On a recent Saturday morning in September, a small group of people files into a room at Arizona State University’s Counseling Training Center on the Tempe campus. Laid out on tables are drums of various shapes and sizes. They each pick one, some tapping hesitantly to test the sound, and then take a seat.
Clinical Associate Professor Cynthia Glidden-Tracey welcomes them and gives a brief introduction to the day’s agenda, which is to be a rehearsal for the upcoming Rhythmic Cognitive Restructuring demonstration from noon to 1 p.m. Tuesday, Sept. 19, at the Banner MD Anderson Cancer Center in Gilbert, Arizona (pictured above).
Tuesday’s event is part of Banner’s PIKNIC (Partners In Knowledge, News In Cancer) series, an informal educational forum that provides patients, caregivers, family members, volunteers and staff an opportunity to hear about the issues, needs and concerns relevant to the cancer experience.
Video by Ken Fagan/ASU Now
Glidden-Tracey has a background in psychotherapy, which uses certain techniques to treat psychological disorders like depression and anxiety, often emerging as a result of a cancer diagnosis. One of those techniques is cognitive restructuring, in which patients are encouraged to consider the ways in which their thoughts can influence their feelings.
When they realize they’re thinking something negative, the idea is to stop, evaluate the thought and change it into something positive.
“Catch it, check it, change it,” Glidden-Tracey tells the rehearsal group.
There is much research evidence that such cognitive restructuring techniques work when it comes to improving patient outcomes, Glidden-Tracey said. Still, some of her clients found it difficult to implement in their daily lives.
“Sometimes clients report trouble remembering or using the positive messages generated in counseling sessions when they are facing negative or self-critical thoughts outside of the session,” she said.
A one-time music major, she began to wonder how the introduction of rhythm might affect clients’ use of the technique after becoming involved in ASU’s African Drum Ensemble.
“The more I learned in the [drum ensemble] about how rhythms are used to communicate messages, including in healing ceremonies, I realized that counseling also uses language and nonverbal communication to help our clients,” Glidden-Tracey said.
“This got me thinking about how paying attention to the cadence of speech in a client’s words and teaching them to speak and/or tap out words in rhythm could provide auditory and motor reinforcement to well-researched cognitive-behavioral therapy techniques like (negative) thought-stopping and (positive) thought-substitution.”
In a cancer setting, that positive thought might be something like, "Don't give up," repeated in rhythm. Other situations might call for more mindfulness-centered phrases. On Saturday, participants at the rehearsal tapped out various rhythms to the mantra: “Find the rhythm of your breath, feel the beating of your heart.” Some beat their drums quickly, a tap for each syllable; some beat them more slowly. There was some discussion as to which is best.
“My feeling is that it’s more powerful if [the tempo] comes from the person themselves than if I’m telling them” how fast to go, Glidden-Tracey said. “Find your own internal rhythm.”
After her earlier experiences with the African Drum Ensemble, she had set out to learn more, sitting in on ASU School of Music lectures on the psychology of music, music and healing, and music for community building. Along the way, she met several faculty and students who were intrigued by her theory, which she now refers to as Rhythmic Cognitive Restructuring (RCR).
Glidden-Tracey got to know one student, Grace O’Leary, now a graduate of ASU’s music therapy program, at an African Drum Ensemble meeting. O’Leary worked with Glidden-Tracey in the development of the RCR technique and provided research from the field of music therapy to inform Glidden-Tracey of how music therapists work in similar situations.
Glidden-Tracey has even implemented the RCR technique with a small number of clients at ASU’s Counseling Training Center, “with good responses and effects.”
“So far, the numbers have been small … but I am becoming more clear and more convinced about the value in testing it out,” she said. “The evidence so far for good results has come from clients’ and their counselors’ (my supervisees’) glowing descriptions of how much they liked it and found themselves using it after learning it in counseling sessions.”
ASU School of Music Associate Professor Roger Mantie participated in Saturday’s rehearsal. He specializes in music education and community engagement, and he has been involved with a program supported by the Arizona Arts Commission called “Mayo Music Makers,” in a partnership with Mayo Clinic. When he learned about Cindi’s work at Banner, he immediately reached out to learn more.
“Music therapists have been using music to help people for many decades … and in some areas of the world have been expanding their work into an area called Community Music Therapy,” he said. “The goals of RCR, as I understand them, are quite different. This isn’t about music therapy, per se, but about a form of community engagement where drumming is used as a motivator and a support. I suspect the engaging aspects of drumming may incline some people who might otherwise be reluctant to participate in cognitive restructuring to give it a try.”
While Mantie stressed that he is not a trained counselor or therapist, and therefore not qualified to speak on the medical aspects of RCR, he did say, “Although the medical model has been the predominant paradigm, I think it’s worth noting that social models of health are on the ascendency. Based on my knowledge of the emerging music and health literature … I am excited about the potential of rhythm to enhance the social aspects of RCR.”
Glidden-Tracey has enjoyed developing her theories and learning more about music therapy but is eager to get into the research and data collecting process on RCR. One professor she hopes to collaborate with in that respect is Monica Tsethlikai, an assistant professor at ASU’s T. Denny Sanford School of Social and Family Dynamics who studies cognitive development in cultural contexts involving biosocial stress.
They hope to design a research project around drum circles for children in Mesa schools.
Glidden-Tracey said she has also thought about putting together a camp for kids to test RCR techniques and even potential collaborations with the YMCA.
“I am carefully weighing options and resources as I explore these ideas that so intrigue me,” she said.
Her hope overall for the future of RCR is that “adding the rhythmic element from a music-therapy context to this set of widely employed cognitive-behavioral therapy techniques will make the positive messages even more memorable, accessible and even fun in those stressful moments when the client most needs to remember and use them.”
Top photo: Clinical Associate Professor Cynthia Glidden-Tracey (standing) leads the Rhythmic Cognitive Restructuring demonstration Sept. 19 at the Banner MD Anderson Cancer Center in Gilbert, Arizona. Photo by Kelley Karnes/ASU