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About

All human beings respond to music and are inherently musical. This basic response to music is present from birth and remains throughout life, often unimpaired by disability or illness. It is this powerful and innate response to music through which music therapists develop therapeutic relationships with their clients (adults, young people and children). Musical communication and self-expression is common to all of us and is the powerful medium via which positive change and development can occur in music therapy sessions.

Engagement in music therapy sessions supports the development of physical, emotional, mental and social wellbeing. Clients are also supported to reach their full potential through regular active participation in a creative therapeutic safe space. Music therapists use music and sounds within sessions to communicate and interact with their clients. Music therapy is one of the creative arts psychotherapies and the nature of sessions is therefore confidential.

The music therapy team is made up of highly trained and skilled clinical practitioners who support their clients to engage in shared music making through improvisation, tailored to the unique responses of each individual. We are all state registered with the Health and Care Professions Council (HCPC).

What happens in music therapy sessions?

Most clients’ needs are supported with individual sessions so the support offered by the therapist is on a one-to-one basis. The therapist responds to movements / vocal sounds / instrumental playing led by the client, incorporating them into a musical context: by developing a relationship through spontaneous music making, the client can explore new ways of relating, leading to development and change. The use of musical sound as an expressive medium is central to all human communication.

  • Creative play through shared music making is always a central component of music therapy sessions and plays a crucial part in the development of social and emotional wellbeing. It is just as important in adults as in young children.
  • Children can experience meaningful communication with the music therapist through vocal and instrumental sounds before they have developed formal language. Making sounds with musical instruments offers a non-verbal means of communication and self-expression.  This is just as important for adults who do not have formal spoken language.
  • Clients can create musical self-portraits through the music being improvised with them and there is a direct connection between their needs/difficulties and this music. Thus music therapists experience the music improvised in sessions as the expression of the person’s self at that moment. A wide range of feelings may be experienced in response to musical sounds in sessions, whether improvised or pre-composed.
  • The music therapist is able, via clinical improvisation techniques, to reflect musically the emotions that a client may be feeling which helps to develop experiences of emotional self-expression and self-awareness.  
  • If the client’s needs predominantly relate to communication and social interaction difficulties with his /her peers then group sessions may be more appropriate. 
  • Music therapy sessions are often recorded for the therapist’s clinical use. Consent for audio or video recordings will be discussed with the person making the referral. Refusal for any recording will not affect the client’s access to music therapy sessions. Recordings constitute part of the client’s clinical notes and are therefore securely stored as confidential records. 

Who might benefit from music therapy sessions?

Adults, young people and children with a range of conditions, including:

  • learning disabilities
  • developmental delay
  • dhysical/sensory disability
  • autistic spectrum difficulties
  • communication disorders
  • emotional and/or behavioural difficulties
  • lack of self-confidence or poor self esteem
  • attachment issues
  • neurological conditions
  • dementia
  • abuse (physical/emotional/sexual)
  • life limiting conditions
  • mental health issues, including anxiety and depression
  • trauma and bereavement experiences.

 

 

Our services

We work with children, adults and community groups throughout Hertfordshire. Referrals can be made directly to us by parents and carers, by adults who may self-refer or by professionals involved with these client groups. Our team aims to support the people involved with the vulnerable children and adults with whom we work and we aim to liaise closely with those involved with our clients.

We work in schools, music centres, care homes and other suitable venues within the county. We offer two types of service:

  1. Our Sessional music therapy service which takes referrals for children, young people  or adults from individual referrers and are usually delivered at the client’s base, which may be a school or care home, or in one of our county music centres
  2. Our Contracted services via service level agreements (SLA) Usually for schools or care homes who wish to contract a period of time (half or whole day) each week for a full year at a time and who then make their own referrals within this service

We offer both individual one-to-one sessions between the client and the music therapist and group sessions. The needs of the individual client will determine whether individual or group work is most clinically appropriate.

 

The referral process for sessional work

  • The first enquiry will be followed up by informal discussion with you as the referrer via a phone call or email communication from the Head Music Therapist, Jennie Small.
  • A referral and consent form and information about the sessional service will then be sent if the person making the referral wants to proceed on to arranging a music therapy assessment for the client.
  • Further discussions to arrange a suitable venue and regular weekly session time will be followed by the allocation of one of the music therapists in the team for the client.
  • This music therapist will then have an informal discussion with you and arrange an initial visit to observe the client in their normal setting, usually at school or at a care home. They will also speak to other appropriate professionals in order to begin to get to know the client before the first actual session. This is a very helpful starting point and enables us to form a better understanding of the needs of the client. This initial visit forms the first of the assessment sessions - further details about the assessment process are below.
  • You will be asked to agree to the terms and conditions of the sessional service before the first music therapy session can take place.

 

The referral process for Service Level Agreement work

Referrals are made in the same way via referral and consent forms. Discussions about the initial referral would happen in the school or care home between the music therapist and professionals in the team making the referral. Observation of the client would happen in the same way before the first session.

Please contact the Head Music Therapist, Jennie Small, for more details and costings for Service Level Agreement (SLA) contracts.

The current cost for a whole day music therapy SLA (December 2019) is £9400 and for a half day £4700.

 

Music therapy for children

Music Therapy is especially valuable for children who have difficulties with verbal communication or who might not feel comfortable using counselling sessions.

A music therapist forms a musical relationship with a child through improvised music making. A variety of musical instruments is available in the room, such as drums, cymbals, xylophones, usually a piano and guitar, and maybe some smaller instruments such as tambourines, shakers and bells.

The therapist will also usually sing. The child will be supported to make
music through which they can express themselves.

 

The assessment process

There will always be an initial assessment period of 3 or 4 sessions, during which the therapist will begin to get to know the child and will assess their suitability for ongoing music therapy. A written assessment report will be prepared and the therapist will discuss with you whether music therapy is going to be an appropriate way of working.

In the unlikely event that the therapist decides, following the assessment sessions, that music therapy is not going to be suitable you will only pay for the assessment sessions.

It is quite usual that a child may attend music therapy sessions for at least a term or longer, so there is a firm commitment required. You will be asked to agree to the terms and conditions of music therapy sessions before the first session can begin.

 

How will the sessions be arranged and will I attend with my child?

  • The music therapist who will work with your child will ring you for an informal discussion before sessions begin and to arrange a suitable time for you.
  • Sessions will always take place at the same time and in the same venue each week, with the same therapist. Music therapy works via the development of a musical relationship between the therapist and the child.
  • In music centres only: normally, unless the child is very young, they will attend in the therapy room on their own.  There will be a space for you to wait outside the room. This offers the child a space to work in their very individual way to form a musical relationship with the therapist. Children’s behaviour is accepted within music therapy sessions and understood in terms of what the child is communicating about their emotions.

 

How much do children's therapy sessions cost?

  • Individual sessions cost £41 per session. A session may be 20 – 25 minutes of actual contact time for very young children, 30 – 40 minutes for older children and young people. The therapist will write detailed clinical notes following each session. There may also be some feedback discussion with you – if appropriate – or the therapist may take time to phone you to discuss sessions. It is often not appropriate to discuss the content of the sessions with you if the child is also present.
  • Paired sessions cost £21 per child per session and group sessions will be £15 per child per session.
  • The therapist will write assessment and other reports as appropriate and these may be available for EHCP reports or other professionals.
  • There will be at least 33 weeks of therapy sessions per year, 11 per term, although sessions will usually run for the whole term if agreed between you and the therapist. Some terms are up to 13 weeks and 11 sessions in a term would leave a long break between sessions.
  • You’ll receive your first invoice shortly after sessions have started and these will be on a monthly basis. Invoices will be adjusted for missed sessions, if you have given at least 24 hours’ notice. You will not pay for sessions cancelled by the music therapist.
  • Eligible families can get help with music fees. Children Looked After are entitled to music therapy sessions without charge.
  • Absences: You will need to give at least 24 hours’ notice of a cancellation otherwise you will be charged for the session (in accordance with British Association of Professional Music Therapists’ guidelines)

 

If you wish the child to finish music therapy sessions this will need to be discussed with the music therapist and then you will need to give half a term’s notice in writing.

If the therapist decides, in consultation with you, that the child is ready to finish sessions, half a term’s notice will usually be given. It can sometimes take children a long time to form a trusting relationship with the therapist and children’s development will be very much helped by adequate preparation for the ending of relationships.

 

How do we get started?

Guidance for parents and carers

What happens in a music therapy session?

The music therapist will aim to establish a musical relationship with your child through shared music making with the accessible instruments available in the room. We will use singing and instrumental play as a way of engaging your child in improvised music making. One of the main aims of music therapy sessions is supporting the development of social interaction, communication and self-expression. The shared music making in sessions is always tailored to your child’s individual needs. 
 

How is therapy different from school or a music lesson?

The therapist will usually allow your child initially to take the lead in sessions rather than direct them in the way that teachers do. This supports the development of a trusting relationship and also allows the therapist to observe and assess your child’s natural skills and development. Following the assessment period the therapist will be able to judge how to develop the sessions to address your child’s needs.  

What do parents/carers do during a session?

Children need time to be able to explore the room and the instruments freely during sessions without feeling that they are being judged. They will do this best in their own way and in their own time. 

If your child is very young and unhappy to be left, you will be asked just to observe quietly and not interrupt the session. Some venues are easier to work in than others - this will de-pend on the location. All children need to gradually learn to trust in new relationships if they are to negotiate school and the world outside home successfully so learning to leave you and build a relationship with the therapist is important for their development. The child’s best interests always need to be taken into account when making a decision about this - but even if your child is happy to remain with the therapist you do need to remain on the premises at all times. 

How long does each session last?

The maximum clinical time will not be longer than 30 minutes - very young children may take time to build up to this length of session. It is not uncommon for a young child to tolerate only a short time in a very new environment and we need to allow children to develop trust in new relationships - try not to insist on a child remaining in a session, or re-turning to it if they are clearly upset. They need to feel in control and free to choose. Over time your child will become familiar with the room and the therapist and may well feel happy to remain for longer. 

What does the fee cover?

Unlike with music lessons or other activities, the fee covers more than the active clinical time. It covers your child’s session, feedback time with you, detailed note writing that the therapist does after each session, report writing and discussing issues which may arise in clinical supervision.


How long will therapy last?

After 3-5 weeks of assessment a decision is taken whether or not to continue. The building of a therapeutic relationship does take time and it would be normal for a child to come to music therapy for around a year - often longer.
 

How will therapy be reviewed?

We provide regular reports for you and other professionals working with your child. We will review therapy with you - either through weekly feedback or through a separate meet-ing/phone call. This depends on each individual situation.

Do you keep in touch with my child’s school?

Yes. We will give feedback/reports to your child’s school and other professionals involved with him/her. We will attend review/CAF/EHCP meetings when we are invited/able to.
 

Will my child learn musical skills?

The role of the music therapist is to form a musical relationship with the
child, rather than teach musical skills. However, improvised music making forms an essential part of this process and children usually gain confidence and improved co-ordination, listening and rhythmic skills - all essential musical skills.
 

Who are music therapists?

Music therapists are professionally qualified and state registered with the Health Professionals Council which ensures that they are competent to practise. They are experienced in working in education with children and young people and have all been police checked.
 

How long will the music therapy sessions last?

The length of each session depends on the age of the child. Very young children (under 5) will probably have shorter sessions of 20 - 25 minutes. Older young people may have up to 40 minutes. It takes time to form a therapeutic trusting relationship with a child, especially if they have a number of difficulties, so the therapist would expect to work with them for at least one term but most usually for a year or more.
 

Where will sessions take place?

There is usually a room set aside for the therapist so that sessions always happen in the same place, and usually at the same time.
 

Is it confidential?

A key feature of music therapy is that, like all other types of arts psychotherapies, it is confidential. This means that the child can feel safe in expressing concerns without fear that they will be discussed elsewhere.

However the therapist will feedback any general points without breaking confidentiality, and reports of a general nature will be written for annual reviews.

If there are child protection concerns and a child appears to be at risk of significant harm, it may be appropriate to seek help from other agencies in line with the safeguarding policy, if appropriate.

Music therapists also attend personal supervision sessions to ensure the quality of their work, but their clients are discussed anonymously.

Help with music fees

 

What people say about children's music therapy sessions

From a new client after the first couple of sessions:

Thank you so much for today's Sessions. The Group Session was a revelation and we saw meaningful interaction and engagement from all of our Residents who participated. The whole Session was handled beautifully and all of our Residents and our Staff cannot wait until next week's session. The 1:1 Session with R. was also a great success and his Mum, who observed some of the Session, was especially delighted with his reaction to the music and the rhythms and his general demeanour and enthusiasm. Thank you once again from all of us, I have no doubt that Monday Music is going to become one of the high spots of every week.

 

From an advisory teacher in Hertfordshire County Council:

"I attended PEP for AB today who you are working with at school.  All professionals reported how beneficial the music therapy sessions are for A. and how much he is enjoying them.  A's behaviour has significantly changed in school and he is now able to access the classroom."

Quote about music therapy from A's mother:

"Since my son started music therapy he has changed emotionally.  He is much happier and his language has got much clearer.  The music really helps reduce his anxiety and every time he gets anxious at school he looks forward to seeing his music therapist and he feels very comfortable with her.  He can share all his thoughts and feelings with ease.  Thanks Herts Music Service for this support."

Quote from a teaching assistant involved in a music therapy group:  

"The children have made so much progress from where they started in September and their progress is being generalised into class – they now often sit really well. They really come out of themselves during the music session. They are more engaged and one child in particular is really developing the use of his voice. It’s a shame they can’t all have it!"

From an observation undertaken by an LSA:

"H. was engaged, pro-active, relaxed and happy for the entire session. The sounds and music improvised by the music therapist provided a relaxing but creatively stimulating back-drop for H.'s direction of play. She showed an awareness of the interaction, confidently leading, and seemed to be in her element and very 'free'.It was a very valuable one-to-one session, building brilliantly on H's total communication skills"

 

Music therapy with adults

The assessment process

  • Following the initial referral an observation visit to the client’s usual base will be arranged. This forms the first assessment session. The music therapist will talk to other professionals working with the client as well as meeting the client themselves.
  • There will then always be an initial assessment period of 3 or 4 sessions, during which the therapist will begin to get to know the adult and will assess their suitability and responses to ongoing music therapy. A written assessment report will be prepared and the therapist will discuss with the carer of the adult – if appropriate - whether music therapy provision will be of benefit. In the unlikely event that the therapist decides, following the assessment sessions, that music therapy is not going to be suitable only the assessment sessions will be paid for.
  • Once it has been established that music therapy sessions will be of benefit to the client then these will be ongoing, usually for at least six months but most often longer, so there is a firm commitment required.
  • Music therapy sessions for adults will usually run throughout the year, with special arrangements during holiday periods.
  • Payment for sessions. The Head Music Therapist will confirm who holds the client’s funding, if not the client themselves, and therefore who will be invoiced for the sessions. You’ll receive your first invoice shortly after sessions have started and these will be on a monthly basis. Invoices will be adjusted for missed sessions, if you have given at least 24 hours’ notice. You will not pay for sessions cancelled by the music therapist.

 

How will the sessions be arranged?

  • The music therapist who will work with the client will ring you (as the person who made the initial referral) for an informal discussion before sessions begin and to arrange a suitable time for the first observation visit.
  • Sessions will always take place at the same time and in the same venue each week, with the same therapist. Music therapy works via the development of musical relationships and consistent boundaries about the session time and venue are central to the building of a trusting relationship between the client and the therapist.
  • Normally, unless there is an established risk, the client will attend in the therapy room on their own.  This offers the client a space to work in their very individual way to form a musical relationship with the therapist without being observed or judged. The therapist will liaise with professional staff working with the adult if appropriate to discuss the risk assessment.  

 

Absences: you will need to give at least 24 hours’ notice of a cancellation otherwise you will be charged for the session (in accordance with British Association of Professional Music Therapists’ guidelines)

If you wish the client to finish music therapy sessions, you will first need to discuss this with the music therapist and if agreed, give six weeks’ notice in writing.

If the therapist decides, in consultation with you, that the client is ready to finish sessions, six weeks’ notice will usually be given. It can sometimes take people a long time to form a trusting relationship with the therapist and their emotional and mental wellbeing will be very much supported by adequate preparation for the ending of relationships.

 

How much do adult therapy sessions cost?

  • Individual sessions cost £49 per session (from December 2021). An hour is allowed for each session but this will include clinical note writing and processing time following each session. The actual contact time with the therapist will vary between clients. Some adults initially find the nature of individual sessions very intense and there needs to be a period of acclimatisation during which sessions may be shorter. Clients may leave and re-enter the therapy room later in the session. This is an important part of the therapeutic process.  There may be some time for feedback following some sessions if appropriate or the music therapist may prefer to arrange a time for feedback via a phone call if more suitable.
  • Detailed assessment and review reports will be available. Information will also be prepared for other professionals as appropriate.
  • The therapist may ask for consent for confidential audio and/or video recording of some sessions, in order to reflect personally on clinical work in more depth. This can be discussed with you if appropriate.
  • Music therapy for most clients would be in individual sessions. However adults, especially those with a significant learning disability, may respond better to flexible group work which they can access in their own way and at their own pace.
  • Small group sessions (at least 3 clients) are charged at £17 per client per session. There is a special rate of £10 per client for larger groups of more than 5 adults. 

 

How do we get started?

  • Contact Jennie Small, Head Therapist, on 01992 555 401 or jennie.small@hertfordshire.gov.uk for an initial informal discussion.
  • Complete an adult music therapy referral and consent form.
  • Talk through more details with the therapist concerned before beginning sessions. You’ll be asked to agree to the terms and conditions of the sessional service before the first session can take place.
 

What people say about adults' music therapy sessions

From a new client after the first couple of sessions:

Thank you so much for today's Sessions. The Group Session was a revelation and we saw meaningful interaction and engagement from all of our Residents who participated. The whole Session was handled beautifully and all of our Residents and our Staff cannot wait until next week's session. The 1:1 Session with R. was also a great success and his Mum, who observed some of the Session, was especially delighted with his reaction to the music and the rhythms and his general demeanour and enthusiasm. Thank you once again from all of us, I have no doubt that Monday Music is going to become one of the high spots of every week.

 

Headway Hertfordshire: "Big Thank You to Hertfordshire Music Service for providing Headway with Music Therapy Sessions. Our clients decided they wanted to write and produce a song about how they feel most days - the result is now on YouTube"

 

 

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