A Day in the Life of

My day starts checking that my team of eight harps are in good shape. The task of tuning these eight therapy harps can involve up to 208 strings! Harp strings go out of tune in the cold weather so I need to take extra care with this in the winter months.

I then pack the car with everything that I need. In some of my groups I never know how many people are going to attend. My sessions are 100% inclusive. So, if more than eight clients attend I need to make sure that I have enough additional instruments (eg desk bells percussion, chimes, rainsticks etc) to accompany the harps and to ensure that nobody is left out.

I have a morning group at Cancerwise in Chichester for people currently going through cancer diagnosis and their associated treatments, as well as for those living beyond cancer. The focus in this group is to allow people the freedom to be creative and to let their imagination flow. The idea is to absorb them in occupation, to help distract them from their treatment plans or impending results, and to allow everyone the space to do something beautiful.


Everybody in the group plays the harp. I believe there is no wrong note and that we are all musical, we do some simple exercises on the harps to build up confidence. All the harps are tuned in the same key and make a sweet sound when played together. Next, we improvise on the harps until our playing naturally comes to a close. During this stage our playing can become meditative and offers a distraction from the uncertainties and anxiety that cancer brings. Some members get into the beneficial Flow (Csikszentmihalyi 2002) state. It’s during this time of relaxation that the parasympathetic nervous system can heal and repair the body.

At the end of the session I make sure my clients are grounded and together we may discuss their experience of playing the harps. For some people playing the harp can be very special and moving. This can be emotional and people often need to share their experience.

Next, I have a session at a care home. I really need to use my flexible occupational therapy skills and my ‘what is willing to meet me’ harp therapy skills at care homes. Sometimes my session is in the lounge for a group of up to 15 people, and sometimes it is divided between individuals in their rooms. I never really know until I get there.


Today it’s a mixture, but it is about participation regardless of where I am. There is a crowd in the lounge and I engage them individually with the harp depending on their levels of physical and cognitive ability. Some play the harp, some like to sing along while I play or tap their fingers, or sway to the music. Some people with hearing impairments love to feel the vibration of the harp strings or place their hands on the sound box to feel the vibrations. The most important thing is that people engage in the activity and are part of the ‘doing’. Next I get out my set of desk bells. With the help of the Activity Co-ordinator we make sure everybody has a table for their bell and we play together. The desk bells are accessible to all and they make a sound when the top is pushed down. Everybody has one bell and each bell has one note. I conduct them through various tunes, such as Frere Jacques or the Star Wars theme. After we complete these tunes, everybody seems to show a sense of achievement and perhaps a raised self esteem.


Next, I play for people in their rooms who are unable to get out of bed. I always make this person centred and engage in cognitive stimulation and reminiscence through music. One lady who is 105 loves to sing a favourite song from her childhood in Scotland – Bonnie Mary of Argyle. This is clearly a meaningful activity for this lady because the staff tell me it is the only activity that she actively takes part in. Her eyes light up, and she sings the words that she remembers, and la la la’s along when she doesn’t. It’s a very powerful experience, and the Activity Co-ordinator films it to share with staff and family.

After discussing what has happened during my session with the Activity Co-ordinator and giving her my notes, it’s back home for admin. I complete my outcome measure, the validated Arts Observation Measure (Fancourt and Poon 2015), and write my notes. Any time left is used to reflect, invoice, respond to enquires, update social media, keep my accounts up to date, write my CPD and plan for tomorrow….


A day out at parliament

I was definitely in the right place at the right time last week. On 4th October I went to an Action Portsmouth networking event and met Stephen Morgan MP . I had just introduced myself and From the Harp and spoken about the benefits of the arts in health when I highlighted that there was a forthcoming arts in health debate  in parliament on 11th October. Stephen invited me to attend the debate with him. It wasn’t on my bucket list but it should have been:

“Attend debate in parliament with my local MP on a subject I’m passionate about”

What were the chances?


The All Party Parliamentary Group on Arts, Health and Wellbeing Report came out in July.  It is a great report and well worth a read (the online version has podcasts and videos).

My first thought was how fantastic to have a report highlighting evidence and statistics in my area of work, while making the arts in health more prominent.

Secondly, what a shame that only one occupational therapist was involved in the advisory groups. After all, occupational therapists have been practicing arts in health for over 100 years. Yet occupational therapy only has two mentions in the report.  Find out more about occupational therapy.

The debate was a follow up to the report and took place in a room next to Westminster Hall.  Westminster Hall is pretty awesome, you may remember seeing it when the Queen Mother was lying in state in 2002 or when Nelson Manela deliverd a speech there in 2003.  It’s so huge, has a fantastic medieval hammer beam roof, and has been a significant backdrop throughout British history.  It’s well worth a visit. Stick it on your bucket list.

Stephen showed me around the public areas of Parliament, and told me some of the history. Did you know that MPs all have a place to hang a sword by their locker?! He explained some of the procedures before having to dash off for a vote. Again, he had been voting all afternoon.


The debate was running late as MPs came and went to fulfil their voting duties.


Ed Vaizey, the member of parliament who called the debate, opened it up by outlining the benefits of arts in health. Ed gave examples from the  APPG report on the arts in health. Medication, length of stay in hospital, agitation, loneliness and mental health all reduced, and he had examples and stats to back this up.

My ears pricked up when he gave harp therapy a shout out!  This is great for harp therapy as it is relatively new in the UK, and not widely known or talked about.

He said that the arts can change the morphology of the brain and I wondered if he got this from Gaynor Sadlo’s (retired professor of occupational science on the occupational therapy courses at Brighton University)  Facebook comment on the debate event . If you haven’t read it, have a read, she talks about the necessity for the brain to be busy to distract from engaging in internal negative self talk.

Ed gave lots of examples including stats and research about arts in health, but the key message was the need to expand the reach and to align with public health for health prevention. The arts have a positive effect on all ages and client groups so should be prominent in the public health arena. There also needs to be equality in access to all of the arts.


Arts are cost effective and also have a positive effect on staff often doing jobs that are wearing on an emotional, spiritual, mental and physical level. Arts funding would be well spent for clients and staff.

It was quickly pointed out that  Philip Dunne Health Minister was not present, although John Glen Minister for Arts was. Everybody was in agreement that it was a debate the Minister of Health needed to be involved in.

I think all the back benchers in attendance wanted to add to the debate and they were each given a 3 minute limit. Time keeping was very strict, and the one hour debate finished bang on time (18.42:02). Not like your average meeting…..

The best one liner: human flourishing is what’s needed, there’s more to life than GDP. Agreed: there’s harps

The back benchers continued to cite the benefits of arts in health from their constituencies. All ages, all client groups, all settings. Nobody present doubted the benefits.

So if this is the case why can’t the medical model incorporate the arts? It appears to be a no brainer.  We need a culture change in government for the arts and health agendas to merge as one.  Social prescribing needs to be available nationwide and not through the current postcode lottery.  Clinical Commissioning Groups and local arts providers need to be known to each other in order to provide social prescribing to the communities that they both serve.


We need to progress from the medical model and we need to incorporate the arts in training for medical staff. I believe occupational therapists may be the only allied health professionals that are taught about the arts.

On my  Health through Occupation MSc at the University of Brighton  I had classes in pottery, and various arts and crafts. We also had sessions on incorporating meaningful creative and imaginative activities in our treatment plans.

Occupational therapists are perfect to take this forward, maybe I’ll let Philip Dunne know, you could too:

Email: philip.dunne.mp@parliament.uk

Or tweet:



On my way out I met up with Jo White from Rhythmix , in Brighton, who create music programmes to help vulnerable people find their voice.  We were discussing the report in Westminster Hall when Ed Vaizey  came out of the debate, we both agreed we should introduce ourselves and get a piccie.  Thanks Ed.

Jo’s take away from the debate was the arts are “Not the icing of the cake but the essence of the cake”.

If you agree please get involved to try and gain more prominence for the arts in health.

You can let Ed Vaizey know what you think. He welcomed the comments he had received by email and on Facebook before the debate:


Twitter: @edvaizey

Facebook: facebook.com/edvaizeym…


The therapy harp and the harp circle

My clients often expect me to turn up with a large harp, the sort of harp you see in an orchestra, they are often wondering how I’m going to get it in the building, and they are surprised when I arrive with my small therapy harps.  Many people have not seen this type of harp before.


Therapy harps are very different to the orchestral harp.  The concert harps have seven pedals around the bottom that are used to change the key so players need very good hand and foot co-ordination.  It means they have more scope to play tunes in different keys, but they’re not practical for my type of work.

The therapy harp has been around since the 1970s, and is basically a small harp, and can be called a small harp or a lap harp or a therapy harp, it’s basically the same thing.  Some of them have levers at the top which enables the player to change the key.

The therapy harp is light weight and can be worn with a strap which enables the harp to be played while walking around, which is perfect for bringing music to people in a large lounge especially if they may have visual or hearing impairments.


A colleague in the therapeutic harp community from America plays using a strap and walks around hospital corridors allowing the live harp music to float into many rooms and nursing stations, bringing the music to more people.  The music changes the atmosphere and can bring a bit of release to patients and loved ones dealing with hospital admission and treatment.

Such light weight harps can be played in bed, in wheelchairs and on the floor, so they are really accessible and the way of playing can be adapted to meet the clients physical abilities.  Playing the harp on the floor works really well with young children, and playing in bed is great for anyone that is unable to get out of bed.

These harps are ideal for harp circles too, where a group of people create music together.  I have a choice of straps and knee sticks to stabilise the harp, so players in my harp circles can choose how they would like to position the harp in the way that is most comfortable for them.


The harp rests on the shoulder and is either supported by the strap of the knee stick, it’s light and allows the player to easily reach all the notes on the harp.

Harp circles are inclusive, they enable participants to be able to do one little part and be part of a whole group making music.  They are uplifting, enjoyable and accessible allowing everyone to take part in some way regardless of challenges or ability.

Harp playing can relax, energise and sooth and can contribute to healing for the youngest of children to the oldest of adults.  Music releases emotional pain, increases interaction, builds self esteem, improves short term memory and attention span, and relieves stress.

Harp circles allow people to enjoy making music, there is no right or wrong way, and we are all musical, there is no wrong note.  Harp circles can incorporate different goals, somebody who has just had a stroke and is able to get their hand to the harp and play a note has achieved.  Somebody who has a brain injury and is able to concentrate and take part in the group is successful.

Everybody has different goals and outcomes, but everybody plays a little bit and we create a whole tune together.

Please get in touch to discuss your clients’ requirements.



Going viral – the dark side of occupation

My second blog post What is occupational therapy? has been viewed nearly 40,000 times, and shared on Facebook about 20,000 times.  This caught me completely unaware and still continues to amaze me because there are so many blogs out there waiting to be read.


This website shows live internet activity stats, as I write this 2,963,172 blog posts have been written today and it’s nearly 3pm.  You can see the number of internet users, the number of tweets sent, google searches and the number of Facebook users.  It’s mind boggling!  We really are spending a lot of time doing online occupations.

Our occupations are pretty much always seen as positive and good for health and well being, but ‘The Dark Side of Occupation’ is a concept created and being developed by Dr Rebecca Twinley.  Find out more here.  There are occupations that can be considered not so good for you for various reasons, graffiti for example is a crime, and drinking and drug taking in excess are bad for health.  My experience of going viral lead me to consider the benefits and difficulties of doing so, and I started to reflect on the downside of going viral as the dark side of occupation.

So when my blog went viral I was pretty much ecstatic, lots and lots of people were reading my blog post, which was only my second post and had sat alone and unread for about three weeks.  It made me feel elated, people liked what I had written, people related to how I had described occupational therapy.  Somebody at New Zealand OT Insight magazine asked me if they could publish it.  Shoshanah Shear asked me to guest blog, and Michael Iwama of the Kawa Model liked it too.  Occupational therapists from all over the world were contacting me, and others who weren’t related to the profession.  Suddenly I was a somebody in occupational therapy, I was contributing, commenting and collaborating with the global occupational therapy community.


Fantastic?  Well this is where the dark side comes in.  As somebody living with and beyond cancer I need to be reducing stress in my life.  I need to be investing time and effort in sleeping well and relaxing.  I need a work life balance and I need to prioritise things that keep me well, like exercise, cooking healthy meals, mindfulness and my hobbies.  All these things enable my parasympathetic nervous system to do it’s thing and heal and repair my body, and allow my killer cells to go after cancer cells in my body.

I was new to posting on social media, and wasn’t quite ready for the world to know about my cancer diagnosis.  (Yes I know I had written about having cancer, but it took a while to click the publish button, my finger hovered over it for some time before I published and I never expected so many people to read it!).  I also wasn’t ready to do so much public commenting, I was just building up gently to having an online presence.

So going viral wasn’t always a positive and productive experience for me.  First I had to stress out about if I had actually gone viral or not.  What figure equaled viral status?  It seems there is no number, if very few people were reading a blog and then thousands were that constituted going viral.

Then I had people contacting me on all manner of platforms: email, messenger, Facebook, Twitter, LinkedIn, blog comments, I had to manage this daily and keep track of it all and reply to people.  This was time consuming, and difficult to manage.  It wasn’t productive as I’m in the process of setting up a little local business, and correspondence from all over the world wasn’t going to make me any money!  Yet the compelling intrinsic motivation to correspond and use this platform to try and promote occupational therapy further was driving me.  This drive dominated over any of the activities and routines I needed to do to keep myself well, and obtain local business to make a living.


I wasn’t sleeping, watching my blog stats go up became an obsession.  I just wasn’t present, and I was being mindless, not mindful, I was stuck in the virtual world. On the busiest day one person was viewing my blog every ten seconds.  I kept checking the stats, staring at my screen, it was like watching the figures go up on a really popular government petition.  As people in the UK started to go offline and to sleep, Americans, Australians and New Zealanders would come online.  So I’d go on checking my stats late into the night and throughout the night if I woke up.  This practice did not promote sleep, and really upset my sleep pattern, which is not good for my immune system.

Going viral was a buzz, I cannot say it wasn’t, but it did not lead to good health and well being, so my experience of going viral was definitely an insight for me to the dark side of occupation.

Although we all put things out there wanting them to be seen, ‘liked’, shared and read nothing can really prepare us for when they become popular, take off and cannot be reined in.

But don’t worry, carry on reading this and sharing it, I’m prepared now.  Going viral again cannot compare to the soaring feeling and obsession of it happening the first time.


Music really is powerful stuff


Music is all around us and a part of daily life, whether we choose to listen to it or come across it playing in shops or restaurants that we visit. Prehistoric humans had music in their lives despite it not being essential for survival like hunting and shelter. Old bone flutes and many cave paintings of instruments from prehistoric times have been found around the world.

Occupational therapy is all about the art and science of living, what we do makes us who we are and music has a lot of meaning to us. We can self regulate by using music so if we need to do household chores we may put on something fast and upbeat, if we want to relax or go to sleep we may play something soothing and slow.

Music is also used to distract ourselves, for example when you are kept on hold on the phone or when waiting in a surgery there is often background music playing.

Music can also serve as company for us, at work, at home and in the car. It gives us an identity through our record collections and our spotify feed. It often helps to bring memories back or enables us to communicate emotions.

It is also an entertainment and is part of every celebration.  The presence of music in our lives shows how important it is and how different meaning is incorporated through music.

Learning to play an instrument strengthens the synapses between the brain cells which has a positive impact on our sensory and perceptual systems, cognition, gross and fine motor skills, co-ordination and learning memory.  All these benefits when we can be having fun, and enjoying ourselves when we are playing our instruments!

I am doing a sound therapy course and have had to buy more instruments to complete the course.  Purchasing instruments as been great therapy, before the sound therapy even starts!  As I sit typing I am surrounded by gongs, crystal bowls, a range of precision, the harps of course, nobody is ever far away from a harp in this house, and the old Joanna – cockney rhyming slang for piano.

As an occupational therapist I am approaching sound therapy from a therapeutic activity perspective.  As part of my course I have had to learn to play these new instruments and engage my senses with them.  Some of the sounds are ethereal.  Hearing them for the first time is an incredible experience, and not one that the mind or body first knows how to process as there is no previous experience of it to go on.  That’s my experience of it anyway, and what a fantastic experience, the older I get the harder it seems to be able to experience things for the first time.  I want to keep my feet firmly on the ground so that does limit my choices, no bungee jumping for me thank you.

I find playing the instruments is energising, and having them next to my desk is the perfect antidote for any mid morning or afternoon slump and serves me better than any coffee would.

Making music is powerful stuff, and energising activity, why isn’t if on prescription?