Delsarte system and Dalcroze eurhythmics

1. Introduction

Version followed: for Dalcroze, the senior rhythmics programme of the Institut Jaques-Dalcroze (IJD), Geneva, as described in the Geneva randomised trial (Trombetti et al. 2011) and in the IJD's current senior-class information, with general lesson structure from Juntunen (2002) and Treviño & Álvarez Bermúdez (2016). For Delsarte, the American Delsartism of Genevieve Stebbins, Delsarte System of Dramatic Expression (1886). Neither is a psychotherapy. Both are movement-education traditions, and this guide is written for a psychotherapist who refers clients to them, works alongside the teacher, or, if trained, brings some of their elements into group music-and-movement work.

Dalcroze eurhythmics. Émile Jaques-Dalcroze (1865–1950), a Swiss composer and teacher at the Geneva Conservatory, saw that his students could not really hear the music they wrote. He had them walk, swing their arms or conduct while listening to his piano improvisations. He called this "eurhythmics", from the Greek for "good flow". He founded a school at Hellerau, Germany, in 1911, left Germany in 1914, and founded the Institut Jaques-Dalcroze in Geneva in 1915 [source: Dalcroze Society of America, Émile Jaques-Dalcroze page]. The method has four areas: rhythmics, solfège rhythmique, improvisation and plastique animée. It treats the body as a musical instrument, and participants hear, feel and express music with the whole body [source: Treviño & Álvarez Bermúdez 2016, pp. 160–161]. His friendship with the psychologist Édouard Claparède is credited with shaping the games of change and quick reaction that train attention [source: Wikipedia, Dalcroze eurhythmics; secondary].

How change is said to happen. The teacher improvises music and keeps changing it. Participants have to listen, decide in an instant and move. The trial authors call this a "music-based multitask" exercise: gait and balance are trained while attention is divided [source: Trombetti et al. 2011]. The EPHYCOS team in Geneva attributes the benefits to brain plasticity and to "cognitive-motor" approaches that combine exercise and cognition. This is the investigators' explanation, not an established mechanism [source: HUG press release on EPHYCOS].

Current published therapeutic use. In the Geneva RCT, 134 community-dwelling adults aged 65 or over at increased risk of falling (mean age 75.5, 96% women) were randomised to six months of weekly one-hour classes, or to a delayed-start control. The class group had about half the fall rate in the first six months (incidence rate ratio 0.46). Fewer people in the class group had multiple falls. Dual-task stride-length variability improved, and that improvement was still present six months after the classes ended. The authors list these limitations: participants were not blinded, the sample was mostly women, there was no attention-control group, and the trial used one centre and one instructor [source: Trombetti et al. 2011]. In the later EPHYCOS study (142 older adults at high fall risk, NCT01811745, Geneva 2013–2018), weekly Dalcroze classes were compared with a dedicated fall-prevention exercise programme held twice a week. HUG reports that the Dalcroze group improved more and had about half as many falls. The release gives no statistics or journal citation, so these results are [uncertain: not verified] [source: HUG press release]. The IJD also runs classes for people with Parkinson's disease and a choir for adults and seniors [source: IJD, Rythmique senior]. A small exploratory study in Mexico (nine participants) used Dalcroze sessions with older adults and looked at flow and enjoyment. Its scores were at ceiling, so its results are inconclusive [source: Treviño & Álvarez Bermúdez 2016]. Dalcroze work has also been used in special education and music therapy, but the sources give no details [source: Juntunen 2002].

Delsarte system. François Delsarte (1811–1871) was a French singer and teacher of declamation. He studied gesture and inflection to bring naturalism back to a stage he found stiff and bombastic, and he left his findings unpublished [source: Dartmouth Journeys; Public Domain Review]. Steele MacKaye, his only American student, introduced the system in the United States in 1871 and added "harmonic gymnastics". Genevieve Stebbins trained with MacKaye and was teaching it by 1880. Henrietta Hovey spread it beyond acting and public speaking. Followers were mostly educated middle-class people, and Stebbins's students were mainly women [source: Dartmouth Journeys, drawing on Ruyter 1999]. Delsarte's surviving family and American Delsartians disagreed over what counted as "true" Delsartism [source: Dartmouth Journeys]. Stebbins called her version "aesthetic gymnastics" and added "energizing" techniques alongside relaxation ones, according to Ruyter as cited [source: Public Domain Review]. Core idea: outer form corresponds to inner feeling, and training the parts of the body to move freely and in sequence frees "the channels of expression" [source: Stebbins 1886, p. 11]. Delsartism is now mainly historical. Some of its exercises are said to survive in acting classes [source: Public Domain Review]. Its influence on modern dance and on dance/movement therapy is often claimed but is [uncertain: not verified]. No current therapeutic programme, trial or certifying body for Delsarte work is known [uncertain: not verified].

2. Framework

Dalcroze senior rhythmics (the version used in the Geneva trial and at the IJD)

Format: a group class led by a teacher who improvises music, usually at the piano. Participants respond in movement. The trial programme was one structured one-hour class a week for six months, led by one experienced instructor, with no home practice [source: Trombetti et al. 2011]. The IJD's annual senior programme runs from September to June with 43 guaranteed classes. It is open to people aged 60 and over and adapted for people with mobility problems. The first two trial classes are free. Participants need comfortable clothing and flexible-soled shoes, preferably with rubber soles [source: IJD, Rythmique senior]. These are published course facts, not a dose the therapist prescribes.
Shape of a lesson: a warm-up that builds concentration and introduces the theme; a musical subject or idea explored in movement, singing and play, moving "from easy to difficult, from outer to inner movement"; improvisation within that structure; and often a close on a song or a composed piece [source: Juntunen 2002]. Lessons can be built like a suite, a theme and variations, or a symphony [source: Juntunen 2002].
Progression over a course: exercises become "gradually more difficult over time" [source: Trombetti et al. 2011]. The teacher spends longer on an exercise, changes the order, or takes up participants' suggestions, guided by "what works" [source: Juntunen 2002]. There are no formal phases or criteria for moving between stages. The teacher decides when the group is ready for more complexity, such as faster changes, extra tasks or objects.
Who may deliver it: IJD senior teachers hold a master's degree in Jaques-Dalcroze rhythmics, have specific postgraduate training and attend regular continuing-education days [source: IJD, Rythmique senior]. In the United States, the Dalcroze Society of America lists three credentials. The Professional Certificate allows teaching introductory courses and typically takes two to five years. The License allows teaching all levels of eurhythmics, solfège, improvisation, plastique animée and pedagogy. The Diplôme Supérieur is examined only at the IJD in Geneva. It allows holders to grant Dalcroze credentials and direct training programmes, and the IJD regulations say it confers the right to teach the method in its entirety [source: Dalcroze Society of America, credentials; IJD Diplôme supérieur regulations]. Training covers eurhythmics, aural training (solfège), piano improvisation, movement technique, pedagogy and plastique animée [source: IJD regulations]. No government licensing of Dalcroze teaching is known [uncertain: not verified].
Where the psychotherapist fits: a psychotherapist without Dalcroze training cannot run Dalcroze eurhythmics, because the method depends on the teacher's live musical improvisation and Dalcroze pedagogy. The therapist's usual roles are to identify suitable clients, screen for safety and refer, prepare the client, keep in contact with the teacher (with consent), and work in therapy with what the classes bring up. A psychotherapist who also holds a Dalcroze credential, or a music therapist with that training, may lead the classes within the scope of both qualifications [synthesis]. Co-leading with a Dalcroze teacher, where the therapist handles group process and the teacher handles music and movement, is a reasonable model for clinical groups [synthesis].

Delsarte (Stebbins version)

Format: a graded sequence of lessons on the body: decomposing (relaxation) exercises, harmonic poise, the principle of trinity, then the legs, the walk, the hand, arm, torso, head, eyes and brow, and nose and mouth. These are followed by pantomime grammar, the gamut of expression, voice and colour [source: Stebbins 1886, contents]. Stebbins argues that practice should come before any advanced step (p. 28). On stage, performers are to "forget all rules" so that "heart-work" replaces "head-work" [source: Public Domain Review].
Who may deliver it: no current credential or certifying body is known [uncertain: not verified]. A psychotherapist who uses Delsarte-derived exercises is drawing on a historical source and should say so to clients. Such use is [synthesis], not an established therapeutic method.

Screening before referral (both methods)

Trial exclusions, as an orientation: neurological disease with motor deficit; orthopaedic disease that significantly affects gait or balance; conditions that limit participation, such as terminal illness; and full dependence on an assistive device [source: Trombetti et al. 2011]. These were research exclusions, not contraindications. The IJD itself says its classes are adapted for mobility problems and runs Parkinson's classes [source: IJD, Rythmique senior].
Falls risk: the World Guidelines for falls prevention recommend that all older adults be advised on falls prevention and physical activity, that community-dwelling older adults be screened opportunistically, and that people at higher risk have a comprehensive multifactorial falls-risk assessment leading to personalised interventions [source: Montero-Odasso et al. 2022, abstract]. A client who has fallen or is afraid of falling should have this assessment through their physician or a falls service before or alongside class, and the therapist should not take that role on [synthesis].
Medical clearance: the IJD page states no medical requirement [source: IJD, Rythmique senior]. The trial reported no falls, cardiovascular events or injuries during classes [source: Trombetti et al. 2011]. For clients with cardiac, respiratory or uncontrolled medical conditions, recent surgery or fracture, dizziness or syncope, marked visual or hearing loss, or significant cognitive impairment, advise a check with their physician before starting. This list is [synthesis]: no official Dalcroze contraindication list is published [uncertain: not verified].
Touch: Dalcroze classes are mainly non-contact, but partner hand games and paired work do happen [source: Treviño & Álvarez Bermúdez 2016]. Ask the client in advance whether they are comfortable with hand contact. Tell them they can always choose solo versions or stop. Ask the teacher to offer non-contact options [synthesis; see Section 3, touch].

3. Guiding principles

Experience before explanation. Musical concepts are felt in movement before being named or notated [source: Wikipedia, Dalcroze eurhythmics; Juntunen 2002]. Practical meaning: in therapy, ask what the client noticed in their body before asking what it meant.
Body and mind as one; the body as instrument. The method rejects a split between mind and body [source: Treviño & Álvarez Bermúdez 2016, p. 160]. Practical meaning: treat a stumble, a freeze or a laugh in class as information, not failure.
Listen, decide, move ("reflection-in-action"). Participants adjust within seconds to changes in the music and in the teacher's instructions [source: Treviño & Álvarez Bermúdez 2016]. Practical meaning: this is the dual-task ingredient. Expect cognitive fatigue and normalise it.
Music leads, supports, then challenges. The music first supports the movement, then gives participants responsibility, and may even go against what they are doing. Start at a comfortable tempo [source: Juntunen 2002]. Practical meaning: in co-led groups, agree with the teacher on when to raise the challenge and when to steady the group.
Easy to difficult, outer to inner. [source: Juntunen 2002]. Practical meaning: never add complexity until the group is steady at the current level, and offer a simpler version of every task.
Gradual progression. [source: Trombetti et al. 2011]. Practical meaning: stepwise progression lowers both falls risk and shame.
Joy and confidence. Claire-Lise Dutoit names "the vital enjoyment of rhythmic movement and the confidence that it gives" as a mark of successful lessons [source: Wikipedia, citing Dutoit; secondary]. Jaques-Dalcroze linked joy to faculties freed from restraint [source: Dalcroze Society of America]. Practical meaning: enjoyment is part of how the method works, not a distraction from it. Monitor it as you would an outcome.
Collaboration and self-expression. The practitioner fosters an atmosphere of collaboration and self-expression [source: Treviño & Álvarez Bermúdez 2016, p. 162]. Practical meaning: rotate leadership, as in imitation-then-lead tasks, and avoid singling people out.
Teacher observes and adapts. "The teacher observes, encourages and possibly corrects" [source: Juntunen 2002]. Practical meaning: correct the task, not the person, and use encouragement more than correction with anxious or older clients.
Delsarte: correspondence. Outer form expresses inner feeling [source: Stebbins 1886, pp. 59–62]. Practical meaning: useful as a way to explore how posture and emotion relate. It is a historical theory, not an established fact [synthesis].
Delsarte: trinity. Stebbins divides the body into three zones: head as mental, torso as moral or volitional, limbs as vital [source: Stebbins 1886, pp. 31–40]. Practical meaning: if used at all, present it as Delsarte's metaphysics (he was a strict Trinitarian), never as anatomy or psychology [source: Public Domain Review].
Delsarte: opposition and succession. Head, torso and limbs counterbalance one another, and movement passes through the joints in order [source: Stebbins 1886, pp. 18, 24]. Practical meaning: slow, continuous, sequential movement, chosen by the client, with no forcing.
Consent and choice in any contact. Professional body-psychotherapy codes require assessment of whether touch is appropriate, informed consent before touch, consent that is monitored over time, the client's right to refuse or end touch at any time, and they state that genital or sexual touch is always inappropriate [source: USABP Code of Ethics, Section VIII]. Clients should be told beforehand if physical techniques will be used [source: EABP Ethics Guidelines, Principle 7]. Mainstream talk-therapy codes forbid sexual contact and require practice within competence and referral when appropriate [source: BACP 2018; UKCP 2019; APA]. Practical meaning: a psychotherapist does not add hands-on correction to this work. Partner contact between participants is always optional.
Stay within competence; collaborate. Offer only what you are trained in, and refer when appropriate [source: UKCP 2019, items 23–24]. If a client is receiving similar services elsewhere, consider what that means and discuss it with the client [source: EABP, 6.b]. Practical meaning: get written consent before talking to the teacher, and agree who handles what.

4. Intervention inventory

Part A covers the Dalcroze class activities as published. A credentialed Dalcroze teacher leads them, or a psychotherapist who also holds Dalcroze training. The psychotherapist needs to know them in order to prepare clients, co-lead and debrief. Part B covers Delsarte exercises from Stebbins. Part C covers the psychotherapist's own procedures. Steps describe the published activity qualitatively. Tempo, length and number of repetitions are set by the teacher for the group in the room, and none are prescribed here. Example language is illustrative unless quoted.

A1. Warm-up and tuning in

Purpose: build concentration, bring attention to the body and introduce the lesson's theme [source: Juntunen 2002]. In senior sessions this opened with gentle stretching and free movement, then movement following a pulse [source: Treviño & Álvarez Bermúdez 2016, pp. 163–164].
Steps: (1) The group gathers, with seated or supported-standing options offered. (2) The teacher plays or improvises music and invites easy movement within each person's comfortable range. (3) The teacher brings in a steady pulse, and participants gradually let their movement fall in with it. (4) The teacher names or hints at the theme of the day.
Example language (illustrative): "Move only as far as is comfortable for you today. You can do all of this sitting down." "Let the music tell you when to move."
Watch for: breath-holding, guarding, pain on movement, and comparing oneself with others. It is working when shoulders drop, faces soften and people begin to move with the beat without effort.

A2. Walking to the pulse and following changes of tempo and direction

Purpose: the core trial exercise. Gait is trained while the person attends to the music, which makes it a dual task [source: Trombetti et al. 2011]. In the senior sessions, participants walked to beat patterns and changed tempo and direction with the music [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) The teacher improvises a clear pulse, and participants walk in time with it. (2) The teacher changes the rhythmic pattern or the tempo, and walkers adapt their steps. (3) Direction changes are signalled musically. (4) The teacher raises complexity gradually as the group steadies [source: Trombetti et al. 2011]. Participants who are not yet ready walk near a wall or chair, or do the stepping seated [synthesis].
Example language (illustrative): "Your feet listen to the piano. When it slows down, so do you." "Missing a beat is part of it. Just pick up the next one."
Watch for: shuffling, looking down at the feet, freezing when the music changes, collisions in a crowded room, and fatigue. It is working when people adapt more smoothly and look up and around while walking. The trial found improved dual-task stride-length variability and gait speed [source: Trombetti et al. 2011].

A3. Quick-reaction and signal exercises

Purpose: to build "mental and physical alertness, control and memory" [source: Juntunen 2002]. These grew out of the games of change and quick reaction associated with Claparède [source: Wikipedia; secondary]. In senior sessions, participants respond to aural signals such as a sound or a rest [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) The teacher agrees a signal with the group, for example a particular chord, a sudden silence or a spoken word, together with the response it calls for, such as stopping, turning, clapping or changing direction. (2) Participants move to the music and respond when the signal comes. (3) The teacher varies when the signal comes, and later introduces a second signal with a different response. (4) For safety with older adults, responses that need sudden stops or turns are introduced slowly, or replaced with arm and clapping responses [synthesis].
Example language (illustrative): "When the music stops, you stop too, as gently as you like." "Two signals now: the high note means clap, the low note means turn around."
Watch for: startle reactions and hypervigilance in clients with trauma or anxiety, embarrassment at "getting it wrong", and unsteadiness when stopping abruptly. It is working when reactions become quicker and calmer and people laugh at their own errors.

A4. Weight shifting, walk-and-turn sequences and exaggerated upper-body movement

Purpose: balance challenges built into the music. The trial programme used multidirectional weight shifting, walk-and-turn sequences and exaggerated upper-body movements while walking and standing [source: Trombetti et al. 2011].
Steps: (1) Standing, with support nearby, participants shift weight in time with the music in several directions. (2) Turning is added to walking, cued by the music. (3) Large arm and trunk movements are added while walking or standing, which is a further task. (4) Seated or supported versions are always available [synthesis].
Example language (illustrative): "Sway with the music, side to side, only as far as feels steady." "Big arms as you walk, as if you were conducting the piano."
Watch for: loss of balance, dizziness on turning, and pain. Reduce the challenge or move to a supported version. The trial found improvement in one-legged stance and the Timed Up and Go test [source: Trombetti et al. 2011].

A5. Seated pulse patterns, imitation and taking the lead

Purpose: feel the grouping of beats into metres and practise coordination and memory. Leading in turn builds confidence and social connection. In the senior sessions these patterns used groups of 3, 4, 6 or 8 beats, with participants first imitating the teacher and then taking turns as leader [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) Seated, the teacher shows a body-percussion or movement pattern that fits a metre. (2) The group imitates it. (3) Group members take turns making up a pattern for the others to copy. (4) Patterns become longer or are combined.
Example language (illustrative): "Copy me first. Then someone else will be the leader." "Any movement is fine, as long as it fits the music."
Watch for: reluctance to lead, which may come from shame or low mood (offer the option of passing), and memory difficulties. It is working when people volunteer to lead and the group spontaneously keeps together.

A6. Auditory discrimination with movement, clapping or rhythm sticks

Purpose: train listening. Participants respond to what they hear, such as high or low, loud or soft, or a particular rhythm, with a movement, a clap or rhythm sticks [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) The teacher plays contrasting musical features and assigns a response to each. (2) Participants respond as they hear each feature. (3) The contrasts become finer.
Example language (illustrative): "When you hear the music get softer, let your clapping get softer too."
Watch for: hearing loss, so check hearing aids and seat people near the instrument, and frustration. It is working when responses get closer to the music's changes.

A7. Work with objects: percussion instruments and balls

Purpose: add a manual task to gait and balance. The trial used percussion instruments and balls [source: Trombetti et al. 2011]. Ball passing in a circle was used in the senior sessions [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) The teacher hands out instruments or balls. (2) Participants play or pass them in time with the music, for example passing a ball around a circle on the beat. (3) Walking, or changes of direction, are added. (4) Seated versions are offered [synthesis].
Example language (illustrative): "Pass the ball on the strong beat. If it drops, let it go, and we carry on."
Watch for: bending to pick up a dropped ball, a falls risk (agree that a helper retrieves it), poor grip from arthritis, and competitiveness. It is working when passing is smooth and people look at each other rather than at the ball.

A8. Follow exercises

Purpose: move continuously with music as it changes. This is one of the original exercise types, alongside quick reaction, replacement, echo and canon. Alperson, as cited, says these exercise types are "a resource and are not essential" [source: Juntunen 2002]. A detailed published description specific to seniors is lacking [uncertain: not verified].
Steps (general, [synthesis] from the source's description): (1) The teacher improvises music that changes in tempo, dynamics or character. (2) Participants let their movement follow these changes as they happen. (3) The teacher makes the changes more frequent or more subtle.
Example language (illustrative): "Just follow. If it gets heavy, your steps get heavy. If it gets light, so do you."
Watch for: self-consciousness about free movement, and over-exertion when the music speeds up. It is working when movement visibly matches the music's character.

A9. Echo and canon

Purpose: memory and divided attention. Participants reproduce a pattern after it has been played (echo), or perform one pattern while listening to the next (canon). Both are named among the original exercise types [source: Juntunen 2002]. Detail is thin [uncertain: not verified].
Steps ([synthesis]): (1) Echo: the teacher plays a short rhythm, and participants reproduce it by clapping or stepping. (2) Canon: participants perform the previous pattern while the teacher plays the next one, so listening and doing overlap.
Example language (illustrative): "Listen first, then answer." "Now try doing the one you just heard while I play the next one. It's meant to be tricky."
Watch for: cognitive overload, which shows as giving up or getting irritated. Return to echo before trying canon again. It is working when participants can hold one pattern while hearing another.

A10. Replacement and inner hearing

Purpose: inner hearing. Part of a rhythm or song is replaced by silence or by a movement, so participants must hear it internally. Robert Abramson combines replacement, inner hearing and improvisation in solfège [source: Juntunen 2002].
Steps ([synthesis]): (1) The group sings or claps a familiar song or rhythm. (2) On a signal, a chosen part is replaced by silence or by a movement. (3) The group comes back in together.
Example language (illustrative): "Keep singing it in your head during the quiet part, and we'll all come back in together."
Watch for: losing one's place in the song, which needs reassurance. It is working when the group comes back in together.

A11. Free movement improvisation, group dance and plastique animée

Purpose: expression and showing musical form with the body. The senior sessions used free movement improvisation and a group dance that showed musical form [source: Treviño & Álvarez Bermúdez 2016]. Plastique animée, the realisation of music in choreography, is one of the method's four areas and is examined in teacher training [source: IJD regulations; Treviño & Álvarez Bermúdez 2016].
Steps: (1) The teacher plays a piece or an improvisation with a clear form, such as contrasting sections. (2) Individuals or the group find movements for each section. (3) The group puts these together into a short shared dance.
Example language (illustrative): "There's no right way. How does this part of the music want to move?"
Watch for: strong feelings stirred by music that carries memories, such as grief or nostalgia (see Section 5), and exposure anxiety. It is working when people shift from performing for others to moving for themselves.

A12. Partner hand games and singing with pulse

Purpose: social connection and coordination. The senior sessions included paired hand games and folk songs sung with a pulse or rhythmic cells [source: Treviño & Álvarez Bermúdez 2016].
Steps: (1) Before any partner contact, the teacher says it is optional and offers a non-contact version, such as mirroring the partner's clapping without touching [synthesis; touch principles from USABP VIII]. (2) Partners clap or tap a pattern while singing. (3) Pairs swap partners only if everyone is comfortable.
Example language (illustrative): "This one can be done touching hands or just facing each other in the air. Choose what suits you, and you can change your mind at any time."
Watch for: discomfort with touch, especially in clients with trauma histories, and pain in arthritic hands. It is working when pairs laugh and keep the rhythm together.

A13. Closing: song, composed piece or relaxation

Purpose: bring the musical idea together and ease the group out of the session. Lessons often end with a song or a composed piece that illustrates the idea, sometimes with relaxation [source: Juntunen 2002].
Steps: (1) The teacher plays or sings a piece that shows the day's theme. (2) Participants listen, sing or move gently. (3) The group rests quietly before leaving.
Example language (illustrative): "Let's listen to the whole piece now and notice the idea we've been playing with."
Watch for: fatigue and light-headedness when standing up after rest. It is working when people leave settled and chatting.

B1. Delsarte decomposing (relaxation) exercises

Purpose: release tension in one body part at a time. Stebbins says these exercises "free the channels of expression" [source: Stebbins 1886, p. 11]. Any use as relaxation in therapy is [synthesis]. Stebbins makes no therapeutic claim.
Steps (as Stebbins orders them, described qualitatively): a body part is allowed to drop loosely from its joint, "as if dead", and is then shaken out, so that the effort stops at that joint. The order runs fingers, hand, forearm, arm, head, torso, foot, leg, whole body, eyelids and lower jaw [source: Stebbins 1886, pp. 11–14]. Safety adaptation [synthesis]: with older adults, or with anyone who has neck, back or balance problems or osteoporosis, keep to the hands, arms and jaw while seated. Leave out letting the head, torso or whole body drop, and shake gently or not at all.
Example language (illustrative): "Let your hand go heavy from the wrist, as though it's resting on nothing, then give it a soft shake." "Only what feels fine. Skip anything that pulls."
Watch for: pain, dizziness, and dissociation or feeling unreal when deeply relaxed. Clients with trauma histories can find complete letting go threatening, so offer eyes open and a choice to stop at any time. It is working when the client notices the difference between holding and letting go.

B2. Delsarte harmonic poise

Purpose: graceful balance through opposition. The weight moves between the feet while the head and torso counterbalance [source: Stebbins 1886, pp. 18–27].
Steps (qualitative): (1) Weight shifts from one foot to the other. (2) The head tilts toward the weight-bearing leg while the torso leans the opposite way. (3) Later forms add sways forward and back and to the side, and turning at the waist with the head and torso going in opposite directions. Seated versions are included. (4) Stebbins stresses slow, continuous movement [source: Stebbins 1886, pp. 18–27]. Safety adaptation [synthesis]: offer standing work only with support within reach, after falls screening. Use the seated versions with frail clients.
Example language (illustrative): "Let your weight move slowly into your right foot, and notice where your head wants to go to keep you balanced."
Watch for: unsteadiness, neck discomfort when twisting, and breath-holding. It is working when movement becomes smooth and the client reports feeling steadier or more at ease.

B3. Delsarte correspondence and the gamut of expression (historical; use only as exploration)

Purpose: in Stebbins's system, outer form expresses inner feeling. Her "Gamut of Expression in Pantomime" pairs scripted emotional scenes with precise attitudes for each part of the body [source: Public Domain Review; Stebbins 1886, contents and pp. 59–62]. The detailed attitudes are [uncertain: not verified].
Steps (therapeutic adaptation, [synthesis] only): (1) Explain that the idea comes from a nineteenth-century theory of acting, not from modern psychology. (2) Invite the client to take on a posture or gesture and notice any feeling that comes with it, or to name a feeling and find a gesture for it. (3) Explore together what the client noticed, without interpreting it for them.
Example language (illustrative): "This comes from an old acting method that believed posture and feeling mirror each other. Let's just try it and see what you notice, with no right answer."
Watch for: the client taking a fixed "meaning" of a posture as true, and strong emotion. It is working when the client becomes curious about how body and mood interact.

C1. Suitability assessment and referral (psychotherapist)

Purpose: identify clients who might benefit, such as older adults with fear of falling, isolation, low mood or low activity, or people who enjoy music, and make a safe referral [synthesis, informed by Trombetti et al. 2011 and the IJD senior programme].
Steps: (1) Ask about falls, fear of falling, mobility, hearing, vision, cognition, pain and medical conditions. (2) If falls or a fear of falling are present, recommend a multifactorial falls-risk assessment through their physician [source: Montero-Odasso et al. 2022]. (3) Recommend a physician check for medical concerns [synthesis]. (4) Find a teacher with recognised credentials: IJD-trained teachers, or Dalcroze Society of America Certificate, License or Diplôme holders [source: IJD; Dalcroze Society of America]. (5) Suggest a trial class first, which the IJD offers [source: IJD, Rythmique senior]. (6) Present any benefits as findings from trials, not guarantees.
Example language (illustrative): "There's a music-and-movement class designed for people over 60. In one Geneva study, people who took part fell less often, though that doesn't mean it will work the same way for everyone. Would you like to try a class to see how it feels?"
Watch for: a client agreeing to please you, and denial of falls. It is working when the client attends and reports enjoying it.

C2. Preparing the client

Purpose: reduce anticipatory anxiety, shame about being clumsy or unmusical, and worries about touch [synthesis].
Steps: (1) Describe a typical class: music, walking, clapping, simple games, and errors expected and laughed at [source for content: Trombetti et al. 2011; Treviño & Álvarez Bermúdez 2016]. (2) Agree the client's rights: sit out, use the seated version, decline partner contact, and leave. (3) For trauma histories, plan how the client will signal a need for a break, where they will stand (for example near the exit), and how they will ground themselves. (4) Advise flexible-soled shoes and comfortable clothes [source: IJD, Rythmique senior].
Example language (illustrative): "Nobody is expected to be musical. Getting it 'wrong' is part of the game. You can always sit down, and you never have to hold anyone's hand."
Watch for: avoidance that grows as the date approaches. Treat it as you would any anxiety about exposure, with a graded and agreed plan. It is working when the client goes and stays.

C3. Liaison with the teacher

Purpose: coordinated care without confusing roles [source: EABP 6.b on parallel services; UKCP referral provisions].
Steps: (1) Obtain written consent and agree with the client what may be shared. (2) Share only what is needed: mobility limits, hearing, startle sensitivity, preference for no contact. (3) Agree a route for the teacher to raise concerns such as distress, falls or cognitive change. (4) Don't share therapy content [synthesis].
Example language (illustrative, to the client): "Would it help if I told the teacher that you'd rather do the partner games without touching? I'd only share what you agree to."
Watch for: the teacher being drawn into a counselling role, or the client "splitting" between helpers. It is working when the client feels supported in both places.

C4. Integrating class experiences in therapy

Purpose: turn class experiences into therapeutic material: experiences of mastery, body awareness, social contact, and reactions to error or to music [synthesis].
Steps: (1) Ask what happened in the body first, then what feelings and thoughts came up (principle: experience before explanation). (2) Link moments of adapting to the music with flexibility in daily life, if the client finds that useful. (3) Use errors and laughter in class to work on perfectionism and shame. (4) Track enjoyment, confidence and fear of falling over time.
Example language (illustrative): "When the music suddenly changed, what did you notice in your body? And what did you tell yourself?" "You said you laughed when you missed the beat. What was that like for you?"
Watch for: turning every class into analysis (keep the joy), and changes in cognition or mobility that need medical follow-up. It is working when the client brings class experiences in by themselves and their confidence spreads into other areas.

C5. Co-leading a group music-movement session for older adults (psychotherapist with a Dalcroze teacher)

Purpose: for clinical groups, for example in day hospitals, memory services or groups for depression in later life. The teacher leads the music and movement, and the therapist holds group process and safety [synthesis].
Steps: (1) Plan the session theme and its stepwise difficulty with the teacher, following the published lesson shape (Section 2). (2) Agree a safety set-up: chairs within reach, clear floor, a helper to pick up dropped objects, water. (3) The therapist moves among the group, offers seated versions, supports anyone who is overwhelmed, and notes group dynamics. (4) Close with a short verbal round on what people noticed and enjoyed. (5) Debrief afterwards with the teacher.
Example language (illustrative): "Let's take a moment before we finish. One word for how your body feels now?"
Watch for: domination by the more able, withdrawal by the less able, grief brought up by songs, and fatigue. It is working when attendance is steady and members begin talking to each other outside the session.

C6. Recognising and passing on adverse effects

Purpose: physical safety and duty of care [synthesis; within-competence and referral duties per UKCP 2019, HCPC].
Steps: (1) Ask after each early class about falls, near-falls, pain, dizziness, chest symptoms and exhaustion. (2) Refer physical symptoms to the physician, and tell the teacher with the client's consent. (3) Note psychological reactions such as panic, flashbacks or shame, and address them in therapy. (4) Report any boundary violation by a teacher, for example unwanted touch, through the teacher's credentialing body or association, and through safeguarding routes for vulnerable adults [synthesis].
Example language (illustrative): "Any wobbles, aches or dizziness after the class? Let's make sure the right people know."
Watch for: under-reporting by older clients who don't want to be a nuisance. It is working when the client reports problems early.

5. Handling problems

The published sources deal with problems only in passing. They say to start at a comfortable tempo, move from easy to difficult, and adapt the order and pacing to "what works" [source: Juntunen 2002]. They say to adapt for mobility problems [source: IJD, Rythmique senior] and to progress gradually [source: Trombetti et al. 2011]. Everything else below is [synthesis].

Fear of falling or a fall in class. Make sure falls-risk assessment has been done through the physician [source: Montero-Odasso et al. 2022]. Ask the teacher about seated and supported versions, and ask for a spot near a wall or chair. After any fall, stop attending until the client has been medically reviewed, then rebuild confidence step by step and look at catastrophic predictions in therapy. Language (illustrative): "Your body had a fright. Let's get it checked, and then work out together how to go back at a pace that feels safe."
Overload from the dual task (frustration, giving up, "I'm too stupid for this"). Normalise it: difficulty is built in deliberately, because the method trains people to cope with divided attention [source: Trombetti et al. 2011]. Ask the teacher to offer simpler versions. In therapy, work on self-critical thoughts. Language (illustrative): "The exercise is meant to be just a bit too hard. That's how it works, not a sign you're failing."
Embarrassment and feeling "unmusical" or watched. Stress that no musical skill is needed. Choose classes where no one performs alone, and use passing or group-only participation at first.
Hearing or vision impairment. Check hearing aids, seat the person near the instrument, and ask the teacher to add visual or spoken cues. Good lighting and a clear floor reduce falls risk.
Cognitive impairment or dementia. Use simpler, familiar songs and shorter sequences, with carers present if appropriate. Before referral, check whether the class is suitable through the teacher or a memory service. Consent and assent should be appropriate to the person's capacity. The IJD trial excluded no one on cognitive grounds, but this population needs more checking [uncertain: not verified].
Parkinson's disease and neurological conditions. The IJD runs specific Parkinson's classes [source: IJD, Rythmique senior]. Refer to these rather than a general class, and coordinate with the neurologist or physiotherapist. The trial excluded neurological disease with motor deficit [source: Trombetti et al. 2011].
Pain, arthritis and orthopaedic limits. Use seated versions and smaller movements, and avoid gripping tasks. Refer back to the physician or physiotherapist if pain persists. Never push through pain.
Startle and trauma responses to sudden signals or silence (A3). Ask the teacher in advance to use predictable signals and gentle responses. Agree a grounding plan and an exit. In therapy, process what happened and decide together whether to continue.
Strong emotion triggered by music (grief, nostalgia, memories). Expect it, especially with folk songs and familiar pieces. The client may step out and should be welcomed back. Explore it in therapy. Don't expect the teacher to manage it in the room. In co-led groups, the therapist offers quiet support.
Discomfort with partner contact (A12). Offer non-contact versions as the default. The right to decline or stop at any time follows body-psychotherapy consent standards [source: USABP VIII]. If a teacher or participant touches someone in a way that is unwanted or sexualised, treat it as a boundary violation. Support the client in reporting through the teacher's association or credentialing body, and through adult safeguarding where relevant.
Non-adherence and dropout. In the trial, mean attendance was 78% [source: Trombetti et al. 2011]. Find out what the barrier is, for example transport, cost, mood, pain or social anxiety. IJD fees can be partly covered by some insurers, networks and social benefits [source: IJD, Rythmique senior]. Use behavioural activation methods such as planning, a companion, or linking class to another valued activity.
Over-reliance on the class for mood, or using it to avoid therapy goals. Acknowledge what the class gives the client. Keep the therapy focus, and link the class to the client's own goals.
Rupture with the therapist after a referral that didn't work. Own your part in the suggestion, explore the client's experience without defending the method, and look at alternatives such as other falls-prevention exercise, dance or music groups. Language (illustrative): "It sounds like the class didn't fit at all, and I'm sorry I pushed it. What would suit you better?"
Delsarte-specific issues. Clients may take Stebbins's trinity or meanings of gestures as fact. Present them as historical theory [source: Public Domain Review; Stebbins 1886]. Leave out whole-body "decomposing" and head-drop exercises for anyone with neck, back or balance problems (B1). Delsarte has no established evidence base as therapy [uncertain: not verified], so do not offer it as a treatment.
Claims beyond the evidence. Do not present either method as a treatment for any physical disease. Attribute the fall-reduction findings to the specific Geneva trials and describe their limitations [source: Trombetti et al. 2011; HUG press release].

Sources

Web sources

Books

Stebbins, Genevieve (1886). Delsarte System of Dramatic Expression. New York: Edgar S. Werner.
Ruyter, Nancy Lee Chalfa (1999). The Cultivation of Body and Mind in Nineteenth-Century American Delsartism (cited through Dartmouth Journeys and the Public Domain Review; publisher [uncertain: not verified]).

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