Music therapy with patients in low awareness states: Approaches to assessment and treatment in multidisciplinary care

Abstract

This paper outlines the rationale for and role of music therapy as a clinical intervention and diagnostic tool in multidisciplinary (MDT) rehabilitation programmes for patients in low awareness states. A review of the literature indicates that music is a useful clinical tool in stimulating a range of behavioural, physiological and expressive responses in patients in low awareness states. Referral criteria for music therapy with this patient group are provided, along with suggested methods for collaborative multidisciplinary work. A case vignette is presented of a client whose diagnosis of vegetative state (VS) was contradicted by her purposeful responses within music therapy assessment, contributing towards a changed diagnosis to minimally conscious state (MCS). The case illustrates the particular role of music therapy in assisting with diagnosis in complex cases. Music therapy provides a clinical forum in which recovery of function can be assessed in an informal way, using a medium which does not rely on language, is non-evasive and elicits emotional responses.

Acknowledgments

The author would like to thank the patient and family whose case vignette has been included in this paper, and Barb Daveson, Head of Music Therapy at the Royal Hospital for Neurodisability for her helpful comments on this paper.

The Royal Hospital for Neuro-disability received a proportion of its funding to support this paper from the NHS Executive. The views expressed in this publication are those of the authors and not necessarily those of the NHS Executive.