Project Piano: A Study To Test And Build Self-Esteem And Confidence In Adolescent Psychiatric Patients
Since 2001, Barbara Silberg has been bringing her innovative style of teaching piano to troubled adolescent inpatients at UCLA's Neuropsychiatric Hospital (NPH). In the process of finding innovative ways to help these young people to “ get the music from the page into their fingers,” Silberg established a positive, therapeutic relationship with them that often impresses staff members who have been dealing with the patients using a more conventional approach.
"The program is an emotional elixir. The kids start out unsure of themselves and often resist the idea of learning how to play the piano. By learning to improvise on the piano, they gain a profound sense of power and glee."
---Barbara Klaskin Silberg
Project Piano Pilot Study Objectives
In November 2004, Silberg and psychiatrist Dr. Mark DeAntonio, Director of Adolescent Inpatient Service, were given approval by the Office of Protection of Human Subjects to conduct a pilot study of adolescent psychiatric inpatients at UCLA's NPH. The study instrument was designed and will be assessed by Robert Caplan, Ph.D. of Community Health and Empowerment in Redondo Beach, California .
The purpose of the study is to determine whether 30-minute piano lessons that focus foremost on raising self-esteem rather than on producing musicians can improve positive feelings about self and well-being in adolescents with severe emotional disorders.
The professional team conducts a pre-test before the first lesson and follows with a post-test after the second, fourth, sixth and eighth lesson to measure mood and self-confidence. The inpatient piano students write short evaluations following the odd-numbered lessons. The evaluations are analyzed for both quantitative data and qualitative feedback.
Selection Of Subjects For Pilot Study
The subjects of the pilot study are male and female adolescent psychiatric inpatients. The study includes patients diagnosed with severe depression; suicidal ideation and attempted suicide; high functioning autism; eating disorders; severe aggression; bipolar disorder; schizophrenia; and obsessive-compulsive disorder.
In most cases, the adolescents chosen for the study first take part in a group music appreciation / composition lesson which Silberg offers once a week. Frequently at the conclusion of the group lesson, some of the students will privately request that Silberg teach them to play a particular song on the piano. Incredibly, the most frequently requested song (which is usually hummed since they don't know the title) is Fur Elyse. Any student who makes such a request is invited to take part in the study.
Many prospective subjects are far more deceptive about their desire to learn to play the piano. Some of the most successful students/study participants have been most vocal in their disdain for all things musical—especially the piano. These kids protest the loudest and perpetually disrupt the music appreciation class by shouting invectives about a piece of music that is being discussed. After Silberg persuades these students to take a few music lessons, she often learns that these kids harbored a secret desire to play the piano, but feared that they lacked the ability to do so.
Project Piano Goals
Based upon the positive effects of Silberg's work with disturbed and disruptive youth at NPH, the research team launched a pilot study to hopefully demonstrate:
- That in-hospital piano lessons can help establish or heighten an emotionally intimate bond and therapeutic rapport between the students and the interventionists;
- That these interactions and lessons will foster a sense of accomplishment and positive self-regard in the participating students regardless of the level of proficiency they develop;
- That these benefits will enhance students' willingness to trust other caring adults, work through troubling issues, and continue to find creative outlets for self-expression.
“I always teach my students piano from what they already know. Even if they claim to know nothing about the instrument and hit a couple of random notes, I can have them up and running in a matter of minutes. Most kids can learn to play a simple chord with one hand and a note from that chord with the other hand and it's instant music. And with that instant music comes immediate glee.”
---Barbara Klaskin Silberg
Many of the subjects have a disorder or are taking medications that prevent them from learning piano in a conventional manner. Very often, the students lack the ability to concentrate or are easily distracted or discouraged. Silberg's unorthodox way of teaching enables the students to have an almost immediate success in an area where most feel that they could never succeed. She begins by immediately teaching chords to her students so that they can invent their own melodies and start to play simple songs by ear. Silberg teaches students to build on their strengths in the hope that one small success will lead to many larger successes in other areas of their lives.
Project Piano Outcomes
I. Impact On Adolescent Psychiatric Inpatients
The data on the first 100 patients have now been collected, but will not be analyzed until a control group is assembled and tested. However, excerpts from the written evaluations of the students are available for your review. Read what the kids have been saying about the piano lessons.
Improved Interpersonal Relationships
"If attempts at mental health intervention are to succeed, a trusting relationship must be developed and esteem must be raised to the point where the adolescent believes, 'I’m worth saving.' If this creation of trust can be generated, it opens the gateway for forming a relationship with the adolescent in which opportunities for success can be introduced. The success is expected to increase self-esteem. These are labeled the short-term effects.
"In turn, self-esteem may increase the capacity to form trusting relationships with the therapist, in school, and in other social settings. These are long-term effects. As this is a feasibility study, it looks only at the short-term effects to see if the procedures can generate these positive outcomes as the first step."
---Robert Caplan, Ph.D.,
Community Health and Empowerment, Redondo Beach, CA
Piano lessons present the student with the opportunity to establish rapport with, gain trust in, and receive on-going positive, one-on-one support from a caring adult in a non-threatening situation. This experience increases the student's receptivity to the assistance, encouragement, support and validation of this adult, and possibly other caregivers. Lessons provide a means and incentive to win positive attention and the high regard of peers, by developing a skill for creative self-expression. They may motivate the patient to make a greater investment in self and community due to heightened self-esteem.
II. Impact On Mental Health Professionals
Project Piano provides a neutral ground on which to establish rapport and develop a therapeutic, one-on-one relationship with the student. The lessons offer repeated opportunities to gently address self-esteem issues, share interests and experiences in common, and give encouraging feedback – knowing the impact of these experiences will extend beyond the moment. The musical experiences create an incentive through which to motivate youth to offer their cooperation in other desired areas.
Replication Of This Study
Silberg and DeAntonio hope to publish and distribute the results of their Project Piano study to adolescent care facilities across the country so that they might see the benefits of teaching piano to their residents. Grant money is being solicited so that Mrs. Silberg's method of teaching might be videotaped and taught to other professional or volunteer piano teachers helping troubled adolescents.