Music therapists serve people with mental health needs in many settings, including schools, medical hospitals, prisons, hospice, and nursing homes. The following stories focus specifically on two specialized settings for mental health treatment: an acute inpatient hospital, and an intensive residential program for youth.
Carol: Engaging in treatment
Age: late 40s
Setting: adult inpatient unit
Goals: engage in treatment, verbalize hope for future
Carol was admitted to the acute inpatient unit following an attempted suicide and presented as extremely depressed. She had never been in psychiatric treatment before and told the unit staff that she did not want to be around “all those crazy people,” instead spending all of her first evening and the following morning of her stay in bed in her room. Carol did tell the staff that she used to enjoy music, so she was invited to participate in the music group on the inpatient unit that afternoon. Along with the other members of the group, Carol was invited to choose songs from a list for the group to sing together while the music therapist accompanied on guitar. At first, Carol sang quietly with her head down, but after the group sang “Amazing Grace,” the young man sitting next to her told her that she had a pretty voice. Carol smiled and thanked the young man, then began singing more loudly with each song. Carol wrote on her evaluation at the end of the session that she felt “so much more relaxed” after singing. For the remainder of her stay, Carol attended all the groups available to her, including the music groups, and was observed to converse frequently with her peers.
Jo: Coping skills for chronic pain
Setting: adult inpatient unit
Goals: learn and practice new coping skills
Jo came to the hospital feeling hopeless that she would ever be free of the heavy pain medications she took for back pain following a car wreck several years before. Although her doctors had maxed out the dosage of pain medications that they would prescribe for her, Jo was still in constant pain, to the point that she told her husband she had thought of “ending it for good.” Jo participated in the music groups on music-assisted relaxation skills, in which the music therapist taught the group members techniques such as progressive muscle relaxation and imagery to assist with relaxation, along with how to choose recorded music for relaxation. Jo visibly relaxed during both of these sessions and reported a decrease in pain from a 10 to a 7 on a 1-10 scale over the course of the last session, a significant decrease for her. Jo asked for additional materials to take home with her so that she could continue practicing these skills after leaving the hospital.
Weston: Emotional expression through drumming
Setting: intensive residential program
Goals: Improve impulse control, learn alternative coping skills for difficult emotions
Weston attended music therapy groups with the other eight young men from his residential cottage. Weston frequently got into fights with the other boys and was difficult to redirect when he was angry, often yelling insults and throwing objects at whatever or whoever came into his path. Weston missed a few music therapy sessions at the beginning of his residential stay because of behavioral restrictions, but when he did come to the group, he sat quietly, not necessarily participating enthusiastically, but following directions and paying attention to what was happening nonetheless. Over his six-month stay, Weston gradually began participating more in the music groups, eventually becoming a de facto leader in the group, encouraging his peers to participate appropriately. Weston’s favorite activity in the music therapy groups was drumming. When given the opportunity, Weston chose to play the large djembe, beating a steady bass rhythm in time with the therapist. While drumming, Weston made eye contact with other group members and the therapist, changing his playing to match theirs. He traded instruments with other group members when asked without any challenges and stopped and started playing as directed, demonstrating improved patience and impulse control. When Weston was discharged from the facility, he thanked the music therapist for the chance to play the drums and expressed his interest in pursuing music classes in his high school.