challenging.
This short case study aims to show that music therapy is far more than musical play or having a ‘sing-song’, although it can involve these elements. It is a therapeutic intervention that can provide creative ways to process emotions and experiences, as well as to support social development. I believe that creative interventions are essential for those for whom language is not the primary means of communication. For Jack, attending music therapy may be rather like you or I attending counselling or talking therapy, providing the means for self-expression where words cannot or do not. Music therapy can also support the development of communication and interaction, use of the voice, social skills such as turn-taking and listening, motor skills and self-esteem. In short, as a music therapist I try to use music as a tool to support non-musical aims, which may be psychological or developmental.
Thank you very much for reading this far and for your support of music therapy!
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