June 2014 e-Newsletter- Expressive Therapy: Using Creative Arts in Therapy
Katie Rotuno, MT-BC and Bethany Squires, MT-BC
A well-respected music therapist, Dr. Kenneth Bruscia, alleges that music therapy is “a systematic process of intervention wherein the therapist helps the client to promote health, using music experiences and the relationships that develop through them as dynamic forces of change.”1 In the same way, author, Jodi Picoult states "Music therapy, to me, is music performance without the ego. It’s not about entertainment as much as it is about empathizing.”2
When defining music therapy, it important to provide some examples of therapeutic music, which are noteworthy, but not structured clinical music therapy. Examples include a person with Alzheimer's listening to an iPod of his/her favorite songs, groups such as Bedside Musicians, Musicians on Call, Music Practitioners, Sound Healers, and Music Thanatologists, a piano player in the lobby of a hospital, a choir or group of entertainers performing music at a hospital, or nurses playing background music for patients by their bedside.
When introducing the concept of organized music therapy to a group of patients, as music therapists, we will often say that music therapy is a place where they can safely express themselves and process emotion, using music as the medium for doing so. Working within the music allows us to connect with a deeper level of emotions, to express in a tangible, audible way beyond words.
Also, utilizing music experiences can help patients to cope with stress and anxiety, and to connect with others in a meaningful way. While from the outside, groups may often appear to be “fun”, music therapy group experiences may also elicit several emotions within a patient which require the knowledge and skill of a professional to help the patient to process these emotions in the most therapeutic way.
If you were to observe a music therapy session, there are many scenarios that you might see. Music therapy can include active music-making, such as singing or playing instruments, songwriting, or lyric analysis.
Depending on the population and the therapist’s own theoretical orientation, the approaches and techniques used can take a wide range of forms. For instance, a music therapist working in a school setting with children on the autism spectrum from a behavioral orientation will approach things in an entirely different way than a music therapist working within psychodynamic orientation at a psychiatric hospital. However, no matter the setting, music therapists are all seeking to support the client’s progression toward health and wellness as it aligns with their specific treatment goals.
To be a music therapist, a minimum of a bachelor’s degree or master’s equivalency in music therapy must be completed. Within each of these programs, students are required to finish a full-time, supervised six-month internship. In addition, training in music, psychology, music therapy specific classes, and supervised practicum’s are required. After graduating from an approved music therapy program, the therapist must pass a board certification exam. Once a therapist is board certified, they are required to complete continuing education to maintain their MT-BC credential. Some therapists opt to receive additional training such as masters or doctoral degrees in music therapy, or in specific approaches to music therapy such as vocal psychotherapy, and guided imagery (depth/psychoanalytical approaches), or Nordoff-Robbins music therapy (humanistic/existential approach).
At Linden Oaks, music therapy plays an active role within the patient’s treatment team in supporting the patient’s recovery. By utilizing music therapy experiences, through the client-therapist relationship, we intend to create a safe space for patient’s to take steps in approaching and exploring positive ways to cope with their illness, intense emotions, and memories. We look to address non-musical goals all while tapping into each individual’s uniqueness and creativity. Music Therapy experiences may support the patients, providing a source of a “dynamic force of change”, potentially awakening hope in their lives, reinforcing a patients values, and assisting the patient in finding purpose and meaning throughout their recovery journey.
For more information on Linden Oaks at Edward’s music therapy program, contact us at email@example.com. If you are interested in music therapy classes that are open to the public, contact firstname.lastname@example.org.
- Bruscia, Kenneth. Defining Music Therapy. Barcelona Publishers. 1998. Print
- Picoult, Jodi. Sing You Home. Atria Books. 2011. Print.
Katie Rotuno, MT-BC - Upon leaving her musical theatre roots to pursue a service-related career, Katie received her a Bachelor of Music in Music Therapy from Baldwin Wallace University in Berea, Ohio. Her primary experience is in psychiatric music therapy, previously providing services in mental health settings in Ohio, Texas, and Washington, and she is currently practicing in Illinois. Katie is currently working towards her Master of Arts in Music Therapy at Saint Mary of the Woods College in Indiana.
Bethany Squires, MT-BC - Bethany graduated from Indiana-Purdue University- Fort Wayne with a Bachelor's of Science in Music Therapy after completing an internship at Park Nicollet Health Services in Minneapolis, MN. After graduating she worked as a music therapist in private practice, serving clients with developmental disabilities in a variety of settings before joining the rehab/expressive therapy team at Linden Oaks at Edward.
Art Therapy: Recovery and Research
Mindy Rushford, LCPC, ATR
What is Art Therapy?
The American Art Therapy Association defines art therapy as “a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem.”1 However, upon entering art therapy groups at Linden Oaks, patients are simply told art therapy is a place to get out whatever they’re feeling. Art therapy is never an art class, not a place to judge other’s work, or a place only “artists” can express their emotions. For some, in the darkest time of their lives, walking into a room with choices (paint, chalk, oil pastels, markers, etc.) can provide a much-needed sense of freedom. To others art therapy is a place to connect with peers, a safe place to purge negative thoughts, and a place to feel humanity restored.
Art Therapy and Recovery
Bruce Moon, Art Therapist, describes an art therapy group’s effectiveness in a concise list. He explains how an art therapy group provides a safe place to express tough emotions that may be difficult to verbalize. According to Moon, creating art with others also instills a sense of hope, reduces isolation, creates a sense of community, empowers, and creates a shared experience.2
At Linden Oaks at Edward we also seamlessly weave Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) into art therapy. For example, we practice emotional regulation by creating art regarding all negative thoughts, ripping up the paper, and using the pieces to create something beautiful. Art therapy is both a beacon of hope and an anchor of stability at Linden Oaks.
Latest Art Therapy Research
There has been recent discussion regarding neurobiology, trauma and art therapy. Gantt and Tinnin suggest there are three paths that support trauma is a non-verbal problem: brain imagery studies of human responses to trauma cues, evolutionary survival response, and the relation between inability to express emotions and post traumatic dissociation.3 They suggest “art therapy is effective for trauma survivors not because it bypasses defenses but because it provides a path where none existed previously.”3
Art Therapy at Linden Oaks at Edward
We have six art therapists currently working in the Linden Oaks inpatient and outpatient locations (Naperville, Plainfield, and St. Charles) in the following programs: adult, adolescent, geriatric, special intensity, self-injury, chemical dependency, and eating disorders. We also have a new after-school Intensive Outpatient Program at Mill Street, the Success Program, which combines DBT and art therapy. Patients are able to learn DBT skills through art experiential activities.
This summer we are also offering art therapy wellness workshops. The Art as Therapy Workshops are for teens and adults. Community members are invited to create art alongside their peers with the support of an art therapist. In addition, the LGBTQ (Lesbian, Gay, Bisexual, Transgender and Questioning) Youth Identity and Support workshop combines peer support with music and art therapy.
For more information on Linden Oaks at Edward’s art therapy program, contact us at email@example.com. If you are interested in art therapy classes that are open to the public, contact firstname.lastname@example.org.
- American Art Therapy Association (2014, May 18th). http://www.arttherapy.org.
- Moon, B. (2010). Art-based group therapy theory and practice. Springfield: Charles C Thomas Publisher.
- Gantt, L. & Tinnin, L.W. (2009). Support for a neurobiological view of trauma with implications for art therapy. The Arts in Psychotherapy. 36, 148-15.
Mindy Rushford, LCPC, ATR - Mindy graduated cum laude with a Bachelor of Art and Psychology from Mac Murray College in Jacksonville, IL and a Master of Counseling: Art Therapy from Adler School of Professional Psychology in Chicago. She has worked as an art therapist at Linden Oaks at Edward for the last five years. She is also the program coordinator for a thriving team of 16 expressive therapists at Linden Oaks. In addition, she works as an adjunct professor at Adler School of Professional Psychology in the Master of Art Therapy program.
Occupational Therapy in Mental Health
Mike Fredrickson COTA/L, Linden Oaks at Edward
As an Occupational Therapy practitioner working in a mental health setting, one of my first priorities is explaining to clients and co-workers what Occupational Therapy is all about. As one might imagine most people relate occupation to jobs/working, so I get responses such as “are we going to talk about work?” or “I already have a job.” My first response is to define the word occupation in the context of occupational therapy (O.T.).
According to Webster’s Dictionary occupation is defined as “an activity in which one engages” and “the principal business of one’s life” or vocation.1 I describe occupations as activities we engage in daily as we live our lives, some are routine such as self-care/home care and others are more meaningful and purposeful such as work, hobbies or family/social activities.
The goal of O.T. is to help people that suffer from illness, injury, or have a disability to be able to participate in meaningful activities across their lifespan. The profession of occupational therapy is deeply rooted in recovery and holistic in nature.
In 2017, the O.T. profession will celebrate its centennial birthday. In 1917, injured soldiers returning from war needed rehabilitation so reconstruction aides were created to help with the overwhelming needs of the soldiers. These were the precursors to occupational therapists but the face of the profession has changed in the 21st century.
There are currently two levels of O.T. practitioners. A registered occupational therapist (OTR/L) is an entry-level master’s degree but, a doctor of philosophy (Ph.D.) and doctor of occupational therapy (OTD) are also offered. The technical level of O.T. is known as certified occupational therapy assistant (COTA/L). A COTA/L works with and under the supervision of an OTR/L. Both levels of O.T. must also complete several fieldwork internships after their coursework and in the state of Illinois are board certified and licensed. Some of settings that O.T.’s work in are school systems, hospitals, nursing homes, rehabilitation centers, work hardening, mental health hospitals, and community mental health centers.
The recovery model consists of 10 components: self directed, individualized and person centered, empowered, holistic, nonlinear, strength based, peer supported, respect, consumer responsibility, and hope.2 These fundamental recovery principles are in full alignment with the philosophy of occupational therapy practice, which is inherently client centered, collaborative, and focused on supporting resiliency, full participation, health promotion, and a wellness lifestyle.
Occupational therapy practitioners work collaboratively with people in a manner that helps to foster hope, motivation, and empowerment, as well as system change. Educated in the scientific understanding of neurophysiology, psychosocial development, activity and environmental analysis, and group dynamics, occupational therapy practitioners work to empower each individual to fully participate and be successful and satisfied in his or her self-selected occupations.3
The following are examples of how the knowledge and skill base of occupational therapy is used in the process of assisting individuals in all phases of mental health recovery:
- Teach and support the active use of coping strategies to help manage the effect of symptoms of illness on one’s life, including being more organized and able to engage in activities of choice.
- Help to identify and implement healthy habits, rituals, and routines to support a wellness lifestyle.
- Support the identification of personal values, needs, and goals to enable informed decision-making, such as when considering housing and employment options.
- Support the creation and use of a wellness recovery action plan in group or individual sessions.
- Provide information to increase awareness of community-based resources, such as peer-facilitated groups and other support options.
- Provide information on how to monitor physical health concerns (e.g., diabetes management, smoking cessation), develop strategies to control chronic symptoms, and recognize and respond to acute changes.
- Support the ability to engage in long-term planning (e.g., budget for major purchases, prepare advance medical and mental health directives) that leads to meeting personal recovery goals.3
For more information on Linden Oaks at Edward’s occupational therapy program, contact us at email@example.com. If you would like more information on occupational therapy, visit the American Occupational Therapy Association website: www.aota.org.
- Occupation. (2014). Retrieved May 4, 2014, from www.merriam-webster.com/dictionary/occupation.
- Substance Abuse and Mental Health Services Administration. (2005). National consensus on mental health recovery. Retrieved January 4, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/SMA05-4129/
- The American Occupational Therapy Association Fact Sheet Occupational Therapy’s Role in Mental Health Recovery. (2011). Retrieved May 4, 2014, from www.aota.org.
Mike Fredrickson, COTA/L, AAS - Mike has worked for Linden Oaks at Edward since 2004 and is the Animal Assisted Therapy and Volunteer Services Coordinator. He is an occupational therapy assistant and completed his degree at the College of DuPage. He is also an occupational therapy fieldwork educator.
Recreational Therapy/Therapeutic Recreation: What is it and how does it help?
Amber Konopa, CTRS, CADCa
Mayo School of Health Sciences states recreational therapists, also known as therapeutic recreation specialists, provide a wide variety of treatments and activities to “individuals with illnesses or disabling conditions to improve or maintain physical, mental and emotional well-being and help reduce depression, stress and anxiety”.1
The goal of recreational therapy is to restore or eliminate the effects of illness or disability. Recreation therapy patients are evaluated with information from standardized assessments, observations, medical records, and discussions with medical staff and family members as well as the individual.
Recreational therapists may instruct patients in relaxation techniques, stretching and limbering exercises, proper body mechanics for participation in recreation activities, and pacing/energy-conservation techniques. Additionally, therapists observe and document patients' participation, reactions and progress. Recreational therapists should not be confused with recreation workers, who organize recreational activities primarily for enjoyment.
Recreational Therapy is unique according to the American Therapeutic Recreation Association (ATRA) because “recreational therapists use recreational modalities for intervention strategies” The ATRA also says that “incorporating the client’s interests, and the client’s family and/or community makes the therapy process meaningful and relevant”.2 Recreational therapy is individualized to each person, their past, present and future interests and lifestyle. Recreational therapists weave the concept of healthy living into the treatment to ensure not only improved functioning, but also to enhance independence and successful involvement in all aspects of life.
The recreational therapists at Linden Oaks lead groups of all ages including adolescents and geriatrics. Groups may focus on social skills, leisure education, emotional self-regulation, wellness, life skills, stress management, assertiveness training, coping skills, experiential, team-building, and healthy relationships. Some other aspects of a recreational therapist’s job are community re-entry trips, fitness, gardening group, reminiscence, sensory stimulation, and self-expression/self-awareness instruction.
The ATRA alleges that patients involved in recreation programs have positive health benefits from participation.2 Evidenced based outcomes are critical for recreational therapy as a health care provider. Specific health outcomes of recreational therapy interventions have been increased health, psychosocial position, mental wellness status, life perception, and in recreational and community activities.2
For more information on Linden Oaks at Edward’s recreational therapy program, contact us at firstname.lastname@example.org. If you are interested in recreational therapy classes that are open to the public, contact email@example.com.
- Recreation Therapy. (2014). Retrieved May 5, 2014, from www.mayo.edu/mshs/careers/recreational-therapy.
- FAQ About RT/TR. (2014). Retrieved May 5, 2014, from www.atra-online.com/what/FAQ.
Amber Konopa, CTRS, CADC - Amber graduated from Winona State University in Minnesota with a Bachelor’s of Therapeutic Recreation degree and she completed an internship at prestigious Mayo Clinic. Amber has been at Linden Oaks at Edward for nine years and is currently finishing her Master’s of Clinical Psychology degree at Benedictine University.