It’s been awhile since I posted any new session ideas or resources for interventions. Last time I showcased some ideas, I was working primarily with clients with developmental disabilities. Now that I’m working full-time in mental health care, my thought processes have changed a bit. Below are some ideas I have had a lot of fun with, and have been quite beneficial and effective for my patients. If you’re unfamiliar with this MT wikia website featuring music therapy with all populations, check it out to help you gather more ideas for mental health (or any other population) that you can use or adapt. Sometimes, it simply helps to read about other MTs ideas to help formulate your existing ideas, or to brainstorm for your patients’ needs.
The following intervention ideas are ones that I utilize for a whole group session, typically ranging from 30-45 minutes, depending on the unit, with approximately 10 patients. These interventions follow after patients introduce themselves and I check-in with/assess the patients who have volunteered to attend.
INTERVENTION RESOURCE #7
“Beach Ball Autonomy“
Goals: Increase autonomy, mood, and expression; decrease feelings of isolation
Intervention: I took a blow-up beach ball and drew on various cloud shapes that included genres, styles, and generic artists inside each shape. I toss the beach ball to a patient and wherever their thumb lands is the song selection we do next. I allow the patient to brainstorm ideas of songs that would fit into that category so I can assess the closet type of preferred song for that particular patient. I might also ask reminiscing or get-to-know-you type questions as follow up questions for this patient. The patient also gets to decide if the group will play instruments, sing, dance, listen, etc. Each group is always a little different, but overall patients tend to love this activity. Just be prepared to lead a solid 45 minutes of singing!
Considerations: I always prep the patients with “guidelines” for play on this intervention, since some patients need more structure than others. Certain guidelines include saying the name of the patient you are about to toss the ball to, so that they are making eye contact with you. I do whatever I can to make sure no patients become upset with one another (in case a beach ball goes towards a patient’s head). Just make sure you lay the ground rules before starting this intervention!
Adaptations: Spin wheel app. There is a great app for your iPad called, Decide Now!, which allows you to make a “spin wheel”. I use the same ideas above but create a customized spin wheel as a different sensory source. The patients on our more intensive unit love the sensory aspects including the sights and sounds of the app, in addition to the increased autonomy provided by the intervention.
Takeaway: This group session is often looked at as “fun” and “entertaining” by the patients, but it’s one of the few where I rely solely on the intrinsic value of music to be therapeutic. Many patients get carried away in enthusiasm for discussing their preferred music. Some of my other group sessions, or sessions provided by other interdisciplinary members don’t always create room for this free discussion. Some patients are also happy to sit and experience the “fun” without directly participating.
INTERVENTION RESOURCE #8
Goals: Increase expression; decrease feelings of isolation; increase cognitive stimulation
Intervention: This intervention idea was found at this site and I loved the idea immediately. I provide the lyrics to 4-5 different song choices to patients that center around generic mental health themes, such as overcoming, support, struggles, etc. I encourage patients to take time to read the lyrics of a chosen song and to choose words out of the lyrics to create their own song, or poem. The idea is to “black out” the lyrics patients don’t want in their song, and be left with the words they have chosen to form a new song. It’s really cool to see how original lyrics can be re-written into entirely new poetry to express themselves.
Considerations: Provide examples of blackout poetry to help give patients a visual. Also consider songs that aren’t too repetitive, as the options for words to choose from would be limited. Try to also provide song lyrics that are unique but relatable so that patients aren’t distracted by the song they already know well.
Takeaway: Some patients do get turned off by the idea of re-writing original songs, so keep that in mind when assessing your group. Don’t be caught off guard if a patient says, “Who does she think she is – changing the words of a classic?!”*
*This is a direct quote from a patient a few weeks ago in response to some lyric substitution!
INTERVENTION RESOURCE #9
Goals: Increase cognitive stimulation and socialization; facilitate discussion
Intervention: This is an adaptation to your classic game of hangman. I draw a thematic picture on the board and direct patients to guess the missing word before the artwork loses all of its details. (For example, “try and guess the word before the tree loses all its leaves”. Or “before the snowman melts away”.) I choose a thematic word and find songs that start with each letter of that word. For example, the word “light” might have the songs, “Let it Be”, “I Can See Clearly Now”, “Get Happy”, etc. Each patient takes a turn to guess a letter. Every letter guessed correctly earns the corresponding song to play and sing. I also try and coordinate songs that share the same thematic idea, in addition to matching the letter.
Considerations: Change the name. I never call this game Hangman due to my client population. I usually call it a “word game”, similar to wheel of fortune. Since I never draw a picture of a hangman, most patients don’t notice I’m not calling the game what it is.
Adaptations: [Theme (word) and corresponding artwork]. Autumn (Heart) and trees; Halloween (Hopeful) and pumpkin; Thanksgiving (Grateful) and turkey; Holidays (Goodwill) and snowman.
Takeaway: This is a great recreational music therapy game that allows patients to have simple, active participation. I do this often on our geriatric inpatient group to help with cognitive stimulation and also socialization.
INTERVENTION RESOURCE #10
Goals: To increase emotional and self-expression, increase socialization; normalize environment; increase positive coping skills
Intervention: This is simply writing the blues. I explain the background of the blues to patients so they understand the basics of having line A, repeating line A, and a subsequent line B. I encourage each patient to “state a problem” or something difficult that they are feeling “blue” about, and then state a solution, or coping mechanism to that problem. We then brainstorm how we can make those statements sound poetic in the songwriting. For the most part, simply using the statement verbatim is great for the blues. For example, “I don’t want to be in the hospital anymore” is a great line A, followed by, “Oh, because I miss my family” for line B. Patients tend to not mind that their lines don’t rhyme. After each patient gets a turn writing their “blues”, we have a continuous improvisation/sing along where we sing through each patient’s blues song as a group, following the same melody line. I also bring my iPad and give each person a chance to improvise on the blues scale keyboard on GarageBand after we sing through their song.
Considerations: Try and make the instructions clear from the beginning that the purpose of the songwriting is to state a challenge and then a solution to allow for better structure of discussing coping skills and strategies to deal with their issues.
Adaptations: “Holiday Coping ” Blues Songwriting. I have done this for the holidays with a focus on the “holiday blues”.
Takeaway: Allowing the patients a safe place to vent their frustrations with hospitalizations, or the difficulties in their life in a constructive way has very positive results. Many patients will tell me like it is, without any reservations, and often once we sing about their problems in their blues song, they appear to have less stress regarding that situation, or they are happy to have been validated in their difficulties.
Comment below if you end up trying any of these intervention ideas with your patients and let me know how they went, or any adaptations you made!