by Elizabeth Ghiorzi MA, MT-BC

Have you ever visited someone in the hospital or long term care facility and heard someone playing music for an individual or group of patients? Who was that person? Was he or she a volunteer musician or were they a Music Therapist?

You might think that who the person is and what their position is might not matter. Music can be a tool for distraction, a source of comfort, and a vehicle for focus. But it really does matter who is providing the music intervention. Music is powerful and can conjure up emotions and emotional reactions. While research shows that music can aid in pain management and the expression of difficult emotions, music therapists are uniquely qualified to identify and treat the many issues that face individuals in the hospital or long term care facility.

Music therapists and volunteer musicians bring their love of music to those in need. The most important distinction between the two groups is the educational training of a music therapist. Music Therapists have bachelors, masters, or doctoral degrees from accredited music therapy programs at colleges and universities across the country. They are accomplished musicians in guitar, voice, and piano among other instruments and are trained in treating the psychological aspects treating patients, helping them to process their emotions. Music therapists also learn skills akin to counseling which are used to help patients communicate how they are relating to the music. This type of intervention helps to maximize the benefits of the musical interaction by providing a sense of closure.

For more information on music therapy visit:
www.musictherapy.org
www.tempotherapy.com

by Krista Winter, MA, MT-BC, Neurologic Music Therapist

Today at work, I broke my guitar. It was 100% my fault and definitely preventable. In fact, I’ve had a few close calls before of the exact same situation that led to the incident. My first thought after turning a pale whitish-blue, as observed by my very gracious supervisor, was, “Do I go home now?” Fortunately this was only a brief thought, I had my brand new Oscar Schmidt Autoharp waiting to be more utilized, and as a vocalist I thought, well there is always my voice. I knew I could continue on with my sessions, but for a brief moment I felt the “crutch” of the guitar.

So I charted on the patient I had just seen—who, by the way, later expressed his sincere empathy for the situation—took a few breaths, and went into see the next patient with the autoharp in hand. It was the ideal instrument for this session, and the autoharp allowed for new elements of structure and opportunities for active participation that the guitar would not have provided. Also, I felt a renewed sense of creativity and energy in the session with a patient with whom I have been working for a relatively extended period of time (in a hospital setting).

This unfortunate incident—which will be fixed—resulted in a needed boost to my professional development. What experiences have you had as a Music Therapist regarding a broken “main” instrument, loss of a “crutch” in the midst of sessions, or self-induced instrument accidents (non-life-threatening) that resulted in either you needing to cancel sessions or drastically change your treatment plans in the moment? I know we all have them and will have them again. I think it can be helpful to talk about them and grow from them. As I drive 45 miles to the nearest guitar store in Joplin later today, I will cry and grieve for my loss, but for now I’m going to see what other creative sessions I can have with the hospital patients.

Adapted from “Government Relations Treasure Hunt” by Carol Ann Blank
Published in Rx Music (2008)

In an effort to make issues related to advocacy a bit less foreboding to the average Jane or Joe, I have designed a Treasure Hunt. Here are the rules:

Do not freak out.
Do not do this while driving.
Share what you find. The more things you share, the more points you get.
Points are totally arbitrary and are not redeemable for any good or service.

Ready? Go!

1. Take these instructions and go to your computer. (5 pts)
2. Go to your favorite search engine (Google, Yahoo, etc) and type in the name of your state and “state” (New Jersey, state or West Virginia, state). (5 pts)
3. Click on your state’s official website (2 pts)
4. Bookmark this page so that you can get to it again. (2 pts)
5. Find your way to the Legislature page of your state’s website. For example, in WV, I found the Legislature when I clicked on a link titled Search WV Code. (10 pts)
6. There are generally “Search” areas on the Legislature pages. Type in the word or phrase of your choice and see what comes up. You might try music or therapy or creative arts or any number of populations (Alzheimer’s, mental illness, addictions). (4 pts).
7. Once the search is run, follow the links to see if there is anything interesting (5 pts). Here are some ways to increase your points:
a. Note whether it is a law or a regulation or a proposed bill. (5 pts)
b. If it is a bill, determine if the bill has passed in the assembly and/or the senate. (5 pts)
c. Determine who the sponsors of the bill are and read up on their profiles. (10 pts)
8. If you find anything interesting, share, share, share. (20 pts)

We all benefit from sharing information. If you have any questions, you can email me at carolannblank@gmail.com. I would love to hear how you did.

by Krista Winter, MA, MT-BC, Neurologic Music Therapist

Winter is slowly turning into spring, snow into rain, and that means the ground will soon be coming back to life. Trees and grass will once again turn green, flowers will be blooming, the joy of Spring! Not so fast, because for some this means struggling to breathe and being wary of the ever increasing pollen count. You might be thinking allergies, but that is a secondary issue to a chronic illness that affects a large percentage of children (and adults), Asthma.

I work at Barton County Memorial Hospital (BCMH), and as of March 8, 2011 we are now certified as an Asthma Ready Hospital—only the 2nd hospital in Missouri to receive this designation. We have 2 Certified Asthma Educators (AE-C), another rarity seeing as there are under 3,000 total in the United States. This all exists in a small rural 24-bed hospital. You might not think this is relevant to you and your practice, but statistically it is very likely that you have at least 1 (probably more) client who suffers from Asthma. According to the Centers for Disease Control and Prevention (CDC), approximately 7.1 million children are diagnosed with asthma, which is just around 10% of the pediatric population. The Asthma and Allergy Foundation of America states that not only is asthma the “most common chronic illness in children” but it is also one of the leading causes of school absenteeism AND hospitalizations of children.

In other words, this is a serious problem and many of our clients will be affected, both children and adults. Asthma occurs out of sight in the persons’ airways, which become constricted and swollen when triggered by external (and at times internal) factors. It can look like someone is just “out of breath” when in reality the air cannot get through the airway and could become a serious life-threatening problem. Unfortunately due to its outward “invisibility” many people do not take it seriously, and children suffer humiliation by coaches, peers, even parents. The good news is, although asthma cannot be cured, it CAN be controlled (American Lung Association). Between the physical manifestations of asthma and the emotional affect, Music Therapy can provide great benefits.

First of all, for any Music Therapist looking to work with the asthma population or related issues such as COPD, I recommend reading “Music, the Breath and Health: Advances in Integrative Music Therapy” edited by Ronit Azoulay and Joanne V. Loewy. Second, educate yourself on Asthma itself. I have attended the nationally certified 6-hour workshop, “Becoming an Asthma Educator”, and borrowed resources from Certified Asthma Educators (who are also Respiratory Therapists). Fortunately I work with two AE-C’s and have gleaned great information from listening closely and collaboration.

The main themes within Asthma Education include teaching students to identify symptoms and triggers, the 3-Step process (I will explain in a moment), and how to properly use the various medication devices (which can be very confusing). The 3-step process is what students need to do when they are having an asthma attack. 1) Stop and sit down, 2) Tell and adult, 3) Take medication. There are many sub-topics that are addressed with students within these topics, but once the student gains this knowledge they are much more likely to be successful in controlling their asthma.

Ways to implement Music Therapy in treating clients with asthma. At BCMH we have incorporated Music Therapy into the Asthma Education program in 3 ways:

1) Inpatient services
2) School assemblies (for all students) and 3-week education (asthma students)
3) Educational Presentations (for caregivers including parents, teachers, daycares)

*Currently the AE-Cs do home visits that do not include Music Therapy; however we are discussing the possibility of Outpatient referrals specifically for participants in the Asthma Education program who have severe anxiety and psychosocial problems.

Goals for inpatients with asthma include increasing respiratory efficiency, teaching age appropriate relaxation skills (which also addresses proper breathing techniques), providing accurate age developmental stimulation if the patient is long-term, and providing opportunities for expression and identification.

Since music is so closely related to breathing and respiration, I have written a few songs that mirror “belly breathing” (or diaphragmatic breathing) lyrically, melodically, spatially, and rhythmically. Interestingly, during one of our sessions, the Asthma Educator was teaching two young boys how to properly use a spacer with their inhaler, it takes breathing coordination, and when I added a simple melodic support on the glockenspiel that mirrored the appropriate action, the boy immediately improved. Since there were two boys I had the boys take turns playing the glockenspiel while the other practiced using the spacer so they were helping one another.

Another favorite song I adapted to a familiar tune uses egg shakers:

“Shake, shake, shake out my ________ insert specific stressor or anxiety of client (3X)
And…stop shaking egg shakers…take in a big deep breath.”

It is a simple song but it incorporates two important elements: naming the client’s trigger and deep breathing techniques for symptom control and relaxation.

Using wind instruments: recorders, harmonicas, slide whistles are also great ways to improve breathing techniques, increase client confidence over asthma symptoms (as reported in several research studies). Using scarves also provides a great age-appropriate way for younger children to see the effects of their breathing as they blow to make the scarf “fly” to a song such as “Somewhere Over the Rainbow” or musical improvisation.

These are a few ways I have implemented Music Therapy in the treatment of asthma, and it has been a very successful addition to the BCMH Asthma Education program. Most importantly, make sure you are “Asthma Ready” for any clients you might serve who could possibly have asthma.

I would love to hear your comments and suggestions as I expand my knowledge in this area. Feel free to contact me at krista.winter@bcmh.net.