An eclectic approach to working with a dyad of a patient with TBI and his caregiver
PURPOSE The purpose of this case study is to describe the impact of music therapy on a dyad relationship between the client and the caregiver. It provides suggestions for methods to work with a client who is severely profoundly brain injured, requiring feeding, bathing, and positioning, five years post-accident.
METHODS A dyad approach was used, which explored the practice of songwriting with a dyad of client and his mother.
RESULTS A song was created during the period of this study and was shared with the caregiver. The song provided support for not losing hope for both the client and his caregiver. An interview was conducted with the caregiver one-year post session. The caregiver commented that music therapy “gives her a breath of fresh air and makes it so much easier.”
CONCLUSIONS As a dyad, the relationship between client and caregiver is crucial to the rehabilitation process. Therefore, the authors suggest treatment practitioners to adopt the family-centered approach to further improve the quality of care.
Key Words:Dyad, family-centered care, quality improvement, traumatic brain injury, music therapy
Report to Congress: Traumatic Brain Injury in the United States. CDC Injury Center. Available at: https://www.cdc.gov/traumaticbraininjury/pubs/tbi_report_to_congress.html
Man, D. Family caregivers' reactions and coping for persons with brain injury. Brain Injury. 2002: 16(12):1025-1037.
Park S, Williams R, Lee D. Effect of Preferred Music on Agitation After Traumatic Brain Injury. Western Journal of Nursing Research. 2016: 38(4):394-410.
Pelletier C. The effect of music on decreasing arousal due to stress: A meta-analysis. Journal of Music Therapy. 2004: 41(3):192–214.
Thaut MH, Gardiner JC, Holmberg D, et al. Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation. Annals of the New York Academy of Science. 2009: 11(69):406-16.
Guetin S, Portet F, Picot MC, et al. Impact of music therapy on anxiety and depression for patients with Alzheimer's disease and on the burden felt by the main caregiver. Encephale. 2009: 35(1):57-65.
Brown B, Mccormick T. Family coping following traumatic head injury: An exploratory analysis with recommendations for treatment. Family Relations. 1988: 37(1): 12-16.
Marsh N, Kersel D, Havill J, Sleigh J. Caregiver burden at 6 months following severe traumatic brain injury. Brain Injury. 1998: 12(3): 225-238.
Bradshaw LE, Goldberg SE, Schneider JM, Harwood RH. Carers for older people with co-morbid cognitive impairment in general hospital: Characteristics and psychological well-being. International Journal of Geriatric Psychiatry. 2013; 28: 681–690.
Finkel SI, Costa e Silva J, Cohen G, Miller S, Sartorius N. Behavioral and psychological signs and symptoms of dementia: A consensus statement on current knowledge and implications for research and treatment. International Psychogeriatrics. 1996 : 8(3):497–500.
Woods RT. Discovering the person with Alzheimer’s disease: Cognitive, emotional and behavioural aspects. Aging & Mental Health. 2001: 5(1):S7–S16.
Northouse L, Mood D, Templin T, Mellon S, George T. Couples’ patterns of adjustment to colon cancer. Social Science and Medicine. 2000; 50: 271–284.
Ferguson RM. The effect of music therapy songwriting on the identification and utilization of short-term coping strategies by caregivers of loved ones with Alzheimer’s disease. Tallahassee, FL: Florida State University; 2006.
Lindberg KA. Songs of healing: Songwriting with an abused adolescent. Music Therapy. 1995: 13(1):93–108.
Rolvsjord R. Collaborations on songwriting with clients with mental health problems. In Baker F, Wigram T (Eds.), Songwriting: Methods, techniques and clinical applications for music therapy clinicians, educators and students (pp. 97–115). London, UK: Jessica Kingsley; 2005.
Hilliard R, Justice J. Songs of faith in end of life care. In A. Meadows (Ed.), Developments in music therapy practice: Case study perspectives (pp. 582–594). Gilsum, NH: Barcelona Publishers; 2011.
O’Callaghan CC. Song-writing in Threatened Lives. In C. Dileo & J. Loewy (Eds.), Music Therapy at the End of Life (pp.117-128). Cherry Hill, NJ: Jeffrey Books; 2005.
Baker F, Tamplin J, MacDonald R, Ponsford J, Roddy C, Kee C, Rickard N. Exploring the self through songwriting: An analysis of songs composed by people with acquired neurodisability in an inpatient rehabilitation program. (2017). Journal of Music Therapy. 2017: 54(1): 35-54.
Baker F. The ongoing life of participant-composed songs within and beyond the clinical setting. Musicae Scientiae. 2013: 17(1): 40-56.
Clark C, Corcoran M, Gitlin L. An exploratory study of how occupational therapists develop therapeutic relationships with family caregivers. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association. 1995: 49(7):587-94.
Hasselkus BR. Meaning in family caregiving: Perspectives on caregiver-professional relationships. The Gerontologist. 1988: 28(5):686.
McKinlay WW, Hickox A. How can families help in the rehabilitation of the head injured? Journal of Head Trauma Rehabilitation. 1988: 3(4):64-72.