Molloy College, a private liberal arts college in New York, founded by the Dominican sisters of Amityville, partnered with PRN (Physicians, Residents, Nurses) Relief International and the Dominican Sisters in Jamaica to organize a twice-annual service trip providing primary care, speech-language pathology, psychiatric-mental health care, and medical/surgical teams in rural and urban Jamaica. During the week-long trips, medical staff and speech pathologists move in teams from clinic to clinic, while mental health professionals, along with midwives and psychiatric nurses, work exclusively with the residents and staff at Homestead Place of Safety in Stony Hill, St. Andrew in the northern outskirts of Kingston, Jamaica. The state-operated facility, established as a home away from home, houses girls between the ages of 12 and 18 who experienced neglect or abuse, victimization, and sexual assault, or those in conflict with the law. Music Therapy services were included as part of the mental health team for the first time in October 2016 and provided an outlet for self-expression, an opportunity to foster resilience, a strengthened sense of community, and a supportive response to trauma. In past years, the mental health team found that the girls engaged freely in creative outlets such as art [therapy], and that music was an integral part of their culture and daily routine. Music therapy was therefore recommended to help normalize the therapeutic process, increase engagement, and develop therapeutic rapport.
The faculty and administration of Molloy College have recognized the value of Short-Term
International Health Missions (STIHMs), which allow for graduate students to immerse
themselves in another culture while accruing supervised clinical training in their
field. STIHMs support the college's Dominican tradition of community, service,
spirituality, and study. Through immersion, STIHMs increase students' cultural awareness
and awareness of social determinants of health in other countries (
In October 2016, music therapy services were provided for the first time as part of the mental health team at Homestead Place of Safety in Kingston, Jamaica, as an outlet for self-expression, an opportunity to foster a sense of community, and to support client response to trauma. I was honored to be the first music therapist on the team, along with one of our graduate music therapy students. Since that time, music therapy faculty/graduate student pairs from Molloy College have been an integral part of the interdisciplinary treatment team on an annual basis. Sessions incorporate group drumming and other improvisation, group singing and songwriting, active music listening and song discussion in addition to music mediated mindfulness, art, and journaling. Music therapy group sessions were scheduled twice each day during the five days at Homestead; we also cotreated in groups with the art therapist and social worker at least once each day in planned program time and had spontaneous sessions with individuals or small groups during occasional down time. We were able to share with them something sacred and deeply meaningful, while also light-hearted and fun.
“Homestead’s mission is to create a stable, supportive and nurturing environment for
girls who have experienced trauma in their lives by providing intervention and
rehabilitation” (
Jamaica is the third-largest island of the Greater Antilles in the Caribbean. The
tropical country is divided into 14 parishes with Kingston as its capital (
We were caught off guard by this at times—a mix of culture shock and ethnocentrism that left us wondering how our own biases might impact the work we were doing there. As a music therapist with a humanistic orientation, I consider myself to be non-judgmental, to employ unconditional positive regard and I felt that my work with the girls reflected that philosophy. I realized, however, when reflecting on our experience for the purposes of this article, I was expressing biases and perhaps subconscious judgment. My perspective was naturally clouded by my own life experiences—though vast and diverse—as a white middle-class American. My own childhood faced challenges with family health and stability, financial insecurity, and occasional antisemitism, yet there was always a close-knit community of friends and family, a set of loving arms, a roof over my head, clothes in the closet, and food on the table, which I took for granted. I had some assumptions that many of the girls had none of those comforts, yet I learned that was not entirely accurate. I was both envious of and surprised by the ability to live off the land surrounding Homestead, with varied interpretations of community and wealth. Jamaica is full of natural riches such as fruit and nut trees, and scenic beauty with beaches, rain forests, and mountains. It was heartwarming to see how the staff at Homestead took pride in sharing a meal with us that they had prepared from the natural resources surrounding them.
Nationalism in the Caribbean emerged in many ways, with music playing a vital role
in ideological cohesion and national identity. Song lyrics and musical rhythms helped
frame Jamaican independence and freedom from colonial rule, giving voice to a
collective identity (
Marley’s “Redemption Song” has served as an anthem of sorts, inspired by local
activism, providing a sense of unity and power with the message of emancipation
(
As we explored music with the girls, we became more and more aware of our own
expectations of what we might consider an appropriate expression or response. We were
startled now and then by their boisterous musicking. While navigating the echoing
acoustics and often other distractions in the main space at Homestead, we found
ourselves wondering why so many of the girls appeared to be yelling rather than
singing. Upon further reflection, we realized we were all singing loudly in large
part to help drown out everything else and focus on the music itself. We also
discovered that the girls were singing with such passion, with such intensity, with
such freedom, that the music provided them with an outlet beyond any other, and the
significance of the connection through their voices and their movements in the music
was palpable. It was not only appropriate, it was essential. I too felt liberated,
stepping out of my own boundaries and into music from my culture and theirs with new
feeling, new understanding. We were consistently inspired by their sudden use of the
chant and the theme song we introduced to them, a unifying and calming force, even
when sung at the same volume or intensity as other songs. Sutton (
While the people of Jamaica includes many ethnic groups, with the majority being of
European and African descent, English is Jamaica’s official language with variations
that include British English to Jamaican Creole, or Patois. According to Lewin (
Although I had worked with this general population (female survivors of domestic
violence or victims of sex crimes and teens with mental illness) in the past, I
experienced some culture shock as I oriented to the new environment: both the natural
surroundings of Jamaica and the Homestead facility itself. Levine and Adelman (
Stige (
Kohls (
An evolving, integrated system of learned behavior patterns that is characteristic of the members of any given society. Culture refers to the total way of life for a particular group of people. It includes what a group of people thinks, says, does and makes – its customs, language, material artifacts and shared systems of attitudes and feelings. Culture is learned and transmitted from generation to generation. (p. 17)
Kim (
The ability of practitioners to provide effective services to two or more culturally
diverse client populations is referred to as cross-cultural therapy (
For years, Jamaica has spent only 5% of its total health budget on mental health care
(
Derived from the Greek word for wound, trauma can be described as an emotional,
psychological and/or physiological shock that causes damage, pain, or suffering in
its lingering effects (
How trauma is perceived and addressed varies based on cultural norms, but the
current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes
trauma as witnessing or experiencing directly or vicariously an actual or threatened
death, serious injury, or sexual violence and includes a variety of stressors of
varying magnitudes, frequency, and duration (
Jamaica is a land rich in natural resources and we were working to foster resilience, to help the girls find their natural inner resources as well, so they could draw upon their own strengths in times of need. Many of the girls lived transient lives to some extent, moving from home to the streets or to foster care, sometimes running away, moving to Homestead, knowing this was just another stop along their journey. In our sessions where we sang and then discussed songs and analyzed lyrics about home, life, challenges, support systems, and future plans, some of the girls were vocal about their personal journey. They named family members who would be offering them a place to live, ideas of jobs or careers they wished to have, and the skills they would acquire to be successful. Some of that was happening already through their schooling and programs at Homestead. They were attending court appearances to clarify their next steps, either with parental support or acknowledging their separation into adulthood, welcoming support from their staff members and digging deep into their own desires to live differently than they had been. There was also talk of God providing them with strength and guidance.
Our theme for the week focused on this transitional time living at Homestead as an
opportunity for the girls to develop the tools they would need to move on,
emotionally and physically. Their ability to move forward would require resilience,
which takes time and intentionality. The cultivation of resilience can help in the
journey of recovery from past traumatic events. Resilience can be defined as “the
process of adapting well in the face of adversity, trauma, tragedy, threats, or even
significant sources of stress” (
The Caribbean Institute of Mental Health and Substance Abuse (CARIMENSA) explored
resilience, defined in part as “the manifestation of positive adaptation despite
significant life adversity” (
The residents of Homestead have benefitted over the years from similar services. Though continuity of care has been intermittent, donations and volunteerism have helped to fund a computer program, garden, cosmetology training, general schooling, and all the services we provided. Our mental health team, over the years, noted similar advantages for the girls in cultivating their strengths and promise for their future, thus expanding the team. Even though trips were cancelled now and then due to unrest or illness in the area, they were ultimately rescheduled. This was a source of motivation upon planning for the work—that not only could each day with the girls bring them joy and strength to that single day, but that our short time with them could provide ongoing motivation and inspiration to move forward in their lives. One of the songs we sang with them often was “Free to be Me” by Francesca Battistelli. It speaks of resilience and hope, belief in oneself, and finding one’s positive traits even among our “dents.” It speaks of support from others which could include therapists, teachers, friends, God, as well as music and support from within.
“As trauma is an experience of life, so is music” (
Originally a boy’s facility, Homestead’s consistent mission has been to create a
stable, supportive, and nurturing environment for those who have experienced trauma
in their lives. They work to achieve this by providing “intervention and
rehabilitation that will ultimately build resilience in the girls, and aid in their
socialization” (
My music therapy colleague who was on the team two years later shared that most of
their sessions were held outside at a different facility; the girls (some of whom I
had worked with as well) were in temporary housing due to renovations at Homestead.
According to the Jamaica Observer (
What struck me initially, when arriving at Homestead, was the large sign outside the
main gate reading Homestead Place of Safety. I did not expect the location for this
type of facility—a safe house—to be public. As a music therapy student many years
earlier, I did clinical training at a safe house in Ohio for women and their children
who had experienced domestic violence—the address was private and there was no sign
outside the house which I thought was typical, but was quite the opposite in this
situation. Homestead has also been written up in the Jamaica papers indicating its
purpose, location (exact address), and its flaws. "House of horrors: Children in need
of care and protection get culturized [sic] by the ones who are in conflict with the
law, and the ones who can't help themselves get beaten up by both sets" (
Homestead services “at-risk” teen girls, a global term describing youth who may be
in jeopardy due to school truancy, poverty, neglect or abuse, stigma surrounding
mental illness, lacking skills needed for employment, or other concerns leading to
challenges transitioning into adulthood. For the girls at Homestead, the most
prevalent risks seem to include all listed above, leading to significant challenges
transitioning to independence, perhaps due to lack of support at home or from family.
For a few of the girls, risk factors also included their pregnancy, with ongoing need
for both mental health care and medical care. Oversight at the facility is provided
by the Child Development Agency (CDA) and Centre for the Investigation of Sexual
Offenses and Sexual Abuse (CISOSA), yet sometimes the girls do not return safely from
school or court appearances. According to the staff on site, some of the girls
reportedly engage in or are forced into occasional sexual activity with offsite
neighbors. There is a men’s boxing gym across the street that, to me personally,
seemed potentially unsafe for the Homestead residents who go offsite. According to
Chevannes (
Due to challenges in their personal lives outside of Homestead and their limited freedom at the facility, the girls had not all experienced typical childhood play required to develop strong executive functioning and a prosocial brain. Barbed wire was all around the locked fencing surrounding the facility, in addition to a 24/7 security guard. Despite my previous work in inpatient and day treatment adolescent psychiatric settings, I was taken aback by the front entrance to the main building, the gates behind which the girls were locked throughout most of their day (Fig. 1 & 2). We were informed this was for their own protection and for liability purposes as the girls need to be accounted for each day. During a song discussion in a small group music therapy session one day, one of the girls (Sheela, introduced below) described herself as “living in a paradise and a war zone.” My initial thought was her environment: the locked gates leading to the worn yard with a broken basketball hoop and partial swing set, while also full of fruit trees, looking out over the barbed wire fencing to the glory of the Jamaica mountains (Fig. 3, 4 & 5). Reflecting further, working through my own cultural biases and cultural empathy, I recognized this polar extreme was truly a reflection of her current situation in transitional housing and personal experiences as an adolescent girl, navigating relationships and responsibilities in preparing for her future.
The Homestead House Gates
The Homestead House grounds
This is just a snapshot of some residents at Homestead and their involvement in music
therapy during our short time with them, and the descriptions below are naturally
colored by my personal perspective. “Because we observe client behaviour through our
world view, we often judge and/or attempt to explain their behaviour from our own
view” (
Sheela displayed aggressive behaviors and often appeared angry outside of music therapy sessions. She was observed attempting to throw a chair toward a peer one morning. The music then seemed to help her regulate and she became a strong, active member of the group. She participated in group singing and drumming followed by song discussion. Sheela described her life in and out of Homestead, her goals for the future, and shared the honest expression of living in a “paradise and a war zone.”
Celine really connected with us. She shared several fears with me and then with our team leader (psychiatrist) as encouraged. She also shared having been sexually abused and having a psychiatric diagnosis. Celine required meds but was no longer taking them reportedly due to lack of accessibility. Music therapy groups appeared to provide her with a sense of purpose, support, and comfort.
Serena (Fig. 6) had scars on both cheeks, reminiscent of a tear-streaked face. She usually wanted to help carry and set up instruments, loved drumming, and while she didn’t speak very much, she often began singing our chant or the theme song spontaneously, in times of calm and chaos. Going back and forth on her stomach on the stools with wheels in the beauty room seemed to ground her, and she kept moving even while remaining engaged in our group process. She appeared gentle with an aura of calm about her but was also quick to fight with the other girls, usually in attempts to intervene when others fought. During one of our team meetings, she looked in on us from outside eager to make positive connections.
“Serena”
Brooke was a leader; she was very connected to the treatment team and open to creative expression. Her participation in group naturally served as a model for the others.
Monica was quiet and reserved but surprised us by sharing a solo song during a group session. She also shared past suicidal ideations and appreciation for her strong connection to the arts as a way of healing.
Sam was bullied by others, “boxed” at night, as they described it, so she was not sleeping well and occasionally fell asleep during the day. She had been given a psychiatric diagnosis and presented with a variety of mental health concerns. She often approached the other girls with complaints about them, leading to social isolation. During our sessions, Sam engaged musically and requested to sing solos, which appeared to provide her with grounding, connection, and self-confidence.
Janet was eager to participate in music therapy each day. She was engaged in song writing, singing, and drumming. One of the leaders in a lyric rewrite for our theme song, Janet also recorded her voice singing it with my grad student accompanying (Video 1).
Jewel (Jane Doe, Fig. 7) did not speak, perhaps selectively mute due to trauma, but no one seemed to really know. We were uncertain of her level of cognition as her response to others and overall communication was somewhat limited. She used a combination of American Sign Language (ASL), her own signs/gestures, which may have been part of Jamaican Country Sign Language if she had ever lived in or with people from the south western parish of St. Elizabeth, and some Jamaican Sign Language (JSL, which was derived from ASL). She wrote her name on her nametag the first day, and then after calling her that, some of the girls said her name was Jane Doe—as labeled on her backpack. She apparently had been living in another facility previously, but it seemed her name was not known there either, as her files that followed her to Homestead were labeled like her backpack. I admit that stirred emotion in me, and I felt her connect with me daily through our mutual understanding of and communication through sign.
"Jane Doe”
Valerie was called Rambo by the other girls and described by them as “sick upstairs.” The team agreed she presented with psychotic behaviors. A few times she was seen throwing rocks at the outside of the beauty room while we were in session. Other times she briefly attended and engaged in the music, seeming connected to the group process for moments at a time.
Alexandra had a sweet smile, engaged musically with the group and sang with my grad student 1:1. However, she had very slow responses, the cause of which we were not sure—perhaps a developmental delay, shaken baby syndrome, and/or trauma related PTSD.
Grace just wanted to be with us. She was sweet and soft spoken, quietly participatory, gentle, and kind. She seemed drawn to the music and appeared to feel content in the space. She was present and quietly engaged in every music therapy session we offered.
Dana was filled with so much joy when she was drumming. One day the staff would not allow her to join the afternoon session because of some behaviors during lunch, so we worked with them to explain how this was therapy and not to be taken away as punishment. The next day she was able to participate and was once again filled with joy which lasted throughout the day and benefited everyone around her.
Each day began with a full group chant followed by deep breathing, stretching, and/or guided meditation with music. As a professional team we alternated leading and supporting the morning routine. The girls were then split into smaller groups to move between music therapy, art therapy, social work/journaling, and 1:1 time with the psychiatrist, psychiatric nurse, or midwife before and after lunch. We usually ended each day with a full group drum circle and song share, though the schedule did change throughout the week due to weather or other things that required groups to converge and resulted in more interdisciplinary work.
Given our differences and the newness of our relationships, I was inspired by the way the girls and the staff took to music therapy. They were open to sharing familiar music while also learning songs that were completely new to them. They took great pride in sharing music from their culture, often choosing to sing a solo or make a request during a group song session, and we were all pleasantly surprised whenever we discovered some mutual favorites, giving us common ground. We had also found popular American songs that had been recorded by Jamaican musicians, such as “Hello” by Adele re-recorded by Conkarah, a popular Reggae artist from Jamaica.
The music and the space we provided appeared to foster a sense of safety and community. The girls worked together cooperatively and cohesively to create drum rhythms, request songs, and rewrite lyrics. They redirected each other’s complaints or unkind words and even supported each other during emotional verbal processing of song lyrics relating to their own lives, fears, hopes, and dreams. While it was clear that music was a natural part of their daily lives in various ways, the Homestead staff became more and more involved with the girls in positive ways throughout the week, engaging in music with them and using a more conversational rather than confrontational tone of voice.
Drumming groups in the beauty room during music therapy
Singing helps to release endorphins that trigger a positive feeling in the body, reducing the perception of pain. In medical and rehabilitation settings, this often means a decreased need for morphine or other pain medications. At Homestead, it was apparent that singing, and music in general, provided mood elevation, a boost in self-esteem, and decreased anxiety leading to more positive interactions and motivation to engage. Through group singing and drumming, the girls also experienced a sense of belonging, cohesiveness, and teamwork as demonstrated by their cooperation and engagement within the musical space. Girls who could not sit beside each other during a meal, or had no previous positive interactions with one another in their typical day, were able to work together in music therapy during lyric analysis, drum circles, and song writing. Engaging collaboratively, their song writing became progressively more supportive and positive—from writing about being in a prison to an abandoned house to, finally, a “better place.” Our theme song, “The Time in Between” by Francesca Battistelli, was chosen to reflect the overall theme for the week and became a source of comfort for them. At any moment, especially quiet times and times with tension, the girls could be heard singing the original version or their rewritten one (Video 1; Fig. 11 and 12).
One of the girls (Janet) singing our small group rewrite of the theme song with my music therapy graduate student from Molloy College playing guitar. There is something so moving about the imperfection in this resident’s pitch and tone as she freely expressed herself through the song.
Lyric rewrite of theme song above the banner created in art therapy
Starting out the day with deep breathing and chanting a positive message (“Oh what a day, what a day we’re gonna have today!”) helped to set the tone for group work, and returning to the chant throughout the day served as a distraction from cursing at and intimidating each other. During the chant and other music experiences, fewer girls joined fights when one or two who were already disengaged became aggressive. Sheela, who described her life as a paradise and a war zone had, only 15 minutes before a session, been expressing anger and attempting to throw a chair. The music therapy group was about to begin, and once calmed as the music started, she engaged in powerful music making for the remainder of the day; she was even able to maintain control in session during a brief dispute with a peer. At times of chaos, some of the girls engaged in regulatory behaviors, such as thumb sucking. During music therapy, self-regulation appeared through musical engagement and reciprocal play with peers. With issues regarding self-esteem, self-worth, and poor body image, the girls often expressed themselves through anger with difficulty regulating. In one tense moment, I began singing “I am beautiful, I am beautiful and so are you!” to the tune of “Marching in the Light of God.” Without missing a beat, there were suddenly girls singing with me and/or drumming along. There was an immediate, clear boost in self-esteem, self-worth, and developing support of one another as evidenced by their positive changes in facial affect, vocal strength, and cohesive, spontaneous, and improvisational music making.
Later on, adding American Sign Language to the song provided the girls with a sense of accomplishment and was something they could help teach one another while demonstrating to us their pride in having learned something new. The manual language was also another form of self-expression, emanating from their natural draw to use their bodies as a vehicle for communication; the sign language allowed them to do so in a safe and responsive, meaningful way. Coupled with music, signs were easily learned, remembered, and shared. This combination provided an ease of self-expression and opportunity to connect more deeply with one another, especially with Jewel, who relied on sign language for her own expressive communication. Jewel remained engaged for longer than usual during this particular group session.
Cline (
Naturally moved to dance, the music therapy setting gave the girls a safe space without sexual connotation. Traditional dances in many cultures reflect ritual, sexual, and spiritual movements; in recent years, daggering has been seen in Caribbean dance halls, a style of dance also referred to as dry sex. Some of the girls had been involved in sex trafficking and some had experienced sexual abuse, so this opportunity to move freely and safely with trusted adults, if they chose to participate, may have been essential for their autonomy, self-image, and self-worth.
During one session, this led to a childhood playground game incorporating hand clapping with partners that fostered a sense of innocence and palpable glee. Our music therapy graduate student was invited into this play time, demonstrating a sense of trust and much needed nonthreatening companionship. It was a truly poignant moment. We were aware of and at times concerned about childish behaviors some of the girls resorted to in an effort to self-soothe, such as thumb sucking. While sucking one’s thumb can release stress and provide comfort, it can also lead to dental issues and stigma, or limitations related to emotional maturity. In contrast, this childhood game allowed the girls to find joy and empathy with peers in ways they may not otherwise have been able to due to their life experiences. The interactive, playful engagement provided a sense of community that could be replicated and help support them outside of Homestead.
Requests for songs such as “Lean on Me” led us to discuss with the girls who they could turn to in times of need and places where they felt protected. Answers included select staff and one or two other girls but primarily people and places outside of the Homestead gates, even outside of Jamaica altogether. Yet despite the lack of trust amongst the residents of Homestead, singing songs like this together provided—once again—a sense of belonging and acceptance. They were open to sharing and listening. A true sisterhood appeared, eliciting genuine smiles, eye contact, and even friendly affection.
Girls at Homestead after a music therapy session
The girls verbally expressed gratitude for the staff now and then, and were the occasional recipients of nurturing affection. However, the boundaries were not always clear. Homestead is understaffed although the staff on duty aim to fully meet the needs of the girls with regard to their nutrition, education, and socialization. Upon request, members of our team provided support and professional development to the staff almost daily during our time there, while the girls participated in group and individual therapy. There was deep appreciation expressed for the new perspectives and ideas shared.
Schrader and Wendland (
Together they had engaged in guided meditation, group singing, counseling, and were
grateful for the opportunity to learn how to more positively meet the needs of the girls
in their care. Music played a pivotal role in this change. With guidance from the music
therapy team, the mental health team leader (an accomplished Yale psychiatrist of
Jamaican origin) taught “Dona Nobis Pacem” to the staff. This became their contact song
(
Staff and resident groups singing and drumming to “Rivers of Babylon” and “One Love” demonstrating a high level of group cohesion and mutual support.
Interdisciplinary work was beneficial for the professional team and the clients alike, especially in easing some of the challenges during our time at Homestead. Along with the art therapist, we created handmade instruments with the girls that we later used in group music making; a mural that was made during art therapy helped inspire song writing and improvisation; group singing and drumming was recorded and accompanied an end of the week slide show. We worked with the art therapist in helping the girls design flip flops we had brought for them and assisted the social worker with music-mediated meditations and journaling. The psychiatrist occasionally joined us in small groups throughout the week, providing his expertise with his shared culture by helping to translate the Patois, as well as helping to guide any major, unrelated conflicts or outbursts back to the music. As music therapists, we also helped with song choices for the social worker and psychiatrist to include in morning meditation and mediation with the facility staff and daily routines. We had prepared a repertoire of traditional music from the Caribbean in general and Jamaica specifically, in addition to songs popular with teens in both Jamaica and the U.S. We brought a songbook for the girls that consisted of lyrics to many of those songs and several others that we wanted to introduce to them, such as our theme song for the week. As a whole, they were eager to share their preferences and appeared to appreciate each new song we shared, as they listened, sang or drummed along, discussed lyrics and requested to learn more.
Flip-flop and journal projects
Mural and rain-stick projects
The girls had a tremendous impact on our experience and the music therapy process. Some engaged so powerfully, but we did not know all their names. Between the large and transient groups, several names that were new to us, the loud environmental sounds and poor acoustics in the space, unfamiliarity with the cadences of their speech, and the loss of name tags, we were sadly unable to learn or remember them all. This created a strange dichotomy, feeling such a strong therapeutic relationship given the short time working together yet hardly knowing them at all. Of the 46 girls in residence at the time, about 40 participated in large group music therapy and 20–30 of them engaged in smaller group work at various times. Occasionally we had 5–10 in a session where deeper and even more intimate work was able to take place.
This was truly intimate work. The girls opened their world to us; they invited strangers into their lives when trust was an issue—some afraid to trust, others knowing they trusted too freely. They embraced unfamiliar music and new experiences we offered to them; they expressed joy in our commonalities. While we were addressing significant issues, our being there for only five full days meant we had to be aware of the risks of re-traumatization. The depth of our work was limited in that respect, yet the power of the work remains palpable. The short length of our time together also impacted our ability to fully appreciate and understand the culture of Jamaica in general and Homestead more specifically. It was my first time in Jamaica, and while I had experience with music therapy in adolescent psychiatry and in shelters for domestic violence, this experience was new territory for me. I had to deal with my own emotional responses to being away from my family, the culture shock and the empathy, in addition to the distinct culture of this particular facility and group of girls. I had to address it each day before I could be my best self in sessions.
Fortunately, our team was comprised of professionals who both needed and could provide support to work through these moments. We engaged in group meditation and group singing; we also processed the sessions and discussed the residents on a daily basis. The team bond was essential, leading to the special work we did both independently and together. I was grateful to my student as well—while I was there as her supervisor and I know I helped to guide her experience and growth, she had previously been on a different music therapy fieldwork trip in Jamaica so she could offer some familiarity as a result. Working in such intimate moments, supervision lines get crossed as well, and my student became my partner. I was proud of her and grateful for the work together. To this day, we can talk about specific moments from that trip, from the work with the girls, and we are immediately transported back in time. Those five short days transformed my life in many ways, impacted my continued work as a music therapist, and gave me perspective. It was powerful. It remains difficult to fully put into words. This poem is one way to describe it:
This paper contextualizes the first music therapy program within the mental health team as a part of the Molloy College Short-Term International Health Mission (STIHM) with PRN Relief International and the Dominican Sisters in Jamaica, servicing residents at Homestead House of Safety. While the trip is planned twice each year, and we have been fortunate to have had three other music therapy clinician/student teams from Molloy College in attendance since this first trip, it has also been cancelled three times between 2016 and 2020: once due to unrest in Kingston, once due to an outbreak of the dengue fever, and most recently, once due to the Covid-19 virus and travel bans. Continuity of care remains a concern. During the dengue fever, the psychiatrist who leads the mental health team was able to travel to Jamaica along with the art therapist and a music therapist from their hospital to work closely with the Homestead staff for a short period of time. Construction and renovations at the facility moved the residents to temporary housing—they remained together but may not have yet been able to move back to their more familiar, more permanent home.
In addition to the purpose of providing ongoing biannual care, the team has been compiling curriculum, materials, and resources that can be implemented in other communities in need. There is hope that the United Nations will adopt and support the program, making it more accessible to those communities. I am personally grateful that music therapy has been incorporated in this work outside of the US where services are not as readily available, and I hope to help expand the literature in this area. As our team continues to provide services at Homestead along with my music therapy colleagues and our students, I am optimistic that the benefits will have an even greater impact and the literature will grow to reflect that work.
Special thanks to Lillie Klein MT-BC, LCAT.
I appreciate the opportunity to share my experience in music therapy! I've worked with
clients and patients in a variety of settings including NICU, early childhood special
education and Deaf education, pediatric medicine, pediatric hospice, child and
adolescent psychiatry, and nursing homes. For the past 25 years I have supervised music
therapy students from Molloy College (and other programs) in their clinical training,
and I'm in my 10th year on the staff and faculty in the music department at Molloy. It
was an honor to be part of the mental health team with the Molloy Mission and I hope to
have another opportunity for this work. I feel strongly about advocating for music
therapy and spent a few years on the New York State Task Force for Occupational
Regulation. I am especially passionate about family centered work. 21 years ago I opened
my own practice, Baby Fingers, servicing families and children where we focus on
relationships and language development through music and sign language. I have served as
an expert for parenting programs, authored sign language books for kids in addition to
music therapy articles, podcasts, and textbook chapters, and have presented at
conferences both regionally and nationally. Lora Heller, MS, LCAT, MT-BC.