I will be skimming the surface of the uses of ukulele in therapeutic music and music therapy. If you would like to know more, there are links to readings and websites in the references section below.

So, What is Therapeutic Ukulele?

My own definition is that therapeutic ukulele is “The learning, playing, and sharing of music on the ukulele to promote and enhance the quality of life of the player(s), listener(s), and community through the spirit of shared aloha.”

Differences Between Therapeutic Music (Ukulele) and Music Therapy

According to caregiving.com, music therapy is provided by a board-certified therapist (MT-BC) to work on individualized health goals. In contrast, therapeutic music is the prescriptive use of music to promote overall well-being or support general health outcomes. According to the American Music Therapy Association, “Music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.” Music therapists have a bachelor’s or master’s degree in music therapy and must complete 1,200 supervised clinical hours before sitting for the national MT-BC exam. We must also complete 100 hours of continuing education every five years. 

Why is the Ukulele an Ideal Instrument for Therapeutic Music and Music Therapy?

The ukulele is a popular instrument for the music therapist, offering many opportunities for creative client involvement and growth. It is attractive, accessible, portable, adaptable, and easy to play, and as we know, the sound of the ukulele invites a spirit of aloha, joy, and coming together. The various sizes of ukulele also allow it to be used with children, teens, adults, and seniors.

Examples of Music Therapy and Therapeutic Ukulele Across the Lifespan

With Hospitalized Children and Teens

Here, the specific type of music therapy is based on an assessment of the patient’s individual needs and is designed to achieve specific goals. The patient’s music preferences are also taken into account. Some clinical goals may include:

· Managing pain 

· Adjusting to and normalizing of the hospital environment

· Promoting comfort, relaxation and stress reduction

· Socializing and decreasing feelings of isolation or depression

· Encouraging positive coping and feelings of control

· Providing emotional support and an outlet for emotional expression

· Aiding physical goals and rehabilitation via playing after injury or surgery

The Ukulele Kids Club & Hospitalized Children

One organization that is making a huge difference is the Ukulele Kids Club, founded in 2014 by Corey and Edda Bergman. For a hospital to qualify, they must have a board-certified music therapist on staff. The UKC is currently affiliated with over 365 music therapy sites around the world, including 13 in the greater Los Angeles area. Over 1,400 hospitalized children received a free ukulele in 2023, and over 15,200 kids have been helped by the UKC.

The music therapy programs identify children to receive the free ukuleles and provide music therapy sessions to achieve a variety of health goals. After discharge, UKC helps kids continue their progress via free access to their resource portal, classes, on-demand lessons, and on-line music therapy sessions with the Music Therapy Program at Berklee College of Music. There are also resources for music therapy affiliates and the ukulele community at large. A number of ukulele clubs have also fundraised for and donated instruments to the UKC.

With Children and Teens in Special Education and Mental Health

In an article in the Fall, 2015 issue of Ukulele Magazine titled “Scientific Study Shows Playing Ukulele Benefits Kids’ Attitudes”, the research team shared that 3rd and 4th grade Canadian kids who participated in ukulele lessons had “larger increases in sympathy and pro-social behavior” than those who did not. They credited the ukulele classes with creating a collaborative environment and forming social bonds between children who sang and played together.

I have found great success incorporating ukulele into my clinical work with children and teens with special needs in a number of settings, including residential facilities, clinics, schools, and summer camps. Here, I have used the uke in a number of individual and group settings to address educational, social, emotional, behavioral, physical, and related needs. As with hospitalized children and teens, the uke is attractive to the students, and success-oriented, which is very important. Kids who may be frustrated using a guitar often experience a feeling of success within a single session incorporating the ukulele. In addition, kids who learn on a baritone uke can then transfer fingerings to the top 4 strings of a guitar and later learn the complete chords.

It is helpful that the uke has been featured in popular songs over the years, and is seen by kids and teens as cool – examples include Hey Soul Sister by Train, Riptide by Vance Joy, Disney’s (Someone to) Lava, I’m Yours by Jason Mraz, Count on Me by Bruno Mars, Dwane the Rock Johnson’s playing Wonderful World in Journey 2 the Mysterious Island, and of course Bruddah Iz’s arrangement of Over the Rainbow. Kids and teens often know these songs, many times via their parents (or grandparents).

Supporting Physically Challenged Players of Any Age

Some prospective ukulele players face the challenge of not having fingers, arms, or limited dexterity due to congenital disorders, disease, accident, or surgery. For example, the music therapist at Shriner’s Children’s Hospital near me serves patients recovering from severe burns and orthopedic surgeries. She has shared that the ukulele is attractive to and motivating for them, which provides the incentive to learn to play, regardless of limitations, pain, or discomfort.

To help people with upper arm disabilities, Deb Guarneiri, a ukulele player from Upstate New York invented the Ukulele Support System. This system is customized to meet each person’s special needs. For some with partial arms, there is the cradle system with articulated arm splints. For other players who have more arm but no elbow, there are arm splints with a push button chord changer and waist strap. Still others may have all of their limbs but lack the physical strength or neurological connections to play. For them, Deb designed pick splints that slide onto one or two fingers with a felt pick positioned to strum. 

One example of an uke artist who has developed impressive skills is Nick Acosta, who was born with his right arm developed only to the elbow. That hasn’t stopped him from pursuing what that he loves most, playing the ukulele. With guidance from legendary ukulele teacher Roy Sakuma, Acosta has become a prodigious ukulele player and an inspiration to many.  

Other Organizations Supporting Therapeutic Ukulele

One of many other examples of therapeutic ukulele applications and organizations is Ukuleles Heal the World, a group of ukulele players in Portland, Maine, founded by Lee Urban who believe in the ukulele’s power to heal. They offer one-week summer ukulele camps to almost every elementary school in their area. The camps not only teach ukulele skills, but life skills like promoting self-esteem. They have said that “If campers live up to the ukulele camp pledge, they will earn the ukulele package of an instrument, gig bag, tuner, and book. Not surprisingly, every one of our kids has earned a ukulele package.”

In the Spring, 2018 issue of Ukulele Magazine, Swedberg shared about the the Heroes Ukulele Group, or HUG, led by veterans and meeting at a Los Angeles VA Campus. It is open to any veteran, their family, families of active service personnel, and any friend who honors and supports our vets and our men and women in uniform. In her article, one HUG member shared “For me it’s a great form of therapy to help me deal with lots of depressing situations that I experienced in the military.”

More About Ukulele for Adults and Seniors

My own work since 2016 has focused on teaching ukulele classes to adults and seniors in a lifelong learning institute associated with a medical school. It has been noted that musical involvement and engagement across the lifespan may promote and foster well being and health.  Carr (2016) discussed advantages of the ukulele for seniors, given that there are only four strings and that the hands of older learners may not be as strong or flexible as they once were.  D’Ville, in a 2021 article in Ukulele Magazine, pointed out that one advantage of older adult ukulele students is their rich life experience and background of problem-solving. Pattison (2017) suggested that learning the ukulele should be considered by those retiring from the workforce as an accessible and enjoyable leisure skill that can be shared with others. In fact, older adults may benefit from the social aspect of an ukulele class as much as the actual learned ukulele skills. For example, Matto et al. (2021) examined how ukulele classes impacted the well-being of older adults. Focus group themes revealed that the participants felt challenged, but also reported increased confidence and enhanced social connections. Drigans, in a 2022 article in Ukulele Magazine, described the benefits of playing ukulele and singing for seniors, especially those with dementia. 

Therapeutic Ukulele in Our Own Lives

The Power of the Group: Ukulele Groups and Therapeutic Community Music

Community music and music therapy consider how individuals, small and large groups, and entire communities can benefit from engagement in music experiences, specifically in relation to their sense of well-being, feeling of belonging, and participation in their communities. Lee and Southcott (2020) explored how ukulele club playing experiences with adults positively influenced their daily lives, resulting in a sense of satisfaction and achievement. As we know, there are hundreds of community ukulele groups in the US (including in the LA area), and many more around the world. D’Ville in 2021 described considerations for starting a community ukulele group in Ukulele Magazine. So, if you are not a member of a group and there is not a group in your area, you can start one yourselves!

Ukuleles for the community to play, check out, and use in ukulele classes are also being featured at an increasing number of public libraries, including cities such as Los Angeles, Santa Monica, and Ventura here in SoCal. The Los Angeles Public Library currently has ukuleles at 18 of the city’s 73 branches.

Rhythmic Entrainment

One phenomenon we have all experienced is the feeling of connection with others while playing in a group, especially when strums and rhythms synchronize. There is a neurological process happening called rhythmic entrainment. As described by Thaut, McIntosh, and Hoemberg in 2014,  “Entrainment is defined by a temporal locking process in which one system’s motion (e.g. rhythm) entrains the frequency of another system. This process is a universal phenomenon that can be observed in physical and biological systems.” In playing ukulele and singing together, rhythmic entrainment becomes a process where our rhythms interact and eventually lock into a common phase or periodicity/rhythm (e.g the island strum). Perception and production of auditory rhythms involve the subcortical and cortical brain networks, and rhythmic entrainment is known to play a role in affecting heartbeat, pain reduction and muscle relaxation. Rhythmic entrainment connects individuals with their own body rhythms and also connects them nonverbally with others. 

Positive Effects of Singing (Even if We Think We Don’t Have a Good Voice)

We enjoy singing in our ukulele groups as well, and singing can have many positive effects in a number of areas and domains. For our mental health, singing can reduce stress and increase mental alertness, especially when done in a group. It can also help improve memory and concentration by engaging multiple areas of the brain. Singing stimulates the release of endorphins, hormones and neurotransmitters such as dopamine, serotonin, and oxytocin, which can make you feel happier, healthier, and more confident. Singing can improve lung function and cardiovascular health, and for our social connectedness, singing together can help us feel a sense of community and belonging.

Using Ukulele Therapeutically in Our Own Creative Self Care

Many of us incorporate the ukulele into our therapeutic self care, often not even realizing it.  We gain respiratory and cardio benefits from singing and playing, and know it can be a physical workout that we enjoy. The ukulele can also be a friend and help us through hard times. An article in the Spring, 2021 issue of Ukulele Magazine was titled “How the Love of Ukulele is Helping People Get Through the Pandemic”. This featured stories from a number of readers as to how the uke helped them during that time. I’m sure many of us here not only played at home, but also connected with others on-line with lessons, performances, and meet-ups.

Ukulele Creates Healthy Vibrations in our Brains and Bodies

In the Winter, 2020 issue of Ukulele Magazine, Eddie Scher, in an article titled “Music as Medicine: 6 Big Ideas to Help Keep You Motivated”, summarized the late neurologist Dr. Oliver Sacks, writing “Music may be so deeply ingrained in us because musical activity involves every part of the brain—the emotional, motor, and cognitive areas. And the positive effects occur whether you’re playing or just listening.”   Indeed, research has shown that blood flows more easily when music is played. It can also reduce heart rate, lower blood pressure, decrease cortisol (stress hormone) levels and increase serotonin and endorphin levels in the blood. When one listens to music that gives them the chills (e.g. Iz singing Over the Rainbow), it triggers a release of dopamine, a neurotransmitter that stimulates sensations of pleasure and well-being. As your brain becomes familiar with a particular song, your body may release dopamine upon anticipating or hearing just the first few notes of the song. Music can also increase levels of the hormone oxytocin, which has been shown to decrease stress and anxiety levels. It can also increase feelings of relaxation, trust, and overall psychological stability.

On a final note before our closing music therapy song and questions, one issue I have not addressed is Ukulele Acquisition Syndrome, or UAS. I feel that UAS is actually not a disorder or disease, but rather a lifestyle choice. Therefore, therapy is not needed. My advice is to buy two ukes and jam out in the morning.

References and URL’s

Alvarado, F. Ukulele Kids Club Provides Instrumental Healing. Ukulele Magazine, Winter, 2014. https://ukulelemagazine.com/stories/news/ukulele-kids-club-provides-instrumental-healing

American Music Therapy Association – https://www.musictherapy.org/

Biard, M. A. NMT and the UKC: Using the Ukulele in Patient Rehabilitation, 2024. https://theukc.org/using-the-ukulele-in-patient-rehabilitation/ https://www.caregiving.com/content/Ultimate-Guide-to-Music-Therapy-and-Therapeutic-Music#

Certification Board for Music Therapists -  https://www.cbmt.org/

Drigans, P. The Joy of Playing Ukulele for Seniors: How to Get Started with Volunteering. Ukulele Magazine, Spring, 2022. https://ukulelemagazine.com/stories/the-joy-of-playing-ukulele-for-seniors-how-to-get-started-with-volunteering

D’Ville, J. (2018).   Building a ukulele club: How to make your group fun, strong, successful. Ukulele Magazine.https://ukulelemagazine.com/stories/news/building-a-ukulele-club-how-to-make-your-group-fun-strong-and-successful

D’Ville, J. Wisdom, Experience, Drive: The Advantages of Being an Adult Beginner. Ukulele Magazine, Spring, 2021. https://ukulelemagazine.com/stories/am-i-too-old-to-learn-ukulele

D’Ville, J. The Healing Ukulele: How People Are Using Ukes to Help Children. Ukulele Magazine, Winter, 2019. https://ukulelemagazine.com/stories/the-healing-ukulele-how-people-are-using-ukes-to-help-children

How the Love of Ukulele is Helping People Get Through the Pandemic. Ukulele Magazine, Spring, 2021. https://ukulelemagazine.com/stories/news/how-the-love-of-ukulele-is-helping-people-get-through-the-pandemic

Krout, R. E.  Growing Aloha Through Community Ukulele with Older Adults: Multiple Perspectives. In K. Goodman (Ed.) Developing issues in world music therapy education and training, Charles C. Thomas, 2023. http://www.mys1cloud.com/cct/ebooks/9780398094027.pdf

Krout, R. E. Ukulele Boot Camp. Music Therapy Online.

https://musictherapyonline.org/p/ukulele-boot-camp

Scher, E. Music as Medicine: 6 Big Ideas to Help Keep You Motivated. Ukulele Magazine, Winter, 2020. https://ukulelemagazine.com/stories/music-as-medicine-6-big-ideas-to-help-keep-you-motivated

Scientific Study Shows Playing Ukulele Benefits Kids’ Attitudes. Ukulele Magazine, Fall, 2015.

https://ukulelemagazine.com/stories/news/study-playing-ukulele-benefits-kids-attitudes

Swedberg, H. Heroes Ukulele Group: Helping Veterans, One Strum at a Time. Ukulele Magazine, Spring, 2018.

https://dev.ukulelemag.com/stories/using-ukuleles-to-change-the-lives-of-some-of-indias-most-vulnerable

Ukulele Kids Club - https://theukc.org/

Ukulele Support System for physical challenges - https://www.facebook.com/UkuleleProsthetics/

Ukuleles Heal the World - https://www.facebook.com/ukuleleshealtheworld

Additional References

Aigen, K. S. (2012) Community music therapy. In G. E. McPherson & G. F. Welch (Eds).The Oxford Handbook of Music Education, Volume 2, pp. 138-154. Oxford University Press. https://doi:10.1093/oxfordhb/9780199928019.013.0010

Ansdsell, G., & DeNora, T. (2012). Musical flourishing: community music therapy,

controversy, and the cultivation of wellbeing. In A. R. MacDonald, G. Kreutz, & L. A. Mitchell (Eds.). Music, health & wellbeing pp. 97-112.  Oxford University Press.

Ansdsell, G., & DeNora, T. (2017). Musical pathways in recovery: Community musictherapy and mental wellbeing (music and change: ecological perspectives). Routledge.

Ansdell, G., & Stige, B. (2016). Community music therapy. In J. Edwards (Ed). The Oxford handbook of music therapy, pp. 595-621.  Oxford University Press. https://doi:

10.1093/oxfordhb/9780199639755.013.6

Bartleet, B. L., & Higgins, L. (2018). Introduction: An overview of community music in the twenty-first century. In B.L. Bartleet & L. Higgins (Eds.), The Oxford handbook of community music pp. 1-22. Oxford University Press. https://doi:

10.1093/oxfordhb/9780190219505.001.0001

Carr, J. (2016). Ukulele for seniors. Mel Bay Publications.

Creech, A. (2018). Community-supported music-making as a context for positive and creative ageing. In B. L. Bartleet & L. Higgins (Eds.), The Oxford handbook of community music pp. 89-108. Oxford University Press.

https://doi:10.1093/oxfordhb/9780190219505.001.0001

Eastburn, K. (2019). Making a strum-back. Coast Monthly, December, pp. 78-81.

Giebelhausen, R. (2016). So, you’re thinking about starting a ukulele program? General Music Today. 29(3), 38–41. https://doi:10.1177/1048371315625294

Giebelhausen, R., & Kruse, A. J. (2018). “A smile on everybody’s face”: A multiple case study of community ukulele groups. International Journal of Music Education, 36(3), pp. 347–365. https://doi: 10.177/ 0772/0255761417744371

Got A Ukulele (2021). Ukulele clubs and societies. https://www.gotaukulele.com/p/ukulele-clubs-and-societies.html

Gracida, L. S. (2018). 5 reasons why ukuleles are great instruments for music therapy.https://samsfans.org/5-reasons-why-ukuleles-are-a-great-instrument-for-music therapy/#2_Ukuleles_can_be_used_even_when_the_goal_is_not_to_teach_the_patients_how_to_play

Holmes, S. (2021) The wider cognitive benefits of cognitive engagement in music. In A. Creech, D. A. Hodges, & S. Hallam. (Eds.), pp. 51-67. Routledge international handbook of music psychology in education and the community. Routledge.

https://DOI.org/10.4324/9780429295362

IMHope (2022). “Fountains of uke” intergenerational music program.

https://imhope.ca/wp-content/uploads/2020/10/Fountains-of-Uke-Program-Description.pdf history/

Krout, R. E. (2015). Music therapy community-based clinical learning experiences here and abroad: A focus on community engagement. In K. Goodman (Ed.), International perspectives in music therapy education and training: Adapting to a changing world, pp. 103-129. Charles C Thomas.

Krout, R. E. (2021). Ukulele boot camp: essential starting points for a sound approach Music Therapy Online. https://musictherapyonline.org/p/ukulele-boot-camp 

Kruse, N. B. (2013). 'Without u, it's just kulele': expressions of leisure and 'ohana in an intergenerational ukulele club. International Journal of Community Music, 6(2), pp. 153-167. https://doi: 10.1386/ijcm.6.2.153_1

Lee, A., & Southcott, J. (2020). The ukulele experiences: leisure and positive ageing in Taiwan. International Journal of Community Music, 13(3), pp. 319-331.

https://doi:10.1386/ijcm_00028_1

Lee, W. (2016). Ukulele groups strike a chord with sections. The San Francisco chronicle, November 27. https://www.sfchronicle.com/business/article/Ukuleles-strike-a-chord-with-seniors-10636655.php.

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Moss, H. Lee, S., Clifford, A. M., Bhriain, O. N., & O'Neill, D. (2021). Together in song: Designing a singing for health group intervention for older people living in the community. Nordic Journal of Music Therapy, pp. 1-18. https:// doi: 10.1080/08098131.2021.2004613

Negrete, B. (2021). Ukulele class in the neonatal intensive care unit: support for parents before and during COVID-19. Pediatric Nursing, 47 (2), pp. 97-103.

https://link.gale.com/apps/doc/A665178075/ITOF?u=txshracd2548&sid=bookmark-ITOF&xid=1ed828e9

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Pattison, K. (2017). Retire - get a ukulele: a tongue-in-cheek version of what occurred when a bunch of uke loving seniors formed a ukulele group to 'entertain' their  local community. Kelvin Pattinson.

ISBN: 9781521476604.

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