Source: Therapy Times
Music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals by a credentialed professional who has completed an approved music therapy program. The music therapy field is continually adapting new music, interventions, and instruments to provide therapeutic opportunities to the increasing number of special populations. The sansula and kalimba have recently been implemented in a variety of music therapy settings with interventions such as: active music making, relaxation exercises, and individual or group musical performance.
Music therapists utilize the kalimba as a vehicle to improve communication, increase group cohesion, encourage creativity through spontaneous music making, and to use as an alternate form of self-expression. This article outlines the music therapy applications of the kalimba and sansula both locally and globally with the following populations: traumatic brain injury, hospice, deaf/hearing impairment, hospital and special needs populations.
Traumatic Brain Injury
The kalimba and sansula both have shown effective outcomes when utilized with people with traumatic brain injury in both group and individual sessions. Brain injuries present with varying levels of functioning; however, these instruments accommodate all levels of abilities and are easy to play while promoting both gross and fine motor skills. In the group settings, clients play the kalimbas in succession to form chord progressions for client-preferred songs. The clients wait for their turn to play along as the therapist cues the chord changes. Guitar, piano, and other instruments also add a pleasing accompaniment quality.
The aesthetic sound of the sansula successfully facilitates relaxation. The reverberating nature of the drumhead captures the resonance and allows the player to direct the sound. For progressive muscle relaxation, the sansula is placed over each part of the body that the therapist describes to the client to focus on relaxing.
Vibro-tactile massage is another method of relaxation, which can be executed (with client permission) by placing the sansula on the client’s back and playing slowly as the vibrations massage the spine and surrounding muscles. The sansula is simple to manipulate while reciting a guided relaxation exercise and still maintains the quality of the sound.
In individual sessions, the kalimba and sansula can be played together or with other instruments. The music created is used to express thoughts and emotions in the absence of words. A therapeutic intervention called “Kalimba Conversation” promotes turn-taking goals; as one plays, another listens, and then participants switch through non-verbal cuing in the music.
For “Kalimba Mirror,” one person plays a short musical phrase and the other imitates the phrase back; then switch leader positions. Here are testimonials from clients with traumatic brain injury.
“I like using the kalimba in music group because we can all play them together and sound real good like a band!” “I have only played the kalimba a few times, and I enjoy it because each time I can create a new melody that sounds different than what I played before.”
Sansula in Jamaica
In June 2010, music therapist Rebecca Vaudreuil provided services at Portland Parish of Jamaica with the Jamaica Field Service Project. The sansula was used in the following settings: hospice/infirmaries and schools for deaf/hearing impaired youth. The residents at the infirmaries suffer from the symptoms and results of long-term and untreated diabetes. Some of the ailments include, but are not limited to: blindness, paralysis, amputation, severe physical and emotional pain and distress.
The sansula was used for relaxation and physical stimulation. Due to the lack of medical treatment and care staff, physical touch can be painful and massage and/or posture adjustments are often overlooked. The sansula’s sound and vibrations provide a method of touch and corporeal stimulation for the older adults experiencing chronic pain.
In working with the deaf students, the sansula is used to provide sound vibrations both physically and through distant resonance. In holding the sansula around the student’s head and ears, they are able to sense the vibrations of the music made by the sansula.
When directing sound through the instrument on the student’s body, they are able to feel what their audible impairment prohibits them from hearing (Photo 5). Much like with drumming, the deaf students gain an alternative method to experience the sounds of the music that they are producing. For these students, what an accomplishment.
Kalimbas in Cambodia
Resounding Joy Inc. (501(c) (3) non-profit organization based in San Diego. Music therapists traveled to Siem Reap, Cambodia with Paul Grossfeld, MD, of University of California San Diego (UCSD) and the cardiac surgical team through Variety Children’s Lifeline. Music therapists Alexandra Field and Noelle Pederson each volunteered nearly sixty hours of their services to twenty patients receiving patent ductus arteriosis (cardiac) surgeries and their families at Angkor Hospital for Children.
Intervention goals primarily focused on relaxation and pain-management, normalization of environment, and diversion from the hospital experience. The therapists compiled detailed-oriented numerical and anecdotal documentation. Grossfeld stressed the importance of “keeping the patients calm to prevent their bodies from entering a hypertensive state post-surgery.”
Sedation and medications can be administered to prevent hypertension; however, music therapy techniques offer a natural and holistic alternative. The therapists used a variety of relaxing melodic mediums to create a comforting, supportive, and relaxing atmosphere for approximately forty people in a one-room surgical unit; among them was the kalimba.
Post-operative data was collected from each patient’s heart monitor every five to fifteen minutes to gauge increases and decreases in the heart beats per minute (bpm). The therapists matched the tempo of the kalimba music to the patients’ heart rates and gradually decreased the speed to entrain the heartbeats to a more relaxed rate.
The medical staff watched in amazement as a patient’s pre-session heart rate was monitored at 146 bpm and was down to 107 bpm post-session after one hour of musical relaxation listening and interactive play. This occurred throughout the sessions and the staff took several photographs and repeatedly acknowledged the power that the music therapy interventions produced.
Sound Minds Teen Parent Program
Resounding Joy’s Sound Minds is an early-intervention program encouraging teen parents to bond with their babies. These music therapy sessions are located in school settings and use music to address goals necessary for child development while teaching the young mothers how to use music with their children to help them relax, learn, and develop.
The program’s lead therapist, Noelle Pederson is a strong advocate for use of the kalimba and sansula stating: “The kalimba and sansula are great with this population. It is incredible to watch the process of the teen moms realizing that they are the ones calming their babies by playing relaxing music on the kalimba and humming along. The babies look up at their mothers with a look of wonder as their eyelids become heavy until they fall asleep. The music creates a bond among the mothers too; one teen will play the sansula while the other moms hold, rock, soothe, sing, and coo with their babies.”
This article has only scratched the surface of possibilities for using the kalimba and/or sansula in the music therapy practice. Music therapists from MusicWorx Inc. and Resounding Joy Inc. recommend tuning the kalimbas to a pentatonic scale to increase accessibility for clients; creates a success-based scale with “no wrong notes”. It is the hope of these music therapists that these instruments will continue to be utilized with more diverse populations and provide high quality, enjoyable, and musical opportunities.
Noelle Pederson BA, MT–BC, is currently in her third year as the Director of Education and Training for Resounding Joy, and she is the lead therapist for MusicWorx. Rebecca Vaudreuil BM, NMT, MT–BC is on staff at both Resounding Joy and MusicWorx. Barbara Reuer PhD, MT–BC is CEO and owner of MusicWorx Inc., a music therapy consulting agency in San Diego county and serves as the Executive Director and Founder of Resounding Joy Inc.
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