Posts Tagged ‘Vocal Health’

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.

Setting and Delivering Standards in Vocal Health

Tuesday, May 8th, 2018

The singing industry is completely unregulated, meaning anyone can call themselves a singing teacher, vocal coach or even vocal rehabilitation coach regardless of training, experience or lack of clinical supervision. At BAPAM, we have many calls from actors and singers with voice problems and we have been aware of an inconsistent approach to care.

Working with a group of vocal health specialists established by our Medical Committee, comprising Ear Nose and Throat specialist doctors, speech and language therapists, physiotherapists and vocal rehabilitation coaches from across the country, we have set standards for our vocal health advice, and competencies for Vocal Rehabilitation Coaches. We are also funding sessions for specialist clinics to have a Vocal Rehabilitation Coach for a pilot period so we can evaluate the impact.

We hope this will be a major step forward improving the quality of care for vocalists who present with problems in healthcare. It will enable them to get a rapid assessment by the right professionals to accelerate the right treatment. It will also provide a set of standards for singing practitioners in the UK who wish to work with a Voice Clinic and provides an improved level of protection and quality assurance for organisations supporting arts professionals accessing specialist health care.

The literature on dysphonia demonstrates that singers presenting with voice disorders are most likely to have Muscle Tension Imbalance (MTI). General ENT Surgeons tend to look for organic pathology or structural abnormality and do not always diagnose MTI.  Diagnosis of MTI in speech is usually made by a Speech and Language Therapist with experience and training in assessing the muscular function of the whole larynx and vocal tract via nasendoscopy.  MTI in singing is being assessed in a few leading clinics by a Vocal Rehabilitation Coach with experience and training in the assessment of the larynx and vocal tract in a wide range of singing styles, also diagnosed via nasendoscopy.  Only specialist Voice Clinics have access to equipment and personnel qualified to deal with this type of problem in professional singers.  Treatment of MTI in singers is carried out by Speech and Language Therapists and Vocal Rehabilitation Coaches, jointly or in succession.

The BAPAM Vocal Health Working Group recommends multidisciplinary clinics with a surgeon and specialist speech therapist using high definition cameras with stroboscopic or high speed videos to analyse the vocal folds as standard of care. BAPAM has adopted this standard for the advice we give to patients.

BAPAM’s advice for GPs is to refer to a specialist Voice Clinic when patients with the following characteristics present with a voice problem:

Patient population

  1. Elite Performers (professional singers, actors, broadcasters, etc)
  2. Studying Performers (FE, Undergraduate and Postgraduate singers and actors)
  3. Quality of Life Performers (singers whose singing is their primary means of socialising like older local choir members)

Presenting Voice Problems

  1. Loss of range, power, flexibility
  2. Pain, fatigue, hoarseness
  3. Gaps in range, delayed onset of phonation
  4. Increased recovery or warm-up time
  5. Chronic throat-clearing, sensation of lump in throat (globus)

Referrals

A referral to a specialist Voice Clinics should be made for:

  1. Any vocal symptom lasting more than 2-3 weeks
  2. Any vocal symptom lasting more than 2 weeks following resolution of a bacterial/viral infection

Advantages of a Specialist Voice Clinic

  1. Stroboscopy to view vocal fold vibration is only available in these clinics
  2. EGG and other specialist equipment for accurate measurements
  3. Expertise in muscular function and dysfunction of the vocal tract
  4. More accurate diagnosis, improving management and decreasing patient recovery time (P.S. Phillips 2005)

The large clinic team enables a multidisciplinary assessment because performance voice problems are likely to be multifactorial and more likely to be muscular with musculoskeletal and/or psychogenic causes. Staffing includes:

  1. Voice Specialist Laryngologist*
  2. Voice Specialist Speech and Language Therapist
  3. Vocal Rehabilitation Coach (Singing Voice Specialist)
  4. Performance Specialist Osteopath/Physiotherapist (in some clinics)

*Some Specialist Clinics are SLT-led with Laryngologist review

Accurate diagnosis and specialist treatments speed up recovery times and save money in the long run.

(see British Voice Association leaflet on Multidisciplinary Voice Clinics)

Patient Outcomes

  1. If organic lesions are present they may be listed for surgery immediately or referred for Speech Therapy then reviewed
  2. Functional disorders will be referred for Speech and Language Therapy and/or Vocal Rehabilitation
  3. Musculoskeletal disorder will be referred for Osteopathy/Physiotherapy
  4. Psychogenic disorders will be referred to Speech and Language Therapy and onwards to access Psychology/Talking therapies as appropriate (for Psychotherapy and/or Speech Therapy)
  5. Most patients will be referred to more than one of the above

Vocal Advice

BAPAM offers 90 minute small group vocal health advice workshops to performers who have concerns about their vocal health once they have received a referral to a Specialist Voice Clinic and been put on the waiting list.

The sessions will be run by a Vocal Rehabilitation Coach with experience working with performers in Specialist Voice Clinics. Participants will receive general 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.

These sessions are educational, not diagnostic, and are not a replacement for an appointment in a Specialist Voice Clinic.

To find our more or book a place at a BAPAM vocal health advice workshop please call us on 020 7404 8444.

The Vocal Rehabilitation Coach

In late 2017, BAPAM’s Vocal Health Working Group approved competencies for Vocal Rehabilitation Coaches to set a standard of practice in this important area. Vocal Rehabilitation Coaches on the BAPAM Directory of Practitioners must meet the following competency criteria:

  1. Hold or have previously held a contract with an NHS specialist Voice Clinic including a job description. Verified by contract document. Where an informal but significant relationship with a Voice Clinic exists or has existed in the absence of a contract, a letter from the Voice Clinic may be accepted.
  2. Have spent at least 10 years practicing as a singing teacher/vocal coach within an educational institution or in private practice. Verified by contract document or evidence of proven track record.
  3. Work under supervision from both voice specialist laryngologist and speech therapist (as appropriate) as part of a clinic team with all clients.
  4. Undertake at least 10 hours of Voice Clinic observation per year. Verified by letter from Voice Clinic.
  5. Have completed relevant anatomy/physiology training formally or in-house. Verified by attendance certificate or letter from Voice Clinic.
  6. Have completed endoscopic interpretation of singing physiology training. Verified by attendance certificate or letter from Voice Clinic.
  7. Have both basic counselling and palpation training, formal or in-house. Verified by attendance certificate or letter from Voice Clinic.
  8. Adhere to data protection standards when keeping client records.
  9. Have current appropriate liability and indemnity insurance policies. Verified by documents.
  10. Provide at least two references, one from a specialist Voice Clinic, one from a reputable professional performance-related company (ex: university or production company).
  11. Adhere to all BAPAM professional practice standards at all times.

Applicants will be included on the directory for a term of three years before needing to revalidate their application.

Information about applying to join the Directory can be found here.

We look forward to reviewing and reporting on our pilot project to support specialist Voice Clinics by funding a Vocal Rehabilitation Coach.

Vocal rehabilitation is a truly multidisciplinary endeavour, with crucial contributions from laryngologists and speech therapists.  A central member of this team is the Vocal Rehabilitation Coach who is uniquely placed between the medical clinicians and the performers to carry the scientific aspects of vocal treatment into the performance practice.  It is critical that these coaches are well schooled in vocal anatomy, physiology, pathology and rehabilitation; this schooling should be assessed with a series of measurable competencies to ensure that they are providing the best possible care. Mr. Declan Costello – Consultant Laryngologist

Following treatment for any vocal problem, like any injury one might sustain during physical exercise, a patient must rehabilitate appropriately with the aim of getting back to their pre-morbid state; to allow them to sing and speak again. In the same way you must learn to walk before you can run, one must set up the larynx correctly before trying to push its limits. Speech therapy achieves this but translating this laryngeal work into the singing voice requires a vocal rehabilitation expert. The expert vocal rehabilitation practitioner will help the performer take their correct setup into their performing voice before returning to their genre specific vocal coach. It can be seen that this is an essential part of the recovery process and having trained, competent and expert help is a comfort to patients.To this end, having the appropriate knowledge and having been assessed as reaching a standard level of expertise means that you know your patient will be in good hands.  Mr Nicholas Gibbins - Consultant Laryngologist

BAPAM Vocal Health Working Group

Mr. Nicholas Gibbins ENT

Mr. Declan Costello ENT

Ms. Tori Burnay SLT

Dr. Ron Morris SLT

Ms. Linda Hutchison VRC

Mr. Dane Chalfin VRC

Mr. Ed Blake Phys.

BAPAM Training Day: The Professional Voice User in Trouble

Monday, September 4th, 2017

Our November 2017 Training Day brings a multidisciplinary focus to bear on vocal health issues affecting professional voice users. Presented in collaboration with voice care experts at the forefront of the field, this event is ideal for medical professionals and students, voice coaches, professional voice users, teachers, healthcare practitioners, and all those engaged in wellbeing in the creative arts, who want to develop specialist knowledge and skills. BAPAM Training Days are also a great opportunity for discussion, sharing insights with peers, making new connections and growing our performing arts medicine network.

Book your place here

Our timetable for the day will be confirmed shortly. Presentations include:

Mr Nick Gibbins, Laryngologist
The Surgeon’s Perspective

Nick Gibbins will take us through the types of vocal injuries and disorders that face professional performers including musculoskeletal issues, inflammatory problems, and organic lesions of the vocal folds. The laryngologist’s role in the multidisciplinary voice clinic will be explored including diagnosis and surgical intervention.

Tori Burnay, Voice Specialist Speech and Language Therapist
The Therapist’s Perspective

Tori Burnay will show us the therapist’s side of endoscopic examination including the muscular behaviour of the larynx and vocal tract in healthy and disordered speech. Muscle tension issues, vocal hygiene, workload management and potential therapy plans will be discussed.

Dr Carol Chapman, Counselling Psychologist and Performance Coach

Dr Jane Oakland, Music Psychologist and Singer
Psychological Perspectives

Examining the difference in presentation, conceptualisation and treatment between professional voice users who have a medical diagnosis and those for whom no diagnosis has emerged and whose problems appear to have a purely psychogenic origin. Discussing the psychological and social/career impact of having voice problems in these circumstances and at different stages during a performing career. Using illustrations from client work, suggesting what clinicians should look out for. Illustrating techniques for rehabilitation and coping.

Prof. Dane Chalfin, Vocal Rehabilitation Coach
The Singing Perspective

Dane Chalfin will guide us through the Vocal Rehabilitation Coach’s role in the interpretation of the laryngopharyngeal gestures in healthy and disordered singing in various styles. Muscle tension issues in the singing voice and rehabilitative pedagogy will be discussed. This will also include a live scoping session where Mr Nick Gibbins will perform nasendoscopy on Professor Chalfin live in front of the audience. We will be inviting attendees to submit requests for singing gestures they would like to see in situ.

Ed Blake, Physiotherapist
The Physiotherapist’s Perspective

Ed Blake presents on physiotherapy treatment for professional voice users suffering voice related symptoms.

Research: Vocal Health Awareness in Singing Students and Teachers

Thursday, February 16th, 2017

Dr Anneliese Sayes is a medical doctor and researcher at the Royal College of Music who is investigating the current knowledge levels of vocal anatomy, physiology and pathology in singing students (within the conservatoire and university systems) and singing teachers.

She is inviting participants to fill in a questionnaire (that should take around 10-15 minutes to complete). There is a separate questionnaire for students and teachers. Full information about the study, which has research ethics approval from Conservatoires UK, is also provided. The survey can be accessed online via the following links:

Vocal Awareness questionnaire for student singers

Vocal Awareness questionnaire for singing teachers

Health and Wellbeing Month – in Association with The Musicians’ Union, Help Musicians UK and BAPAM

Thursday, July 7th, 2016

Through August 2016, we are delighted to be partnering with Help Musicians UK (HMUK) and the Musicians Union (MU) for Health and Wellbeing Month, packed with events where health and performance experts meet music creators to share essential skills for peak performance throughout a healthy and successful career. Health and Wellbeing Month sees each organisation bring their own focus and expertise to benefit the whole UK community of musicians.

Events will be held in Glasgow, Manchester, Birmingham, Cardiff, and London, with more to be confirmed across the UK.

WORKSHOPS

Expert BAPAM trainers will host an array of events sharing practical skills to boost performance and avoid health problems. From Vocal Health, to Ways to Beat Stress and Deal with Perfectionism, right through to Drumming without Pain, the workshops will be available to all musicians or artists, at any stage of their career.

All workshops cost just £5 for MU members, £8 for trade body members, and £10 standard price. Please click on the specific workshop listings below for further information, including how to book. Spaces are limited so please ensure to book in advance.

Tuesday 2 August, 2 – 4.30pm, MU Offices, London
Vocal Health with Jenevora Williams

Wednesday 3 August, 2 – 4.30pm, MU Offices, Birmingham
Vocal Health with Jenevora Williams

Thursday 4 August, 2 – 4.30pm, MU Offices, London
The Healthy Performer with Drusilla Redman

Tuesday 9 August, 2 – 4.30pm, RWCMD, Cardiff
Injury Prevention for musicians – a physiotherapist’s viewpoint with Sarah Upjohn

Wednesday 10 August, 2 – 4.30pm, MU Offices, Birmingham
Realising potential in performance: an introduction to Alexander Technique with Alison Loram

Monday 15 August, 2 – 4.30pm, MU Offices, London
The Healthy Pianist with Penelope Roskell

Tuesday 16 August, 2 – 4.30pm, MU Offices, Birmingham
The Healthy Performer with Drusilla Redman

Wednesday 17 August, 2 – 4.30pm, MU Offices, London
Ways to beat stress and deal with perfectionism with Carol Chapman

Thursday 18 August, 2 – 4.30pm, MU Offices, London
Drumming Without Pain: Injury Prevention Workshop with Martin Ranscombe

Monday 22 August, 2 – 4.30pm, MU Offices, London
Introduction to Feldenkrais for Musicians with Emma Alter

Tuesday 23 August , 2 – 4.30pm, MU Offices, Birmingham
Introduction to Feldenkrais for Musicians with Emma Alter

Tuesday 30 August, 2-4.30pm, Philharmonic Hall, Liverpool
Gain without Pain: Workshop for Woodwind Players with Andrew Roberts

Tuesday 30 August, 2 – 4.30pm, RSNO, Glasgow
Help and Advice for Being a Healthy Performer with Dr Faith Gardner

For any Workshops queries, contact Diane Widdison, National Organiser – Education and Training at MU on diane.widdison@themu.org.

MUSICIANS INSIGHTS

Musicians Insights are an ‘In Conversation’ series of events raising awareness of key health issues for musicians. We’ll hear personal stories from musicians who have dealt with particular issues. The discussions will provide a better understanding of musicians’ individual situations and show about how various charities and services fit into the support network for musicians. Musicians Insights will be an informal yet informative platform to widen perceptions of what it means to be a professional musician, and throw some insight into what can be done to improve situations for the future.

All evenings are free to attend. Please click on the specific Musicians Insights events below for further information, including how to book. Spaces are limited so please ensure to book in advance.

Monday 8 August, 6.30pm – 9pm, Band On The Wall, Manchester

Thursday 11 August, 6.30pm – 9pm, Band On The Wall, Manchester

Monday 15 August, 6.30pm – 9pm, Cardiff

Wednesday 17 August, 6.30pm – 9pm, Glasgow

Thursday 18 August, 6.30pm – 9pm, London

Wednesday 24 August, 6.30pm – 9pm, London

For any Musicians Insights queries, contact Sarah Wainman, Events Officer at HMUK on events@helpmusicians.org.uk, or call 020 7239 9153

BVA Roadshow at the Gathering Voices Festival of Song in Bristol

Monday, September 30th, 2013

The British Voice Association hit the road for a workshop on voice health, spoken voice and singing technique at the Festival Of Song, where over 90 choirs drawn from all over the west will perform.

The speakers are Mike Thomas, Consultant ENT at the Cheltenham General Hospital Voice Clinic, Alison Sutton, Singing Rehabilitation Coach at the same clinic, Carol Fairlamb, Head of Voice at the Bristol Old Vic Theatre School, and Frith Trezevant, Singing Teacher with the National Youth Choirs of Great Britain.

The workshop is on Saturday 12 October at Soundworks in Southville, Bristol, and runs from 10 – 4. Cost is £25 for the day. Lunch is not provided. Find out more here: http://www.festivalofsong.org.uk/workshops/

Weak, Wobbly or Working?

Monday, January 30th, 2012

The next British Voice Association study day, at the Royal Northern College of Music in Manchester, focuses on the effects of ageing on the voice and the vocal problems associated with ageing. Surgical, voice therapy and singing solutions will be discussed.

Follow the link for detailed information and to book your place:

“Weak, Wobbly or Working?” The Multidisciplinary Management of the Ageing Voice

Sunday 25th March, 2012 11.30am – 5.15pm

Speakers include:

•Sue Anderson (Singing Teacher and Researcher)

•Phil Jones (Consultant Otolaryngologist)

•Liz McNaughton (Specialist in the Singing and Speaking Voice)

•Jane Shaw (Voice Specialist Speech and Language Therapist)

•Mark Watson (Consultant Otolaryngologist)