Book review: Silke Jochims (Ed.): Musiktherapie in der Neurorehabilitation (music therapy in neurological rehabilitation)

Schmid, W.

Music therapy in neurological rehabilitation is often seen as a miraculous cure for severely affected patients, which may raise irrational hopes but can also mean a very real chance.

In her book ,Musiktherapie in der Neurorehabilitation - Internationale Konzepte, Forschung und Praxis" (Music therapy in neurological rehabilitation - international concepts, research and practice) Silke Jochims has compiled articles on current research in neuro sciences and on international music therapy research projects and intervention approaches. This combination is intended to provide a more substantial foundation for music therapy in neuro rehabilitation without destroying the myth of a miraculous cure. The book addresses music therapists as well as physicians, therapists and nursing staff in neuro rehabilitation. The comprehensive work has two sections: the first volume (entitled ,Grundlagen" or fundamentals) describes neurological syndromes and presents up-to-date findings from neuro science on perception and processing of music in healthy and brain-damaged humans. The reader feels that what music therapy has been generating and practising in neuro rehabilitation on the basis of experience for 20 years is now corroborated from the perspective of neuro science. Studies by Kotchoubey et al. on the efficiency of simple and complex auditory stimuli suggest, for example, that complex sounds offered by the human voice stimulate event-correlated responses in severely brain-damaged patients far more often than acoustic stimuli in the form of simple sinus notes. Music therapists associate such findings with the concept of singing for coma patients; readers may find many such connections without getting the impression that music therapy has to be legitimized by neuro science.

The second volume (,Musiktherapiekonzepte: Forschung und klinische Praxis" - music therapy concepts: research and clinical practice) presents 20 approaches from music therapy research and practice with adult patients as a wide range of applications of music therapy in neurological rehabilitation. Articles from Europe, U.S. and Australia cover issues from a variety of related aspects - motor, sensory, cognitive, interactive-communicative, social and emotional rehabilitation, and thus form something like a work of reference according to topics. All chapters are of practical relevance and and well-grounded and provide differentiated insights in music therapy concepts and research. Examples are musical-rhythmic work with Parkinson patients, a vocal exercise programme with patients with traumatic brain injuries, or an improvisation group to promote social interaction in stroke patients. Valuable suggestions and ideas provided in these chapters make the book worthwhile for beginners and experienced music therapists alike. Frequent questions emerging in practice, for example the use of earphones for patients in persistent vegetative state, or which condition of life is worth living or not, are critically discussed here. Highly impressive are those chapters that address the limits of music therapy due to the severity or hopeless prognosis of neurological disease. An authentic integration of the discipline within the therapeutic context of neurological rehabilitation requires exactly this kind of thorough and unbiased exploration.

A summary of the practice chapters underlines in addition that the national and international debate about the ,one correct" music therapy approach in neuro rehabilitation does not serve the interests of patients who are often affected in all aspects of their existence. This is why many different types of music therapy concepts are applied in clinical practice, depending on individual symptoms and stage of rehabilitation: active and receptive, exercise or experience oriented, individual and group therapy, as well as interdisciplinary cooperation with, for example, speech therapists. This great variety and flexibility is a specific asset in music therapy and must be underlined as such to insurers, physicians, therapists and relatives. Silke Jochim's book is a valuable contribution. She provides a platform for understandings gained from music therapy experience and scientific findings from neuro physiology and neuro biology and offers interdisciplinary insights that will support the work of music therapists in rehabilitation clinics. The gap between ,miraculous cure" and recognized therapy in neurological rehabilitation has clearly narrowed.

After ,ZwischenWelten - Musiktherapie bei Patienten mit erworbenen Hirnschäden" by Monika Baumann and Christian Gresssner, and ,Music Therapy and Neurological Rehabilitation" by David Aldridge, Silke Jochims has presented another book on music therapy in neurological rehabilitation that will make an essential contribution to sharpening the profile of the discipline.