Episode 2      21 min 45 sec
New Directions in Music Therapy

Associate Professor Denise Grocke explores Music Therapy with host Jacky Angus

Guest: Associate Professor Denise Grocke, Associate Dean (Research) in the Faculty of Music and Head of Music Therapy.

Topic: New Directions in Music Therapy

"I think of music therapy as being one of the creative arts therapies. It!|s the use of music to achieve therapeutic aims with people of all ages who have needs relative to illness or disability." - Associate Professor Denise Grocke




           



Assoc Prof Denise Grocke
Assoc Prof Denise Grocke

Associate Professor Denise Grocke, Associate Dean (Research) in the Faculty of Music and Head of Music Therapy.

Credits

Host: Jacky Angus
Producers: Kelvin Param and Eric Van Bemmel
Audio Engineer: Miles Brown
Theme Music performed by Sergio Ercole. Mr Ercole is represented by the Musicians' Agency, Faculty of Music
Voiceover: Paul Richiardi

Series Creators: Eric Van Bemmel and Kelvin Param

Melbourne University Up Close is brought to you by the Marketing and Communications Division in association with Asia Institute, and the Melbourne Research Office.

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Music Therapy

VOICEOVER

Welcome to Melbourne University, UpClose, a fortnightly Podcast of research, personalities and cultural offerings of the University of Melbourne, Australia. Up Close is available on the web at upclose.unimelb.edu.au. That!|s upclose.u-n-i-m-e-l-b.edu.au.

JACKY ANGUS
Hello I!|m Jacky Angus from the Research Office at the University of Melbourne. Now, have you ever wondered why music seems to lower your anxiety? Imagine you!|re weaving through traffic, you feel tense, irritable about being late to work. You tune into some classical music on your car radio. Soon, your stress level is down and you!|re feeling much better about things. Why does certain music start the unwinding process so you can relax? That!|s a question being asked in two intriguing research projects conducted at the Peter McCallum Cancer Centre and the St Vincent!|s Hospital, both located in Melbourne, Australia, in conjunction with the Faculty of Music at the University of Melbourne. My guest today is very much part of the research teams. She is Dr. Denise Grocke, Associate Professor of Music at the University of Melbourne. As a musician, academic and teacher, Dr Grocke!|s particularly interested in music as a therapeutic tool. In 1975, she co-founded the Australian Music Therapy Association. She then pioneered the study of music therapy here at the University of Melbourne and now heads the National Music Therapy Research Unit. In addition to publishing widely on the subject, Dr Grocke!|s also a practitioner, a music therapist herself. Good morning Dr Grocke, welcome to Up Close.

ASSOC PROF DENISE GROCKE
Good morning.

JACKY ANGUS
Let!|s start with a basic question. What exactly is music therapy, how did it all begin?

ASSOC PROF DENISE GROCKE
Well, I think of music therapy as being one of the creative arts therapies. It!|s the use of music to achieve therapeutic aims with people of all ages who have needs relative to illness or disability. So we work through the entire age span from infants right through to people in the last days of their life.

JACK ANGUS
And who can become a music therapist?

ASSOC PROF DENISE GROCKE
Well one of the pre-requisites for coming into the training is !V in music therapy is that the person is a proficient musician which means that they must be proficient on their particular instrument, whether that!|s piano or guitar or violin or whatever. The main point here is that the therapist must be very much at home with their musicianship because music therapy is based on engaging the client in the musical experience. So we can!|t have people who are you know looking at their notation, looking at their score. They need to be able to engage the person with eye contact and include them in the music experience.

JACKY ANGUS
Well Denise tell me a bit more about these projects, can you give me some details. For example, the current research at St Vincent!|s Hospital and the Peter McCallum Cancer Centre.

ASSOC PROF DENISE GROCKE
Well, I!|ll start with the Peter McCallum study first. This was a story that came about because the radiotherapists at Peter McCallum were concerned about people who come to their very first radiotherapy session and can become quite anxious, so that their body might even start to tremble. And they, of course, need some sort of intervention to help the person calm down for their first radiotherapy session. And we know from the literature that music and music therapy have been used successfully with other applications to help people with anxiety but it hasn!|t been done in this particular context with people who have cancer and who are coming to their first radiotherapy session. And so this study is set up to look at self-selected music. That means that people can bring in whatever music they would like to listen to and as they come into the radiotherapy session, that music is playing and we give them something that they can control. So they actually can control the volume level of the music, because part of the !V the aspect of anxiety that they experience is that everything is out of their control. They don!|t really know what!|s happening; they!|re coming to terms with having cancer. And so the radiotherapy set up is actually quite an intimidating one. So to give them something that they can control, even though it!|s just quite simple !V the volume level of the music !V we!|re just interested to see whether that helps reduce anxiety. So it!|s a random control trial. Some people will have music, others won!|t. And we!|re going to look at the difference between anxiety, pre-post the radiotherapy session.

JACKY ANGUS
That!|s very interesting. And what about the one at St Vincent!|s? That!|s a bit different I gather.

ASSOC PROF DENISE GROCKE
Yes, the study at St Vincent!|s !V we!|ve finished that study. This was a study we looked at people living in the community: people who have severe mental illness, people who have been living with mental illness for many, many years. And as you know these people are no longer hospitalised in big institutions; they!|re placed into the community as soon as possible. And we were interested to know whether music therapy could be a form of therapy that would help with their socialisation and their social anxiety, and whether music therapy would contribute generally to their quality of life and their sense of wellbeing.

JACKY ANGUS
I understand you!|ve actually got some tapes of the music that was !V was it composed by the people themselves? Can we hear some of that?

ASSOC PROF DENISE GROCKE
Yes we !V we can, it was the music therapy session involved the people, the participants !V singing songs that were familiar to them. But they also composed their own songs, which meant that the music therapist helped them compose original lyrics. And then the music therapist facilitated the group in actually writing the song: you know the !V the melody, the rhythm, what sort of style do you want the song to be, do you want the melody to go up or down, do you want the harmonies to sound like this. And !V and so what we found was that each group !V we did five groups !V each group felt very, very proud of the song that they had written. It was their song.

JACKY ANGUS
And they had no musical training as far as you know?

ASSOC PROF DENISE GROCKE
Well, some of them did. Some of them were quite good guitarists and so on, but we certainly didn!|t select in terms of their musicianship. And that!|s the difference between, say, music entertainment or !V or anything like that. I mean we take all people in because we !V we work with their innate musicianship.

JACKY ANGUS
When you say innate, that sounds as though that!|s itself self-curative: that !V that capacity to write and to !V and to engage with music.

ASSOC PROF DENISE GROCKE
Well, the innateness of music is that everyone can sing. Now of course many people will say but I don!|t sing well because people think that you have to be in tune and !V and have a really lovely singing voice, but in fact when we engage people who perhaps have never really sung in their whole life really, but when we engage them in singing songs it !V it has a physiological effect to begin with, because you need to take in much deeper breaths to be able to project a sung tone over speaking. And so, often people have a physiological benefit as well from being involved in singing. Anyone who!|s been a member of a choir knows how great it is to sing.

JACKY ANGUS
Yes, yes.

ASSOC PROF DENISE GROCKE
And so that!|s the innateness, but also when we use improvisation which simply means that we have melodic and rhythmic instruments that people can play and we find that people sort of get into their own rhythm, they create their own melodies on !V on the instruments and that!|s what we think of in terms of innate musicianship.

JACKY ANGUS
Well, it!|s obviously got huge implications for medicine and therapy as a whole. Let!|s listen to some of that now.

[Excerpt of song !!!OBallad for a Better World!!L]

JACKY ANGUS
Dr Grocke can you tell me a bit more about that song we just heard? What !V what !V a bit more of the background, perhaps.

ASSOC PROF DENISE GROCKE
Well, this was a song written by one of the groups. It!|s titled !!!OThe Ballad for a Better World!!L. I should say that !V that over the five groups, they wrote altogether seven songs and this was over the !V the music therapy program which ran for about eight weeks. So what I then did with the lyrics from all of these songs is I !V I did a lyrical analysis to look at the themes that emerged from the seven songs that they had written. And one of the themes that was prominent in many of the songs was this concern for the world, concern for world peace, concern about the war and the violence. So the !!!OBallad for a Better World!!L is about that. They!|re calling for !V there must be !V another answer; there must be another way than what!|s currently going on for the world to achieve peace.

JACKY ANGUS
Sounds like pretty wise sort of comment.

You!|re listening to Melbourne University Up Close. I!|m Jacky Angus and I!|m talking to Dr. Denise Grocke, Associate Professor in the Faculty of Music.

And there was a second song you wanted to play for us, wasn!|t there?

ASSOC PROF DENISE GROCKE
Yes, the !V the second main theme from the lyric analysis of all of these songs was that the groups talked about the experience of having mental illness and what was needed to cope with !V with the mental illness. So the second song is called !!!OHeart and Soul!!L, and it!|s just about this experience of living with mental illness and how no-one can actually get your soul. So you can keep your own soul.

[Excerpt of song !!!OHeart and Soul!!L]

JACKY ANGUS
Now, look you!|re talking about mental illness. Are there any limits to this therapy? Beause presumably some people are very ill and perhaps the boundaries need to be established for the therapist when they face someone like that.

ASSOC PROF DENISE GROCKE
Definitely. Well, we use music therapy in different sorts of ways depending on the severity of illness. So for people, say, for example with mental illness, for people who are !V who have florid psychotic symptoms, for example, what we do is we work in a very structured way. So we would give quite simple tasks for people to follow, for example, and we would contain a lot of that music therapy experience. For people who are coping quite well and who might be more interested in sorting out their problems. We might think of these people as the worried well, so they may not be people who have a diagnosis, but they!|re just unhappy with their life. And what we might do there is use music therapy in more of an insight-directed way, which means we might use something like guided imagery and music, where people are deeply relaxed, listening to mostly classical music and where images are revoked by the music that can be metaphors for what is happening in the person!|s life. And through interventions we can help the person reflect on some of these metaphors, these images, and to gain some sort of understanding about what!|s happening in their life. But that sort of method !V the guided imagery in music method !V we would not use with people who have psychotic illnesses because it requires a certain degree of !V of ego strength and !V and that!|s where the boundaries are incredibly important.

JACKY ANGUS
And presumably you work in conjunction with medical doctors and physiotherapists, occupational therapists and so on. So there!|s a huge range here of application.

ASSOC PROF DENISE GROCKE
Absolutely.

JACKY ANGUS
What sorts of projects you !V have you got lined up now for the future?

ASSOC PROF DENISE GROCKE
Well, we!|re doing a lot of research in the Faculty of Music. My colleague Dr Katrina McFerrin is doing some studies down at the Royal Children!|s hospital. She!|s working with young girls who have eating disorders and again looking at !V at music, particular songs that these girls are !V are writing. She also is doing some studies in special education, particularly looking at how music therapy can help children who have disorders such as autism, and we know already from !V from meta-analyses that music therapy is very effective with children who have autism because music is non-verbal and so it activates a different part of the brain than many of the education processes that require analytical skills. So music seems to engage particularly autistic children !V girls who have Rhett!|s Syndrome, for example !V where they!|re more attracted to the non-verbal medium. And so they can play instruments, they can improvise with their instruments and the music therapist also improvises with music instruments. So you avoid the whole need for language and !V and syntacs of !V of language and in that sense music can be a lot more immediate, it can enable people to communicate and express themselves and to express a wide range of emotions. I mean people can really pound on the drum and get rid of a whole lot of anger and frustration and it!|s kind of socially acceptable to do that. You would expect that from someone who was drumming, whereas to sort of shout or to yell is kind of not socially acceptable. So music really sort of allows the full range of emotions to be expressed.

JACKY ANGUS
Sounds like we should all be listening to much more of it. What about popular music? You know, sometimes you hear people saying, !!!Ooh that!|s just noise, it!|s not music!!L. But from what you!|re saying, it sounds as though all sorts of music is fine and really it!|s up to oneself, or would you say that classical music is somehow better for certain conditions?

ASSOC PROF DENISE GROCKE
Well, there are two aspects to that. I mean on the whole, the rule of thumb is that you use music that is familiar to the person and is their preferred music, and that!|s why at the Peter MacCallum Study we!|re asking people to self select, we!|re asking them to bring in the music they want to listen to. But there!|s also research to show that music that has certain properties is particularly good at relaxation and reducing anxiety, and this can be music that!|s classical or light classical, or it can even be some nice jazz. But the key proponents of that music are that it has a steady beat; it doesn!|t really waver; that the melodic line is quite narrow !V you haven!|t got big leaps; that the instrumentation is mostly around the use of strings and maybe the guitar or flutes, some woodwinds but not brass and not percussion; and that the harmonic range tends to be more in the consonant range of harmonies and not dissonant obviously, I guess. And, particularly for relaxation, we find that music that is roughly at a resting heartbeat, which is around 60 beats per minute or up to 72 beats per minute, I guess. Within that range. That when the music has that sort of pulse to it, then it helps !V we use the word !!!Oentrain!!L !V it kind of helps the body entrain to that rhythm and that helps with the breathing. Slow the breathing down.

JACKY ANGUS
I can see why you have to be a musician to be good at this music therapy business. Can you tell me now what your plans are, for the next six months? You!|ve obviously got lots of them.

ASSOC PROF DENISE GROCKE
A study that will look at the quality of life of carers of people who have dementia, where they are keeping the person at home. And as you probably know, it!|s an aging population and the incidence of dementia is rising and we want to keep people at home as much as possible. Now, what happens is that for the carer it!|s a 24-hour day. You know they have to be attending to this person all the time and they become very tired and they become ill. And so we!|re looking for ways in which we can help the carer care for the person with dementia. And one of the ways we can do that is through music. So we!|re going to try and train the carer to use music, either by singing familiar songs or even doing some movement to music, doing some dancing to songs that are known to the person who has the dementia. And also having some time of just listening to music and relaxing. We!|re hoping that that might improve the quality of the caring experience for the carers.

JACKY ANGUS
You!|re listening to Melbourne University Up Close, a fortnightly Podcast. I!|m Jacky Angus and I!|m talking to Denise Grocke, Associate Professor in the Faculty of Music.

Now Dr Grocke, if you wanted to be a music therapist and you felt that you had the gift, but not much musical training, what would you recommend someone in that position to do?

ASSOC PROF DENISE GROCKE
Well there are four training programs in the country; one at the University of Queensland, two in Sydney and the University of Melbourne, which is the oldest of the courses. We established our course in 1978. So at the moment we have a two-year Masters Coursework Degree, and we take in people who either have a Bachelors Degree in Music or Music Education. We also take in people who have a Bachelors Degree in an allied health profession like occupational therapists, social workers, psychologists, who have very good music skills. And we audition people into the course and, as I said before, you know if people coming into the music therapy course immediately go out on clinical training and so they need to be able to immediately engage people with a musical experience. So the level of musicianship is actually quite high.

JACKY ANGUS
So they have to be able to read music as well as play?

ASSOC PROF DENISE GROCKE
Oh definitely. And be quite proficient at music which means that they need to be !V need to hold eye contact with the client and create music. So it!|s not a matter of reading a song book. Most music therapists have a repertoire of hundreds of songs in their heads that they can just play, whilst looking at the client.

JACKY ANGUS
It sounds like a gift, a real gift to be able to do this !¢FDcause it combines so many skills, doesn!|t it, and empathy with people?

ASSOC PROF DENISE GROCKE
Oh, absolutely. And it involves values, too. I mean most musicians I think would prefer to be performing musicians, so those who want to actually share music with other people and particularly people who are in a vulnerable situation come with a different set of values and it!|s about, as I say, sharing music, creating music. And in a sense as a music therapist, you have to put yourself out of the situation in a funny way. I mean you !V you can!|t poss- it!|s not a matter of you performing for people in fact because then they!|ll just sit back and listen to you. So you have to get yourself out of the situation so that they will come into the music experience, because that!|s where the therapy lies. Therapy lies in them being engaged in that music experience.

JACKY ANGUS
Thank you very much Dr Grocke, that!|s been fascinating.

Melbourne University Up Close is brought to you by the Marketing and Communications Division, in association with Asia Institute and the Melbourne Research Office, of the University of Melbourne, Australia. Our producers for this episode were Kelvin Param and Eric Van Bemmel. Audio engineering by Miles Brown, theme music performed by Sergio Ercole. Melbourne University Up Close is created by Eric Van Bemmel and Kelvin Param. I!|m Jackie Angus. Till next time, thank you for joining us. Goodbye.

VOICEOVER

You!|ve been listening to Melbourne University Upclose, a fortnightly Podcast of research, personalities and cultural offerings of the University of Melbourne, Australia. Upclose is available on the web at upclose.unimelb.edu.au. That!|s upclose.u-n-i-m-e-l-b.edu.au. Copyright 2006, University of Melbourne.


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