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  • Hi, welcome to Mental Health Matters. I'm Shannon Eliot.

  • Today I'll be discussing the role of music in mental health recovery with a music therapist

  • and vocalist.

  • Michael Kessler serves as the Program Specialist at Alameda County Behavioral Health Care Services.

  • He has practiced music therapy for more than 20 years. Michael has developed therapeutic

  • programs in adult acute psychiatric, geriatric, and long-term rehabilitation settings. In

  • his sessions, Michael uses a variety of tools including guitar, piano, drum circles, and

  • composition. He has a Bachelors degree in Music and a Masters in Rehabilitation Counseling.

  • Paulette Franklin was born and raised in the East Bay and has been singing in church since

  • the age of 5. For many years, she also operated her own child development center. While going

  • to therapy, she discovered that singing was the best wellness tool to lift her spirits

  • and help her get through one day at a time. Her training with Best Now and internship

  • at Alameda County Behavioral Health Care Services are contributing to a healthier lifestyle.

  • Welcome, Michael, and welcome, Paulette. Thank you for joining me today.

  • Paulette, I know you've experienced a lot of loss. Can you tell me what led to your

  • mental health challenges?

  • >>Sure. My brother was murdered in Alaska. Someone tried to rob him and shot him in the

  • head. And so he passed away. And then next my mother, she had cancer of the liver, and

  • I took care of her months. And then of course she passed away. And then 18 months after

  • that my father passed away. And after that I think my mind just couldn't take any more.

  • And that's when all my challenges began. And I started to go get help for the challenges

  • I was experiencing.

  • >>What kind of challenges were you experiencing?

  • >>Mostly depression. I didn't want to talk. I didn't want to go outside. I didn't want

  • anybody to ask me about anything. I just wanted to be by myself.

  • >>So how did you discover music as a wellness tool and use it for recovery?

  • >>Well I have been singing since I was a child. My grandfather used to take me to churches

  • and make me get up and sing. He said, "Just stand there and sing. It'll be ok." [Laughs]

  • And I was a little nervous, but I would do it. And then just from that point on I've

  • been singing. I was in a group, we made an album, and different things music has been

  • in my life. So it wasn't until I had stopped going because after my mother passed that

  • I went back. And I could hear my mom telling me to sing. She said, "Just sing, Paulette."

  • She would love to hear me sing. And so I started singing again and I realized that's what contributed

  • to my wellness.

  • >>So Michael, you have a background in music therapy. Can you tell me a little bit about

  • what music therapy is and how it works?

  • >>Music therapy -- the definition I like to use is art and science, using music to achieve

  • a non-musical goal in conjunction with a credentialed professional therapist who has gone through

  • training to do it. A great example of that is the ABC song, just singing a song not to

  • learn the song, but to learn the alphabet, so that's one thing. And I use music as you

  • mentioned in sing-alongs, drum circles just trying to get people focusing and working

  • together.

  • >>Paulette, what kind of treatment options did you try when you were going through your

  • depression and how did those compare to music for you?

  • >>I've tried therapy, small groups with women who had similar things that were going on

  • with me, medication, and it wasn't until -- like I said earlier -- I went back to church and

  • started singing that I realized that event though I had to do all those things and I

  • was doing them, it was ok but I really wasn't feeling a lot better. And then when I would

  • sing, it just made me feel a lot different. And I knew that's what I needed to do.

  • >>Do you think the singing magnified the effects of those other things or do you think the

  • singing on its own is really what has gotten you to a better place today?

  • >>I think a combination of both, I mean of all things that have helped me. But I think

  • that singing was at the top of the list.

  • >>Michael, from a provider perspective, how effective do you think music therapy is compared

  • to these other treatment options?

  • >>Music therapy is fun. It's non-threatening. It's not invasive. It's kind of a sneaky form

  • of treatment. You don't really know. You're having fun, having a good time. And it's much

  • easier, I believe, to express yourself or tell what the sound of the drum just made

  • than what is going on inside. It's much easier to sing someone else's words sometimes and

  • just understand them and go hey, that connects to me in such a way as well that I can just

  • talk about this other person's lyrics. And it hits home without actually having to tell

  • you what's going on in me and come up with it on my own. It's that way.

  • >>And that's a beautiful thing because even though you go to talk therapy to feel better,

  • there's probably a lot of anxiety just going into talk therapy because you know you're

  • not only going to have to explore things that are painful but then articulate them in a

  • way for another person to understand. And this seems so much more welcoming and non-threatening.

  • >>Correct. And you're going in thinking, "Ok, this guy is going to analyze me...."

  • >>Yeah. What's his background? What are his credentials?

  • >>"He's going to dig into my head." And no, let's just sit back and have a good time and

  • hopefully something wonderful will come out of it.

  • >>So walk me through a sample music therapy session. What do you do? What are the goals?

  • What are the ideal outcomes?

  • >>Ok. Usually we start off with a talk session. Sit down and do an assessment with the client,

  • just finding out what they're there for, what issues they want to talk about or deal with.

  • So come up with a really good assessment and also talking about the history. And what music

  • does connect with you, what music doesn't, if you are musically inclined, if you're not.

  • And then after that come up with a goal. Help the client identify what they want to try

  • to achieve. Sometimes people come in and they have no clue.

  • >>What might a sample goal be?

  • >>A sample goal might be anything from being able to get up out of bed. Just getting up

  • and starting the day. Or being able to talk to somebody, being able to engage, start a

  • conversation, just get the conversation going. Or sometimes there's music therapists -- I

  • haven't done it -- but work with people with physical disabilities as well. So helping

  • someone to start walking again and so forth. So that's what we come up with, these goals

  • or overall goal. Then I will go into my little bag of tricks and find a nice session plan

  • or develop a session plan which would have the overall goal and objectives, how we're

  • going to try to get there, what hurdles we might see in the process of getting there,

  • and hopefully there will be some hurdles that I don't expect because I kind of like working

  • when things don't quite work right. And then do the session. And it could be -- like with

  • you, you're talking about just singing -- we just find out some songs you like. Sit back

  • and just sing.

  • >>Sing.

  • >>And maybe even -- you talking about singing at church...

  • >>That's right.

  • >>Encourage you do to more of that. Go our and sing at church. Sing with your family.

  • >>Not only in the therapy session but out in the world in your everyday life as well.

  • >>And that's hopefully what the music therapy will do. It will transfer to everyday life.

  • Because you will start off with just trying to express yourself or identify a feeling

  • that you might not even know is there. And then maybe that will transfer to going to

  • a grocery store and just trying to converse with the person at the counter.

  • >>Are you taking new patients? [Laughs]

  • >>So you said you liked the hurdles. You smiled a little bit when you mentioned that. What

  • are some potential hurdles that someone might face?

  • >>The hurdles that someone might face is dependent upon where they're coming from. I was mainly

  • speaking of hurdles within what I think will or what I'm hoping an assessment will look

  • like and if it doesn't. I've gone into group sessions with a whole plan started up and

  • the group just looks at me and goes, "Uh uh. That's not going to work today." My music

  • therapy professor when I went to school, Ron Borczon -- brilliant guy, helped me out, my

  • mentor -- he told us to prepare for an error-free environment meaning...

  • >>Is there such a thing?

  • >>There isn't. But just try to figure out what might happen and what might go wrong

  • before you go in just so you're ready. Because you don't know. So yeah, the hurdle is the

  • group not digging it, not wanting to do what I had in mind. And then we change and turn

  • it around and say ok well, we're not going to write a song today. We're going to just

  • listen to music really loud and dance or find out what's going on with them.

  • >>So Paulette, you've pretty much been singing your whole life, definitely since you were

  • five. There are other people out there who have not been singing as long or who might

  • not be as musically inclined but are sort of drawn to music as a recovery tool but might

  • be scared trying it. What would you say to them?

  • >>See Michael. [Laughs] You have to try. Find a group, find a vocal teacher, find someone

  • that knows something about music and at least go and try. Figure out if that fits for you.

  • You know, like he said, some people, it's not for them. And if you have it inside, I

  • think more people, if they would try, would see that it's there. Because music is a thing

  • that really touches your heart and gives you a lot of feelings that I can't express to

  • you. But it really does something for you. So I encourage people that I know who may

  • say, "Oh, I can't sing." I tell them, "Oh, yes you can." You don't need to be in tune,

  • nothing. Just sing.

  • >>Have you engaged in musical activities other than singing?

  • >>Yes. I've been in a band. I used to play the bells. I used to play the violin. I still

  • do on occasion but not very often because my nails are too long. [Laughs] I love the

  • violin. My mother played it and my son played.

  • >>Michael, in your experience, does music ever lead to negative flashbacks and if so,

  • how do you deal with those?

  • >>Negative flashbacks, no, not per se. As I mentioned before, I do a thorough assessment.

  • So hopefully I will find or figure that out. But yeah, ideally some thoughts that maybe

  • the client did not know they had come up. Because then you're touching upon things that

  • have maybe been repressed. Again, I like kind of playing on my toes. So if there is something

  • that comes up out of left field and I had no idea and the client had no idea where it

  • was coming from, we can really just grab hold of it and focus on what's fueling that. So

  • yeah, negative no, but maybe thoughts they didn't have or emotions that weren't there

  • come to the surface.

  • >>So you really see that as a growth opportunity.

  • >>Exactly.

  • >>Paulette, what do you do when you hear a song that triggers your sadness?

  • >>Well I'm a little different than Michael. I don't want to deal with it. Hearing something

  • that brings back things that I don't want to deal with, I shut it out. And that's where

  • I'm at right now. But the other day after speaking to some friends, a song came on.

  • And it was a song of course I didn't want to hear but because I'm around other people

  • I can't say, "Turn off the radio. I don't want to hear that." So I tried to deal with

  • it. And it wasn't bad, but I still -- right now I'm not at a place where I want to hear

  • those things.

  • >>That's interesting you mention that. At parties or in social settings if you hear

  • something that upsets you, how would you recommend to someone else dealing with that in the moment?

  • >>There's no way in life that you're going to be able to go anywhere that something's

  • not going to trigger you. And so you really have to deep down inside figure out how can

  • I deal with this. And have that plan in your mind so that if you go to a place that triggers

  • you, you can walk out of the room or sit down and take a deep breath, whatever you need

  • to do. But you have to have a plan so you'll be able to deal with those things.

  • >>Michael, how cost effective would you say music is as a recovery tool or music therapy

  • is as a therapeutic practice?

  • >>It's getting more. Around the mid-90s, a few celebrities and neuropsychologists went

  • to the feds and said this needs to be reimbursable and Medicare. So for some music therapy interventions,

  • it is. Those people are like Dr. Oliver Sachs, who wrote "Awakenings" and is a strong advocate

  • for music therapy. So that's one thing. Unfortunately right now also in behavioral health and mental

  • health, salaries aren't that high, especially for a creative arts therapist. So it's an

  • inexpensive form of therapy that way. We're working on trying to educate the providers

  • and the powers that be. I said Medicare, but MediCal -- some states have state-funded things. California

  • is working on it. But not yet, not that I'm aware of. So it's cost-effective. But there's

  • also not that many providers that actually offer it. They say they do creative arts therapy,

  • but they might not have a credentialed creative arts therapist on staff. So yeah, music and

  • arts can be therapeutic and we all do it. Even walking down the street, you're hearing

  • the beats. Music is everywhere.

  • >>Everywhere.

  • >>So we're doing it. Having it billable as music therapy you need a credentialed music

  • therapist.

  • >>How important is it to be a credentialed music therapist as opposed to just a musician

  • leading a drum circle or leading a singing choir?

  • >>I think it's quite important. And unfortunately music therapy is not a licensed profession

  • in this state. So there's no governing body overseeing it. As a creative arts therapist,

  • I need to do it myself. So if I see something I will go, "Hey, wait a minute, I know what

  • you're doing is great, but...." And the rationale behind that is the training. We're not just

  • playing music to entertain. As I was saying, it's about those things that I don't expect.

  • Fortunately I had the training and now the experience to backpedal and figure out how

  • to not cause damage.

  • >>That's a lot of responsibility.

  • >>That's the ultimate goal. You might not reach your ideal goal or your rehab goal,

  • but I don't want to hurt you in the process. And maybe someone who doesn't have the training

  • and the experience might send you somewhere you shouldn't be going.

  • >>How does music therapy work with deaf and/or mute clients?

  • >>It's interesting. Humans don't hear music with just their ears. You feel the music.

  • You feel the beats. You feel the drum. If I had one here, if I had my hand on it and

  • bang, you'd hear the vibration. I personally haven't worked with the hearing impaired or

  • deaf community per se. But what I've read and the research I've read about says that

  • taking speakers, instead of having them standing up, you put them face down on the floor. And

  • you raise the bass up a little bit and crank it up a little bit. And you're going to feel

  • that through the room. You probably hear cars driving by with the thumper in the trunk.

  • You're going to feel that going. And then the movement. We haven't really touched upon

  • music and movement. It's hard not to bop your head when you're listening to music. You're

  • going to move. You're going to feel the beat. So that's what I've read and learned about

  • when working with people with hearing impairments.

  • >>Paulette, how does singing now in your life compare to singing before you had your mental

  • health challenges?

  • >>It's a big difference for me. When I was singing when I was younger or as a teenager,

  • I was just singing. And now everything has a meaning. And I feel what I'm singing and

  • I listen to the words and apply it to me so that I can become a better person and recover

  • from my illness.

  • >>Michael, in your experience, what are some success stories you've witnessed?

  • >>Oh wow, that takes me back. The first one was when I was doing my music therapy training.

  • We were placed at different facilities. The first place I went was UCLA in the children's

  • unit. And there was this one boy there, about 10 or 12 years old. And whenever I came in

  • -- I went there once a week for an hour -- whenever I walked in to start the session with the

  • kids, he would misbehave and the staff would remove him. He was actually there because

  • he assaulted his baby brother pretty badly, but the child was ok. So one day I show up

  • with my guitar. And I walk in and he sees it and runs right towards it. And he goes,

  • "I want to play it." And I said, "Great. Have a seat at the session and right when we're

  • done, you can play the guitar." Because I was using the guitar, he couldn't play it

  • right then. So we're all on the floor with kids and I'm playing and right when I finish

  • the activity, I took the guitar without warning and just dropped it in his lap. And this tough

  • hard adolescent -- really, 10 year-old -- looks at me and has that 10-year-old look in his

  • eye again and went, "How? Show me how." And he was a little kid again and that's what

  • he needed to be. So it was wonderful. I stayed longer than I needed to because of schooling

  • but I stayed and played.

  • And then more recently, when I was working in inpatient, a locked acute unit over in

  • San Francisco, there was one woman who showed up, an older woman from Austria, very very

  • quiet. Mute, actually. She refused to talk or didn't talk. We didn't know if she refused

  • to at first. I tried to get her to come to groups and she never wanted to. But one day

  • she started sitting in the room where I was doing my music groups. And she stood there

  • for awhile. I would say a month, maybe. And then I was thinking, going through my musical

  • knowledge trying to figure out some song that might connect with her. And the only thing

  • I could think of relating to Austria -- because what do I know -- was Sound of Music. And

  • I said "Edelweiss." That's the flower. So I'd sing it and she started singing and talking

  • to a point where the docs on that unit were kind of annoyed that she was talking and advocated

  • for yourself, which is what you're supposed to be doing when you're a patient. You're

  • supposed to tell them what you need. And so it really connected and was tons of fun.

  • >>So how do you gauge which music works for which people? Do some genres have adverse

  • effects while others have positive?

  • >>Again it would be with that initial assessment, finding out what would work and what doesn't.

  • And it's not always a genre of music. It could just be beating on a drum or making up your

  • own. You said you were in a bell choir? You play bells? Just ringing bells or just listening.

  • Listen to other people within the group. That's the one thing I really like to focus on with

  • music. For me, music is community. Music is not me, it's everybody. So I try to encourage

  • that in my sessions. Like with bands. When we started, we had a little band going and

  • a choir going. And just people being able to get out of their heads and get into something

  • and interacting with somebody else and singing with someone else. And hopefully again that

  • will transfer to outside things. Again I spend most of my time working as a music therapist

  • in inpatient locked units. So these people, they didn't want to be there. And I was able

  • to help them find something fun and try to connect with other people and then maybe be

  • able to go out and have society accept the way they are.

  • >>Paulette, would you say music has also helped you connect with others in addition to just

  • overcoming your own internal struggles?

  • >>Yes, I feel it has. Who would have ever thought that through music that you could

  • reach so many people? And people enjoy music. And when they hear you singing -- depending

  • on where you're at -- most people will join in and say, "Oh yeah, let's sing this" or

  • "Let's do that." It's helped myself recover along with other people, even if maybe they

  • don't have the condition that I have. But I think just music in general can help everyone.

  • >>Michael, what have you learned from your clients?

  • >>That I need to know more. I started as a music therapist. I got my degree in music

  • therapy and then working in the field, I thought I need to know more. So I went back and got

  • my graduate degree in rehab counseling focusing on psychiatric rehabilitation, which is the

  • Boston model. It's really simple. Everyone thinks it's all intense and stuff, but it's

  • really simple. You just ask somebody what they want to do and then help them do it.

  • It's not that complicated. Even if it's way out, find out why they're going there. And

  • also it's not about the diagnosis. It's not. It's a real thin line to hop you over into

  • that. I used to tell the clients that the only difference between me and them was that

  • I had a key to the front door, unfortunately. But music has been therapeutic for me. It's

  • kept me from having someone else diagnose me. I'm not going to do it. So yeah, it's

  • not the diagnosis. That's not who they are. It's a diagnosis, which again for most people

  • is not a cure, so how are we going to function with it and have fun doing it?

  • >>Well thank you both. We have a special treat and you're going to close with a song for

  • us. But before we get there, I'm going to close with some resources.

  • To find a music therapist near you, visit the American Music Therapy Association at

  • www.musictherapy.org.

  • "Musical Minds" is a one-hour NOVA documentary on music therapy produced in 2009 by Ryan

  • Murdock. You can learn more about the piece at www.pbs.org.

  • To learn more about how rap therapy is being used for youth and other segments of the population,

  • view a previous episode of Mental Health Matters at www.youtube.com/user/peerstv.

  • So now we're going to listen to "His Eye is on the Sparrow" performed by Paulette and

  • Michael.

  • >>The title of our song is "His Eye is on the Sparrow." And it's very important to me

  • because it tells me that God is always watching over me and knowing Him makes me happy.

  • I sing because I'm happy And I sing because I'm free

  • For His eye is on the sparrow And I know He watches me

  • And I sing because I'm happy And I sing because I'm free

  • For His eye is on the sparrow And I know He watches me

Hi, welcome to Mental Health Matters. I'm Shannon Eliot.

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