As a new initiative for MTSA this summer, we are choosing to share different ideas for Music Therapy practice in the hopes that this will provide a valuable resource for beginning music therapists and as inspiration for practicing therapists. Every Monday, a different intervention idea will be presented. They will be very basic and will be best as beginning inspiration to be varied and adapted for different clinical settings. They may include specific music, but will typically only indicate the style of music to be incorporated.
The following basic format will be given for each intervention: 1) Activity, the type of intervention; 2) Target population, the intended client population for the intervention; 3) Materials, the instruments and supplies required; 4) Goals/Aims, ideas for goals or aims that could be addressed in the intervention; 5) Method, a detailed description of what would occur during the intervention; 6) Comments, an explanation of why this intervention is applicable for the given client population and how the goals/aims are addressed; and 7) Evaluation, questions to allow for reflection on whether or not the intervention was effective for a particular client or clients.
(30 Minute Session: Exercise and Group Creativity)
by Len McCarthy
Singing familiar songs with actions
Creating lyric/action variations in a group
Adults, 70-80 yrs. old with early to mid phase dementia, coming to a Day Center. All capable of speech, but forgetful and easily confused (difficulty with daily routines/events, making decisions, following directions), resulting in lack of confidence and little social interaction. All are mobile, but slow-moving and/or unsteady, so they are sedentary for most of the day, and losing muscle tone/strength, resulting in a need for physical activity.
Hand percussion (that you can walk with)
– To provide motivation to move and exercise to music, using actions to target arms and legs
– To use familiar songs and genres for lyric improvisations
– To improve confidence/skill with group interaction and decision making, specifically regarding choosing new tasks
– To promote entrainment to beat with percussion instruments and body movements
– To remember a work activity (manual job/tasks) that clients have experienced in previous years
– To simulate a “work day” in the session (getting up, going to work, back home and to bed)
Therapist leads the session (ideally with a guitar/ukulele, to permit moving with the clients). If 8 songs are sung during a 30 minute session, the first and last two songs (Songs # 1, 2, 7, & 8) should have been sung in previous sessions, while the middle songs (#3-5) are “new today”, although at least two of them should be well known songs.
The following list of songs is a suggested list of pieces that could be included in this type of themed session.
1) “Hello Everyone” – Insert each client’s name in the piece (4 min)
2) “When The Red, Red Robin” – A wake up and greet the day song (3 min)
3) “You Gotta Sing” – Activity song, incorporating clients’ suggestions (4-5 min)
4) “Heigh, Ho” (From Disney’s Snow White) – Marching off to work. Incorporate playing instrument on the beat. (3 min)
5) “Drill Ye Terriers, Drill” – Verse 1 only and Chorus (repeated), with new tasks and occupations placed within the song (5-8 min)
6) “Heigh, Ho” – Marching back home from work (2 min)
7) “Show Me the Way To Go Home” – Slower than “Heigh, Ho”, segue into #8 (2 min)
8) “Goodnight Irene” – Can be adapted into a Goodbye song by adding clients’ names (3 min)
“You Gotta Sing” is an African American folksong, often sung at camp, popularized by the Canadian folksinger Raffi.
“Drill Ye Tarriers, Trill” is an American work song dating back to the 1880s, describing the construction of the railroad. “Tarriers” was a nickname for Irish workers.
The lyrics structures of both #3 (You Gotta Sing) and #5 (Drill Ye Tarriers) are easily varied with new tasks and actions.
Dementia damages the frontal lobes (which process new information and then transform them into long-term memories), resulting in problems learning new things and following directions (unless they are variations of something familiar), making decisions and social interaction. Dementia is most common with adults age 65+, although it sometimes affects people earlier. Long-term memories are mostly unaffected, so remembering details (and songs) from one’s youth and middle-aged period is common/easy. As dementia progresses, physical movement can become impaired; balance is affected, with poor muscle tone.
MT (Music Therapy) experts with dementia clients all agree that using familiar songs and reminiscence gets and maintains attention, and helps people become aware of the present (“Reality Orientation”). Improvisation works best when starting from something familiar and then reprising the original statement (A-B-A structure – where “B” = improvisation; corresponds to tradition jazz improvisation [head/song, improvisation, reprise of head]).
Mid-tempo songs encourage movement/exercise (“Active Music Therapy”).
This session sequence alternates well-known songs (#1, 2, 4, 6) with the lesser known songs (#3, 5), and then ends with two favourites. These work songs are very simple and easy to pick up if particular clients do not know them, in mid-tempo minor keys (good for singing with a bluesy, full voice – suitable for work songs) with a strong beat good for moving and for playing percussion. They can be extended or shortened easily.
The ensemble improvisation makes it simple for the music therapist to evaluate individual members of the group without centering anyone out.
Who participated the most – with lyric/action suggestions?
How did they participate with their bodies? Where there any difficulties or improvement (compared to previous sessions)?
How did the “newer”, potentially less-familiar songs (#3 & 5) work out?
Was anyone frustrated with following directions or making actions?
Did anyone remember previous jobs they had when they were younger?
Which songs stimulated conversation and camaraderie?
Were any other songs requested or triggered by these particular songs?