I am most passionate about working as a music therapist with mental health communities. For many clients - music therapy is a novel experience that allows them to approach treatment in a different way. Individuals with mental illness are often incredibly creative and love to use music as a source of healing. I have facilitated groups in a variety of settings, such as inpatient psychiatry, outpatient facilities, community centers, intensive outpatient, partial hospitalization, and residential treatment. In these settings, I have worked with individuals with a variety of diagnoses, such as major depressive disorder, bipolar disorder, eating disorders, post-traumatic stress disorder, psychosis and substance use disorders. Before I delve deeper, here are a few “must know” terms:
• Detox - the first step in one’s recovery from substance abuse, a process in which the initial psychological and medical symptoms are treated (tremors, anxiety, cold sweats, AH, VH, headaches, nausea and vomiting, poor appetite, 24 hour medical and psychological support
• Residential - a 24 hour program focused primarily on the safety of the client, medication management and beginning psychological aspects of the illness
• Partial Hospitalization (PHP) - typically 8-12 hours/day of treatment, psychological symptoms are the main focus of treatment
• IOP - lower level of care, typically 3-4 hours a day, continued focus on psychological symptoms as well as after care
• Sober - one approach to substance abuse recovery, living without the use of substances, “clean”
• Harm reduction - another approach to substance abuse recovery that involves lessening the usage of drugs and alcohol but not removing them entirely
• AA/Big Blue Book - Alcoholics Anonymous, a 12 step model housed in the “Big Blue Book” that takes a spiritual approach to healing
• ETOH - short hand for alcohol
• THC - short hand for marijuana
• SI - short hand for suicidal ideation
• SH - short hand for self harm
• HI - short hand for homicidal ideation
• Delusions - fixed, false beliefs that conflict with reality (examples may include delusions, such as the belief that one is the president or a famous musician)
• Hallucinations - perceived visions, sounds, or smells that seem real, but are not
• Mania - a period of abnormally elevated or irritable mood, intense energy, racing thoughts, and other extreme behaviors (examples include excessive spending, binge eating)
There are a variety of ways that music therapists can help individuals with mental illness diagnoses. Goals that I work on with clients include:
• Increasing relaxation
• Increasing emotion identification and expression
• Increasing insight and self-awareness
• Increasing coping skills
• Increasing goal setting
• Increasing healthy social connections
• Getting in touch with self outside of the mental illness symptoms
• Decreasing anxiety
• increasing mood
• Increasing mindfulness
• Increasing reality orientation
Interventions to facilitate these goals include:
• Song Story Questionnaire (Writing down song associations that pertain to various times in a person’s life, such as “childhood” or “a difficult mental health day” to help tell the story of one’s life)
• Songwriting
• Group Drumming
• Group Instrument Playing
• Music and Art (creating album artwork/track-list, mindful drawing/listening)
• Song Sharing
• Music and Mindfulness
• Guided Meditation
• Music and Movement (Stretching, Breathing)
• Lyric Analysis / Music Video Analysis
Working in mental health can be both very difficult and also incredibly rewarding. I often will see clients readmitted to a facility four or five times a year. I feel thankful that they are safe under a facility’s care, but it can also be incredibly upsetting to see someone continue to struggle. The mental health system in America is also incredibly broken, and I sometimes see clients at the mercy of this by means of poor access to after care and treatment stays cut too short.
On the other hand, I also get to bear witness to clients’ incredible strength and vulnerability. I often find myself amazed seeing a client’s progress from their time of admission to discharge. In these moments, I feel honored and privileged that I got to play a small part in their journey towards healing. As someone who has also struggled with mental illness personally, this work also allows me to pay it forward to those in need, just as I once was.
Here are a few resources I have found helpful throughout my time as a music therapist working in mental health: