In this new age of Covid-19, ABIL’s quarterly forums have been launched online. I signed up, eager for the sense of normality which came with them. The seminars, now webinars, also help with my perspective. Sometimes, and especially this year, I find that I have retreated mentally to a place where my thoughts and concerns are always about me. While this is useful from time to time, it is not a good mental state long term. The ABIL and other brain injury webinars have always provided a range of perspectives which illuminate and challenge me. For more background, I’ve written before about ABIL and their conferences.

In October, ABIL’s seminar tackled the difficult question of ‘How to look after yourself and enjoy life whilst caring.’ For their last seminar in a difficult year, ABIL presented us with ‘Art and Music therapy in a Pandemic’. The use of music in reabilitation or as a tool alongside other therapies had never occurred to me. Elizabeth Nightingale, the Neurological Services lead at Chiltern Neuro and Medical services provided an introduction to this  fascinating field.

Elizabeth spoke about the use of Musical Mnemonics Training help to lay down memories in people after a TBI. To a layperson, this seemed to turn irritating ear worms into useful reminders for repetitive tasks. One of her clients is an adult left with memory problems after a brain injury whose occupational therapist had referred for help with everyday tasks. Elizabeth worked with the client on a lyrical mnemonic to remember a recipe and to purchase ingredients in the supermarket. It worked, and her client was able to make themselves a hearty macaroni & cheese.

Music therapy proves useful for physical activities and the team at Chiltern Music Therapy also work with clients on their physiotherapy goals. Music encourages engagement and makes repetitive, and often painful, exercises more appealing. Elizabeth used video examples to demonstrate the use of song to encourage a specific movement in time with the beat.

In her example, Elizabeth was using video call software to interact with a client in conjunction with onsite care team. The video also demonstrated that the pandemic has led to therapists and their clients discovering previously hidden digital abilities. Initially, the team at Chiltern Music were worried about clients who might have problem with focussing on a screen. However, as the weeks went on, many clients including older adults were engaging with the remote services.

There were challenges in the switch to online services, including the ever present dodgy connections. Furlough meant that staff and clients needed to adjust to new people as well as new technology. The changes had a more personal toll as the team found that the amount of personal energy needed to run an online therapy session proved to be exceptionally challenging. As Elizabeth memorably put it

'I’ve never spent so much time with my own face.'

Elizabeth and her team persisted and found they were able to provide services beyond one-to-one work. Chiltern Music were able to run group sessions, with a structured format of turn taking. Though there were challenges around muting participants in order to prevent feedback.

Alongside live events, the team also provided recorded videos to provide stimulus and therapy in the home. Where there have still been troubles, pre-recorded work to allow more flexibility or for an onsite therapist or loved one to engage with the client in a planned session.

Looking to the future, Elizabeth conjectured that services could be adapted to include digital musical therapy as part of a discharge service. In the more immediate future, and an exciting development, Chiltern Music Therapy will be working with Homerton Hospital. They will be integrating their ideas from 2020 into a six month programme in 2021 working alongside Shaun Caton, the Art Curator and Programme Manager at Homerton Hospital.

As I said, this was a fascinating introduction to an area of brain injury rehabilitation which I hadn’t come across before. The video is available as a Microsoft Teams Presentation here and is well worth your time - especially for the 2020 Christmas number one ‘Mingle all the way’!