Sounds of Sanctuary:

Matthew Phillips, LSW, MT-BCLauren Smith, MA, MT-BCBethany Children’s Home

April 14, 2011

Trauma-InformedMusic Therapy

• Part 1– Introduction to Music Therapy– Introduction to the Sanctuary Model– Relationship between adolescents and music

• Part 2– Music Therapy Psychoeducation groups• Safety• Emotion• Loss• Future

Outline

Community MeetingHow are you feeling?

(play it, then say it)

What is your goal for today?

Who will you ask for help with that goal?

What is Music Therapy?“Music therapy is a goal-directed process

in which the therapist helps the client to improve, maintain, or restore a state of well-being, using musical experiences

and the relationships that develop through them as dynamic forces of

change.”(Bruscia, 1987, In Bruscia, 1998)

What is Music Therapy?

Therapist Client

Music

• Culturally-relevant• Met with less resistance than strictly verbal

interventions• Less threatening means of self-expression• Flexible medium that can be adapted in the

moment• Access to nonverbal, fragmented trauma

memories

Why Use Music?

Training of a Music Therapist• Bachelor’s, Master’s or Doctoral

degree in music therapy• Practica and Internship• MT-BC – Music Therapist Board

Certified

Bethany Children’s Home

Types of Music Experiences

Listening

Composition

Re-creating Improvisation

• Receptive musical experience • Live or recorded musical example• Help the listener establish personal

connections or points of discussion with the lyrical or instrumental content

• Evokes emotional responses• Supports an image-driven relaxation

experience

Listening ExperiencesDefinition

Listening ExperiencesGoals

• Establish personal connections with lyrical or musical content

• Identify points of discussion• Evoke and support emotional

responses• Support an image-driven relaxation

experience

Re-Creating ExperiencesDefined

• The client learns or performs a pre-composed vocal or instrumental piece– Performance - to share with others– Non-performance– Group Sessions– Individual sessions

Re-Creating ExperiencesGoals

• To develop appropriate social skills• To improve attentiveness• To develop leadership and teamwork skills• To develop and utilize coping skills• To increase self-esteem and self-expression• To share talent and strengths with the BCH

community• To create a shared and meaningful music

experience within the BCH community

Composition ExperiencesDefined

Composition is a process that fosters emotional awareness, cognitive

understanding and creative expression through musical means such as lyric

writing, lyric substitution, instrument playing and accompaniment

• To develop organizational and planning skills• To promote self-responsibility• To develop the ability to document and

communicate inner experiences• To promote the exploration of therapeutic

themes through lyrics• To develop the ability to integrate and

synthesize parts into whole (Bruscia, 1998, pp. 119-120)

Composition ExperiencesGoals

Verse 1Started out really early, young and so afraidNo one would have realized because attention I wasn’t paidStopped every dream I had, so I could play Mom and DadEverything I wanted was never what I had ChorusSometimes it’s smarter to push your own way thoughBecause some things you need, may not be handed to youI learned the hard way, trying to help everyone succeedAnd at the end of the day I had no one to count on but me

Composition Experiences“My Journey”

Verse 2Then I found myself all alone, in a place so unrealSeemed like what I ever felt was no longer what I could feelI tried to hide my fear in a search for a way outBut when I reached for help is when I figured it out ChorusSometimes it’s smarter to push your own way thoughBecause some things you need, may not be handed to youI learned the hard way trying to help everyone succeedAnd at the end of the day I had no one to count on but me

Composition Experiences“My Journey”

Verse 3:Now I’m in a better place and my dreams will soon come trueI learned from the mistakes and situations I’ve been throughI have myself to love, and that is how it will always beIt’s not hard to realize how much this place has changed me Chorus:Sometimes it’s smarter to push your own way thoughBecause some things you need, may not be handed to youI learned the hard way trying to help everyone succeedAnd at the end of the day I had no one to count on but me

Composition Experiences“My Journey”

To all my people in the struggleFor all my people who feel trappedCan’t get anything outFor all the hard timesAll the long daysCan’t think of nothingTo free their soul

Composition Experiences“Trapped”

Trapped in these walls and it feels like I can’t breathTrapped in these walls and I can’t break freeAll my anger grows up insideI can never go to a place where I can just hideCause my heart beats faster and I start to sweatI know I’m nowhere finished with this yet

Is it the motivation that wakes me up in the morningOr is it the dedication that makes this not boringIs it the hope that helps me find my wayOr is it the fear that I fear every day

Composition Experiences“Trapped”

I feel like a new personWith every step that I makeI’m doing all these thingsAnd I can never get a breakTrapped in these waysAnd I can’t tell where I amBut maybe one day I can understandWhy I’ve been trapped for all these yearsIt gets me so madIt almost brings me to tearsI’m living in a body, living in a world that’s fakeI have one way out And it’s not yours to take

Composition Experiences“Trapped”

Improvisation ExperiencesDefined

• Creating music in the moment in response to individual feelings and/or a collective group intention– Nothing is written down– No “mistakes”– Percussion Instruments - fun and accessible– Other Instruments

Improvisation ExperiencesGoals

• To establish nonverbal communication• Provide a fulfilling means of self-

expression and identity formation• Explore various aspects of self in relation

to others• Develop group skills• Develop creativity, expressive freedom,

spontaneity and playfulness with various degrees of structure

(Bruscia, 1998, p. 116)

Improvisation Experiences

An overwhelming event that causes intense feelings of fear, helplessness or horror.

There are many different kinds of trauma and not everyone responds the same way

to a traumatic event. (Sanctuary Staff Training, Module 1)

What is Trauma?

• Trauma-informed model of care• The shared language of S.E.L.F.– Staff Training– Psychoeducation Groups

• Seven Commitments• Toolkit– Staff Training– Core Team– Red Flag Reviews– Psychoeducation Groups

What is Sanctuary?

A Change in PerspectiveSickness Model

“What’s wrong with you?”vs.

Injury model“What Happened to You?

Sanctuary Commitments

•Nonviolence

•Emotional Intelligence

•Social Learning

•Shared Governance

•Open Communication

•Social Responsibility

•Growth and Change

S.E.L.F.

Safety

Loss

Future Emotion

S.E.L.F.•A way of organizing complexity

•Dynamic and nonlinear

•Phases you move in and out of (not stages you climb)

•An accessible language

•Gets everyone on the same page

•Applicable to children, adults, families, staff, organizations

Adolescents and Music“How does loud music calm him down?”

• Music is not a “universal language,” but it does foster connectedness• Iso Principal - Music first matches the mood and

slowly changes to shift to the desired mood state (Safety Plan CD)• Delayed gratification - release from the

discomfort comes only after fully being present with the discomfort (Sad songs can ultimately cheer you up)

Adolescents and Music“Violent songs make violent kids”•Music plays a reflective (not a causative)

role during adolescence •Music functions as a window through to

the internal state of the teenager•Music can be used to increase personal

understanding (“Lil’ Wayne is the only one who gets me”)

(McFerren, 2010)

Intermission• Where we’ve been: Foundations• Music Therapy• Sanctuary• Adolescents and Music

• Where we’re going: MT Psychoeducation Groups

• Safety• Emotion• Loss• Future

Psychological

Safety

Moral

Physical

Social

Safety• Physical, Psychological, Social Moral

• Music is safe - teaches about safety and provides a safe environment

• Popular songs address themes of safety

• Music provides a safe container and context for the experience

• Youth begin with discussing safety issues in the music, and gradually move to processing personal experiences

Safety“Welcome to My Life” by Simple Plan• Lyric discussion and songwriting

experience• Teaches the four domains of safety:

physical, psychological, social and moral

Safety“Being in my Life” by BCH Youth

To be loved, to feel wantedTo be free in the worldTo be glad when you’re sadIt feels like you’ve been in loveTo be on the edge of everything and

strength is there to save youNow you do know what it’s likeBeing in my life

Safety“Use It” Music Video

• Outside of Psychoeducation Groups• Girl’s Cottage (Ages 15-19) worked with

houseparents, MT, SW, CTRS• Chose music, wrote lyrics, recorded the song,

staged and filmed the video

Emotion Management

•Cultural instinct prompts adolescents to listen to music when experiencing distress

•Identify current means of managing emotions and meet the youth where they are

•Teach new means of managing emotions

• Group Improvisation – Play emotions together– Adjust the “volume” of

the emotion• Solo Feelings

Improvisation– Like a charades game,

using emotion cards– Relate to community

meeting

Emotion ManagementImprovisation

•Music is a cue and a context for progressive muscle relaxation and guided imagery• Relaxation is a learned skill• Unique responses of each individual• New Age music with minimal movement

is very holding• Beware of classical music, as it will

always move the client somewhere else

Emotion ManagementMusic-Assisted Relaxation

Loss• Loss is uncomfortable, but music can make it

safe to explore–Time-ordered Structure–Projective Tool–Promotion of Universality

•Music can elicit complex responses

LossRe-enactment Triangle

Perpetrator

Victim Rescuer

LossAutobiography in Five Short Chapters

• Sound Poem with structured instrument playing

• Underline colors indicate when each instrument plays

• Gives words a musical (emotion) context

Future• Themes of popular music - thinking

about future and working together to make the world a better place

• Make change within the group and generalize to experiences outside of the group

• Multi-layered lyric discussion and songwriting experience that focuses on making a change for a healthy future

• Listen to the song and identify important themes

• Two-sided fill in the blank handout• “The Kids Don’t Stand a Chance”• “The Kids Do Stand a Chance”

Future“The Kids” by B.o.B.

Future Adapted from “The Kids” by B.O.B.

Our boys and girls have choicesThe streets are not their home

They’re filled with hopeful voicesOur kids do stand a chance

They’re free to choose their futureInspired to live their dreams

They’re filled with expectationsOur kids to stand a chance

I said our kids do, our kids do stand,Our kids do stand a chance

Future“Man in the Mirror” by Michael Jackson• Summer training for all staff

and youth• Staff and youth worked

together to rewrite lyrics based on theme of “Growth and Change”

• Staff and youth reflecting on the growth and change within the campus community

Community Interventions• Religious Services - choir, world music

drumming, solos, small groups • Talent Shows and Coffee Houses• Occasional Community Performances• Special Events - Anniversary Day

• Know your strengths and limitations• The non-therapist musician and the non-

musician therapist bring very different skill sets

• Be aware of music’s capacity to elicit intense response (particularly in relation to loss)

• Know your population and their unique characteristics

• Extensive training is required to interpret client musical responses

• It’s not music therapy without a qualified music therapist

Non-Music Therapists

Final Thoughts

“Teenagers relate to music. Music plays an important role in society. Musical engagement

can be health promoting. And most importantly, music can be fun. Just show me a

teenager who doesn’t want to be happy.”(McFerren, 2010, p. 74)