Insight-Oriented Music Therapy with Elderly Residents

By Short, Alison E. | Australian Journal of Music Therapy, Annual 1995 | Go to article overview

Insight-Oriented Music Therapy with Elderly Residents


Short, Alison E., Australian Journal of Music Therapy


Abstract:

As approaches to therapy change, and the body of information about needs and issues of the elderly continues to develop, it is useful to consider the design and implementation of insight-oriented approaches (Wheeler, 1987) to music therapy programs with the elderly. Current issues for the elderly form a composite with past and future issues, any of which may emerge during a music therapy session. They may include, for example, unresolved experiences from the past, or anticipation of death, and/or current problems relating to health and peer loss. These issues may be interfaced and addressed using an insight-oriented music therapy approach (Wheeler, 1987). In the current approach, song-related material is developed, which is aimed at addressing issues of elderly residents and enhancing re-educative and reconstructive goals (Wheeler, 1987). Making strong use of the isoprinciple, song categories and outlining a paradigm of music therapy with the elderly, a typical entire session is discussed section by section and results are analysed in terms of group mood, interactions and issues. The long-term benefits of this program of music therapy with the elderly and difficulties which may arise are discussed, and recommendations for further research are suggested.

Introduction

Current research trends in areas such as gerontology and geropsychiatry are broadening and expanding our understanding of the needs of the elderly. Much of the literature in the field of music therapy practice with the elderly focuses on client needs as relating to increased sensory stimulation and music-related physical activities (Lynch, 1987; Bright, 1981; Liederman, 1967), a level which Wheeler (1987) classifies as activities-orientated music therapy. However, it is useful to consider research from related areas into the needs and issues of the elderly, in relation to Wheeler's second and third levels of insight-oriented music therapy (1987) which are based on psychodynamic principles. It seems that there has been very little reporting of music therapy used with the elderly in this way, and it is the purpose of this article to outline a music therapy program and theoretical paradigm directed at addressing needs and issues of elderly residents at an insight-oriented level, via the use of song-related material.

Needs and issues of the elderly

As background, it is useful to define the needs and issues of the elderly clients. Psychotherapists often speak of the issues of the client, whereas music therapists traditionally base their goals on the needs of the client. An issue may be "a matter not finally settled and on the settlement of which something else depends" (Gave, 1986, p. 1201), whereas a need may refer to "a physiological or psychological requirement for the maintenance of the homeostasis of an organism" (Gave, 1986, p. 1512). Combining these two concepts, it becomes clear that the need for the client is encouragement and assistance towards the resolution of issues. Insight may be defined as "the power or act of seeing into a situation or into oneself" with "immediate and clear learning that takes place without recourse to overt trial-and-error behaviour", and includes "the fact of apprehending the inner nature of things or of seeing intuitively [with] clear and immediate understanding" (Gove, 1986, p. 1169).

Elderly clients may have many issues which may relate to aspects of their past, future or present (Short, 1992a). Clients may or may not have conscious understanding or insight into their own issues, and may have issues from various areas intermingled at different times and in different configurations. A composite of the client's issues may appear in the responses and reactions within the music therapy session.

Past

As clients progress through life, they bring with them unresolved issues from the past. Issues of relationships and communication may relate to their primary family--mother, father, siblings and other close relationships. …

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