Today I'll be discussing the role of music in mental health recovery with a music therapist

and vocalist.

Michael Kessler serves as the Program Specialist at Alameda County Behavioral Health Care Services.

He has practiced music therapy for more than 20 years. Michael has developed therapeutic

programs in adult acute psychiatric, geriatric, and long-term rehabilitation settings. In

his sessions, Michael uses a variety of tools including guitar, piano, drum circles, and

composition. He has a Bachelors degree in Music and a Masters in Rehabilitation Counseling.

Paulette Franklin was born and raised in the East Bay and has been singing in church since

the age of 5. For many years, she also operated her own child development center. While going

to therapy, she discovered that singing was the best wellness tool to lift her spirits

and help her get through one day at a time. Her training with Best Now and internship

at Alameda County Behavioral Health Care Services are contributing to a healthier lifestyle.

Welcome, Michael, and welcome, Paulette. Thank you for joining me today.

Paulette, I know you've experienced a lot of loss. Can you tell me what led to your

mental health challenges?

>>Sure. My brother was murdered in Alaska. Someone tried to rob him and shot him in the

head. And so he passed away. And then next my mother, she had cancer of the liver, and

I took care of her months. And then of course she passed away. And then 18 months after

that my father passed away. And after that I think my mind just couldn't take any more.

And that's when all my challenges began. And I started to go get help for the challenges

I was experiencing.

>>What kind of challenges were you experiencing?

>>Mostly depression. I didn't want to talk. I didn't want to go outside. I didn't want

anybody to ask me about anything. I just wanted to be by myself.

>>So how did you discover music as a wellness tool and use it for recovery?

>>Well I have been singing since I was a child. My grandfather used to take me to churches

and make me get up and sing. He said, "Just stand there and sing. It'll be ok." [Laughs]

And I was a little nervous, but I would do it. And then just from that point on I've

been singing. I was in a group, we made an album, and different things music has been

in my life. So it wasn't until I had stopped going because after my mother passed that

I went back. And I could hear my mom telling me to sing. She said, "Just sing, Paulette."

She would love to hear me sing. And so I started singing again and I realized that's what contributed

to my wellness.

>>So Michael, you have a background in music therapy. Can you tell me a little bit about

what music therapy is and how it works?

>>Music therapy -- the definition I like to use is art and science, using music to achieve

a non-musical goal in conjunction with a credentialed professional therapist who has gone through

training to do it. A great example of that is the ABC song, just singing a song not to

learn the song, but to learn the alphabet, so that's one thing. And I use music as you

mentioned in sing-alongs, drum circles just trying to get people focusing and working

together.

>>Paulette, what kind of treatment options did you try when you were going through your

depression and how did those compare to music for you?

>>I've tried therapy, small groups with women who had similar things that were going on

with me, medication, and it wasn't until -- like I said earlier -- I went back to church and

started singing that I realized that event though I had to do all those things and I

was doing them, it was ok but I really wasn't feeling a lot better. And then when I would

sing, it just made me feel a lot different. And I knew that's what I needed to do.

>>Do you think the singing magnified the effects of those other things or do you think the

singing on its own is really what has gotten you to a better place today?

>>I think a combination of both, I mean of all things that have helped me. But I think

that singing was at the top of the list.

>>Michael, from a provider perspective, how effective do you think music therapy is compared

to these other treatment options?

>>Music therapy is fun. It's non-threatening. It's not invasive. It's kind of a sneaky form

of treatment. You don't really know. You're having fun, having a good time. And it's much

easier, I believe, to express yourself or tell what the sound of the drum just made

than what is going on inside. It's much easier to sing someone else's words sometimes and

just understand them and go hey, that connects to me in such a way as well that I can just

talk about this other person's lyrics. And it hits home without actually having to tell

you what's going on in me and come up with it on my own. It's that way.

>>And that's a beautiful thing because even though you go to talk therapy to feel better,

there's probably a lot of anxiety just going into talk therapy because you know you're

not only going to have to explore things that are painful but then articulate them in a

way for another person to understand. And this seems so much more welcoming and non-threatening.

>>Correct. And you're going in thinking, "Ok, this guy is going to analyze me...."

>>Yeah. What's his background? What are his credentials?

>>"He's going to dig into my head." And no, let's just sit back and have a good time and

hopefully something wonderful will come out of it.

>>So walk me through a sample music therapy session. What do you do? What are the goals?

What are the ideal outcomes?

>>Ok. Usually we start off with a talk session. Sit down and do an assessment with the client,

just finding out what they're there for, what issues they want to talk about or deal with.

So come up with a really good assessment and also talking about the history. And what music

does connect with you, what music doesn't, if you are musically inclined, if you're not.

And then after that come up with a goal. Help the client identify what they want to try

to achieve. Sometimes people come in and they have no clue.

>>What might a sample goal be?

>>A sample goal might be anything from being able to get up out of bed. Just getting up

and starting the day. Or being able to talk to somebody, being able to engage, start a

conversation, just get the conversation going. Or sometimes there's music therapists -- I

haven't done it -- but work with people with physical disabilities as well. So helping

someone to start walking again and so forth. So that's what we come up with, these goals

or overall goal. Then I will go into my little bag of tricks and find a nice session plan

or develop a session plan which would have the overall goal and objectives, how we're

going to try to get there, what hurdles we might see in the process of getting there,

and hopefully there will be some hurdles that I don't expect because I kind of like working

when things don't quite work right. And then do the session. And it could be -- like with

you, you're talking about just singing -- we just find out some songs you like. Sit back

and just sing.

>>Sing.

>>And maybe even -- you talking about singing at church...

>>That's right.

>>Encourage you do to more of that. Go our and sing at church. Sing with your family.

>>Not only in the therapy session but out in the world in your everyday life as well.

>>And that's hopefully what the music therapy will do. It will transfer to everyday life.

Because you will start off with just trying to express yourself or identify a feeling

that you might not even know is there. And then maybe that will transfer to going to

a grocery store and just trying to converse with the person at the counter.

>>Are you taking new patients? [Laughs]

>>So you said you liked the hurdles. You smiled a little bit when you mentioned that. What

are some potential hurdles that someone might face?

>>The hurdles that someone might face is dependent upon where they're coming from. I was mainly

speaking of hurdles within what I think will or what I'm hoping an assessment will look

like and if it doesn't. I've gone into group sessions with a whole plan started up and

the group just looks at me and goes, "Uh uh. That's not going to work today." My music

therapy professor when I went to school, Ron Borczon -- brilliant guy, helped me out, my

mentor -- he told us to prepare for an error-free environment meaning...

>>Is there such a thing?

>>There isn't. But just try to figure out what might happen and what might go wrong

before you go in just so you're ready. Because you don't know. So yeah, the hurdle is the

group not digging it, not wanting to do what I had in mind. And then we change and turn

it around and say ok well, we're not going to write a song today. We're going to just

listen to music really loud and dance or find out what's going on with them.

>>So Paulette, you've pretty much been singing your whole life, definitely since you were

five. There are other people out there who have not been singing as long or who might

not be as musically inclined but are sort of drawn to music as a recovery tool but might

be scared trying it. What would you say to them?

>>See Michael. [Laughs] You have to try. Find a group, find a vocal teacher, find someone

that knows something about music and at least go and try. Figure out if that fits for you.

You know, like he said, some people, it's not for them. And if you have it inside, I

think more people, if they would try, would see that it's there. Because music is a thing

that really touches your heart and gives you a lot of feelings that I can't express to

you. But it really does something for you. So I encourage people that I know who may

say, "Oh, I can't sing." I tell them, "Oh, yes you can." You don't need to be in tune,

nothing. Just sing.

>>Have you engaged in musical activities other than singing?

>>Yes. I've been in a band. I used to play the bells. I used to play the violin. I still

do on occasion but not very often because my nails are too long. [Laughs] I love the

violin. My mother played it and my son played.

>>Michael, in your experience, does music ever lead to negative flashbacks and if so,

how do you deal with those?

>>Negative flashbacks, no, not per se. As I mentioned before, I do a thorough assessment.

So hopefully I will find or figure that out. But yeah, ideally some thoughts that maybe

the client did not know they had come up. Because then you're touching upon things that

have maybe been repressed. Again, I like kind of playing on my toes. So if there is something

that comes up out of left field and I had no idea and the client had no idea where it

was coming from, we can really just grab hold of it and focus on what's fueling that. So

yeah, negative no, but maybe thoughts they didn't have or emotions that weren't there

come to the surface.

>>So you really see that as a growth opportunity.

>>Exactly.

>>Paulette, what do you do when you hear a song that triggers your sadness?

>>Well I'm a little different than Michael. I don't want to deal with it. Hearing something

that brings back things that I don't want to deal with, I shut it out. And that's where

I'm at right now. But the other day after speaking to some friends, a song came on.

And it was a song of course I didn't want to hear but because I'm around other people

I can't say, "Turn off the radio. I don't want to hear that." So I tried to deal with

it. And it wasn't bad, but I still -- right now I'm not at a place where I want to hear

those things.

>>That's interesting you mention that. At parties or in social settings if you hear

something that upsets you, how would you recommend to someone else dealing with that in the moment?

>>There's no way in life that you're going to be able to go anywhere that something's

not going to trigger you. And so you really have to deep down inside figure out how can

I deal with this. And have that plan in your mind so that if you go to a place that triggers

you, you can walk out of the room or sit down and take a deep breath, whatever you need

to do. But you have to have a plan so you'll be able to deal with those things.

>>Michael, how cost effective would you say music is as a recovery tool or music therapy

is as a therapeutic practice?

>>It's getting more. Around the mid-90s, a few celebrities and neuropsychologists went

to the feds and said this needs to be reimbursable and Medicare. So for some music therapy interventions,

it is. Those people are like Dr. Oliver Sachs, who wrote "Awakenings" and is a strong advocate

for music therapy. So that's one thing. Unfortunately right now also in behavioral health and mental

health, salaries aren't that high, especially for a creative arts therapist. So it's an

inexpensive form of therapy that way. We're working on trying to educate the providers

and the powers that be. I said Medicare, but MediCal -- some states have state-funded things. California

is working on it. But not yet, not that I'm aware of. So it's cost-effective. But there's

also not that many providers that actually offer it. They say they do creative arts therapy,

but they might not have a credentialed creative arts therapist on staff. So yeah, music and

arts can be therapeutic and we all do it. Even walking down the street, you're hearing

the beats. Music is everywhere.

>>Everywhere.

>>So we're doing it. Having it billable as music therapy you need a credentialed music

therapist.

>>How important is it to be a credentialed music therapist as opposed to just a musician

leading a drum circle or leading a singing choir?

>>I think it's quite important. And unfortunately music therapy is not a licensed profession