Therapy with ASC clients

Music Therapy, to our mind, is a perfect medium for working towards therapeutic goals with autistic clients. Of course we think that; Harry and I are Music Therapists after all. However, let us go a bit deeper into our mindset and approach, and the way we view Music Therapy in work with all, and specifically autistic, clients.

A large reason for accessing arts therapies is an inability to express oneself with words or finding that language doesn’t capture the client’s inner world in an accurate or satisfying way. Autism, as a spectrum, may fulfil one or both positions and so we are left with a question: How does someone in this position seek therapy when talking therapies may not help (or be frustrating)? There’s a lot of philosophy and theory around music as a tool for communication and expression (we write about some on our blog! https://www.bristolmusictherapy.co.uk/blog/emotions-in-music), but the summary is… it lets one or more people be emotionally expressive without needing to find words in language. It is perhaps the only aural expression that can happen with others simultaneously (have you ever tried having a conversation where you can only talk at the same time as someone else?). Making music with someone else, or sharing music that already exists, can be an incredibly helpful tool in pursuing the goal of togetherness and shared experience without relying on language.

Being able to adapt the structures we make for ourselves is important as it allows us to connect with other people who operate outside of those structures. Music is a fantastic medium to explore how we feel about structure, to analogise it to painting it covers everything from carefully colouring inside the lines to a Jackson Pollock work. In music therapy the therapist and client can establish structures together, sharing in the activity in a way that the client is able to tolerate. As the relationship develops so does the capacity for changing the structure of the shared play. A client may start with tightly defined rhythms or turn-taking games with limited capacity to play outside of these parameters. Over time we explore the boundaries of these structures and seeing how making small changes makes us feel, allowing us to share more positive experiences together and demonstrating that changes to our safe structures are not always catastrophic or threatening. This can be a cornerstone to the work with young children who are finding it difficult to be with and play with peers, where their interactions can become maladjusted and lead to difficult behaviours (these difficult behaviours can be the most direct form of expression that doesn’t rely on words, as above). To circle back around to painting, we aren’t saying that client’s need to become Jackson Pollock, it’s not an end goal and working within structures is hugely beneficial. Maybe it’s closer to understanding that we have lines to colour inside of but experiencing that it’s okay to colour outside the lines too; you might find something extraordinary.

When shocks to the system happen, we need to find a way to manage how it makes us feel. The goal is for us be able to bear the shock without being overwhelmed. For ASC individuals this can be more difficult when they prefer structure and regularity. Music therapy can provide a space for clients to explore how these shocks to the system feel, develop an understanding of what it feels like for them to be getting close to a dysregulated state, and sometimes help them develop ways of managing the initial feelings outside of the therapy room. Approaching dysregulation can be difficult to recognise, the benefit of therapy is that all expression is permitted, and the client has an environment that is free to experiment and experience new things in; one of the things may be to leave as they reach that state of dysregulation, another may be to signal that the activity needs to stop. The therapist may offer ideas and experiences through the relationship so the client can experience self-regulation alongside someone else, exploring associations between aloneness and self-regulation.

Most people have used music as an “object” at some point in their life, like we might reach for a soft toy for comfort we might also reach for a certain song or playlist to help regulate ourselves. Clients may take moments and music out of the therapy space and use them in everyday life, particularly when they make transitions between activities or places. Music during bedtime routines, waking up rituals or the right “pump up” playlist help people transition to and from activities. For ASC individuals their structure may be unyielding and exiting the structure (like breaking through a wall) is stressful when it’s not on their terms. Music as an object for transition is like installing a door, it makes the process easier.

A summary of all the things that music therapy can offer for ASC individuals would require books upon books, hopefully this short excursion into some of the thing’s music therapy can offer has been helpful. If you’ve read this blog and have any further questions then please feel free to email us, and we will try to help as best we can, otherwise find some more music therapy topics below to explore!

Garrick Wareham