20-second songs to sing while you wash your hands

How long do you have to wash your hands? At least 20 seconds each time. This equates to the time it takes to sing “Happy birthday” twice. But if you’re looking for a refresh on your hand-washing set let,  Kevin Budd, a CHOC Children’s music therapist, has compiled this list of 20-second snippets of your favorite songs, to sing while you wash your hands. (And you can get more hand-washing tips from a CHOC Children’s pediatrician here.)

Just the Way You Are – Bruno Mars
When I see your face
There’s not a thing that I would change
’cause you’re amazing
Just the way you are
And when you smile
The whole world stops and stares for a while
‘Cause you’re amazing
Just the way you are

Mr. Brightside – The Killers
Jealousy, turning saints into the sea
Swimming through sick lullabies
Choking on your alibis
But it’s just the price I pay
Destiny is calling me
Open up my eager eyes
‘Cause I’m Mr. Brightside

Love on Top – Beyoncé
Baby it’s you
You’re the one I love
You’re the one I need
You’re the only one I see
Come on baby it’s you
You’re the one that gives your all
You’re the one I can always call
When I need to make everything stop
Finally you put my love on top

Stressed Out – Twenty One Pilots
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out
Wish we could turn back time,
to the good old days
When our momma sang us to sleep
but now we’re stressed out

Can’t Hold Us – Macklemore
Can we go back? This is the moment
Tonight is the night; we’ll fight till it’s over
So we put our hands up
Like the ceiling can’t hold us
Like the ceiling can’t hold us X2

Some Nights – fun.
Some nights, I stay up cashing in my bad luck
Some nights, I call it a draw
Some nights, I wish that my lips could build a castle
Some nights, I wish they’d just fall off
But I still wake up, I still see your ghost
Oh Lord, I’m still not sure, what I stand for oh
What do I stand for? What do I stand for?
Most nights, I don’t know anymore

Truth Hurts – Lizzo
Why men great ‘til they gotta be great
Don’t text me; tell it straight to my face
Best friend sat me down in the salon chair
Shampoo press, get you out of my hair
Fresh photos with the bomb lighting
New man on the Minnesota Vikings
Truth hurts, needed something more exciting
Bom bom bi dom bi dum bum bay

Whatever it Takes – Imagine Dragons
Whatever it takes
‘Cause I love the adrenaline in my veins
I do whatever it takes
‘Cause I love how it feels when I break the chains
Whatever it takes
You take me to the top I’m ready for
Whatever it takes
‘Cause I love the adrenaline in my veins
I do what it takes

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The benefits of music therapy: Antonio’s story

A typically happy and energetic Antonio began to feel isolated during an extended hospitalization. His music therapist Rebekah helped him feel more social, while providing “normalized” experiences for Antonio and his family.

At CHOC, music therapy is just one of the specialized therapeutic programs offered through the Cherese Mari Laulhere Child Life Department.

When Antonio was a baby, he was diagnosed with an immune system disorder called chronic granulomatous disease (CGD), which meant his white blood cells couldn’t properly fight bacteria and infections. He got sick more than other kids and took twice-daily medications, plus injections three times per week. Antonio was 9 years old when doctors determined he was a good candidate for a bone marrow transplant, so that his body could learn to make infection-fighting blood cells. His infant brother was a perfect match and served as his donor.

After a bone marrow transplant, the immune system is very weak, and patients are typically kept in isolation with limited visitors and other precautions in place in order to protect their fragile health. Antonio spent about six weeks in isolation.

At first, he was skeptical of music therapy, but he came around quickly.

“When I first went to Antonio’s room, he was playing video games in bed. He didn’t look at me or respond to me, so I told him I would simply tell his mom who I was and what music therapy was about, and he could listen if he wanted to,” Rebekah said. “By the time I sang the second line of his favorite song, he transitioned from lying in bed to sitting up, smiling and singing along with me. His mom played along with an avocado shaker, his infant siblings were both shaking maracas. The feel of the room had been transformed”

Since hospitalizations also impact siblings and parents deeply, Rebekah strives to include families in music therapy sessions whenever she can. After their initial session, Antonio was eager to engage in any musical experience that Rebekah suggested.

“In the middle of a long hospitalizations, there would be days Antonio was in a funk and the only thing he wanted to do was play video games,” his mom Maria said. “But when Rebekah came to his room, he would immediately turn off his video games, smile, happily get out of bed, and interact with her.”

At first glance, music therapy might look like simply singing or playing instruments, but the evidence-based work of a board-certified music therapist supports a patient’s clinical goals. In the medical setting these goals may range from promoting symptom management, like pain or nausea; increasing emotional expression related to diagnosis and hospitalization; or normalizing the hospital environment and promoting typical developmental milestones.

Antonio and Rebekah have a jam session in Seacrest Studios.

Some of Antonio’s goals for music therapy included decreasing isolation, increasing engagement in preferred activities, and managing stress and anxiety. Children who remain engaged with their environment typically respond to stress in a more positive way. By creating songs about Antonio’s favorite foods and hobbies, he can focus on the healthy aspects of himself—a reminder that he is more than his diagnosis, treatment or hospitalization. These goals were established to counteract the potential negative impacts that a prolonged isolation and hospitalization can bring.

Sessions were filled with creativity, laughter and smiles – from Antonio, his siblings and his mom. Some days, he and Rebekah wrote songs about Antonio’s favorite things.  Other days they wrote about his mom or favorite nurses. During music therapy, Antonio also frequently created original music through playing ukulele, drums and guitar. Since young patients often don’t get to make many decisions, they worked in opportunities for Antonio to feel autonomous and “direct” the other band members (his siblings and mom).

“Music therapy cheered up my son while he was in isolation,” Maria said. “It makes me happy that CHOC has things like this for kids when they can’t leave their rooms.”

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Music therapy in a mental health setting

Music therapy has been part of CHOC Children’s specialized therapeutic programming for more than 10 years. The program has grown recently, due to increased awareness of its effectiveness and a growing need among CHOC patients. We sat down with Kevin Budd, a board-certified music therapist in CHOC’s Mental Health Inpatient Center, to discuss the benefits of music therapy in an inpatient psychiatric setting.

Q: Music therapy is more than just listening to music. What encompasses this practice?

A: Music therapy is the clinical and evidence-based use of musical interventions to accomplish individualized goals. This occurs within a therapeutic relationship between a credentialed professional who has completed an approved music therapy program, and a patient. During music therapy, we address physical, psychological, cognitive and/or social functioning challenges for patients of all ages. Essentially, we utilize evidence-based, musical interventions for non-musical outcomes; meaning music is the tool which helps support a patient’s non-musical need or goal.

Q: How does music therapy support clinical goals?

A: A patient’s clinical goal is the starting point for determining which musical intervention will be most effective. In the Center, these goals could include: mood regulation, self-expression, self-esteem, anxiety, interpersonal effectiveness, treatment motivation, positive coping skills, and more. There’s no one-size-fits-all treatment when it comes to music therapy within mental health. We might work towards their goals several different ways, including: focused music listening, songwriting, song discussion, group instrument playing, music and relaxation, singing, and many others.

For example, if a patient’s clinical goal is to increase identification of positive coping skills, we might work on lyric analysis within the patient’s preferred style of song. We could discuss triggers, resilience, and negative life situations in the song. During this lyric analysis, I can help navigate the discussion to include the patient’s interpretation of the musician’s experience and how it might relate back to their own life. After this discussion, we could rewrite the chorus of the song including identification of a negative situation and a positive coping skill to help address it. The patients can then be encouraged to share what they created— by singing, spoken word, or other creative means.

Within this exercise, not only has the patient identified a negative situation and how to better cope with it within a creative medium, they have experienced the active utilization of a positive coping skill, built up confidence after completing and sharing their creation, felt more connected with others in the group due to being vulnerable and feeling validated, improved their mood from the positive experience, and formed a sense of increased treatment motivation.

Music therapists utilize assessment, treatment planning, and evaluation to determine whether a patient’s current methods of music therapy are meeting their needs. Without treatment goals, there could be no effective music therapy.

Q: What kind of impact have you seen in mental health patients who have participated in music therapy?

A: In any setting, music has an instantaneous effect on our bodies — mentally, physically and behaviorally.

Patients have shared several stories about how music therapy has helped them with their clinical goals. It’s amazing how one musical intervention can address multiple goals.

Sometimes it’s hard for patients to verbalize past trauma or express their current struggles. But with music therapy, they can discuss a song that may relate to their current life situation— whether that be bullying, family problems, feeling hopeless, having anxious thoughts, or another stressor. During this process, patients may be able to process and verbalize more, since the lyrics are an easier gateway for expression.

During group instrument playing, patients who might have difficulty with interpersonal relationships are able to cohesively and successfully play music together in a positive and supportive space without the need to talk.

During group ukulele playing, patients can work on distress tolerance and problem-solving skills while persevering through a challenging task — and by the end, they have improved self-esteem.

Q: What is unique about music therapy in an inpatient psychiatric facility?

A: Music therapy can look different in the inpatient psychiatric setting than in other areas of the hospital.

Within the Center, goals for music therapy are focused on combatting the reasons why a patient is admitted— these could include suicidal ideation, depression, anxiety or other factors that keep these youth from participating in a healthy way in daily life. The goal of the MHIC is to stabilize these patients and provide them with as many resources as possible to cope with their mental health challenges.

Music therapy does just that and provides opportunities for patients to learn, process, practice and discover new skills through tailored music interventions such as group instrument playing, songwriting, music listening, song discussion, beat-making, singing, rapping, and many other techniques. The MHIC offers opportunities for group work, that allows for a diverse group of kids and teens to come together and express themselves in a supportive, safe and validating environment. Individual music therapy sessions are available to patients in the Center who need additional one-on-one support to complement their other treatment.

Q: Why did you want to become a music therapist? Why a mental health setting specifically?

A: I’ve gone through my own mental health challenges throughout my life, and I always found that music validated my journey. Music helped me distract myself and process my feelings. Music met me where I was in the moment and gave me hope. It also gave me a platform to express myself in ways I didn’t know how to otherwise.

When considering career paths, I wanted to find a way to harness the role music had played in my life in a therapeutic way. After receiving my undergraduate degree in music, I developed a special interest where psychology and music intersect—the space where music therapy truly breathes. I pursued my graduate degree in music therapy, and then became a board-certified music therapist.

I feel humbled and fulfilled to be able to support kids and teens at CHOC with the tool of music. By creating an authentic therapeutic alliance, I can support them through a harsh and challenging time in their lives. I am thrilled to be on the front lines of the music therapy program at CHOC Children’s and I look forward to supporting its growth and success in treating pediatric patients.

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Olivia’s Journey with Music Therapy

Olivia was unexpectedly born two months premature and spent the first seven months of her life in the CHOC Children’s neonatal intensive care unit (NICU). During some moments of their extended NICU stay, her parents weren’t sure if they would ever get to take their baby girl home.

From the day she was born, Olivia had been exposed to a high level of stimulation in the hospital setting. Despite the NICU’s environment of healing, the beeping of machines, and steady flow of clinicians in and out of her room had overwhelmed Olivia and made her weary of physical touch.

“Even though the doctors and nurses were very gentle with her, and everything was done with her best interest in mind, it’s a natural outcome for someone who has spent their entire life thus far in a hospital to be apprehensive of physical touch,” says Leilani, Olivia’s mother.

The NICU’s developmental team quickly saw that Olivia would benefit from music therapy, and introduced Olivia’s family to Brie Mattioli, a board-certified music therapist at CHOC who specializes in the NICU setting.

Initial goals of music therapy for Olivia included pain management, learning how to self-soothe, and self-regulation. Once her pain improved, she could show more self-expression and even develop preferences for certain types of music. (Her favorite song is “Rise Up” by Andra Day.)

Sometimes Brie’s goal was to help Olivia get to sleep, which is healing. During other sessions, their goals were focused on development and stimulation.

The calming effects of music therapy was just what Olivia needed.

Afterall, she underwent her first in a series of surgeries when she was just 2 weeks old. During prenatal scans, doctors discovered that Olivia had enlarged kidneys, and at birth they discovered her stomach was enlarged as well. Surgery was a priority. Under the care of Dr. Peter Yu, pediatric general and thoracic surgeon, Olivia’s intestines were repaired. Another surgery, when Olivia was 2 months old, shortened her lengthy spinal cord.

Olivia also showed traits of Noonan Syndrome ― a rare genetic disorder that affects one in 1,000 to one in 2,500 people. Noonan Syndrome is commonly associated with physical characteristics like atypical facial characteristics and a short stature, and clinical symptoms like heart defects, bleeding problems, feeding issues, developmental delays and malformations of bones in the rib cage.  Although Olivia seemed to exhibit mild physical characteristics of the syndrome, she displayed prominent clinical symptoms.

While she underwent genetic testing for Noonan Syndrome, Olivia’s care team also indicated that she was a candidate for genomic sequencing, the process for determining someone’s complete DNA sequence. Through a partnership with Rady Children’s Hospital, some critically ill infants and children in CHOC’s intensive care units have access to rapid whole genome sequencing. The research collaborative intends to decrease the time between an acute diagnosis and the implementation of effective treatment for difficult-to-diagnose cases. Olivia was genetically tested as were her parents. Two weeks later, the results came in. Neither parent tested positive for Noonan Syndrome, but Olivia did. Since neither parent was a carrier, this meant that Olivia had a uniquely altered gene that resulted in the syndrome.

“When the results came back, we were in disbelief and grieving,” Leilani recalls. “The news was unexpected and heartbreaking. We had never heard of Noonan Syndrome and we had done most of the genetic testing offered during my pregnancy. Our baby was so innocent, and she didn’t ask for any of this. I found myself fast-forwarding to the future and wondered what life would look like for her.”

Music as a journey to healing

While in the hospital, Olivia saw Brie four times a week for music therapy. The more music therapy sessions Olivia had, the more relaxed she became in a sometimes-stressful hospital environment.

“When bodies are relaxed, they heal better,” Brie says. “More opportunities for relaxation mean more opportunities for healing, positive gains and progress.”

In addition to helping patients make progress towards clinical goals, music therapy can provide a sense of normalcy to families in the midst of an emotional time.

“Music promotes a sense of positivity and peace in the room,” Brie says. “It wasn’t the nursery they planned to bring their baby home to, but it provides a sense of normalcy to families.”

The practice resonated with Leilani, who had even considered pursuing a career in music therapy in college. While pregnant with Olivia, she would frequently play music, everything from Ed Sheeran to N*SYNC for her daughter.

“My pregnancy was difficult, and music had always been a form of therapy to me,” Leilani says.

When Olivia was discharged from the NICU, her parents were given a CD specially recorded by Brie with Olivia’s favorite music therapy songs so she could continue healing at home.

“No parent signs up to be in the hospital for all those months,” Leilani recalls. “But I am so happy that CHOC was there when we needed them. CHOC was the right place for Olivia.”

Learn more about music therapy at CHOC

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The Power of Music Therapy: Darlyn’s Story

On a sunny day in the middle of spring, Darlyn was born at St. Joseph Hospital in Orange. She was immediately transferred across the street to the level IV neonatal intensive care unit at CHOC Children’s. As the spring turned to summer, and summer gave way to fall, the NICU remained Darlyn’s home as she battled with a myriad of health challenges.

Before she was born, prenatal ultrasounds showed that Darlyn had a congenital diaphragmatic hernia (CDH), a rare birth defect where a hole in her diaphragm allowed organs from the abdomen to move into the chest. After birth, she was diagnosed with bilateral CDH. Approximately one in every 2,500 babies born are diagnosed with CDH. Of those, only one percent have a bilateral CDH. Darlyn’s parents Mirian and Edgar understood the seriousness of this diagnosis and weren’t sure if their baby would survive the pregnancy, or pass away shortly after birth. In her first week of life, Darlyn underwent her first in a series of surgeries.

“For the first two or three weeks of her life, our main goal was survivorship,” recalls Edgar.

darlyn-and-her-father-nicu
Darlyn and her father Edgar in the NICU.

Darlyn also has underdeveloped lungs (a condition known as pulmonary hypoplasia), which makes it a struggle to breathe on her own. She lacks a fully formed esophagus, meaning she also can’t swallow or eat on her own either. During Mirian’s pregnancy there was a build-up of amniotic fluid due to Darlyn’s duodenal atresia (a blockage of her small intestine), so the baby was especially active and moved around constantly. The only thing that calmed her down was playing music ― everything from lullabies to classic rock did the trick. Knowing their baby loved music even before she was born, her parents gave her the middle name Melody.

“From day one she has been the melody of our lives,” Mirian says.

Darlyn and her mother in the NICU at CHOC Children's
Darlyn and her mother in the NICU at CHOC Children’s.

Music has continued to play a big role in the now seventh-month-old’s life. Daily music therapy sessions conducted in tandem with occupational therapy sessions have helped her make progress on clinical goals such as developing fine motor skills. Other goals she’s already accomplished include standing for longer periods of time, reaching for and grasping toys tightly, and visual tracking.

A music therapy session conducted in tandem with occupational therapy in the NICU.
A music therapy session conducted in tandem with occupational therapy in the NICU.

“Before starting music therapy, Darlyn wasn’t very active and she often lost oxygen very quickly,” Brie says. “This baby is a new baby since experiencing music therapy.”

Environmental music helps create a soothing space to teach patients to calm themselves in an over-stimulated environment, which can help them heal, even after they go home.

“From the outside, it may look simple, as if I am just serenading a baby in a soothing tone, but I’m working hand in hand with their developmental team to help them reach clinical milestones.”

darlyn-music-therapy-nicu
A music therapy session conducted in tandem with occupational therapy in the NICU.

Darlyn’s care team is vast. Her medical team at CHOC sees music therapy as a trusted partner in helping Darlyn achieve her clinical goals. Her support system includes: Dr. Irfan Ahmad, a neonatologist; Dr. Peter Yu, a pediatric general and thoracic surgeon; and pediatric specialists from gastroenterology pulmonology, cardiology, infectious disease, the NICU developmental team (made up of occupational, physical and speech therapists), and a dedicated team of NICU nurses.

“We love and appreciate our NICU nurses more than we can even put into words,” Mirian says. “Without them, this journey would be more difficult and more heartbreaking. They take care of Darlyn as if she was their own baby girl.”

Jamie, a NICU nurse, celebrates July 4th with Darlyn.
Jamie, a NICU nurse, celebrates July 4th with Darlyn.

“Music helps calm down infants,” says Dr. Ahmad. “During their fetal life, they are exposed to rhythmic sounds, such as their mother’s heartbeat. They get accustomed to these sounds, and after birth when they hear music with a similar rhythm, they like it. Older neonates become more interactive with rhythmic music, and they look forward to their sessions.”

Darlyn isn’t the only one who has been looking forward to her daily music therapy sessions― her mom does too. After each session, her developmental team calls Mirian to give a full report on her occupational therapy progress and disposition.

Her parent’s high level of engagement is deeply appreciated by her care team.

darlyn-halloween-costume-nicu
Darlyn’s parents chose a Snow White theme for her first Halloween, which she celebrated in CHOC’s NICU.

“Darlyn’s parents are amazing. They ask good questions, and they trust us to take good care of their little girl. It would be hard to tackle this level of complexity without their trust,” says Dr. Yu. “We still have a long road ahead of us, and maybe more challenges too, but they are resilient, just like their daughter.”

Darlyn-private-room-decor-nicu
Darlyn’s parents have decorate her private room in the CHOC Children’s NICU to feel more like home.

A few months into her time in CHOC’s NICU, Darlyn moved into the brand new 36-room unit with all private rooms. Her family has loved having their own private space.

“In the old unit, it could get noisy and we didn’t feel like we had any privacy. Now, we get to decorate her room and make it feel more like a nursery,” says Mirian.

Darlyn's parents have decorate her private room in the CHOC Children's NICU to feel more like home.
Darlyn’s parents have decorate her private room in the CHOC Children’s NICU to feel more like home.

The family has displayed notes of encouragement from loved ones and her favorite nurses- including nurse Jamie, who taught Darlyn how to stick out her tongue. They’ve even hung up the outfit she’ll wear when she finally gets to go home.

darlyn's-going-home-outfit
Darlyn’s parents have hung up the outfit she’ll wear when she finally gets to go home from the NICU.
Learn more about music therapy at CHOC

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