How do we help parents feel confident in their role as their baby’s primary carer and nurturer? And, how can music therapists make what they know, acceptable and user-friendly for parents? To adress these two key concerns, Helen Shoemark, an acknowledged Australian music therapist and researcher, has developed the program «Time Together».
In this blog post, she explains how working with parents in the NICU for 20 years has enabled her to consider optimal ways and times for supporting parents and their babies through their experience of hospital. Helen is also a member of amiamusica’s scientific board. She hopes that the «Time Together» program provides a useful addition to how we think about helping parents interact everyday.
How music therapy embraces the unique needs of families
When researchers and clinicians think about the needs of the families they work with, the focus is often on those with the greatest need. It is crucial that these families receive much-needed attention, thinking, innovation and support. However, we also know that being in hospital with your baby is difficult for EVERY family. So I think it is also important that the staff find efficient ways to offer every parents tailored input to ensure they feel confident in parenting in hospital. Contributing support to all families will promote optimal functioning to be well for themselves and for their baby.
«Being in hospital with your baby is difficult for EVERY family»
Helen ShoemarkFrom previous research we know that when a music therapist sings with a baby to create interaction, the baby learns to trust the therapist. That’s because when adults respond consistently to babies’ behaviors, babies quickly learn that their behaviors have consistent meaning for the adult. We understand each other.
About «Time Together»
«Time Together» helps parents to understand those consistent behaviors, and also helps parents use their own behaviors in response. Parents don’t have to learn new behaviors/ actions, «Time Together» helps them to think about the behaviors they already have and can use. For example, newborns in the NICU experience a lot of overwhelming experiences and may have very little ability cope with stimulation, so it is useful for parents to know how their baby expresses the early cues for feeling overwhelmed. Some babies raise their eyebrows really high as the first clue that they’re feeling tired or overwhelmed.
So the first intention of «Time Together» is to help parents think about their babies’ behaviors and what they mean. Parents might also realize that it is always the little chant “ch-ch-ch” that soothes their baby at this earliest cue.
The second intention is to encourage parents’ own behaviors which encourage interaction without stressing their baby. This means parents can feel more confident in their interaction, and more satisfied that their baby is getting meaningful interaction so that their development continues while they receive medical care.
© Picture: Helen Shoemark (2011). Time Together Program Booklet (p.9). Unpublished research source.
Instant impact
Apart from developing their parenting confidence, one of the other best features of «Time Together» is that the outcomes we hope for are achieved in just one session. So it is easy for everyone to access just one time, and then there can be more music therapy if that is useful too.
Reference
Shoemark, H. (2018). Time Together: A feasible program to promote parent-infant interaction in the NICU. Music Therapy Perspectives, 36(1), 6–16. https://doi.org/10.1093/mtp/mix004
Dear Helen, thank you so much for your beautiful contribution. Indeed, to lure out endogenous capacities of parenting may be one of the most crucial aims in music therapy so that the most powerful resource for the infant is available: the love and care of the family. In my experience, often, the first session is the key session in the whole therapeutic process. And of course, we should support as many families as possible. What could be challenging with „time together“? What are your experiences and recommendations?
Dear Helen
thank you for your contribution! Your report on Time Together was one of the first I read when I started work as a music therapist on the Neonatal and intensive care wards in the Children’s Hospital Zurich, and I would love to translate the programme into German and into our Swiss culture.
What it changed for me at work with critically ill newborns: I often take a moment to stop by families who I am not officially caring for, encouraging them when they are singing or reading to their child, offering them a „quick stop“ even if I don’t have time to work therapeutically with them, asking if they need support or ideas in communicating with their baby. Quite often these are special moments in a busy day, parents are excited to see how their baby responds to them, and keen to report back to me on later occasions. It would be so good to be able to give them a printed resource to support them in their every day parenting on the ward. Because unfortunately we therapists don’t have the capacity to go to every family, although this time is truly difficult for EVERY one of them.
Dear Friederike
The challenge to always keep in focus is that everyone values music and their voice in their own way. As music therapists we obviously believe in the usefulness of music, but not everyone feels the same. Some time parents do not want to sing, for some their culture does not support it, for others it is not a familiar activity. We must let go of all that singing might be, and help parents to see that all they can already do is enough. Can they talk to their baby? That will be good. Can they repeat a nursery rhyme, or recite a prayer they’d like to teach their baby? Something they can do over and over will be great. But on days when emotion is high, sitting by the bed and breathing deeply in and out is enough.
Dear Rachel I am so pleased it has been helpful to you. I agree that everyone in the NICU benefits from support. This is why I developed Time Together to provide a universal level of support to families who might not see the music therapists otherwise. In family-centered work, it is the family that we come to meet and work with – parents and infant. So bringing what we know to share with parents IS the same work – we champion parents voices and actions because they are the most precious to the infant. A printed resource can be useful, but we do not want it to be just one more thing that a parents feels they should be doing. I am always developing resources so please contact me if you’d like to work on something in German.