Music Therapy Offers Tools for an Interdisciplinary Approach to Care for Youth Mental Health
Suicide is a leading cause of death for adolescents, making it a public health crisis. Organizations are rightfully trying to address this issue. One of the top goals of the United Nations (n.d.) aims to “reduce … premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” UNICEF (2021) urgently calls for more data on the mental health needs of youth because “the true burden … could be more dire than estimates suggest.” Although goals and data are undeniably necessary, we cannot wait to address the mental health needs of our clients in Family Life Education (FLE) practice. Dr. Carl Fleisher encourages adults to initiate conversations with adolescents to keep communication lines open (UCLA Health, 2022). However, adults with the best intentions often find that these conversations are difficult to navigate. This is where Certified Family Life Educators (CFLEs) can offer effective solutions to today’s mental health crisis using an interdisciplinary approach.
Mental health practices include how clients gain awareness and education, care for their physical health, regulate their emotions, build resilience, work through thinking errors, meet the needs of belonging and positive self-esteem, and cope with environmental demands. Mental health factors such as mental flexibility, problem-solving skills, communication skills, and other conditions contribute to these practices.
How Not to Cross the Proverbial Line Into Therapy
Interdisciplinary work provides families with unique, effective, and respectful practices to assess and attend to their mental health. Because both CFLEs and Family Life Coaches (FLCs) are trained not to cross the line into treating mental illness (unless we are qualified and licensed), we too easily believe we cannot address mental health. However, mental health is a dynamic component of well-being, which is a huge part of our training. CFLEs and FLCs are underused professionals that can precede higher cost services, such as diagnostic and treatment services (Rotheram-Borus et al., 2018). Because CFLEs and FLCs are trained to “[create] positive change, enhance familial well-being, and foster the development of family life” (Allen, 2017, p. 16), they can be powerful resources in providing mental health services for early intervention, prevention, maintenance, and mitigation of risks. Our proactive approach can constructively guide our clients toward assessing and attending to their own mental health practices to enhance protective factors that contribute to and promote their health and well-being (Children’s Bureau, 2020). It is essential for CFLEs and FLCs to know that mental health is not the absence of disease, nor is it consistent happiness. A definition of mental health is
a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one's own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium. (Galderisi et al., 2015, pp. 231–232, emphasis added)
Motivational Principles of Music Therapy as Part of the Interdisciplinary Work
Among other creative arts therapies, the National Center for Complementary and Integrative Health (2021) lists music therapy as one of the complementary and integrative health medicines. It is an evidence-based practice with high potential for continued family sciences research (Jacobsen et al., 2022). Traditionally, music therapy is a prescribed treatment to address social, cognitive, emotional, physical, and spiritual needs in clinical settings (Halverson-Ramos et al., 2019). However, there are natural motivational principles of music that elicit positive responses outside of clinical settings.
To begin using music as a tool in nonclinical Family Science work, we suggest first determining whether music is motivating to clients by listening to them closely. Does the client talk about experiences with music such as how it makes them feel? Do their social interactions include dancing or playing in a band? Do they use music while getting ready, exercising, or cleaning? If a client points to music as a motivator, music-focused interactions may be beneficial to them in caring for mental health. The following paragraphs offer glimpses into how CFLEs and FLCs can use the motivational principles of music therapy.
Music Provides a Nonthreatening Space to Learn and Practice Awareness and Mindfulness
The first step to learning any skill that is beneficial for mental health care is awareness. Awareness is required for acceptance, respect, flexibility, and humor, but it takes practice. Through music, clients can practice expression, process feelings, feel validation, and challenge their thinking errors to gain awareness. When clients struggle with awareness of their needs or feelings, we suggest they take a mental musical break. Any kind of music and/or movement intervention that facilitates relaxation and produces positive energy can foster awareness of their feelings and thoughts. Awareness of feelings is key in reducing anxiety, and this is where music can offer a powerful tool. Music can assist in developing awareness by analyzing lyrics of the client’s own work or recorded music. We can use music to guide practice for mindfulness and relaxation techniques such as breath training, progressive relaxation, and body awareness/scanning. In addition, caregivers and youth can use music-supported guided imagery as a great way to develop an awareness of desires and visualize the future.
Music Provides a Nonthreatening Space to Practice Connection That Can Improve Quality of Life
Connection is a foundational human need that makes rapport a driving factor in the client’s success. Music topics can be used to develop rapport and help clients feel supported. Also, familiar background music provides a welcoming ambiance. Family connection can also be encouraged through Songs of Care that support bonding and attachment within families throughout the lifespan. Songs of Care are shared experiences across cultures and generations for soothing purposes, such as lullabies, favorite musicians, and music that evokes shared emotional responses and memories. In addition, we guide caregivers to bond with their children by practicing healthy, responsive, and authoritative parenting during music-based activities. Singing or “belting out” lyrics can facilitate connection through validation in difficult moments or transitions and may give both caregivers and youth feelings of support. To encourage connection, social skills, and reminiscence, we recommend that family members engage in improvisational activities such as drum circles and games such as “name that tune,” musical chairs, sing-a-longs, and “fill-in-the-blank” activities.
Music Offers Cues for Activities of Daily Living, Daily Family Functions, and Memorization
Support for daily functions and memory helps build feelings of self-worth, self-efficacy, and trust, which are all vital to mental health. Families can be encouraged to understand the value of music as a cue for behaviors and memory. Families can find, develop, and use music to support their daily functions and provide motivation for the completion of tasks. For example, listening to the Carwash theme song (“Working at the carwash, yeah”) as a cleaning song may energize youth to get their work done faster and, ideally, with fewer complaints. Singing or playing recorded music for a specified time as if it was a timer is a great tool for time management. Songs such as “Monday, Monday” by the Mamas and the Papas on Monday mornings might be helpful in getting through the morning and off to work and school. Likewise, music may support the memorization of educational concepts such as multiplication tables or steps involved in an activity like setting the table.
Coming Together
Our mental health and well-being are strongly interconnected and are part of what makes us human. We hope to instill confidence in those who engage in interdisciplinary work and to be a preliminary mental health resource for youth and caregivers by using music as a resource and contributing to the prevention of deaths by suicide. CFLEs and FLCs can leverage music as a safe catalyst for lasting positive changes while guiding families toward managing their mental health without crossing that proverbial line into treatment—aka therapy. The motivational principles of music therapy give nonclinical family science professionals methods to elicit awareness, create connection, and guide daily function and to empower, enrich, and guide families toward their unique and dynamic needs for mental health equilibrium. To consult or collaborate with a music therapist, or to refer a client for MT services, locate a music therapist through the American Music Therapy Association at https://www.musictherapy.org/.
*Please be aware of ethical and possible legal concerns referring to the use of music in Family Science work as “music therapy.” Music therapists are unique in their work because they are trained in musical and psychological behaviors and processes that facilitate change that carries over to nonmusical settings. Music therapists’ training involves a 4-year undergraduate degree (or an approved equivalency), a full-time 6-month internship, and a passing score on the Certification Board for Music Therapists Board Certification Examination. They are proficient and effective at observing clients’ behaviors, completing assessments, preparing implementation plans, facilitating growth and change, documenting progress, continuing assessments, and providing appropriate termination procedures.
References
Allen, K. (2016). Theory, research, and practical guidelines for family life coaching. Springer International.
Children’s Bureau. (2020). National Child Abuse Prevention Month. Child Welfare Information Gateway. https://www.childwelfare.gov/topics/preventing/promoting/protectfactors…;
Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., & Sartorius, N. (2015) Toward a new definition of mental health. World Psychiatry 14(2), 231–233. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471980/
Halverson-Ramos, F., Breyfogle, S., Brinkman, T., Hannan, A., Hyatt, C., Horowitz, S., Martin, T., Masko, M., Newman, J., Sehr, A. (2019). Music therapy in child and adolescent behavioral health. American Music Therapy Association, Inc. https://www.musictherapy.org/
Jacobsen, S. L., Gattino, G., Holck, U., Ørnholt Bøtker, J. (2022). Music, families and interaction (MUFASA): A protocol article for an RCT study. BMC Psychology, 10(1), 252. https://doi.org/10.1186/s40359-022-00957-8
National Center for Complementary and Integrative Health. (2021, April). Complementary, alternative, or integrative health: What’s in a name? https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name
Rotheram-Borus, M. J., Swendeman, D., Rotheram-Fuller, E., & Youssef, M. K. (2018). Family Coaching as a delivery modality for evidence-based prevention programs. Clinical Child Psychology and Psychiatry, 23(1), 96–109. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858574/
UCLA Health. (2022). Suicide rate highest among teens and young adults. UCLA Health System. https://www.uclahealth.org/news/suicide-rate-highest-among-teens-and-young-adults
UNICEF. (2021). Adolescent mental health statistics. UNICEF DATA: Monitoring the situation of children and women. https://data.unicef.org/topic/child-health/mental-health/
United Nations. (n.d.). Goal 3. Ensure healthy lives and promote well-being for all at all ages. Department of Economic and Social Affairs, Sustainable Development. https://sdgs.un.org/goals/goal3
Autumn H. Cano-Guin, Ph.D., BCC (she, her, hers), North Carolina 4-H Youth Development Program Design & Evaluation Specialist and Adjunct Assistant Professor, Agricultural & Human Sciences, North Carolina State University.
Tiffany Burnette, MT-BC, CFLE-P, BCC, owner/music therapist/coach, Rhythm & Cadence Family Services, LLC. E-mail: [email protected]