The outbreak of Covid-19 pushed us to do a lot of things differently. A lot of families are pleasantly surprised by how quickly they adapted to receiving online inputs. In fact, some have said that online Music Therapy has been their 'lifeline', and others considered that it the highlight of the week. Is online Music Therapy here to stay? Can it replace in person Music Therapy all together? Let's take a look at its benefits and challenges, as well as how we may work around these challenges creatively.
Benefits of online Music Therapy
Since the beginning of the lockdown, I've been offering online Music Therapy sessions to both new clients and clients I've been working with before the lockdown. While it is undeniably different from having sessions in person, online sessions have worked better than I anticipated. Here are some benefits I have discovered in the last couple of months:
1. More time effective and more convenient
With online Music Therapy, travelling time and remote locations are no longer restrictions to our work. Clients based in remote areas who are previously placed on the waiting list are now accessing online Music Therapy. In addition, I now use the time I'd normally be commuting on creating resources to support my clients between each session. For instance, some families I work with now receive pre-recorded musical materials that parents can use to facilitate daily Neurologic Music Therapy inspired training for their children until our next session.
2. Compatible with clients with immunosuppression
I can recall so many occasions before the outbreak where my clients could not receive Music Therapy sessions in person after medical procedures or following a decline of their health. Unfortunately, children can feel particularly isolated in such situations and that could be the time they needed support the most. Online Music Therapy allows us to have continuity in our therapeutic relationship, which is invaluable for children who have already experienced so many social changes within a short span of time.
3. Engage clients who normally find social interaction stressful
Online Music Therapy can be a good 'way in' for children with social anxiety and for those who are protective of their personal space. In fact, a study shows that young people with impaired social skills can engage just as well during online sessions and can display an increase in positive social interactions comparing to having sessions in person (1). Some of my young clients reported that they feel a greater sense of control when engaging online. Even though my clients very rarely choose to mute themselves or to turn off their video, having the options seemed to be reassuring for them and have encouraged them to share their thoughts more freely within our sessions.
4. Model safe use of online resources for children and adolescents
Children born in the last two decades are true digital natives. Music Therapist Derrington observed that for some young people she worked with, 'the virtual world was as important as the real world' (2). However, research shows that children are not naturally 'savvy' to using the internet safely (3). Online Music Therapy provides children an opportunity to engage with online communications in a secure environment, where the therapists can model safe use of virtual meeting programmes.
Challenges and how to work around them
While doing everything online have become the norm for many of us, there are definitely challenges of having Music Therapy online. For instance, I really miss being able to have play music with my clients in the same room! Here are some challenges I've had to work around when offering online sessions:
1. Internet connections
We've all been there! It's frustrating and sometimes baffling. Fortunately, usually asking our electronic devices nicely and restarting our calls can fix the problem. With an increasing demand in secure video conference platform, I am hopeful that these programmes will continue to improve.
2. Finding new ways of having a shared musical experience
Unlike other medium, music-making is highly dependant on time. Improvising and singing together online has proven to be very challenging because of the time lag. From my point of view, the experiential aspect of creating music 'in synch' in person is truly irreplaceable. With that said, my clients and I have been discovering new ways of making music together online. For children in early developmental stages, we have used turn-taking, virtual conducting and songs with call and response structure more often. For older children with significant executive functions, using apps like GarageBand to create soundtracks, improvising while the other person listens and analysing lyrics of favourite songs all seem to be effective ways of emotional expression in our sessions.
3. Discovering new ways of communicating effectively
Clients who struggle with comprehension of short sentences in person have found it even more difficult to understand my verbal cues from the audio output of their device. Our ways of communicating non-verbally online are limited as well. It is much harder to observe each other's eye contact, body movement and physical distance through a little screen. In response, I noticed that both my clients and I naturally used bodily gesture a lot more to make up for the fact that we are not in the same room. Exaggerated facial expressions, using Makaton signs, and using the visual cards have been helpful in supporting my clients' communication and choice-making in our online sessions so far.
4. New safeguarding practice
Safeguarding children during online sessions is a whole new ball game comparing to in person sessions. Safeguarding policies are constantly updated to keep up with the updates of virtual meeting programmes. We as therapists do as much as we possibly can on our end, such as 'locking' our virtual meeting and frequently changing meeting links, to ensure our clients' safety. However, we are highly dependent on another responsible adult on the other end to keep children safe. For instance, parents are required to be present in the house during the sessions and must check in and out before and after the sessions.
5. More involvement from parents or carers is required
Apart from having to check in and out for safeguarding purposes, parents of pre-verbal children and children with limited mobility are required to stay throughout the session to support their children in choice-making and physical movements. What used to be a rest bite for a mother can become another 40 minutes of providing intensive support for her child. Yet, from a therapeutic point of view, having 2 supportive adults in the sessions makes it easier for a child to witness demonstration of social skills. It also allows parents to witness their children's development in the sessions. It can also give parents some ideas on what activities to include on a daily basis in order to support specific developmental goals for their children.
What does it mean post-Covid?
Through necessity and opportunity, online Music Therapy has taken shape during the pandemic. While online Music Therapy may not be able to completely replace in person Music Therapy, it opens new possibilities for Music Therapists like myself and clients:
Online Music Therapy can be an alternative option for families who live in remote areas, families with members who are immunosuppressed and clients who may experience high social anxiety.
A more time effective model of providing Music Therapy partially through in person sessions and partially through online input supplemented with home programmes and additional online resources may be available.
More online Music Therapy tools and electronic music-making apps will be available for clients with different levels of developmental abilities and different therapeutic needs.
A more communal approach of creating music together virtually, such as virtual choirs and virtual music-sharing platform, may become a new way for us to connect with each other.
How have you and your families been adapting to online educational and therapeutic input? What are your views on online Music Therapy? Let us know what you think in the comments!
In the next blog post, we'll be looking at what music-making apps I've been using in online Music Therapy sessions with my young clients.
(1) Krout, R. and Baker, F (2009). 'Songwriting via Skype: An online Music Therapy intervention to enhance social skills in an adolescent diagnosed with Asperger's Syndrome', British Journal of Music Therapy, 23(2), pp.3-14.
(2) Derrington, P. (2010). '"What's the wifi-code here?": Connecting with adolescents in Music Therapy', Mcfrren K, Derrington P and Saarikallio S ed. Handbook of Music, Adolescents and Wellbeing, Oxford University Press. Oxford, p.172.
(3) Davies H.C. ,Halford S., Gibbins N. (2012) 'Digital natives? Investigating young people’s critical skills in evaluating web based information.' WebSci 2012, pp. 78-81.