Posts Tagged ‘Vocal Rehabilitation’

Laryngeal Manual Therapy (LMT) and Head and Neck Massage: BAPAM Guidance

Tuesday, November 26th, 2019

In the light of recent press about a death following manipulation (www.bbc.co.uk/news/uk-england-york-north-yorkshire-50397867) and the publication of research last year on the dangers of head and neck massage if practised by improperly trained salon employees (“Crick” in Neck Followed by Massage Led to Stroke …), we at the British Association for Performing Arts Medicine, along with our clinical colleagues, thought it would be useful to provide guidance on Laryngeal Manual Therapy (LMT) and Head and Neck Massage, which is often used by professional voice users.

We recommend that manual therapy techniques applied to the head, neck and larynx should only be performed in clinical environments by the following registered professionals:

Physiotherapist – registered with the Chartered Society of Physiotherapists (CSP)

Osteopath – registered with the General Osteopathic Council (GOC)

Speech and Language Therapist – registered with the Royal College of Speech and Language Therapists (RCSLT)

Chiropractor – registered with the General Chiropractic Council (GCC)

Sports Therapist –registered with the Complementary and Natural Healthcare Council (CNHC), Federation of Holistic Therapists (FHT) or British Association of Sports Rehabilitators (BASRAT).

Massage Therapist –registered with the Complementary and Natural Healthcare Council (CNHC) or Federation of Holistic Therapists (FHT). Massage Therapists should be qualified to diploma level and registered with the CNHC or FHT, which are the only Registering bodies for Massage Therapy that are accredited by the UK Professional Standards Authority. While there are many organisations that provide training in massage, only some of them provide training at a level that provides a route to registration with CNHC or FHT.

Membership of a registering body accredited by the Professional Standards Authority is a guarantor of professional standards. It indicates that the practitioner operates within a structure that oversees qualifications, working practices, ethical behaviour etc. and can investigate complaints and impose sanctions on practitioners who fall short.

The BAPAM Directory also lists BAPAM-Registered Vocal Rehabilitation Coaches (VRCs). A VRC is a type of specialist voice coach who works as part of a multidisciplinary team that includes clinicians such as Speech and Language Therapists and Laryngologists. BAPAM-Registered VRCs have undertaken training to carry out palpation assessment. This is to assess tension only, and for onward referral, not to perform manipulations. Training in palpation assessment should be provided by a clinically qualified practitioner such as an Osteopath or Physiotherapist. Like clinical professionals, VRCs require clinical supervision from a Laryngologist, Speech and Language Therapist and sometimes a Psychotherapist.

NHS Specialist Voice Clinics Vocal Rehabilitation Coach Pilot

Friday, May 10th, 2019

BAPAM is excited to announce the start of a new pilot project, in which we are funding a Vocal Rehabilitation Coach (VRC) to work alongside clinicians in NHS Professional Voice User Clinics.

Vocal health problems in singers and actors are often multifactorial, requiring a specialised multi-disciplinary approach to diagnosis, in order to get patients onto the right pathways of treatment and rehabilitation and back to performing as quickly as possible. Over the last two years, we have been working with a group of clinical experts in this area, including Laryngologists and Voice-specialist Speech and Language Therapists, who have advised us that adding a Vocal Coach into this team – an experienced singing teacher with understanding of the clinical processes in vocal health – would further help the diagnosis and rehabilitation of performer patients. Lewisham and Greenwich NHS Trust already employ a Vocal Rehabilitation Coach and BAPAM has agreed to fund a VRC post across up to three NHS hospitals for a pilot year, with funding support from PPL, Help Musicians UK, Musicians’ Union and Equity, following which the pilot will be independently evaluated to assess the requirements for the VRC role and the effectiveness of this model in the care of performers. Dane Chalfin, an experienced VRC and singing teacher, is taking on the role for the initial 12 months’ pilot. The first of these BAPAM-funded clinics has just started at Wythenshawe Hospital, part of Manchester University NHS Foundation Trust. Guy’s and St. Thomas’ NHS Foundation Trust is expecting to start to offer this additional service from September, and a third NHS Trust is expected to be confirmed soon.

BAPAM undertook a survey across existing specialist Voice Clinics in order to develop the competencies required to work in this new role and these were reviewed and approved by our Vocal Health clinical experts and adopted by the BAPAM Medical Committee. There is currently no professional body able to provide formal registration of VRCs and BAPAM hopes that by facilitating a process whereby experienced vocal coaches can demonstrate that they meet a set of competencies, we can help provide a level of confidence in this role both to the NHS and to performers themselves, and reassure our funders that we are investing in the best services. Four practitioners who meet these competencies have so far been approved to join a new section of the BAPAM Directory of Practitioners as VRCs, and we are hoping to expand this number in the near future. We can provide guidance to practitioners interested in this field towards appropriate training that may be required to meet our competences.

We hope that this pilot will provide some initial evidence to support the involvement of practitioners with an educational background in the rehabilitation of performers and, specifically, the wider adoption of this practice to improve patient care in vocal health. If the pilot is successful, we hope to be able to secure funding to support substantive VRC appointments going forward via an open appointments process. This work takes place against a backdrop of developing education and science in vocal health, with practitioners at the UCL Performing Arts Medicine MSc and the MA in Vocal Pedagogy at the University of Wales undertaking exciting new studies which are increasing our understanding in this area of performing arts health. BAPAM is pleased to be able to make this small contribution to continuing improvement in vocal health for performers.

Further enquiries are welcome via info@bapam.org.uk

Related information:

BAPAM VRC Competencies