In reading the article, A Consumer-Directed and Partnered Community Mental Health Music Therapy Program: Program Development and Evaluation by Sue Baines, it reminded me of a recent position I held at an adult and geriatric psychiatric hospital in the Southeast of the United States of America. I believe that the community-based program described by Baines (2003) also may be utilized with mental health consumers who are hospitalized. It could assist in the transition consumers have when they are discharged from the hospital and return to the community. During my tenure as music therapist at this hospital, I noticed a shift from the medical model of treatment to a more consumer-directed model with similarities to concepts described by Baines.
This shift in thinking was led by the U.S. Governments Consensus on Mental Health Recovery (U.S. Department of Health and Human Services, n.d.). There are ten equal components of Recovery: Self-Directed, Individualized and Person Centered, Empowerment, Holistic, Non-Linear, Strengths-Based, Peer Support, Respect, Responsibility and Hope. Clinicians that utilized this Recovery Model should strive to incorporate each of these components into treatment plans and programs for their consumers (clients).
In 2004, treatment providers, consumers, family members and other experts in the mental health field came together to form this national consensus on mental health recovery. From this meeting, a statement of recovery was initiated which stated, "Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential" (U.S. Department of Health and Human Services, n.d., p. 1).
The program described by Baines (2003) fits this definition. It is a strong template for music therapists working with this population either in hospitals or in the community within the Recovery Model. Baines’ program utilizes components of this model that are stressed in today’s mental health facilities. One of the main focuses of the Recovery Model is to empower consumers and give them the ability to direct their treatment alongside their treatment providers. This is achieved in Baines’ music therapy program. The group is an open group, which allows for a consumer to decide whether he or she wishes to join. It also allows a consumer the freedom to leave the group during the sessions by his or her choosing. Thus, the music therapist is giving the consumer the ability to "self-direct" treatment within his or her world of scheduled medications, labs and other treatments regimens.
Music therapists that listen to the requests of their consumers allow attendees of the group to feel empowered to share songs of great personal significance, express their feelings and participate in talent shows that illustrate the consumer’s strengths (strengths-based). The atmosphere is one of respect between the consumers and the therapist.
While working as a music therapist in a psychiatric hospital and witnessing the transition to the Recovery Model approach, I began to incorporate this model into my music therapy groups. Previously the wide range of diagnoses and abilities of the consumers had often led to arguments and low participation by some group members; however, by shifting to a more consumer-led focus, the group began to work well together and negative behaviors decreased. There was a simultaneous shift in the group process. Consumers who were normally quiet and reserved began to request songs and have an increase in socialization. Others who had difficulty interacting with peers and had more severe psychotic symptoms were assisted and encouraged by their peers to participate. By empowering others, they began to take leadership in the group and utilize their strengths through planning special events and concerts for their peers as well as leading games during the music therapy group.
There was a community and hospital-wide initiative to incorporate the Recovery Model into all aspects of care at the hospital. Committees were formed to assist with this transition, which included visits from the state Office of the Inspector General (OIG), to ensure that each employee of the hospital was utilizing the Recovery Model during treatment groups.
Music therapists are utilizing the components of the Recovery Model everyday in their work; however, they may not be familiar with the correct terminology as it applies to mental health treatment. Music therapists working with consumers of mental health services should actively incorporate the Recovery Model terms into their interventions with their consumers, as well as utilize consumer-based treatments.
Baines, S. (2003). A consumer-directed and partnered community mental health music therapy program: Program development and evaluation. Voices: A World Forum for Music Therapy. Retrieved March 12, 2009, from https://normt.uib.no/index.php/voices/article/view/137/113.
U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (n.d.). National consensus statement on mental health recovery. Retrieved March 15, 2009, from http://mentalhealth.samhsa.gov/publications/allpubs/sma05-4129/