Course work 3

Description of the implemented therapy

The therapy that I have selected to treat the selected students is Music
Therapy. Music Therapy is the clinical and evidence-based use of music interventions
to accomplish individualized goals within a therapeutic relationship by a credentialed
professional who has completed an approved music therapy program. (American
Music Therapy Association definition, 2005.) Music therapy is also a form of
alternative treatment that uses music to improve the physical, mental, emotional
wellbeing of a person.
Music therapy is one of multiple types of therapy based around art; others
include dance therapy and art therapy. What makes music therapy so unique is that
there are little physical requirements. There is no physical medication to ingest and
no movement required. The only requirement to this is the ability to hear and listen to
music, which is something most of us do every day.
The fact that music therapy is an alternative form of treatment it is not
mainstream and most people have not tried it, but for except those who may not
believe in traditional medication. Despite its lack of popularity, Music therapy is an
alternative to traditional form of treatment that more people should consider.
Music therapy is the use of music and all of its facets to achieve therapeutic
goals in the physical, behavioural, mental, emotional, social, and spiritual domains
(Bruscia, 1998). It is used with many client populations including developmentally
delayed children, mentally ill adults, at-risk youth, people afflicted with HIV/AIDS,
adults and children with chronic physical diseases, geriatric patients, and adults in
psychotherapy. It is also a common treatment modality for children with autism
(Bruscia, 1998)
There are four main methods used in music therapy. They are receptive music
experiences in which the clients listen to music, composition experiences in which
clients compose or contribute to the composition of a song or instrumental piece, recreative music experiences in which the clients play or sing music that has already
been composed and improvisation experiences in which clients create music
spontaneously using instruments or their voice (Bruscia, 1998). Each one of these

types of musical experiences offers a variety of benefits based on the clients clinical
needs.
Nordoff Robbins Music Therapy originally called as Creative Music Therapy is
an improvisational and compositional approach to music therapy developed by Paul
Nordoff, an American composer/pianist, and Clive Robbins, a special educator from
Great Britain (Bruscia, 1987; Kim, 2004). They worked closely together from 1959 to
1976 as therapist and co-therapist with children with special needs in various settings
(Nordoff & Robbins, 1971). After the death of Nordoff in 1976, Robbins continued to
develop the work worldwide. Today NRMT is practiced and studied throughout the
globe.
Traditionally, NRMT involves two therapists participating in sessions, the
primary therapist is responsible for spontaneously creating music on a harmonic
instrument, usually on guitar or piano; the co-therapist interacts directly with the child,
facilitating musical participation and engagement. A central concept in NRMT is the
music child, which is based on the belief that all children have an inborn musicality
and the capacity, regardless of pathology, to respond to musical experiences (Nordoff
& Robbins, 1977, p.1).
However, in order for the music child to flourish the child must be open to
experiencing himself, others, and the world around him; for it is through these
experiences that receptive, cognitive, and expressive capabilities are developed
(Robbins & Robbins, 1991, p. 57). What prevents the music child from functioning is
what they called the condition child (Nordoff & Robbins, 1964; 1977). The condition
child, encasing the music child, represents what the child has come to be. He
learned responses to the world and his personality development based on how he
has internalized lifes experiences. Nordoff and Robbins (1964; 1968; 1971; 1977)
found that, through the use of music improvisation, the condition child can be
bypassed, reaching the inborn musicality of the individuals music child.
In nurturing, challenging, and supporting the music child through musical
experiences, the child develops beyond the conditioned self and into new ways of
experiencing the self and the world. A new self is born, and the condition child
becomes the old self (Robbins & Robbins, 1991, p.59). The primary focus of
interaction in NRMT, then, is the musical relationship between the child and

therapists. Verbal interaction is not essential in NRMT, rather, it is the musical

experience and level of musical relatedness of the child that is important. Because
the primary focus is on music, the musical process is the clinical process (Aigen,
2005, p. 94), meaning that the therapists primary concern is to develop and
incorporate musical interventions to deepen the childs musical engagement and
interaction.
In NRMT, musical goals are clinical goals (Aigen, 2005). What a child
accomplishes musically is regarded as a clinical or therapeutic accomplishment. For
example: NR therapists may work on a childs ability to increase the dynamic range
(loud and soft) of his drum playing, or expand the range of tempo (fast and slow)
while playing the xylophone. Although the focus is on musical goals and the widening
of the childs musical experiences, it is clear that these goal areas can also address
cognitive, expressive, sensory, and social deficits. In considering all that is involved to
achieve the above musical goals: motor planning, auditory cuing, fine and gross
motor skills, visual spatial processing, and sensory modulation, it becomes clear that
developmental goals are realized through musical goals and experiences. In NRMT,
the child is an active creator of music, playing a vital role in the direction of the
musical process. The child plays various instruments that require no formal training
or experience, while the therapist improvises music built around the childs musicmaking, emotional state or movements.
The purpose is to musically engage, match, support, and enhance whatever
the child is offering, musically or non-musically, therein promoting relatedness,
communication, socialization, and awareness within the music itself. In working within
the Nordoff-Robbins approach, the therapist directly responds or calls out to the child,
creating musical questions and answers to elicit a back and forth musical dialogue.
The therapist may create a musical scenario that seeks a musical response; create
music that reflects a childs being or emotionality; or improvise music to address the
childs sensory needs for musical engagement.
Furthermore, the therapist may create music that seeks to provoke a child into
a certain musical response, or improvise music to a childs idiosyncratic,
perseverative behaviours to make the behaviours communicative and interactive. In
all forms of NRMT, the therapist uses his or her musicianship, creativity, intuition, and

clinical knowledge of the child to improvise music that will activate the childs will,
motivation, and passions, thereby bringing the child into musical mutuality and
intentionality. Through the experience of co-actively improvising music, children can
experience themselves in a new way, beyond their pathology, and perhaps free from
their habitual behaviours (Sorel, 2005).
Implementation of the therapy chosen
During the practicum in school, I have identified students who are having
problems and need guidance in my classroom. The selected students are from class
3 Rajin, the class that I have assigned to teach for practicum. Even though this is the
top class amongst the four classes in each level, I have identified 5 students that
have difficulties in their studies, communicating and socializing with their classmates
and not being able to speak in English. I have noticed their behaviour in the
classroom and I can sense that they need help. They do not cause destructive
behaviours in the classroom, however their lack of communication skills can cause
disruptive behaviours that will lead to problems during the teaching and learning
session.
The patients that I have selected for my music therapy are Fakrul Najmi, a boy
with mild autism, Nur Nazurah, a girl with ADHD or Attention Deficit Hyperactivity
Disorder, Abdullah Aiman, a boy with extreme level of shyness, Wardina Insyirah, a
girl who has OCD or Obsessive-Compulsive Personality Disorder Symptoms and last
but not least, Ahmad Raimi, a boy who has speech problems. (APPENDIX) Before I
can proceed with the therapy, I have to collect the data and information of each
patient. These patients undergo the therapy session twice, the first venue was in the
library and second venue was in the classroom. Time taken for the therapy was 60
minutes, estimated around 12 minutes per person. The results of the therapy was
written using hand and then transferred into the computer. After the session has
ended, I immediately proceed on doing this write-up.
Before I proceed with my music therapy with these patients, I have prepared a
set of questionnaires for them to answer (APPENDIX) and I will evaluate them during
pre-test, while-test and post-test. The songs that I used is a Harmonic Orchestra
song, Another Arni Village from Chrono Cross videogame official soundtrack
album, The Lazy Song by Bruno Mars and a song that they have sang in the

classroom during my teaching and learning session two weeks before, People In My
Town by Peter Weatherhall. They need to answer the first 5 questions that I gave to
them before they can review the songs that I played for them. After I clicked play,
they need to clap, move to the left and to the right so that they can synchronize with
the tempo of the song. This is to generate positivity in them and to make them enjoy
the song.
One of these students is also diagnosed with mild autism, as one of the class
teachers told me. Fakhrul Najmi, is a student who likes to sit at the back of the
classroom and does not frequently socialize with his colleagues. He also likes to
have conversations with himself and does not focus whenever I teach in the
classroom. When he was in year 2, he likes to hurt himself using a sharp pencil and
isolate himself from others. Self-harming is not a behaviour that a teacher can
tolerate. But luckily, when he entered the class year 3 Rajin, he has not been hurting
himself. A teacher told me that this behaviour is caused by the inability to accept his
parents divorce 3 years ago.
What is Autism and what causes it? Autism is a brain development disorder
that manifests itself before three years of age. It is marked by impaired social
interaction, impaired communication, and restricted and repetitive behavior (Autism
Society of America, 2007). The word, autism, derives from the Greek word autos,
meaning self. The term was first coined in 1911 by Swiss psychiatrist Eugen Bleuer
(1950) as he was defining symptoms of schizophrenia in adults. Autism is referred to
the individuals withdrawal from the outside world. It was not until 1943, however, that
its classification as a disorder originated, when Dr. Leo Kanner (1943) introduced the
term early infantile autism to describe his work with children who showed no interest
in connecting with other people.
Nur Nazurah is a cheerful student in class year 3 Rajin. However, she
sometimes exaggerates her actions and causes disruptive behaviours in the
classroom such as throwing her bottle to her classmates; laughs loudly and always
like to seek attention. Her behaviours can be unpredictable sometimes as she quickly
changes her mood from angry to sad in a fast manner. She also likes to cry in class,
disturbing the teaching and learning session and forces the teacher to focus on her.
ADHD means a syndrome of disordered behaviour, usually diagnosed in childhood,

characterized by a persistent pattern of impulsiveness, inattentiveness, and

sometimes hyperactivity that interferes with academic, occupational, or social
performance. It is also called attention deficit disorder. (The American Heritage
Science Dictionary. Retrieved March 11, 2015).
Abdullah Aiman is a boy who is conditioned as social anxiety disorder. Social
anxiety disorder is a persistent fear of one or more social or performance situations in
which the person is exposed to unfamiliar people or to possible scrutiny by others.
The individual fears that he or she will act in a way (or show anxiety symptoms) that
will be embarrassing and humiliating. (Social Anxiety Disorder. Retrieved March 11,
2015, from socialanxietyinstitute.org, Website: https://socialanxietyinstitute.org/dsmdefinition-social-anxiety-disorder) He speaks very softly and acts very gently. He only
talks when I approached him personally but he will not speak if I call him forth to
speak publicly. He will also cry if I force him to speak.
Wardina Insyirah is a student from year 3 Rajin that will never complete the
tasks and homework that her teacher gave, including me. She will tend to neglect all
the works that she got and resulting in messy and incomplete work book. I believe
she is in a condition called OCD or Obsessive-Compulsive Personality Disorder
Symptoms. Obsessive-compulsive disorder (OCD) is an anxiety disorder
characterized by uncontrollable, unwanted thoughts and repetitive, ritualized
behaviours one feel compelled to perform. (Reus VI (2012)
The last patient for the music therapy is Ahmad Raimy who has very terrible
speech problems. He tends to stutter so much when he speaks and cause him to be
shy whenever someone corrects him. Stuttering is a speech fluency disorder of an
unknown etiologic, which represents serious disturbance of the individuals
communication and it interferes with their normal functioning. (M, M. (2006).
Based on the music therapy that I have done with these patients, I noticed
Fakhrul Najmi gave a positive outcome, Nur Nazurah still remain unchanged
although she is much more calmer, Abdullah Aiman has a great improvement in
terms of communicating with me, Wardina Insyirah responded positively and
Abdullah Raimi has less stutters than before this. Majority of them gave a positive
outcome and I was surprised on how much the Nordoff Robbins Creative Music
Therapy has affected them. Although the correct sequence of the Creative Music

Therapy is to produce music with the patient and not by clicking play on songs that
others published. Overall, the students have a slight improvement in their behaviour
and they enjoyed the music therapy because it develops them holistically as a much
more positive person.
Suggestions for the improvement
Nordoff Robbins creative music therapy traditionally involves two therapists
participating in sessions, the primary therapist is responsible for spontaneously
creating music on a harmonic instrument, usually on guitar or piano then the cotherapist interacts directly with the child, facilitating musical participation and
engagement. (Turry, A., & Marcus, D. (2005).
So based on the explanation stated, the therapy focuses on creating music
with the patient rather than playing it from a sound file. However due to my limited
skills in music, I am able to teach the patients on how to sway from left to right and
clap their hands to maintain tempo. If I am able to play musical instruments, I would
be able to produce an authentic piece of music so that I can play it with my patients.
Other than that, I need to limit my patients to only 3 persons instead of 5
because of the time constrain. I would be able to spend more time playing more than
the 3 songs stated. I could also be able to do more than 2 sessions with the students
so that I can gather more information from them.
Conclusion
As a conclusion, the music therapy is a very good therapy for students that are
having problems and need guidance in my classroom. The responses from them
were good and some have changed in terms of their behaviour. I believe that music
therapy can be a great therapy for students with problems and normal students alike.

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APPENDIX