Vocational and Wellness Group for Teens

Egg shaker gameA few weeks ago, I wrote about the ways that music therapy can address vocational skills, you can read that post here, the clients that I was referring to in that article had diagnoses such as developmental delays, autism and Cerebral Palsy and they attend day programs. But this week I had the opportunity to provide a music therapy program for a completely different type of vocational training program.

DK Advocates  has programs in Phoenix and Tucson and they offer training for call centers, computer skills, food service, retail and more. Their clients are people who may need to change careers due to an injury or illness. There was also a group of teens that had been doing a summer work program and I did a drum group in honor of their completion of the program.

Music therapy is still an effective modality for these clients, but the goals are different, the session structure is different and the focus is different as well. These clients didn’t need any help to share and trade instruments and most could keep a steady beat. So when doing this group, I gave each client the opportunity to lead a rhythm pattern and have a solo to provide opportunities to practice leadership skills.top of the crescendo

We also discussed the many ways that being involved in the music making is good for your brain and your body and the importance of personal self-care. Then the discussion turned to the great value of always learning new things and to find things to be passionate about. The participants asked very interesting questions such as ways to use music  while studying and while exercising.

All in all it was so much fun for me to work in a different program and meet new people. And I hope that the teens learned a little bit about wellness and about different types of careers, and I hope that my new friend, Mario, who plays bass and drums and is planning to major in psychology in college, will investigate a career in music therapy.

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This Summer I Took My Clients On A World Wide Vacation

So I didn’t hire a car, plane, boat or train to transport us to far off places but we did pretendBecome actively involved in the music making!

The topic of summer vacation is pretty universal, most of us have schedule changes to accommodate for vacations and the ending of one school year and the start of another.

I like to start my groups with some sort of movement and Independence Day is the perfect reason to use patriotic songs as we wave flags and march to the beat. I then hand out instruments and we sing and play American folk songs. This is all very fun and the outcomes are fairly predictable and I use the same format with all of the groups (ages 3 years up to 94 years). But then, after we have gotten all of our neurons firing and our bodies are releasing all of the “feel good” hormones it is time to start our cognitive exercises.

As a college student I watched many videos of music therapy in action. It was the “Nordoff-Robbins” method that stuck me with the realization that when improvisation is done correctly, everyone can have a voice. So I incorporate improvisation into my sessions whenever possible. One of my favorite interventions is to use the blues song “Kansas City” written by Jerry Leiber and Mike Stoller and take my clients “on vacation”. (enjoy the video below by Muddy Waters) The way I do this is to sing the original (slightly edited) first verse and then I go around the room and ask each individual the question “If you could go anywhere for your vacation, where would you go?”  When I ask kids I get answers like “Disneyland, Sea World and camping”. We then put the answer into the song.  But now that I work with adults in memory care and skilled nursing the answers are much broader and have led to some great discussions about their travels and experiences. Millie is a resident on a memory care unit and usually unable to tell me her name. But this past week, when I asked Millie where she would like to go, she got the most beautiful expression on her face and said “Jerusalem”. It is those in the moment experiences that illustrate the power of music.

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Addressing Vocational Skills in Music Therapy Groups

Each week I work with a variety of people, from very young children in preschool to older adults in memory care and skilled nursing facilities. One of my adult groups has individuals from age 22 Music Therapy Supports Social Interractionand up with the oldest member in her late 50’s. They have all been diagnosed with a variety of developmental delays such as Down’s Syndrome, Cerebral Palsy, and Autism. The program director told me a few weeks ago that he wanted programs that had more vocational skill development.

Now many of these individuals can and do get jobs in the community, they can bag groceries, sweep floors, wipe tables, and many other important tasks where they are interacting with customers. So am I going to write songs about sweeping floors so they can practice those skills during our music therapy groups?  Probably not because it’s not the best use of my skills and resources.

But let’s look at some other basic skills necessary to have a job in a community setting. First, a person needs to have basic social skills such as making eye contact with others, speaking to other employees and customers, and cooperation and teamwork. All of these skills are addressed multiple times in each music therapy group. During the “hello song” I greet each person individually and make eye contact and ask how they are doing today. Basic manners are essential to any workplace.

Other important vocational skills are making choices, taking turns, and sharing. These are also addressed during the music therapy group. I will often give a participant the opportunity to choose the next song or activity, I give them a choice such as “Do you want “Blue Suede Shoes” or “Hound Dog?” and they tell me which one they want. Often times another group member will want the song that wasn’t chosen and they are told to be patient, that we will do this one first and then the next one. I also tell participants to trade instruments between songs. This supports turn-taking, sharing, trading, and cooperation. As we are making music together we become a team working together and having fun while we are doing so. Music therapy can and should be an ongoing part of vocational training programs.  Call Mind-Full Music Therapy Services, LLC today to schedule or pass this blog on to a vocation training center or sheltered workshop that you think would be interested.

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Physiological and Neurological Changes: the Most Important Reason for Weekly Music Therapy Sessions

neurology, autism, brain injury, Alzheimer's

Being involved in music making excites more of the brain than any other activity. Photo courtesy of NIH

The research is published and the word is out. Participation in music making interventions improves physiological functions such as regulation of heart rate and respiration and the release of endorphins into the system. We also know that participation in the music making process supports neurological functioning throughout the brain. Music therapists have specialized training in getting people involved in the music making, we are trained to work with a wide variety of special needs individuals and groups and can meet individual goals and objectives for each person in a group setting so that the progress for each person is maximized.

Researchers in Japan published a 2 year study of the effects of music therapy on elderly patients with moderate to severe dementia. They measured blood pressure rates of patients receiving music therapy services and compared them to a control group and determined that both those patients with low blood pressure and those patients with high blood pressure reached normal levels over time while the control group  blood pressure levels were not affected (Takahashi, Matsushita Music Ther (2006) 43 (4): 317-333 doi:10.1093/jmt/43.4.317)

Another study published on ScienceDaily reports that brain imaging shows that people with musical training have enhanced executive brain functions. “Executive functions are the high-level cognitive processes that enable people to quickly process and retain information, regulate their behaviors, make good choices, solve problems, plan and adjust to changing mental demands.”

In addition, The National Autism Center (NAC, 2009) recognized music therapy as an “emerging practice” classification, meaning that current research is showing significant improvements for individuals with Autism Spectrum Disorder (ASD).

Music therapy is a research and evidenced base profession and Board-Certified Music Therapists (MT-BC) are held to high standards of practice so that our clients reach maximum potential. In order to truly provide the best possible outcomes for patients/clients/students we need to have the time to work with them, access to records and time to provide appropriate documentation for their files.  Music therapy has benefits in so many different settings with so many different people.  Sign up for your weekly sessions with Mind-Full Music Therapy Services, available throughout the Phoenix, AZ area!

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Consistency: The Second Reason Weekly Music Therapy Sessions Are Important

In my last post, I stated that having weekly music therapy sessions supports social skill development and retention (read that post here).

Group drumming supports neurological and physiological growthThe second reason that I feel weekly music therapy sessions are important is Consistency. Having sessions every week allows participants to understand the routine, they enjoy attending and look forward to the groups. Consider the case of Alan, a 15 year old boy diagnosed with Autism Spectrum Disorder. Most days Alan doesn’t like to get up and get ready for school in the morning, but on Wednesday, he knows the music therapist is coming and his mom reports that this is the only day of the week that he gets ready for school independently.  Andrew is a 17 year old student that participates in music therapy at his after-school program. His mother shared that every Tuesday morning he reminds her that he has music therapy and doesn’t want her to pick him up early. Then there is my friend Walter, who awaits my arrival in the day room of his Skilled Nursing Facility every Monday so he can request his favorite songs.  Music therapy is important to the participants and having a consistent schedule builds confidence and trust and gives them a way to be proactive about their healthy lifestyle habits.

In addition to motivation there is another benefit of consistent weekly music therapy sessions. Every session that I do is structured to meet goals and objectives of each individual, even in the group setting. Within the structure are rules of behavior, such as how to hold an instrument and play it appropriately, how to answer questions and interact with the therapist and other participants. When I ask children to do something, I am communicating using words and music, and I am also communicating visually by using gestures, sign language, pictures calendarand facial expressions which improve comprehension. The participants remember the structure more easily and those social skills transfer to other areas of daily life when the sessions are held weekly.

In the next post I will address what I believe may be the strongest reason to provide music therapy sessions at least once per week and that is the physiological and neurological changes that happen in the body when participating in music therapy.

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Social Skill Development and Retention: The First Reason Weekly Music Therapy Sessions are Important

A recent survey of music therapists reported that the majority of therapists see clients in weekly 50min sessions, some in groups and some individual sessions, in order to maximize treatment goals and objectives (Kern, P, et al., Journal of Music Therapy, 50(4), 2013, 274–303). The survey didn’t include why music therapists chose to treat clients weekly as opposed to once or twice per month. But I can tell you three reasons why I believe weekly sessions are important. They are; Social skill development and retention, consistency, and physiological and neurological changes.

calendarThe first issue to examine is Social Skills Development and Retention – One of the primary ways that music therapists get people to interact with the music is to create a trusting environment. This is important whether or not your client is a young child with developmental delays or and older adult recovering from stroke or anything in between. And this is also necessary whether it is an individual or a group setting. As a therapist I provide opportunities for clients to get involved in the music making. I am inviting them to play an instrument they may have never played before, and to sing and move in ways that may not be easy. In order for me to engage them, I need to provide a safe, friendly and motivating opportunity for that person to succeed. In order to build the level of trust, sessions must happen often enough that the client can remember the therapist, or at least the comfortable environment created by the therapist. When working with dementia patients this becomes a crucial element to support their functioning level, skill retention, and provide more opportunities for interaction. The patients in my memory care groups don’t remember my name, or what I do, but they do remember that they like me.Become actively involved in the music making!

Group sessions support social skill development and participants engage with other group members in meaningful and appropriate ways during the music making process. Each individual is encouraged to make choices such as what instrument to play or what song to sing. They are encouraged to participate in discussions and to work cooperatively in the music making. The more these skills are practiced the better the carry over into other areas of daily life.  ScienceDaily cited research from the Pertanika Journal that stated that weekly music therapy sessions can have a positive effect on behavior in children with autism.

In the next post I will explain the importance of consistency of weekly sessions.


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Music Therapy Saves Money In Special Education

 So you just read the title and clicked on this post, all the while you  may be thinking to yourself, “Oh come on, how can a service that I have to pay for out of my already stretched thin budget really save my facility money?”First of all let me say that YES, You will have to pay for music therapy services, BUT keep on reading and I will elaborate on how it will save you money.Evidence-Based Research with Proven Results Music therapy is a scientifically based practice. Music therapist’s set goals for each individual or group and we document progress toward those goals. We conduct research and publish the results in our professional journals and those of related disciplines.

So if you are the administrator for a public or private special education program, these are outcomes that are experienced by a large majority of students– even those individuals that don’t respond well to other types of interventions.

¯ Reduces disruptive behavior –In June of 2003 Psychiatric times published a review of    music therapy research that concluded that music therapy is an effective modality to reduce disruptive behavior in children and teens with behavior disorders, communication disorders and autism spectrum disorders. Read that article here.

¯ Music Therapy Enhances Social Skills Enhances social skills – The National Institute of Health website posted research on specific music therapy techniques to support social skill development for children and adolescents. The research was conducted at three separate sites and concluded that social management and peer relations skills were significantly improved for the children in the program. Read that study here.

¯ Builds trusting relationships – One of the key ingredients to achieving goals and objectives is to have a  consistent structure and a strong rapport between the   therapist and the students. As the mutual trust is developed, therapists can personalize goals and objectives for each student and address  individual needs within the group. Music therapy sessions are fun so children look forward to the weekly sessions and this can be used as a motivation to achieve goals outside of the music  therapy sessions as well.

¯ Improves language and communication skills – In May 2011, researchers in Australia published a study of a music therapy program for disabled children and their parents and found that language and communication skills were improved as were the non-verbal communication and parent/child bond. Click here for the link. The practice of Neurological Music Therapy is that the therapist looks at ways to involve each individual into the music making process and therefore increasing neural synapses throughout the brain. For more specific information about Neurologic Music Therapy check this website.

Music Therapy Supports classroom curriculum and IEP Goals¯ Supports educational curriculum Music   therapists are trained to learn a wide variety of music and use that knowledge to provide specific songs, dances and improvisational experiences that support thematic material and classroom curriculum. 
¯ Addresses IEP goals – Music therapy can address IEP goals in the group or individual setting and can be documented as a supportive service on the IEP.  Music Therapists use differentiated instruction techniques and a multi-sensory approach to address multiple goal areas in each music therapy session.
¯ Music Therapy as a Marketing Tool-Music therapy has been receiving a lot of media attention and parents are more aware of the benefits of music therapy as they are shopping for appropriate education placement. An article published in the Huffington Post in 2012 summarized research about music therapy with the ASD population and stated that music therapy was effective where other therapies were not and stated “So, the more music therapy the better for those with ASD!” Read that article here.
Schedule your consultation today!
Call Alison Bowers, MM, MT-BC


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Music Therapy Saves Money On Health Care Costs

So you just read the headline and clicked on this blog post, all the while you may be thinking to yourself, “Oh come on, how can a service that I have to pay for out of my already stretched thin budget really save my facility money?”

First of all let me say that YES, You will have to pay for music therapy services, BUT keep on reading and I will elaborate on how it will save you money.

Evidence-Based Research with Proven Results –Music therapy is a scientifically based practice. Music therapist’s set goals for each individual or group and we document progress toward those goals. We conduct research and publish the results in our professional journals and those of related disciplines.So if you are the director of a nursing home or rehabilitation facility, these are outcomes that are experienced by a large majority of clients – even those individuals that don’t respond well to other types of interventions.

Decreases anxiety and stress¯¯ Reduces anxiety and stress – Music therapists address these goals in the group setting by using calming music and teaching clients breathing and imagery techniques that they can use outside of the music therapy session.Dancing encourages physical movement and releases endorphins while at the same time reducing cortisol levels and is a positive wellness technique.

¯¯ Improves mood and emotional states – Patients are encouraged to express their emotions through music in the group or individual session. We use techniques such as lyric analysis, group songwriting and improvisation to help the client identify their feeling and the reasons behind them and then provide opportunities to express those feelings through the music.

¯¯ Increases patient participation in treatment Music is fun and motivating but many individuals may feel self-conscious about participating. Music therapists have specific training to help patients to feel comfortable and to participate at whatever level they are able. By explaining to patients what we are doing and why it is important, we enable the patient to then have some ownership over their treatment program, which carries over to other treatment modalities.

¯¯ Reduces need for pain medication –The American Psychological Association published a summary of research about music therapy and stated that the researchers found that patients that engaged in music therapy had increased levels of the antibody Immunoglobulin A, which is known to kill cancer cells. They also found reduced levels of cortisol, the stress hormone and increased endorphin levels. Other studies cited that music therapy helped regulate breathing and heart rate for patients from infants in the NICU to adults and elderly in intensive care, cancer treatments and rehabilitation. Patients reported less pain and also had reduced need for pain medication. Read the full article here .

¯Reduces length of Stay-The National Institute of Health (NIH) published a study in 2011 that determined that patients who participated in music therapy had less depression and shorter

Music Therapy is an excellent marketing tool.

Music Therapy is an excellent marketing tool.

lengths of stay than patients that did not receive this service. Read that article here. In addition, a review of music therapy in the Southern Medical Journal was published in 2012 which stated that Patients in intensive care were less anxious before surgical procedures and recovered more quickly and satisfactorily after surgery. They also required less sedation and reported better satisfaction with their hospitalization click here to read that article.

¯Music Therapy as a Marketing Tool-Music therapy has been receiving a lot of media attention and patients are more aware of the benefits of music therapy as they are shopping for services. In 2002 Demmer and Sauer published documentation that supported the fact that patients had higher satisfaction levels for facilities that offered music therapy services. Read an excerpt of “Survey of Nurses’ Attitudes and Perceptions Toward Music Therapy in the Hospital Setting” By Miriam G. Hillmer, 2003

2013 logo (219x106)Call Alison Bowers, MM, MT-BC, at 480-296-9842 to schedule your consultation today!

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Rhythmic Entrainment in Music Therapy to Assist With Social Awareness part 4 of 4

Meghan is a 12 year old girl with Autism Spectrum Disorder (ASD), She has words, but uses them to repeat lines from TV or movies, she plays with her stuffed animals and often times appears to be unaware of the world around her. Meghan didn’t participate in the music therapy groups when they first started in her facility. I would always greet her and ask her to join us but the teacher told me that she doesn’t participate in any group activities and it was one of her goals.

Group drumming supports neurological and physiological growthIn March I wrote a blog series called “Sensory Integration, Not Just for Autism Spectrum Disorders” in which I discussed the importance of using a multi-sensory approach in the music therapy group so that individual goals can be achieved in the group setting. This month I have written about the importance of “Rhythmic Entrainment, What is it and Why is it Important in Music Therapy?” “Rhythmic Entrainment for Motor Planning“,  and “Rhythmic Entrainment in Music Therapy to Assist in Language Development”. I discussed that I focus on the rhythmic aspects of the music to support neurological and physiological growth. These were the techniques I was using in Meghan’s class.

As the weeks went on, Meghan began to move closer to the group but still held onto her dolls and seemed to be unaware of her surroundings. I continued to observe her while leading the group and interacting with the other kids and I noticed that after about several weeks her dolls started dancing to the music and then each week, I noticed more and more involvement. One day, a staff member brought 2 chairs up and sat them behind the circle, she sat in one and had Meghan and her dolls sit in the other. At first she could only stay for the “Hello” song, but then she would leave the group and come back multiple times, participating in background but not as a part of the group. Finally Meghan began to feel more comfortable and stayed in the group longer and we began to move her closer to the group as well. She didn’t show interest in the books, visuals or movement activities, but she was interested in the instruments and would repeat the names, and began to request them but didn’t actually play them herself.  So the assistant would sit next to her and play the instruments and sing to model appropriate behavior. The assistant began to fade her assistance and Meghan stayed in the group with the instrument beside her and would sing to her dolls.  One day I looked over and Meghan was playing the guiro, she was holding correctly and playing it rhythmically with the group.  This story isn’t over as I still work with Meghan and have for the past two years. But now she is able to sit for most of the session, she still has her stuffed dolls and they play instruments with her. She is able to trade and share instruments with other kids in the group and she will even request songs if asked.

I have mentioned the multi-sensory approach that I use in my music therapy groups in many of my blogs. I provide a wide variety of sensory interventions using visuals, tactile objects (instruments) and movement so that each child can receive a variety of sensory input. In Meghan’s case it was the instrument playing that was the motivator for her, and when she did start to play, she was able to play rhythmically with the group. This was a signal to me that even though Meghan appeared disconnected and unaware at the beginning, she was still receiving the input on a neurological basis.

An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group.

An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group.

I have also seen this same phenomenon on the Memory Care units that I serve. An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group. Marilyn is one such client. She is very musical and hums to herself all day. During the sing-along activities she is able to sing most of the songs and can play the instruments appropriately. Marilyn is in the late stages of Alzheimer’s disease and she cannot answer simple questions most of the time. In February, we were singing love songs for Valentine’s Day (of course) and Marilyn had been happily singing and playing so I looked at her and asked her what she did for Valentine’s Day as a child. She looked me in the eye and said “We made valentines out of paper and glue and lace doilies.” It was so great to be in that moment with her. Sadly, Marilyn hasn’t been able to respond appropriately since then, but she is still singing and playing instruments and I know that the music is working in her brain and in her body.

Music Therapists are not the only ones looking at the phenomenon of rhythmic entrainment in the brain. Scientists have found that rhythm and speech are so tied together that they have identified similar behavior in animals that have some speech capabilities such as parrots and dolphins. Check out the links below and come back to www.mindfullmusic.com for my next blog. Until then, embrace your musical mind.



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Rhythmic Entrainment in Music Therapy to Assist in Language Development part 3 of 4

In March I wrote a blog series called Sensory Integration Not Just for Autism Spectrum Disorders, in which I discussed a multi-sensory approach that includes visual, auditory and tactile interventions to provide support for individuals with sensory needs. This month I have been blogging about the importance of rhythmic entrainment techniques in music therapy as an integral part of the multi-sensory approach. In the first post, “What is Rhythmic Entrainment and Why is it Important in Music Therapy?”  I stated that Rhythmic Entrainment in music therapy is a specialized practice used to assist in helping people become more “in tune” to their own rhythm and the rhythms of the world around them.  Last week in the blog about the importance of “Rhythmic Entrainment for Motor PlanningI briefly mentioned that even those individuals that can’t move their bodies can still benefit from rhythmic entrainment techniques because the brain can still receive and respond to rhythmic stimulus even when the body cannot.

Become actively involved in the music making!The thing about the music therapy session is that you can address multiple goals and objectives at the same time! So while I am singing or chanting and playing or moving rhythmically with my clients, I am addressing motor development (or rehabilitation), cognition, language development and social skills simultaneously. The how and why of this comes back to how the brain responds to music; “All music therapy goal-directed activity is aimed first and foremost at enhancing the functioning capacity of each client’s brain” (Taylor, 1997 p. 14). So when my clients are actively involved in the music making process, the entire brain is working. We cannot tell one part of the brain to wait because we only want to activate the language centers right now, and then tell the language centers to stop while we address motor ability. Even if that were possible it would defeat the purpose of a holistic approach to therapy that is inherent in music therapy.

There are many different languages, spoken, signed and body language are used throughout the world. We need an effective method of communication or our needs may not be met. Babies cry when they are hungry, sick or need to be changed. Communication develops as the child develops so language development becomes a very important goal in music therapy.  Also language has rhythm already built into the way we speak and our emphasis and inflections.

I use many techniques for language development in my music therapy groups. Last week I described the way I use the “HiDa” song with maracas as a basic beginning rhythmic entrainment technique. This song is also great for early language learners because the words, while they don’t really mean anything, have 4 syllables that are easy to pronounce. With older kids and adults that are in rehab, I use similar techniques but the music is age appropriate and the presentation is different.

Singing books to support language and literacy goals

The multi-sensory approach that I use in my music therapy sessions includes not only singing, dancing and instrument play, but also includes singing books. (click here to reathe blog “The importance of pictures in music therapy”) There are many children’s books out there in the big world and I have an extensive bibliography of books that I use in my music therapy practice. I choose books based on subject content but also based on rhythm and rhyme. Some of the books are as simple as the “Brown Bear” series by Bill Martin, Jr., which I sing with a simple 3 note melody. Others I may chant while having the kids pat to the beat. I have 6 books that I created music sound tracks, a repetitive chorus and sign language. The children love these activities and request them every week. I will be sharing more about these books and how I use them in upcoming blogs. 

Next week I will be posting about how rhythmic entrainment techniques can lead to social awareness.

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