Music Therapy Case Study

Peter (name changed) is a gentleman in his 40s who has severe learning disabilities. He was very anxious meeting new people and going to unfamiliar environments and was referred to music therapy by his mother to help develop his confidence and give him a means for self-expression. Peter, from an early age enjoyed singing familiar songs such as nursery rhymes and Christmas carols and music has been a great source of enjoyment and meaning to him.

At the start of therapy Peter was very shy and appeared quite fearful, standing very close to his support worker or going into the corridor, returning for only a short time to sing songs with the therapist. When in the room, Peter preferred to stand rather than sit at the piano, where he became more withdrawn and found it difficult to participate. Peter was never pressured to sit down, however as therapy progressed and trust developed, Peter started to move a chair next to the piano so that he could play alongside the therapist.

Due to Peter’s love of singing, this was chosen as the starting point of therapy. Peter was initially offered familiar songs such as “Oranges and lemons”, but sometimes  was too shy to sing at all. Gradually as Peter got to feel more comfortable with the therapist he began to sing more words and was able to choose which songs he wanted to sing, saying either the first or last words of the song title. Over time the therapist introduced popular music as more age appropiate for Peter, including songs from The Beatles, Queen and Bob Marley. Peter enjoyed singing them with the therapist and began to clearly express which songs were his favourites, through ignoring choices he did not want and saying the song title he did. Peter was now able to sing short phrases in songs rather than the occasional word, and as he became more assured, he no longer needed to go into the corridor and would spend the entire session in the therapy room.

As Peter’s confidence in singing grew, it was observed that he was starting to initiate using his own words in sessions to express aspects linked to his appearance or places he had visited, for example saying “shoes” or “park”. Through creating a song about his week, Peter was able to reflect upon activities he had participated in. For example, when he visited a local park, Peter was able to comment on what he had seen such as ducks, deer or flowers and was also able to talk about what he had drunk e.g. cup of tea or juice, which were then incorporated into the song. The therapist felt it was important to give Peter an opportunity to express and voice aspects of himself and places he had visited, which were meaningful to him.

Being able to trust and feel comfortable with adults supporting him is of great importance to Peter. This was observed as the therapeutic relationship grew and developed between the therapist and Peter, and he became more confident to try new ways to make music using different instruments. Using a familiar song “Music Man”, Peter chose to play different instruments for short periods of time, in particular the horn, piano, guitar and xylophone. Through providing a musical structure with gaps for Peter to play, his music making became more confident, and the length of his playing also increased. This resulted in Peter sitting down at the piano during one session of his own accord, and playing a few notes which then turned into an improvised piece of music with the therapist playing next to him. Using improvised play on the piano is now a major feature in the sessions and Peter is able to incorporate this when familiar songs are used or when the therapist introduced a structured improvised piano piece, further demonstrating growth in his confidence and ability to express himself.

Peter’s story highlights how he has engaged so positively in music and how it has helped him to develop skills, confidence, relationships with others, and to make clear choices for himself, whilst giving a means of creativity, self-expression and different ways of communication through music-making.