Hello Music Lady: Have You Brought a New Instrument today? A Music Therapy Group for Children of Families in the UK Armed Forces

By Becky White

Introduction

A music therapist walks into a school carrying a sack full of percussion instruments and a guitar. She walks through a classroom; several children look up and shout, the music lady's here!

This was the regular opening scene for the group work that I undertook in September of 2007. I was employed by the local music service to go into the school and deliver one hour of music therapy.

The school was unusual since it was situated on a base for families in the UK armed forces. The families were in transition and waiting for housing. They often had problems such as family break-up and domestic problems. The children tended to stay at the school for up to six weeks only. A music therapist had previously worked at the school but had to leave because of family commitments. The therapist had run two groups for the course of a year. The head teacher had felt that the therapy had been beneficial and had provided emotional support for the children in difficult family situations and transitions. The school therefore asked for further music therapy input from the education authority, and I was employed for an hour a week. I decided to write this paper because of the unusual nature of the school, but also because of the changing population. All names have been changed to protect the confidentiality of the children and staff, and permission to write this article has been obtained from the school governors and head teacher.

Running the Group

There were several key factors that contributed to the running of the group:

1. The outer framework of the group.
2. Reflecting the nature of the school.
3. Providing a consistent predictable musical framework.
4. Focusing on the present moment.
5. Using a new instrument to encourage creativity.
6. Building good relationships with staff.
7. Finishing.

The Outer Framework

The work began with a single session group assessment with a 'Key Stage Two' class (age’s seven to eleven.) It was clear the work needed to be in a separate space from the class room. This was because the class room environment had specific rules for the children, whereas music therapy had different rules about when the children could make noise and move around. Also it needed to be in a quiet place without disturbance, a place that felt special and safe for the children. The head teacher was very supportive and provided the 'garden room', a room used for therapeutic story telling with beautiful displays on the walls. The head teacher also took into serious consideration who would act as an assistant during the therapy, and was aware that it needed to be someone who could switch between the two different approaches. Before the sessions started, I gave Mary (name changed) guidelines on working in music therapy and also talked about the approach.

I decided to begin the group for six children. The children were in the school for short periods of time (up to six weeks), coming and going quickly. I decided to run the group with six spaces, and then when a child left, another would take their place. The actual individuals were chosen in discussion between teaching staff and myself. It was often hard to decide since spaces were limited. The staff chose children they thought would benefit.

The teaching staff said that they particularly wanted more feedback from the sessions than they had received previously. I decided to use a written record of the sessions which I could also give to staff. This consisted of brief, simple observations on how the children had been (see Figure 1).

Figure 1. Example of written feedback and session record sheet.

I also changed the time of the sessions to coincide with the end of the school day. This meant that there was time after the therapy to give verbal feedback and also talk to staff informally. Finally, I also kept my own personal therapy notes, as a record.

All this preparation for the group work was key to creating a reflective space within the school. As I prepared for this clinical work I had in mind the article written by Julie Sutton (2002a). Sutton writes about the effort that goes into preparing a potential space for group work. The importance of preparation and thought is a key factor when setting up a group. I also thought about this preparation as creating an 'Outer FrameworkÂ’, which would support the group (Grogan & Knak, 2002).

The group work began with five children from 'Key Stage Two' and one younger boy. The children showed that they needed a place for emotional support, and a place to build up confidence through creativity. For example, an older and younger brother (Tom and Andrew) came to the group. The younger brother emulated the older. Both seemed troubled emotionally, both had difficulty listening and waiting their turn. They seemed to be looking for maternal attention from myself and Mary. Both presented as emotionally needy, and wanted lots of attention. We tried to provide an accepting safe environment for them to express their needs. They responded by quickly building up a relationship with us. The young brother often looked for mothering attention from Mary, and the older wanted to sit close next to me as I played the guitar. They clearly needed more than we could give them in this short series of group sessions. But we provided them with some experience of adults paying them close positive attention. The two boys were also highly enthusiastic about being given permission to be playful, and relished using the instruments, having a chance to be creative.

Reflecting the Nature of the School

Over the Christmas period I had some time to review how the work was going, and to think about any changes I could make. As the terms had developed I became more aware of the complex needs of some of the children. The nature of being part of a family in the armed forces meant that many of the children had to deal with parents who were over seas, some in war situations such as Iraq. The children lived with parents continually coming and going from home, sometimes with the constant movement of where the family was living. Many families were at the base because of break up and domestic problems.

Linnet McMahon (2000) writes about working with children who are in difficult family situations and have emotional and behavioural difficulties. She describes groups in schools run by social workers, play workers and occupational therapists focusing on the importance of play. I found this useful, in my thinking about the group, focusing my thoughts on the value of play and creativity to help improve self image and relationships. Julie Sutton (2002) writes about working as a music therapist in Northern Ireland, and how the trauma of living in a place of conflict can affect families and communities. Some of the children at the school lived with the knowledge that one of their parents was in a war zone. The difficulty of living with this was expressed in various ways such as emotional withdraw, playground games connected to war and challenging behaviours.

As well as emotional and social needs, some of the children had a diagnosis of special needs. As a therapist coming into the school for only one hour a week it was difficult to address these complex needs. How to provide benefit for these children in music therapy, in such a short time was a question that dominated my thoughts throughout the remainder of this work. For example, it had been difficult to give sufficient time to each child. I changed the group size from six to four. This was done in consultation with staff, who agreed to choose four children instead of six. Over the Christmas holidays only one child I had seen remained in the school and so three new children were chosen. This made a huge difference in how much time each child received during the therapy. I also continued to operate the group as an open group with a changing population. Through having this structure I was almost creating a microcosm of the school, reflecting the nature of the school in music therapy. Perhaps this is always an important factor when creating a group within a school?

Providing a Consistent Musical Framework

During term three I decided instead of changing the music each week that having a music structure which was consistently the same would have a much better effect. The thinking behind this was the children's lives were in so much transition, to have 'Sameness' was really important. The school provided a stable, structured environment during times of huge uncertainty for the children. At the start of the new term in January, the structure I used in music therapy was the following:

1. Hello song, played on the guitar and sung, with a single instrument.
2. A 'Blues' played on the piano, using a bass line, children choose from the bag (see figure 2).
3. Goodbye song, sung after the children have packed the instruments away.

Figure 2. The bag of instruments.

Focusing on the Present Moment

Sometimes I only saw a child for one session, with little notice. This also reflected the experience of the staff at the school. Often children would come and go from the school very quickly. I began to understand that an important aspect of the group work was the need to focus on the children as they presented for that hour. Main (2006) writes about relating to others and how truly focused attention on another increases health and self actualization for that person. So my job as the music therapist was to be aware as possible of the children as individuals, who they were in their own right today, and what they were communicating. This way of thinking had an impact on the group, creating an atmosphere of acceptance and highly focused interest in the children.

Using a New Instrument to Encourage Creativity

Another key component of the group was the introduction of a 'New Instrument' at the start of every session. I had continued to use the basic structure described earlier. However, I used a different instrument every time to pass round during the hello song. The idea behind this was to contribute to the creative feel of the group with a 'Surprise Instrument'. The group of children attending in January seemed to relish this idea. Soon they were shouting at me as I entered the school, "Hello music lady, have you brought a new instrument today?" This became an important part of the therapy for these children. In bringing a new instrument it meant that I had thought about them the day before (when I packed the bag). It also communicated that they were special. I felt like a special aunty bringing presents for her nephew and nieces! Of the instruments that I took to the group two proved to be popular, a quarter size guitar and a Brazilian pandeiro (see figure 3).

Figure 3. Pandeiro and Guitar.

Building a Good Relationship with Staff

At the end of term three I arranged to do a short presentation on the work of music therapy to staff and the head of the school. The music service had requested this and also wanted me to explore the possibility of more hours at the school. I prepared a presentation with video and a short-hand out for staff. This helped staff to understand further the work of music therapy and it produced healthy discussion about the differences from the class room. Staff commented that they had found it difficult to understand at first what I was doing, but had started to see the benefit. They commented on the difference between giving the children a structured activity and a less structured music therapy session (in which the children moved around and made a lot of noise.) We agreed that there was benefit in both approaches for these children. Doing a presentation also showed staff that I was committed to communication and cared about working as a team.

Finishing

During term six the therapy group was coming to an end. I had decided that I would not continue to work at the school after July. This was because of the travelling and number of hours involved. It was a difficult decision to make since I very much enjoyed the work at the school and found it interesting. However, I lived a long distance from the school and was also only receiving one hourÂ’s paid work for what was taking three hours a week. The music service was confident it could employ another therapist in my place, so I made the decision to leave.

At the start of term six the four children in the group were Alan, Daisy, Karen and Jim. Alan (who had been in the school since term four) had a terribly traumatic background, his mother had recently attempted suicide and he had been witness to this. He presented as an intelligent young man, almost grown into a teenager. He had a mop of curly hair and talked in a very adult way. When he first came to music therapy he was very creative and played enthusiastically. However, his behaviour quickly changed. Within a few sessions he started to challenge me, and I felt he was testing me to see if I was really interested in him. Before session twenty seven he didn't want to come. In my notes I wrote about AlanÂ’s behaviour and possible feelings, "Saying he was rubbish at music on the way in, dragging his heels, interest gained by the accordion, but did not have a go, asking to have a go on the guitar, my guitar, saying he could play it, feeling very low (Alan)." (Music Therapy Personal Notes 21/5/08)

Alan was in real need of adult attention and support and he needed to know who he could trust in the school. I believe he understood music therapy to be a place where he could find some support but he had to test me out first. It was like he was asking if I was really serious about listening to him. Perhaps he thought that it would only be worth playing music if I paid him real focused attention. With this in mind I took all his suggestions seriously. I provided another guitar for him to use, letting him use my guitar pick. I also said it was 'OK' to just come and sit, and listen if he wanted to. Alan also tended to hang around at the end of the session, which I took to be a communication of his need of adult support. In my notes I wrote that the group had "A feeling of being together as a group, only a short time left." (Music Therapy Personal Notes 18/6/08)

As part of the finishing process, I used a chart showing the dates and names of everyone in the group. This included myself and staff who attended. At the start of each session I used the chart to discuss where everyone was going. All the children were going to different parts of the country, and this time allowed feelings and thoughts about this to be processed. In retrospect, it might have been useful to have a chart like this all the way through the work. I was also leaving and so was able to really identify with the children's feelings. I reminded the group each week of the fact we were finishing, and I had to keep this task in focus. For the therapist this can take a lot of energy, and is often a difficult task, especially when you are leaving yourself. During session thirty three the group agreed to sing goodbye to a member who had left the school during the week. It was a very poignant moment. I had composed a special goodbye song, just to use when the children left. It used C major and E minor chords at the end, to reflect the emotional content of the song, (See Figure 4.)

Figure 4. Goodbye song.

The group sang goodbye to Karen and then fell silent. Daisy stated, "That's hard to take." Suddenly there was a sad feeling in the room, and Daisy's comment summed up what everyone was feeling. Session thirty five was the final session and I wrote in my notes, "My feelings, sad, not really wanting to leave, guilty, feeling down." (Music Therapy personal notes 23/6/08)

The children communicated clearly that they did not want to leave school or music therapy. Alan joked about hiding in a cupboard and staying at school. Daisy just plainly said she did not want to leave. Jim showed some very silly behaviour in the last session, and found it hard to express his feelings. During the last session the head teacher came into the room. She walked in as the group was singing goodbye, so we included the teacher in the song. She brought in a gift for me, which marked the ending. In music therapy the children had used it to think through their situations and it had provided a valuable space for discussion and having their feelings recognised. The therapy finished at this point, both myself and the children were going to new schools, it was both an ending and beginning.

Conclusion

This group provided much-needed support to children going through times of transition and difficult domestic circumstances. The non-verbal nature of the music meant that the children could easily access the therapy. It provided a space for children to express their feelings and have focused attention from adults. The work also provided support to the school, in the form of an outside professional offering observations and a listening ear. Running this group had both challenges and joys. The setting demanded a lot of thought around how to set up music therapy. This one group took a lot of energy in preparation, execution and analysis. The work looked straightforward on paper but in reality was very demanding and challenging. I have tried to describe the various thought processes I went through in working at this school. I hope that it will be useful for other music therapists setting up therapy group works in schools.

References

Grogan, K. & Knak, D. (2002). A Children's Group: An Exploration of the Framework Necessary for Therapeutic Work. In A . Davies & E. Richards (Eds.), Music Therapy and Group Work (pp. 202-215). London: Jessica Kingsley Publishers.

Main, J. (2006). Word into silence: A Manual for Christian meditation. Canterbury: Canterbury Press.

McMahon, L. (2000). The Handbook of Play Therapy. (5th ed). London: Routledge.

Sutton, J. (2002a). Preparing a Potential Space for a Group of Children with Special Needs. In Davies, A. and Richards, E. (Eds.), Music Therapy and Group Work (pp. 188- 201). London: Jessica Kingsley Publishers.

Sutton, J. (2002b). Trauma in Context. In J. Sutton (Ed.), Music, Music Therapy and Trauma, International Perspectives (pp. 20-21). London: Jessica Kingsley Publishers.