A few years ago, we wrote for the Voices about the development that music had had in the health environment in Cuba. We described the formation of the “Group of Music Therapists from Cuba”, and the work we had developed up to 2003 (Fernandez de Juan, 2003). Since this time - and following a number of courses held by the Director of the Cuban group and other visiting music therapists from abroad - we are working towards a deeper specialization in the educational and professional fields of this discipline. Therefore in this short article we would like to present two areas of work that have developed most significantly within the Cuban Group since our last report, and to provide an update on education and training.
The rapid ageing of our population is a challenging issue for modern society. Depression is one of the most important psycho-geriatric illnesses associated with the growth of the older population. The use of creative arts therapies, such as music therapy, with this population improves physical and mental health. Since 1998, Dr. Oliva and his team, tutored by Dr. Teresa Fernandez de Juan, have made a great effort oriented towards the improvement of mental health through music therapy. In a preliminary study, from 1998 to 2001, the team observed 71 particpants between 60 and 78 years old with mood and communication disorders. Imagination, creativity and memory were stimulated by musical listening and improvisation, alongside physical expression through musical instruments and relaxation techniques (Oliva & Fernandez de Juan, 2003).
In a second study, from 2002 to 2004, 35 depressed patients between the ages of 60 - 83, were studied at the county of Regla, in La Habana. Musical improvisation, psycho-dramatic techniques and interactive games were the most common activities, as well as opportunities to listen to and participate in Cuban music. At the end of the period of study, there was an important diminishing of the use of medication amongst the population studied (Oliva & Fernandez de Juan, 2006).
From 2002 to 2006, the team studied 43 depressed patients between 60 and 83 years old from the county of Regla. Musical listening, improvisation and dialogue, traditional Cuban games, singing and physical expression were the most relevant activities. Cuban music began each session. The music therapy sessions with elderly patients of both sexes were held weekly, and lasted one hour. Between 12 and 15 sessions were held for each therapeutic group.
This brief description demonstrates the first attempt made in Cuba to evaluate the use of music therapy for the improvement of the mental health of depressed elderly people.
Starting from the premise that there is a necessity to improve quality of life for people with special educational needs, professionals from various disciplines are researching various kinds of therapeutic intervention that promote wellness and personal development. Cuba is no exception in this regard. A variety of programs have been developed with these goals. Music – as an expressive art form – has taken the lead as a channel for communication, with musicians and therapists working to improve psychological development, motor function and interpersonal relationships. Experience in Cuba has shown that combining music therapy with other therapies, can enlarge its field of action and results can be significantly enhanced.
This has been the case with the therapeutic use of horses (described here as ‘hypo-therapy’), which uses the temperature, textures, rhythms and movements of the horse in the stimulation and rehabilitation of motor functions and mental health. Within this setting, this study has been developing since 2002, with groups of patients with Down syndrome, Rett syndrome, cerebral palsy and different motor disorders aged between 8 months to 19 years of age.
The incorporation of elements of music therapy and hypo-therapy helps in the stimulation of psychomotor and sensory integration of children and youngsters with special educational needs. Music and the animal become the fundamental means of communication between child and therapist, both of which are valued specifically for their non-verbal communicative potential. The project, which is based in experiential and humanistic principles, starts from the development of the abilities and potentialities of the children themselves. The natural environment stimulates emotional affective, communicative, cognitive, social, and sensory aspects.
The intervention starts from a multidisciplinary diagnosis and assessment in the areas of emotional, communicative, cognitive, social and sensory functioning, which allows the team to extablish an individual program with achievable goals. The family group is also encouraged to be actively involved in the program. The role of musical elements are clearly determined within the frame of the combined therapy sessions. What is new about this work is the integration of both techniques with similar therapeutical goals.
Interesting results have been observed in emotional, social, sensitive and psychomotor areas. Several assessment instruments have been developed and refined from this project. The research study has been presented at national and international scientific events and at this moment is part of a Master thesis developed by Idida Rigual and tutored by Dr. Fernandez de Juan.
To conclude this paper, we are delighted to announce the recent approval, by the Superior Educational Ministry from Cuba, of a Masters Degree Program in Cuba, under the chair of Teresa Fernandez de Juan, and designed with the direct support of Lic. Diego Schapira, from Argentina (developer of the ‘Plurimodal’ approach in music therapy and a well-known professor in several health institutions and music therapy programs within Argentina and other Latin American countries). The program is based in the most recent and important theoretical developments in music therapy. We are very pleased to announce the start of this program in this contribution to Country of the Month. The program will be supported by collaboration between the Facultad de Música of the Instituto Superior de Arte de Cuba, through its Dean, MsA Mivian Ruiz Perez, and the Facultad de Psicología de la Universidad de La Habana, also through its Dean, Dr. Dionisio Zalívar Perez.
After consolidation of the program at the end of this year and the delivery of the first module of study, it will continue in 2008 with the support and presence of well-known music therapy clinicians and professors from Brazil (Lia Rejane Mendes Barcellos, Marly Chagas, Martha Negreiros), from Argentina ( Diego Schapira, Karina Ferrari, Viviana Sánchez) and from Spain (Patricia Sabbatella) among others, as well as professor–researchers from El Colegio de la Frontera Norte de Tijuana, BC, México, Cuban professors with PhD degrees in Psychology and well-known Cuban musicians. We look forward to the strengthening and growth of the music therapy discipline in Cuba, through this exciting development.
Fernandez de Juan, Teresa (2003). Music therapy in Cuba: A brief journey to the immediate future. Voices: A World Forum for Music Therapy. Retrieved September 30, 2007, from http://www.voices.no/country/monthcuba_october2003.html
Oliva, Rigoberta & Fernandez de Juan, Teresa (2003). La musicoterapia en los gerontes: Una alternativa de salud [Music Therapy in the Elderly: a Health Choice]. Rev. Psicología y Salud, Vol 13, 136-143. México
Oliva, Rigoberta & Fernandez de Juan, Teresa (2006). Mental health and ageing: A community experience in music therapy with depressed patients. Rev. Psicología y Salud, Vol 16 No 1, 93- 101.
Fernandez de Juan, Teresa, Oliva Sánchez, Rigoberto & Rigual González, Idida María (2007). Update of Music Therapy in Cuba. Voices: A World Forum for Music Therapy. Retrieved June 12, 2013, from http://testvoices.uib.no/?q=country-of-the-month/2007-update-music-therapy-cuba