Musical Therapy and OT

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On my placement in acute care, one of the OTs was mentoring a musical therapy student. This student specialized in the guitar and would discuss with her preceptor which patients could benefit from musical therapy. Often, she would go to palliative care or play music with the elderly. She ran rhythm circles and told me that her clients really enjoyed participating in these groups. I was in neuro acute care and one of the most memorable clients had an anoxic brain injury. As this patient was recently admitted, the rehabilitation team had high hopes for a recovery but was also weary about whether or not the client would improve. The musical therapy student told me that when she went into the room and played music, the patient was sleeping but was tapping his/her fingers to the beat. The student then began strumming the guitar, singing a song and singing out the patient’s name. In that moment, the patient opened his/her eyes and looked at the student- He/she appeared to be connecting to her and to the music. The spouse, who was in the room began to get emotional and cry. Through this experience, the spouse felt a glimmer of hope and felt that maybe there was potential for recovery.  When I heard this story, I found that music can be so powerful. Whether or not the patient was understanding what was happening, the patient along with the spouse and musical therapy student seemed to be silently communicating through music.

Research about musical therapy:
Maratos, A., Crawford, M. & Procter, S. (2011). Music therapy for depression: it seems to work, but how?. The British Journal of Psychiatry, (199), 920-93. Retrieved from http://bjp.rcpsych.org/content/199/2/92.full

This article discusses the benefits of musical therapy for depression. The researches suggest that music therapy partly is effective because active music-making within the therapeutic frame offers the patient opportunities for new aesthetic, physical and relational experiences.

OT Innovations has a good website writing about music therapy and OT practice:

OT Innovations. (2008). Music & sound therapy. Retrieved from http://www.ot-innovations.com/content/view/36/57/

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(OT Innovations, 2008)

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Making Art- A qualitative study

Howells, V., & Zelnik, T. (2009). Making art: a qualitative study of personal and group transformation in a community arts studio. Psychiatric Rehabilitation Journal, 32(3), 215-222.

This study found that making art helped participants build new identities and roles. In addition it found that through participating together in a meaningful activity, the individuals felt part of a new community (artistic community). This study indicates that many mental health programs focus on illness and symptom reduction and treatment but do not necessarily look at how these individuals can become meaningful members of their community. Regular programs also don’t always look for different avenues for these individuals to connect with others. Venues like an art studio for these individuals can really help bridge this gap and provide an alternative form of mental wellbeing and sense of community for this population. 

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Lab 10: Mental Health and Artistic Expression

In today’s lab we used art to express our internal emotions. 
The stations included Expressive Media, sculpting, finger painting, rhythym circle and self-evaluations. These activities can be an outlet for individual’s who may not be as comfortable expressing their emotions in words.  

In the finger painting table, we were suppose to paint how we feel on the inside. I like this activity because we can be as expressive as we feel using our hands and colors. The artwork also does not have to be perfect and because it is finger painting, everyone’s work will almost look child like. Finger painting can be good for many mental health populations such as children, elderly, learning disabilities or autism spectrum disorder.

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In my artwork, I drew an ocean because I feel like water and ocean is a very big part of my life. I grew up by the ocean and whenever I look at it it makes me feel calm. In contrast, I drew fireworks, because sometimes I feel like I have a lot of energy and feel excited and energetic. I also drew musical notes because music is a big part of my life and I always have a tune in my head. 

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Scultping:
I found this activity particularly difficult as it asked for us to sculpt a self-portrait of how we believe others perceive us. This type of activity may be difficult for individuals with self-image problems/ body dysmorphia or eating disorders as a symptom of their disorder is believing that others think they look different than they look in reality. This may make individuals like this feel vulnerable and self-conscious, especially in a group setting. This may be an activity that an OT would want to carefully grade into therapeutic sessions. 
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The last station was a rhythm station. We were all provided an instrument and told to use these sounds to express our feelings. My group and I ended up making collaborative sounds of a rain and a thunderstorm. The instruments are all different and easy to play so there is little expectation of skills needed. This type of therapy could be particularly useful to use with children or the elderly. 

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Overall, art and music is a creative and wonderful way for individuals to express their mental state. Art and music can also act as an emotional outlet and could be a cathartic experience. However, I could also see this method of therapy being very difficult to implement with those who are self-conscious or are very logical in their expressions. Comparatively, for those who embrace their ‘right-side’ of their brain, this could be a very meaningful and productive therapeutic activity. 

OT Assessment and Resources

Here is a list of OT assessments and Resources that may be helpful for future practice.

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http://www.qotfc.edu.au/mental-health/documents/links/ot_resources_townsville_mhs.pdf

Screen for child anxiety disorders

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http://www.cot.co.uk/mental-health/ot-assessment-mental-health

Self esteem assessment: http://www.melbabenson.com/articles_files/Self%20Esteem%20Assessment.pdf

Rosenberg Self-Esteem Scale

http://www.bsos.umd.edu/socy/research/rosenberg.htm

Anxiety self-assessment questionnaire:

http://www.revivre.org/utilisateur/documents/T.%20anxieux/Self-Assessment_Anxiety.pdf

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CAOT mental health page: http://www.caot.ca/default.asp?pageid=3627

Lab 9: CEC Interviews

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This was by far my favourite lab this semester. From all the knowledge we have attained in mental health over the semester, I was able to apply it and witness it live during the CEC interviews. The best way to learn is by actually ‘doing’. I have learned that mental health patients may benefit from a time use journal. I have heard and read again and again that individual’s with mental disorders may have a lack of a schedule. Despite understanding this, I was quite thrown off when my volunteer told me that he/she really didn’t do much during the day. The volunteer also had flat affect and as an interviewer I had to push aside the ‘social norms’ we may expect people to respond and continue asking my questions. My partner and I used the Engagement in Meaningful Activities Survey (EMAS) as well as an activities check list.

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From my interview, I discovered that some people may benefit from structured questions, and some people may benefit from an unstructured, casual interview. Though, I had to explore and experiment with the EMAS, I did not find it very helpful in my experience with this particular volunteer. One of the questions at the end of the EMAS asks, “Which of these activities make you feel good about yourself? Choose the top 3”. First off, my volunteer was very blunt and told me that the activities he/she partakes in are more obligations and means of survival versus enjoyment. He/she also didn’t have 3 activities he/she participated in so this question I found to be quite restrictive. I was able to re-word the questions to better suit the circumstance and volunteer, but if I had to choose how I would interact with this person, it would not be through this method. Though the volunteer claimed to find little pleasure in daily activities, after veering into a more casual conversation, my partner and I were able to discover that he/she did in fact find enjoyment in various activities. He/she even admitted that he/she does have a desire to do activities and that he/she wants to enjoy them, but it is his/her own personal barriers in life that restrain him from doing so. I believe that more structured interviews would be beneficial for those who find difficulty in expressing themselves but unstructured interviews allow for more rapport and a stronger therapeutic relationship.

Snoezelen Rooms

Screen shot 2012-12-12 at 3.46.36 PMSnoezelen or controled multisensory environments is a therapy for people with autism or developmental disabilities. Because of their disability, these individuals may feel understimulated or overstimulated.  These rooms are here to provide different senses in order to assist in creating sensory balance.

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Sensory rooms in Mental Health: Champagne (2006) suggests that OTs must become more active in collaboratively creating and promoting the use of sensory rooms across mental health. She suggests that these rooms should be applied to adult inpatient acute mental health and forensic settings (Champagne, 2006). Studies indicate that sensory rooms can provide sensory and emotional modulation for mental health clients, as certain stimulus can be nurturing and healing. As well, Champagne (2006) indicates that sensory rooms have potential to positively influence self-organization and impact recovery.

References:
Champagne, T. (2006). Creating sensory rooms: Environmental enhancements for acute inpatient mental health settings. American Occupational Therapy Association: Mental Health29(4), Retrieved from http://uspra.info/Education/Conference2011/HANDOUTS/605MHSISdec2006.pdf

Random Act of Kindness at Queen’s

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Random Act of Kindness at Queen's

I found this note from a fellow student in the girls bathroom at Queen’s University. This makes me realize that many people around me can be feeling lonely and out of place without being obvious about his/her emotions. Sometimes emotions and mental health can impact an individual, but he or she does not know what to do or how to get help. It is still hard for individual’s to admit if they have a mental condition or problem, especially with the consistent stigmas so prevalent in mental health.

What makes me upset is that this individual felt the need to reach for help through a post-it note in the bathroom. We need to help make our university environment more open to communication regarding mental health. The lovely individual who left this note in response shows that there are people out there in our own community that DO understand and DO want to provide support. We all need to take a stand and perform random acts of kindness like this. Perhaps the girl who wrote a response helped put a smile on the girl’s face who was seeking for help. At least now she knows she is not alone, whatever her condition or mental state.