Group Drumming Creates Connections

Rhythm Establishes Connections 

By John Scalici, Arts in Healthcare Teaching Artist, Rhythm Facilitator and Michelle Puckett, MS, OTR/L

Drumming and rhythm can be a powerful tool for reducing stress and anxiety, while simultaneously satisfying many of the goals of the occupational therapist during a given session.

In June of 2005, I was contacted by VSA Arts of Alabama (a non-profit organization which provides opportunities in the arts for people with chronic illnesses) to facilitate outcome-based rhythm and drumming activities with adolescent and child psychiatric patients at Children’s Hospital in Birmingham, AL. 

I initially met with Michelle Puckett, MS, OTR/L and Lauren Hansell, MS, OTR/L, to discuss our goals and activities.  These goals include:

  1. Establish positive peer interaction
  2. Learn sequencing skills
  3. Develop social skills
  4. Learn appropriate self expression through the drum
  5. Attending to task

Because our groups frequently change, by size and diagnosis types, we have established a protocol that gives us some consistency in measuring results.

Before each session, we have a briefing of any new dynamics that may be going on within the group.

I gather as much information from this short meeting as possible. 

To start the session, I introduce an ocean drum, a two-headed, thin instrument with metal beads inside, which when held level, will produce the soothing sounds of the ocean.  This activity establishes a few key concepts as we pass from person to person:

  1. Positive peer interaction
  2. Sequencing and coordination skills (taking the drum from one person, holding it balanced, experiencing it for an appropriate length of time then passing it on.)
  3. Using the metaphor of balance.  This is a teachable moment to comment that when our emotions and feelings are in balance, then our lives come into balance.  With the help of our OT team, we reinforce the idea of healthy expression of emotion to achieve balance.  For some, attaining this balance means taking medication or continuing counseling.

Next, small percussion instruments are laid out inside the circle.  Patients choose from instruments such as shakers, rattles, finger cymbals, bells, and wooden frogs.  As this is done, there is some chaos—another teachable moment!  This is a good time to introduce some visual/verbal cues to help us control our “new voices” as well as practicing turn taking and appropriate peer interactions.  

As we proceed with the activity, I explain that we will create a rhythm or sound with our new voices one at a time, upon me making eye contact with the first person to my right or left.  As I play a simple rhythm on my drum, I look to the person next to me, inviting them to play along with me.  Because I am the one creating the steady beat, there is no need for the others to maintain a steady rhythm.  The activity becomes about building eye contact and social skills and learning how to function as a group.  

When that person has played for a brief moment, they make eye contact with the next person, signaling that it is their turn to play.  This continues around the circle. Next, I asked them to play “together”, creating a bit of “controlled chaos”. 

I use body language to signal them to play quietly (which I can do because I have spent time establishing trust and building rapport with the group).  The activity ends by me asking the group to collectively fade out their sounds.  With this simple activity, we have achieved several goals:

  1. Non-verbal communication skills (making eye contact)
  2. Auditory sequencing
  3. Creativity as an individual and as a group
  4. Accountability and responsibility

The final activities utilize hand drums.

First, we learn how to create “rumbles”—fast drum rolls.  We speak about the chaos again and how we can be in control in times of such chaos.  Each person is given the opportunity to start the group on a “rumble” and then control the volume by using hand gestures for “up”, “down”, and “stop”.  

Following is a list of the activities utilizing hand drums.

Rhythm Question/Answer

Each participant is encouraged to respond to a “rhythm question” which is played on the drum by the leader.  With the help of the OT team, participants are encouraged to respond by including one or two sounds they heard in the question, i.e. scratch, tap, rub, or knock, then add their own rhythm.  

Expressive Drumming

I ask the participants if it is possible to use these new sounds to express a certain emotion or feeling.  We begin by giving examples of emotions like fearful, angry, disappointed, frustrated, depressed, or confused.  I ask each participant to identify one feeling or emotion they are feeling or have felt in the past and express that feeling on the drum, utilizing whatever sounds they want. 

Group Rhythm

This activity helps to develop problem solving skills and social interaction.

The process begins with the facilitator (me), playing a simple pulse on my drum, inviting each person to add something to my rhythm that they feel will complement, but not overpower the rhythm.

In some sessions, this may take several tries to maintain a successful group rhythm. Many times, if the rhythm falls apart, we discuss the importance of listening to each other, or leaving some space in our rhythm for the next person to create their rhythm.  These concepts are very important to developing proper social skills. 

After the session, a brief questionnaire is handed out. This data is currently being collected to analyze the effectiveness of the program.  

Some questions are:

Did you like drumming today?

Do you feel better, worse, or no different after drumming?

Do you feel drumming helped you to express feelings without using words?

The occupational therapist is looking for change in affect for the patients, change in self-confidence and self-esteem, any sensory related issues (tactile or auditory), as well as rhythm and sequencing difficulties. 

Drumming is an activity that allows one to experience group success while being an individual.  Because of the physical nature of drumming and rhythm activities, our program serves to reduce stress, anxiety and allow patients to express themselves in alternative ways.  

This program has proved that drumming and rhythm-based activities are a valuable methodology for developing social skills among participants while allowing the OT to make vital connections with clients. 

John Scalici is an internationally recognized drum circle facilitator, speaker, musician, clinician, and master teaching artist.  His work with special needs groups has been featured nationally on the Hallmark Channel.  He can be reached at

To find a Drum Circle or Facilitator near you, check out the Remo Rhythm Event and Facilitator Finder