Motion and Emotion: The Dance/Movement Therapy Experience.

"The function of dance is communication. It comes from the depths of man's inner nature, the unconscious, where memory dwells."

Martha Graham

American dancer and choreographer

Exposure to dance and movement begins in infancy. Little arms and legs are moved in time with music; a toddler enjoys bouncing to a happy tune and, of course, we know how much teenagers love to dance. This basic expression of emotion continues throughout life and does not have to diminish with age.

At Maplewood of Cheshire County, a 150-bed, nonprofit, county-owned facility in Westmoreland, New Hampshire, dance/movement therapy (DMT) has been offered as a complementary--not alternative--therapy for six years. "We use a number of complementary therapies, such as massage, healing touch and dance/movement that are designed to complement what we do with more traditional Western medicine," states Maplewood Administrator Jim Beeler.

Lenore Wadsworth Hervey, PhD, ADTR, NCC, and Beeler established Maplewood as a training site for dance/movement therapy graduate students from Antioch New England Graduate School in Keene, New Hampshire. This is a mutually beneficial arrangement for both institutions: Maplewood has added another feature to improve the quality of life for its residents, and DMT graduate students gain experience through hands-on training with actual nursing home residents. By providing real-life encounters, these residents help "teach" the students.

Occasionally people become "out of sync" between their bodies and their emotional selves. Dance/movement therapy helps to restore that "rhythm," that connection. "Like any nursing home," says Dr. Hervey, "Maplewood has residents who, at times, feel lost and depressed or become passive, unmotivated or resistant. DMT has helped many of them engage in joyful, stimulating and meaningful interactions with group members." Dr. Hervey describes dance/movement therapy as "a form of psychotherapy that uses movement or dance as a primary vehicle for communication," adding that "it is particularly effective with residents who have physical limitations, perceptual and communication losses, and various forms of dementia." Among its benefits, DMT helps' to achieve meaningful interaction with others, increase self-esteem and promote self-expression, and can alleviate depression.

Dance/movement therapy is not a conventional dance class, but rather a spontaneous experience where the therapist gauges the resident's quality of movement as it occurs through kinesthetic empathy--moving with the resident exactly as he/she does. This serves as an informal assessment in the moment. If warranted, other, more detailed, more formal assessments, such as the Kestenberg Profile, are available. By using props and music, DMT helps to extend the function of the body/mind connection for those with physical, sensory or mental disabilities.

Each of Maplewood's four care units has a windowed dining room where sessions are held. It is a bright, cheery setting that permits passersby to observe the activity. Many staff, family and residents stop to watch, and seeing the group having fun often encourages a resident observer to join in. The only requirements are that the resident is alert and responsive.

Therapy is tailored to the level of care of each unit, including the Alzheimer's and Behavioral units. In all the groups, the suggested movements are adapted to the stamina and physical abilities of its members. DMT with residents who have dementia is necessarily less dependent on creating a linear progression of events and is more focused on responding to what is offered in the moment. In contrast, the groups with residents who enjoy intellectual stimulation can incorporate more sustained storytelling and interpersonal dialogue. A fully equipped cart is used to bring dance/movement therapy to those who cannot attend the group sessions.

So that residents can receive personalized attention, group sizes generally range from six to ten residents. Weekly, during the academic year, graduate students will come in to assist the interns and therapists with a larger group of 10 to 15 residents.

As the group begins to assemble, the graduate students begin gently tapping balloons toward each resident. Although this activity is a structured exercise, it is not unusual to see a resident extend his reach or grasp in trying to keep the balloon in motion. Because he's not thinking or bored by the repetitive action of exercise, his mind and spirit encourage him to make that extra effort to bat the balloon to another person. That movement, in turn, promotes socialization, and so on.

Next there's a seated warm-up that stimulates and activates body parts and increases body awareness and aerobic activity. Then, those residents who are able stand and dance with assistance from coleaders. Scarves, balls of varying sizes and stretch bands are some of the props employed during a session. Even the smallest gesture helps to express a resident's emotions.

A resident confined to a wheelchair might reminisce about how she loved to dance when she was younger. "But look at me now. I can't dance," she might say. But the philosophy of DMT is that if you can dance in your heart, you can dance. Even the smallest movement is encouraged--not in repetitive exercise-like fashion, but as a meaningful form of self-expression.

The primary technique used in Maplewood's DMT program is the Marian Chace style of dance movement therapy, using mirroring or reflection and amplification. The reflection technique has the resident and therapist moving together, "mirroring" each other's movements. In amplification, the therapist encourages the resident to make his/her movements larger or fuller.

Each year, Maplewood puts on a staff talent show for residents and their families. One of the highlights of this year's show was a performance by one of the DMT groups using ribbonsticks (streamers attached to short sticks) to aid in their interpretation of the music. The applause and congratulations from the appreciative audience boosted the confidence and self-esteem of these resident performers, who thrived on showcasing their DMT achievements.

Dance/movement therapy's positive effects brighten the emotional outlook of its participants--and for a reasonable financial investment. Dr. Hervey explains that the first and largest expense is lining up a dance/movement therapist to supervise the program. The easiest way is to engage a DMT therapist as a consultant for a predetermined number of hours (see below for possible resources). After that, the only other expense is in purchasing audio equipment (if necessary) and any props that will be used. At Maplewood, the supervisor is paid for through the facility's activities budget and, according to Beeler, only $200 to 300 was spent for props and audio equipment. "Because we are a nonprofit, county facility, we have excellent funding, which enables us to introduce innovative programs, such as dance/movement therapy, to our overall concept of care," said Beeler.

At Maplewood they are trying to break the usual nursing home mold by offering more than physical therapy, standard activities and bingo. One of the answers, for Maplewood, is dance/movement therapy.

DMT Certification

Professional training takes place at the master's graduate level and includes studies on topics such as DMT theory and practice, psychopathology, psychotherapeutic theory and a supervised internship that leads to recognition or registration as a Dance Therapist, Registered (DTR). The National Board for Certified Counselors (NBCC) and the American Dance Therapy Association (ADTA) have recognized dance therapy as a specialty of counseling and have designated the Academy of Dance Therapists, Registered (ADTR) credential for dance/movement therapy signifying readiness to teach, supervise and work in private practice.