Music Therapy with Abused Children and Adolescents

Definition:

Abuse is the physical, emotional, or sexual injury to an individual aged birth to 18 years of age. Such injury is often committed by a parent, a guardian, or other individual in the position of power.

Types:

Physical: burns, bruises, abrasions to the skin. Injuries to various parts of the body, fractures, the inconsistency or failure of an explanation for any of these types of injuries.

Emotional: In infants, failure to thrive or develop at a normal pace. In toddlers, signs of distrust, passive attitude or personality, overly concerned with pleasing adults. In school aged children, difficulties in developing relationships with peers, social withdrawal.

Sexual: Incest including father/daughter; mother/son; brother/sister. Other adult/child non-consensual sexual relationships.

Contributing Factors

Parental Insufficiency: low self-esteem of parent or guardian.
A Different Child: Inability to control a difficult child. Inability for parent to form strong ties to the child. Over expectation of the child's ability to perform in school or society by parent.
Inadequate support system: Lack of sufficient support system for parent to turn to in times of extreme stress.
Inability to cope with crisis situations.
Lack of lifestyle management.

Behavioral Symptoms and Characteristics:

May include poor self-esteem, withdrawal from friends and family, failure to thrive or develop, hyperactivity, over concern with pleasing adults, abusive behavior to self or others, difficulty developing relationships, weight loss or gain, physical injuries.

Music Therapy Goals

To improve self-esteem.
To increase expression of feelings.
To create non-abusive lifestyle.
To decrease stress and anxiety.
To decrease fear.
To promote independence.
To facilitate communication.
To develop coping skills during times of stress.
To improve social skills.

Functions of Music

As a relaxation agent.
As a stimulus for discussion of emotional and spiritual concerns.
As a means of communication.
To provide structure.

Music Therapy Activity Example

Activity Type: Drumming
Equipment Needed: A variety of hand and floor drums, recorded instrumental music.
Procedure: Provide the client with an assortment of drums and allow them to become comfortable with them initially by just hitting them and exploring the sounds which each instrument can make. When the client is familiar and comfortable with the drums, explain that together you are going to listen to a piece of music and make sounds with the drums. Be sure that the client understands that there is no right or wrong way to "play" the drums and encourage them just to make sound. Then play a variety of music which expresses a variety of emotions (something light and "happy", something slower and "sad", and something with a lot of energy--anger). As each piece of music plays, just make sound with the drum. After each piece (or you may want to do several pieces first before processing the experience with the client.), discuss how it was for the client to play the drum. Discuss differences in each piece, which were more difficult to do, and how the client felt during each experience. Further discussion and process can follow from week to week, concentrating on one emotion at a time etc. Also, talk about how it was for the client to express each emotion using the drums (non-verbal vs. verbal communication).
Where to go from here: From this type of activity, one might explore other ways to express feelings non-verbally through movement and music exercises. Also, other ways to express emotions through music might be explored.

Bibliography

Bass, Ellen, & Davis, Laura. (1988).  The Courage to Heal: A Guide for
     Women Survivors of Child Sexual Abuse.  New York: Harper &
     Row, Publishers.

Burgess, A. W., Groth, A. N., Holmstrom, L. L., & Sgori, S. M. (1978).
     Sexual Assault of Children and Adolescents.  Lexington: D.C. Heath
     and Company.

Clendenon-Wallen, J. (1991).  The use of music therapy to influence the self-
     confidence of adolescents who are sexually abused. Music Therapy
     Perspectives, 9, 73-81.

Courtois, C. & Sprei, J. (1988).  Retrospective incest therapy for women.  
     In L. Walker & E.A. Leonore (eds.), Handbook on sexual abuse of
     children.  New York: Springer Publishing Co.

Dolan, Y. M. (1991).  Resolving sexual abuse: Solution-focused therapy
     and Ericksonian hypnosis for adult survivors.  New York:  W.W.
     Norton & Company.

Edgerton, C. D.  (1990).  Creative group songwriting.  Music Therapy 
     Perspectives, 8, 15-19.

Glassman, L. R.  (1991).  Music therapy and bibliotherapy in the rehabilitation of traumatic brain injury:  A case study.  Arts in
     Psychotherapy, 18 (2), 149-156.

Ficken, T.  (1976).  The use of songwriting in a psychiatric setting. 
      Journal of Music Therapy,  13 (4), 163-172.

Goldstein, S. L.  (1990).  A songwriting assessment for hopelessness in
     depressed adolescents:  A review of the literature and a pilot study.
     Arts in Psychotherapy,  17(2), 117-124.

Finkelhor, D., & Araj, S. et al.  (1986).  A sourcebook on child sexual
     abuse.  Beerly Hills, CA:  Sage Publications.

La Fontaine, J.  (1990).  Child sexual abuse.  Cambridge UK: Polity
     Press.

Maltz, W., & Holman, B. (1987).  Incest and sexuality.  New York: 
     Lexington Books, Health & Co.

Mrazek, P. B., & Kempe, C. H..  (1981).  Sexually Abused Children
     and their Families.  Oxford: Pergamon Press.

Rogers, P. (1992).  Issues in working with sexually abused clients in music 
     therapy.  British Journal of Music Therapy, 6 (12), 5-15.

In addition, I have written an article about my use of song writing with
an abused adolescent.  This article is scheduled to come out in the 1997
issue of Music Therapy, the journal of the American Associaion
for Music Therapy.

KathySL@aol.com

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Katherine A. Lindberg, RMT-BC
Created May 20, 1997
Last update September 28, 1997