2013 feature

Next Generation Music Therapy:

Clinical Applications of YouTube Videos

Sarah E. Pitts, MA, MT-BC

Georgia Regional Hospital at Savannah

Savannah, Georgia

Kirsten E. Meyer, MA, MT-BC

Music Speaks, LLC

Council Bluffs, Iowa

Introduction

Music therapists are currently in an era of ever-changing technology. In the last two decades, the way in which people listen to music, transport music, and create and write music has been transformed. These advances have a direct effect on how music therapists use music in sessions as well as how they can create and distribute music to their clients. One way music therapists are able to learn and access music is through the use of videos available on websites, such as YouTube. Publicly shared videos can assist in teaching concepts, learning songs, or providing an avenue for expression. The purpose of this article is to discuss the increased use of technology among music therapists and to describe how certain types of YouTube videos may be used in clinical settings, with a special focus on applications and adaptations for settings involving children aged 0-5 years old.

According to the professional competencies of the American Music Therapy Association (AMTA), music therapists are expected to be able to “demonstrate basic understanding of technologically advanced instruments” (AMTA, 2009). Crowe and Rio (2004) surveyed music therapy clinical training directors and professors as well as reviewed literature to investigate the use of technology in music therapy research, education, and training. Their recommendations indicated that a more detailed survey of music therapists regarding their use of technology was needed, as well as continued education on developments in technology related to working with people of all abilities. More recently, researchers asked music therapists and interns about their specific uses of technology and the goals addressed with such usage. Results indicated that professional music therapists use technology more often than interns in clinical practice; however, both groups would like continued training on the clinical applications of technology (Cevasco & Hong, 2011).

Using music videos found on YouTube is one way that both students and professionals may first become exposed to or learn a song. Clients may request an unfamiliar selection, and an easy way for the therapists to familiarize themselves with the song is to find an online audio or video recording. Although songs written before the creation of the modern music video may not have “official” videos for viewing, many have videos created from audio recordings and photo collages or live performances. In fact, the content of a music video can change or enhance the therapeutic effect of music used in sessions, as well as possibly influence the decisions clinicians make about how they use music within the clinical setting. Students who viewed the music video of a song as opposed to just listening to the audio recording were more likely to select the possible age range, possible population, and appropriate population that most related to the video’s content (Gooding & Mori-Inoue, 2011). Both professionals and students may need to be cautious if utilizing music videos for familiarization with songs or within the context of a session. Such uses might influence clinical applications of specific musical selections.

Types of Videos

Music videos can be utilized to address a variety of goals across populations. “How-to” videos typically provide the viewer with a series of broken down steps or modified versions of dances. There are a number of videos teaching dance sequences to songs of all genres. The authors have utilized “how-to” videos for songs such as “The Cupid Shuffle” and “Achy Breaky Heart” to teach group dances during music therapy sessions.

These dances might need to be modified based on children’s ages and motor skill development. Children who can stand independently and walk should be encouraged to participate in these dances with minimal assistance in order to strengthen gross motor coordination, spatial awareness, and balance. Music therapists may want to learn how to play the song on a live instrument so that the tempo can be increased or decreased based on the various levels of the abilities of the children. Parent-child dyads might also practice dances to help strengthen the relationship between the two partners (Standley & Walworth, 2010).

Another type of video involves instruments made from non-traditional materials. These videos may be instructional in nature and explain the process of making a certain type of instrument, or may involve performances featuring homemade instruments. Some of the non-traditional instruments found in YouTube videos include vegetables carved to create wind instruments, a pop bottle orchestra, and PVC pipes cut to different lengths to recreate Boomwhackers® or Joia Tubes®.

While these videos may be used as inspiration, there is no limit to what items may be used to create instruments or ensembles. In fact, many children do this naturally, engaging in spontaneous musical play using sounds found in the environment, such as banging on kitchen pots and pans. A characteristic of musical play is that it is multimodal; children blend movement with the creation of sounds (Marsh & Young, 2006). When given a selection of household items and the encouragement to explore various timbres and sounds, children will likely display active music making, both aurally and kinesthetically, which can be used to address a variety of cognitive and gross motor goals.

Children aged 0-5 years may lack the fine motor coordination required to create instruments from non-traditional materials on their own, but with modification or assistance from a music therapist, children may be able to complete the steps necessary to create a simple instrument, and thus address goals related to fine motor coordination and creativity. Children in the upper end of this age group may be able to give input in designing the instrument, giving them an opportunity to use teamwork and increase communication skills.

Music therapists may also draw inspiration from YouTube videos of vocal ensembles or instrumental ensembles that use standard instruments.

Although children 0-5 years likely would not already know how to play a melodic instrument, the concepts in these ensemble videos could be modified to be appropriate for young children. Adaptations could include simplified or open tuning, arrangements of familiar songs, adaptive notation, or modification of the instruments themselves. For example, children may benefit from an Orff ensemble (possibly using adaptations such as removing extra bars from the instruments) as a way to experience teamwork, increase communication and socialization, and practice gross and/or fine motor coordination. Children may also be exposed to instruments, vocal traditions, or ensembles of other cultures and thereby increase cultural awareness. However, for the youngest children, musical play is most often spontaneous, rather than pre-planned or based on a specific genre of music (Marsh & Young, 2006). For this reason, the use of ensembles with young children should be structured in a developmentally appropriate manner; children may often respond more creatively to musical play when it is not directed by adults (Marsh & Young, 2006). Music therapists may consider supporting musical play by engineering the environment and limiting the amount of actual direction during an intervention to nurture the creative process.

Music therapists have recently begun creating music videos as part of interventions with both individuals and groups. Using this intervention with groups of students can be a way to increase socialization and promote conflict resolution among peers, promote conflict resolution, promote positive feedback among peers, and allow a healthy way for students to express themselves in a creative way. Smith (2012) assisted adolescent girls from impoverished neighborhoods to create a therapeutic music video over the course of nine sessions. Each girl wrote her own solo verse and the group wrote a chorus together. They also included dances and had a premiere party inviting friends and family. At the conclusion of the nine sessions, the author discussed how the students had exhibited changes in socialization, self-expression, and creating healthy relationships and boundaries with peers. Other groups of youth also have written their own songs and created their own music videos without the direct assistance of a music therapist.

Researchers have used therapeutic music videos as an intervention available to patients who are experiencing long-term treatment, such as stem cell transplantation (Burns, Robb, & Haase, 2009). In this case, patients were allowed to rewrite the lyrics of one of ten songs representing a variety of genres. The process took six sessions that were structured based on the physical health of the patient. Results indicated positive changes in quality of life, distress related to symptoms, defensive coping, and spirituality, as well as trends in other measured areas. Therapeutic music videos also could be implemented with parent-child dyads in which the child is experiencing long term hospital treatment. Parents may find that creating music videos with children may result in tools for advocacy or create beautiful memories of the child’s life.

Young children could benefit from the process of creating music videos featuring songs and/or characters that are familiar or age appropriate. Including parents in the process may strengthen the relationship between parents and children and bring an element of normalcy into an otherwise stressful environment. Children who spend long periods of time in hospitals for treatment can regress academically and developmentally, so music therapists could use this intervention to maintain or teach skills in a fun, interactive way. Children born in the current generation may already be familiar with learning through technological means (e.g., Leapfrog, iPads, tablets). Future additional research in this area is indicated.

Parody videos offer another possibility for therapy. Merriam-Webster (2013) defines a parody as “a literary or musical work in which the style of an author or work is closely imitated for comic effect or in ridicule.” Parody videos are easily found on YouTube, ranging from studio productions (e.g., Share it Maybe) to homemade (e.g., Minnesota Gurls; I’m Farming and I Grow It). These videos may feature lyrics that have been adapted from the original version, as well as video footage to reinforce the changes in the lyrics. While young children  may not have developed many of the skills required to plan, write, and produce a therapeutic music video or to understand the concept of a parody video, these formats may be generally adapted for use within early childhood music therapy sessions. Children may be asked for input related to song choice, themes, props, or lyrics. These choices can be made using open-ended questions, giving options for the children to choose from, fill-in-the-blank songwriting, or adapted communication such as a Picture Exchange Communication System (PECS). By participating in such a process, children learn to use teamwork, conflict resolution, and peer-to-peer feedback, and have opportunities to increase language skills, creativity, and self-esteem.

Music videos depicting actual music therapy sessions are also available on YouTube. However, professionals should be cautious regarding their usage for education or advocacy. During a descriptive analysis of music therapy related videos, researchers identified over 26,000 videos under the search criteria “music therapy” while only 32 depicted “music therapy sessions” (Gooding & Gregory, 2011). Only five videos were analyzed for depiction of professional competencies in music therapy or evidence of the MT-BC credential. The researchers recommended that music therapists be cautious about uploading session videos to social networking websites and be clear about the competencies, credentials, and other professional issues. However, using websites such as YouTube by professional organizations to keep members informed or provide advocacy may be the next “big thing” in the world of technology (AMTA, 2010). The researchers completed a similar analysis on music therapy online documentaries, and found that while these videos might provide a more accurate representation of music therapy, professionals still need to use them with caution (Gregory & Gooding, 2012) and to be vigilant about obtaining permission from families prior to posting.

Professionals and clinical training directors may use videos for modeling behavior. Many music therapy educators video record students conducting music therapy interventions with clients and then have fellow students analyze those videos as part of their observational skill development. Alley (1980) completed two studies with students to see if this method was more efficient than using purely educator feedback. Results indicated that video analysis increased skill development and transfer of skills to different settings more than one-to-one feedback with educators. However, students did enjoy the interaction with their professor.

Some music therapists utilize videos as part of a behavior-modeling program (e.g., for children with autism spectrum disorder) (Bellini & Akullian, 2007). Typically the children create a video of themselves completing an appropriate behavior within the context of a music therapy session and then take the video with them for use in different settings. Parents of clients are able to view the behavior and then help to generalize it to other settings, such as home or school.

While videotaping is used for education or research studies, music therapists may want to consider creating videos with clients for skill development or creating a tangible record of goal progress. Research on the use of videos for clients is warranted.

Current Recording Technology

There are many options available for video and audio recording, for both Mac and PC, ranging from free programs to professional editing software. A common audio recording and processing option available for both Mac and PC is a free application called Audacity. This program allows recording, importing and exporting of various file formats, and multi-track editing. Both PC and Mac users can record audio through iPods. There are recorders built specifically for inserting in the bottom of the iPod using the iPod’s memory as the storage. Users then upload the audio files to iTunes when syncing the iPod. iPhones have built in microphones, but have similar capabilities. Olympus also makes a digital recorder with a USB connection for easy uploading. Mac users can edit audio through a program called GarageBand™, which allows users to record instrument tracks or use pre-recorded loops to create songs. Users can utilize MIDI keyboards or other electronic instrument equipment through USB access and record straight into the GarageBand™ program.

Using an iPad or iPhone is a simple and popular way to record video. Many professionals are able to obtain iPads for use in their facility and take them directly to the clients. A video editing option for PC is Windows Movie Maker, which is currently a part of the Microsoft Windows standard software package. A low cost option for video editing on Mac or PC is Adobe Premiere Elements, sibling to the professional level Adobe Premiere Pro. Mac users can use iMovie, which is a step-by-step program for editing and making videos. The program allows for frame by frame editing and is created to be fairly user friendly.

Conclusion

Music videos can be an effective intervention for working with a variety of populations as well as a tool for advocacy and education for the field of music therapy. However, there are several cautionary aspects to consider when utilizing or creating music videos. Always remember to respect client confidentiality. This may seem very basic, but sometimes even professionals with the best intentions can overlook minor details. Parents may want to use or show videos for different purposes, but professionals do not have that same courtesy. With that in mind, remember that once a video is uploaded to a website such as YouTube, there is no way to completely “delete” it from the Internet. Even if the video is taken off one website, it may still be on other websites. The World Federation of Music Therapy (WFMT, 2010) has compiled recommendations about client information or therapeutic material and the Internet. This may be accessed at: http://www.wfmt.info/WFMT/WFMT_Documents_files/Internet%20and%20Privacy%20Issues%20related%20to%20Music%20Therapy.pdf

References

Alley, J. M. (1980). The effect of self-analysis videotapes on selected competencies of music therapy majors. Journal of Music Therapy, 17, 113-132.

American Music Therapy Association (2009). Professional competencies. Retrieved from http://www.musictherapy.org/about/competencies/.

American Music Therapy Association. (2010). AMTA music therapy’s channel. Retrieved from http://www.youtube.com/user/AMTAmusictherapy.

Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 264-287.

Burns, D. S., Robb, S. L., & Haase, J. E. (2009). Exploring the feasibility of a therapeutic music video intervention in adolescents and young adults during stem-cell transplantation. Cancer Nursing, 32(5), E8-E16.

Cevasco, A. M., & Hong, A. (2011). Utilizing technology in clinical practice: A comparison of board-certified music therapists and music therapy students. Music Therapy Perspectives, 29, 65-73.

Crowe, B. J., & Rio, R. (2004). Implications of technology in music therapy practice and research for music therapy education: A review of literature. Journal of Music Therapy, 41, 282-320.

Gooding, L. F., & Gregory, D. (2011). Descriptive analysis of YouTube music therapy videos. Journal of Music Therapy, 48, 357-369.

Gooding, L. F., & Mori-Inoue, S (2011). The effect of music video exposure on students’ perceived clinical applications of popular music in the field of music therapy. Journal of Music Therapy, 48, 90-102.

Gregory, D. & Gooding, L. F. (2012). Music therapy online documentaries: A descriptive analysis. Music Therapy Perspectives, 30, 183-187.

Marsh, K., & Young, S. (2006). Musical play. In G. E. McPherson (Ed.), The child as musician: A handbook of musical development (pp. 289-310). New York: Oxford University Press.

Parody. Def. 1. (2013). In Merriam-Webster Online. Retrieved from http://www.merriam-webster.com/dictionary/parody

Smith, L. (2012). Sparking divas! Therapeutic music video groups with at-risk youth. Music Therapy Perspectives, 30, 17-24.

Standley, J., & Walworth, D. (2010). Music therapy with premature infants: Research and developmental interventions (2nd ed.). American Music Therapy Association.

World Federation of Music Therapy (2010). Internet and privacy issues related to music therapy. Retrieved from http://www.wfmt.info/WFMT/WFMT_Documents_files/Internet%20and%20Privacy%20Issues%20related%20to%20Music%20Therapy.pdf

About the Authors

Sarah E. Pitts, MA, MT-BC is the Recreation & Volunteer Coordinator and music therapist at Georgia Regional Hospital at Savannah. She currently provides music therapy services to adult psychiatric and forensic patients as well as directs the hospital’s volunteer program and develops a variety of psychosocial rehabilitation programming.

Contact: sepitts9@gmail.com

Kirsten E. Meyer, MA, MT-BC is a music therapist with Music Speaks, LLC, serving seven counties in southwest Iowa and eastern Nebraska. Her experience includes work in psychiatric, hospice, early childhood, and Veterans Affairs settings.

Contact: kirsten.meyer@gmail.com

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