Music Therapy for People Recovering from Mental Illness

 

Music has been used to help people with various psychiatric problems since ancient cultures including the Egyptians, the Babylonians, the Greeks and the Romans. In modern western countries like Australia, the UK, and the US, music therapists have been employed in hospitals to provide supplemental treatment in facilitating symptoms alleviation and engagement in meaningful activities for psychiatric inpatients for over four decades. Nowadays, the use of psychiatric music therapy has extended beyond acute inpatient treatment to outpatient care in a variety of community settings. Music therapy has been used to help people with chronic mental illness in their recovery process, through facilitating their discovery of personal strengths and resources, coping with residual symptoms, enabling socialization and integration back to their community.

My interest in psychiatric music therapy led me to take on an independent placement during my music therapy study, and to work as a project-based music therapist now, at a psychiatric rehabilitation association in Hong Kong. My clients are mostly people recovering from chronic mental illness who reside in long term stay homes. Using music therapy to facilitate the recovery of people with mental illness that have been in and out of psychiatric hospitals for an extended period of time is both challenging and rewarding. Below are examples of some of the music therapy work I have done in one of the long stay care homes.

 

Music therapy groups at residential units

          To have active and meaningful engagement is essential for the well being of residents at the long term stay home; however, there are a number of residents that do not or cannot participate in any of the activities offered regularly or periodically at the common areas of the home. They remain “hidden” and isolated in their residential unit all the time.  In a pilot project that aimed to reach out to these residents, weekly music therapy group sessions were offered inside different residential units to entice their engagement with music that they are interested in or are familiar with. Music therapy interventions used in these group sessions included song/instrumental choices, singing of familiar songs, instrumental improvisations, and interactive musical games. The goals of these programs included providing opportunity of active engagement with music as a medium; enabling a sense of control and self expression through song or instrumental choices; facilitating distraction from residual symptoms and refocusing through engagement in various music activities; and enabling positive social experiences through musical interactions with music therapist and other group members. It was challenging to find songs and music that can attract the whole group as it consisted of members with a wide range of age and background, and to design musical activities that would be suitable for members with different levels of cognitive functions as affected by residual symptoms or medications. Nevertheless, there have been visible improvements on self motivation and active engagement in a number of residents participated in these groups as observed by the music therapist and other staff members at the home.

 

Individual music therapy sessions

For residents at the home with special needs and specific therapeutic aims, individual music therapy sessions are more appropriate in effectuating desired therapeutic outcomes.  The process often begins with referral by staff members that are familiar with the background, conditions, and needs of a resident that could potentially be benefited from music therapy. Then, I will have an assessment session to evaluate the baseline conditions, understand the musical interests, and set therapeutic goals with the client. The individual music therapy programs that I have done at the home included enabling the self expression and improving the self confidence of a client through writing and performing of original songs, facilitating the recovery of personal strength of a client who has extensive training as a classical pianist through playing of piano duets and instrumental ensembles, and encouraging the discovery of new personal resources through musical instrument lessons.  In adopting a person-centered strength model approach, the therapeutic focus is on empowerment. My challenge as a music therapist is to enable my client to determine and to achieve what he/she wants rather than what I, the professional therapist, think he/she needs. Although the process of individual music therapy is usually longer, it can address deeper issues and potentially results in longer lasting outcomes.

 

Musical performances in festive occasions

          At the long term stay home, special occasions like Christmas, Chinese New Year, and Mid Autumn Festivals are important times of the year with special celebrations and often marked with excitement and joyous expectations. Helping residents to plan, to prepare, and to perform music can be an effective music therapy intervention to enhance their well-being. Musical performances are good opportunities to facilitate development of personal resources through targeted practice of singing or musical instruments and singing; to enable socialization through musical interaction, mutual decision making, group membership and sense of belonging; and to improve self-confidence through musical performance that are applauded and cheered by others. It has been challenging for me to help clients to strive for musical competency and to maintain interests and enjoyment at the same time. In using musical performance as an intervention, one of my main focuses is to foster a supportive and encouraging environment for my clients, which is essential to the therapeutic process and instrumental to achieve desired outcomes.

 

The above examples are only a fraction of the vast multitude of ways music therapy can improve the well-being of people recovering from chronic mental health problems. As a music therapist, I have the privilege to witness the amazing power of music, when systematically utilized to address the needs of those being served within the support of a therapeutic relationship. I sincerely hope that more people can see the benefits of music therapy in mental health care and support its utilization as a preventive measure in daily living, a supplementary therapy in acute settings, and an indispensable service in recovery care.

 

<This article is written by Registered Music Therapist Ho Mei Yee>