On the tip of my tongue Series 3 Episode 7 - "Therapy Notes: Elizabeth Nightingale"

Transformative Power of Music Therapy with Elizabeth Nightingale

In this podcast episode of 'On the Tip of My Tongue,' hosts Rob Edwards and Jonathan Hirons are joined by Elizabeth Nightingale, a neurological music therapist. The discussion delves into the impactful role of music therapy across various fields, including stroke recovery, pediatrics, and palliative care. Elizabeth shares insights into the innovative programs at Chilton Music Therapy, which blend music with community outreach and online learning. The conversation also covers the specifics of music therapy for Aphasia patients, highlighting the cognitive and emotional benefits, the development of new neural pathways, and the creation of supportive communities. The episode emphasizes the nationwide accessibility of these services through online platforms, making therapeutic music interventions available even in remote and under-served areas.

00:00 Introduction to the Podcast

00:54 Meet the Hosts and the Topic of Aphasia

01:49 Welcoming Elizabeth Nightingale

02:23 Overview of Chiltern Music Therapy

03:57 Impact of Music Therapy on Various Conditions

05:22 The Science Behind Music Therapy

07:23 Online Aphasia Music Therapy Groups

09:13 Access and Participation Details

18:23 Promoting the Online Groups

21:24 Concluding Remarks and Resources

For more info about Chiltern and Aphasia

https://www.chilternmusictherapy.co.uk/stories/use-your-voice-aphasia

Transcript

Podcast - S3 E7 - Elizabeth Nightingale (Chiltern Music Therapy)

@Rob: [00:00:00] Tune into our latest podcast episode featuring Elizabeth Nightingale, a neurological music therapist. Discover the incredible impact of music therapy in diverse fields from stroke recovery to pediatrics. Chiltren Music therapy is pioneering programs that blend music therapy with community outreach.

Whether it's supporting premature babies or offering palliative care, learn how children's innovative approach makes a difference. Plus explore their new online learning platforms designed to empower caregivers with musical tools. Don't miss this insightful conversation on transforming healthcare through music.

Listen now, we'd love to hear from you. Check the show description to text us any questions.

Hi, and welcome everybody, and we hope you enjoy this [00:01:00] podcast called On the Tip of My Tongue. Now I'm Rob Edwards. And I'm Jonathan Hirons. And this podcast is a follow up to a film which Jonathan made about Aphasia. So what is Aphasia? Well, it's a condition caused by some kind of injury to the brain, which is often could be a stroke or could be just falling off a bike and it affects your a bit of.

To use language in all its forms, speaking, writing, reading, sending texts, whatever. 350,000 people in the UK suffer from a debilitating condition called Aphasia. Fewer than half this number suffer from Parkinson's, and yet most people have heard of Parkinson's. Whilst almost nobody has heard of Aphasia.

Elizabeth Nightingale: So, welcome Elizabeth. Thank you for coming on on the tip of my Tongue podcast. It's great to have you with us. Perhaps you can tell me a little about, about yourself. 

Yeah, sure. It's great to be [00:02:00] here. Thanks for having me. So I am a qualified neurologic music therapist, and I have a couple of roles at Chiltern. One involves kind of overseeing. Some of our different neuro services but I also work as a clinical practitioner specializing in stroke and brain injury, and I also do some work in pediatrics as well.

Tell me a little bit about Chiltern music therapy. 'cause it's an interesting organization. So you tell me , what it, what it does. 

Yeah, so Chiltern, we are a nonprofit social enterprise and we provide music therapy services all the way from kind of premature babies all the way through to kind of palliative care, elderly care, and everything sort of in between. So we have music therapists that might be working in school services. Or in a hospital or in community, seeing [00:03:00] people at home as well.

And we additionally have a range of community groups that we run in person or different kind of client groups supporting in different areas. Some of those are run by music therapists and some of those are run by our community musician team that we have as well. And we have recently launched some online learning platforms.

As part of children's offering as well, so kind of increasing our training arm for equipping family caregivers and other therapists in kind of healthcare with different ways of using music to support their work. So a whole range of things really that we do as an organization.

Obviously as you said that you go out into the wide world. It's not just online, it's in groups presumably. I think I said somewhere you go to care homes and that sort of thing. Is that. 

That's right. Yeah. So in terms of the kinds [00:04:00] of clients that we might see, we might be supporting people with global developmental delays. We might be supporting people with autism or a ADHD but it might be. Neurodegenerative conditions like dementia, Huntington's, Parkinson's, or perhaps more on the rehabilitation side might be supporting people who've had a stroke or a brain injury.

So it's a real broad spectrum. And then we do also do a lot of mental health support in kind of mainstream settings as well. So somebody doesn't have to have a specific diagnosis to benefit from accessing music therapy, but we would seek to kind of support. People in four main areas, we tend to say, so we might be supporting them emotionally in terms of wellbeing.

It might be with supporting them more functionally in terms of things like communication or cognitive skills, or even movement skills as well. Mm-hmm.

Yeah, I mean, music is a, a [00:05:00] fantastic thing, isn't it? Obviously I've come across this you know, on my journey as they say. And some people who can't, for example, can't speak, we'll talk about this later, but can't speak, but, but they can make noises may not sing, but they may. Singing like noises, should we say.

So it is a fantastic thing. , Do you know why music has that effect on people? 

Well, what we know from the research to date. Is that nothing stimulates so many parts of the brain at the same time as music. And we also know that because of the unique way in which it's processed in the brain, it can be used to kind of build new neural pathways around areas that have been damaged, perhaps by disease, maybe by injury, the brain as well.

And it's that global activation really. So it's interesting you, you gave an example there, which we often might reference actually. we are speaking, [00:06:00] our language center is on the left side of the brain, but if we're singing, we actually engage the right hemisphere. So we're using a different part of the brain.

So that can create a great in for us as music therapists because if we find the language side is damaged on the left, but the right is intact, we might be able to use singing or phrases in tone singing. To have an alternative in to then begin working on some of their functional speech.

Does it help people improve with their, the left side? So if, if the right side's working better, should we say if you've got as I do something like Aphasia does it help, it doesn't obviously cure it, but is it, does it help people use your language better.

Absolutely. I mean, what we know with the, you know, the principles of neuroplasticity is music can be a great tool for really supporting in that as well. [00:07:00] So we can, as I say, kind of build those new pathways using music in a unique way in which it's processed to create new pathways to support somebody after something like a stroke.

And that might be specifically around language. Areas, or it might be, as I say, something around some of their cognitive skills or their movements needs as well.

Right. So maybe it's a good time to move on to your the thing we're actually gonna talk about, which is your work with people with Aphasia. So perhaps tell me a bit how, how that's gonna work.

So we have recently launched some online Aphasia music therapy groups, and those are groups that we are going to be running twice a week on a Tuesday morning and on a Thursday afternoon. And the kinds of things that we'll be supporting people within those groups will be around communication and [00:08:00] social interaction.

Some cognitive areas as well that we'll be supporting and really equipping people with ideas and strategies using music that they can carry forward every day to support them with speech, communication, attention, skills, memory, different kind of strategies that people might need to support them every day will be kind of using and exploring and sharing together in those groups.

So how we, we, we talk about a group, how, how big will the groups likely to be,

That's a good question. So I know the groups, we are trying to not make them too large 'cause we want to be able to foster those kind of relationships and a sense of community in the group as well. So I know at the moment. We've recently launched in the group. Currently is sort of under, I think it's just under five, but we'll be growing that over time.

But I think the idea is that we wouldn't have more than sort of 15 [00:09:00] to 20 per group. But if we're seeing the need continue increase, great, we will launch some other groups. That's what we're really hoping is that we'll be able to increase that appetite over time.

I think that the takeaway for me, for you, for your organization is you do it anywhere in the country. I mean, the problem I I, and obviously I've come across this as well, sometimes , you get some parts of the country. They have good communications with people like with Aphasia, and some have none.

But obviously you are, you are beating that by, by being online. 

I mean, you're right, it's, it's a real postcode lottery, particularly when you are looking at community access post discharge. I know some NHS trust, for example, where the waiting list perhaps to access. Community speech and language therapy might be over a year that someone's wasting from the point they're now back home.

And we know that can be really, really challenging [00:10:00] for families. So being able to have an online option that kind of overcome some of those geographical barriers is something that really kind of a aligns with our values of kind of increasing access for people in the community.

Right. And does this include the, the people who are caring for the people with Aphasia? 'cause obviously some people have more skills than others, don't they?

Absolutely. So caregivers or family members are very welcome to join on the call as well. Sometimes that's been great for them to have those shared experiences together for those caregivers also to learn about things they might wanna carry forward with that person in the week. And other times we've seen where they've joined them initially thinking, well, they're really gonna need my support.

But actually as they've got to know the therapist, as they've become more familiar with the group members, actually that's then something they've been able to attend more independently, which has felt really meaningful for some, some individuals. So yes, it's something we're open to [00:11:00] and very supportive of if that person needs that support in the session.

And we're talking about, obviously music's involved in this, but we're, we're not talking about a choir, are we, we're talking about using music as a way of, as you say, opening up part pathways or, and that with the person who's got the problem Aphasia or whatever. 

Absolutely. So yes, you know, there will be, there will be kind of vocal based exercises, but. The goal is more around sort of developing and rehabilitating some of that communication and then we might be trying to synthesize that work through some shared singing after doing some targeted work. But that's really to kind of bring together all of those communication areas that we'll have been working on.

But there'll also be opportunities to practice different types of communications that we might be doing. Music listening and reflection. We might be doing some [00:12:00] songwriting and making choices together and how do we make choices and how can we practice and explore and support each other in different ways to share our preferences when we do have Aphasia.

So there'll be a whole host of kind of fun, engaging ways of sort of supporting people in the fashion, so not just focused on 

Jon: singing. 

Elizabeth Nightingale: I mean, I mean, songwriting sounds interesting. I have to say that's, you wouldn't, you wouldn't, I wouldn't immediately think about doing songwriting. But I suppose the, the, is that just picking on songwriting specifically, is that to do with the, the rhythm of the, the, the words as well as the, as the music itself is, is that the idea? 

It can be, but it also, song writing can be a really great way of working on executive function skills like choice making, organization and planning, reasoning and comprehension, but through a really fun, engaging task. And particularly in a group setting, it can be really [00:13:00] rewarding to be able to contribute working on those skills and create a high quality kind of product together at a period of time.

So when we've done exercises like this before, we might be using, I have a number actually on my desk here. We have different visuals we might be sharing. You know, do we prefer option one or two? Would we like this instrument? Do we want it fast or slower? And why do you want, why do you want that one? Can you give us a reason?

Can you explain or can we work on some problem solving together? 

So there's lots of fun ways of practicing those sort of executive function skills through something like songwriting. That of course, when we come to writing the lyrics then yes, that also then can feed into lots of other really meaningful communication.

Speaker 5: Loving the podcast. Subscribe for more episodes and support the journey. Your donations help keep the show thriving. Please go to tip of my tongue film.com. Thank you for being [00:14:00] part of our community.

Elizabeth Nightingale: Now. This is a, new initiative, isn't it? You're starting this up. , To what you've been doing previously.

Yes. So in the past when we've run online Aphasia groups, those have been exclusive and only been able to be accessed. By patients that were referred from a specific NHS service who had some community funding to do a project with us. So we know from experiences running those kind of exclusive groups that that's been really valuable for those patients.

Whereas this offer is something that anybody can refer into with Aphasia that wants to explore kind of whether an online group like this. Could be useful and enjoyable for them. And that's partly why we've also got this option for the pair. As you go to, people don't have to commit long term. They might just decide, let me try one [00:15:00] and get a sense of what that might feel like and be like for me.

And then if I enjoy it, I can look at looking some kind of blocks of apps. 

So and what, what are we talking about per, per session then in, in terms of money? 

Yes. If you are just doing a pay as you go option, it's 15 pounds for one session. But if you decide to then go on a book a block, then those are discounted so people can look into those different cost options on our website. So that would just be Chiltern music therapy co uk slash online. And when you scroll down on that page.

You'll see more information about the groups, so you can get more info on the cost options that one.

So it, I mean, it's, it's a relatively modest fee. I would say, I mean, you know, people pay this for Netflix or something, but, you [00:16:00] know, so, 

Jonathan Hirons: it's cheaper than going to the gym, so. 

Elizabeth Nightingale: well, it, it's basically a, you know, a gym for your brain probably way of thinking about. 

but write that one down. 

Jon: Yeah, exactly. Yeah. Like a full body workout for your brain. 

Elizabeth Nightingale: yes,

Good. 

Jonathan Hirons: Yeah. 

Elizabeth Nightingale: So are we talking about in terms of frequency, how, how often will you run these, these, these obviously depends on how many you get people in, but 

so the groups being run every week 

right. 

there will obviously be kind of breaks for kind of, you know, Christmas, et cetera, depending on where the dates fall. But yes, that is gonna be sort of something that's available to access every week for the foreseeable.

And, and how long will each session take?

Yeah, so sessions are up to one hour that allows sort of sufficient time to kind of welcome people, get 'em settled. Do a range of different kind of interventions together, and then have some wrap [00:17:00] up time at the end.

Okay, so presumably an hour is probably enough for anybody to concentrate on. Is it, is that, that really the idea about that. 

Jon: That's it. It is also, it's, you know, an online format can be more cognitively demanding for some clients who've had Aphasia. So it's, it's recognizing, you know, what would be sustainable for people. And also, you know, that feels like a shorter term commitment in someone's day. Hopefully something that they could commit to on a regular basis if they found that valuable.

Elizabeth Nightingale: Yeah. I, I think it really, it's really great. And I think I'm, I'm, as I say, I, I think the fact That it can be accessed anywhere in the country, presumably any in the world, I guess. But certainly in the country, and as we've said earlier, it's very patchy, isn't it? I mean, I, I waited when I had my, my bleed on my brain.

I think I waited six weeks before I saw a, a speech therapist. [00:18:00] And that's, apparently, that's quite quick.

That is very quick. Yeah.

But and some people, as you say, can wait months, can't they? Like, as, as depending on which part of the country they are. So they could obviously, they, they can come to you independently as it were.

So how, how, how are you going to, how are you going to show, tell people how that it actually exists? O obviously you've got a website, are you doing other things other than the website? 

Yes. We've been doing a lot on social media. We've been linking in with some different Aphasia organizations to kind of raise the profile, get the word out. We've been reaching out. To existing relationships we have with hospitals, but also other hospitals so that they might even signpost or recommend that for patients on, on discharge as a potential service that they might wanna consider.

So there's lots of different things we are trying to do to support and obviously things like this today, being able [00:19:00] to have different kind of platforms where we can let people know what we're offering.

Well, yes, I mean, obviously what will happen here, well, this, this won't go out, I'll tell you that. What I, we usually do is the, in the show notes, we'll have all the links to, to, to your as you say, the online thing. We'll, we'll put all those links into the into the shown notes, and we do, obviously we'll do some social media about you as well.

Jon: That would be great. Yeah. Thank you.

Elizabeth Nightingale: great. So all right, well, thank you. Elizabeth, Thank you.

very much. Is there anything else you want to say? Now you've got your opportunity. 

Probably just that when we have run these groups previously, as I said, in a more exclusive access to an NHS trust, we were working with at the time. One of the unexpected joys really of running that was. The relationships that ended up being formed between the people that joined the group and people [00:20:00] that actually then ended up forming friendships through that group, other family members and caregivers that then had another family who had been through something similar and the support that they were then able to continue developing outside of those sessions.

So that was really lovely to be able to be part of. not just a community online, but being a part of helping to foster a community that continued on outside of those sessions as well.

It's a fantastic thing to get people back in because when you've got something like Aphasia it's quite isolating. And getting back into the, the swing of things as it were. 

Jonathan Hirons: It's 

Elizabeth Nightingale: really important. 

Yeah, absolutely. 

And as we said, if you are living in a very rural area, perhaps, you know, limited public transport access, maybe you are, you're no longer able to drive, you know, what are the opportunities for you to access community in that, in that environment? So. Online can go some way to help [00:21:00] bridge that gap.

Yeah 

I always think not everybody's got somebody to you know, a partner or in that sense because they might be living on their own. 

Yeah. Not everyone has family nearby to support help. . 

So the, what you are doing is that it brings people into that, that into that area, doesn't it? It helps them think they're belonging to something.

At least 

Thank you Elizabeth, for coming on on the podcast.

It's great and, and, and good luck with, with what, what you are doing. 'cause I think it's fantastic with what you're doing. Thank you very much indeed. Okay.

@Rob: Thank you for listening to this on the tip of My Tongue podcast. We hope you found it helpful and informative. Now, if you want more help and information about strokes and Aphasia, please go to stroke.org.uk. Say Aphasia. That's SAY Aphasia, or one [00:22:00] word.org or the Aphasia page of nhs.uk. This has been a Buffalo Lounge production. Please follow Buffalo Lounge on all the socials.