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Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) - usually caused through physical impact - can have major implications for the person concerned. The approach and objectives of the music therapeutic treatment depend on the phase in which therapy starts.

In the beginning due to inner bleedings or edema often the pressure in the brain is going up, In this phase patients are often comatos or not fully awake. The treatment of those patients is described at people with vegetative state (PVS). With increasing vigilance the cognitive and motoric implications of the TBI become clear and thus get into therapeutic focus.

With TBI very often the frontal areas of the brain are affected. This may cause a behavioral and cognitive dysexecutive syndrome. The patients have difficulties in their social behavior, in the controll of emotionality and in solving problems in their daily routine.

In a music therapy group social and communicative skills can be trained by making music, which is based on practical rules. Music and emotionality are closely linked. Thus music therapy provides a highly suitable frame for the therapeutic work with emotions of those patients. Disorders of alertness, attention and problem solving can be effectively addressed through active musical playing.

In TBI also visual deficits (hemipanopsia) can occurr, since the traumatic injury may also affect the back regions of the cranial bone. After impairment of the left frontal side of the head it is likely to find patients affected in their language function. These can often be treated effectively with music therapeutic methods for aphasics.

Frequently patients with a TBI experience difficulties with their memory. Musical remembrances are often deeply stored and can be used in the therapy with those amnestic patients. Music can be utilized to set mnestic "ancors" or to stimulate old "ancors" (through familiar musical pieces).

By facilitating the memory with the musical activity, also the transfer into daily routine will be enhanced - which of course is the main goal of the treatment. Also the psychological stress caused by the sudden injury of the body with all its consequences for the live of the patient can be tremendous.

It is essential to therapeutically support the process of psychological coping. Here music psychotherapeutic concepts come into play.