Music is proving a valuable treatment for people with learning and physical disabilities. Now the Republic is about to get its first purpose-built room for music therapy, writes Arminta Wallace
When we enter it the room is silent, its pale lilac walls exuding an airy calm. Scattered about the floor, however, are musical instruments whose presence ensures that, if you wanted to, you could produce one heck of a noise in this modest space.
Drums, cymbals, a piano, a guitar and a xylophone are among the more familiar; on the exotic side, what looks like an oversized wooden flute turns out to be a rain stick. When I shake it, it produces a sound so like that of rain that I glance instinctively, and somewhat guiltily, at the ceiling.
The transparent skin of an "ocean drum" reveals an inner core of tiny stainless-steel balls that, rolling lazily around inside, recreate not only the sound and the look but also, somehow, the feel of waves breaking on a shore.
Within these walls, clearly, music is a three-dimensional experience, something to see and touch as well as to listen to.
The purpose-built music therapy room at Cheeverstown House in Templeogue, Dublin, which will be officially opened this week, is the first of its kind in the Republic of Ireland. That it exists at all, says Tracey Jones, Cheeverstown's full-time music therapist, is a tribute to the parents of those who have passed through her sessions over the past three years.
"They pushed for the room - and for my full-time post, come to that," she says. "Parents of children with physical and learning disabilities in Ireland have to push for everything." Like a proud parent herself, she points out the miniature entrance hall, which allows disoriented or reluctant clients to enter the room gradually or opt out for a moment if things get too much for them.
"And do you like this?" Her colleague Jim Cosgrove, who works here one day a week, is beaming out from behind a Z-shaped nook. "Sometimes children play peekaboo games with us from this corner. Music therapy can be about that sort of behaviour too: come in, withdraw; there, not there; sound, silence."
But what is music therapy, exactly? A science that is still in its infancy is one answer. In the UK in the early 1960s, special-needs teacher Clive Robbins and composer Paul Nordoff began to experiment with musical improvisation as a way of communicating with children who had learning disabilities. It quickly became evident that because it can bypass language and tap directly into the emotions, music can evoke responses in many children who fail to respond to traditional verbal or even visual stimulation; it appears to be especially effective in helping autistic children to relate to others and to the world around them.
The therapists use specially composed "hello" and "goodbye" songs to give structure and familiarity to the sessions, during the course of which they try to find music to match their clients' emotions. Sadness, anger, joy and pain can all be expressed very straightforwardly through music, which has obvious advantages for those who can't use language. And the discipline of developing even simple musical rhythms and melodies introduces the notion that emotions don't have to be overwhelming, that they can be worked on, played around with, then put away for another day.
The first formal music therapy training course, at the Guildhall in London - of which Cosgrove is a graduate - was set up in 1968. Since 1998, Ireland has had a master's degree course in music therapy at the University of Limerick, and there are now about 22 therapists at work in the Republic, most of them part-time. To qualify as a music therapist you need a degree in music or, at least, a very high level of musical proficiency. Then, says Jones, you need to forget everything you've learned at college.
"I think that's the hardest part of music therapy training, learning to let go of the rules. You would never, for instance, suggest to a client how they should play an instrument. There is no right or wrong way."
Cosgrove nods. "You might find the rain stick being used for a tug-of-war-type game or for rolling back and forth on the ground," he says. "A guitar might become a little person which walks along beside a child" - he demonstrates, bouncing the instrument jauntily along the carpet - "or they might knock on the sound box or pluck a string and listen to the sound fading away. They'll come to it in some weird and wonderful ways."
For Cosgrove, music therapy is perhaps best defined by stating what it isn't. "Music therapy is not music teaching," he says. "It's not about performance or about producing sounds which are aesthetically pleasing. It's not about putting on shows or putting together bands. It's more concerned with the therapeutic process than with what transpires sound-wise in the room. It's to do with emotional utterances and patterns of communication."
The clients need know nothing about music when they arrive, he says - in fact, it can prove a drawback. "The worst thing that can happen in a group is that somebody knows three chords on the piano, because then you're stuck with those three chords and it can be very hard to break away from them. If the person comes with no musical knowledge at all, they explore as a child does, with a sense of wonder."
As clients at Cheeverstown range from babies of nine months to adults with profound learning disabilities, the level of communication varies hugely from one session to the next, as does the rate of progress. For someone who is profoundly learning-disabled, even a second or two of focused eye contact with the therapist will count as a leap forward. Clients are referred from the school at Cheeverstown, from on-site residential care and from day-care programmes.
"Not everyone will respond to music therapy, but I think we all have the ability to respond to the different elements of music: pitch, rhythm and timbre," says Jones. "To see children who are at a very profound level of learning disability start to initiate vocalisation is fantastic."
Because of client confidentiality, the therapists cannot talk about current cases, but Cosgrove remembers one of his most gratifying experiences. It was, he says, with a client who had been referred because of behavioural difficulties.
"He couldn't tolerate being in the same room with me initially and would have thrown the instruments at me," he says with a smile. "And he was a man in his 30s, so there had to be two nurses in the room, just in case. I would go to the other end of the room, and gradually I'd play a bit of piano and then maybe offer a drum, very slowly, to see if he would make a sound. At first it was mostly silence, but over the first five sessions he learned to be able to share space with me.
"After working with that man for a number of years, his behavioural outbursts had come down, although, of course, one couldn't attribute that purely to music therapy, as it was part of a range of treatment."
In a world of funding shortfalls and the need to get ever larger numbers of clients through the system, is music therapy, with its emphasis on one-to-one treatment and slow, hard-to-measure, often roundabout progress, a luxury, the icing on the therapeutic cake?
Absolutely not, says Catherine Jackman, Cheeverstown's principal psychologist. "Since I've experienced having music therapists on the team, I can see what a valuable tool it is to have in your toolbox. A lot of the people I work with will say, 'I can't control my anger,' or, 'I can't control my pain.' Through music therapy they see that they can.
"Music adds a different dimension, another language, which allows more people to access psychotherapy than ever before and in ways that were never dreamed of - and it's fun. For me, quality of life isall about connections to other people. It's not about, you know, do you get a bigger ice cream or an extra ride on the bus or another outing to the cinema?"
Jackman believes that as learning-disability programmes adapt to 21st-century circumstances, music therapy will move centre stage. "All the learning-disability services have a big population between 30 and 50," she says, "and over the coming years there's going to be a huge number of people there who will need continuing care. And we'll have to change as a service. At the moment we always look at rehabilitation and skill gaining, quality of life in that area. What about quality of life for somebody who's going downhill fast or somebody who's dementing? We'll have to ask ourselves, what kind of therapy should we provide for them?"
Music therapy may well provide some of the answers.