By Edward McKinnon

Carrie Jenkins’ music therapy studio is a small cube hidden inside your run-of-the-mill beige suburban strip mall. In the corner, where she sits talking about her profession and what she might do with a client throughout a therapy session, she is framed by a keyboard to her left and a television monitor to her right. Across the room, there is another keyboard. Right beside it, there is a beautiful ocean-blue guitar next to a bookcase featuring music literature, her college diploma and her certificate from the Certification Board for Music Therapists.

An otherwise tight space feels much fuller and more vibrant thanks to the bright green colored walls, collection of musical instruments, and of course, Jenkins herself. In this space, she works mostly with children with various developmental disabilities such as autism spectrum disorder (ASD) and Down syndrome. She also travels to schools to hold group sessions as well as senior care facilities where she can work with Alzheimer’s and dementia patients. During a session, she has clients work on tasks that usually involve her or them playing songs.

Typical sessions unfold similar to other types of therapy, but Jenkins incorporates musical elements to help clients. With many clients, she has them sing greeting and departure songs to signal the beginning and end of a session. From there, she must learn to improvise and adapt to any client’s need. Sometimes, clients will develop new lyrics for familiar songs to express their feelings. She has a guitar, keyboard and ukulele handy that she can use to perform songs. If a patient already has baseline musical skills, she will incorporate their skills into the session. For example, with her long-time client Daniel LeBlanc she used all of these elements in their meetings, enabling him to play the trumpet or write lyrics depending on the situation.

“They’re learning musical aspects,” Jenkins said, “but it’s not focused solely on musical properties. It’s figuring out how to read, how to focus, how to finish a task before moving to the next one.”

Jenkins has run Music Therapy of Northwest Arkansas under the Cardinal Care Center in Farmington since 2012. During more than 10 years on the job, music therapy globally has grown significantly in popularity, especially during COVID-19. ASD diagnoses have tripled in children ages 8 or younger in the last 20 years, with the CDC reporting 1 in 54 children in the age range diagnosed in 2016. Music therapy has proven very effective in helping children with ASD, among other similar groups, and is only becoming more popular.

Jenkins has experienced this demand to the point where she has to waitlist some prospective clients or groups. While national interest in music therapy continues to grow, she remains the only practicing music therapist in Northwest Arkansas. Statewide, she is only in contact with one other music therapist, Andrew Ghrayeb, who works at Arkansas Children’s Hospital in Little Rock. Even if she is on an island of sorts, Jenkins takes solace in the fact that her work makes a noticeable difference. It is her dream job, she said. She has always loved music, lived around the medical field her whole life and has a natural inclination to help others. Music therapy is the perfect outlet.

Jenkins grew up in Farmington, attending high school down the road from her office at the Cardinal Care Center. Her dad is a retired pharmacist who loves music and initially wanted to be a music major, and her mother is a nurse. As a kid, she took piano lessons and taught herself guitar. This created an ideal development environment for an aspiring music therapist, but Jenkins did not always know she would do this kind of work. In her own words, it was all a fluke.

“I was working at an MRI clinic as a file clerk, and the guy that would come in and service our MRI machine to make sure it was working properly found out I was helping with music at my church … And he was like, ‘You know, I think you have the personality — you should look at music therapy.’”

Ironically, Jenkins nearly shrugged off the idea of music therapy as a calling with the same confusion a skeptic might direct toward her today. However, she was interested enough to research the topic, and she discovered that Drury University in Springfield, Missouri, offered a music therapy program. After visiting and talking to professors, she realized this profession was her ideal landing place.

After earning her bachelor’s degree, she partook in a six-month internship at the STAR Center in Jackson, Tennessee, and then decided to pursue her master’s degree. 

Shortly after Jenkins completed her master’s program at Drury, Cardinal Care Center opened. Sherri Gansz, the owner, wanted to offer a variety of services to address mental health, and Jenkins’ expertise fit that goal, making her a mainstay at Cardinal Care. 

“Due to the specialized therapy Carrie offers, we are known in the area for her talents,” Gansz said. “Her population is specific. None of us have the experience or training.”

Before even getting settled with Cardinal Care, Emily LeBlanc, the mother of Jenkins’ would-be-first individual client, contacted her. She found out about Jenkins online after searching out possible music therapy options in the region for her late-teenage son, Daniel, but did not realize Jenkins was still completing her degree. After Jenkins graduated and settled in Farmington, Emily reached out again. She had taken her son to other talk therapists before discovering Jenkins, but it was not as effective as music therapy.

“Singing about it was what he needed to do to fully express what he was feeling,” Emily said while sitting beside her son on a Zoom call.

Growing up with autism, Emily said her son Daniel was unhappy in public school and in search of an outlet to express his feelings constructively. “It was sad,” he said.

“It was sad,” Emily said, echoing her son’s sentiment. “(His struggle in school) was actually pretty normal for someone with autism. Having somebody else working on it was very helpful. Carrie would have him sing about different emotions. There were songs for greeting and for leaving, and in between, she would have different goals, such as keeping rhythm with her to help him link up to another person.” 

Much of what they worked on during therapy sessions emphasized mirror neurons, which are linked to brain activity in social interactions and expressing empathy. People with autism have mirror neurons and do feel empathy but cannot tell what others are feeling at a specific moment as easily.

Emily said Carrie was having him work on his mirror neurons musically by trying to match beats and play music. One task he worked on was playing Bach’s “Toccata and Fugue in D minor,” one of his favorite pieces.

After nearly 12 years of practicing professionally, Jenkins has refined her craft by learning to go with the flow during sessions. Music therapy is a versatile service that can mean a lot of different things depending on who the patient is and what the practitioner’s musical background is. For a client, such as Daniel, who is working on expressing their feelings, using music to elicit an emotional response is a point of emphasis. For other patients with disabilities whose primary struggle is staying on task, performing music is common regardless of their skill level.

“With music therapy, I’m focusing more on if they can play with one finger at a time,” Jenkins said. “Can they focus long enough to complete an entire song? Can they be able to match letters on a page to letters on the keys that I have to see if we have cognitive and visual tracking?”

She demonstrates this by showing the special keyboard she uses with clients. It is set up to play “Twinkle, Twinkle, Little Star” and features various settings that force a user’s level of involvement to increase incrementally. With the basic setting, a client can tap any key on the keyboard and it will produce the correct note for the song. Next, a client must press the correct key, which is illuminated, in order to continue performing the song, and so on.

“That’s not only working on focus and staying on task until it is done,” Jenkins said, “but it is being able to follow directions, follow the light, move from one key to the next. And then we progress to this little book, which has the letters. So, they are learning to read and track from keys up to the book. So, that’s just a basic progression of something we would do for keyboard skills.”

When working with older groups such as dementia clients, the objectives and tactics change.

 “It’s not necessarily looking for growth in what we’re doing,” Jenkins said. “It’s more about maintaining what they have and maintaining their quality of life for as long as possible. So, with my dementia client groups, I’ll see them for an hour for each group, and it’s either once a month or twice a month depending on availability and the budget of the facility.”

Carrie said with older patients, memory recall exercises are highly useful. Around Valentine’s Day, she plays older love songs with older groups, which can serve as a jumping-off point for members to talk about their loved ones and other special figures in their lives.

She also plays games such as “Name that Tune” with these groups.

 “I’ll play a song but won’t sing the words, and we’ll see if they are able to recite any of the words back to me and tell me the name of it,” Jenkins said. “And like nine times out of 10, they’re very much able to. There are some songs where they are able to tell me what the song is in three notes, which is just phenomenal considering I can come in and someone could forget my name and have to ask what my name is 18 times. But I sing the first three or four notes of ‘You Are My Sunshine’ and they’ll sing the entire song to me.”

Though Jenkins said she gained a lot of confidence in herself during her practicum, she has had to swim in uncomfortable waters to build out the toolbox necessary to succeed as a music therapist. As a student, she expected the job to be more structured, but in reality, it commands more of a read-and-react approach. As someone who can be introverted, Jenkins has had to become more of an extrovert to build out a public presence and let people know about the services she offers — especially given she is the only practicing music therapist in the area. Within the therapy sessions, she has learned to become more resourceful.

In the present, Carrie Jenkins is happy about where she is in her career. Her career progression has coincided with the increasing popularity of music therapy worldwide. But even if she has found her footing, there are many obstacles she still has to overcome to be successful in her work, such as the stigma that surrounds it.

When people hear the term “music therapy,” they may fail to grasp its legitimacy immediately. Perhaps most people did not realize that close to 100 colleges across the United States offer undergraduate music therapy programs. Jenkins said people have cynically asked her if the job simply entails turning on an iPod, making people listen to music and telling them to be happy.

There are also barriers specific to Arkansas that she said she would like to see addressed in the future. Notably, the state has no colleges and universities that offer music therapy degrees. Arkansas currently does not offer licensure for music therapy, meaning she cannot accept insurance as a form of payment, and most clients are required to pay out of pocket for her services, unlike other therapy options. Eighteen states have licensure as of 2024, with many states establishing it within the past five years. Licensure would further legitimize her practice and perhaps could lead to more practitioners operating in the state. Jenkins played a role in establishing a task force for getting licensure in the state in 2018, but the pandemic brought much of the progress to a halt.

Through her colleagues at Cardinal Care Center as well as recommendations from facilities where she has hosted group sessions, Jenkins has built out an extensive network of contacts that enables her to always have a strong client base. But because there are no other practicing music therapists in Northwest Arkansas, she is frequently stretched thin, she said. Aside from therapy, she also offers music lessons and is a worship leader at her church. She hopes to get more help in some shape or form. “I would love to be a multi-person music therapy clinic and be able to contract out to other music therapists and say, ‘Go out, do this, be awesome!’” she said.

Although she has difficulties being a one-woman music therapy operation in a time of growing demand, Jenkins never sounds upset with the state of things. If anything, she embraces the challenges. “I’ve always had a drive to help people,” Jenkins said. She recognizes the demand for her services and wants to help as many people as possible. She wants to dedicate her spare time to putting her musical skills to use while helping at church or giving music lessons.

For the LeBlanc family, Jenkins’ positive demeanor has rubbed off in a multitude of ways. Beyond expressing feelings, Daniel and Emily reflect on the strong sense of joy the sessions have provided over the years. Daniel saw Jenkins for music therapy for a decade before relocating to Jamestown, New York, with his family. When they discuss their relationship with her, almost every answer is present tense, as Jenkins has remained in touch with the family. Daniel regularly sends her some of his best illustrations of dragons through the mail. With plans to take animation classes at the local community college in a work preparation program and dreams of one day running a film and animation studio, he said he is in part inspired by the time he spent with Jenkins and the skills he developed.

“She’s awesome!” Daniel said, excitedly. “She plays guitar just like I play trumpet.”

Emily interjected to ask her son a question. “Does she encourage you?”

“Yes.”

Emily described Jenkins as cheerful and happy in her sessions. Daniel, offering clarification, said he has fond memories of Jenkins because she understands him.

Jenkins is a helper. Music is her tool. When asked what helps her, she said she finds herself returning to acoustic covers of pop songs to chill out and lo-fi covers when she has to focus and get stuff done.

“It is so very therapeutic,” Jenkins said. “In a personal setting, I am listening to music all the time, 24/7. It gets me up in the morning, it gets me to and from in the car. If I’m having a bad day, I know what kind of music I’m listening to in order to get me out of a funk. If I need to stay in that funk and live in it, I know what music I want to listen to.”

She goes as far as to characterize therapy sessions as helpful for herself.

“There are times where I’ll be headed to an assisted living facility, and I’ll be like, ‘Man, I’m so tired. I don’t feel it today. I don’t want to do this, but I know I have to do this.’ Then, by the end of the session, I’m in a better mood than some of the clients are because being able to engage them and be part of that moment with them is just so rewarding and so wholesome, and it just helps me as much as it does them.”

Jenkins’ trajectory with respect to music therapy is not that different to clients such as Daniel. Though she comes in expecting to help each person she works with, music therapy and working with individuals have helped her just as much.

Although Jenkins did not specifically mention how she keeps a positive disposition when confronted with various obstacles outside her control in a session, it helps when the work doubles as her own therapy.