Within the first few online therapy sessions, David knew he would have to find a different way to connect with his clients.
As a mental health therapist who practices Therapeutic Behavioral Services (TBS) for the Oakland-based Fred Finch Youth & Family Services, David’s job is to help young people throughout the east bay who have suffered from extreme trauma change aggressive, unsafe and self-harming behaviors. He works with them to develop coping skills and self-regulation techniques. But with the pandemic requiring a switch from in-person meetings to communications via video chat, therapy was not going well.
David was struggling to connect with his clients from the youngest, a 5-year-old to the oldest at 18. He knew he had to adapt his method.
As a musician himself, he understands firsthand the therapeutic benefits of music so he set about integrating music throughout his sessions, culminating in the introduction of software that allow his young clients to compose their own songs.
“With music, (my clients and I) are in an emotional space. They are able to express things they wouldn’t verbally,” David said. “It opens up an emotional door that the kids might not normally have access to. They are taking anger or other emotions that would turn into violence and instead, putting it into art.”
David’s clients are at risk of being removed from their homes, even placed in psychiatric hospitalization because of their behavior. Each of the young clients also has a primary therapist, who does long-term, conventional therapy, helping the young people process their trauma and understand how it has impacted them. But by design, TBS is short-term – from 90 days to a year – and intensive with therapists meeting with the youth and their family three to five times a week. The goal is to enable the youth to stay in their current placement.
With such a short time span to work with the young people and no end in sight to the pandemic, David couldn’t afford to lose precious time with his clients. To make online therapy effective with his young clients, David had to first address the communication problem. Surrounded by others in their households also under the pandemic lockdown, his clients were too embarrassed to talk openly. David researched music-assisted therapy and discovered online resources, including workbooks. He then individualized a workbook for each of his clients.
With a shared screen, David and his clients type into the worksheets online, which start with what could be described as musical icebreakers such as “a song that makes me feel alive,” or “a song that I never want to hear again.” These questions open up the clients, David says. From there, he may have the client consider the various elements of music (tempo, dynamics, melody, harmony, rhythm, instrumentation, theme, silence) and then consider their life as a song. It could then culminate in listening to or reading the lyrics of songs about change before considering what they would like to change about themselves and how they can make the change. The workbooks made a huge difference, David said. Now that they no longer had to
speak out loud, but could write instead, the young people were engaged again, participating in their recovery.
David also introduced music software for his clients to use. Integral to TBS is the reward part the session when the clients choose a fun activity after completing their directed therapy. Soundtrap is a virtual music studio, allowing youth to produce their own music. With a shared screen, the clients select loops, starting with the beat and then choosing the instruments (e.g. drums, bass, piano, trumpet). They take the selected loops and arrange them to their liking, laying them out, combining loops, until they have completed their song. David has three to four individual sessions with each of his four clients a week – in addition to family sessions – and more often than not, they choose Soundtrap as their reward. David isn’t surprised by that. Beside the fact that young people are inherently drawn to music, it’s a way for them to create something that they hold onto and value.
“These young people have a lot of self-esteem issues. They have had a history of trauma,” David said. “A lot of what I do is strength-based so when they can create something like this, they can take pride in it.”
For more information on our work at Fred Finch Youth & Family Services, check out our website www.fredfinch.org