The Creative Arts in Counseling - Samuel T. Gladding

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become increasingly aware of the connectedness between hard work and achievement. Their self-esteem and self-expression may increase as well, with a substantial decrease in hostility and disruptive behaviors (Rio & Tenney, 2002). Teens may also realize that playing a socially desirable musical instrument such as the piano or guitar increases their acceptance among peers.

      In addition, adolescents are often interested in song writing and may wish to express themselves lyrically (Cheesebrow, 2018). A song is generally considered to be a poem set to music. To foster a preventive and therapeutic process, music therapists and counselors skilled in music can work with adolescents using a number of song-writing techniques, “including changing the words to familiar songs, filling in the blanks of edited familiar songs, vocal improvisation, adding new verses to known songs, parodying familiar songs, and using natural rhythms of speech as a starting point” (Goldstein, 1990, p. 119). Counselors who are musicians themselves may also use original music they have written to help adolescents explore difficult areas such as gender issues and sexuality (Hodas, 1991). In addition, school counselors and counselors who work with adolescents in other settings can use musical interventions such as listening to music and sharing and using music in psychoeducational activities.

      One interesting use of music in counseling at-risk youth—in particular, inner-city Black and Latinx adolescents—is transforming rap music into rap therapy (Armstrong & Ricard, 2016). Rap therapy (Elligan, 2004) is rooted in social learning theory and a cognitive behavioral model. Through it, “clients become aware of the association between personal lyric interpretation, their emotions, and at-risk behaviors. This awareness aids in their ability to be reflective and allows them to effectively problem solve” (T. Gonzalez & Hayes, 2009, p. 162). Like in other counseling approaches, assessment is completed and rapport is established before any attempts at change take place. However, once these two stages of counseling are complete, clinicians work to help broaden clients’ appreciation of types of rap other than those that dominate their lives and then, through written exercises, role-play lyrics as well as engage clients to create and interpret their own lyrics. Finally, clients are encouraged to move into positive actions that are maintained through modeling and reinforcement.

       Adults

      In addition to being therapeutic for adolescents, rap therapy is beneficial for adults. For instance, Hakvoort (2015) found several benefits using rap in therapy to reduce anxiety and to improve emotional regulation and impulsivity with an incarcerated population diagnosed with various psychiatric or psychological disorders. Likewise, in a limited qualitative study using person-centered groups of prisoners, A. Richards et al. (2019) found that when elements of rap music were integrated into the therapeutic process, participants self-reported reduced feelings of anxiety, more autonomy, a great sense of identity, a strong connection to others, and improved happiness. Creating a beat to represent their emotions and experiences made it easier for many participants to speak as well as connect with and feel heard by others.

      Music also makes a difference in reducing post-meal-related anxiety for adults with eating disorders (Bibb et al., 2019). In a study of 13 adult women in an outpatient facility who attended a 1-hour music therapy group following a lunchtime social eating challenge, anxiety decreased significantly. Group members chose, sang, listened to, and discussed familiar songs together from a songbook that included 50–60 popular songs. Their engagement in singing and talking focused their attention on their relationship with the music and not on their problems with eating, a strategy they could use after treatment.

      Other research has suggested that in addition to offering adults sounds to relax by, music enhances movement (Park et al., 2019). Therefore, adults who are athletes or who regularly exercise can enhance their efforts by coordinating their physical movement with certain sounds. These positive effects occur because music either distracts people by causing them to selectively focus on pleasant stimuli or physically inhibits negative feedback transmissions (i.e., fatigue) because of the pleasurable electrosensory reactions it generates. Music is a prime ingredient in helping people physically and mentally maintain health or rehabilitate.

       Older Adults

      “Music serves two primary roles in the lives of older people. . . . First, it evokes emotions, memories, and past connections in the person’s life. Second, it can facilitate the enjoyment of shared interests and activities” (Duffey et al., 2006/2007, p. 52). Older adults benefit from participating in music. In fact, sharing a song can result in the creation of a therapeutic bond that affects the quality and longevity of life. For instance, in his Creativity and Aging study, Cohen (2005) followed a group of older adults averaging 80 years in age who participated in chorale programs at the Levine School of Music in Washington, DC, beginning in December 2001. After 2 years of comparing the music participants with a control group of similar individuals, Cohen found that the music participants

       reported better health and fewer falls;

       showed a slower rate of increase in doctor visits than nonparticipants;

       increased medication usage at a significantly lower rate than nonparticipants;

       showed greater improvements in depression, loneliness, and morale; and

       increased social interaction while nonparticipants decreased interaction.

      Overall, playing or making music with older persons has several goals, including the promotion of social interaction, the enhancement of self-worth, the encouragement of self-expression, the increasing of mood and energy, the lessening of pain, and the recall of past events (Clements-Cortés, 2017; Osborn, 1989; Rio, 2002). Ways of conducting sessions vary, and sessions may be carried out in a formal or an improvised manner. When sessions are formally conducted, members of these groups follow more of a schedule, and their personal or interpersonal gains may become secondary to the achievements of the group as a whole. If the sessions are less formally conducted, however, more creativity and interaction may occur with less music.

      Creative Reflection

      In reminiscence or in present-oriented social groups, music may be the key to encouraging discussion of past or present feelings and thoughts about events, such as learning, romance, loss, and family life (Duffey et al., 2006/2007). Music is typically played that revolves around a particular theme, such as the importance of home or family. This activity usually takes place after the group as a whole has warmed up by participating in a brief sing-along of familiar songs that includes their own accompaniment of clapping and foot tapping. This approach is effective at helping reduce depressive symptoms in older people (ages 73–94 years) with dementia (Ashida, 2000) and has value in other older group settings too.

      In a maximum-participation group, members select their own music and theme. In less democratic groups, most of the selections are made by the leaders with particular foci in mind. Songs such as Jerry Butler’s “Only the Strong Survive” as well as Barbra Streisand’s “The Way We Were” and early American ballads like “My Old Kentucky Home” are used to set a tone and a mood that encourage talk and interaction after the singing has stopped.

      Music

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