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Neuro rehab therapies

Music therapy sessions and songwriting

Chroma discuss how it can be a valuable tool in self-expression after brain injury



Rachel Robbins, music therapist at Chroma, uses songwriting in her music therapy sessions as a means of supporting client self-expression


Following a brain injury, trying to engage someone to write a song can be difficult, so it is a good idea to approach the session by asking the client, “What kind of songs do you like? Should we listen to those songs?”  Through listening to those songs, Rachel attempts to match the lyrics with the client’s feelings.

Rachel may also use the ‘fill in the gap’ technique, whereby she will ask the client: “What is your favourite food or favourite thing on TV?” She writes down their responses, puts it together and reflects it back to them as an improvised song.

Reflection in this way is a powerful process. Adding the lyrics to a song they are familiar with is not distracting, so when playing it back to them, clients are emotionally moved by it. Just four to five lines in a song proves it to be a very reflective tool.

Songwriting is always a work in progress. It may be revisited the following session to reflect upon, find a new perspective, or add another line.

If the client has the capacity to understand what is happening during sessions, Rachel may begin with a bubble diagram with what makes them, them – family, the accident/injury etc, which provides a lot of information and brings up feelings. Singing back is a great means of self-expression but for some it is too painful to sing.

For some clients, such as those who experience psychotic episodes as a result of their brain injury, find that songwriting minimises the chaos and confusion in their mind. It is also effective for those who have issues with aggression and frustration following personality changes due to the brain injury.

Rachel said: “Songwriting is a great tool for expressing emotions. Within each session, I usually frame captured lyrics on the guitar or piano. The whole session is not songwriting. I will also incorporate the keyboard for functional exercises – dexterity. And there are options of instruments for them to play.

“In a typical session, I may include some NMT techniques to maintain engagement. Singing songs, especially ones they enjoy are an effective means to hold engagement. I may even use a timer for the sessions. Or start with a song and end with the same song to frame that session – it all depends upon each individual client as to how I frame the session. But there is always a fluid flow – songwriting, singing, playing instruments, with conversation in between.

“For a successful therapy session, as a therapist it is important to go with a plan but to be prepared for its path to change depending on the client’s mood, engagement etc.

“It is necessary to be flexible and fluid with different techniques ready to be implemented at any time to give the client the best outcome from each session.”

To learn more, speak with Chroma