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Musik Terapi Setelah Kejadian Brain Injury

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  • PLAYING THE PRECUNEUS:

    MUSIC THERAPY AFTER ACQUIRED BRAIN INJURY

    By

    Kristen Anderson

    Bachelor of Arts, Music, McMaster University, 1994

    Major Research Paper

    Submitted to the Faculty of Music

    in partial fulfillment of the requirements for the degree of

    Master of Music Therapy

    Supervisor: Dr. Colin Andrew Lee

    Wilfrid Laurier University

    2010

    Kristen Anderson, 2010

  • ii

    TABLE OF CONTENTS

    ABSTRACT .............................................................................................................................. iv ACKNOWLEGEMENTS .......................................................................................................... v

    DVD TRACK LIST .................................................................................................................. vi CHAPTER I: INTRODUCTION ............................................................................................... 1

    1.1 Background ....................................................................................................................... 1 1.2 The Client ......................................................................................................................... 2 1.3 Purpose of study ............................................................................................................... 3

    1.4 Research Questions .......................................................................................................... 3 1.5 Value of the Study ............................................................................................................ 4

    1.6 Stance of the Researcher .................................................................................................. 4 2.1 Case Study Research ........................................................................................................ 7 2.2 Consciousness and Identity .............................................................................................. 8 2.3 Introducing the Precuneus ................................................................................................ 9

    2.4 Post-Traumatic Stress ..................................................................................................... 11 CHAPTER III: METHODOLOGY .......................................................................................... 13

    3.1 Research Design ............................................................................................................. 13

    3.2 Procedures ...................................................................................................................... 14 3.3 Research Setting ............................................................................................................. 14

    3.4 Data Collection Procedures ............................................................................................ 15

    3.5 Data Analysis, Interpretation and Presentation .............................................................. 15

    3.6 Ethical Issues .................................................................................................................. 16 CHAPTER IV CASE DISCUSSION ..................................................................................... 18

    4.1 Introduction .................................................................................................................... 18 4.2 Consciousness ................................................................................................................. 19

    Help! ................................................................................................................................. 19

    4.3 Visuo-Spatial Imagery .................................................................................................... 21 Waking Up Blind .............................................................................................................. 21

    Confusion in Imagery ....................................................................................................... 23 Spatial Discrimination ...................................................................................................... 24

    4.4 Memory .......................................................................................................................... 25

    Memory In Words ............................................................................................................ 25 Memory In Music ............................................................................................................. 26 Every Session Is The First Session ................................................................................... 28

    4.5 Yawning ......................................................................................................................... 28 Yawning In Music ............................................................................................................ 29 Yawning As Music ........................................................................................................... 31 Yawning Towards Insight ................................................................................................ 31 Yawning As Toning ......................................................................................................... 33

    4.6 Self and Identity ............................................................................................................. 34 Am I Dead? ....................................................................................................................... 34

    Empathy And Insight ........................................................................................................ 36 Insight And Self Definition .............................................................................................. 37 Music and the Precuneus .................................................................................................. 39

    CHAPTER V CONCLUSION .............................................................................................. 40 Figure 3: Music Effect on the Precuneus ......................................................................... 41

  • iii

    CHAPTER VI REFLECTIONS ............................................................................................. 44 GLOSSARY ............................................................................................................................. 46 APPENDICES .......................................................................................................................... 51 Appendix A: Wilfrid Laurier University Research Ethics Board Approval ............................ 52

    Appendix B: Hamilton Health Sciences Participant Consent .................................................. 53 Appendix C: Hamilton Health Sciences Substitute Decision Maker Consent ......................... 56 Appendix D: Hamilton Health Sciences Research Ethics Board Approval ............................. 59 Appendix E: Excerpt from Session Index ................................................................................ 60

  • iv

    ABSTRACT

    This study explores the use of music therapy with an adult having an acquired brain injury

    and aims to make connections between the perception of music after brain injury and the brain

    regions activated in the process. Much has been studied about how the human brain perceives

    music. It is through studies of healthy brains and those with dysfunctions that we begin to

    comprehend the effect of music and the regions activated during the perception of music.

    Literature about the use of music therapy for clients with acquired brain injury also exists, as

    does that with post-traumatic stress. Through a qualitative account of eleven music therapy

    sessions presented as a single-case study, the research will demonstrate a link to the

    Precuneus region, as demonstrated by the client interaction and supported by the literature.

    The study aims to augment a theoretical and practical understanding of music therapy with the

    acquired brain injury population and lay the foundation for future investigation into the nature

    of music perception in the human brain.

  • v

    ACKNOWLEGEMENTS

    I would first like to thank you, Chad, for your participation in music therapy and in

    this research study. Your continuous positive outlook was inspirational and a reminder that

    we are capable of achieving things greater than what we could ever imagine. Thank you for

    allowing me to witness and take part in your journey.

    To Chads family, thank you for your support and guidance during Chads therapy and

    for trusting in me to explore his story further. Your familys devotion is truly moving.

    To my supervisor, Dr. Colin Lee, thank you for your steadfast commitment and

    invaluable advice. You were key in helping me to maintain direction and positive focus while

    I navigated the course of qualitative research.

    To the faculty and my classmates, thank you for your precious feedback and guidance

    throughout this experience. The diversity of thought and unique perspective allowed me to

    see the forest for the trees.

    To the rehabilitation team at Hamilton Health Sciences ABI Unit, I thank you all for

    your support during my practicum and throughout this research study. Each one of you has

    contributed to the knowledge and experience that I have gained in working with this

    population.

    To my f

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