Self Care and Mental Health for Music Therapy Interns and Students

Music therapy students, like those in other health or music-related fields, are especially vulnerable to mental health challenges due to demanding coursework, performance pressure, and clinical responsibilities. The transition to college often coincides with emerging adulthood (ages 18 to 25), a critical period marked by ongoing brain development, increasing independence, and emotional growth. This stage of life is also when many mental health conditions first appear, with about 63% of individuals experiencing onset before age 25 (Gooding et al., 2024).

Even without a formal diagnosis, emotional distress is common among college students. One survey found high rates of anxiety, exhaustion, loneliness, and feeling overwhelmed by responsibilities (ACHA, 2018). Music therapy majors may also experience additional stress from student debt, practicum requirements, and uncertainty about their future. For students with invisible disabilities such as mental health conditions, these challenges can be even more difficult, potentially affecting both academic progress and personal well-being.

Self-care is essential not just for surviving college but for sustaining long-term success and well-being as a music therapist. Without intentional self-care, students risk burnout, compassion fatigue, and long-term disengagement from their work. Here are key self-care strategies drawn from current research and student experiences:

General Self-Care Tips:

• View self-care as an act of self-preservation, a way to recharge after putting energy into academics, clinical work, and helping others.

• Remember that how you care for yourself now can influence how effectively you care for clients in the future.

• Build habits that support your emotional, physical, spiritual, and social health early in your training.

Emotional & Social Self-Care:

• Nurture relationships that exist both within and outside of your academic or clinical environment to maintain a strong, balanced support system.

• Lean on your support system to stay emotionally grounded and reduce feelings of isolation.

• Set emotional boundaries so you don’t become overextended in school or clinical responsibilities.

Physical & Nutritional Self-Care:

• Regularly move your body to manage stress and maintain energy levels.

• Eat balanced meals and try to keep a steady sleep routine.

• Pay attention to your body’s signals. Rest when you’re tired, stay hydrated, and avoid pushing yourself past your limits.

Time & Occupational Self-Care:

• Make time for activities that are not related to school or music therapy, such as hobbies or rest.

• Create a manageable schedule that includes breaks from music-related tasks.

• Set realistic expectations for yourself and feel comfortable saying “no” to avoid burnout.

Music Based Self-Care:

• Keep a personal connection with music that is not tied to school or clinical goals.

• Revisit the music that originally sparked your love for the field.

• If music starts to feel exhausting, explore other self-care practices such as silence, journaling, time in nature, or other creative outlets.

• Find ways to use music for your own growth and comfort, not just for therapeutic work with clients.

-Asila Folds, Music Therapy Intern

Resources:

Boeser, A., & Silverman, M. J. (2024). Development and implementation of self-care strategies in undergraduate music therapy students: A qualitative thematic analysis. Nordic Journal of Music Therapy, 33(4), 344–360.

Gooding, L. F., & Ferrer, A. J. (2024). Supporting music therapy majors with mental health conditions. Music Therapy Perspectives, 43(1).

Fiore, J. (2020, August). Self-care toolbox for music therapy students [Podcast]. AMTA-Pro. American Music Therapy Association.

American College Health Association. (2018). American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2018. Silver Spring, MD: Author.

Music Therapy for Anxiety and Depression

According to researcher Doublet (1998), stress is related to complaints in about two-thirds of medical consultations in the United States. When left untreated, chronic stress can lead to mental health conditions such as anxiety and depression. These disorders, as defined in the DSM-5, involve significant disruptions in thinking, emotional regulation, or behavior that interfere with daily functioning.

Anxiety and depression share a common thread: persistent emotional distress. This may include feelings of  sadness, emptiness, irritability, or excessive worry. These feelings are often accompanied by physical and cognitive symptoms such as fatigue, sleep disturbances, low motivation, muscle tension, and difficulty concentrating. These symptoms can make it hard to participate fully in everyday life.

Music therapy has been shown to help reduce many of these symptoms. Engaging with music stimulates the brain’s emotional and reward systems, increasing levels of endorphins, dopamine, serotonin, and oxytocin. These chemicals play a role in improving mood, reducing stress, relieving pain, and fostering social connection.

How music therapy helps individuals with anxiety and depression:

• Regulates the stress response: Active music-making (ex: drumming, singing, playing instruments) can reduce stress hormones like adrenaline, easing restlessness and tension.

• Promotes emotional grounding: Rhythmic engagement provides a sense of stability and helps clients release emotions in a safe and structured way.

• Improves sleep and relaxation: Slow tempo, steady rhythm music,  combined with guided breathing or meditation, can help the body shift into a relaxed state.

• Boosts energy and motivation: Music that involves movement and creativity activates brain regions tied to energy, appetite, and motivation.

• Encourages social connection: Group sessions using improvisation or songwriting support emotional expression and reduce isolation.

• Rebuilds self-worth and trust: Collaborative music-making fosters connection and gives space for shared emotional experiences.

• Supports body awareness: Techniques like body percussion can help individuals reconnect with their bodies through rhythm and resonance.

Music therapy offers a holistic and flexible approach to treating anxiety and depression. It addresses emotional, cognitive, physical, and social symptoms, offering not just symptom relief, but also support for long-term healing and emotional growth.

-Asila Folds, Music Therapy Intern

References:

dos Santos, E. A., Sanchez, E. M., Ortiz, M. Á. N., & Germes, M. A. O. (2019). Effects of music therapy in depression and anxiety disorder. TMR Journals.

Aalbers, S., Fusar-Poli, L., Freeman, R. E., Spreen, M., Ket, J. C. F., Vink, A. C., Maratos, A., Crawford, M., Chen, X.-J., & Gold, C. (2017). Music therapy for depression. Cochrane Database of Systematic Reviews

Flores Gutierrez , E. O., & Camarena , V. (2015). Music therapy in generalized anxiety disorder. The Arts in Psychotherapy, 44, 19–24.  

Music Therapy for Children Who Are Hard of Hearing or Experience Hearing Loss

Because music is predominantly an auditory stimulus, it is often assumed that music listening and music therapy would not be appropriate for children who are hard of hearing or have experienced hearing loss. Research throughout the decades has concluded that music perception and appreciation influence other factors and make music therapy appropriate for improving language development, speech production, socialization, and the development of musicality.

Therapists must consider various types of hearing loss when planning music therapy sessions for clients with hearing impairments. Conductive hearing loss occurs due to disease, malformation, or obstruction in the outer or middle ear, and devices such as hearing aids are often helpful. Sensorineural hearing loss occurs due to damage or absence of the hair cells in the inner ear. Hearing aids and cochlear implants are used to assist with hearing. The thing to know about sensorineural hearing loss is that the more extensive the damage is the less effective hearing aid devices are. The final type of hearing loss is central hearing loss, which occurs due to damage to the central nervous system.

The age of onset of hearing loss often results in a wide variety of needs associated with hearing loss. The primary need of children who experience hearing loss is the development of spoken and written forms of language. An article on music therapy for children who are deaf or hard of hearing states that “children with severe hearing losses may have speech with improper pitch level, omitted or improperly formed speech, and less intelligible speech.” 

This results in music therapists targeting four main goal areas when treating individuals with hearing loss. These goals are language development, speech production, auditory training, and social skills attainment. Music therapy for language development uses interventions to increase the appropriate use of vocabulary, increase spontaneous communication, and increase sentence structure. Lyrics of songs should be selected to introduce and practice target vocabulary. This includes songs filled with vocabulary such as numbers, colors, and animals. Interventions such as writing songs or pairing sign language with music allow clients to generate new ideas through expressive language. Music therapy for speech production uses interventions to increase vocalization, increase production of natural speech rhythms, and increase the production of common speech sounds. Therapeutic singing allows for the controlled production of speech sounds in a predictable and controlled tempo. Lastly, music therapy interventions are used to increase social skills for children by providing structured opportunities for taking turns, paying attention, following directions, sharing, and expressing feelings appropriately.

Overall, music therapy is an adaptable approach that can support individuals with hearing loss and those who are hard of hearing. Music therapy can aid in the impact that hearing loss can have on a child’s life through targeting that enhances language and speech development.

-Rebecca Smith, Music Therapy Intern

References:

Edwards, J. (Ed.). (2017). The Oxford handbook of music therapy (First published in paperback). Oxford University Press.

Gfeller, K. (2024). Music as Communication and Training for Children with Cochlear Implants. In N. M. Young & K. Iler Kirk (Eds.), Pediatric Cochlear Implantation (pp. 443–458). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-67188-3_27

Angelman Syndrome and Music Therapy

Angelman syndrome is a condition that is caused by a genetic change in the UBE3A gene. This change can cause delayed development, speech problems, balance needs, cognitive disability, and occasionally seizures. The developmental delays begin between 6 months to a year of age and are often the first sign of Angelman syndrome. According to Sommese and Corrado (2021), more than 80% of Angelman syndrome patients experience seizures with onset before the age of three.

Additional characteristics of individuals with Angelman syndrome consist of the following:

• Seizures

• Stiff or jerky movements

• Small head size by age 2

• Tongue thrusting

• Hand flapping and arms uplifted when walking

• Crossed eyes

• Scoliosis

Angelman Syndrome is rare and most often researchers do not know what the cause is for the genetic change that results in the syndrome. Physical, Speech, and Occupational Therapy for individuals with Angelman syndrome has been proven to be effective and often targets physical and sensory goals.  Music therapy is an approach that can effectively target and improve these areas as well.

Common music therapy techniques used with Angelman syndrome consist of:

• Using mnemonic devices to teach factual information (name, address, phone number) as well as for cognitive rehearsal for life and leisure skills.

• Effective for gait training, using rhythmic entrainment. Engaging in movement to music can target gross motor skills, such as improving hand use, crossing the midline, and reaching both high and low.

• Targets receptive communication skills through choice-making, motor planning, sentence structure, speech intelligibility, phonemic awareness, and pattern of language. 

• When providing collaborative intervention with other disciplines, such as Speech Therapy, Occupational Therapy, or physical therapy , music therapy can provide sensory stimulation and increase motivation while targeting various areas. 

• The neurologic music therapy technique, Musical Attention Control Training, targets various kinds of attention, such as selective, divided, and sustained attention, by directing a patient using a musical stimuli (Thaut & Hoemberg, 2014).

Overall, there is very little current research on music therapy and Angelman syndrome. The most recent studies explored the differences in response to music in individuals with Angelman syndrome and individuals with Prader-Willi Syndrome. The most significant finding documented was the effect music had in reducing heart rate in individuals with Angelman syndrome. The article concluded that “because Angelman Syndrome is associated with short attention span, and because heart rate deceleration is known to be related to orienting response,” the auditory stimuli of music were seen to aid in therapeutic treatment for Angelman syndrome.

-Rebecca Smith, Music Therapy Intern

References:

Angelman Syndrome. (2024, March 8). Mayo Clinic Staff. https://www.mayoclinic.org/diseases-conditions/angelman-syndrome/symptoms-causes/syc-20355621#:~:text=Angelman%20syndrome%20is%20a%20condition,happy%20and%20easy%20to%20excite.

Guy, J. (2005). Music Therapy & Angelman Syndrome Fact Sheet. Music Therapy Center of California. https://www.themusictherapycenter.com/wp-content/uploads/2016/11/mtcca_angelman.pdf

Kotler, J., Mehr, S. A., Egner, A., Haig, D., & Krasnow, M. M. (2019). Response to vocal music in Angelman syndrome contrasts with Prader-Willi syndrome. Evolution and Human Behavior, 40(5), 420–426. https://doi.org/10.1016/j.evolhumbehav.2019.05.003

Sommese, M., & Corrado, B. (2021). A Comprehensive Approach to Rehabilitation Interventions in Patients with Angelman Syndrome: A Systematic Review of the Literature. Neurology International, 13(3), Article 3. https://doi.org/10.3390/neurolint13030036

Thaut, M. H., & Hoemberg, V. (Eds.). (2014). Handbook of Neurologic Music Therapy. Oxford University Press

Songwriting for Emotional Expression and Regulation

Songwriting in music therapy is a therapeutic intervention designed for the client and therapist to create lyrics and music. Songwriting is used to target a wide variety of clinical diagnoses and goal areas. These common goals consist of increasing verbal communication, improving self-concept, validating experiences and emotions, externalizing thoughts, and developing cognitive skills.  When planning a songwriting intervention, the therapist music takes into consideration the emotional and cognitive needs of the client. This results in the original goals of the intervention sometimes shifting to meet the present needs of the client.

When leading a songwriting intervention, the music therapist controls the content, structural components of the lyrics, and the melodic form, which contributes to the process. Types of songwriting consist of original compositions, Lyric substitution (piggy-back) lyric writing, fill-in-the-blank, guided, and improvisation. Lyric substitution (piggy-back) song writing consists of taking an existing song and the client adapts and rewrites their own lyrics. Fill-in-the-blank songwriting consists of the client completing lyrics with preexisting song structure. Guided songwriting consists of the therapist providing structure and suggestions collaboratively with the client during the songwriting process. Lastly, improvisation songwriting consists of the client engaging in spontaneous music making and/or lyric writing.

A case study example of song writing targeting the reduction of stress is found in the article “The Feasibility of Songwriting as Stress Management for Parents of Hospitalized Children.” In this study, patients are parents of children who are hospitalized for two or more weeks and are dealing with anxiety and stress. Short term prognoses consist of reduction of stress levels and long-term prognoses varied depending on the severity of reason for children’s hospitalization. These needs were assessed through self-report from patients/caregivers and then were also assessed through referrals from health care providers. There were three phases as part of the music therapy session that were used to target reducing anxiety. Live music for rapport building, guided music meditation and then song writing. The interventions specifically rely on counseling techniques such as paraphrasing, redirection, and body language to build rapport and allow for exploring of clients’ ideas. For the song writing intervention the therapist used lyric substitution and original song writing. The projected outcomes consist of decreased stress and anxiety levels of parents with children who are staying in the hospital longer than two weeks. The song writing intervention also allowed for bonding and processing of emotions for the parents. The interventions were personalized based on parent comfort and the current anxiety levels of the parents which allows for therapeutic discretion and manipulation of the session. This discretion allows for the generalization of this intervention to other clients with similar needs.  

Overall, music therapy provides the space for parents to reduce their stress and anxiety levels using song writing, by providing the parents with autonomy through discussion to promote positive coping skills.

-Rebecca Smith, Music Therapy Intern

References:

Marcovitz, J., Zhang, Q., Jang, H., Adelman, S., Pincus, B., Bauman, J., & Mullur, R. (2024). The Feasibility of Songwriting as Stress Management for Parents of Hospitalized Children. Music Therapy Perspectives, 42(2), 123–128. https://doi.org/10.1093/mtp/miae010

Aasgaard, T., & Blichfeldt Ærø, S. C. (2015). Songwriting Techniques in Music Therapy Practice (J. Edwards, Ed.; Vol. 1). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199639755.013.20

Music Teacher, ‟Ioan Sima” Art High School, Zalău, Romania. Email: ellie.pastor94@gmail.com., Pastor, E., Heath, B., & Music Therapist, Singer, Songwriter, Musician, Associate Lecturer, University of West England. Email: bob.heath.therapy@gmail.com. (2022). A Case Study on Songwriting in Music Therapy. Studia Universitatis Babeş-Bolyai Musica, 67(1), 37–48. ttps://doi.org/10.24193/subbmusica.2022.1.03