Music therapy and dementia care – it’s now time to win friends and influence people

Shibley Rahman completed his PhD in frontotemporal dementia at Cambridge University, commencing a lifelong interest in the timely diagnosis of dementia. In this article he argues for more high quality research into the possible benefits of music therapy for people living with dementia; as well as making the case for the development of dementia care strategies which include the vital insight of people trying to live well with dementia today, so we can improve the experience of care for the many people in future who will receive a diagnosis of dementia.
You can learn about Shibley’s book,
Living Better with Dementia, here

It won’t have escaped you, hopefully, that the five-year English dementia strategy is up for renewal at any time now. The last one ran from 2009 to 2014.

Probably the usual suspects will get to command the composition of the new one. “Dementia Friends” has been a great initiative which has taught at least a million people so far about some of the ‘basics’ about dementia, but this ‘raising awareness’ is only part of a very big story.

In my book Living Better with Dementia: Good Practice and Innovation for the Future, about to be published by Jessica Kingsley Publishers, I argue that it is the people currently trying to live better with dementia who should be the ‘champions’ for the future. I believe strongly they should drive policy, not ‘leading Doctors’ or senior members of big charities.

My reasoning is as follows.

The population at large can be thought of as consisting of many people, represented below as dots. Networks

In a ‘cohesive’ (close) network such as A, members in the network are connected in close proximity. This builds trust and mutual support, discourages opportunistic flow of information, facilitating communication but minimising interpersonal conflicts. A cohesive network might be the hierarchical network of medical professionals.

A ‘sparse’ network (C) is effectively opposite to cohesive networks; but let’s say for the purposes of my example C consists of people with an interest in non-pharmacological interventions in dementia, including unpaid family carers.

In bridging networks, the ‘bridge’ (B) acts between disparate individuals and groups, giving control over the quality and volume of information exchange. I think of politicians such as Debbie Abrahams MP and Tracey Crouch MP, and the All Party Parliamentary Group on dementia at large, as people who can act as the bridges. These people are pivotal for policy formation.

I devoted a whole chapter of my new book to promoting leadership by people aspiring to live better with dementia.

Having all these people involved will improve the thought diversity and relevance of the new strategy for people actually living with dementia

We are currently in the middle Music Therapy Week 2015, dedicated to raising awareness about how music therapy can improve the lives of people with more progressed dementia. It’s no accident I’ve devoted the bulk of one chapter in my book to explain the brain mechanisms behind why music has such a profound effect on people living with dementia.

We, as human beings, all react uniquely to different music – there’s every reason to believe that certain people living with dementia, whether in the community, at home, in residential home, or a hospice, in other words wherever in the “dementia friendly community”, can hugely benefit from the power of music.

According to NHS England;

“Over the next five years and beyond the NHS will increasingly need to dissolve these traditional boundaries. Long term conditions are now a central task of the NHS; caring for these needs requires a partnership with patients over the long term rather than providing single, unconnected ‘episodes’ of care.”

In Rotherham, GPs and community matrons work with advisors who know what voluntary services are available for patients with long term conditions. Apparently, this “social prescribing service” has cut the need for visits to accident and emergency, out-patient appointments and hospital admissions.

Today sees a wide-ranging, open discussion of music therapy and dementia in Portcullis House, in Westminster. Prof Helen Odell-Miller, Professor of Music Therapy, Director of The Music Therapy Research Centre and Head of Therapies at Anglia Ruskin University, presented significant research findings at the meeting.

I feel music is not being given a fair ‘crack of the whip’ in the current policy. The first English strategy,  “Living well with dementia: a national dementia strategy” , was initially launched by the Department of Health, UK in order to improve ‘the quality of services provided to people with dementia . . . [and to] promote a greater understanding of the causes and consequences of dementia’ (Department of Health, 2009, p. 9).

We could have done, I feel, so much more on research into music by now. We could have done much more to increase the number of music therapists in England by now. Maybe some of this is due to ‘parity of esteem’, which has seen mental health play ‘second fiddle’ to physical health.

There are, however, glimmers of hope though, I feel. For example, it was last year reported in the Guardian:

“Overseen by Manchester University, it is part of a 10-week pilot project called Music in Mind, funded by Care UK, which runs 123 residential homes for elderly people. The aim is to find out if classical music can improve communication and interaction and reduce agitation for people in the UK living with dementia – estimated to number just over 800,000 and set to rise rapidly as the population ages.”

Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased.  Musical memory is considered to be partly independent from other memory systems. In Alzheimer’s disease and different types of dementia, musical memory is surprisingly robust, and likewise for brain lesions affecting other kinds of memory.

Given the observed overlap of musical memory regions with areas that are relatively spared in Alzheimer’s disease, recent findings may, actually, explain the surprising preservation of musical memory in this neurodegenerative disease. Jacobsen and colleagues (2015) found a crucial role for the caudal anterior cingulate and the ventral pre-supplementary motor area in the neural encoding of long-known as compared with recently known and unknown.

That’s why I believe we should support the British Association for Music Therapy (BAMT), the professional body for music therapists and a source of information, support and involvement for the general public.  The title music therapist can only be used by those registered with the Health and Care Professions Council. So there is regulatory capture, if not corporate capture.

This year’s campaign by the BAMT focuses on the instrumental role music therapy has to play in supporting people with dementia and those who care for them. Indeed, the current Dementia Strategy acknowledges that music therapy, as well as other arts therapies, ‘may have a useful role in enabling a good-quality social environment and the possibility for self- expression where the individuality of the residents is respected’ (Department of Health, 2009, p. 58).

Leading research has suggested that music therapy can significantly improve and support the mood, alertness and engagement of people with dementia, can reduce the use of medication, as well as helping to manage and reduce agitation, isolation, depression and anxiety, overall supporting a better quality of life. But very recently Petrovsky, Cacchione and George (2015) have found that there is “inconclusive evidence as to whether music interventions are effective in alleviating symptoms of anxiety and depression in older adults with mild dementia due to the poor methodological rigor”. This reinforces my view that service provision will only be markedly improved if we invest in high quality research, as well as the allied health professionals who can offer high quality (and regulated) music therapy as clinical service.

Living Better with DementiaAs I argue in my new book, “Dementia Friends” is great – but we’ve gone way beyond that now. The “Prime Minister Dementia Challenge“, I feel, showed great leadership in prioritising dementia as a social challenge, and the “Prime Minister Challenge on Dementia 2020” follows suit.

Being honest, we haven’t got a good description of what ‘post diagnostic support’ means, and therefore what it precisely looks like, for dementia. But one thing that is very clear to me that we need to invest in the infrastructure, including research and service provision, to implement living better with dementia as a reality in England. But I remain hopeful that my colleagues in the music therapy world will be able to win friends and influence the right people.

Find out more about Shibley’s book, Living Better with Dementia, read reviews or order your copy here.

Thoughts behind ‘The Music of Being’

Levinge_Music-of-Being_978-1-84905-576-5_colourjpg-printIn The Music of Being, Alison Levinge explains the approaches of key child development theorists and explores how they apply to and inform the practice of music therapy. In this article, she discusses the inspiration behind writing this unique book and how she feels Winnicott’s theories resonate with the central aspects of music therapy.

We only have to observe a mother with her baby to realize that we are deeply musical beings. Training as a musician, combined with an understanding of human development, has led me to consider the significance of this medium and in particular, its value as a therapeutic tool.

No matter what our musical preferences may be, whatever our age, where we live or more significantly, in what ways we may find life difficult, music can enable us to connect more deeply to who we really are. And this can happen even when we are yet to be born!

Our early experiences are impressed upon not only our physical being but also upon our cognitive and psychological states of mind. But what is it like to be a baby? How do we let people know what we are feeling? How do we ask for what we need when we do not have words? Above all, what is it that we require in order to help us along the journey of life in a healthy way? Through helping children and adults who have difficulties, I discovered the value of music and its remarkable ability to engage a child or adult in a relationship. I discovered music, in fact, is a universal language.

In the world of words, there are many who have studied early development. Donald Winnicott, a pediatrician and psychoanalyst, is one who dedicated his life to the study of babies with their mothers and it can be said, was an early prime mover in the field. My book evolved through interweaving some of Winnicott’s ideas with my experiences as a therapist, combined with my understanding of a musical relationship. Music can allow us to express ourselves in so many ways that words may not.


Alison Levinge, PHD, LGSM(MT), Cert.Ed., is a music therapy practitioner and researcher. She specializes in music therapy with children experiencing early developmental difficulties and issues relating to bereavement. She teaches and lectures internationally and is based in Bristol, UK. Read more on her book The Music of Being or order your copy here.

Call for Comic and Graphic novel submissions

Jessica Kingsley Publishers and Singing Dragon (an imprint of JKP) have recently started developing an exciting new line of comics and graphics novels and we are now open for submissions.

At JKP we are committed to publishing books that make a difference. Our range of subjects includes autism, dementia, social work, art therapies, mental health, counselling, palliative care and practical theology. Have a look on for our full range of titles.

Singing Dragon publishes authoritative books on all aspects of Chinese medicine, yoga therapy, aromatherapy, massage, Qigong and complementary and alternative health more generally, as well as Oriental martial arts. Find out more on

If you have an idea that you think would work well as a graphic book, or are an artist interested in working with us, here is what we are looking for:

Graphic novel or comic – Long form

We are looking for book proposals that are between 100 and 200 pages, black and white or colour, and explore the topics listed above or another subject that would fit into the JKP/Singing Dragon list. Specifically we are hoping to develop more personal autobiographical stories.

Here are the guidelines for submission:

  1. A one-page written synopsis detailing the plot/outline of the book, as well as short bios of all the creators involved.
  2. Character sketches of the main characters with descriptions.
  3. Solo artist/writers or writer and artist teams should submit 5 to 10 completed pages to allow us to get a sense of the pace, art style and writing.
  4. Solo writers will need to submit 10 to 20 pages of script as well as the one-page synopsis from point 1.

Comic – Short form

We have some shorter comic projects underway and are looking to expand the range of topics covered. These books can run from 20 to 40 pages, black and white or colour, with dimensions of 170x230mm. We are mainly looking for comics that provide ideas and information for both professionals and general readers.

For example, the first in this series, published by Singing Dragon, is a book exploring the latest developments in chronic pain research.

Here are the guidelines for submission:

  1. A one-page written synopsis detailing the narrative style and subject matter to be explored in the book. Also include short bios of all the creators involved.
  2. Solo artist/writers or writer and artist teams should submit 3 to 5 completed pages to allow us to get a sense of the pace, art style and writing.
  3. Solo writers will need to submit 5 to 10 pages of script as well as the one-page synopsis from point 1.

When submitting please provide low-res images and send them, along with everything else, to Mike Medaglia at

If you have any other ideas that don’t directly relate to the subjects described above but you feel might still fit into the JKP or Singing Dragon list, please feel free to get in touch with ideas and enquiries on the email above.

On the value of writing with traumatised young people – with Marion Baraitser

Baraitser_Reading-and-Exp_978-1-84905-384-6_colourjpg-printMarion Baraitser demonstrates the power of writing with traumatised children and young people. Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.

On the value of writing with traumatised young people:
When disturbed young people have read aloud together a strong text, talked about it with a practiced facilitator in a roomful of trusted community members, discussing characters and subjects that concern their own lives, and then written about it, it can transform their idea of themselves and of their future lives. They are better able to externalize self-hood so they can exist in the world, feeling that their internal being has connected to the outside world through books, in some profound way, a form of ‘being-in-development’, a process of growing and changing the many selves they can uncover by this process. The facilitator brings energy, optimism, warmth and responsiveness, even inspiration, or at least motivation or affirmation, to each session.
Here is Amina on the value of writing in helping her to heal:
Writing is helping me to put down memories, different perspectives, to try to find the line… Talking doesn’t do this. When I write I am having a relationship with my journal. Writing is like having a conversation with yourself. I tend to be more honest… pick up on things that lie deeper. I love myself, in writing… I am lucky to be here… I am lucky to be alive… You must keep going and finding yourself, at the same time staying true to yourself… even though you cannot forget where you started from.


How reading great books together can change lives:
The Nigerian writer Ben Okri, who holds childhood memories of civil war in Nigeria, of his schooling in Lagos 400 miles from his family and of how, on reaching England, he lived rough, by his wits, homeless and miserable. He went to London because of Dickens and Shakespeare, but he also loved African writers like Chinua Achebe and Wole Soyinka. ‘Literature doesn’t have a country. Shakespeare is an African writer… Dickens’ characters are Nigerians.’ (Okri, 1992) As the young people read aloud in the company of a facilitator and a like-minded group, they become the writer, they are taken out of themselves, and if the writer is worth his salt, that encompasses a whole new set of dimensions that can change the way they regard life and their place in it.

Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.




The Self-Portrait Dance – extract from Anna Halprin

Learn about the self-portrait dance – An interpretation of oneself through drawings of the individual components of the body. Merging them together allows you to see the image you have of yourself brought about by your subconscious. When combined with dance, the mind and body can connect and begin to raise questions about this image.
For more on the life and works of Anna Halprin, see Gabriele Wittmann’s book ‘Anna Halprin – Dance – Process – Form’  


The perceptual journey through the body, accompanied by Movement Ritual and psychokinetic visualisation, can be followed through images, texts and episodic dance. Visualisations of different areas of the body – the head, spine, ribcage, shoulder girdle, abdomen and pelvis, arms and hands, legs and feet – finally come together in the drawing of a life-size self-portrait in which the separate images fit together in one large whole. Daria Halprin says: ‘Thinking of the body as a family made up of separate yet interrelated members, we know that each part has an impact on the whole and that each part can help us understand the whole. When a family is in conflict, it is important to listen to each member separately as well as listening to how they communicate with one another so that we can really hear and understand.’36 As if in a mirror, the person who did the drawing sees and encounters herself in the image she has created, and embarks on the journey of deciphering the messages concealed in it. She approaches the image not as one who knows, but as one asking questions. Anna Halprin drew a self-portrait and transposed the image into dance when she was coming to terms with her cancer diagnosis, of which she writes:


‘This process of connecting with our internal imagery involved “dancing” the images that welled up from the unconscious as another way of connecting the mind and the body. In learning this imagistic language, it became clear I was receiving messages from an intelligence within the body, an intelligence deeper and more unpredictable than anything I could understand through rational thought.’ Various pathways open up as one approaches one’s self-portrait. The person who drew it lets the entire image, or aspects of it, speak to them and tries to hear, see and feel its messages (see Figure 18). The selfportrait is asked questions: Where are you from? Where are you going?


Answers come out of the silent dialogue, from the ‘soul’ of the image.38 In creative writing, texts and dialogues emerge between different forms and figures inthe image. They open up the gaze and the senses to the hidden, mysterious, unknown and seemingly alien, and blend together in a life story of the self-portrait. Processes of developing a concluding performance are walked through, following the model of RSVP Cycles (described below). The emotional process of discovery follows the thread of the Five-Part Process on the way to integrating the experiences gained.

For more on the life and works of Anna Halprin, see Gabriele Wittmann’s book ‘Anna Halprin – Dance – Process – Form’  

Summer Holiday activites for younger children with Autism and other learning difficulties (Day 5).

This one probably requires a trip to the local arts store but will provide hours of possibilities and fun once it’s mixed together.


In just a few steps we can turn basic tap water into buckets of fluorescent fun.glowing_water_by_plmethvin-d37fq3m

Here’s all you need

  • Water
  • A container
  • NON-TOXIC fluorescent paint
  • Backlight bulb

1. Add a few tablespoons of fluorescent paint in any color into very warm or hot water:

2. stir until completely mixed

3. add as much water as you’d like to increase the volume, stopping before the glow is too diluted.


You’ve got the base for glow-in-the-dark water balloons.

And that’s IT! Now get glowing!


Taken from The Asperkid’s Game Plan by Jennifer Cook O’Toole

Drawing your family as animals – activity from How to Get Kids Offline, Outdoors and Connecting with Nature

In this extract, you can try several different activities based on drawing family members metaphorically. For the younger children, this may be a case of drawing the family as people and this should still be encouraged despite not being within the guidelines of the activity! Older children may enjoy the chance to be creative by taking characteristics of the family members and representing them in animals and types of water.


read the extract…

For more great activities to keep children stimulated and active, see Bonnie Thomas’ How to Get Kids Offline, Outdoors and Connecting with Nature.

Summer Holiday activites for younger children with Autism and other learning difficulties (Day 1).


We realise the importance of keeping children occupied over the summer holidays and with that in mind will be featuring a different activity that you can do with your kids every day this week. These will be interesting, low-cost activities for parents with younger children – first up today is a drawing exercise that can involve the whole family (including the family pet).



Primary learning focus

  • Auditory perception, visual-motor integration

Materials needed

  • Paper and markers or crayons
  • File folder or other object to use as a visual barrier


In this game, the child attempts to draw a picture that looks the same as the adult’s picture, given only auditory clues. The adult and child each have paper and drawing materials. Place the file folder or other barrier in between the child and the adult, so they cannot see each other’s paper. The adult then draws one item at a time, giving a verbal direction for the child to do the same thing. For example, the adult might say “Draw a large square in the center of the paper, with a small circle inside the square. Next make a smiley face in the top left hand corner of the paper.” After several directions, remove the barrier and compare the two pictures, discussing how they are different or similar. Let the child take turns being the one to give directions to the adult.


  • Use lined paper and give directions to copy sequences to encourage memory skills (for example, “Let’s draw circles to make this pattern: red, blue, green, red, blue, green”)
  • While shapes and colors are easier to describe, this game is also fun when you make it more creative. For example, give directions for drawing the family pet, but add silly directions, like making a green tongue, or wearing dog mittens.
  • Draw while lying on your belly, or at a vertical surface to strengthen upper body skills.


As featured in Simple Low-Cost Games and Activities for Sensorimotor Learning by Lisa A. Kurtz

Reconnecting, establishing safety, empowerment with humour – extract from ‘Unpack my Heart with Words’ By Marion Baraitser

In this extract, Marion Baraitser provides activities for both younger and older children in order to explore their feelings of safety and the importance of humour.
‘Reading and expressive writing with traumatised children, young refugees and asylum seekers – Unpack my heart with words’ is available now from the JKP website. 

Baraitser_Reading-and-Exp_978-1-84905-384-6_colourjpg-printYoung adults’ group

Reconnecting, establishing safety, empowerment with humour

1. Read aloud together Sholem Aleichem’s story On Account of a
Hat (1953). It is about a young man from the shtetl returning
home on a train anxious not to be late for his wife’s celebratory
dinner, who finds to his horror that he has by mistake picked
up the hat of the important official sitting next to him on thestation. Everyone treats him with a deference entirely false to
him. He is forced to return to the station, replace the hat and
arrive home late for dinner, to an enraged wife.

2. Ask the group to talk about their own humorous incidences of
frustration within their everyday lives that involve their need for
finding a safe place.

3. Write about stories they know about how to face dangerous
and frustrating situations realistically, and how to find workable
solutions that give a measure of empowerment.

4. Read these aloud and share.

5. Enact them.

Young children’s group

1. As a warm-up, pass an endearing stuffed animal around the
group, with each child saying how they are feeling and what
they would like to talk about.

2. Create a safe place in the room and ask them to create a pose,
then tap each person to ask them to show and tell the group
what their space looks like, what it contains and what they are
doing there.

3. Ask each person to make sculptures, using ‘characters’ that
threaten them. Then ask them to step away and make changes,
telling their feelings to the group. Or they may create a wax
museum containing characters from their past that reflect their
feelings and situations about a theme such as anger or hate and
the others can walk through it.

4. Enact these ‘characters’. The rest of the group should question them.
Write stories about them.[AQ]

I was on my mettle – after a lifetime spent with literature, I needed to sift and sort the books I knew that were of great truth and impact, to find appropriate texts that applied to, or transformed, traumatised young people’s problems in a way they could absorb and use them effectively. This meant trawling through not only English literature, but also world literature in translation.

‘Reading and expressive writing with traumatised children, young refugees and asylum seekers – Unpack my heart with words’ is available now from the JKP website.