Alie Chandler, MM, MT-BC

Transcript:

Bethany Darragh: Today on the podcast, we have Alie Chandler, who is a music therapist with OSSIA Music Therapy. Alie, could you start by sharing a bit about your background and what led you to work in music therapy?

Alie Chandler: Sure. Yes. Thanks for having me. I started my career, my clinical career 22 years ago and music therapy.

And what led me to that is I was always a musician and I wanted to be also a psychologist or a therapist. So I found this career, which was really a calling. And I've been doing it ever since. And I've been trying to run my own practice as well, OCA music therapy for about 17 years now.

Brennan Barber: Alie, what is it about music therapy that makes it an effective form of intervention?

 Alie Chandler: So there are two major ways that music therapy works. Number one, it's really engaging emotionally. So we have this awesome tool of music to just engage our clients so quickly and build rapport so quickly. And also music itself is so engaging for the entire brain.

So your whole brain is lighting up when you're involved in music. You've not only got speech things going on, but you've got motor movement, the emotional connection, so many things happening at once. So I know that you're a champion of at home practice and encouraging that from your experience, how can regular practice at home enhance the effectiveness of your sessions?

So I work in near rehab often and I and we see that for that, for neuroplasticity to actually occur, we need the repetition, we need this high frequency repetition and we need engagement. So that's so easy for music therapy. We've got the engagement, people are emotionally into it and we have songs that are really repetitive, that are really great for working on speech.

Just the frequency. So that's what we need. We have to find that at home. And I've developed a program for home practice called Sing for Speech E-program so that people can really be empowered to practice these techniques at home and then change the brain and improve.

Brennan Barber: I understand that. A lot of the work that you're currently doing is mainly with adults.

Do you have experience working with children? And if so, do you find that adults respond differently to home practice than children might?

Alie Chandler: Yes, I do. I have worked throughout my career with children. I still do. I provide some services at a school for kids on the spectrum. And most of my work is with adults now.

But I see, I still see that everyone is socially motivated. Adults may be more internally motivated. But if they don't have that carrier to help out a little bit, or some kind of social engagement, like a group, a zoom group, whatever it is they won't do as well. So just having that, as, as far as for children too, you have to have some of that social motivation.

Brennan Barber: With the adults that you're working with, is that primarily rehabilitative care, or is it a mix of both chronic and rehabilitative?

Alie Chandler: It's a mix. I do dementia care, which is always fascinating to see people just and I also do rehabilitative care for people post stroke or post brain injury to just really work on a lot of different things.

Cognition, speech, motor skills just, and also the emotional side.

Bethany Darragh: Yeah, I think the emotional side. Helps everything stick a little bit more. I think we put a little bit more weight on things that we feel deeply. And I think that's why I've seen music be a huge tool in my own therapy. I totally agree with that.

I'm talking about motivation and I think something we've talked about on this podcast a lot is that intrinsic motivation. And I heard you say that social interaction is very motivating for everyone. I know that music itself is very motivating for kids, but there are other things you find that can help light that fire in a child to get them into what you're doing, get those reps in what do you find is motivating?

Alie Chandler: Yeah, I think in general, just creativity is motivating. And there's a great quote by Maya Angelou that you can't use up creativity. The more you use, the more you have. So it's a skill you can practice and then it becomes this limited resource. So what we do in music therapy a lot is. It's some improvisation led by the child.

So based on the child or adult, whatever they're doing, we can match the syllable that they're saying and turn it into a song and turn it into just la, whatever we're working on with them using their syllables that are there in sounds or their movements. And we can adapt that musically just to bring that.

Attention to the other person and to the goal that we're working on. Whatever you can do creatively just to make them feel her And then turn that into some kind of a task that you're working on.

Bethany Darragh: Yeah, I noticed this week, I have a student who is very motivated by music, but he's gotten in the habit of his reward being independent play with a musical toy.  We're not getting that same social engagement or modeling or back and forth that I would hope to get. And he knows if I just get my work done, I can go play with this toy. I was trying to prolong that a little bit and see if I could find something else. And he makes a lot of kind of like doodah sounds in his mouth.  And I just imitated him and I got, maybe five or six more minutes of attention and play with him before he remembered, Oh yeah, I went to want to go get that toy, but I was like, okay, I'm definitely going to start using this more where I just model his sounds and see if we can do like a back and forth conversation with doodahs for a little while to keep the engagement before he just runs and plays with that toy.

Alie Chandler: Yes, that could be, we call it reflecting and improvisation. And that can be even reflecting there. Movements like just a mouth movement or an arm movement or blink or anything and turning that into a rhythm and just giving them the sense that, yes, I'm here and I want to be with you and we can be together and playfully interact.

Brennan Barber: Alie, can you talk a little bit then about. You mentioned patient goals, and it sounds like it's really a blend in some ways of the patients that you work with. Some may have goals around speech, certain verbalization techniques, and others may be a little more physical with movement.

Can you talk about, a little of what that looks like for each of those categories, and then what it may look like for individuals that are working on both.

Alie Chandler: Yeah, definitely. I think for my career, I've focused on communication because I've seen, I started out, working with autistic kids and seeing how, wow, they can speak through music when they're otherwise not speaking much.

Just. Really focused on that. And then I moved into aphasia care. So people who've had brain injuries and have the same like expressive language difficulties, but they can sing five verses of their favorite song, so we do some neurologic music therapy techniques where we. basically use rhythm and melody to access language because you're using different pathways in your brain when you're singing than when you're just speaking.

This can actually create new neural pathways like if you're using these music therapy techniques. So there's that side of it. And then yeah, sometimes we will work on range of motion through playing instruments. We'll work on fine motor through playing guitar or piano. And I often collaborate with OTs and speech therapists and PTs.

And then we roll it all together and also. Do some of the therapy part with the emotions. So all good stuff. 

Bethany Darragh: So I know a lot of clients and families come to therapy with the best intention to do their exercises at home and to integrate things at home. And then they get home and. Things get lost in the shuffle.

Do you have any creative ways or strategies that you give your clients to help them integrate the practices into their daily routine?

Alie Chandler: Yes, I definitely do. I send a lot of videos, make little videos of what we're doing and send it to them. I also have this Sing4Speech e program, which is basically an online manual with interactive videos and audio, and it's all clearly, clear directions.

So you can really. Be empowered to do all these things we do in the session at home every day. So there's that. And they also think about the 10 minute method where you just schedule in 10 minutes a day and just schedule it in. And you really can get a lot done in 10 minutes and most of the time you will go over that 10 minutes to do it.

So just committing to that is at a specific time every day is really done wonders for people.

Brennan Barber: And with that commitment to home exercises have you seen tangible results in the clients who are engaging consistently? And how are you tracking some of that success?

Alie Chandler: Yes, I had a case study that I did for about five weeks with one of my clients.

So I have a lot of anecdotal evidence. I also track goals. Just okay, how many lyrics? How many lines of lyrics is this person singing today and are these clear and what percentage? So we do all that data. But the case study using the sing for speech program at home really showed so much progress with this man who had a stroke and had severe aphasia and apraxia.

So a lot of the motor speech problems. And he was able to Say all seven of the phrases that we had done and that he had done every day at home with his program And really could do everything in the program So it's amazing to see like the home practice really works.

Bethany Darragh: I think some people have a hard time Understanding that the goals for music therapy are oftentimes not music related.

They're just Everyday life goals. And so it's a lot, it's a lot easier when, physical therapy goals are, walking and standing and then occupational therapy goals are like actual hand motor skills. And then speech therapy goals are oftentimes the same as the speech therapist, PT goals, OT goals.

But then just a totally different way of getting there, which is sometimes. The secret ingredient?

Alie Chandler: Absolutely. Yeah, we definitely, our holistic kind of therapy and that's one of the definitions of music therapy is we do target non musical goals, and sometimes we have a musical goal.

If it expands their means of just exploring music and exploring themselves. So it works.

Bethany Darragh: So let's talk about caregiver and parent involvement with therapeutic journeys. Do you see the caregiver playing a role from the beginning with goal setting and also with home exercise programs, or do you see them coming in at a different point?

How does that work with your therapy?

Alie Chandler: Yes, I definitely think I always address the family and do a person centered plan. The goals have to be meaningful to that person and to their family as well for there to be, engagement and progress and all of that. And the good thing about music therapy is that everybody benefits from the endorphins that you get when you're doing music together.

So you are all getting like dopamine, serotonin boosts. So that. That means that if you engage in these types of exercises with your person you're caring for, then you're going to, get those good feelings and want to do it more often as well. It's, a lot of people will say, I can't do music, I can't sing, but if I can give you, a home program that is doable with videos then you can, use apps and you can.

Just have all those tools at home. So I wanted to empower the caregivers to do that.

Bethany Darragh: Yes. And you bring up a good point. A lot of times the caregiver journey can be very draining or traumatic or emotional. And I think that's a good point that them participating in this type of therapy could also be.

helpful and therapeutic to the caregiver as well because they're also dealing with a lot of emotions and stressors and fatigue that sometimes goes unnoticed. So I like how participating in the therapy together could benefit both parties in different ways.

Alie Chandler: Yeah, definitely. And actually a report just came out from the UK.

I just looked at about dementia care and how if there are staff and carriers involved in the music therapy group, their attitudes change, they learn more about the person and the whole system can change just from being in that experience together. So it's super empowering for everybody.

Brennan Barber: Add a little firsthand experience with this as well.

So with my son, he's very into music and he likes a very eclectic mix of music. And there are times where we want to work on certain fine motor skill Exercises and, we're just very exhausted from doing some of the same things over and over again. And we've purchased him like a little keyboard that he can play.

And then we've got some drumsticks and we make a lot of really bad music together, but it's a good time. And certainly, breaks things up a little bit, and he loves it, makes us feel like we have worked on some of these things that you had mentioned range of motion, some of the classical music that he's gotten into now.

He likes to pretend that he's conducting as he listens to it. It's just a great way for us to implement some exercises that doesn't really feel like work, especially when it's, To your point, after a long day in the office or a long week and, you're looking to relax on the weekends and Yeah, it's a great way to integrate some different practices into what we do.

Alie Chandler: Yeah, absolutely. So glad that works out for you and it is a great way just for everybody to relieve stress and when you're singing you're getting deep breaths. You're automatically relaxing you're stimulating the vagus nerve When you're singing or humming or chanting or anything like that, which just relaxes your system.

And then, yeah, beating on some drums with your kiddo. What a way, what great way to just connect as well as both release any stress.

Brennan Barber: Yeah. And he loves pounding away on the keyboard too. So it's like I said, a lot of bad music being made, but it's fun. It's great.

Bethany Darragh: Alie, we love to celebrate on this podcast.

So are there any celebrations with any of your clients that you could share with us?

Alie Chandler: There's several I can think of one in particular where the man I was working with who had a stroke and had lost a lot of language his daughter was getting married, so we put together a recording and recorded his singing because he can sing fluently He sang a beautiful song and it was played during the wedding, like in lieu of his speech and all of that.

It was a great way for him to just be part of that and for his family just to hear his voice and like literally given a voice and also metaphorically.

Bethany Darragh: I love that. That's beautiful. What advice do you have for therapists who are trying to start setting up more of a home practice regimen with their clients, but don't even really know where to start with?

What's manageable? What is what can you expect your clients to be able to participate with? How have you managed that?

Alie Chandler: I think it's very individualized. Just asking The family, like, when is the best time to practice and the client do you have a better time in the morning or in the evening and setting a regular time that works out? And then, of course, having giving them all the tools if there's any games or apps that, that kind of can be included, any kind of homework. That's a really clear tool for them.

Bethany Darragh: Yes. And I'm glad you mentioned games and apps because I also want to ask about technology. How do you see technology playing a role and supporting our therapy?

Alie Chandler: I think it's, it's just so everywhere in this society, like you can, you can't not have technology. So I think gamification is a great way to do any kind of therapy. It's a really effective way. I know there's a lot of apps through different companies. I think just having some kind of a guide and a tool for home care is really essential and technology is the way to do that.

One of my missions is adding music and art and creativity into these apps so that they're more engaging and so that they can be a creative outlet too.

Bethany Darragh: Alie, thank you so much for being on our podcast today. Do you have a way that people can reach you or find you on the internet?

Alie Chandler: Yes. Definitely. Thanks for having me. My website is Ossia Music Therapy, that's ossiamusictherapy.com . You can find everything there and feel free to email or call.

Bethany Darragh: Thank you so much.