Company director and arts therapist Daniel Thomas tells Care and Nursing Essentials about the work Chroma does with families, as well as neurology patients…
Tell us about Chroma and what you do…
We are the UK’s leading national provider of arts therapies services working across a range of sectors to improve the lives of every person who works with us. Our 70+ team of experienced therapists provide a national service covering the education and health and social care sectors. We provide art psychotherapy, music therapy, neurologic music therapy and dramatherapy. We work with social care partners and local authorities supporting adopted children and their families, in healthcare for people who need rehabilitation from brain injuries but also those with dementia or other neurological diseases. A lot of our time is spent in the education sector, providing arts therapy sessions to pupils in SEN schools as well as mainstream schools but also within early years to help children’s development. Currently one of our main focuses is around neurologic music therapy and how this can be used to improve the outcomes for those living with acquired brain injuries.
How can neurologic music therapy help those living with acquired brain injury?
Neurologic Music Therapy (NMT) offers an effective rehabilitation treatment that is backed by a wealth of clinical evidence and has been shown to have a profound influence on the brain. NMT is used as a method of rehabilitation for those living with acquired brain injuries such as a Stroke or injuries from a car crash. Music can bypass damaged areas of the brain, providing a scaffold to do the part of the work the brain is not doing in coordinating movement. But there is also the basic ‘use it or lose it principle’. When you exercise something, it gets stronger and the more you exercise, the better it becomes. There is strong neurological evidence that music activates many different areas across the brain. The motor system is very sensitive to picking up cues from the auditory system so when we hear music, particularly pulse or rhythm, it kicks straight into the motor system going around the brain.
Is neurologic music therapy readily available in the UK?
Currently NMT isn’t available as a standard NHS practice however there are a number of private hospitals and rehabilitation centres across the UK that we work with who provide NMT to their patients. We have partnered with STEPS rehabilitation centre in Sheffield as well as Hobbs rehabilitation which has 10 centres across the south of England. We also work with HCA healthcare at the Wellington and Portland hospitals in London. Recently we have secured a number of other pilot programmes across the UK which we are excited about launching so NMT is slowly becoming more readily available in the UK. We hope our work in taking music therapy into the mainstream will help ensure that at some point music therapy is available as standard in healthcare. As proof of our commitment to this, we have begun working with 3 NHS hospitals, Charing Cross, York General and the Great North Children’s Hospital. We also have pilot projects under consideration with 3 more NHS brain injury services.
Where does the pioneering research on neurologic music therapy come from?
The benefits of music therapy have been recognised for more than 70 years and, in the UK, it is a recognised Allied Health Profession however Dr Michael Thaut is widely acknowledged as the “Creator of Neurologic Music Therapy”. Dr Thaut’s work in this area is renowned as having brought a new clinical and systematic approach to its use in neurology. His research in brain function and music has focused on neurologic rehabilitation of key cognitive and motor functions, frequently enabling those affected by issues such as strokes and brain injuries to make significant strides towards recovery. Dr Thaut’s work over the last few decades has had a dramatic impact and influence on the growth in stature of NMT within clinical environments. There are 100s of studies highlighting the efficacy of NMT across brain injuries; for example a Randomised Control Trial in 1997 found that NMT was more effective that physiotherapy alone in gait rehabilitation. More recent studies have concluded that by increasing walking speed by only 10cm per second, a 7% reduction in the risk of falling can be made. Put these two finding together, and you see why NMT is such a breakthrough treatment.
Tell us about Chroma’s work with children and young people.
We work with a range of children and young people whose needs and requirements vary dramatically and so our approach in therapy is to ensure we provide each child/group with the right therapy to maximise their development and/or progress. Our early years development is in the form of ‘Sing and Grow’, a programme we have been running since 2010. The programme supports families with young children by strengthening their relationships, enhancing parent-child attachment and encouraging the use of music to support educational attainment. Our experienced team also work with primary school students with a range of challenges including autism, learning difficulties and troubled backgrounds. We work with the staff, carers and pupils to strive for shared goals for each child. We also work with secondary school students through our “Drumpower” programme. The intervention supports students in the constructive handling of aggression as an individual, develops their sense of community and their levels of co-operation, as well as growing their confidence in their own voice and to communicate with others more effectively. We also work with special schools and alternative provision partners throughout the UK, slotting in easily with established MDT’s.
Is neurologic music therapy a cost-effective approach to rehabilitation?
There have been a number of studies completed recently that have concluded neurologic music therapy is a cost effective method of co-ordinated rehabilitation services. Residential cognitive behaviour programmes have been shown to result in a £1.3 million saving per patient treated in the first year after a traumatic brain injury. This saving was made due to the ability to return patients to greater levels of independence and more economic community care compared to hospital costs. Figures from the American Music Therapy Association revealed a range of hospital and care costs savings by introducing NMT. Their study reported that children, on average, left intensive care facilities five days ahead of schedule, saving around £7000 per patient. They also found NMT helped reduce anxiety and agitation in hospice patients leading to a reduction of falls. NMT also had a 100% success rate in eliminating the need for sedation for paediatric patients receiving EEG tests. So there is a wealth of information out there which concludes NMT is a cost-effective method of rehabilitation.
How does neurologic music therapy fit within mainstream rehabilitation programmes?
We’re passionate about working with other health care professionals to provide a multidisciplinary approach to rehabilitation for patients. Our main goal is to improve the outcomes for those living with acquired brain injuries and NMT is an incredibly effective tool to do this. However we do recognise that rehabilitation requires a range of services and care and so we work closely with nurses, physiotherapists, occupational therapists and carers, amongst many other health care professionals, to maximise treatment for patients. We truly believe in a multidisciplinary approach to rehabilitation and our therapists already work side by side with a variety of health care disciplines in rehab centres and hospitals across the UK.
What more needs to be done in terms of research to further improve the effectiveness of neurologic music therapy?
In terms of building the research around NMT, any new evidence simply adds to the 100s of previous articles and studies. What has to happen now for NMT to increase its effectiveness is for NHS and other rehabilitation services and organisations (The Stroke Association, Parkinson’s UK) for example to grab the intervention with both hands and go for it! This is what Chroma is doing across the UK, and internationally with centres of expertise in the USA, Australia and elsewhere.
