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Music Therapy for Neurological Conditions

Apr 7, 2023

Betsy Hartman is a neurologic music therapist. She’s a board certified music therapist with extensive experience working with people living with cancer and multiple sclerosis and their families. She founded PNW Music Therapy in Seattle in 2014 and since that time has partnered with Swedish Medical Group to build and lead its flagship music therapy program at the Swedish Cancer Institute and Swedish MS Center. Betsy is passionate about developing tools and resources to help reduce pain and anxiety, improve coping skills and wellness, and enhanced motor speech and cognitive health. In addition to her clinical work, she partners with companies to develop resources, tools, and content which improve access to and awareness of music therapy. Betsy participated in developing the award-winning music therapy resource MS in Harmony. Betsy is a guest speaker for podcasts such as MS Journeys on iHeartRadio and real talk MS.

Watch the Entire Presentation

Key Takeaways:

*Note the Music Therapy experiential portion of the presentation begins at 20:35.

Do you need to have a music background to benefit from Music Therapy?

No! Most of the people I work with have no background or experience in music whatsoever and my greatest joy is to be able to give people the gift of music, and helping people learn that you don’t need to know how to play an instrument you don’t need to be able to carry a beat. You can still immensely benefit from the fundamental components of music from rhythm, from melody, from pitch, from sound. Not not only that, but you can benefit from how music makes you feel and helping people learn how to tap into the the healing power of music.

What is Music Therapy?

Music therapy is evidence-based. We support individualized clinical goals and it’s important that you’re working with a board-certified music therapist because board certified music therapists have extensive training in what we do. I’m sure you’ve all experienced the therapeutic benefits of music listening to a song on your morning commute that boosts your mood, or the power of a a lullaby, or a soothing song at night to help you fall asleep. That’s immensely therapeutic, but board certified music therapists have extensive training in psychology, special education, and exercise science. Neurologic music therapy is a specialized training specifically aiming to do for people living with conditions like MS.
Music therapy supports the physical, emotional, cognitive, verbal and social challenges and side effect of living with MS, using evidenced-based music intervention.

Active vs. Receptive Music Therapy

In active music therapy the client or group is involved in playing or creating music. This is irrespective of performance experience. We’re not looking at how good you can be or sound at an instrument. We’re looking at how different evidence-based music interventions help you accomplish your clinical and therapeutic goals. Music experience or confidence is not required. You wouldn’t be expected to be an athlete to go to a physical therapy session and you’re not expected to be a musician to go to a music therapy session.

In receptive music therapy the client of group is listening to live or pre-composed music. The music therapist may be presenting live or recorded music to be listened to.

Music Therapy Goals

  • Motor/Physical – gait, fine and gross motor skills, speech and language skills, pain management, sleep hygiene, energy
  • Emotional/ Mental Health – Coping skills, anxiety and stress management, personal insight and awareness, mindfulness practice
  • Cognitive – Memory recall and attention control
  • Speech and Language – Speaking, breath control, volume support, oral motor and respiratory skills
  • Social – Interpersonal connection

How does music help with Motor Skills?

Rhythm (rhythmic auditory stimulation) helps with walking pace, stiffness, weakness, spasticity and irregular gait patterns. Using rhythm to stimulate our movement when we have auditory input we have a direct motor output without even thinking about it. We have a subconscious physiological response when we hear rhythm. I always give the example if you’re out at a restaurant and all of a sudden you notice you’re tapping your foot and then you think, “oh I didn’t even know there was music on.”

One technique is walking to a metronome or a song with the beats per minute that matches the pace we want to walk at. We teach about entrainment. Entrainment is the ability for us to mesh to mold with music when we hear that beat we find the beat internally and then we train the person we’re working with to march in place to that beat and then to eventually start walking at that tempo without even thinking about it because we respond to rhythm. Because we are rhythmic beings,
we know that when we have auditory input we have a direct motor output the person that we’re working with starts walking with symmetry and predictability. Their whole body straightens up and if there’s any type of left side or right side weakness because they’re focused on making that beat happen.

We also use pattern sensory entrainment which is using melody and pitch. If you’re having difficulty standing up from sitting to standing we can mimic that motion using sound. Thinking about rhythm and tempo playing like an ascending scale that’s you standing up, holding your pose, being strong, being confident, taking a breath, and going back down.

Sensory entrainment with rhythmic auditory stimulation lets the music be the bridge between your brain (what you want to have happen) and your body. Then you practice with the music stimulation and eventually neuroplasticity, you’re building up new pathways to do the movements that you once were able to do but are now challenging. You’re going to relearn how to do those movements in a different way using music as the instigator, music as the motivator. Music is a tool to help you accomplish that.

What is Neurologic Music Therapy?

Neurologic music therapy is an advanced training. Music therapy is the core fundamental of how do you take music and help it address people’s therapeutic clinical goals so in our training at university whether it’s an undergraduate or graduate level program you know first and foremost we’re musicians but then all of our studying is in how can we put this into a clinical setting in schools and hospitals and private practice. Neurologic music therapy is specific to how we can take all of that and apply it one step further one more specific level of study into neurologic disorders like Parkinson’s, Down syndrome, TBI, MS, etc. Neurologic music therapy really focuses on the fundamental components of music: rhythm, tempo, melody, and pitch. For someone with a vocal goal like enunciation we might start with the breath and then working on things like the typical going up and down the scale, classic vocal exercises that you’d see in a choir setting but then music therapists are trained to adapt these to the person’s clinical goals.

Learn more about Music Therapy

  • Watch Betsy’s presentation at the 2022 Virtual Holistic Health and Wellness Forum for MS
  • Betsy runs a virtual Music and Wellness Music Therapy group for MS patients and caregivers on Wednesday 11am PST. Get in touch with her program manager for more details.
  • Betsy run a virtual Singing and the Brain Betsy group which uses singing to enhance speech and language skills. Get in touch with her for more details.
  • American Music Therapy Association has many resources and links to providers
  • MS in Harmony has many music therapy informed interventions you can do on your own