What “Playing Now” Looks Like in Telehealth

 

It’s overwhelming, right? Trying to take a craft steeped in interpersonal interaction that you’ve been honing for years and moving it to a screen in a matter of weeks — in the middle of a global pandemic, no less — where nothing feels solid and anxieties are high. It is a formidable challenge with high stakes. Telehealth music therapy services have provided both a puzzle and a sense of relief for the West Music Music Therapy team during this season of uncertainty. It has forced us out of our traditional patterns of thinking and led us to problem-solve and implement new practices. It is a constant exercise in ingenuity for us and for those who use our services.

 

Some of clients are ready to jump right in with our changes, while some take a little more convincing. Some have a personal collection of instruments, others have none. Some have great technology skills, and some struggle with technology. Creating meaningful musical interactions in this environment takes some extra resourcefulness and flexibility, but luckily, that’s what we’re trained for! This universal challenge is expanding our skill sets and making us more versatile clinicians in the current climate and for when in-person services resume in the future. In many ways, we feel like infant music therapists — which is weird, but also kind of cool.

As people who are used to daily connections with many groups and individuals, it can be jarring to suddenly interact only with members of our households for days and weeks at a time. Similarly, our clients are facing immense amounts of isolation, loss of routine, and confusion. They, too, are confined to their homes without visitors, outings, work, or school. Therefore, interpersonal interaction with a music therapist from the “outside world”, even while on a screen and not in person, can provide a bright spot in a downcast day. Our relationships with clients are really the biggest tool in successfully doing what we do, and we can continue to strengthen those relationships by providing telehealth services https://musictherapy.westmusic.com/. It will be interesting when we conduct sessions with clients haven’t previously met.

 

Once we figured out the technical side of things (the most important piece seems to be adequate internet speeds with at least 15 Mbps download and 5 Mbps upload speed, or the picture and sound can get a little dicey), planning the remote sessions required a lot more work than planning pre-COVID sessions, but the planning has seemed to pay off, because things have gone pretty well. We don’t know yet if that’s the learning curve evening out, or a reality of offering remote services. In some ways, we all feel limited in what we can do. Interventions can’t be done the same way they used to, and it’s not so easy to “read the room” and improvise nearly as well via video. Still, in other ways, it might be an even better option. For example, we need the staff, parents, and caregivers to be involved in this therapy. This can be a challenge, but also a real boon when everyone comes together. A client who is typically quite distracted may now seem somehow more engaged when seeing their therapist on-screen. On the other hand, we had someone else fall asleep during a session, leaving the therapist looking at a ceiling.

It’s now become important to consider ways to address client goals that won’t involve instruments or props, particularly because not everyone has these things. Some successful options we’ve trialed have included singing and lyric games, body percussion, and movement to music, and occasionally we’ve been lucky enough that someone has had maracas or bongos to use.

With a little pre-planning and creativity, anyone can create an instrument from things around the house! Pots and a spoon become a drum. Chopsticks become rhythm sticks. Maybe someone wants a fun family project and they can be encouraged to look at online tutorials for paper plate tambourines, plastic egg or rice shakers, and coffee can drums. There are even instructions for homemade ocean drums and bottle cap castanets! If someone does have a desire to purchase real instruments, shakers, tambourines, frame drums, and Boomwhackers provide a variety of options. Access to just one of these (or a makeshift version) makes planning just a little bit easier as it provides a wider range of activities that can be used to address an individual’s goals.

It is important to keep these things in mind as we continue to expand telehealth services. Telehealth can be challenging and requires creativity and flexibility, but we do not need to be perfect or polished in order to make a difference in the lives of others. Sometimes all we need to do is show up, be authentic, and do our best. Seeing a bright smile on the other side of a screen, singing a favorite song together, or simply laughing about the absurdity of the situation can have a significant positive impact on us all.