I came home mid-November from a two-week long trip to Louisville, Kentucky for the American Music Therapy Association conference. It was my first national conference, and I decided to drive so that I could visit my brother, a post-doctoral fellow at Penn State, along the way, and visit my childhood friend at her dairy research farm at UK. I also spent four days at a pre-conference training to complete my certification in Neurologic Music Therapy. The field of NMT was developed by the Center for Biomedical Research at Colorado State University; the training is endorsed by the World Federation of Neurorehabilitation and the European Federation of Neurorehabilitation Societies. NMT treatment is research-based and stimulates the human brain with the therapeutic application of music (in this case, standardized techniques) to treat neurologic diseases. Completing this training allows a board-certified music therapist to practice with the credential of Neurologic Music Therapist (NMT) for three years, at which time further training is required.
Here are some things I liked about the NMT training:
1. It is a model based on neuroscience with twenty standardized techniques that address functional goals with music. This means that while the work is in the music, the results are in real life- improved motor skills, speech, communication. We are re-educating the injured brain with music therapy.
2. It is based on thoroughly-researched principles of motor, speech, and cognitive-based learning. This means that there are no questions about whether or not the treatments are effective. They are, and because we can bill insurance, more clients can access these services.
3. "Rhythm drives the change". The NMT techniques are based in rhythm, which makes me (a percussionist) very happy. The change in the patient happens sub-orally, so the patient may not even be aware of the change, but the change will happen within three or four beats.
In short, I can now write "Neurologic Music Therapist" under my name and use these techniques to help clients with brain injury, Parkinson's, dementia, intellectual and developmental disabilities. I learned a lot about how music is processed in the brain and why results are seen more quickly with music than with other therapies.
I've always been familiar with concepts of music and the brain- I went to grad school at New York University and there is incredible research being done in NYC by Dr. Joanne Loewy at Beth Israel Medical Center, Dr. Oliver Sacks and Dr. Connie Tomaino at the Institute for Music and Neurologic Function, and so many other places. NYU teaches a broad application of music therapy interventions for a variety of populations, with an emphasis on music psychotherapy. This means that we learn about behavioral music therapy techniques but work with the person as a whole- adjusting the music within the interventions to meet the clients emotionally.
I'm grateful for the training and education I received while at NYU- and honestly, I didn't realize there were differences in the focus of each graduate school for music therapists until after I chose one. It became strikingly clear while at the conference; talking to music therapists from across the country allowed me to learn about their backgrounds and perspectives. (One of the most engaging workshops I attended was a talk by Jim Hiller of the University of Dayton on the role of emotion in music; the discussion in the room was diverse and heated.) I had the opportunity to assist in research at Beth Israel, take the level 1 GIM (guided imagery in music) training to learn about psychoanalytic models, film sessions at the Nordoff-Robbins Center for MT (using an improvisational way of musicing together to deepen connections and communication), and work as part of the integrative medicine team at Memorial Sloan Kettering Cancer Center (participating in rounds, writing chart notes, receiving referrals, working on the transplant floor, the ICU, and outpatient services). These experiences gave me a well-rounded perspective of the field of music therapy and helped me develop my mission and philosophy as a therapist. This will constantly evolve as I gain more experience and training. The Neurologic Music Therapy training was a wonderful addition and it was an honor to spend the week learning from experienced neuroscientists, educators, and music therapists. That being said, I think any therapist is missing an opportunity to connect with their clients if they don't draw from a variety of philosophies. If I were hired to work strictly in a rehabilitation center for very specific goals- and only those goals, I can see only using the specific NMT techniques. (particularly, for billing purposes) But to really meet the client where s/he is, one needs to address the whole person with music- and if the client are blocking their ability to work on a movement intervention, the movement technique from NMT may not be effective anyhow.
Music therapists, in my opinion, who are focused on trying to replace or replicate physical therapists or speech therapists in order to gain respect from the medical community, are missing the point. There are certain techniques- using a metronome to walk, or a melody to learn to speak- that other therapists have been doing for years. Music therapy is not particularly special in its understanding of rhythm driving the brain. What makes the field really stand out is the MUSIC. And the clients' engagement in music is making the brain's neurons fire in not only the areas of cognition, but also emotional areas. To avoid or ignore the emotional response to music, just because you can't bill for emotion, blocks that client from deepening his engagement and therefore slows the therapeutic process.
The NMT training has already informed my work; my approach changed this week with a client who has autism and just the addition of a metronome into the session has improved her drive to communicate in the music. I plan to continue learning, and draw from a variety of resources depending on the needs of my clients. What an exciting way to work!