Archive for the ‘Performers’ Category

NHS Specialist Voice Clinics Vocal Rehabilitation Coach Pilot

Friday, May 10th, 2019

BAPAM is excited to announce the start of a new pilot project, in which we are funding a Vocal Rehabilitation Coach (VRC) to work alongside clinicians in NHS Professional Voice User Clinics.

Vocal health problems in singers and actors are often multifactorial, requiring a specialised multi-disciplinary approach to diagnosis, in order to get patients onto the right pathways of treatment and rehabilitation and back to performing as quickly as possible. Over the last two years, we have been working with a group of clinical experts in this area, including Laryngologists and Voice-specialist Speech and Language Therapists, who have advised us that adding a Vocal Coach into this team – an experienced singing teacher with understanding of the clinical processes in vocal health – would further help the diagnosis and rehabilitation of performer patients. Lewisham and Greenwich NHS Trust already employ a Vocal Rehabilitation Coach and BAPAM has agreed to fund a VRC post across up to three NHS hospitals for a pilot year, with funding support from PPL, Help Musicians UK, Musicians’ Union and Equity, following which the pilot will be independently evaluated to assess the requirements for the VRC role and the effectiveness of this model in the care of performers. Dane Chalfin, an experienced VRC and singing teacher, is taking on the role for the initial 12 months’ pilot. The first of these BAPAM-funded clinics has just started at Wythenshawe Hospital, part of Manchester University NHS Foundation Trust. Guy’s and St. Thomas’ NHS Foundation Trust is expecting to start to offer this additional service from September, and a third NHS Trust is expected to be confirmed soon.

BAPAM undertook a survey across existing specialist Voice Clinics in order to develop the competencies required to work in this new role and these were reviewed and approved by our Vocal Health clinical experts and adopted by the BAPAM Medical Committee. There is currently no professional body able to provide formal registration of VRCs and BAPAM hopes that by facilitating a process whereby experienced vocal coaches can demonstrate that they meet a set of competencies, we can help provide a level of confidence in this role both to the NHS and to performers themselves, and reassure our funders that we are investing in the best services. Four practitioners who meet these competencies have so far been approved to join a new section of the BAPAM Directory of Practitioners as VRCs, and we are hoping to expand this number in the near future. We can provide guidance to practitioners interested in this field towards appropriate training that may be required to meet our competences.

We hope that this pilot will provide some initial evidence to support the involvement of practitioners with an educational background in the rehabilitation of performers and, specifically, the wider adoption of this practice to improve patient care in vocal health. If the pilot is successful, we hope to be able to secure funding to support substantive VRC appointments going forward via an open appointments process. This work takes place against a backdrop of developing education and science in vocal health, with practitioners at the UCL Performing Arts Medicine MSc and the MA in Vocal Pedagogy at the University of Wales undertaking exciting new studies which are increasing our understanding in this area of performing arts health. BAPAM is pleased to be able to make this small contribution to continuing improvement in vocal health for performers.

Further enquiries are welcome via info@bapam.org.uk

Related information:

BAPAM VRC Competencies

Hand Surgeon and Professor of Piano joint BAPAM clinic

Wednesday, May 1st, 2019

There are intrinsic relationships between health and performance excellence, and educational and clinical expertise in the performing arts. In overcoming medical problems, specialist diagnostic and medical expertise can be complemented by performance technique and lifestyle and health-related guidance. In a new joint clinic at BAPAM, Mr Mark Phillips, Hand Surgeon, and Penelope Roskell, Professor of Piano at Trinity Laban, are exploring this opportunity for clinicians and educators to provide each other with unique insight and feedback. We asked them to tell us more about this innovative approach.

Could you explain the idea behind the joint clinic and why you decided to do it?

Mark Phillips: In my experience when treating musicians I found quite an overlap between the physician’s knowledge and the specialist physiotherapist/hand therapist’s knowledge, who’s an expert in musicians. But I soon realised there was a huge gap for the third element which is filled by the expert tutor on that instrument. I happen to be a trumpet player so as a musician I have some insight into the patient but that’s not enough when it comes to some of the issues they face. I can relate to some of the psychological performance issues, but the expectation patients have is of someone that can really understand how the technical demands of the instrument interface with the physiological problems they’re having and anatomical problems they may have and the outcome of the clinical assessment.

Penelope Roskell: The knowledge we have between us is enormous. My students have included musicians with injuries for 40 years, and so we fill in the gaps. Seeing musicians together in a joint clinic is very important because you can then see the whole picture and then decide on the best way forward. Sometimes it may be steroid injection and sometimes it may be surgery. But sometimes it may be that a tweak or a change of technique will solve that problem and reduce the need for further intervention. So, seeing them together we can get to the root cause, which we can’t always do if seeing them independently.

How do you decide if a patient would benefit from this dual approach? What can a patient expect at a typical joint session? How do you each approach the patient?

How do you prepare for a joint clinic session?

Mark Philips: Normally I will contact Penelope to say I’ve got a patient or she may say she has a student. We will both select patients for this clinic.

Penelope Roskell: Sometimes Mark will send me over a video of that person playing, so I’ll have a chance to look at it and pick out the obvious problems about what I think may be causing it. I’ll also have a clinic letter which will give some sort of background.

Mr Phillips: We then meet up for a coffee and chat about the patient. So then the patient comes in, and if it’s my patient I present it to Penelope and on one occasion Penelope presented the patient. And then we do the history in the normal way, present findings and run through it all. I then suggest what may be the anatomical or physiological problem and how that relates to this person’s technique. The technique may have worked well for a long time but now there’s a problem which is unique to them. Looking at the technique can help if I’m referring to Penelope. Or similarly if Penelope is referring to me is there a way that some of my interventions such as hand therapy or injections or my approach to examination would throw some light on the matter. It’s that overlap which is invaluable really.

Penelope Roskell: So for instance one of my students came to the last clinic and she had problems for the last year and had come to me for that reason. And Mark gave her quite a different diagnosis to what she had been given in the past, which then informed me. So now we are working slightly differently in the lessons that I have with her privately, having now had this intervention from Mark and he also suggested a steroid injection which we are waiting to see the results to. We can then see the whole picture about the ways forward, because there isn’t always one solution. A patient may need a steroid injection or piano playing adjustments to the technique.

Mark Phillips: It’s multi-faceted, there may be Alexander Technique, hand therapy and it may be someone looking at their posture. I learn so much by looking at Penelope tutoring at the piano in terms of elbow position, shoulder position and what impact that has in terms of the way the fingers lie on the key for example. Each presentation has its own unique cocktail of remedies really.

There are complex multi-faceted problems by the time they come here and it comes down to how we triage these patients essentially. I don’t bring every pianist to this clinic.

Penelope Roskell: It’s inevitably going to be someone with a piano related injury. If they’ve broken their wrist by falling down the stairs then they should go straight Mark. Whereas it’s different when it’s something like accumulated stress from years of playing with a technique which is a tiny bit off balance. They may be very experienced players and their technique has lasted them well, but there’s something that just tips it over.

Mark Phillips: What I see in my patients is that half of them have the same problem as everybody else and that may affect how they use their instrument. And the other half have instrument related problems and it may be a combination of the two. And say if someone broke their wrist a year ago and it may be throwing out their elbow, their shoulder or their posture and it may well be a good way down the line that it’ll come to me that a session with Penelope would be helpful. Because it may be to do with their elbow and shoulder which may be making some notes inaccessible and we can work around. They’re so unique each of these cases an each of them would have their own relative roles for the two of us sitting together and discussing the case. It would be good to extend this to guitar, violin and cello and get tutors to do a similar thing. And it’s pretty unique, I don’t think there’s anyone else out there in the world doing it.

What do you feel are the benefits of having an educator in a clinical setting?

Penelope Roskell: It is a very formal environment which is a positive thing and it focusses everything which is very important.

It is a sort of pilot, it’s the first of its kind and I think it is very valuable and let’s hope that other clinics may take the idea from this and develop that further.

What are the direct benefits for patients of having the educator and clinician in the same room in a clinical setting?

Mark Phillips: We often find that patients are often reticent about coming to these clinics. They really don’t want to look at their own techniques and I suppose they remember back to days when they were being tutored and they feel self-conscious. They have to want to come to this clinic and to be looked at. It isn’t like going for a piano lesson or being taught. We are looking to see whether there’s anything about their technique that may be in anyway connected to the clinical problem they have. So we’re not trying to look at the way they play from any other perspective than that. People play in lots of different ways. Also videos are really useful, anyone with a smartphone can record themselves. When we look at them we can slow them down, go back over a sequence, look at it carefully, look at it together and see how that relates to their clinical problem.

Penelope Roskell: There is something different about the joint clinics, because I’m there involved in the consultation I’m able to ask them questions from my own point of view so that I’m well informed as to how best to help them in the future. Because a piano teacher is not qualified to diagnose and that is absolutely number one and nor am I qualified to answer questions that students sometimes ask me, like should I have that steroid injection or that operation and it’s not for me to advise on that but in this situation between the three of us we can discuss the best way forward viewing it from all the different angles.

Any challenges you are finding with the joint approach?

Mark Phillips: It’s 30 minutes long, which is short. We are just getting into our flow by half an hour.

We haven’t had a chance to find out what patients think, especially how they feel about the added value of seeing us both together.

The four patients we have seen in this format have individually expressed to us they thought it was a good session and it stimulated a lot of discussion and ideas. It would be great in the future to include a hand therapist and do a proper multi-disciplinary clinic. Hand surgeons always work very closely with hand therapists. Because there are so many different joints in the hand and different diagnoses. In the hand you’ve got unique problems to one finger or there will be a combination of problems. So your hand therapy is always bespoke, it’s all tailor made to that patient so you have to discuss each patient individually and with musicians it’s even more so.

Certainly with the three most commonest instruments this is going to be a major area of growth in the next ten years and it’s very exciting.

During the half an hour the patients sense the trust we have with each other (Penelope: we work very well as a team, we both have a lot of respect for each other’s knowledge. So I think they go away feeling they’re whole picture has been seen and assessed and we are seeing them as an individual with a problem that can be resolved.)

All patients have been bought over by the end of the 30 minute sessions. You can see the reticence and slight nervousness at the start of the half an hour turning into trust and outpouring of confidence and sharing of the problem and by half an hour we are in to the nitty gritty aren’t we. The output of that is usually I will see them again or Penelope will see them again.

What they can do is continue seeing Penelope for a while and see me in the clinic two months later and see how things have been going on in the meantime. And because we know each other well we can send secure emails back and forth and stay in touch.

New Clinics in Liverpool and Belfast

Wednesday, April 17th, 2019

As part of our commitment to reach and support performers throughout the UK, we are pleased and excited to announce new regional clinics, this time in Liverpool and Belfast starting in May 2019. 

BAPAM are delighted to be working with the Royal Liverpool Philharmonic Orchestra, who will host the clinic at the Philharmonic Hall, and Dr Marie McKavanagh, a Performing Arts Medicine specialist GP (and musician).

Liverpool Philharmonic have pioneered an exemplary approach to developing and supporting performance excellence through providing specialist health and wellbeing services to orchestra musicians. The positive effects of this investment are proving that performer wellbeing and artistic excellence are interlinked. Taking care of both also makes good business sense. Performers are healthier, happier, take less time off sick and are better prepared for elite performance. Through their key support for the new BAPAM clinic, Liverpool Philharmonic are now helping to bring this approach to the whole performing arts community.

The first clinic will be held on Wednesday 1st May. 

Belfast

BAPAM are also delighted to be working with the Oh Yeah Centre, Belfast’s music hub, who will host the clinic, providing vital support for a healthy and vibrant performing arts community.

The clinic is led by Dr Christine Hunter, a BAPAM and  NHS GP and Medical Adviser to the Ulster Orchestra.

BAPAM’s Belfast Clinic will be held monthly from May 22

Who is the clinic for?

If you make a proportion of your living from, or study in the performing arts, and have a physical or psychological health problem related to your work, BAPAM can help you. BAPAM clinicians can provide an accurate diagnosis and information to help you overcome problems. The BAPAM team can identify the best sources of ongoing care, both in the NHS and from other specialists, and advise you about sources of financial support for people experiencing health problems affecting their ability to work or study.

Other regional clinics:

Glasgow: Friday 10th May, 7th June

Leeds: Thursday 2nd May

How to book a FREE confidential appointment?

Call 020 7404 8444 to register | Or email info@bapam.org.uk

A major event in Occupational Health

Tuesday, March 19th, 2019

Are you a freelance performer, regularly working on short contracts and short-term engagements? BAPAM in collaboration with the Occupational Medicine Department of the Royal Society of Medicine is organising an event looking at Occupational health in the performing arts. The industry is commonly termed the original gig economy as a huge proportion of the workforce are composed of freelance performers. There is also unfortunately a high number likely to become injured or have other health problems as a result of their work.

In traditional settings occupational health teams keep people well at work – physically and mentally. But when it comes to the gig economy the healthcare support for a performer may not be as certain.

Amongst other things this event on 27th March 2019 will be looking at the health and work needs of the self-employed, especially those working in this gig economy. As well as the current needs and experiences of performers when they are faced with ill health and also performance-related injury and how they can be treated back in to work.

Click here to book on to the event which promises to be a very useful day for all performers and clinicians working with performers.

  • Interested in finding out more about occupational health and performing arts, there is a collection of resources on the subject on the Society of Occupational Medicine website.

 

Free Health and Wellbeing Webinar Series with ISM

Tuesday, February 5th, 2019

Tuesday 5th February to Tuesday 26th February

We have teamed up with the Incorporated Society of Musicians to present a series of free webinars looking at musicians’ health. Our performance health experts will lead the sessions, exploring solutions to problems frequently encountered in music careers. For more information on each session and how to book a free place click here.

Looking after yourself on tour: Tuesday 5th February
Health in the gig economy: Wednesday 13th February
Resilience and bullying in the workplace: Tuesday 19th February
Preventing playing related injury: Tuesday 26th February

 

Surge in demand for backstage therapists due to pressures of social media

Thursday, September 13th, 2018

The pressures of performing in today’s social media culture means more and more therapists are working backstage to support performers in need according to an article in the Sunday Telegraph.

BAPAM registered psychotherapist Helen Brice who is featured in the article, says she is getting more requests for her services due to the fear of a blunder going viral within moments.

She says the emergency sessions which she gets called out for involve calming exercises to reduce a performer’s anxiety. According to her other factors affecting performers at the moment includes a demand to tour frequently, falling incomes and the need to stand out in a hugely competitive industry.

Helen has worked for more than twenty years in the music business in the areas of performance, production, publishing, artist management and classical music. She says over the last couple years people have started to become aware that the mistakes they make may be spotted and commented about on online within seconds. This possibility is becoming the source of more anxiety and is adding to the pressure to always say the right thing and avoid any thing that may be deemed inappropriate.

Her work backstage involves supporting clients with breathing exercises, using low energy techniques or more dynamic work depending on what the client needs the most at that time. The kinds of people Helen has helped includes musicians on the orchestral circuit as well as pop and classical artists and more recently, grime artists.

Vocal Health Workshop in Glasgow

Friday, September 7th, 2018

Top vocal and performance coach Lucy Heyman will be conducting an afternoon workshop for vocalists in Glasgow.

The BAPAM training session organised by the Musicians Union will take place at the Scottish Trades Union Centre in Glasgow on 13th September. It will cover essential skills for enhancing vocal performance with the aim of giving tools and skills needed to succeed and thrive in music careers.

As a manager Lucy Heyman has worked with a range of artists including some of the UK’s biggest names, so has a real understanding of the trials and tribulations a performer goes through.

The topics she will cover include vocal techniques and warm-ups, preparation for performance and psychological skills for optimal performance.

BAPAM’s healthy performance training sessions are designed to avoid health problems which are often encountered in the course of an arts career and are led by the experts in the field. To enquire about booking a BAPAM training session email info@bapam.org.uk

We also run free medical assessing clinics for performing artists in Glasgow every month. (Next one is 5th October) To register as a patient and book an appointment call our helpline on 0207 404 8444/5888

The Accent Method Course

Thursday, June 28th, 2018

A 3-day course conducted by two of the leading names in vocal health will be taking place in Birmingham.

The course which is organised by the British Voice Association will be fairly practical with some time devoted to explaining the scientific rationale behind the technique. It is used widely in rehabilitation for voice disorders, but also used for training healthy voices and developing the dynamic range of performers.

The first two days of the course will take place on 12th and 13th July 2018 with a five month break followed by a final day in January 2019.

The technique is well researched and has a good evidence base and is designed to co-ordinate respiration, phonation, articulation and resonance to produce clear and well modulated speech.

Specialist speech and language therapist Sara Harris and singing teacher and voice coach Dinah Harris have been working together for many years, most notably at the multidisciplinary voice clinic in Lewisham Hospital.

Vocal Health Advice Workshops

Monday, June 4th, 2018

Many people come to BAPAM for help with voice problems. In most cases the best care is available through the NHS at a Specialist Voice Clinic. Our new Vocal Health Advice Workshops are designed to provide accessible support to arts professionals and students who are waiting for a clinical assessment in the Voice Clinic.

Look after your voice

Release vocal tract tension

Release tension in the breathing mechanism

Find out what to expect in the Specialist Voice Clinic

These 90 minute small group vocal health advice sessions are run by a Vocal Rehabilitation Coach with experience of working with performers in Specialist Voice Clinics. Participants will receive advice on how to look after their voice, gentle stretching to release vocal tract tension, exercises to release tension in the breathing mechanism, and information on what to expect in their Specialist Voice Clinic appointment. They are preparatory and educational, not diagnostic, and are not a replacement for an appointment in a Specialist Voice Clinic.

Call 020 7404 8444 for information and to book your place for just £20.

We can also advise you about asking your GP for an NHS Voice Clinic referral, as well as private options. We will need to see proof that you are on the waiting list at a Voice Clinic before we can book you into a Vocal Health Advice Workshop at BAPAM. We cannot offer this session to people who are already receiving medical care for a voice problem but we can advise you about appropriate sources of further care if required.

Healthy Performance Workshops at The Actors Centre

Thursday, September 28th, 2017

We’re pleased to announce a new series of healthy performance workshops in partnership with The Actors Centre, with funding support from Equity.

Members of The Actors Centre can book their place for the first two sessions now.

Look out for more workshops as the series continues through 2018.

Friday 10th November: Finding a Work-Life Balance in Changing Times 

Dr Carol Chapman
Counselling Psychologist and Performance Coach

This 3 hour interactive workshop looks at ways of establishing a viable work-life balance and managing time effectively in the context of irregular jobs and irregular working patterns. These can affect health and well-being and impact on family and social life. The workshop illustrates ways of managing the stress reactions these unpredictable patterns can bring, and shows how to facilitate resilience. Participants will be able to raise appropriate issues that affect them personally and options for coping will be described and discussed. Suggestions for taking ideas further will be made. Book here

Friday 8th December: Healthy Voice

Dr Jenevora Williams
Singing Teacher and Vocal Health Expert

All voice users suffer from ill health at some time. Find out how to minimise the vocal fatigue suffered as a result of overuse or misuse. You can also learn

about the effects of medications, environmental factors, hormones, ageing, and of course – stress.

Dr Jenevora Williams will begin with a brief summary of how the voice works, followed by a practical guide to understanding and managing your own voice use. Book here