Online therapy continues to support clients during rehabilitation

Delivering online arts therapy sessions to clients with brain injuries throughout the pandemic has been a resounding success and in certain circumstances, going forward, will continue to be used complementary to face-to-face sessions, according to Chroma, the UKs leading national provider of arts therapies.

Over the last 12 months, Chroma has had to adapt their therapy sessions to successfully deliver Neurologic Music Therapy (NMT) services in various settings such as residents in specialist care homes and special schools for children with a range of complex needs including autism, brain injuries and learning difficulties, and vows to continue diversifying the delivery of sessions if and when circumstances permit.

Evie Mason, NMT specialist at Chroma, has been working at Voyage Care residential homes in Bristol and Tewkesbury for two years delivering NMT sessions to Haemorrhagic Stroke clients and has seen the biggest impact sessions have had upon the residents’ speech and language skills.

Evie said: “When moving to online sessions, I noticed an immediate change in the speech output of my stroke patients. Focus had in fact improved as there were no other distractions – the client had to focus solely on me which helped improve their speech production.”

For speech and language development, Evie would use techniques such as using a keyboard to play different chords and when the chord changed, the client then changed the word being said. They would work on specific vocabulary, using well-known tunes from songs.

And for clients with hearing difficulties, Evie delivered tailor-made non-verbal sessions which included imitation work to develop attention and communication skills, and is itself quite playful. In these incidences, the client chooses a piece of music and the client and therapist take it in turns to lead and follow each other’s movements. When leading, Evie creates moves encouraging the client to play instruments which work on movement patterns which develop the client’s flexibility and endurance in specific muscle groups, such as those affected by one-sided weakness.

Evie said “There’s been some crossover using dance to music too. When I am working with clients to help improve walking, the client would choose a piece of recorded music, listen to it, and then follow my instruction to walk to the music.

“Unfortunately, due to time delays, I wasn’t always able to use live music during sessions. But working remotely brought a freedom to the role allowing me to try things I may not have normally tried, yet sessions were always client-centred focusing on what the client actually needed at that time, whether that was physical or psychological input.”

Lucy Collings Pettit, another Neurologic Music Therapist at Chroma, has been working at Pathfield School in North Devon for the past eight years, delivering NMT and MT to children aged 3–19 years of age with brain injuries such as brain tumours, Hypoxic Ischemic Encephalopathy (HIE), cerebral palsy and epilepsy. The basis of her work is to improve functional outcomes to those pupils who have neurological conditions or suffered a brain injury. Rehabilitation helps children acquire or maintain functional skills, often for the first time in their lives. Rehab for pupils with a neurological condition is developmental focused, working to reduce or remove significant barriers to education and improve quality of life.

Lucy added: “Arts therapies are creative and as such, so are we, so adapting to the challenges faced as a result of the pandemic was possible. We found that online sessions, where appropriate to a child’s needs, really helped. I select interventions based on what will achieve the most functional and relevant educational outcomes. Specific techniques are used to maintain or improve children’s skills within the speech and language, motor and cognitive domains.

“To be able to bring all those factors online, sessions required more parental and carer guidance to help facilitate and ensure safety. This had benefits in itself as it has helped build alliances and make those bonds stronger. It has provided opportunities for primary caregivers to gain valuable insight into the work, including the difficulties faced by their child on a daily basis and how they can best support the work to contribute to positive outcomes.”

“Of course, online sessions are not a suitable option for all pupils, especially some children with sensory difficulties. Yet, some children who have profound learning difficulties have flourished through working remotely. I think preparation is the key to success—ensuring the space is safe, the volume is right, the child can see me clearly—it all helps bring the experience to life.”

The success of these online sessions highlights the importance of the relationship between therapist and client as, together, we were able to make communication work.