Startts - NSW Service for the treatment and rehabilitation of torture and trauma survivors  



Self Care for Teachers

> Rosemary Signorelli is a Registered Music Therapist, Psychotherapist, Occupational Therapist at STARTTS

In part I of this 2 part series, we looked at how music and movement can engage and help to regulate the survival system. The focus was on using music to help the child feel safe or to create a balance between the various stress responses.

In this part we will look at how music and movement work in the other stages of recovery, to enhance normal developmental processes, and to help children move forward from their trauma experiences.

Music Therapy and other music and movement activities can provide an integrating experience involving sensory, motor and verbal expression, and can address individual, family and community goals. Music and movement activities can bring together mind, body and relationship, and sit very well within the STARTTS bio-psychosocial model. The activities may include singing, instrument playing, rhythmic movement and dance, listening to music, and song writing. They may involve social engagement with other children (in teams, choirs, bands, dance or other physical activities such as Capoeira), or community activities.

These activities can serve all three components of Judith Herman’s trauma recovery model, including safety, remembering and mourning, and reconnection.

When working to establish and maintain safety, activities will be guided by the child’s musical preference, either drawing on the child’s own cultural heritage or on western music. Opening and closing songs or other musical rituals can provide structure and a boundary for the session. Attention may be given to the use of specific harmonies, scales, holding rhythms, drones, and avoidance of musical triggers. Strategies to manage triggers were covered in part I of this article. Other safety strategies include the setting of group rules, and the use of musical holding techniques, such as the use of tonic dominant underlying harmonies and the pentatonic scale.

When aiming to assist with remembering and mourning, once safety and the means to maintain safety are well established, children may be invited to bring songs, or write songs, that have special meaning for them, and to share them with the therapist or the group. For older children, the writing of rap songs is very accessible and does not require advanced musical knowledge. The steady rhythm can provide a holding and regulating feature for the exploration of the meanings and feelings. Another simple songwriting method is to change the words to a familiar tune. This stage of the recovery process needs to be monitored and facilitated by an appropriately trained and experienced counselor or therapist, who can ensure that safety is maintained.

All of these shared activities will also contribute to the reconnection component of the recovery process, whether on a one-to-one basis with the teacher or therapist, with a group of other children, or with a wider community group. Safe reconnection will be based on respect for differences and also in the universality of the musical interests and content of the shared songs. Group excursions to concerts, or other venues such as the Sound House Museum to look at electronic music equipment, can further enhance reconnection.

A brief look at the ARC model gives a useful framework for this work with traumatized children, but especially in the early childhood age group. ARC stands for Attachment, self-Regulation, and Competence.

Attachment activities can include work with infants and preschool children, with their parents and other care-givers. Parents can receive support, enjoy seeing and sharing in their child’s enjoyment and engagement, can learn about the importance of attachment and learn some new developmentally appropriate activities to do with their child. Peekaboo games, songs that include hiding and finding instruments, and games in which people or objects fall and rise up again, help with addressing separation anxieties. Attachment needs are also served with school aged children and adolescents through the relationship with the teacher, counselor or therapist, and relationships with other children. For all ages, call and response techniques, improvisation and imitative activities can encourage listening, turn taking, interactive behaviour, communication and relationship in the ‘the here and now’.

These techniques also enhance self-regulation and co-regulation. Other self-regulation activities can include stop-start songs and games, loud-soft, fast-slow, listening activities, and the use of steady rhythms. Hand signs can be used for “stop’, “wait” “my turn”, “your turn” and “finished”. In early childhood activities, children more easily follow instructions that are sung, and a pack-away song, using the simple soh-doh-la tune (like the “Rain, Rain Go Away tune) increases the child’s cooperation. Parents can carry this strategy over at home, changing the words to suit a specific daily task. The parent also gains confidence, calmness and self-regulation in coping with behaviour challenges with their children, and their calm demeanour can then be more easily mirrored by the child. Self-regulation is also enhanced by the use of music activities that can bring about a balance in the sensory and stress response systems, as described in Part I of this 2 part article.

Competency is enhanced through these and all age appropriate music and movement activities, as children gain fine motor, gross motor, social, emotional, cognitive, language and self-regulation skills.

Another aspect to consider in using music and movement is how to match the activities with the child’s developmental stages, as outlined in such develomental models as Stanley Greenspan’s Floortime DIR model, and Bruce Perry’s Neurosequential Model of Therapeutics.

The Floortime DIR model is a team approach which was developed specifically for work with children with special needs, but can be applied to work with children with emotional and social difficulties. Greenspan describes 9 stages of emotional functional development, all driven by affect and relationship. Each child is recognized to have individual differences in their central nervous system functioning, which are expressed in their sensory processing, motor planning, sequencing, affective, cognitive and learning processes.

Development progresses from shared attention, engagement and regulation, two-way purposeful communication, through affective reciprocity and gestural communication, to shared social problem-solving and eventually more complex cognitive and social abilities. By 10-13 years of age, the child can engage in logical and abstract thinking, multicausal and comparative thinking, reflection and expression of feelings. All of these stages can be matched by appropriate music and movement activities.

Within Bruce Perry’s Neurosequential Model of Therapeutics, the child’s strengths and weaknesses are identified in relation to his or her development at the levels of brainstem, cerebellum, limbi, cortex and frontal cortex function. Bruce Perry refers to the use of music and movement activities at all these different levels of the central nervous system. Therapeutic activities are tailored so that development can progress from the lowest brain level, upwards through the other levels of brain organisation.

Following this sequential approach, the first musical activities, based on brainstem function, would be those involving steady repetitive, patterned sensory input, such as massage to music, playing a steady beat on drums or other percussion instruments, swaying, bouncing, singing and humming. Activities at the level of the cerebellum could include fine motor activity with age appropriate percussion instruments, and gross motor activities involving walking, running and jumping songs, dance and more complex rhythms. Activities related to the limbic stage of development could include working in teams, taking turns, sharing, music games and more complex movement.

Working at the cortical level could include storytelling, music drama, songwriting, and improvisational playing and singing. At the frontal cortex level, activities could include reflection on the meaning of shared songs and the group’s musical activities.

In conclusion, in working with children impacted by trauma, music and movement activities can be tailored to several bio-psychosocial, recovery and developmental models. The various recovery components and activities require different degrees of monitoring and therapeutic facilitation to ensure safety and the appropriate outcomes for the child.

If you have questions about this article you can contact Rosemary at Rosemary.Signorelli@sswahs.nsw.gov.au

> Rosemary Signorelli

Rosemary is a counselor and music therapist at STARTTS. She also has extensive private practice experience with children and adults with special needs, and in early childhood music teaching and music therapy programs. Music Therapy is the planned and creative use of music, facilitated by a registered music therapist, to attain and maintain health and well being. People of any age or ability may benefit from a music therapy program regardless of musical skill or background. The focus on meeting therapeutic aims distinguishes music therapy from musical entertainment or music education. The therapeutic process allows an individual’s abilities to be strengthened and new skills to be transferred to other areas of their life.

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