Music therapy is being adopted at The Portland Hospital to encourage young children with Cerebral Palsy who have undergone Spinal Dorsal Rhizotomy (SDR), to improve participation during post-operative physiotherapy sessions.
SDR is a specialised neurosurgery that treats lower limb muscle stiffness (spasticity) in children with cerebral palsy, by dividing sensory nerve rootlets in the spinal cord. Intensive physiotherapy is crucial following SDR to practice movement patterns in the absence of spasticity and build up muscle strength.
At the Portland Hospital, which is part of HCA Healthcare, children receive three weeks of twice-daily physiotherapy post-SDR. A music therapist will join physiotherapy sessions once or twice a week to support rehabilitation.
Music therapy is used to grab the child’s attention and improve participation with functional activities like crawling, kneeling, sitting and standing. Music therapy effectively facilitates physiotherapy sessions by offering distraction from a challenging task.
It also lends itself a unique opportunity for the child to build a relationship with the physiotherapist. It removes the hierarchy, making the relationship feel more balanced.
Having music therapists involved with sessions can also encourage family involvement, allowing parents to engage with the music. They are also able to discuss the child’s musical preferences and play music with their child. Importantly, music therapy is easily accessible to children and parents.
“Music is motivating,” says Jonathan Fever, Chroma’s music therapist at Portland Hospital.
“In these instances, physiotherapists (PTs) have a difficult job trying to get the ‘very young’ child to perform rehab exercises, partly because of their age, they may want to do something else, they may not understand why they’re doing it or it’s simply uncomfortable.
“But music helps facilitate movement. So I may use music to support them in standing by positioning instruments around the room and they could be standing and playing an instrument and moving and playing within a song – it’s motivating. Children generally do not ask ‘why is that drum there’ they just want to play it – it’s fun!”
Jonathan also implements a technique to sessions called ‘Song Story’ where the child can use their own character and understanding of the situation to explore their emotions through the story as they go through rehab. It is more of a psychological/emotional support that also allows the child to bring in others within the space and give them different characters.
He adds: “For example, one child made her physiotherapist a mouse in the story. The mouse began a very scary character but became less so as time went on. The child could not remember the PT’s name (or chose to never use it when sessions first began), but after a session or two, the child began to call the physio by name.
“Music therapy helps break down boundaries and create a sense of equality in the space, which a child needs to help support effective recovery outcomes.”
Chroma expands services in two Voyage Care homes
Music and arts therapies will be used to help support the emotional and psychological wellbeing of residents
Arts therapies provider Chroma has extended its contract with social care and support provider, Voyage Care, to deliver creative arts therapy services at two more of its care homes.
Residents at Devonshire House in Manchester and Cedar Road in the West Midlands will receive music therapy (MT), neurologic music therapy (NMT) and art therapy sessions to support their emotional and psychological wellbeing.
During assessment procedures, additional functional needs were identified in some residents, so NMT techniques are also being incorporated to facilitate opportunities to work towards other goals in joint working with speech and language and physiotherapy.
Devonshire House, in Ardwick, Manchester is a 24-bed specialist brain injury rehabilitation service with three wings. Residents are either active rehab, slower stream rehabilitation or long-term stay. Therapists work with all three residential sectors across the three wings.
Cedar Road is a nine-bed residential care home for slower stream, long-stay residents who receive the support they need to enable them to develop and maintain their independence and cognitive skills following a brain injury.
The creative arts therapists use a range of psychological and psychodynamic techniques to support the expression of memories and emotions in ways that do not rely on words. The forming of a therapeutic relationship is key to enabling and empowering individuals to express their emotions, manage overwhelming feelings and to process traumatic memories, safely.
Both individual and group sessions are used depending on the needs of the people supported.
The creative arts therapists also support individuals to meet functional goals through NMT techniques including Melodic Intonation Therapy (MIT), which uses rhythmic speech cueing to encourage speech, Rhythmic Auditory Stimulation (RAS) to help improve gait or Therapeutic Instrumental Musical Performance (TIMP) to prepare the body for functional movement.
Louise Houghton, ABI placements manager at Voyage Care, said: “Voyage Care is centred on social rehabilitation. The impact of loneliness and poor mental health, for care home residents, has been highlighted throughout the pandemic, which is why we are extremely happy to be able to provide these services within the already well-established multidisciplinary team and look forward to the positive impact we know it will make to our residents and their emotional needs.”
Chroma’s neurologic music therapist Claire Maddocks and art therapist, Jackie McVey, will deliver one-to-one sessions as well as support speech and language and physio therapists.
Claire said: “It’s exciting to have two arts therapy modalities in Voyage Care homes, and being able to incorporate them early on in a new home alongside the multidisciplinary team. It demonstrates the acknowledgement of the importance of arts therapies and the significant role they play in providing emotional and psychological support.”
Jackie said: “It is commonplace, in residential care homes, for long-term residents to experience loneliness to some degree and it’s important we do as much as we can to help reduce such incidences.
“Group therapy has proven itself a great way to promote interaction with others. We have previously delivered group music therapy sessions at Lorenzo Drive to help tackle loneliness, which was a resounding success so I have every confidence this art therapy group will too.”
Alongside one-to-one art therapy sessions, Jackie plans to create group sessions focusing on social interaction and social skills.
Since the arts therapies services began in September 2021, attendance to weekly sessions has remained consistently high, reflecting the positive impact sessions are having upon residents’ lives, both emotionally and psychologically.
Work of Calvert Reconnections highlighted by BBC
The pioneering neurorehab centre is transforming lives through its use of traditional and outdoor therapies
The work of Calvert Reconnections in using a totally new approach to brain injury rehabilitation to transform lives has been highlighted by BBC Breakfast News.
Calvert Reconnections, in the Lake District, is the UK’s first acquired brain injury (ABI) rehabilitation centre combining traditional clinical therapies with physical activity in the outdoors.
The residential centre is based at Old Windebrowe in Keswick, a Grade II listed Tithebarn and one-time home of William Wordsworth. The building has undergone a £1.4 million transformation but retains its character and real-life setting.
Since opening in June 2021, Calvert Reconnections has delivered a new goal-focused, outcome-based approach to ABI rehabilitation, delivering tangible results and pathways back to everyday life.
Speaking to BBC Breakfast, participants at Calvert Reconnections explained how the service is transforming their lives.
Scott said his recovery to date had exceeded his expectations making him “fitter mentally and physically and able to live a better life”, while Roger explained how he had learned to walk again with Calvert acting as a “whole new family” during his “deepest, darkest times”.
As shown on the flagship national BBC breakfast programme, Calvert Reconnections actively seeks to incorporate a wide range of outdoor activities into each participant’s rehabilitation programme.
This may range from reflective activities such as fishing, bird watching or a nature walk to higher adventure activities such as horse riding, canoeing, rock-climbing and abseiling – all closely assessed and graded to a person’s interests and functional abilities.
Importantly, participants are involved in every aspect of the activities they undertake. They complete meaningful tasks, from concept to completion, in a real-world setting.
Claire Appleton, head of service at Calvert Reconnections, said: “We are very grateful to the BBC for raising awareness of brain injury rehabilitation.
“The focus on outdoor activities as part of our therapeutic model makes Calvert Reconnections completely unique in the UK.
“We are committed to transforming the way in which brain injury rehabilitation is delivered.”
Calvert Reconnections is part of the Lake District Calvert Trust, a charity with 45 years’ experience in delivering outdoor experiences for people with disabilities.
The centre is currently taking referrals. For further information, visit www.calvertreconnections.org.uk
Calvert Reconnections delivering positive outcomes
Only months after opening, patients are already realising the benefits of the groundbreaking neurorehab centre
Participants at ground-breaking neurorehabilitation centre Calvert Reconnections are already realising the benefits of the centre’s unique approach.
Calvert Reconnections opened its doors in June 2021, bringing a new, goal-focused, outcome-based approach to ABI rehabilitation.
Five months on, feedback from participants is now demonstrating how Calvert’s programme is delivering tangible results and pathways back to everyday life.
“Our programme is transforming the lives of our participants,” explained Claire Appleton, Head of Service at Calvert Reconnections.
“One of our recent residents said that his stay at Reconnections had transformed his quality of life, enabling him to return home, to his wife, rather than going into permanent 24-hour care.
“Such was the life-changing progress of another resident, he recently walked to the summit of Latrigg having only been able to walk a few hundred yards when he first came to stay with us.
“The whole team is hugely excited about the difference we are making to people’s lives.”
During meetings with other residents, Calvert Reconnections received the following feedback:
- “I feel comfortable here, all the staff are really nice, they put up with me being confused or disagreeing, they are very patient.”
- “You have made me realise you can get me closer to how I was before my accident. I accept who I am, I couldn’t do that before, I am OK with myself now.”
- “I now have confidence to go about my ways.”
- “You have improved my ability in lots of ways.”
- “I cannot think of anything you could do differently or improve.”
- The staff have a great can-do attitude.”
- “I feel like I am getting better, getting fitter every day – my friends say I am getting better.”
- “Doing different things all the time matters.”
- “The specialist bike, the other people and the staff are all great.”
- “I have a special bond with one of the participants – we love the banter.”
- “It’s good to feel fitter again.”
- “The staff are prepared to alter the programme with the weather and any other reasons.”
- “It’s the people – we all keep an eye out for each other.”
- “The food is great.”
- “I have a lot of trust. I am asked to do things which seem difficult but it’s been possible, I’ve managed to be a metre or 2 off the ground on the climbing wall.”
- “The cycling was good.”
- “I am working on my dorsiflexion and this is brought in to my activities each day.”
- “Reconnections has given me the opportunity to achieve my independence.”
- “You asked me how we could improve Reconnections. I have no criticisms – this is different to other rehab units, in a good way.”
- “This is the best place for me to be.”
Calvert Reconnections has also recently announced its winter activity programme which includes walking and star gazing, bushcraft sessions, environmental art, photography projects, rock climbing (Calvert sports hall available), canoeing (Calvert swimming pool available), equine therapy, basketball (Calvert sports hall available), curling (Calvert sports hall available), badminton (Calvert sports hall available), sledging, cycling, ghyll scrambling and orienteering.
The centre has also been shortlisted for Best Initiative in Care at the Caring UK Awards.
Calvert Reconnections has places available now. For further details, visit here
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