Blog Category: Mental Health

Women in Recovery and Music Therapy

It’s a Thursday afternoon, and one of Roman Music Therapy Services lead therapists, Laetitia Brundage, has pulled up in front of the home where she will be seeing her next clients. 

Inside, ten to twelve women ranging in ages from nineteen to forty-five wait in the living room for Laetitia’s arrival. With couches moved around to form the shape of a ‘U’, participants in the upcoming music therapy session are asked to pick their instruments. Once everyone is outfitted, Laetitia opens the session with a check in, finding out where each member of the group is at, emotionally, that day. Then she leads the group with a song to gather everyone together, breaking the ice and setting the tone. A rhythm everyone can play is picked, something that offers a beat for participants to land on as they drum. Sometimes it’s ‘Boston, Massachusetts’, other times Laetitia asks if the women would like to offer the mantras they say to themselves to get through a tough challenge or a rough day.

This home is the residence of an inpatient substance use disorders treatment facility specifically for women. The women in recovery are typically there for six to twelve months and engaged in various therapies and life building sessions.

While many people are familiar with music therapy in after school programs or within the setting  of nursing homes, they are less familiar with music therapy playing a  role in the treatment of mental illness, such as PTSD, anxiety and substance use disorder, to name only a few. Laetitia helps the women in this group identify, process and develop coping mechanisms surrounding their emotions, as well as build resiliency and gratitude. By sharing their emotions with the group, displaying respect for one another and listening to each other, as well as a willingness to explore their personal experience with treatment, the goal is to increase a participant’s potential success in sobriety after leaving the supportive and contained environment of the house.

Much of the feedback Laetitia has received after her sessions is positive. One woman revealed that “music really turned my attitude around”. Another shared that it was “really cool to take all these emotions and put them into song” after a session of songwriting with her peers.”

Laetitia is honored to be part of the progress these women are making.“It’s such different work…it’s very rewarding to go into this amount of depth with people.” The women have been extremely open and Laetitia says working with them has been “really beautiful…I feel like I’m making a real difference in their treatment and giving them another tool.”

After 45 minutes of music, the session comes to a close. Typically, the group ends with a mandela, an exercise that has one person begin a beat, followed by the next person, followed by the next and so on until everyone in the circle is contributing their own music. It shows the women that while they maintain their group cohesion, they still retain their individuality. And just as they started, they finish one by one, until there is a lone drummer, before they too fall silent and the group session concludes until next week.

If you, or anyone you know, is struggling with a substance use disorder, please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information and help.

If you would like more info on music therapy and it’s use during treatment and recovery, please contact us.

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The Intersection Between Music and Medicine

NPR’s Robert Siegel, host of All Things Considered, recently spoke with the director of the National Institutes of Health, Francis Collins, and Renee Fleming, world renowned soprano and Artistic Advisor at Large at the Kennedy Center. Their conversation centered on the work they are doing jointly to advance the study of music and medicine.

This weekend both Collins and Fleming will be collaborating at Sound Health, a two-day event exploring connections between music, health, wellness and science.

Listen to, or read, their ideas on how the brain responds to music.

 

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Music Therapy and Mental Health

Meaning of LifeMusic therapy has been recognized and supported in the mental health field for many years. In the early history of music therapy, musicians worked with veterans from World War 2 playing songs in hospitals or rehabs. These musicians and surrounding staff saw noticeable changes in the veterans mood and affect. The field has grown largely since then, working with a range of demographics, disabilities, in such settings as; mental health, special education, hospice, nursing homes, and hospitals.

One study done in Finland, at the Music Therapy Clinic for Research and Training, was conducted with 79 adult participants ranging in age from 18 – 50. Each participant had been diagnosed with unipolar depression. The participants were given a baseline psychiatric assessment at the beginning of treatment and at a 3 month and 6 month follow up to assess progress. There were two groups of patients, one group received music therapy and standard care, and one group received standard care solely which consisted of 5-6 short term psychotherapy interventions, medications, and counseling.

The participants receiving individual music therapy treatment were encouraged to express themselves musically through improvisation and playing with a psychodynamic music therapy approach which involves using the exploration of instruments, to encourage self-expression. In this approach of music therapy, the therapist and participant create a relationship through the music to delve deeper into the relationship. Participants in this study received 20 bi-weekly individual music therapy sessions for 60 minutes each. Participants were offered various choices of percussive instruments, and encouraged to improvise by themselves and with the music therapist.

In this study, participants receiving music therapy showed greater improvements in all of the areas assessed; depression symptoms,  anxiety symptoms, and general functioning. The results concluded that music therapy, was an effective method of treatment along with standard care when confronting depression.

How does music therapy work as part of mental health treatment?

Music therapy in the means of mental health relies on music for communication and expression. Music therapy looks beyond verbal expression, allowing participants to find their voice in the music, in a time where it may not be easy to find the right words to say.  Music therapy in mental health settings includes interventions such as musical improvisation, song writing, music listening, and lyric analysis.

Why does it work?

Music therapy uses a participants personal relationship with music to access and create meaningful experiences. The American Music Therapy Association lists possible ways that music therapy can reinforce positive outcomes in the treatment of mental health needs.

  • Explore personal feelings and therapeutic issues such as self-esteem or personal insight
  • Make positive changes in mood and emotional states
  • Have a sense of control over life through successful experiences
  • Enhance awareness of self and environment
  • Express oneself both verbally and non-verbally
  • Develop coping and relaxation skills
  • Support healthy feelings and thoughts
  • Improve reality testing and problem solving skills
  • Interact socially with others
  • Develop independence and decision making skills
  • Improve concentration and attention span
  • Adopt positive forms of behavior
  • Resolve conflicts leading to stronger family and peer relationships

Music therapy should not replace standard care, or psychotherapy, however the research provided proves that music therapy is a positive addition to standard care, increasing a person’s opportunities for living a successful and fulfilling life.

Channing Shippen MT-BC

References:

Erikka, J., Punkanen, M., Fachner, J., Ala-Ruona, E., Pontio, I., Tervaniemi, M., Vanhala, M., & Gold, C. (2011). Individual music therapy for depression: randomised controlled trial. British Journal of Psychiatry , Retrieved from http://bjp.rcpsych.org/content/early/2011/04/07/bjp.bp.110.085431.full.pdf

Music therapy and mental health. (2006). Retrieved from http://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf

 

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Resources for Recovery

Our team here at Roman Music Therapy Services sends out our heartfelt thoughts to all of those affected by the tragedies in Boston this week. We have seen an out pouring of support for those affected by the tragedies of Monday. We encourage those seeking any kind of assistance to reach out and take advantage of the support and kindness of local resources.

As parents, many of us also need to reconcile how to talk with our children about these terrible events and support them in understanding while we ourselves struggle to understand.

Below you will find a list of resources that we have found that we believe may help you and your family. We will continue to add resources as we find them.

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This page was created by Brene Brown following the tragedies in Newtown, but it contains a number of helpful links and resource for parents.

www.brenebrown.com/resources-for-parents

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Resources from our community partners at The Massachusetts School for Professional Psychology Freedman Center for Child and Family Development

The MSPP INTERFACE helpline is available Monday-Friday 9AM-5PM at 617-332-3666 x1411 should you, a loved one, or friend feel it appropriate to seek mental health support in the coming days and weeks following this incident.

For parents as well as providers or school staff members working with children, the following resources may be useful:

Parent tips of preschool aged children:http://www.nctsnet.org/sites/default/files/assets/pdfs/appendix_tips_for_parents_with_preschool_children.pdf

Talking with children about the bombings:
http://www.nctsnet.org/sites/default/files/talking_to_children_about_the_bombing.pdf

Additionally, regardless of how directly we were affected, all of us will need to ensure that we take good care of ourselves in order to be available whether it be for your own children, students, clients or friends and loved ones. Please find some helpful reminders about caring for ourselves in light of this tragedy courtesy of the Riverside Community Care Trauma Center:
http://riversidetraumacenter.org/documents/PracticingSelf-CareAfterTraumaticEvents.pdf

Please note that these resources, as well as many others that may be useful to you, are available at our website: http://msppinterface.org/

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Common Sense Media

On the Common Sense Media Page there is helpful information about explaining the news to our children. You can read more here.

http://www.commonsensemedia.org/advice-for-parents/explaining-news-our-kids

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The National Association of School Psychologists offers this site to support parents and teachers on helping children cope.

http://www.nasponline.org/resources/crisis_safety/terror_general.aspx

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The American Psychological Association offers these resources for dealing with disasters and traumatic events.

http://www.apa.org/helpcenter/disaster/index.aspx

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Leonard Bernstein Quote

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OCD Treatment with Music: Notes from “Case Studies in Music Therapy”

A Co-op’s Post: Taking a Closer Look at Music Therapy
Written by Britney McNeilly, Northeastern Co-op Student at RMTS

Recently I read an interesting study about a thirty-one year old man with Obsessive Compulsive Disorder.  This condition caused him feelings of doubt, unrest, and panic, and resulted in emotional and social issues that affected his every day life.  Characteristic to OCD, John* (as I will refer to him for privacy purposes) had a strong need for order and was afraid and overwhelmed by irregularities.   Though he had been working with a psychotherapist for years, there had been no notable improvements in John’s condition.  On a whim, John’s therapist decided to refer him to music therapist Jose Van Den Hurk.  After a brief assessment, the music therapist decided that he would use improvisation as his primary therapeutic tool.

“John* had an intense need for security, predictability, and set rules,” said Van Den Hurk.  “From the very first contact, it was obvious that my client did not want to take any risks.  He was afraid of the unknown.” (pg 329)  During his early music therapy sessions, John’s fears were reflected in his improvisation– he was passive, submissive, uncreative, and showed no spontaneity.  He selected instruments which were familiar to him, and he did not experiment with them.  John had low self-confidence and required validation, approval, and reassurance.  Because of this, he found it difficult to make decisions, often second guessing himself or asking others for advice.  This attitude could be seen in his hesitance to choose musical instruments and to improvise.

John was a very intellectual person; however his emotions were lacking and unaccessible.  He would play music mechanically, interjecting no feeling into his play through the manner or dynamics or tempo.   Because of his low-self confidence, John was afraid of being hurt.  Rationalizing his emotions and focusing on his intellectuality, he defended himself from any possible rejection or betrayal.  John also feared intimacy.  This was demonstrated in his therapy sessions by his lack of musical contact with his therapist.  It was as though the act of playing together and connecting musically scared him.

From his initial observations and discussions with John, Van Den Hurk devised a treatment plan.  First, he selected two different but familiar instruments for John and himself (guitar and percussion).  In this scenario, John was playing a familiar instrument, did not have to make the decision of choosing an instrument, and was using an instrument different from the therapist (in order to eliminate any possibility for an intimate musical connection)– the ultimate safe haven.

At the next stage, the music therapist selected two identical, familiar instruments.  Though John did not have to make a choice or play an unfamiliar instrument, he was forced to risk intimacy with the therapist.  He began by refusing to look at the therapist when playing, concentrating solely on his own mechanical technique and rhythm and ignoring any means of connection.  However as time passed, it was noted that John paid more attention to the therapist, especially when playing piano.  This newfound emotional connection was created because John felt more at ease on the piano, and therefore his self confidence was boosted.  Feeling worthy and confident, he was less hesitant to look the therapist in the eye and sync his rhythms with him. John’s improvisations became more dynamic and expressed more emotions as he improved musically– an important step forward.  Emotionally reserved, music was a safe way for John to acknowledge his feelings and release them.

To work on John’s decision making, the therapist encouraged him to now choose his own instrument.  He was forced to deal with the difficulty of decision making, but had control over which instrument he picked (familiarity) and whether it was similar or different to that of his therapist’s (intimacy).  This focused on a different aspect of John’s OCD, but allowed him to integrate his previous progress of playing with the therapist.  He was no longer afraid of selecting similar or identical instruments, and

The last stage worked on John’s lack of spontaneity and incessant need for routine.  When improvising with John, the music therapist initially used a technique called “empathy” (Bruscia 1987) in which the therapist works on imitation, synchronization, and pacing and reflecting.  Once noted progress had been made in other areas, this technique was exchanged with that of “elicitation” and “redirection.”  These strategies include repeating, making spaces, interjecting, and introducing change.  Through this style of improvisation, John was forced to experiment, take initiatives, and react spontaneously.

John’s progress in music therapy was notable, but the real challenge was applying the concepts he’d mastered in class to his life. Music therapy was an important transitory step for John, and through continued music and psycho therapy, his Obsessive Compulsive Disorder has become easier to manage.

 

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