MUSIC THERAPY

Indication:
Music therapy is most frequently used to help the mentally or physically disabled. For
example is a patient suffering from speech difficulties or autism, may be enabled to express
themselves more effectively by making musical sounds and music can help people with physical
disabilities to develop better motor control.
Mechanism:
Use of music as an addition to relaxation therapy or in psychotherapy to elicit
expressions of suppressed emotions by prompting patients to dance, shout, laugh or cry in
response.
Materials:

 Cassette/s
 CD/s
 Tape/s
 Stereo/s

Art therapy
Indication:
Art therapy practice is based on knowledge of human developmental and psychological
theories which are implemented in the full spectrum of models of assessment and treatment
including educational, psychodynamic, cognitive, transpersonal, and other therapeutic means of
reconciling emotional conflicts, fostering self-awareness, developing social skills, managing
behavior, solving problems, reducing anxiety, aiding reality orientation, and increasing self-
esteem.
This therapy is an effective treatment for the developmentally, medically, educationally,
socially, or psychologically impaired and is practiced in mental health, rehabilitation, medical,
educational and forensic institutions. Art therapists in individual, couples, family and group
therapy formats serve populations of all ages, races, and ethnics backgrounds.
Mechanics:
Art therapy is defined as a human service profession that uses art media, images, the
creative process, and patient/client responses to the created products as reflections of an
individual‟s development, abilities, personality, interests, concerns and conflicts.
Theories from psychoanalysis and art education are the foundations for the two poles of
the field, which are termed art psychotherapy and art as therapy. Whether the therapeutic
process is inherent in talking about a work of art and in expressing oneself or in the specific act
of creation has been a subject of considerable debate. Most art therapists find that they draw
 from both approaches, modifying what they do or emphasize according to the population with
which they are working.
Materials:

 Crayons
 Bond papers
 Water colors
 Pastels
 Scissors

Psychodrama
Indications:
Psychodrama is a therapeutic discipline, which uses action methods sociometry, role
training, and group dynamics to facilitate constructive change in the lives of participants.
Psycho-dramatists provide services to diverse groups from children to the elderly, and from the
chronically mentally ill to those seeking understanding and learning in their work settings.
Mechanics:
By closely approximating life situations in structured environment, the participant is able
to recreate and enact scenes in a way, which allows both insight and an opportunity to practice
new life skills. In psychodrama, the client focuses on a specific situation to be enacted. Other
members of the group act as auxiliaries, supporting the protagonist in his or her work, by taking
the parts or roles of significant others in the scene. This encourages the group as a whole to
partake in the therapeutic power of the drama. The trained director helps to recreate scenes that
might otherwise not be possible. The psychodrama then becomes an opportunity to practice
new and more appropriate behaviors, and evaluate its effectiveness within the supportive
atmosphere of the group. Because the dimension of action is present, psychodrama is often
empowering in a way that exceeds the more traditional verbal therapies.
There are several additional branches of psychodrama. Sociometry is the study and
measures of social choices within a group. Sociometry helps to bring the surface patterns of
acceptance or rejection and fosters increased group cohesion. This surfacing of the value
systems and norms of a group allows for restructuring that will lower conflicts and foster
synergistic relationships. Sociometry has been used in schools and corporations as well as
within the mental health field. Sociodrama is a form of psychodrama that addresses the group‟s
perception in social issues. Rather then being the drama of a single protagonist, this is a
process that slows the group as a whole to safely explore various perceptions. Members might
address problems such as teenage pregnancy or drug abuse, and together arrive at
understanding and innovative responses to these difficult issues.
 Psychodrama seeks to use a person‟s creativity and spontaneity to reach his or highest
human potential. With its perspective on the social network in which an individual lives, it
promotes mutual support and understanding. In explaining his work, Dr. Moreno stated
psychodrama‟s goal: “cannot have less an objective than the whole of mankind.”

Dance therapy
Indications:
Dance therapy is based on the premise that the body and mind are interrelated. Dance
therapists believe that mental and emotional problems are often held in the body in the form of
muscle tension and constrained movement patterns. Conversely, they believe that the state of
the body can affect attitude and feelings, both positively and negatively.
Mechanism:
Dance movements promote healing in a number of ways. Moving as a group brings
people out of isolation, creates powerful social and emotional bonds, and generates the good
feelings that come from being with others. Moving rhythmically eases muscular rigidity,
diminishes anxiety, and increases energy. Moving spontaneously helps people learn to
recognize and trust their impulses, and to act on or contain them as they choose. Moving
creatively encourages self-expression and opens up new ways of thinking and doing.
On a purely physical level, dance therapy provides the benefits of exercise, improved
health, well-being, coordination, and muscle tone. On an emotional level, it helps people feel
more joyful and confident, and allows them to explore such issues as anger, frustration, and
loss that may be too difficult to explore verbally. On a mental level, dance therapy seeks to
enhance cognitive skills, motivation and memory.
Your dance therapist can also address specific problems in specific ways. For example,
to help a patient reduce stress, a dance therapist would first identify how the person‟s body
reacts to stress, and then explore specific movement techniques to increase circulation, deepen
breathing, and reduce muscle tension. Our dance therapy experience will depend on your
ailment, whether you work with a dance therapist in private practice or in the context of a
treatment team. And whether you are the only patient or part of a group. And naturally different
dance therapist has different styles. You need absolutely no previous dance training to benefit
from this therapy.
Generally speaking, however, for the initial consultation, you will meet with the dance
therapist in a dance studio. You should wear comfortable clothing for this and all subsequent
sessions. First, the therapist will talk with you about your needs and your reasons for wanting
the treatment. Next, the therapist may ask you to walk around the studio in order to analyze you
body shape, posture, and movements. Is your body erect or caved in? Do you reach out or hold
yourself in? Do you move in a fluid or restricted way? Finally, dance therapist will discuss your
treatment goals with you and the two of you may arrive at an agreement regarding the duration
and nature of the therapy. You should review your goals with the therapist periodically to see if
you are meeting them.
In your regular sessions, your dance therapist will watch you dance, encourage you to
express you feelings through movement and at times, imitate your movements called empathic
mirroring to establish rapport and make you feel accepted. The therapist may also try to help
you connect your thoughts, feelings and memories to your movements.
If you are part o movements.
If you are part oce therapist will typically assess how the group works together, how you
all interact and share emotional expression through movements and intervene or direct the
action accordingly. For example, the therapist might introduce the idea of leading and following
to help draw a member of the group out of isolation or self-preoccupation. The dance therapist
might also employ equipment such as beanbags, balls, and stretch cloths to explore a theme
like trust.
The number of sessions, both for individual and group work, will vary. You might have to
commit to at least six months of treatment. Depending on the ailment. The sessions are usually
weekly, although this can vary as well.

Sensory Therapy
Indication:
Stimulation, which is produced in the sufficient frequency, intensity and duration excites
the brain, improves the organization of the brain and permits increased functional activity.
Mechanism:
Designing a program for severely brain-injured children in a clinical or school setting is
extremely difficult. At maximum, there are six hours a day, and five or six days a week to work
with a child, which is not enough time for a severely involved child. A severely brain-injured child
should be worked with virtually every waking moment, seven days a week, every day of the
year. In a clinical setting, there is the problem of staff. Staff, which must be paid. At U.C.P., I
had three children for each staff member on a good day, when there were also volunteers, and
five children per staff member on a bad day. The children we were working with could not
provide their own stimulation. If left alone for two minutes, they would fall into an almost sleep-
like state. With a maximum of six hours per day, we could not afford to waste even a minute of
their time.
 The next morning I called a staff meeting and made an announcement. No child shall be
without stimulation for a single minute; from the time he enters the building until he leaves.
Within a week, what had been rather normal looking clinical rooms, were transformed into
maximum sensory environments. The floors became a series of ramps and platforms covered
with padded mats and textured carpets, as well as vinyl surfaces. Mounted on two walls and the
ceiling of each stimulation room was the most exotic light show equipment I could find, so we
could produce vivid moving visual images in every corner of the room. We also mounted slide
projectors, which were synchronized with tape recorders that played into cordless headphones,
so we could supply different auditory stimulation to different children at the same time, while
allowing them movement throughout the room. Each room also had dozens of sponge balls
scattered around the floor, which the staff would throw toward, and at the children. In addition,
two staff members would constantly move throughout the room changing body position,
increasing movement, masking, stimulating taste and smell, and in general, creating as much
disturbance as humanly as possible. This is where the children would stay when they were not
being taken into one of the many individual therapy rooms where they received their specific
individual programs in mobility, language, vision, auditory competence, manual competence,
tactility or academics. The children thrived in this new environment, and progressed at a rate
that amazed me.

 The stimulation provided to the children in these high stimulation environments was great
enough to get through even the poorest sensory channel.
 The children were being provided with specific stimulation delivered with the greatest frequency,
intensity, and duration possible within the economic and social parameters afforded.

Stimulation
As stated earlier, the level of function achieved by an individual is a reflection of the
stimulation and opportunities afforded the individual by his or her environment.

 Brain injury is in the brain. The goal of treatment must be either the creation of function where
none exists, or improvement of function where it is delayed or inhibited.
 Stimulation „excites‟ the brain. What does excitement of the brain produce? Functional activity.
What is functional activity? Breathing, metabolizing food, walking, talking, reading, etc.

Bio-Responsive Multi-Sensory Environment

In its efforts to assist a full range of children, NACD has designed an environment, which
is to be utilized within our facilities for that segment of our clients who are at the lower end of the
continuum of function. The comatose, semi-comatose, or severely brain injured child is difficult
to assist because of the extent of their injuries, their medical complications, and the extreme
difficulty involved in providing such children with sensory input, which is specific enough and
intense enough to stimulate and organize their brain.
The Multi-Sensory Environment is patterned after the environment designed several
years ago for Dawn and for our preschool children. This environment consists of specific intense
visual, auditory, and kinesthetic stimuli that are of such intensity so as to be perceived by
children with only the lowest level of function. Such as environment with its built-in controls will
also be utilized for „normal‟ infants as well, permuting us to provide for their specific
developmental needs.
Greatly enhancing the usefulness of the Multi-Sensory Environment is the application of
bio-monitoring and biofeedback equipment. Such equipment permits the utilization of the
sensory environment as a bio-responsive, Multi-Sensory Environment. Bio-responsiveness
refers to environmental response to biological or physiological action. Bio monitoring is possible
for all of our bodily functions B the electrical activity of our brain, our respiration, circulation,
even the tension within our muscles. By monitoring the child‟s reactions to various inputs, we
can determine just what input is stimulating the child‟s rain, and what is not. Such knowledge
will greatly enhance our effectiveness in designing sensory programs for the severely involved
child.
Biofeedback, as a branch of treatment and rehabilitation, is relatively new. Even in its
infancy, biofeedback technology has proven useful in such areas as the control of seizures,
improving circulation, and changing muscle tone. Biofeedback essentially provides us with
instantaneous feedback as to what our body in doing, thus permitting us to exert influences over
these basic functions that were otherwise unresponsive. This feedback normally is provided by
instruments, which give us visual feedback (lights going on and off) or auditory feedback (tonal
changes or clicks). For the young child or severely involved child, such feedback is
meaningless. However, if such feedback permits the child to control the entire intense sensory
environment B with intensive visual input and intensive auditory input, a well as the very surface
upon which the child lies B we will, hopefully, be able to teach the child to reproduce these
movements.

GROUP THERAPY
Indication
For many clients with mental disorders, who often have difficulty with interpersonal skills.
Contraindication
Patients who are suicidal, homicidal, psychotic, or in the midst of a major acute crisis are
typically not referred for group therapy until their behavior and emotional state have stabilized.
Depending on their level of functioning, cognitively impaired patients (like patients with organic
brain disease or a traumatic brain injury) may also be unsuitable for group therapy intervention.
Some patients with sociopathic traits are not suitable for most groups.
Procedure
In group therapy approximately 6-10 individuals meet face-to-face with a trained group
therapist. During the group meeting time, members decide what they want to talk about.
Members are encouraged to give feedback to others. Feedback includes expressing
your own feelings about what someone says or does. Interaction between group members are
highly encouraged and provides each person with an opportunity to try out new ways of
behaving; it also provides members with an opportunity for learning more about the way they
interact with others. It is a safe environment in which members work to establish a level of trust
that allows them to talk personally and honestly. Group members make a commitment to the
group and are instructed that the content of the group sessions are confidential. It is not
appropriate for group members to disclose events of the group to an outside person.
Preparation
A psychologist or psychiatrist typically refers patients for group therapy. Some patients
may need individual therapy first. Before group sessions begin, the therapist leading the session
may conduct a short intake interview with the patient to determine if the group is right for the
patient. This interview will also allow the therapist to determine if the addition of the patient will
benefit the group. The patient may be given some preliminary information on the group before
sessions begin. This may include guidelines for success (like being open, listening to others,
taking risks), rules of the group (like maintaining confidentiality), and educational information on
what group therapy is about.
After Care
The end of long-term group therapy may cause feelings of grief, loss, abandonment,
anger, or rejection in some members. The group therapist will attempt to foster a sense of
closure by encouraging members to explore their feelings and use newly acquired coping
techniques to deal with them. Working through this termination phase of group therapy is an
important part of the treatment process.
Mechanics of the Therapy
There are two general ways of categorizing group therapy.
First, group therapy can be offered on an ongoing basis or for a specific number of
sessions. In an ongoing group, once the group starts, it continues indefinitely, with some group
members completing treatment and leaving the group, and others joining along the way as
openings are available in the group. Most of these groups have between six and twelve
members, plus the psychologist. There are some psychologists who have had a therapy group
running for ten years or more.
Time limited groups are just as you would expect, limited in the amount of time they will
run. This does not refer to the length of the group sessions, but to the number of sessions, or
the number of weeks, the group will run. Time limited groups have a distinct beginning, middle
and end, and usually do not add additional members after the first few sessions. Most time
limited groups run for a minimum of eight to ten sessions, and many will run for up to twenty
sessions. The length of these groups always depends on the purpose of the group, and the
group membership. The psychologist running the group will structure it to run for the number of
sessions necessary to accomplish the goals of the group.
The focus of the group is another way of categorizing group therapy. Some groups are
more general in focus, with goals related to improving overall life satisfaction and effective life
functioning, especially in the area of interpersonal relationships. These groups tend to be
heterogeneous. This means that the group members will have varying backgrounds, and
varying psychological issues that they bring to the treatment group. The psychologist will select
group members who are likely to interact ways that will help all group members. These groups
tend to be open-ended, because of the nature of the group therapy process. However, some of
these groups are also time-limited, but they may run longer than most time-limited groups.
Other groups are "focused" or "topical" therapy groups. The group members tend to
have similar problems because the group is focused on a specific topic or problem area. For
example, there are therapy groups for Depression, Adult Children of Alcoholics, or Parents of
ADHD Children. Some focus therapy groups are skill development groups, with an emphasis on
learning new coping skills or changing maladaptive behavior. There are groups to help people
develop Stress Management Skills, Parenting Skills, Assertiveness, and Anger Management
Skills, among others. Focus therapy groups can be either open-ended or time-limited groups.
The skill development groups (Stress Management, etc.) tend to be time limited and usually run
between eight and sixteen sessions. The single-issue focus groups (Adult Children of
Alcoholics, Women's or Men's Groups, etc.) may be open-ended or they may run for a specified
number of sessions.
Objectives

1. After group therapy the client will gain inspiration or hope.

2. At the end of group therapy the client will feel or become aware that one is not alone
and that others share the same problems.
3. Provide safety and protection for all the client who attended the group therapy.

Materials Needed
 1. Couple of chairs

COMMUNITY THERAPY
Indication
One‟s personality involved more than individual characteristics, inadequate or
unsatisfying relationship or and schizophrenia.
Procedure
Individual psychotherapy is the modality with one patient and one therapist. This form
offers the most attention to the patients individual concerns however it can be limited in that it
cannot directly study family or social relationships. There are many different styles or
theoretical orientations of therapists such as psychodynamic, cognitive and behavioral.
Family psychotherapy is conducted with all or as many members as possible of a
family. The work may all be done with the entire group or involve various combinations of family
members. The process helps identify and modify maladaptive or destructive interaction patterns
as well as foster group communication and problem solving skills.
Preparation
Patients stay at a residence where they lead a highly structured life. This approach can
be used for substances abusers, or people with severe disorders that impair their ability to
function in normal living.
After Care
The end of long-term group therapy may cause feelings of grief, loss, abandonment,
anger, or rejection in some members. The group therapist will attempt to foster a sense of
closure by encouraging members to explore their feelings and use newly acquired coping
techniques to deal with them. Working through this termination phase of group therapy is an
important part of the treatment process.
Mechanics of the Therapy
This therapy involved patient‟s interaction with each other, practicing interpersonal
relationship skills, giving each other feedback about behavior, and working cooperatively as a
group to solve day-to – day problems.
Objectives

1. Establish satisfying interpersonal relationship during the therapy session.

2. Be able to provide a correct interpersonal relationship for the client.
3. To give the patient the opportunity to respond correspondingly to current problems in a
variety of differentiated situations and to discover and develop the constructive parts of
his personality in various groups and situations.