Singing for Healing and Hope: Music Therapy Methods that Use the Voice with Individuals Who Are Homeless and Mentally Ill

Editorial Note: Today's post is the first by our intern Jordan! She'll be writing monthly posts for us on music therapy research articles she finds interesting. Enjoy!

During my internship, I’m required to read one article per month related to music therapy. So I figured I’d share my thoughts on it with you fine people! My goal is to make the articles as accessible to the public as possible. You won’t need any knowledge on music therapy for these articles to excite you. And if it doesn’t excite you… I’m not using enough exclamation marks.. Okay, okay. Ready? Here we go.

Singing for Healing and Hope: Music Therapy Methods that Use the Voice with Individuals Who Are Homeless and Mentally Ill

It’s no secret that homelessness is a serious problem, I’d even go so far as to say a chronic illness. It seems that those who are homeless are stuck in a cycle of homelessness, regardless of aid that is given to them. Did you know that a 2006 study showed that 60% of individuals who are homeless have a diagnosis of schizophrenia? What’s more, 15% diagnosed with bipolar disorder I, and 1% diagnosed with depression. The core of the issue is that individuals who are homeless and mentally ill are, essentially, victims. They are victims of their illnesses, illnesses that debilitate and harm them. They are victims of a society that stigmatizes them.

So, how can music therapy help these individuals? Let’s start by identifying some therapeutic goals. For starters, people who suffer from homelessness and mental illness need increased socialization with other individuals and the community. Socializing encourages those who are homeless and mentally ill to engage; engage in life, engage in relationships with others, engage in their well being. Homelessness often results in disengagement, where the individual loses contact with friends and family and isolates themselves in their own world. Another therapeutic goal for this population is to improve self-esteem. Due to poor socialization and engagement in life, the homeless and mentally ill deal with feelings of low self-esteem and self-worth. Self-expression is key for this population because feelings of sadness and despair are common with this population. These individuals also commonly report feelings of anxiety, annoyance, frustration, all of which result from mental illness or life on the streets.

After discussing the needs of the homeless and mentally ill, it’s obvious that some sort of therapy needs to be implemented. But why music? More specifically, why singing? Vocal singing provides greater expression of feelings than verbal language alone. Think about this in your own life. Remember that time in high school you first fell in love? All the songs you listened to were love songs, it was almost like the artist wrote this song FOR you and your boyfriend/girlfriend. That’s why couples had “their song”, right? Now, think about the time you were in college and were completely single, and loved it! Chances are, most of the songs you listened to glorified the single life, or in my case, were all about female empowerment. The point is, when any of those songs came on the radio or our iPods, we rolled down the windows, blasted the volume, and sang at the top of our lungs! Singing those songs that made us feel so much released something in us. It engaged us, awakened our spirits, boosted our self-esteem, and expressed our emotions. All of which are therapeutic goals for individuals that are homeless and mentally ill.

The CSS/CTP Program at the 30th Street Men’s Shelter in New York City is a unit for men who are homeless and have a history of mental illness. This article discusses the case-studies that took place here, and how voice-centered music therapy met the specific needs of this population. I will discuss two of these case studies, but I highly encourage you to read the article for full details!

There was a 37-year-old man from West Africa named Kweku. He became homeless after he escaped the violence of war in his homeland. His diagnosis was unclear, but it WAS clear that he struggled with depression, and had a history of auditory hallucinations. His English was minimal, which made it hard for him to express himself, communicate, and build relationships with other men in the CSS/CTP Program. He was highly educated in Africa, but due to the language barrier, he found it hard to live a full life here and have loving relationships with women. During a music therapy session, Kweku was asked to sing a song alone and accompany himself with an instrument of his choice. He chose to sing “No One” by Alicia Keys and used a tone bar to accompany himself. The lyrics to this song mirrored Kweku’s situation, as he felt he was searching the world to find what he had in Africa: a career, a home, and a significant other. Kweku sang this song boldly and loudly. At the end of his song, he received a round of applause and encouragement from the group. So let’s analyze how the above scenario helped Kweku. He was able to express himself in a healthy way; he expressed his feelings and thoughts in a way that was finally understood by his peers. He sang loudly, showing his confidence in his ability, or a disregard to what the others thought about him. Either way, it showed an increase in self-esteem. The group’s acceptance of Kweku’s performance translated to Kweku’s acceptance of himself: after he finished singing, he laughed. This laughter says so much: his enjoyment of the activity and his increased feeling of acceptance and love from others in that moment. The author goes on to say that throughout Kweku’s time in the CSS/CTP program, his self-esteem gradually improved through singing (shown through behaviors like singing loudly and laughing afterwards). The author also states that Kweku’s attitude changed over a period of time to reflect more openness, expressiveness, and a greater social involvement.

Another study discussed involved group singing. A benefit of group singing is it decreases the need for perfection. Individuals may not be comfortable singing a solo, but most will sing in a group, where it feels safe. In a group setting, there’s a feeling of camaraderie and cohesion. In this article, the author tells of a man who seemed disengaged during the music therapy session. He was distant and non-responsive. That is, until he heard one of his favorite jazz tunes. He eyes lit up, he smiled, he started singing, and encouraged the rest of the group to sing along with him! You see this result often with older adults who are diagnosed with Alzheimer’s Disease; they may seem distant or disengaged, but when you play a familiar song, you’d be surprised at the response you get! I’ve seen a 70-year-old woman immediately jump up and start shaking her booty! All because she heard a song she used to dance to when she was a girl.

In the article, there are more stories like the two above. Stories that involve group chanting and vocal improvisation (similar to writing a song), so I highly encourage you to read it!

This article strongly argues the point that the voice offers individuals who are homeless and mentally ill a unique experience of doing something that gives meaning, sparks creativity, and encourages socialization with others. I loved reading this article, because as a vocalist, it was so cool to see such powerful responses to the voice-centered music therapy. Singing and vocal sounds create opportunities for social interactions and self expression in a way that verbal communication can not, especially for this socially isolated population.*

Hope you enjoyed! Comment below for any questions or comments you may have!

Iliya, Y. A. (2011). Music for healing and hope: music therapy methods that use the voice with individuals who are homeless and mentally ill. Music Therapy Perspectives, 29(1), 14-22.

Jordan Van Zyl, LPMT, MT-BC

The George Center, 12060 Etris Road, Roswell, GA, 30075