Case Studies:

Adventures in Neurologic Music Therapy

Chroma’s Rebekah Keenan charts her journey from musician to respected member of the multidisciplinary neuro-rehab team.

Neurologic Music Therapy (NMT) provides specific, individualised and standardised interventions for people with brain injury or neurological conditions.

It is distinct from traditional music therapy approaches as it is not based on a social-science model.

Rather, it is underpinned by neuroscience and recognises music as a hard-wired brain language.

The discipline of NMT improves cognitive, sensory and motor dysfunction caused by neurologic disease of the human nervous system; and is becoming increasingly relied upon to deliver better neuro-rehab outcomes.

It is endorsed by major bodies, including the World Federation of Neurological Rehabilitation (WFNR) and the European Federation of Neurorehabilitation Societies (EFNS), and employed by a growing number of UK care providers.

Among them is STEPS, the specialist facility in Sheffield where I work as part of the multidisciplinary rehabilitation team.

STEPS provide residential and day services to people with neurological conditions, stroke and brain and spinal cord injury, as well as orthopaedic and other complex trauma injuries.

NMT is an important element of its multidisciplinary approach, enabling musical techniques to progress patients towards functional non-musical outcomes.

It uses specific musical techniques to work towards functional aims shared by other therapeutic disciplines including speech and language, physio and occupational therapy – so it also aids cohesion and efficiency within the team.

There is a lot of joint working at STEPS between different members of the team, which is a really positive thing.

As a music therapist and NMT Fellow I am a totally accepted part of the team working to improve the patient’s independence and life quality.

This wasn’t always so for people on my career path, however. When I first qualified as a music therapist in 2003, it was relatively rare to find practitioners embedded in rehabilitation teams.

In the early days of my career, it was hugely challenging to find positions within healthcare settings and to be given the opportunity to prove that music therapy was effective in driving patient progress.

But with the emergence of NMT, an evidence base has developed which provides a compelling case for its use in the lives of neuro-rehab patients.

Particularly appealing to other therapists in the multidisciplinary team is that it stands up to before-and-after assessments in various areas – such as speech and language, sensorimotor movement and cognition – that clearly test whether it is having a positive impact.

But getting to this stage has been a long journey, for myself and the wider NMT profession.

Like many music therapists, I studied music at university before going on to complete a music therapy masters degree. Sandwiched between those courses was a year gaining experience working with adults with learning disabilities.

After 14 years of working in the field, I then underwent NMT training in partnership with Chroma and the Unkefer Academy of Neurologic Music Therapy which enabled me to take up a role which is currently experiencing surging demand.

Because the field is always moving forward, however, my training and skills development is ongoing.

The latest step on my journey was to complete the NMT Fellowship with Chroma, which was delivered by the renowned practitioners Dr Michael H. Thaut and Dr Corene Thaut.

Dr Michael is founding faculty member of the Unkefer Academy of Neurologic Music Therapy and currently Professor of Music with cross appointments in neuroscience and rehabilitation sciences at the University of Toronto. Dr Corene is programme director and primary faculty and co-founder of the academy’s training programmes.

They are the brains behind many NMT techniques and have helped to drive research into the approach – which, in turn, has contributed to the evidence base which now exists and continues to grow.

The experience has been invaluable in terms of developing my skills and knowledge as an NMT practitioner.

It will undoubtedly have a positive influence on my contribution within the STEPS team, and on the many patients I work with to reach non-musical goals through music.

Rebekah Keenan is a neurologic music therapist at Chroma, which provides arts therapies across the health, education and social care sectors.