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Creative and Improvisational Music Therapy - Nordoff-Robbins Model
Relevant information about Creative and Improvisational Music Therapy - Nordoff-Robbins Model.
Creative and improvisational music therapy was established as such in the years 1976-1977. Also known as the Nordoff-Robbins model in honor to its founders Clive Robbins (special education teacher) and Paul Nordoff (composer and pianist) who began their work together in 1959 to explore the application of improvisation and composition techniques in music therapy. Throughout 16 years of work they created and developed the model " Nordoff - Robbins" for the music therapy work especially oriented to children and adolescents with different disabilities: autism, schizophrenia, aphasia, emotional and learning problems, hearing and visual disabilities.
The emerging approach is musical improvisation that is established between the patient and therapist with various musical instruments or singing, depending on the availability of patients, neurological conditions and especially its vital functions. Creative music therapy in improvisation is "bilateral” since contemplates not only the type of treated patient, but also the personality of the therapist. It is an interpersonal event.
But, behind the artistic creativity that uses like work tool, the Nordoff-Robbins boarding also finds a solid scientific base with years of investigation financed by the Department of Health of the United States, which they gave like result a method for the planning of the treatment, but for the clinical investigation in music therapy.
Robbins has continued to work hard as a therapist and group leader in exploration and new approaches to individual and group therapy. He has worked for 40 years with children who suffer from multiple disabilities, has composed songs, instrumental activities, games and musical theater as a means to achieve therapeutic goals with a variety of disabled children. He has been linked to the development of centers for the practice of the methodology "Nordoff - Robbins in London, Germany and Australia. Along with Dr. Paul Nordoff have published several books: “Musicoterapia for the disabled child”, “Therapy in music for disabled children”, “Music therapy in the special education”, “Creative Music therapy” and different creative musical activity books for children.
- An overview of the treatment
This method is one of the five officially recognized within the field of music therapy that were named in the 9th World Congress of Music Therapy held in Washington, USA, 1999. The five official models are:
- Nordoff-Robbins-Model: Creative and improvisational music therapy.
- GIM - Model (Guided Imaginery and Music): Guided Imagery and Music.
- Benenzon Model: Psychoanalyst.
- Behaviorist - Therapy Model
- Analytical Model of Music Therapy: Psychoanalys.
While they all share certain fundamentals and objectives of music therapy, each model shows different characteristics depending on their theoretical guidelines and consequently propose a particular type of therapy.
The method of Creative and improvisational music therapy is also known as Method Nordoff-Robbins. Like the other models that were developed in the late 60's, this method started in 1959 from the work of Paul Nordoff and Clive Robbins. Part of its foundations are based in human therapy.
Humanistic psychology is a psychological orientation that highlights and focuses especially on the value of man. He criticizes the behavioral and experimental approaches for their limited and biased view and understanding of human beings. For humanistic psychology, man exists only in a human context and expresses its nature in the relationship with their peers, which determines their actions. While the man is constantly aware, not all levels of consciousness are accessible. Considers that the man is not merely a passive spectator of his experience but is a participant in it. The actively make choices and have intentions on building your identity.
The Nordoff-Robbins approach takes some of these ideas and develops a method where creativity and improvisation are central. It is based on improvisation to search for contacts and communication that uses individualized to reflect the here and now of a person, creating musical exchanges. The work is an exchange and intereacción. Requires the intervention of a pianist and an assistant. The first session is always a touchdown to assess the responses, reflecting and supporting each intervention in a musical way. It is necessary that the music therapist dominates the language of music and different tools and resources. It is based on improvisation at the piano by the therapist, which enhances what the patient expresses through the piano and percussion instruments, prompted by the co-therapist.
According to Nordoff-Robbins, all have a musical child intact, although we have some kind of pathology. Musical improvisation is often therapeutic to "ask questions" through music. This "musical children" appears as the natural instinct that we all have to respond to the sound stimulus and demonstrates that we understand perfectly the shape, structure and characteristics of musical language. A Sufi aphorism says: "In response to a question, one is manifesting itself." In interactive improvisational music therapy, who respond spontaneously to the music, the therapist and the situation is continually communicating its self and the state of that self.
- What problem/ s is expected to be solved
Dr. Nordoff and Robbins created and developed the model "Nordoff - Robbins' especially for music therapy work with children and adolescents with autism, mental retardation, neurological and physical problems, sensory-motor problems, emotional problems, etc.
This therapy is mainly individual and its main objective is to involve the patient to express himself through the instruments, making music.
Nordoff and Robbins argue that everyone, even the most disabled, have a musical sensibility that can be used to stimulate their growth and development.
According to this model, the music is extremely versatile as a way of therapy, because it acts at very different levels. You can work physically, you can work on the cognitive, through emotions, you can set an interactive dialogue, to make us move, make us think.
Although their application is mostly known for children with special needs in geriatrics and psychiatry, has grown its use in the medical field worldwide, and currently receiving music therapy services from premature babies to seniors, children and adults through with different diagnoses.
There are treatments for pain, oncology, neonatology, maternity, postoperative recovery, neurological rehabilitation and many others. They even use the benefits of music to reduce doses of anesthesia or to provide stimulation and quality of life for people in coma.
The therapeutic approach proposes an active role for the patient: the music therapist does not make music for the patient, but with the patient.
Need not know anything about music to be benefited with its enormous therapeutic potential. "The kind of work we do is called "Creative Music Therapy" because it is based largely on improvisation," said Robbins.
- Explore: Find discover the possibilities and limitations of the child / patient.
- Consistent: Once established contact, we try to keep to support the idea of "support."
- Flexible: Encompasses all possibilities of response and enhances the development of new opportunities that may arise.
Treatment is understood as a process in which phases are distinguished targeted. There is an early stage of exploratory contact which is known to the patient and observe how the disease manifests. This helps determine the communication skills available as well as potential. On this basis the music therapist and music sets the appropriate focus.
In a second time the music is customized. By strengthening the relationship, develop communication and to overcome their shortcomings, it works on developing the capacity to respond. This is the time integrated development.
Finally, there comes a time and update personal communication including: greater level of communication, self-organization, awareness and confidence among others.
The improvisation that makes the therapist is constructed according to what the child / patient transmits and is capable of doing. It takes into account facial expressions, gaze, body posture, behavior and language.
Each child / patient responds according to their musical and personal level. In an attempt to systematize these responses, we can locate some types:
- Complete rhythmic freedom: It is time sensitive to changes and rhythmic patterns.
- Unstable rhythmic freedom: The answer is complicated by an over-reaction and loss of control.
- Liberty limited rhythm: The answer is determined by a decline in development, both in listening, as in the expression.
- Hitting compulsive: inflexible and continuing a pace that does not match the music.
- Hitting messy: totally unaware that the answers do not connect with the rhythm of the song. Answers distant and disorderly.
- Interpretation evasive: Avoid touching time with the music, due to emotional difficulties such as the relationship with the therapist or fear of that experience.
- Emotional force in the interpretation: Touching meaningless to demonstrate their strength and ability to make noise.
- Chaotic-creative Interpretation: Form hyperactive touch anything stable, is unpredictable.
Not every area is suitable for this type of treatment, usually the music therapy room is soundproofed, has a piano, a video camera and a variety of musical instruments, base drum or timpani, cymbals, tambourines, chimes, curtains, and various clubs and sticks.
The techniques used in the session vary according to the patient, the therapist and the link established. Some of the techniques used are humming, whistling, singing, neutral syllables, singing melodic phrases with words about the feelings of the patient to imitate vocal sounds, words or melodic motifs that the patient makes, presenting melodic motifs with silences are completed per patient, completing sentences or introducing a familiar song.
Robbins said: "Each session should be recorded, and then must be analyzed carefully before asking the next session. The important thing is to have the freedom to improvise, but then the time to see what you have done, and how far the child (or patient) has come. "
As we see, it uses musical improvisation as a kind of radar that allows to see where are the answers and what it is possible to be made with them to work.
Depending on the case will be treated and the specific situation to which it faces, that each music therapist will plan the general and specific objectives. This will determine also the structure of the session, their periodicity, time and duration.
Be considered the end of treatment when you have achieved the objectives or the user no longer benefits from the sessions. Also possible that for various reasons, beyond the treatment itself, the assistance is not possible or the establishment, institution or company, to complete its activity.
In any case, to begin the process of completion of treatment, is working to prepare the patient for a farewell, in order not to cause distress, pain or prejudice in any way the user. Bonding and establishing trust between the individual / s and therapist are very strong, and a bad end, can spoil the whole treatment done, resulting in an injured person.
Usually the sessions are conducted weekly for a period longer than six months and less than two years. However, as stated above, this is not standardized and more flexible in terms of the conveniences of the case.
The working methodology has enabled studies that provide clinical evidence of treatment outcomes. Today we can find studies on rhythmic timing and movement in people with Parkinson's, on the use of song to stimulate or restore the speech, about the benefits of using music with premature babies to stimulate the development, among others. Thus, from the hand of a scientific research increasingly strong, the working field of music therapy has grown and spread to unusual places.
Here in Robbins's own words for a man who woke up in a coma after a music therapy treatment.
"All I could do was breathe, and the therapist just sang to the rhythm of your breathing, very softly. After a few weeks, began to move his hands, opened his eyes, but the remarkable thing is that once recovered, she remembered having heard the voice of someone who wanted to help, he wanted to reach him through music. "
This type of therapy is mainly individual and its main objective is to involve the patient to express himself through the instruments, making music.
In general terms, the method of creative music therapy is betting on the use of musical sensitivity for growth and development as well as giving channel and promote the flow of creativity. He argues that these skills are present in all people, even those who are most committed physically, socially or cognitively.
To make music, to play with music or simply to listen to all type of music, do not constitute its own, a music therapy treatment. Therapeutic treatment is a "process" that is established between the therapist and the patient. You can not talk about treatment in a single session of music therapy. There should be a link between therapist and patient, where it first is a touchdown and, little by little, confidence arises from the patient into the professional and to the activities. This interaction takes place in time and with the incorporation of many elements and not just in the musical background.
While music therapy uses music for therapeutic purposes, is not a primary objective to work on suffering or disease.
While this can be achieved, its aims are focused more on stimulating growth, creativity and development.
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