"I grew so much from [therapy], the most important thing I got is that everything is connected, and every emotion comes from somewhere… Just being aware of it in everyday life puts you at such an advantage…"
When the COVID-19 pandemic struck, millions of people were affected worldwide and life changed overnight. Many lost their employment, schools pivoted to online learning, and social isolation increased along with other devastating consequences.
Now, almost a year and a half later, 68.2% of adults and 65.5% of youth aged 12 and over received at least one vaccine dose. While restrictions have been lifted and many elements of daily life/activities have resumed, the looming mental health crisis of the pandemic remains as it has harbored a heightened sense of uncertainty, fear, social isolation, and loss that many of us have experienced.
According to a recent report from the Center for Disease Control, young people reported the highest perceived need for mental health care yet they have among the lowest rates of service use. In many ways, the effects of the pandemic overlap with some of the core attributes of a traumatic experience, which occurs in a sudden and unexpected way that is potentially life-threatening. While the pandemic has affected folks of all ages and walks of life, the effects on youth and their families are notable with an emphasis on those who are low-income and identify with racial/ethnic minorities groups.
Back in March 2020, the pandemic imposed social distancing norms and various disruptions and stressors on youth, including school closures and restricted social activities with friends. These changes resulted in youth and adolescents feeling emotionally and physically distant from friends, overwhelmed by family stress, and restless from not being outside. Despite an increasing return to a “new and hybrid normal,” the potential long-term mental health consequences cannot be overlooked as it has complicated an already complicated developmental stage in which youth begin to develop their identity, form social relationships, and establish a greater sense of independence.
These challenges highlight the growing importance of getting young people connected to therapy. For this reason, I focus here on the role of creative technology-based strategies that use music to help engage youth and adolescents in teletherapy by meeting them where they are: on their headphones, smartphones, and laptops.
Seeking Help and Engagement for Youth
Many factors shape our decisions to seek and engage in therapy. Therapy offers a meaningful opportunity to understand ourselves better and make important changes that help us navigate the challenges we face. At the same time, seeking therapy can be a stressful and anxiety-provoking experience. Stigma is a good example, which relates to concerns about being treated differently or judged in negative ways by people in our lives (i.e., weak, crazy, unpredictable).
There are a growing number of campaigns and programs to fight stigma. These include the voices of many celebrities, musicians, and public figures who have used their platforms to open up about their mental health difficulties and how they got help. Examples range from musicians such as Jay-Z, DaBaby, and Logic to NBA stars like DeMar DeRozan and Kevin Love. Other factors that affect our decision to seek therapy include perceptions and fears such as mistrust towards providers, perceived (un)helpfulness of treatment, and feelings of hopelessness, to name a few.
The pandemic has created a rise in virtual mental health care, which has invited some concerns from many parents who may have wanted their children to engage in traditional (in-person) therapy. For some parents, these concerns may signal "one more hour in front of a computer screen;" others may question whether virtual therapy would even be engaging enough or worth it for youth, as compared to in-person. These concerns add another layer of complexity to help-seeking for youth and adolescents during a period of increased time at home and family stress. The good news is that studies have found that tele-mental health services are similarly as effective as in-person services.
Creative Therapeutic Opportunities and Strategies
The renowned Hip Hop artist J. Cole famously said in his song Love Yourz, "there's beauty in the struggle…" to illustrate how even in challenging times, there are always opportunities for growth.
In spite of these challenges, the rise in teletherapy presents a unique opportunity and potential to use technology to deepen engagement for youth and adolescents. Even pre-pandemic, youth and adolescents were increasingly immersed in technology (i.e., music, social media, popular culture), as it is their “go-to” platform for information and the place they feel most comfortable. After all, to whom do older adults turn when they can’t load their email?
While technology raises certain challenges, it has also been a lifeline for youth during the pandemic because it keeps them connected to friends and family. How then can technology-based strategies harness the potential of music to deepen youths’ engagement in virtual therapy by meeting them where they are: on their headphones, smartphones, and laptops?
Over the past decade, the use of creative arts and technology in mental health treatment has been on the rise because it enhances engagement and the therapeutic process in a variety of ways for youth and adolescents. Creative arts therapist, Cathy Malchiodi, argues that “expressive therapies focus on encouraging clients to become active participants in the therapeutic process.”
The science supports this too. For example, the World Health Organization recently synthesized a growing body of research on how expressive arts strategies (i.e., music, rhythm, dance, visual arts) that include technology can support engagement, prevention, and treatment of health and mental health conditions. This WHO report highlights the capacity of music and visual arts to stimulate our imagination, activate our senses, evoke our emotions, and bolster our cognitive attention. After all, therapeutic activities that are synchronized and rhythmic can improve our ability to regulate our emotions and reduce levels of stress, anxiety, and depression.
The Benefits of Music Therapy
Music serves as a powerful therapeutic tool to encourage youth and adolescents to talk about and process their emotions, affirm strengths, develop goals, and strengthen coping skills in an age-appropriate and culturally responsive way. You can see a powerful example of this in Robert Morrison's award-winning short documentary, Mott Haven. The film shares the story of a Hip Hop Therapy Studio Program in a transfer high school in the South Bronx (developed and led by social worker, JC Hall) that uses the inherently therapeutic capacity of Hip Hop culture to help students cope after the death of one of their peers.
The use of music can be appealing to youth for several reasons. First, they are large consumers of music and popular culture. For example, a recent study found that youth spend approximately 40 hours per week listening to music. Second, music is inherently therapeutic and empowering as lyrics/narratives, rhythms, and melodies often speak to our life experiences, emotions, identity, and much more.
Many of us turn to our headphones when we need some extra motivation or encouragement, clear our mind from a long day, cope with a breakup, prepare for an exam, and beyond. A recently published study in JAMA Pediatrics found that among the 25 most popular Hip Hop songs in 2018, nearly 70% percent contained at least one mental health reference (i.e., anxiety, depression, coping). Finally, music can help facilitate conversations about mental health and promote self-expression in ways that are less stigmatizing and more “appealing and intuitive” for youth and adolescents.
Practical Applications and Activities
There are many ways that music can be used in a therapeutic capacity during teletherapy sessions. Platforms such as Zoom allow for screen sharing (i.e., audio, video) and remote controlling, which allows for a variety of innovative and collaborative activities. This can include activities that are active and receptive.
Active Activities. They focus on the creation of music such as playing instruments, making beats/melodies, and writing song lyrics to deepen the therapeutic process. There are a variety of free online programs such as GarageBand, BandLab, and Google Music Lab that allow for all of these activities to come to fruition.
An example activity could be to invite the youth to reflect on certain emotions that have been challenging (i.e., anger, sadness, frustration) and then to think about what that emotion would sound like if it had a theme song/soundtrack. For example, would your anger sound like a “loud and high tempo beat or a slow and steady or intense and sporadic, etc?”
This prompt alone invites self-reflection and observation in a mindful way. GarageBand, BandLab, or Google Music Lab can be used collaboratively on Zoom (with share screen) to create a beat, rhythm, or song that captures the experience and presence of that particular emotion. Why might this be relevant? It inherently invites youth to engage in a mindfulness practice and develop skills that can help them identify and manage their emotions. More specifically, the invitation to observe with curiosity their emotion(s) and then use music as an expressive outlet can help them better understand and navigate challenges in a more creative, engaging, and fun way.
Receptive Activities. They focus on music listening and using song lyrics as a vehicle to help process, understand, and express our emotions. For example, let's say that managing depression was a theme during sessions with a young person and the goal was to help process those emotions. The therapist or client can *bring* a song to session that references struggling with depression (i.e., or other relevant mental health content) and then listen (e.g., YouTube, Spotify, Apple Music) to it while reading along with the lyrics (i.e., share screen).
Genius is a useful resource that houses song lyrics and provides line-by-line interpretations of them, which can help stimulate engaging dialogue on the meaning of the song. An example could include the popular hit record by the musician, Logic, who wrote a song titled 1-800-273-8255, which is the Suicide Prevention Lifeline.
During the 2017 MTV Video Music Awards, Logic delivered an emotionally charged yet empowering performance of this song while sharing the stage with individuals who have attempted suicide wearing shirts that read, "you are not alone" (highly encourage readers to check out the link above to the performance). In this song, Logic talks about the challenges of coping with feelings of depression and suicide while simultaneously cultivating hope for the future.
The song begins with the lyrics, "I've been on the low, I've been taking my time; I feel like I'm out of my mind, it feels like my life ain't mine (who can relate? Woo)." Many young people (and older folks too) can identify with the lyrics in this song, as they are relatable and empowering. Such lyrics can help youth talk about their emotions and provide ways to help them navigate these challenges. Another component of this activity could be to invite the youth to reflect on the emotions that the song evoked and to write their own song lyrics (or simply jot down any thoughts) about their experiences. Hearing a renowned and mainstream musician openly talking about depression fights stigma, offers validation, and can instill hope.
This is just one of many examples of how music and song lyrics can be used to facilitate conversations about mental health. Music can provide an outlet for youth to express their emotions in an engaging, interactive, and therapeutic way.
While the darkest days of the pandemic are behind us, the looming mental health toll of the pandemic cannot be overlooked, particularly for our youth. The pandemic has drastically shifted daily life in the ways that we know it and our return to a “new normal” will likely involve a “hybrid approach” (i.e., technology and in-person activities) for the foreseeable future.
As humans, we inherently possess the capacity to evolve, grow, and transform ways in which we respond to and navigate life experiences. For many, therapy can be an outlet that can help facilitate that process. In the era of COVID-19, there are many innovative and creative approaches that harness the inherently therapeutic capacity of music and expressive arts that can help youth and adolescents recognize their emotions and stressors in an engaging way. To learn more about what this journey can look like, we invite you to contact our team.