Disabilities & Rehabilitation

Voice Movement Therapy founder Paul Newham began developing his modality of therapeutic voicework in hospitals with patients who had experienced illness, disabilities, and accidents that negatively impacted their voice or hindered vocalization. It was in this context that he developed many of the therapeutic techniques and the deep understanding of affective sounds that became the expressive arts modality of Voice Movement Therapy.

Learning & Developmental Differences

Voice Movement Therapy is a person-centered way of working that does not rely on verbal or cognitive exchanges. As practitioner Deirdre Brownell (VMTR) writes: “[by] working in sound rather than focusing on words, you are working more with the right brain/creative center and it feels more like play and less like work. In children, this removes a lot of pressure and brings the practitioner down to their level, opening up the creative potential.” For people who have always felt like they never ‘measure up,’ working in sound and play can build confidence and a sense of accomplishment.

The non-verbal aspect of VMT makes it a valuable treatment approach for those who find communication difficult. The VMT practitioner is trained in using voice, breath, and movement to create meaningful connections with others and in helping people find alternative ways of expressing themselves. Voice Movement Therapy practitioners meet the client where they are and, from this place, support an expansion of the client’s sense of Self and the development of vocal and physical expressivity.
Central to Voice Movement Therapy is the concept of the embodied voice. In other words, the practice aims to integrate the expressive intentions of the client with their movement (including but not limited to gestures) and with the sounds that are available to the client. In this aligning of voice, body and mind we broaden the client’s communicative options and find alternatives to habitual patterns.
With an intricate knowledge of the physiology and psychology of the voice, the VMT practitioner guides clients in finding, understanding, and using their voice effectively. Practitioners observe and identify the physical and emotional aspects that inhibit free expression and work with the client towards achieving their treatment goals.

Working with specific breathing techniques, clients experience a feeling of contraction, expansion, and flow within the body. Incorporating VMT massage, manipulation, and compression techniques, the practitioner helps the client stimulate vocalization and understand how to create a supported sound. By exploring vocal resonance and the feelings of various sounds in the body the client develops body awareness. Engaging through movement and sometimes with musical instruments (a drum, for example), the VMT practitioner encourages more bodily connection and integration in the client.

Songs play a significant role in the Voice Movement Therapy approach. When working with those experiencing learning, developmental and language delays, the melody, changes in pitch, dynamics, etc. of a song offers a different acoustic and physical experience for the client, and presents an alternative learning strategy. Such a strategy can help facilitate the acquisition of speech where other methods have failed.
“When I speak of singing, I do not consider this to be an artistic exercise, but the possibility, and the means to recognise oneself, and to transform this recognition into conscious life.”
Alfred Wolfsohn
The concept and embodied experience of the flexible, malleable vocal tube is at the heart of the VMT approach. Practitioners help clients become increasingly aware of their ability to change vocal quality and resonance through exercises and explorations that encourage the vocal tract’s malleability. This aspect of the work develops the client’s ability to refine their use of the vocal tract, leading to more flexibility and control over voice production and articulation.

Voice Movement Therapy offers affective education to clients through a uniquely creative and embodied strategy. The client takes the lead and the practitioner works with what is and with what can be done, without focusing on what is seemingly lacking. Practitioners create a safe space for the expression of all experiences, developing a meaningful connection with the client within the non-judgmental therapeutic relationship; clients feel seen and heard. Voice Movement Therapy can provide the client with a sense of agency that enables the expression and sharing of emotions.

In her article entitled ‘Teaching the Tube: Using VMT with Children Experiencing Language Delay’ (PVMTJ #3, 2008) practitioner Anne Brownell (VMTR) writes about her work in this context. “[T]he aim of my work is to facilitate sound out of movement and language out of sound…” Anne continues: “The purpose of using VMT with individuals with developmental, and especially language delays, is twofold:

1. To help persons with little or no verbal language to increase and focus their ability to vocalize: as a means of forming relationships, expressing their wants and needs non-verbally and, if possible, as a precursor to speech, preliminary to or in conjunction with the work of a speech/ language pathologist;

2. To assist persons whose social development is affected by limited language, physical/neurological conditions, behavioral disorder and/or emotional trauma, to find the voice to express what they mean and what they need.”

Neurological Differences

Voice Movement Therapy is valuable in working with those experiencing neurological differences and challenges, such as (but not limited to): stroke, brain injury, epilepsy, Parkinson’s disease, multiple sclerosis, dyspraxia, and dementia. The VMT practitioner’s approach of using singing, active breathing, movement, and the integration of affective experiences, is different from — though can be complementary to — that of the speech and language pathologist. VMT offers a unique way of integrating the left and right hemisphere of the brain and stimulating the neural networks through various different sensory processes. The modality provides an embodied, creative, and psychotherapeutic framework that can support the whole person from a non-medical standpoint, broadening the vocal palette and increasing expressive ability.

Aside from private individual sessions, some VMT practitioners offer group sessions for people living with chronic conditions. Such lively community singing sessions often become part of long-term treatment programs and are sometimes viewed by caregivers and participants as a physical therapy. Singing and supported breathing releases bodily tension while strengthening the diaphragm, toning the muscles of the face, mouth, and throat, and improving speech clarity. Carol Grimes writes: “Muscle tension and rigidity; shortness of breath; loss of vocal strength and stamina; monotonic speech patterns; imprecise articulation; a closing down of facial expression; low self-esteem; tremor in the jaw, lips, and tongue; disturbed swallowing patterns; fatigue – all these symptoms seem to be helped considerably with singing and breath work.”

Regular VMT group sessions are uplifting and supportive. Such groups give people a sense of belonging, purpose and community which takes them out of an all too common experience of isolation which can lead to depression. Nina, a participant of one of Carol’s groups says, “[w]hen we are singing together at the top of our voices, I feel a release from the constraints of my disease and a connection with joy.”

Physical Differences

Voice Movement Therapy lends itself easily to those experiencing physical differences, difficulties, or challenges. VMT exercises and techniques can be applied to clients using wheelchairs or other assistive devices, those experiencing limited mobility and/or ranges of motion, those that prefer to sit rather than stand, etc. VMT welcomes, accepts, and celebrates the wide range of human physical capability and potential, with the philosophy that developing an embodied voice is a worthwhile endeavor and experience for all bodies.
The Treatment of Autism using Voice Movement Therapy. By Corinne De Langavant. The above video shares one way of working in a given situation.