Case Examples

All case examples are written by Belltree therapists and edited to protect the identity and confidentiality of the client.

Working with an adult with a developmental disorder

Emma is in her 30’s. She was born with Williams’ syndrome, a diversity of chromosomes with a distinctive cognitive profile. Although she has a moderate learning disability, Emma also possesses an exceptional auditory memory for words and music and a unique way of expressing herself. She, as others with Williams’ syndrome, can be highly sociable, enthusiastic and empathetic but with an undercurrent of anxiety related to social situations.

Emma was initially referred to Belltree for music therapy because staff at the home she shared found it difficult to find activities which she found meaningful enough to engage her for any length of time. Also, because of her love of music.

Early sessions were characterised by Emma’s anxiety in a new social situation. She was reluctant to explore the instruments. However, as we gradually built up trust, Emma became more and more adventurous and spontaneous in our shared music making. Whilst we explore many themes and emotions depending on what is happening from week to week, the majority of our shared music which is made up on the spot, is joyful, humorous and exciting. Emma makes up rhyming songs, plays piano, drums, cymbal, xylophone, and dances.

Part of a recent spontaneous song went like this:

“I may be right, I may be wrong, jump up and down and sing this song. Clap your hands and turn around, come on now, don’t turn a frown!”

Emma’s confidence in herself and her music has grown in the three years we’ve been working together. Music therapy is a place where Emma’s enthusiasm can really flourish and find expression.

Emma says:

“Our music is a celebration of life. It’s an achievement. Our music has grown and changed through the years. Music changes me.”

Working with an adolescent with autism

I began working with Tim (then 13), three years ago. The sessions have taken place once a week, during term time, at Tim’s school which is an independent school for children with Autism.

The first time we met, Tim wore a dark hoodie, covering most of his face. He communicated by nodding and shaking his head. He was shy and withdrawn and did not want to play any of the instruments I offered him. Therefore, I introduced recorded pop music and invited him to play along with me on tuned and percussion instruments. Tim began to show an interest in the guitar, and I brought 2 guitars to the next session. We played together, along to the recorded music. A few weeks later, Tim brought his own guitar to the session.

By now he was communicating more, and we were having brief conversations about music, and he was bringing his own choice of music to the sessions. His hood was now down, revealing an open friendly face with a wide smile. For months, Tim played like a rock star, with freedom, passion, and dexterity. I joined him on the keyboard, on the African drum, drum kit and on the guitar, helping to join the dots and make sense of the music. I took his music seriously. I praised him and listened to what he had to offer. His confidence grew and he began to blossom.

Tim began having guitar lessons and I noticed that suddenly, his music started to make sense. He had learnt some chords and some riffs, and I was genuinely impressed. His rock star style continued as before, and his confidence and sense of self continued to grow. He revealed a sharp sense of humour, and I observed him walking around the school with his head held high, cheerfully greeting his teachers and peers.

Tim now brings music that he listens to at home to share with me. We talk about how the music makes him feel, and what it means to him. He recently shared with me some music that he wrote and explained that it was inspired by heartbreak. Tim’s confidence, ability and self-belief has grown to the extent that he was recently able participate in an open mic session at a local pub, accompanying a singer on guitar. Both he and his family are so proud of this achievement which demonstrates a significant increase in self-confidence and self-esteem.

During our time together, I have found myself wondering about the impact therapy was having on Tim. This often led me to thinking about the therapists’ role, being to provide a safe, nurturing space for their client. Somewhere that they can build trust, form a healthy attachment relationship which is non-judgmental and wholly accepting and which facilitates them to create and explore, build a sense of self-worth and autonomy and to realise their potential. Tim’s case is a reminder of how the therapeutic relationship, of simply being with a client, understanding their communication, and finding a way of being with them through closely observed attention, can be enough to elicit positive change.

Tim and I are still working together. Tim remains enthusiastic and continues to enjoy the sessions. As do I.

Working with an adult with a range of challenges to their physical and mental health

Maria lives with a range of challenges to her physical and mental health. Suffering from fibromyalgia, PTSD and recently diagnosed as autistic, she can be easily overwhelmed emotionally and can find it hard to assert herself.

Maria referred herself for some vocal psychotherapy sessions. She was feeling extremely socially isolated, anxious, and felt she had lost touch with herself. Through breathing and vocal exercises, she began to reconnect with her singing voice and also give time to some of her underlying feelings which were causing her to feel overwhelmed.

As Maria felt increasingly safe with me, her confidence to explore her singing voice grew and she began to improvise with the support of my voice, and accompaniment on the piano. Maria selected which chords she wanted me to play on the piano, to reflect her emotional state and help her connect with her inner world.

Through our vocal improvisations, Maria was able to go on a very personal journey which connected her with the powerful feelings which were affecting her outlook on life and ability to cope. Through singing about these feelings with and without words, she found some clarity about what was most important to her and the things which gave her strength. Maria was able to connect very strongly with a sense of home-coming, to herself but also to a time in her life when she had been happier and more fulfilled. Through hearing and exploring her singing voice within the therapeutic relationship, Maria found an inner strength and optimism which she thought had been lost.

After just a small number of sessions Maria felt stronger, happier and more motivated to live a fulllife.

She says:

“I felt huge value in knowing that Tina is also an experienced psychological therapist, and I instantly felt very safe in the room with her. She is very professional but also empathetic. During the sessions I opened up completely. With Tina guiding me and holding space for my thoughts, I felt safe. I felt no shame or negative emotions around the things I spoke about or felt during the sessions."
"Walking out of the sessions, I felt immediate relief. My time with Belltree helped me come home tomyself. I feel reconnected with my voice and now have the confidence to use it. I am happy that Tina has helped me to open my voice again. I even find myself singing out loud sometimes and am far less self-conscious about this than I have been in the past.”

Belltree’s Specialist Services

In addition to traditional Music Therapy, some members of our team have additional training and specialisms:

Vocal Psychotherapy – is a specialist form of music therapy which uses breath, vocal sounds and singing in combination with talking to explore the client’s inner experience. Based on Jungian principles, and founded by Dr Diane Austin, vocal psychotherapy enables the client to develop a deeper sense of integration between past and present and a greater capacity to recognise and manage their emotions. Singing together with the therapist offers the client new ways of relating with themselves and others, and explore issues with identity, intimacy and being ‘seen’. Vocal psychotherapy is a trauma-focussed treatment which offers the client a safe space to explore painful memories and opportunities to repair psychological wounds.

Neurologic Music Therapy – Neurologic Music Therapy ® (NMT) is an evidence-based treatment system that uses standardized, research-based techniques to treat the brain using specific elements of music such as rhythm, melody, dynamics, tempo, etc. The Neurologic Music Therapist is a stimulus specialist who is trained in the neuroscience of music perception, music production/creation, and music cognition. The Neurologic Music Therapist uses standardised techniques to address non-musical goals such as speech, physical movement, cognition, and other functional abilities. The therapist focuses on the music as therapy, emphasizing specific elements of music in the construction of therapeutic exercises as research so indicates, to optimise function and/or reroute neuropathways to achieve functionality.

Research has shown that rhythm and music are able to prime motor, cognition, and speech and does so at a subconscious level. Music can be used to help build new connections in the brain (called neuropathways) thus improving brain function and allowing one to lead a more productive and functional life.

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