This paper describes a conceptual framework in music therapy with adults with severe and profound levels of intellectual disability. Drawing from Carl Rogers’ person-centered work and his notion of the good life as a direction, the author presents four core relational experiences (curiosity, invitation, celebration, and recognition) that underpin the therapeutic process with this client population. Case vignettes from the author’s clinical work illustrate how core experiences are presented through improvisational musical experiences. Considerations are given to the clinical significance of good-life-oriented experiences on the emotional health of individuals with severe and profound intellectual disability, and to its implications beyond the music therapy space.
This article presents an improvisational approach to insight-oriented therapy in music therapy with a woman with severe cognitive impairments following haemorrhagic stroke. Analysis of five clinical excerpts across 40 sessions demonstrates how a prepared improvised musical experience can facilitate meaningful self-exploration in dialogue, leading to a renewed self-identity in life after brain injury. The therapist's reflective processing is integral to the therapeutic outcomes; these are examined alongside the casework material. This article suggests that insight-oriented musical experiences may be one way of supporting the emotional health of individuals living with the enduring consequences of severe brain injury in slow-stream rehabilitation or long-term neurological care.
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