Trauma & Treatment:Neurologic Music Therapy and

Functional Brain ChangesSuzanne Oliver, MT-BC, NMT Fellow

Ezequiel Bautista, MT-BC, NMT

Music TherapyMT-BC

❖ Music Therapist - Board Certified

❖ Certification Board for Music Therapists (CBMT)

➢ National Certification Program

➢ National Examination & Continuing Education

➢ Ensuring Protection of the Public

Neurologic Music TherapyNMT & NMT Fellow

❖ Music Therapist - Board Certified

❖ Professional Designation of Advanced Training

➢ University of Toronto, Music and Health Research Collaboratory

➢ Fellowship process (initially within first 3 years, then every 5 years afterwards)

➢ Ensuring Best Practice Treatment Through an Evidence-Based Treatment Model

Neurologic Music TherapyThe therapeutic application of music to cognitive, sensory,

and motor dysfunction due to neurologic disease of the

human nervous system.

Rhythm, Music, and the Brain: Scientific Foundations and Clinical

Applications (Thaut, 2005)

Handbook of Neurologic Music Therapy (Thaut and Hoemberg, 2014)

Neurologic Music Therapy❖ Based on a neuroscience model of music perception and

production.

❖ Considers the influence of music on non-musical brain

function and behavior.

❖ Focuses on rehabilitative, developmental and/or adaptive

goals.

Neurologic Music TherapyUtilizes a research-based system of standardized clinical

techniques in the areas of:

❖ Sensorimotor Training

❖ Speech & Language Training

❖ Cognition Training

Neurologic Music Therapy:Optimizing Neuropathways

Working Mechanisms of MusicRhythmic Stimulation and Entrainment

- Provides timing through predictability, immediate effect; can be used for

training long-term change.

● Rhythm is perceived subcortically and bilaterally

● Rhythm acts as a priming mechanism for the motor system,

impacting timing, fluency, output

● No training period -Change occurs within 3-4 beats

● Cortical Focus can impede impact

(Ex: Heels, Dance Class)

Working Mechanisms of MusicPatterned Information Processing

- Facilitates cognitive processing, enhanced learning, memory, executive

functioning.

● Temporal templates: processing space and time

● Rhythm provides time information across the duration of time

period/movement, not just at the endpoints.

(Ex: ABCs)

Working Mechanisms of MusicDifferential Neurologic Processing

- Activates parallel or shared neural pathways

● Music is not cortically distinct, but rather shares cortical networks

activated in similar non-musical tasks

● PET studies: music activates many areas of the brain

○ “It is now known that music listening, performing, and composing engage

regions throughout the brain, bilaterally, and in the cortex, neurocortex,

paleo-, and neocerebellum (Levitin & Triovolas, 2009)

(Ex: Gabby G., Stroke, Autism Slide)

Working Mechanisms of MusicAffective-Aesthetic Response: Arousal, Motivation, Emotion

- Effects on arousal, motivation, and emotion which effects learning and

behavior

● The motor system is physiologically very sensitive to arousal by the

auditory system

● Arousal and cognitive processing are primary to effectively

processing emotion

(Ex: Cleaning vs. Sleeping, Response to Tempo Change)

Key Components to Keep in Mind❖ Optimization and Efficiency

❖ Immediate Change rather than through a gradual learning

process

❖ Drives Cortical Plasticity, effectively changing the brain

that is engaged in music (Thaut & McIntosh, 2010)

PlasticityNeuroplasticity: also known as cortical re-mapping,

refers to the ability of the human brain to change as a

result of one’s experience, that the brain is ‘plastic’ and

‘malleable.”

From ‘Train you mind, change your brain’ Sharon Begley

“The Brain that engages in music is changes by engaging in music.”

(Thaut, 2005)

Impacts of Trauma on Self-Regulation/Emotional Regulation● Difficulty with:

○ Inhibition

○ Self-Regulation

○ Emotional Regulation, Stability

○ Body Image

○ Boundaries

○ Somatization

Auditory Perception Training (APT) ● “...focuses on auditory perception and sensory integration…. APT integrates

different sensory modalities (visual, tactile, and kinesthetic) during active musical

exercises such as playing from symbolic or graphic notation using tactile sound

transmission or integrating movement and music…” (Thaut, 2005)

● Participant Experiential

Impacts of Trauma on Executive Functioning● Difficulty with:

○ Planning

○ Decision Making

○ Problem Solving

○ Abstract Reasoning

Musical Executive Function Training (MEFT)● “...exercises presented individually or in groups to practice executive functioning

skills such as organization, problem solving, decision making, reasoning, and

comprehension.” (Thaut, 2005)

● Participant Experiential

Impacts of Trauma on Psychosocial Health● Social Isolation

● Difficulty Labeling & Expressing Feelings

● Difficulty Attuning to Others

● Low Self Esteem

Music in Psychosocial Training and Counseling (MPC)● Uses musical performance, guided music listening, musical role playing, and

expressive improvisation or composition exercises to address issues of mood

control, affective expression, cognitive coherence, reality orientation, and

appropriate social interaction to facilitate psychosocial functions. (Thaut, 2005)

● Participant Experiential

Final Thoughts and Opportunities● Increase Your Own Awareness of Music/Rhythm Around You and Its Impact

● Explore and Discern the use of Live vs. Recorded Music, Benefits and Limitations

● Seek Out NMT as a Treatment for Complex Trauma When Needed

○ NMTs effectively participate as members of an interdisciplinary team

○ Treatment can be provided individually or within a group process

○ Funding sources include: Private Pay, Insurance, Medicaid, Medicare/Part B

Questions?Email questions & comments to info@nmtsa.org

www.nmtsa.org

ReferencesAmaya-Jackson, L., & DeRosa, R. R. (2007). Treatment considerations for clinicians in applying evidence-based practice to complex presentations in

child trauma. Journal Of Traumatic Stress, 20(4), 379-390. doi:10.1002/jts.20266

Crasta, J.E., Thaut, M.H., Anderson, C.W., Davies, P.L.,Gavin, W.J. (2018). Auditory priming improves neural synchronization in auditory-motor

entrainment. Neuropsychologia, 117, 102-112. doi:10.1016/j.neuropsychologia.2018.05.017

Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., & ... van der Kolk, B. (2005). Complex Trauma in Children and Adolescents.

Psychiatric Annals, 35(5), 390-398.

LaGasse, A. B., & Thaut, M. H. (2013). The neurobiological foundation of neurologic music therapy. Music And Medicine, 5(4), 228-233.

doi:10.1177/1943862113502547

Marshall, D. F., Passarotti, A. M., Ryan, K. A., Kamali, M., Saunders, E. H., Pester, B., & ... Langenecker, S. A. (2016). Deficient inhibitory control as an

outcome of childhood trauma. Psychiatry Research, 2357-12. doi:10.1016/j.psychres.2015.12.013

Thaut, M. H. (2005). Rhythm, music, and the brain: Scientific foundations and clinical applications. New York, NY, US: Routledge/Taylor & Francis

Group.

ReferencesThaut, M. H., Peterson, D. A., & McIntosh, G. C. (2005). Temporal Entrainment of Cognitive Functions: Musical Mnemonics Induce Brain Plasticity

and Oscillatory Synchrony in Neural Networks Underlying Memory. In G. Avanzini, L. Lopez, S. Koelsch, M. Manjno, G. Avanzini, L. Lopez, ...

M. Manjno (Eds.) , The neurosciences and music II: From perception to performance (pp. 243-254). New York, NY, US: New York Academy of

Sciences.

Thaut, M. H., & Abiru, M. (2010). Rhythmic auditory stimulation in rehabilitation of movement disorders: A review of current research. Music

Perception, 27(4), 263-269. doi:10.1525/mp.2010.27.4.263

Thaut, M. H. (2010). Neurologic music therapy in cognitive rehabilitation. Music Perception, 27(4), 281-285. doi:10.1525/mp.2010.27.4.281

Thaut, M. H., & Hoemberg, V. (2014). Handbook of neurologic music therapy. New York, NY, US: Oxford University Press.

Thaut, M. H., McIntosh, G. C., & Hoemberg, V. (2015). Neurobiological foundations of neurologic music therapy: Rhythmic entrainment and the

motor system. Frontiers In Psychology, 5