Meet Ms. Sara

Hello, My name is Sara Demlow! I am one of the newest music therapy interns here at Therabeat, inc. In college, my primary instrument was voice, but I have also played clarinet since middle school and enjoy playing guitar, ukulele, and piano. My favorite music to listen to is musical theatre and this is largely due to the influence my brother had on me as a kid, and even still now. Since I was young, he has been giving me new cast albums to listen to and we have been able to connect with each other through them. This was one of the many things that sparked my love of music that still grows and grows every single day.

I discovered the music therapy profession in high school and since then, I have known that this is what I want to do for the rest of my life. My parents helped me search for colleges in the state that offered the degree and when I researched Georgia College, I knew that it was the school I wanted to go to. With my parents' support and encouragement, I made it to GCSU, and now I finally am working on the last puzzle piece to finish my degree.

Within my first week here at InHarmony, I can already tell how much of an amazing place it is and how much of an impact this facility has on the clients they serve. Not only will I get the opportunity to learn from the fantastic music therapists on staff, but I will also get to learn from the other therapists at the clinic (PT, OT, ST) and see how this facility works together to create the best possible plan of care for each of their clients. I am so excited to continue my journey of learning and look forward to the rest of my time here.

Making Social Connections among Adults with Disabilities

Humans have an innate need for social connections with other individuals. According to Maslow’s hierarchy of needs, humans prioritize feelings of love and belongingness immediately after satisfying physiological needs and safety (McLeod, S.A., 2020, para. 2). Social groups provide us with an important part of our identity, and assist us in relating to our peers (McLeod, S.A., 2020, para. 1). Adequate social connections also benefit our health and quality of life. Social relationships have been found to boost mental health by reducing levels of stress, improving self-worth, and improving perceived confidence (McLeod, S.A., 2020, para. 2). 

Individuals with intellectual and developmental disabilities often struggle with forming personal relationships with others due to their environment and how they are viewed in society. These individuals may feel frustrated due to lack of social interactions and personal connections, as well the inability to express themselves and be understood. Additionally, lack of meaningful connections may lead to a negative self-image and a further decline in social and communicative skills. 

Music therapy group sessions provide clients with opportunities to make meaningful connections with each other and develop prosocial behaviors, such as initiating conversations, participating in reciprocal dialogues, and expressing emotions (Baumgarten & Wheeler, 2016, p. 120). Music therapy interventions can facilitate motivation, communication skills, and social interactions in a non-judgemental, non-threatening environment (Baumgarten & Wheeler, 2016, p.119).  A 2016 study measured the ability of group music therapy sessions to increase initiation of conversations, reciprocal turn taking, and the ability to express an increased range of emotions among adult clients with various intellectual and developmental disabilities (Baumgarten & Wheeler, 2016, p. 120). Music therapy methods used in this study included listening to music, music assisted relaxation, improvisational music therapy activities, and re-creative music therapy activities such as songwriting and musical song-games (Baumgarten & Wheeler, 2016, p. 121). Results of this study showed that the clients were able to form trusting relationships with other group members. This contributed to an enhancement of prosocial behaviors, such as engaging in conversations, turn taking, and supporting emotional expression. Additionally, the clients displayed a reduction in antisocial behaviors, such as starting fights, teasing other group members, and being disruptive during the music therapy sessions (Baumgarten & Wheeler, 2016, p. 125). 

Current government guidelines set in place to prevent the spread of COVID-19 have altered how we as a society interact with each other. A lot of organizations and individuals in the community understand the need to continue social interactions during this trying time. Before the practice of social distancing was established and enforced, music therapists at Therabeat Inc. partnered with Empower Cherokee to provide in-person opportunities for adult clients with disabilities to interact with each other and express themselves in a non-threatening environment. Luckily, these clients are still able to meet and engage with each other during online music therapy sessions via zoom. 

A popular intervention used in virtual music therapy with clients from Empower is songwriting. This intervention has been used in sessions to address the current changes in daily life and the development of social skills. Additionally, this intervention provides opportunities for the clients to get to know each other better by relating to the personal responses of others. In the picture shown, the music therapy intern and clients worked together to write a song discussing things that make them happy using the tune “A Wonderful World” by Louis Armstrong. This intervention allowed the clients to express their individual preferences as well as learning what their peers like as well. 

Maintaining meaningful social connections is more important now than ever. With the uncertainty of society today, it is essential to have opportunities to engage with others and express ourselves. Individuals with intellectual and social disabilities need the opportunity to continue to develop their social skills and manage their emotions by engaging with their peers. As Empower states on their website, “physical distance, not social isolation.” (no author, 2020).

References

Baumgarten, H.R., & Wheeler, B.L. (2016). The influence of music therapy on prosocial behavior of adults with disabilities. Music & Medicine, 8(3), 118-127. 

McLeod, S.A. (2020). Maslow’s hierarchy of needs. Retrieved May 28, 2020, from https://www.simplypsychology.org/maslow.html

No author (2020). The importance of social connection. Retrieved May 28, 2020, from https://www.mindwise.org/blog/uncategorized/the-importance-of-social-connection/

No author (2020). Empower cherokee. Retrieved May 28, 2020, from https://www.empowercherokee.org/

Pavlicevic, M., O’Neil, N., Powell, H., Jones, O., & Sampathianaki, E. (2014). Making music, making friends: Long-term music therapy with young adults with severe learning disabilities. Journal of Intellectual Disabilities, 18(1), 5-19.

A Music and Art Program to Promote Emotional Health in Elementary School Children: A Review

While music therapy is considered to be an allied health profession, it is also a creative art therapy as well. Other creative art therapies include dance-movement therapy, drama therapy, and art therapy. Music therapy and art therapy often coincide, especially when helping those individuals who have endured some type of trauma (Payne II et. al, 2018, para. 1). Common benefits to music and art therapy include stress management, improving communication, increasing expression, and aiding physical rehabilitation (Payne II et. al, 2018, para. 2). 

This article review seeks to highlight the importance of creative art therapies, specifically music therapy and art therapy. While In-Harmony does not provide art therapy, crafting incorporates many of the motor skills and cognitive skills addressed in other therapies such as OT, PT, ST, and MT. For this reason, a crafting section has been incorporated in each day’s activities during Therabeat’s Virtual Summer Camp. More information about online summer camp and material kits can be found HERE.

Giles et. al’s  1991 study of the role of music and art programs in school examined the effects on how music and art could help the emotional health of elementary school children. The subjects were 255 first and second grade students from northern Virginia schools (Giles, 1991, pg. 138). There were 11 classes from 5 schools. At the beginning of the day, children would select either a happy face or sad face to color (baseline emotion). After recess–when researchers believed students would be at their peak energetic or agitated state–  the students would come into their homeroom and then listen to 3 excerpts (classical, Walt Disney soundtrack, and new age) totaling 5 minutes (Giles, 1991, pg. 138&139).  After the listening, students would select a new happy or sad face to color. This process continued for 11 days, with 9 days of treatment and 2 days of no treatment (control). Art therapists were consulted to analyze the drawings for signs of distress, anxiety, anger, aggression, and depression. 

       A significant difference was found between the before/after of the treatment each day. Additionally, art therapists discovered through the baseline happy/sad data that 44 children were sad at least 8/11 times in the beginning, which equates to roughly 73% of the time (Giles et. al, 1991, pg. 139). They considered this to be excessive and alarming. Coincidentally, these children were less responsive to the music treatment. The researchers remarked that these children “may require more positive reinforcement more often and for longer periods of time” to help alter mood (Giles et. al, 1991, pg. 146). 

     The researchers concluded the following from their study (Giles et. al, 1991, pg. 147): 

Children who may be at risk for emotional or behavioral disorder may need more exposure to such a program of music and art for longer periods of time, since the study showed that they were more resistant to mood change….It is incumbent upon the schools to find models to help children cope with their stresses, build self-esteem, and foster emotional health. 

The researchers also note that both music and art are “trusted allies” to children (Giles et. al, 1991, pg. 147), allowing therapeutic relationships to exist more organically. Giles et. al also mention that both activities are frequently woven into day-to-day schedules for primary school children, yet many states and districts undergo yearly budget cuts  that often lead to the discontinuing of fine arts and performing arts. During a time when childhood depression and anxiety is increasing, providing as many positive creative outlets as possible to children is essential.  

References:

Giles, M. M., Cogan, D., & Cox, C. (1991). A Music and Art Program to Promote Emotional Health in Elementary School Children. Journal of Music Therapy, 28(3), 135-148.

Music Therapy Benefits for Clients with Depression

Depression is one of the most common mental disorders in the U.S. with more than 3 million cases per year (National Institute of Mental Health, 2018). Depression is defined as a mood disorder that affects virtually every facet of an individual’s life. Depression affects the way in which a person thinks, feels, and executes daily activities of living, such as sleeping, eating, and working (National Institute of Mental Health, 2018). It is normal to feel depressed due to various life circumstances. However, if these symptoms continue for a prolonged period of time, the depressive episode may be diagnosed as a depressive disorder. Depressive disorders refer to the amount of time that symptoms have been present in an individual’s life. An individual is typically diagnosed with clinical depression when they have experienced symptoms continually for at least two weeks (National Institute of Mental Health, 2018).

The most well known symptom of depression is a feeling of overwhelming sadness. However, depression includes many other symptoms that affect an individual’s ability to function. An individual with depression may show a decreased energy level and loss of interest or pleasure in activities that they previously found intriguing. An individual with depression may also show signs of irritability, restlessness, and difficulty concentrating on a task. Depression may also manifest itself in an individual’s sleep schedule and changes in appetite. Finally, depression may lead to thoughts of death and suicide, and may potentially lead to suicide attempts (National Institute of Mental Health, 2018).

Major risk factors for depression include major life changes, trauma, or stress (National Institute of Mental Health, 2018). For the majority of this year, COVID-19 has altered life as we know it. Schools have closed and transitioned to online learning. Businesses have also been affected, resulting in job loss among many individuals. Social distancing has affected the ways in which people can congregate and fellowship. These major life changes may lead to feelings of isolation and depression. 

Music therapy has been shown to be effective in addressing emotional, social, and cognitive needs. Music therapy provides a non-threatening environment for the client to express themselves in a healthy way. Music therapists work to enhance the client’s self-awareness and environmental awareness, address problem solving skills, and increase the client’s attention span. Music therapists assist the clients in developing individualized coping skills, problem solving skills, and decision making skills. Additionally, music therapy sessions support healthy feelings and behavior (American Music Therapy Association, 2006). 

Receptive music therapy has the ability to modulate a client’s mood through music relaxation (Eyre, 2013, p. 342). Music relaxation interventions involve listening to music for the purpose of effecting a relaxed response. Music relaxation interventions may include guided imagery accompanied with relaxing music as well as progressive muscle relaxation. The overarching goals of music relaxation interventions are to release physical tension and increase a sense of well-being (Eyre, 2013, p. 343). In an ideal music relaxation intervention, the client’s preferred music will be utilized to facilitate a relaxed state, as evidenced by a slowing breathing rate, a slowing heart rate, and an adjusted mood (Eyre, 2013, 344). 

Improvisational music therapy involves the spontaneous creation of musical dialogue in music therapy sessions. One study evaluated the effects of short-term improvisational music therapy sessions on the severity of depressive symptoms (Aalbers, Spreek, Bosveld-van Haandel, & Bogaerts, 2017). The music therapy researchers administered a questionnaire before and after music therapy treatment to measure if this form of treatment was effective for clients experiencing depression. Improvisation interventions utilized during music therapy treatment assisted clients to express their feelings, thoughts, and actions in daily life. Over the course of music therapy sessions, the music therapist gradually related improvisation experiences to stimulate healthy thoughts and behaviors through active music playing and discussion (Aalbers, Spreek, Bosvel-van Haandel, & Bogaerts, 2017, p. 262). Results of this study showed an overall reduction in identified depressive symptoms and a significant benefit from music therapy sessions (Aalbers, Spreek, Bosvel-van Haandel, & Bogaerts, 2017, p. 262).

Songwriting in music therapy sessions provides clients with opportunities for self-expression and self-awareness. Songwriting interventions focus on the dialogue created in the creation of the song as well as the final product of the intervention (Silverman, 2013, p. 134). In addition to emotional benefits, songwriting in group settings can allow clients to foster and develop social skills. Silverman (2013) examined the effects of group songwriting among clients with depression and other mental health concerns. Group songwriting, combined with psychoeducational discussion, allowed the clients the freedom to express themselves and interact with others in an appropriate manner. Topics addressed during the songwriting interventions, such as coping skills and support systems. Results of the study found that the group songwriting interventions benefited the participating clients in the social and emotional domains (Silverman, 2013, p. 141). 

It is normal to experience depression in response to severe, unexpected life changes. COVID-19 has altered the way many of our lives in ways that were previously unimaginable. It is essential during this uncertain time to take care of both our physical health and our mental health. Music therapy has been shown to be effective in facilitating relaxation, improving mood, and fostering coping skills. 

-Jasmine Bailey, Music Therapy Intern

References 

Aalbers, S., Spreek, M., Bosveld-van Haandel, L., & Bogaerts, S. (2017). Evaluation of client progress in music therapy: An illustration of an N-of-1 design in individual short-term improvisational music therapy with clients with depression. Nordic Journal of Music Therapy, 26(3), 256-271. 

American Music Therapy Association (2006). Music therapy and mental health. Retrieved May 18, 2020 from http://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf

Eyre, L. (2013). Guidelines for Music Therapy Practice in Mental Health. Barcelona Publishers.

National Institute of Mental Health (2018). Depression. Retrieved May 18, 2020 from https://www.nimh.nih.gov/health/topics/depression/index.shtml

Silverman, M. (2013). Effects of group songwriting on depression and quality of life in acute psychiatric inpatients: A randomized three group effectiveness study. Nordic Journal of Music Therapy, 22(2), 131-148.

#HowAreYouReally: Mental Health in Caregivers and Parents

May has come to be known as the Month of Mental Health. On May 15 the Mental Health Coalition started a new online campaign using the hashtag “How are you, really?”. Its purpose? To be more transparent about everyday mental health struggles and open up a dialogue about honest and real feelings. 

While a large concentration has been on maintaining and supporting children’s mental health during this crisis, acknowledging the strains of caregivers’ and parents’ mental health is equally important, especially if there is a child with special needs involved. The Mental Health Coalition estimates that 1 in every 4 people will experience some type of mental health condition at some point in their lives (The Case for Mental Health, para. 1). With this in mind, knowing how to best give or recommend support to caregivers and parents of children with special needs is crucial.

With school and business closures, online work has been a hallmark of COVID-19. Parents and caregivers have become full-time teachers overnight, therapy facilitators, and entertainers in addition to job responsibilities. Despite the World Health Organization and American Academy of Pediatrics recommendations that children ages 6-10 only receive 1-1.5 hours of screen time a day with that limit increased to 2 hours for children 11-13 (EyePromise, 2019, para. 3 &4), an increased amount of screen time for everyone–children and parents alike– has become inevitable. In a 2018 study, researchers found that an increased amount of screen time in children correlated with lower psychological well-being and less emotional stability, as well as increased anxiety and depression (Twenge, 2018, pg. 272). Additionally, a 2017 study found that the amount of TV watching and computer use can predict the depression level among adults (Madhav et. al, 2017, pg. 68). To combat these effects,  Amy Kelly– Devereux Advanced Behavioral Health National Director of Family Engagement– recommends “unplugging” from screens for set periods of time for the entire family (Kelly, para. 10). 

Juggling various responsibilities can be overwhelming. Having times dedicated to engaging in realistic self-care practices can help alleviate feelings of anxiety and stress. While yoga and mindful meditation are effective strategies, it can be difficult to block out set amounts of time. Seattle Children’s “Realistic Ways for Parents to Manage Stress” article suggests going on a short walk outside or 5-minute stretching or single-song dance party as a quick self-care practice (Ibarra, 2020, para. 23). Taking 5 deep breaths periodically as well as bringing awareness to water intake and posture are additional easy self-care practices as well (Ibarra, 2020, para. 24 &25).

For those families who desire for self-care practices to be inclusive of all family members, board-certified music therapist  Stephanie Leavell’s “Yoga Song” is intentionally written for children and is family-friendly. Stephanie’s song is based on 11 different yoga poses that are easy for beginners and children. During the song, she slowly counts to 10 before transitioning to the next pose. At the end of the song, she focuses on breathing before gently ending. Her song is part of her album “Move It, Move It!” and can be found on Spotify and iTunes music, as well as YouTube (with visuals of the poses). The song can help decrease heart rate, increase oxygen, and encourage mindfulness for all parties participating. 

Seattle Children’s also recommends 5 steps for caregivers and parents to take during times of frustration (Take 5 When You’re Overwhelmed or Frustrated, 2020): 

1. Stop and step away

2. Take a short break to breathe

3. Remind yourself “I can do this” or “It’s important to stay calm.”

4. Ask yourself, “How can I handle this situation in a way that I will feel good about?”

5. If possible, ask for support from a partner or family member. Call or text a friend or neighbor. It’s ok to ask for help. 

Per step 5, speech-language pathologist Jim Mancini from Seattle Children’s recommends to “practice physical distancing, not social distancing” (Ibarra, 2020, para. 38). He points out that regularly talking–via phone call, via video chat, or text message– can help all individuals regulate during this time of quarantine and isolation. Affirming feelings and checking in by asking “How are you, really?” can let others know that they are not alone. 

-Sarah Deal, Music Therapy Intern 

References: 

Eyepromise (2019). Screen Time Guidelines by Age. Retrieved May 16, 2020 from https://www.eyepromise.com/wp-content/uploads/2019/05/Screentime-Recommendation-Chart-Final_AAP-WHO.pdf 

Ibarra, R. (2020). Don’t Have an Hour for Yoga? Realistic Ways for Parents to Manage Stress. Retrieved May 16, 2020 from https://pulse.seattlechildrens.org/dont-have-an-hour-for-yoga-realistic-ways-for-parents-to-manage-stress/ 

Kelly, A. (2020). COVID-19: Helping families with special needs during a public health crisis. Retrieved May 16, 2020 from https://www.devereux.org/site/SPageServer/?pagename=helping_families 

Madhav, K. C., Sherchand, S. P., & Sherchan, S. (2017). Association between screen time and depression among US adults. Preventive Medicine Reports, 8, 67–71. 

The Mental Health Coalition (2020). The Case for Mental Health. Retrieved May 16, 2020 from https://thementalhealthcoalition.org/cases/ 

Twenge, J.M. & Campbell, W.K. (2018). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventative Medicine Reports, 12, 271-283.