Music and Resilience'

'Banda Senza Frontiere'

ass. Prima Materia, Montespertoli (Fi) Ulaia Artesud Onlus, Rome National Institute for Social Care and ocational !rainin" #$eit Atfal Assumoud# %e&anon Waldensian Church; Region of Tuscany; Province of Florence; Municipality Union Empolese- aldelsa; Municipality Montespertoli; !RC" Empolese- aldelsa; ER!M Music Therapy Florence; Finnish Psychologists for #ocial Responsa$ility; !ssopace Mola di %ari

Music Therapy Programme

Music Therapy in general - Description of model - Applications in NISCVT Presentations, seminars and pu lications - !mergence of pro lems and challenges, August "#$% Conclusions to date - & 'ecti(es of the "#$%-$) programme - IMTAP $st hypothesis of IMTAP application - Meeting *ith mental health team, !l us +,C, Suur, "-th August "#$% - Proposed meeting *ith all mental health team mem ers, .anuary "#$)/
I have prepared this brief report for all partners in the project and for NISCVT's Mental Health teams. 14 months after the be innin of the project! and at the be innin of a " nd #ear's plannin ! it aims to res$me the developments so far! and to offer possible h#potheses for f$t$re %or&. Music Therapy in general M$sic and so$nd str$ct$res pervade h$man e'perience from the ver# first moments of life. M$sic is perceived a( modall#! %hich acco$nts for its po%er literall# to 'move' $s. It is a pre( and non(verbal means of information! e'pression and comm$nication! %hich creates real(time e'perience sim$ltaneo$sl# re istered at sensor#(motor! affective and co nitive levels. This ma&es it a po%erf$l a ent of 'inte ration' and 'harmoni)ation'. It also has the advanta e of bein hi hl# motivatin as an activit#! %hether for therape$tic or other p$rposes* Contemporar# m$sic therap# +mt, practice has developed to define man# different models and methods! s$pportin preventitive! rehabilitative and care interventions in mental health and ps#chiatr#! ed$cation and ps#cholo #! oncolo #! pediatrics! eriatrics! intensive and palliative care. Description of model The mt model introd$ced in -ss$mo$d is 'So$nd .r ani)ation'! a personal elaboration of the ps#chod#namic improvisational model! informed b# -ttachment theor#! Motivational S#stems Theor#! and /aniel Stern's 'theor# of vital form'. It places m$sical activit# at the centre of the therape$tic process! %hich $nfolds b# means of pla#in instr$ments0 sin in 0 movin ! etc. The h$manistic approach places tr$st in the child's abilit# to ma&e positive chan es! %ith the s$pport of a ' ood eno$ h therapist' +li&e 1innicott's ' ood eno$ h mother',.The model is non(directive or at most semi(directive! leavin the child free to e'press and to e'periment %itho$t pre(set a endas. The ' $idance' of this freedom for therape$tic aims relies on the sensitivit#! s&ill and e'perience of the therapist 2 %e are %or&in on this*

Applications in NISCVT /$rin "31"(14! individ$al mt %as offered to some 43 children %ith var#in patholo ies! incl$din mental retardation! developmental dela#! speech and learnin disorders! emotional and attention disorders! a$tistic spectr$m! cerebral pals#. Cases %ere doc$mented b# video recordin and case st$d# elaboration! $sed for s$pervision and! in part for presentations +NISCVT conference Ma# "314! Ital# 5$ne "314,. - small p$blication +5$ne "314, presents an overvie% of the #ear's %or&! %ith 13 short case st$dies. - c$stomi)ed eval$ation form in -pril "314 collected data on positive chan e in the children in 4 main areas of f$nctionin 2 motor! co nitive! social0relational! e'pressive0comm$nicative 2 as observed b# the m$sic therapists! b# another specialists in the team! and b# each child's parents. The res$lts %o$ld appear to s$ est that mt is most effective! in this conte't and over this lar e ran e of patholo ies! in stim$latin and s$pportin improvement in social0relational and e'pressive0comm$nicative s&ills. Ho%ever! ood res$lts %ere also sho%n for improvement of co nitive s&ills and for motor s&ills6 it is li&el# that these improvements are relative to the specific cases %ith deficit in these areas. It is probable that mt is %or&in at base level to decrease emotional dist$rbance evident in all 7alestinian ref$ ee children d$e to their life conditions. Mt sho%s effectivness in6 rela'in defense mechanisms! b$ildin sense of sec$rit#! self(esteem and sense of a enc#! reinforcin emotional re $lation processes! improvin a%areness and e'pression of emotion. This addresses primar# objectives in cases of affective0relational disorders! and is $sef$l in all cases! in order to prepare the child better for the adaptive learnin processes tar eted b# other therape$tic disciplines. 8or the non( verbal child! or the child %ho finds the f$nctional $se of lan $a e diffic$lt! the so$nd0m$sic medi$m provides an alternative and essential means of comm$nication! the consolidation of %hich is a prere9$isite for lan $a e development. Presentations, seminars and publications These events tar et the objective of ma'im$m e'pos$re! both specificall# of the project and enerall# of the sit$ation of :ebanon's ref$ ee pop$lation! of 7alestinian and other nationalities! and of the NISCVT's socio(sanitar#(ed$cative mission; ""nd 5$n "31" 3=th Sept 1>th Sept 4rd Mar "314 -pril 1Bth(1Cth Ma# "Bth Ma# 1>th ( "4th Ma# 1=th Ma# 1=th Ma# 5$ne "3th 5$n "1st 5$n ""nd 5$n ""nd 5$n direct broadcast from <eir$t! Controradio 8lorence! intervie% %ith /eborah 7ar&er presentation Montespertoli! in the presence of Stefano 8$si! 7rovince of 8lorence! and Matteo 8iorentini! Montespertoli m$nicipalit# presentation! Mola di <ari! in the presence of :$i i Cacc$ri! Mola di <ari m$nicipalit# presentation and seminar! Stratos m$sic therap# association! <ari p$blication article ?Trasforma)ioni M$sicali6 introd$cendo la m$sicoterapia nei campi prof$ hi palestinesi del :ibano@! ?N$ove -rtiterapie@! n.1A! aprile "314 +ISSN ""43(B3C"; %%%.n$oveartiterapie.net,. presentation and %or&shop! >D NISCVT Conference! <eir$t presentation! =D Con ress C.N8I-M +Italian Confederation of M$sic Therap# associations and schools,! 7adova visit to Ital# of :iliane Eo$nes! NISCVT ps#cholo ist and project coordinator and Mohamad .rabi! NISCVT ps#cholo ist for presentation of concl$sion of 1D #ear of project direct broadcast! Controradio 8lorence! intervie% %ith Mohamad .rabi and /eborah 7ar&er presentation! VD Commission! 7rovince of 8lorence p$blication ?M$sic Therap# and Social Care in the ref$ ee camps of :ebanon "31"(14! a diar# of discoveries@ +available from infoFprimamateria.it,. seminar! Mola di <ari presentation! seminar ?Sociall# Here and No%@ alternative medicine ro$p ?7ercorsi <ioSal$te@! 8lorence seminar for m$sic therapists! Montespertoli presentation! -GCI 7o))ale +Hmpoli,! in the presence of Stefano 8$si! 7rovince of 8lorence! and Ii$lio Man ani! ma#or of Montespertoli

mergence of problems and challenges, August !"#$ /$rin the #ear! the problems of %aitin lists in some mental health clinics have emer ed! alon %ith the need for pro rammes of intervention in the ro%in n$mbers of tra$mati)ed #o$n ref$ ees from Siria. The possibilit# to develop a model of ro$p m$sic therap# for affective! social and relational objectives! %as disc$ssed both %ith the mt team! at team meetin s and %ith Mr Jassem. /$rin this present period of contin$ation of trainin and clinical re(assessment! f$rther challen es have emer ed; some of the ori inal mt team members have left -ss$mo$d. Ne% people have been inte rated! b$t trainin no% incl$des " levels. It is necessar# for NISCVT to develop an internal capacit# to pass on the initial trainin received! at least partiall#. Some of the people trained in mt lac& basic information abo$t ps#cholo # 0 relational %or& 0 specific patholo ies! %hich creates diffic$lties in appl#in m$sic therap#. More basic! eneral trainin is needed! and more internal s$pport in s$pervision of their mt %or&. There is a diffic$lt# in interfacin %ith the team specialists and other therapists. The mt pro ramme needs to define tar et ro$ps and objectives clearl#! and to adopt a standardi)ed method of eval$ation. The B 8ICs are not standardi)ed in the application of mental health pro rammes! each developin independentl# accordin to locali)ed characteristics and needs. The mt pro ramme needs to develop fle'ibilit# to allo% for this. The escalation of violence and insec$rit#! partic$larl# in the North! has prevented contin$it# in the mt pro ramme for the centres in <edda%i and Nahr Hl <ared. It has been impossible for the mt team members from these camps to attend the trainin %ith re $larit#! as it has been impossible for me to travel to the North to s$pervise clinical %or&. H$da -saad +Nahr Hl <ared, is not $nderta&in an# case%or& in m$sic therap# at the moment! beca$se of a lac& of ade9$ate specialist s$pport in the centre. Conclusions to date m$sic therap# is considered a $sef$l tool in NISCVT's mental health %or&! for a %ide ran e of dia noses! and as a complement of other therape$tic techni9$es. in partic$lar eval$ations reveal a consistent improvement in emotional0affective and relational f$nctions! s$ estin that m$sic therap# in this specific conte't is an effective method for red$cin an'iet# and stress!for reinforcin emotional stabili)ation processes! and for s$stainin e'pressive0com$nicative motivation. Some NISCVT mental health clinics have problems %ith lon %aitin lists for potential patients6 reso$rces for specialist treatment are ins$fficient to meet demands6 the Sirian crisis has provo&ed a massive presence of ne% ref$ ees s$fferin from displacement! stress and tra$ma! partic$larl# dama in to the #o$n pop$lation. 1ith the e'ception of Saida and Hlb$s! the 8ICs do not have the possibilit# to develop ro$p m$sic therap#! d$e to lac& of availabilit# of staff0vol$nteers to cover the role of co(therapist. The clinical ps#cholo ists %ith mt trainin ! :iliane Eo$nes and Mohammad .rabi! %ill $nderta&e all liason %or& %ith the mental health teams! and %ill ive s$pport and s$pervision to the other mt team members! %hen necessar#. 8rom a financial perspective! the project has no f$ndin at present. 7rima Materia and NISCVT are $nder%ritin all costs. - f$ndin application to the re ion of T$scan# is a%aitin ans%er +.ct. "314, 1e have s$bmitted a proposal in response to the 'call for papers' for the 1orld M$sic Therap# Conference! Jrems -$stria! 5$l# "314. +Conference theme; ?C$lt$ral diversit# in m$sic therap# practice! research and ed$cation@,. If the proposal is accepted! %e %ill need to find f$ndin to cover e'penses for :iliane Eo$nes. %b&ecti'es of the !"#$(#) programme consolidation and development of trainin and clinical %or&6 contin$ation of individ$al mt for severe cases! development of ro$p m$sic therap# for affective0social0relational objectives. trainin in IMT-7K assessment techni9$es! for trac&in of clinical res$lts. development of str$ct$red data collection for all clinical cases. development of research project! to present to f$t$re potential 4rd part# f$nders.

*IMTAP+ Indi'iduali,ed Music Therapy Assessment Profile This is a standardi)ed! enerali)ed m$sic therap# assessment tool! first p$blished in "33>! desi ned b# an -merican team of m$sic therapists in California. The a$thors are professionals from a %ide ran e of methodolo ical bac& ro$nds implementin behavio$ral! h$manistic! ps#cho(d#namic! socio(ed$cational and holistic models. The assessment is hi hl# fle'ible and allo%s the possibilit# to consider an# n$mber of the 13 domains; ross motor! fine motor! oral motor! sensor#! receptive comm$nication0a$ditor# perception! e'pressive(comm$nication! co nitive! emotional! social! m$sicalit#. Hach domain identifies a comp$lsor# set of 'f$ndamentals' to be assessed! follo%ed b# other possible domain aspects %hich can be selected for assesment. The soft%are pac&a e allo%s a$tomatic comp$tin of data collection! to provide a 9$antative presentation of the assessment. No 9$alitative interpretation of data is iven! in order to preserve the tool's fle'ibilit# and $tilit# in diverse frame%or&s of thin&in . #st hypothesis of IMTAP application 8or an initial trial period! %e %ill limit the assessment to 4 domains; 'emotional'! 'social'! and 'm$sicalit#'! selectin some constant! specific aspects in addition to the 'f$ndamentals'. -ssessment sessions %ill be video(recorded and the assessment %ill be made after revie% of the recordin . -fter initial assessment! a second assessment %ill be made at the end of the period of mt! if brief +4 or 4 months,! or ann$all# for lon (term treatments. Meeting -ith mental health team, lbus ./C, Suur, Thursday !0th August !"#$1 7resent; /r. Gabih! /oll#! Hlie! 8arah! Tare&! Nanc#! all social %or&ers! /eborah -fter a ver# $sef$l disc$ssion e'plainin the mt pro ramme so far! follo%ed b# 9$estions from the medical team abo$t possible objectives and res$lts from mt! %e approved the h#pothesis of %or&in in " %a#s; contin$ation of individ$al mt for severe cases! partic$larl# non(verbal children. Introd$ction of short(term +1" sessions, ro$p mt! %ith m$sic therapist and co(therapist! as preparator# phase for children on %aitin list! before enterin other therape$tic pro ramme. Main objectives6 social0relational! emotional and com$nication s&ills. Introd$ction of IMT-7 assessment! both at baseline and to trac& pro ress.

Proposed meeting -ith all mental health team members, 2anuary !"#)1 The ne't period of s$pervision is planned for 5an$ar# "314 +"nd 2 Ath,. /$rin this time! a meetin %ith all mental health specialist team members %o$ld be ver# helpf$l! to collect feedbac& on the inte ration of m$sic therap# into the eneral mental health pro ramme! to clarif# problems! and to devise strate ies for f$t$re development.

<eir$t! 1st September "314 /eborah 7ar&er

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Community Music Education Programme

Project Music and Resilience - Report on the exchange organized by Associazione Prima Materia with the National nstitution !or "ocial #are and $ocational %raining &eit At!al Assomoud' in the &ourj a "hemali camp in %yre !rom ()th -)*th August' )+(,.bjecti/es To offer a follo% $p m$sical activit# for the ro$p of 7alestinian m$sic st$dents %ho be an m$sical activit# in the S$mmer of "31" from the Hl <$ss and <o$rj a Shemali camps! and incl$din ne% st$( dents %ith m$sical e'perience to ether %ith a ro$p of 1B Italian m$( sic st$dents +bet%een 1" and 1= #ears old,. To create a social e'chan e! stim$lated b# the m$sic pro ram! bet( %een the 7alestinian and Italian st$dents %hich %o$ld lead to a reater a%areness of the similarities and differences bet%een the " c$lt$res. Materials The m$sical instr$ments from the <o$rj a Shemali camp %ere a$ ( mented this #ear b# 4 violins! " violoncellos and a sa'ophone bro$ ht from Ital# for the f$t$re development of the %ind and strin ro$ps ac( tive in the camp. %imetable The st$dents too& part in 4 ho$rs of rehearsals dail# from A.43(14.43 from 14th("1st -$ $st. The Italian ro$p performed a short concert on Monda# 1Ath -$ $st for the S#rian ref$ ees in the camp and on 1ed( nesda# "1st a performance of the joint pro ram +%ith more than B3 7alestinian and Italian m$sic st$dents performin a pro ram of arabic and %estern m$sic to ether, %as presented to the parents of the participants. In addition! the chan e of plan d$e to the cancellation of the co$rse in <edda%i camp beca$se of area tensions meant that the Italian ro$p too& part in an evenin of m$sic and dance %ith the old people in the camp. In the afternoon vario$s pro rams or ani)ed b# -bir L allo%ed the Italian st$dents to ain val$ble insi ht into life in the camp %ith meetin s bet%een the older eneration of 7alestinian ref$( ees! intervie%s %ith the S#rian ref$ ees and %ith 7alestinian shop&eepers! joint activities %ith a S#rian #o$th theatre ro$p and leis$re activities %ith the 7alestinian m$sic st$dents. In the second %ee&! d$e to the prolon ed sta# in the <o$rj a Shemali camp a co$rse for 4B ne% 7alestinian st$dents %as or( ani)ed %ith 4 ho$rs of dail# lessons %ith the st$dents divided in " ro$ps to offer an intitial contact %ith m$sic. The Italian st$dents helped %ith instr$mental t$ition. 0etailed Report The m$sic pro ram %as divided into 4 &inds of ro$p activit#; arabic m$sic in( volvin all the st$dents! %ind band m$sic! and a ro$p of %ind instr$ments and ba pipes. Ms$all# the mornin rehearsals %ere divided bet%een separate re( hearsals for the %ind and strin ro$ps and f$ll rehearsals involvin all the st$( dents performin to ether. The rehearsals %ere r$n b# Henr# <ro%n +%ind and eneral ro$ps,! Valentina Geba$den o +strin s, and Valentina 8ort$nati + $itar and o$d,. In addition -b$ Mahmo$d +7alestinian %ind band, and .sama Nidan +7alestinian strin ro$p, %ere often present to help. The emphasis of the m$sical trainin %as to%ard establishin a ro$p feelin and a sit$ation of m$t$al help. The Italian st$dents +%ith more #ears of m$sical trainin , %ere enco$ra ed to share their e'perience! %hile several 7alestinian st$dents helped %ith lin $istic problems. Thro$ h %or&in to ether close ties %ere formed bet%een the st$dents.
5

The aftenoon activities allo%ed for the contin$ation of the social interaction! %ith the 7alestinian st$dents actin as $ides and interpreters in the camp. The pro ram of doc$mentation %hich the Italian st$dent ro$p is prod$cin +$sin photo raphic! video! %ritten and verbal means, %as enriched b# intervie%s! visits! theatre activit# and even a football match. The res$lt of this pro ram! OGeco$ntin the CampP %ill be presented in Ital# in a series of evenin events in dif( ferent locations. 1inal presentation o! the intrumental course In the = da#s of the co$rse " arabic son s %ith instr$mental accompaniment! " arabic instr$mental pieces! 4 pieces for %ind band and " pieces for %ind and ba pipes %ere rehearsed and performed. The event %as video(recorded "econd course 2 ntroduction to music The second co$rse for ne% 7alestinian st$dents follo%ed the plannin of the S$mmer co$rse in "31" %ith " ro$ps of 1B("3 participants led b# the Italian staff %ith the Italian st$dents as helpers. Hver# lesson for the children be an %ith Ocircle amesP to introd$ce concepts of ro$p interaction! of listenin (response! beat(rh#thm! melod#(phrasin in a conte't of ame pla#in . In the openin lesson the m$sical instr$ments %ere presented and in t$rn the children had the possibilit# to tr# them o$t. S$bse9$entl# a choice %as made and the child then remained %ith that instr$ment for the remainder of the co$rse. +It %as not possible to provide all the children %ith the instr$ment of their choice, <asic m$sic notation %as described and presented as a possible %a# to transmit m$sical information. The emphasis %as on the ro$p parameters +rh#thm 2 pla#in to ether 2 vol$( me, %hilst non(standard pla#in +%a# of holdin the instr$ment or bo%! method of breathin , %as tolerated in s$ch a %a# as not to inhibit the activit#. #onclusion /espite the disappointment of not bein able to visit the <edda%i camp in Tripoli the co$rse in <o$rj a Shemali f$l( filled in ever# %a# the set objectives. The non(competitive! sociall# orientated %a# of ma&in m$sic to ether created stron ties bet%een 7alestinian and Italian st$dents. The or ani)ation of -ssomo$d in hostin the Italian ro$p %as re ( mar&able in its efficienc# and its h$man %armth. -t no point! even in the tense political crisis apparent in the co$ntr#! %ere the Italian st$dents e'posed to ris& and the care %hich the -ssomo$d staff sho%ed for the ro$p %ent far be#ond a %or& relationship 2 the Italian ro$p became part of an e'tended famil# and the ties created %ill have lastin effects.

#ontinuation and de/elopment o! the music project -part from the financial $ncertaint# the event$al contin$ation of this project %ill depend on several factors. The approach to m$sic teachin %hich characteri)es 7rima Materia +and %hich corresponds closel# to the aims of social care and ed$ca( tion of <eit -tfal -ssomo$d, depends on creatin a sense of ro$p. 8or this to be possible in the st$dents it is also f$ndamental that the m$sic staff are also capable of %or&in to ether! not mere# as indivi( d$als. This re9$ires or ani)ational s&ill and also a capacit# for creatin a m$sical overvie%. It can be learnt b$t it re9$ires formation! ideall# contin$in formation. 1hile it ma# be possible to involve Italian! or forei n teachers! the most $sef$l %a# of emplo#in event$al financial aid %o$ld be to train 7alestinian staff. It %o$ld $sef$l to create a pool of m$sicians %ho mi ht be interested in teachin m$sic in the camps and to offer forma( tion co$rses.

-%aitin the possibilit# to be in m$sic in the <edda%i camp the <o$rj a Shemali camp in T#re alread# offers 4 di( stinct m$sic ro$ps; the ba pipe band OI$irabP! the %ind band and the strin ro$p. .n m$sical ro$nds interaction %ith the ba pipes offers onl# ver# limited scope 2 the instr$ment is too lo$d and basic to be s$ccessf$ll# inte rated %ith other instr$ments. .f the " other ro$ps it appears that the strin instr$ments are often the most re9$ested b# the chil ( dren and this ro$p is certainl# more s$ited to arabic m$sic. It %o$ld be relativel# eas# to inte rate this ro$p %ith %ind instr$ments! as this S$mmer co$rse has demonstrated b$t it re9$ires a partic$lare t#pe of m$sical direction. This %o$ld be possible to coordinate from Ital# b$t %o$ld need the cooperation of the 7alestinian m$sic staff in identif#in clearl# the participants and their level of technical s&ill. In all cases an approach to m$sical notation! and ho% to teach it in a creative manner! is necessar#. -s a direct res$lt of the e'tensive $se of m$sical intr$ments! it it %ill become necessar# to create %or&shops on the maintenance of the instr$ments. It %o$ld be a ood idea to create formation co$rses in strin and %ind instr$ment re( pairs %hich in the f$t$re co$ld also offer emplo#ment to #o$n 7alestinian men and %omen. 8inall#! the possibilit# to host 7alestinian st$dents in Ital# and to ret$rn the hospitalit# sho%n to the Italian ro$p %o$ld be a re%ardin e'perience for all participants! both in a c$lt$ral and social sense! and %o$ld help in brea&in the isolation of the 7alestinian people.

Montespertoli! Bth September "314 Henr# <ro%n