Case Studies In Music Therapy Case One Like Singing With A Bird: Improvisational Music Therapy With A Blind

Four-Year- Old Edited by Kenneth E. Brusica

Diana Fox Foundations of Music Therapy September 20, 2012

For my first case study review I read about Gabriela. Gabriela was a four-year old girl who had severe developmental delays and physical abnormalities. She suffered from osteopetrosis and as a result Gabriela was blind from an early age. Her head was disproportionately large compared to the rest of her body and it was believed to have caused her physical discomfort when she moved She had little vocalization skills and often echoed phrases or words she heard during the day. She rarely engaged in spontaneous or purposeful speech. Because of her impairments, Gabriela was insecure and vulnerable except for when she was at home with her family. Gabriela had been working with one music therapist named David but was then joined by Jo who attended the sessions for a few months. The music therapists in this case wanted to use clinical improvisation in an open-ended approach to create a rich musical environment. It was in this environment they hoped to encourage Gabriela to use unconstrained selfexpression. An important goal was to bring out Gabrielas in the moment responsiveness. Something she lacked during her everyday interactions. A powerful, harmonious atmosphere was carefully established in hopes to awake the four-year olds musicality. The main goal was to produce a safe world for Gabriela that valued and thrived on acceptance, impulsiveness, and artistic freedom. Music was utilized in several ways for Gabrielas case. In the beginning sessions a name cadence was established for her. This is where we saw Gabrielas first steps towards rhythmic improvisation. As the name cadence theme was being played she started to tap the rhythm of the song. As the tempo changed, Gabriela made the appropriate changes to her tapping. Later on in her sessions new instruments were introduced. This was done to see how she would respond to new sounds. When a violin was brought in Gabriela began to make birdlike calls. The violin was then used in preceding sessions, which prompted Gabrielas journey to discovering new sounds. Gabriela quickly became attached to the violin and it became the gateway to revealing her once concealed harmonic and melodic abilities. (After Gabrielas sessions concluded it was recognized that she could not picture someone playing the violin but that it was another presence in the room.) When the therapists introduced Skip To My Lou using the violin, Gabriela and the therapists experimented with a mixture of tempi, timbre, dynamics, and tonalities. All to which Gabriela readily responded too. Skip To My Lou was also where Gabriela began to echo precise phrases in a call and response manner. With each session, Gabrielas confidence grew. When Gabriela and the therapists sang Mockingbird and the therapists changed the words to Everyone Loves Gabriela, Gabriela began to sing more jubilantly than ever. While Gabriela was singing she exercised the use of vibrato in her voice. The therapists believed the vibrato was Gabrielas way of trying to imitate the violin. Everybody Loves Gabriela was used again in a later session but with a new melody and tonal setting. In a triumph of joy Gabriela began to sing on her own. Like the violin, Gabriela became very attached to David and Jo. When Jos time was over, Gabriela was very upset and confused by her absence. Jos absence was met with Gabrielas crying and yelling. But, eventually she opened up and the session resumed. David avoided playing any songs from the repertoire Jo and him had established. Much to Davids amazement, Gabriela asked

in a very distinct and appropriate way to play songs that had been part of David and Jos sessions! What I really liked about this case was the music was the number one channel that changed Gabrielas life. Gabrielas world used to be a place where she was damaged, lonely, and helpless. David and Jo created a conducive environment that allowed Gabriela to feel free to introduce her own ideas. It was during her music therapy sessions that Gabriella experienced herself in a very unfamiliar and new manner. Through their open-ended clinical improvisation, the music therapists were able to expose Gabrielas strengths by welcoming and treating her ideas with acceptance. I was very surprised when I read about Gabrielas adjustment to Jos leaving, and even more surprised when she asked for David to play songs from their repertoire! I recently left my job teaching piano lessons at All Music in Plainview, N.Y. after five years. I was extremely attached to all of my students and had a difficult time saying goodbye, as did they. After reading this case study it gave me comfort and hope that my students will adjust and continue to play the piano even thought I am no longer their teacher.