Ergina Sampathianaki

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Approaches: Music Therapy & Special Music Education | 4 (1) 2012 | http://approaches.primarymusic.gr    © Approaches / GAPMET 2012 ISSN: 1791-9622  56    Book Review  Music Therapy with Adults with  Learning Disabilities Tessa Watson (Editor)  Reviewed by Ergina Sampathianaki  Music Therapy with Adults with Learning Disabilities  Tessa Watson (Editor)  East Sussex: Routledge (2007) 176 pp, ISBN: 978-0-415-37909-0    Ergina Sampathianaki trained as a music therapist at the Nordoff-Robbins Music Therapy Centre, City University London. She currently works as a music therapist for Nordoff Robbins (UK). She works with children and adults with various diagnoses including learning disability, autism and mental health, as well as speech, language and communication difficulties. She also manages the service for Adults with Learning Disabilities for the Nordoff Robbins, London Centre.    Email: ergina.sampathianaki@gmail.com     Introduction The suggestion to review this book was presented to  me  one-and-a-half  years  after  I  started  my clinical practice as a music therapist. It came just after I undertook the responsibility of co-managing (in  collaboration  with  colleagues)  the  service  for Adults  with  Learning  Disabilities  at  the  Nordoff Robbins London Centre (UK). My responsibilities in this managerial role include consultation sessions for  adults  with  learning  disabilities,  writing consultation  reports  and  liaising  with  staff regarding  placements  and  groupings.  I  also  work with  adults  with  learning  disabilities  individually and  in  groups,  therefore,  the  idea  to  review  the book  Music  Therapy  with  Adults  with  Learning Disabilities  was  directly  relevant  to  my  clinical practice. Indeed, this book broadens the theoretical understanding  of  this  clinical  area  and  offers  an insight to various issues that arise when working with this population. This theoretical understanding and  insight  can  contribute  significantly  to  the development of one's clinical thinking and practice.  Themes and structure of the book  The  editor,  Tessa  Watson,  is  an  active  and experienced music therapy practitioner and trainer. She is involved in arts therapies research, whilst she presents and publishes her work. For the purposes of  this  book,  Tessa  Watson  has  brought  together seven music therapists, all experienced in working with  adults  with  learning  disabilities.  The  book consists of ten chapters which are divided into four sections, around which I structure this book review.    Section One Section One comprises Chapters 1 and 2. Chapter 1, written by Tessa Watson, explores the definition Approaches: Music Therapy & Special Music Education | 4 (1) 2012 | http://approaches.primarymusic.gr    © Approaches / GAPMET 2012 ISSN: 1791-9622  57  of  ‘learning  disability’  and  gives  a  brief  social history of this population (i.e. people with learning disabilities), with a particular focus on the UK. It also summarises the recent National Health System (NHS) and government guidance which provide the current  framework  for  working  with  this  client group in the UK. Tessa Watson also looks at how a diagnosis  of  learning  disability  can  affect  certain aspects  of  everyday  life  and  introduces  Music Therapy  with  Adults  with  Learning  Disabilities including a literature review of this clinical area.  Chapter  2,  also  written  by  the  editor,  further explores the idea of music therapy with adults with learning  disabilities  by  describing  clinical  work with three fictional clients. The clients are briefly introduced to the reader who has the opportunity to follow  the  therapeutic  process  from  the  very beginning  to  the  end  of  the  therapeutic  course. Particular reference has been given to some of the key stages of the therapeutic process, such as the referral, the assessment and the ending. Along with the above the author reflects on different theoretical and practical aspects, and finds the opportunity to introduce some of the main concepts and practices that inform her work.  In  this  section  the  editor  gives  a  solid  and coherent basic knowledge that will help the reader access more detailed information that is given later in  the  book.  This  information  includes  an exploration of different aspects of the diagnosis of learning  disability  and  an  introduction  to  music therapy work with adults with learning disabilities.  Section Two Section Two comprises chapters 3, 4 and 5. All of these  chapters  are  concerned  with  music  therapy work  with  clients  with  a  specific  diagnosis.  The authors give information about each diagnosis and talk  about  their  music  therapy  work  with  these client groups, including clinical examples.   Chapter  3,  written  by  Rhian  Saville,  gives  a definition  of  autistic  spectrum  disorders  (ASD), including  Asperger's  Syndrome.  The  author  gives an  overview  of  possible  causes  for  ASD  and describes  the  ways  this  diagnosis  can  affect someone's  life.  Saville  theoretically  justifies  the value of music therapy when treating people with ASD  by  reviewing  the  literature  of  this  clinical area. Furthermore, she refers to some of the main theoretical  concepts  that  inform  her  clinical practice. She clarifies that these concepts originate from  musical,  developmental  and  psychodynamic models,  and  suggests  that  these  three  models  are essential when working with adults on the autistic spectrum. Finally, her theoretical ideas are brought to  life  in  a  case  study  from  her  own  clinical practice, at the end of the chapter. Chapter  4,  written  by  Cathy  Warner,  explores the  term  ‘challenging  behaviour’  and  suggests different ways of thinking about it. She also refers to a number of approaches that that have influenced her music therapy practice when working with this client group. Her clinical example comes from her own clinical practice and includes descriptions of different stages in music therapy work, as well as summaries of the discussions between herself and the care staff that were present during the sessions. The chapter finishes with a number of suggestions for good practice when working with people with challenging behaviour. Chapter 5, written by Eleanor Richards, sheds some light on the complex area of people with dual diagnoses of learning disabilities and mental health illness.  Richards  explains  the  different  kind  of factors  that  can  put a  learning-disabled  person at risk of mental health illness. She also referrers to the complexities of diagnosing mental health illness in  people  with  learning  disabilities  and  to  the implication  these  complexities  might  have  when planning  a  client’s  treatment.  She  suggests  the value of music therapy when working with people with dual diagnoses, and presents two case studies from her own clinical practice. Finally, she refers to the importance of the music therapist's input when working within a multi-disciplinary team.  In this section the three writers give a sufficient overview  of  different  diagnoses  in  adults  with learning  disabilities.  When  they  talk  about  music therapy  work  with  adults  with  ASD,  with challenging  behaviour  or  with  dual  diagnoses  of learning disabilities and mental health, they provide the  reader  with  a  deep  understanding  of  the different ways music therapy can contribute to the clients’  treatment  and  can  offer  unique opportunities  for  communication,  self-expression, managing behaviour or being understood by others. This deep understanding is communicated vividly through  the  insightful  case  studies  that  help  the readers to ground the given theoretical knowledge in a concrete applicable way.  Section Three Section Three comprises chapters 6, 7 and 8. All these chapters discuss music therapy group work; each one with a different focus. Chapter 6, written by Clare Fillingham, focuses on  group  work  and  friendship.  Fillingham  talks about the valuable role of friendship in everyone’s life. She explains some of the reasons why people with  learning  disabilities  often  find  it  difficult  to form  and  sustain  friendships  and  notes  that integrating  people  into  the  community  does  not necessarily lead to social inclusion and an increase of  friendships.  The  author  gives  an  overview  of Approaches: Music Therapy & Special Music Education | 4 (1) 2012 | http://approaches.primarymusic.gr    © Approaches / GAPMET 2012 ISSN: 1791-9622  58  group work theories and finally presents a research case study. This study, carried out by the author, looks at how music therapy can support people with learning disabilities to deal with the impact of their difficulty with relationships and can help them to extend their social network.  Chapter  7,  written  by  the  editor,  (Watson), focuses  on  music  therapy  and  community  work. The author explores the idea of community and its meaning for people with learning disabilities. She discusses  two  new  models  in  music  therapy; culture-centred  music  therapy  and  community music  therapy,  noting  that  both  ways  of  working hold at their centre the therapeutic effects of music. Finally, Watson presents a case study from her own clinical  practice;  this  case  study  is  based  on  her work  with  a  group  of  adults  with  learning disabilities which was specifically set up to address the clients’ issues around community life.  Chapter  8,  written  by  the  editor,  focuses  on group work with adults with profound and multiple learning disabilities (PMLD). The author discusses the diagnosis of PMLD and refers particularly to its impact  on  the  area  of  communication.  Watson justifies the value of music therapy work for people in this client group and presents a group case study. This case study is quite detailed and includes both the  process  of  the  group  and  the  therapists’ experience.  Particular  reference  is  made  to  the music  used  during  the  sessions,  including descriptions  of  the  therapists’  and  the  clients’ musical contributions.  In  this  section  the  writers  raise  issues  related with  the  social  life  of  adults  with  learning disabilities. This is a particularly important area of concern as very often this adult client group suffers from isolation. The authors illustrate the need for a fulfilling social life and note that even though this need  has  been  acknowledged  by  UK  government papers, it is difficult to address practically. Group music  therapy  can  play  an  important  role  when trying  to  meet  the  social  needs  of  people  with learning disabilities, including people with PMLD. It can provide a safe place where people can share feelings and experiences related to their lives in the community  and  can  also  give  opportunities  for communication  and  social  contact  within  a supported environment.  Section Four This  section  comprises  chapters  9  and  10.  These chapters focus on working with other professionals.  Chapter  10,  written  by  Ben  Saul,  presents  the author’s  recent  research  that  took  place  at  an organisation  working  with  adults  with  learning disabilities  in  South  East  London.  The  research examines how professionals and carers view music therapy, and how they value the music therapist’s input  in  the  multi-disciplinary  team.  Saul  used questionnaires  and  interviews  to  explore  themes related  to  communication,  expression,  social functioning,  health,  and  also  communication between  carers  and  clients,  as  well  as communication  between  the  music  therapist  and other  professionals.  Staff  who  responded  to  this research gave a clear indication that music therapy can have a positive input in those areas.  Chapter 11, written by the editor (Watson) and Karen  Twyford,  discusses  multi-disciplinary  and collaborative work in music therapy. The authors present  four  different  levels  of  successful  multi-disciplinary  work,  and  explore  the  benefits  and challenges  of  multi-disciplinary  work.  They  also present an interesting dialogue about music therapy between  five  members  of  a  community  learning disability  team,  including  a  speech  and  language therapist,  a  consultant  psychiatrist,  a  community learning disability nurse, a clinical psychologist and a music therapist. Finally, the two authors present examples of collaborative work between colleagues and  give  guidelines  for  good  multidisciplinary practice for music therapists.  In  this  section  the  writers  discuss  one  of  the most  important  areas  for  the  music  therapy profession;  team-working  and  collaboration  with other  professionals.  Having  in  mind  that  a  well-coordinated  care  plan  promotes  the  efficacy  of  a client’s  treatment,  good  collaboration  between music  therapists  and  other  professionals  is  of  a great  importance.  This  collaboration  needs  to  be based  on  the  successful  communication  of  the music therapy work with other professionals and it is necessary for our colleagues to understand our work and value it.   Conclusion Music  Therapy  with  Adults  with  Learning Disabilities comes to fill in a gap in music therapy literature, as it is the first book of its kind which focuses entirely on  music therapy work with this client group. I found all the themes of the book successfully chosen,  since  they  address  very  important  issues that  emerge  when  working  with  adults  with learning  disabilities.  For  example,  many  of  the referrals for this client group that we receive at my workplace  refer  to  the  clients’  needs  for communication,  social  contact  and  emotional expression/outlet. The  book  has  a  very  good  balance  between generic information, theory and practical examples which can support every reader to gain a sufficient understanding of this clinical area. For the music therapists who already work with this client group, Approaches: Music Therapy & Special Music Education | 4 (1) 2012 | http://approaches.primarymusic.gr    © Approaches / GAPMET 2012 ISSN: 1791-9622  59  the  theoretical  concepts  that  are  explored  in  this book  can  enrich  their  thinking.  I  found  all  the clinical  case  studies  particularly  useful,  as  they helped  me  deepen  my  understanding  of  the expressed knowledge.  Tessa Watson has provided us a guide to which we  can  turn  to  inform  ourselves  about  many different aspects of our clinical work. Her work is well-versed  in  contemporary  ways  of  thinking about  adults  with  learning  disabilities  which acknowledges their right to have full opportunities as equal members of society and to be supported to take  control  of  their  own  lives.  Furthermore,  it takes  into  account  all  the  relevant  NHS  and government  guidance  that  form  the  framework within which our clinical practice is taking place.      Suggested citation: Sampathianaki, E. (2012). Book review: “Music Therapy with  Adults  with  Learning  Disabilities”  (Tessa  Watson, Editor).  Approaches:  Music  Therapy  &  Special  Music Education,  4(1),  56-59.  Retrieved  from http://approaches.primarymusic.gr 

Book review: "Music Therapy with Adults with Learning Disabilities" (Tessa Watson, Ed.)

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