Exploring the effectiveness of music therapy intervention as part of interdisciplinary assessment and treatment for patients with prolonged disorders of consciousness


  • Rebecca Susan O'Connor National Rehabilitation Hospital Dublin, Ireland
  • Dee Mary Gray National Rehabilitation Hospital, Dublin Ireland




A four - year study took place at a Rehabilitation hospital in Ireland where two music therapists worked as an integral part of a Prolonged Disorders of Consciousness (PDOC) interdisciplinary team (IDT). The study aimed to explore the impact of music therapy as part of IDT assessment and treatment for patients with PDOC and their familiesPDOC is defined as diminished or absent responsiveness and awareness persisting for more than four weeks following a catastrophic brain injury. 

A mixed method approach incorporating a case study series, the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC), questionnaires from patient’s families and IDT and video analysis was undertaken. 

Three research questions were explored:

  1. Does the inclusion of music therapy within an IDT enhance the service offered to PDOC patients? 
  2. How does music therapy impact on the experience of family members? 
  3. Can a music therapy assessment and treatment pathway be developed for this patient population?

Three case studies taken from the case study series are outlined to illustrate aspects of the clinical work and address the research questions. Findings suggest that music therapy can enhance an IDT and have a positive impact on family members.


Author Biographies

Rebecca Susan O'Connor, National Rehabilitation Hospital Dublin, Ireland


Creative Arts Therapy Department

Creative Arts Therapy Lead, Senior Music Therapist, Lecturer and Researcher

Dee Mary Gray, National Rehabilitation Hospital, Dublin Ireland

Creative Arts Therapy Department

Senior Music Therapist


Royal College of Physicians. Prolonged disorders of consciousness: National clinical guidelines. London, RCP, 2013

Magee, W.L., Siegert, R.J., Lenton-Smith, G; Daveson, B.A., Taylor, S.M. (2014). Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness. Neuropsychological Rehabilitation, 24 (1), 101-124

Magee, W.L., O’Kelly, J. (2015) Music Therapy with Disorders of Consciousness: Current Evidence and Emergent Evidence-Based Practise. Annals of the New York Academy of Sciences, 1337, 256-262. Sciences, 1337, 256-262

Laureys, S., Celesia, G.G., Cohadon, F. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med 8, 68 (2010). https://doi.org/10.1186/1741-7015-8-68

Giacino, J.T., Kalmar, K., Whyte, J. (2004) The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 85(12) 2020-9

Giacino, J.T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D.I., Zasler , N.D. (2002) The minimally conscious state: Definition and diagnosis criteria. Neurology, 58(3), 349-353

Hirschberg, R., Giacino, J.T. (2011) The vegetative and minimally conscious states: Diagnosis, prognosis and treatment. Neurologic Clinics, 29(4) 773-786

Schnakers, C. (2012) Clinical assessment of patients with disorders of consciousness. Archieves Italiennes de Biologie, 150: 36-43

Vogl, J., Heine, A.M. Steinhoff, N., Weiss, K., Tucek, G. (2015) Neuroscientific and neuroanthropological perspectives in music therapy research and practice with patients with disorders of consciousness. Frontiers in NeuroScience, 9 (273) 1-6

Heine, L., Castro, M., Martial, C., Tillmann, B., Laureys, S., Perrin F. (2015) Exploration of functional connectivity during preferred music stimulation in patients with Disorders of Consciousness. Frontiers in Psychology, 6:1704. doi: 10.3389/fpsyg.2015.01704

O’Kelly, J., James, L., Palaniappan, R., Taborin, J., Fachner, J., Magee, W. L.(2013) Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states. Frontiers in Human Neuroscience, 7, 884 doi:10.3389/fnhum.2013.00884

Gill-Thwaites H., Mundy, R. (2004) The Sensory Modality Assessment and Rehabilitation technique (SMART): A valid and reliable assessment for vegetative state and minimally conscious state patients. Brain Injury 18, 1255-1269

Gill-Thwaites H., Mundy R., Elliott K. Sensory modality assessment and rehabilitation technique manual. version 2. London: Royal Hospital for Neuro-disability; 2008

Shiels A., Horn S.A., Wilson B (2000) The Wessex Head Injury Matrix (WHIM) main scale: A preliminary report on a scale to assess and monitor patient recovery after severe head injury. Clinical Rehabilitation 14: 408–16 doi:10.1191/0269215500cr326oa

Giacino, J.T., Kalmar, K. Diagnostic and prognostic guidelines for the vegetative and minimally conscious states. Neuropsychol Rehabil. 2005;15(3–4):166–74. doi:10.1080/09602010443000498

Boeseler, K. (2012) Needs orientated, emotional-communicative dialogue in music therapy with unresponsive wakefulness syndrome patients in neurological early rehabilitaiton. In Jox, R.J., Kuehlmeyer, K., Marckmann, G., Racine, E. ( Eds.) Vegetative State - a paradigmate problem of modern societies: medical, ethical, legal and social perspectivies on chronic disorders of consciousness. Practical Ethics, Zurich: Literature. 80-94

Magee, W.L. Why include music therapy in a neurorehabilitation team? ACNR 2020;19(2): 10-12

Magee, W.L. Music in the diagnosis, treatment and prognosis of people with prolonged disorders of consciousness. Neuropsychological Rehabilitation, 2018;17;28(8):1331-9

Leonardi, M., Giovannetti, A.M., Pagani, M., Raggi, A., Sattin, D. (2012) Burden and needs of 487 caregivers of patients in vegetative state and in minimally conscious state: results from a national study. Brain Injury, 26(10) 1201-10

Tramonti, F., Bonfiglio, L., Di Bernardo, C., Ulivi, C., Virgillito, A., Rossi, B., Carboncini, M.C. (2015) Family functioning in severe brain injuries: correlations with caregivers’ burden, perceived social support and quality of life, Psychology, Health & Medicine, 20(8)1-7

Chiambretto, P., Rossi Ferrario, S., Zotti, A.M. (2001).Patients in a persistent vegetative state: Caregiver attitudes and reactions. Acta Neurologica Scandinavica,104(6), 364–369

Romaniello, C., Simoni, C., Farinelli, M., Bertoletti, E., Pedone, V., Northoff, G. (2016). Emotional Burden, Quality of Life, and Coping Styles in Care Givers of Patients with Disorders of Consciousness Living in Italy: Preliminary Data. Brain Impairment, 17(3), 254-264. doi:10.1017/BrImp.2016.26

Kennelly, J., Brien-Elliot, K. (2001) The role of music therapy in paediatric rehabilitation. Paediatric Rehabilitation, 4, 137-143

Magee, W.L. (2016) Validating the MATADOC Against Best Practice Standard External ReferenceStandard. IdentificationNo. NCT02959736.Retrieved from https://clinicaltrials.gov/ct2/show/NCT02959736





Full Length Articles