Lullaby Project

1. Introduction

Version followed: the Carnegie Hall Weill Music Institute (WMI) model as set out in its National Handbook for Prospective Partners 2017–2018 and the current programme page (2026), with delivery details from named partner adaptations: Wesleyan University (3–5 one-hour individual sessions), Fèis Ròis in Scotland (12-week group), Live Music Now with NHS perinatal services (UK), NYC Health + Hospitals/Elmhurst, and the Futures Without Violence programme profile for domestic-violence settings. Where these differ, this guide names which one it is following.

What it is. The Lullaby Project is a community and arts-in-health programme. It is not psychotherapy and it is not music therapy. WMI pairs expecting and new parents and caregivers of children aged 0–3 with professional musicians ("teaching artists"), who help each parent write, sing and record a personal lullaby for their baby [source: Carnegie Hall programme page]. In New York it runs in healthcare, social-service and justice settings. Named sites include hospitals, homeless shelters, high schools, community centres and the Rikers Island jail. Partner organisations run their own versions elsewhere in the US and abroad [source: Carnegie Hall Handbook; programme page; The 74]. It began at Jacobi Medical Center in the Bronx with teenage and young parents. Press coverage cites nearly 60 partner organisations and more than 4,000 lullabies in over 40 languages [source: The 74].

How change is thought to happen. WMI says that writing and singing a lullaby supports parental health, helps early child development and strengthens the bond between parent and child [source: programme page]. The process is meant to work in a few ways:

The parent reflects on their hopes for the child, often by writing a letter to the baby.
The parent turns those hopes into a song they wrote themselves, which builds a sense of agency and creative achievement.
The parent ends up with a soothing ritual they can sing to the baby again and again.
The parent is witnessed by an artist and, often, by a community.

WolfBrown's evaluation of ten New York-area Lullaby Projects (66 mothers and family members aged 16–44, in hospitals, temporary housing, foster care, alternative schools and correctional settings) drew on session transcripts, lullaby journals and lyrics. Mothers spoke more positively and hopefully while working on their lullabies than when talking about the rest of their lives, and described new or renewed connections with partners, family, other mothers and their children. The report calls its findings qualitative and an initial framework, not formal research [source: Wolf, Lullaby: Being Together, Being Well, 2017, rev. 2020]. A Futures Without Violence profile summarises WolfBrown findings as parents gaining "agency, creativity, well-being, self-confidence" [source: Futures Without Violence profile]. A small two-site pilot randomised trial with pregnant women found no significant between-group differences in maternal–fetal attachment, symptoms or perceived stress [source: Hinesley et al. 2020].

Professional frame. Lullaby Project roles are not a regulated profession and there is no registration or credential for them. WMI asks for teaching artists with "high-levels of artistry, empathy, and humanity". It trains them at its yearly National Convenings and through consultation during the year [source: Handbook]. If you are a psychotherapist, you will usually be one of three things:

the person who refers families in;
a clinician who works alongside the project in a host service, such as a perinatal mental health team, mother-and-baby unit, shelter, prison or hospital;
a partner-staff member who supports the artists.

If you want to use songwriting as a therapy method in its own right, that is music therapy. In the UK it requires HCPC registration; in the US, the MT-BC credential (AMTA and CBMT). It must not be presented as part of this programme [synthesis]. In domestic-violence settings, the Futures Without Violence profile says implementers need a strong grounding in the dynamics of domestic violence and sexual abuse. It says the programme is best delivered by a DV/SA advocate or a survivor [source: Futures Without Violence].

2. Framework

The programme is flexible and has no fixed protocol. The Handbook sets no minimum or maximum group size and gives no session count [source: Handbook]. Formats that have been published include:

Format	Source
A single session of about 90 minutes per parent, or several sessions with a family over time; individual, group or dyadic; in person, virtual or hybrid; under 6 weeks	Futures Without Violence
3–5 individual sessions of about one hour; babies welcome; Spanish available	Wesleyan
12 weekly 2-hour group sessions, with a crèche, group music first and individual songwriting second	Fèis Ròis
Drop-in hospital workshops on most Thursdays, October to April	NYC Health + Hospitals/Elmhurst
Mixed digital and live cohorts of 8 mothers with 4 musicians, supported by an NHS community engagement team	Live Music Now, Cheshire and Merseyside

WMI recommends about one teaching artist for every one or two participants. A group of 6–10 can split up so that each parent works individually with an artist [source: Handbook].

Phases. The phase names below are this guide's summary of the steps the sources describe.

Partnership set-up. The partner organisation provides:
- lead and supporting artists;
- a venue;
- recording;
- all local funding and local programme needs;
- confirmed dates;
- ongoing contact with Carnegie Hall.
Carnegie Hall provides support and evaluation materials (the evaluation materials are designed by WolfBrown), SoundCloud hosting, press support and consultation [source: Handbook]. Costs vary with structure, artists' pay rates and how elaborate the recording is [source: Handbook]. Move on when artists, venue, recording plan, referral route and safeguarding lead are all agreed [synthesis].
Recruitment and referral. Host-service staff connect families to the project [source: NYC H+H Elmhurst]. Fèis Ròis found it helped to present the group as fun and community-building rather than as a service for "needy" mothers [source: Fèis Ròis 2021]. Move on when the parent has agreed to take part and the safety and consent checks in section 4 are done [synthesis].
Reflection. The parent writes a letter to the baby or answers prompts in a workbook or "lullaby journal" [source: Handbook; The 74]. Move on when there is enough material (images, wishes, routines, names, languages) to suggest lyric lines [synthesis].
Lyric writing. The artist and the parent turn that material into simple, singable lines, often with rhyme and a hook [source: Handbook; The 74].
Melody. The artist draws out a tune from the parent, in a key the parent finds comfortable [source: Handbook; The 74].
Revision. The pair try different versions until the parent has a song they love. Drafts are recorded on a phone [source: Wesleyan]. Move on when the parent says it is their song and can sing it, or chooses to have an artist sing it [synthesis].
Arrangement. The artist writes charts, lead sheets or full scores and chooses instruments [source: Handbook; The 74].
Recording. The song is recorded in a studio or in the workshop space as a keepsake [source: Handbook; Live Music Now].
Sharing and continued use. The parent takes home a printed lyric sheet, keepsake templates and the recording [source: Handbook]. Sharing can also include:
- optional upload to Carnegie Hall's SoundCloud;
- celebration concerts, where songs are sung by professionals or by the parents;
- alumni days.
[source: Handbook; The 74]. The aim is that the song keeps being used. In the WMI early-childhood director's words, it should not be "something that sits on a shelf" [source: The 74, quoting Tiffany Ortiz].

3. Guiding principles

The parent leads the song. The Handbook warns that it is tempting for the artist to take the song and run with it [source: Handbook]. Practical meaning: the artist offers options, and the parent chooses words, mood and tune.
No experience is needed. Artists must be comfortable drawing out songs from people with little or no songwriting experience [source: Handbook]. Practical meaning: never ask for musical skill and never correct the parent's singing.
Artistry, empathy and humanity. These are WMI's selection criteria for artists [source: Handbook]. Practical meaning: musical quality matters because the song is a lasting gift, but the relationship comes first.
True feelings are allowed. The Handbook notes that lullabies often carry "frustration or sorrow", and treats singing complex feelings as a sign of intimacy [source: Handbook]. Practical meaning: do not push the parent to only write happy content.
Leave room for silence. Let there be silence while ideas are forming [source: Handbook]. Practical meaning: wait before you fill a pause with suggestions.
Deep listening, trust-building and generosity (WMI's description of the process) [source: The 74, quoting Ortiz]. Practical meaning: listen to the parent's story before you start shaping lyrics.
The parent's own voice. Help parents feel comfortable singing the lullaby themselves [source: Handbook]. Practical meaning: pitch the song for the parent's voice, not the artist's.
Use beyond the project. The song is a tool for everyday soothing and connection [source: Handbook; The 74]. Practical meaning: practise it with the baby where possible, and make sure the family can play it back.
Performance is not the main aim [source: The 74]. Practical meaning: concerts are optional and never a condition of taking part.
Culture and language belong to the family. The journal prompts invite parents to pass on language and cultural rituals, and songs are written in more than 40 languages [source: The 74]. Practical meaning: support code-switching, heritage melodies and family languages, and use interpreters where needed.
Fit the setting. Partners adapt the project to their community and to participant input [source: Futures Without Violence; programme page]. Practical meaning: match length, group or individual format and recording to what the setting allows.
Focus on the parent. Parents valued a group that centred their own needs [source: Fèis Ròis 2023]. Practical meaning: childcare or a crèche helps, and the session is time for the parent, not a parenting-skills class.
Arts activity is not therapy. Musicians do not interpret, diagnose or treat. Distress, disclosures and clinical needs go to the host service's clinical or safeguarding route [synthesis].
Safety and consent come first. These cover recording and publication, perinatal mental health and safeguarding of the infant and the parent, and are agreed before any creative work starts. The published programme sources do not set these out in detail, so section 4 gives this guide's own synthesis [synthesis].

4. Intervention inventory

The sources describe a songwriting process rather than named "techniques". This section lists every step they describe. It also adds the safety, consent and referral steps a clinician needs, which the programme sources do not cover. Those steps are marked [synthesis].

4.1 Referring into, or hosting, a Lullaby Project

Purpose. Connect a client who is pregnant or parenting a child aged 0–3 to a local project, or set up a project inside your service. Use it when the client wants a creative, bonding-focused activity alongside, not instead of, their clinical care [synthesis].
Steps.
1. Find a partner. Look on Carnegie Hall's partner listings, or email the WMI programme contact (lullabyproject@carnegiehall.org) about starting one [source: programme page; Handbook].
2. If your service is hosting a project, agree a written partnership with the artists that covers:
  - venue;
  - dates;
  - recording;
  - funding;
  - a named safeguarding lead;
  - a named clinical contact for distress or disclosures [source: Handbook for the partner duties; the safeguarding and clinical leads are synthesis].
3. Explain to the client that this is an arts project with musicians, not therapy. Explain that the song stays theirs and that taking part is voluntary [synthesis].
4. With the client's consent, share only what the artists need to know, such as access needs, language or whether the baby is in care. Do not share the clinical history [synthesis].
5. Keep your therapy sessions separate. If the client wants to, they can bring the experience or the finished song into therapy [synthesis].
Example language (illustrative). "This is a songwriting project run by musicians. It isn't therapy, and you don't need any musical experience. You'd write a lullaby for your baby and get a recording to keep. You can stop at any point."
Watch for. Clients who agree in order to please you. Clients for whom an infant-focused activity may be painful, such as after a loss or a removal; see 4.3. It is working if the client attends by choice and talks about the song as theirs [synthesis].

4.2 Perinatal mental health and safety screening before starting

Purpose. Up to 1 in 5 women experience mental ill health in pregnancy or the first postnatal year [source: Live Music Now, quoting an NHS partner]. A creative project can bring feelings to the surface, so screening makes sure there is a referral route [synthesis].
Steps (all synthesis).
1. Agree with the host service who checks wellbeing, and how. Use the service's usual screening; the programme sources describe no clinical screening of their own. In the pilot trial, every participant was given referral information for mental health support [source: Hinesley et al. 2020].
2. Agree the referral routes:
  - specialist perinatal mental health team or mother-and-baby unit;
  - midwife or health visitor;
  - GP or obstetric team;
  - crisis and suicide-risk pathway.
3. Brief artists on the warning signs that mean they should pause and get the named clinician:
  - severe low mood or hopelessness;
  - thoughts of self-harm or of harming the baby;
  - confusion or unusual beliefs (possible postpartum psychosis, which is an emergency);
  - intoxication;
  - disclosure of abuse.
4. Decide whether now is the right time. Acute psychosis, active suicidality or a current crisis usually means postponing until the person is stable and their clinical team agrees.
Example language (illustrative). "If anything comes up during the sessions that feels heavy, the musicians will check in with you and can put you in touch with [named person]."
Watch for. Artists acting as counsellors. Distress that is noticed but not passed on. Disclosures that go undocumented. Follow standard risk-assessment practice for any self-harm or suicide concerns [synthesis].

4.3 Setting-specific safeguards

Purpose. Adapt the project to the high-risk settings it is designed for [source: Handbook; The 74; Futures Without Violence; NYC H+H]. The detailed safeguards below are synthesis.
Steps.
- Domestic-violence shelters. Use implementers who understand DV/SA dynamics [source: Futures Without Violence]. Then (synthesis):
  - never record or publish anything that identifies a location, a child's name or the family's whereabouts;
  - check whether the abuser could find a published song;
  - keep the recording only on a device the parent controls safely.
- Prisons and jails (for example Rikers Island, NY, and Hiland Mountain Correctional Center, Alaska) [source: Handbook]. The following is synthesis:
  - agree in advance with the prison what equipment, instruments and recording are allowed;
  - plan how the song will reach the child and carer, including the carer's agreement;
  - prepare for grief about separation;
  - make sure staff are available after sessions.
- Hospitals and NICU-adjacent work. Hospital staff link families to the project. At Elmhurst, workshops run on most Thursdays from October to April [source: NYC H+H]. The following is synthesis:
  - follow infection-control rules and the ward's rules on sound;
  - get clinical clearance before singing to a medically fragile infant;
  - this is an arts activity and not NICU music therapy, which is a clinical service in its own right.
- Perinatal mental health units and mother-and-baby units (for example the planned Swansea Bay work at Tonna Hospital) [source: Live Music Now]. Work under the unit's clinical lead [synthesis].
- Teen parents and school settings. The project began with teen parents at Jacobi [source: The 74]. When the parent is under 18, follow the rules for minors on consent, involving parents or carers, and mandatory reporting [synthesis].
- Families involved with child-protection services, or where the child is in care. Agree with the social worker whether, and how, the song can be given to the child [synthesis].
Example language (illustrative). "Before we record, let's check: is there anything in the words, like names or places, you'd rather keep private?"
Watch for. Identifying details in lyrics or titles. Pressure from staff to perform. Parents who cannot safely keep a recording. It is working if no safety plan is compromised and the parent stays in control of their song [synthesis].

4.4 Consent for recording, sharing and publication

Purpose. Recordings may be uploaded to Carnegie Hall's SoundCloud, performed at concerts and used in press material [source: Handbook; The 74]. Neither the Handbook nor the WolfBrown report describes how consent to record or share is taken; the report says only that families and musicians agreed to be recorded [source: Handbook; Wolf 2017]. The steps below are therefore synthesis [uncertain].
Steps (synthesis).
1. Take separate, layered consent for each of these, with a separate yes or no for each:
  - phone drafts for working use only;
  - the final recording for the family;
  - partner archive;
  - public upload;
  - live performance by artists;
  - press or photographs.
2. Explain in plain language, and in the family's language, who will hear the song, where it will live and for how long.
3. Agree how credit will appear: full name, first name, pseudonym or none.
4. Agree who owns the song and the recording, and confirm the parent can use it freely.
5. Check consent again before anything is published. Make it easy to withdraw and to have a song taken down.
6. Where there is a co-parent, or a carer holds parental responsibility, consider their view if the child's name or images appear.
7. For parents under 18, follow local rules on consent for minors.
Example language (illustrative). "You can keep this just for your family, or share it more widely. You can choose each option separately and change your mind later."
Watch for. Consent given under institutional pressure, for example in prison or a shelter. Consent given while distressed. Confusion between "recording to keep" and "public upload" [synthesis].

4.5 Opening: getting to know the parent

Purpose. Build trust and gather the parent's stories, hopes and dreams before any writing [source: Wesleyan; The 74].
Steps.
1. Introduce yourself and the process.
2. Ask about the baby and the family, and about the music that matters to the parent [source: Live Music Now].
3. Welcome the baby in the room if that is possible [source: Wesleyan].
4. Confirm the language or languages for the session [source: Wesleyan, which offers Spanish; Futures Without Violence, which lists English and Spanish materials].
Example language (illustrative). "Tell me a bit about your baby, or the baby who's on the way. What music did you grow up with?"
Watch for. Rushing into lyrics. It is working if the parent volunteers images, names, routines or memories [synthesis].

4.6 Letter to the baby and journal prompts

Purpose. Lyrics usually begin from a letter the parent writes to the child [source: Live Music Now; The 74].
Steps.
1. Offer the workbook or journal. The parent can either write a letter to the baby or answer prompts [source: Handbook].
2. The Handbook groups prompts into three areas: the future, what the parent wants for the child, and daily routines. Example prompts ask what helps the parent calm down and which moments with the baby they love most [source: Handbook, paraphrased].
3. Further prompts, as reported in the press [source: The 74]:
  - imagining the child years from now;
  - passing on family language or cultural rituals;
  - sharing stories about being a parent.
4. If writing is hard (literacy, language, fatigue), the parent can speak and the artist writes it down [synthesis].
Example language (illustrative). "If you could tell your baby one thing about the world, what would it be?"
Watch for. Prompts about the future can be painful for a parent facing separation, illness or loss. Offer present-moment prompts instead, such as routines or calming things [synthesis].

4.7 Brainstorming and shaping lyrics

Purpose. Turn the letter into lines that are simple to sing [source: Handbook].
Steps.
1. Pick out key phrases and images from the letter.
2. Build on each other's ideas [source: The 74].
3. Find a hook, meaning a repeating line.
4. Use rhyme and short, singable phrases [source: Handbook].
5. Read the lines back and check that every word is the parent's choice [source: Handbook, on the parent leading].
Example language (illustrative). "You said 'you're my sunrise'. Could that be the line we keep coming back to?"
Watch for. The artist's vocabulary taking over. It is working if the parent edits or rejects your suggestions [synthesis].

4.8 Drawing out a melody

Purpose. Help a parent with no musical training find a tune of their own. The Handbook gives ten tips, compiled by Carnegie Hall teaching artists, for helping someone create an original lullaby melody; steps 1–10 below paraphrase all ten [source: Handbook]. Try them in any order until one opens a way in.
Steps.
1. Ask the parent how the line "goes", and catch whatever comes out first, whether sung, spoken or a description of the rhythm. Build from that first impulse.
2. Have the parent speak the hook in rhythm several times, simply and in their own voice, as if alone with the baby at night, and listen for a tune emerging.
3. Ask what mood or energy they want the song to have, then pick one word to sing with that feeling.
4. Play an accompaniment that carries the overall feeling or a key word and let the parent sing over it, without suggesting a starting pitch or rhythm.
5. Talk about musical styles the parent likes, and invite them to sing the words the way a favourite performer might.
6. Try a physical movement, such as cradling or swaying, and see whether it suggests a tune.
7. Offer a melodic instrument so the parent can pick out a tune themselves.
8. Choose a vivid word in the lyric (for example "star") and find a musical way to express it.
9. Take a word the parent has marked as important and make it stand out through repetition, a high note or a distinctive rhythm.
10. Sing the text on a single note and ask which words should move up or down. [source: Handbook, "10 Tips for Helping Someone Create an Original Lullaby Melody", steps 1–10 paraphrased]
11. Choose a key the parent finds comfortable to sing in [source: The 74].
12. If the parent wants to, use a melody from their own heritage or a family song, and check it is theirs to use [synthesis].
Example language (illustrative). "Say that line again, the way you'd say it to your baby at 3 a.m. Now let's just let it go up a little at the end."
Watch for. Embarrassment about singing. Offer humming, call-and-response, or the artist singing first. It is working if the parent starts singing without being prompted [synthesis].

4.9 Iterating versions and recording drafts

Purpose. Keep ideas and give the parent real choices [source: Wesleyan].
Steps.
1. Record drafts on a phone as you go, with the parent's agreement.
2. Play back two or three versions and let the parent pick.
3. Work at the parent's pace across sessions [source: Wesleyan].
4. Delete working drafts once the final recording is done, unless the parent has agreed to keep them [synthesis].
Example language (illustrative). "Here's the slower one and the swaying one. Which feels more like you?"
Watch for. Drafts stored on artists' personal phones without consent [synthesis].

4.10 Arranging

Purpose. Prepare a finished, playable version of the song [source: Handbook].
Steps.
1. The artist writes a chart, a lead sheet or a full score [source: Handbook].
2. Agree instruments with the parent. Arrangements have ranged from piano and marimba to flute, cello and percussion [source: The 74].
3. Keep the arrangement simple enough that the parent can sing it alone at home [synthesis].
Example language (illustrative). "Do you hear this with a guitar, a piano, or just your voice?"
Watch for. An arrangement that buries the parent's voice or moves the key out of their range [synthesis].

4.11 Final recording

Purpose. Create a keepsake the family can play again and again [source: Handbook; The 74; Live Music Now].
Steps.
1. Record in a studio, which can be sponsored to cut costs, or in the workshop space [source: Handbook].
2. The parent sings, or a professional sings, whichever the parent prefers [source: The 74].
3. Confirm the consent choices again (see 4.4).
4. Give the family a copy in a format they can actually play [synthesis].
Example language (illustrative). "Would you like to sing it yourself on the recording, or have one of us sing while you listen?"
Watch for. Performance anxiety. Offer to record with the baby present or in a quiet room [synthesis].

4.12 Singing in the parent's own voice and using the song at home

Purpose. Turn the song into a daily soothing ritual [source: Handbook; The 74].
Steps.
1. Rehearse the song with the parent until they can sing it without support [source: Handbook].
2. Suggest moments in the day to use it, such as feeds, nap time, bedtime or car journeys [synthesis].
3. Encourage the parent to change the song over time, for example adding verses as the child grows [synthesis].
Example language (illustrative). "This song is yours now. Sing it however it comes out, because your baby knows your voice."
Watch for. A parent who only plays the recording and never sings. Gently invite them to sing along [synthesis].

4.13 Take-home keepsakes

Purpose. Make the song tangible [source: Handbook].
Steps.
1. Print a lyric sheet that can be framed inexpensively.
2. Use WMI's templates for a baby onesie and a CD cover [source: Handbook].
3. In groups, add craft such as mobiles, and reflective journals [source: Fèis Ròis 2021].
Example language (illustrative). "Would you like the lyric sheet with your baby's name on it, or would you rather keep it without names?" [synthesis]
Watch for. Keepsakes showing names or places in DV or child-protection contexts (see 4.3) [synthesis].

4.14 Sharing, celebration and alumni events

Purpose. Let the parent be witnessed and stay connected to the community [source: Handbook; The 74].
Steps.
1. Offer optional ways to share:
  - a group sharing at the end [source: Wesleyan];
  - a celebration concert, where the song is sung by the parent or by professionals [source: The 74; Live Music Now];
  - SoundCloud upload [source: Handbook].
2. Invite parents back for alumni days [source: The 74].
3. Carnegie Hall hosts a yearly celebration concert in New York and national convenings for partners. The next concert is listed for June 2027 [source: programme page; Handbook].
Example language (illustrative). "There's a sharing evening if you'd like to come. You can sing, have someone sing for you, or just listen."
Watch for. Feeling obliged to perform. Exposure risks for families in shelters or prisons [synthesis].

4.15 Group format (Fèis Ròis model)

Purpose. Add peer support and social connection [source: Fèis Ròis 2021; 2023].
Steps.
1. Run 12 weekly 2-hour sessions with three or four musicians per group.
2. Start each session with group singing and music-making that parents can use at home.
3. In the second half, each mother works one-to-one or in a small group on her lullaby, alongside craft and journalling.
4. Include a coffee break, and offer a crèche so mothers can focus.
5. Offer recording at the end.
6. Draw on local traditional music, such as Gaelic song in the Scottish groups. [source: Fèis Ròis 2021; 2023]
Example language (illustrative). "We'll sing together first, then after the break each of you can work on your own lullaby with one of us." [synthesis]
Watch for. Facilitators reported tension between keeping the group nurturing and meeting the deadline for finished lullabies, and difficulty recruiting [source: Fèis Ròis 2021]. Parents who start with high wellbeing leave little room for measurable change; the report suggests targeting the programme more precisely [source: Fèis Ròis 2023].

4.16 Online and hybrid delivery

Purpose. Reach rural or isolated parents, or keep going when meeting in person is not possible [source: Fèis Ròis 2021; Live Music Now; Futures Without Violence].
Steps.
1. Keep the same core sequence.
2. Accept that the crèche and craft will be lost.
3. Mix live and digital sessions where you can. [source: Fèis Ròis 2021; Live Music Now]
4. Agree a privacy check at the start of each call, plus a plan for what to do if the connection drops when someone is distressed [synthesis].
Example language (illustrative). "Before we start, are you somewhere you can talk freely? If we get cut off, I'll ring you on the number you gave us." [synthesis]
Watch for. Rural mothers rated online delivery well, but it was not their preferred format [source: Fèis Ròis 2021].

4.17 Evaluation

Purpose. Show partners and funders what difference the project makes [source: Handbook].
Steps.
1. Use the WolfBrown evaluation materials WMI provides [source: Handbook].
2. Partners have used validated measures [source: Fèis Ròis 2021]:
  - the Parenting Sense of Competence Scale;
  - the Parental Reflective Functioning Questionnaire;
  - a non-standardised wellbeing and loneliness questionnaire;
  - optional parent–infant video observation (CARO).
3. These are licensed or published instruments; obtain them from their publishers. Make evaluation optional and separate from taking part [source: Fèis Ròis 2021].
Example language (illustrative). "These questionnaires help us learn about the project. Filling them in is up to you, and saying no won't change your place." [synthesis]
Watch for. Small samples. Fèis Ròis found no statistically significant changes and recommends larger, controlled studies [source: Fèis Ròis 2021; 2023]. The registered pilot trial (NCT03207919: 44 pregnant women at two US sites, three group sessions) found no significant between-group differences on attachment, symptom or stress measures, and a randomisation error left the groups unbalanced [source: Hinesley et al. 2020].

4.18 Working alongside: bringing the song into therapy

Purpose. For a client who is also in psychotherapy, use the experience to support reflection without turning the project into therapy [synthesis].
Steps (synthesis).
1. Only if the client brings it up, invite them to talk about what writing the song stirred up, such as hopes, grief, or their own experience of being parented.
2. Notice changes in how the client talks about the baby.
3. Respect the song as the client's gift to the child. Do not analyse its content as evidence of anything.
Example language (illustrative). "You mentioned you've been singing your lullaby at bedtime. What's that been like for you?"
Watch for. Clients who feel judged on their "parenting" through the song.

4.19 Hearing, physical and space safety

Purpose. Protect infants and parents. The programme sources do not address this, so it is all synthesis.
Steps (synthesis).
1. Keep volume low. Infants' hearing is sensitive, so avoid loud amplification, close-range drums or cymbals, and headphones on babies.
2. Watch the infant for startle or distress, and turn the sound down.
3. Keep cables, small percussion parts and instrument strings out of babies' reach. Clean shared instruments.
4. Follow the setting's infection-control and contraband rules, for example in hospitals and prisons.
5. Make sure seating is safe for a parent holding a baby.
Example language (illustrative). "If it gets too loud for your baby, just signal and we'll bring it right down." [synthesis]
Watch for. Crowded concert venues with infants. Offer quiet spaces and ear protection suitable for infants.

4.20 Musical and lullaby-specific trauma triggers

Purpose. Lullabies and childhood songs can bring back the parent's own early experiences of care or neglect. Infant-focused work can be painful after miscarriage, stillbirth, NICU stays or child removal. This is all synthesis.
Steps (synthesis).
1. At the start, ask whether any songs, styles or themes are off-limits.
2. Let the parent choose not to use family or traditional songs.
3. Offer present-focused prompts (see 4.6).
4. If grief appears, follow the parent's lead. A song can still be written for a baby who has died or is absent, if the parent wishes, but only with clinical support in place.
Example language (illustrative). "Are there any songs, or kinds of music, you'd rather we stayed away from? You don't need to say why." [synthesis]
Watch for. Sudden withdrawal, dissociation or tearfulness when a particular melody or memory comes up. Pause and offer the named support person (see 4.2).

5. Handling problems

The published sources give only creative guidance here. Their main points are:

let silence happen;
keep the parent in the lead;
welcome sorrow;
balance nurture against deadlines.

[source: Handbook; Fèis Ròis 2021] Everything else below is synthesis.

The parent is stuck and says "I can't write". Go back to the letter or to spoken stories. Offer concrete prompts about routines and calming moments. Write down the parent's spoken words for them. Offer two options to choose between rather than a blank page [source: Handbook for the prompts and silence; the rest is synthesis].
The parent is reluctant or unsure about taking part. Present the project as enjoyable and community-building, not as help for those who are struggling [source: Fèis Ròis 2021]. Make it clear that recording, sharing and performance are each optional [synthesis].
The artist takes over the song. Name it in supervision or debrief. Go back to offering choices and to the parent's words [source: Handbook, on the risk; the response is synthesis].
Distress, tearfulness or overwhelm in a session. Pause the music. Stay calm. Do not probe. Offer water and time. Ask whether the parent wants to keep going, change the subject or stop. Tell the parent about the named support person, and pass on any concern the same day [synthesis]. Remember that sorrow in a song is not, in itself, a crisis [source: Handbook].
Signs of perinatal mental illness, or risk. These include:
- persistent hopelessness;
- thoughts of self-harm, suicide or harming the baby;
- confusion or unusual beliefs.
Artists stop the session and follow the host's risk pathway immediately. Suspected postpartum psychosis is a same-day emergency. The clinician carries out risk assessment using standard practice; artists do not [synthesis].
Disclosure of abuse, domestic violence or risk to a child. The artist listens, does not investigate, does not promise secrecy and reports to the setting's designated safeguarding lead under local child and adult safeguarding procedures. In DV settings, check that any recording or publication cannot reveal where the family is [source: Futures Without Violence for DV expertise; procedure is synthesis].
Missed sessions and dropping out. Schedules with infants are unpredictable [source: Fèis Ròis 2021]. Offer flexible or drop-in slots, like Elmhurst's weekly hospital workshops, and shorter formats such as a single 90-minute session [source: NYC H+H; Futures Without Violence]. Keep draft recordings so the parent can pick up where they left off [source: Wesleyan].
Ruptures, such as the parent disliking the result or feeling judged. Apologise. Go back to the version the parent preferred. Re-record if possible. Make it clear the song belongs to them [synthesis].
Separation (prison, child in care, NICU, bereavement). Choose prompts that fit, such as present-focused ones or a message to be heard later. Agree with carers or social workers how the song will reach the child. Make sure staff support is in place after sessions [synthesis].
Language and culture. Work in the family's language. Use interpreters or bilingual artists. Welcome heritage songs, while checking how traditional material can be shared or published [source: The 74 for multilingual practice; synthesis].
Literacy or learning difficulties. Use oral composition and audio-only materials. Keep consent forms in plain language [synthesis].
A co-parent's or family's views, or conflicts over the song. The song belongs to the parent who wrote it. Agree beforehand who decides on sharing, especially where there are custody disputes [synthesis].
Requests to take a song down. Respond promptly and confirm when it has been removed [synthesis].
Artist wellbeing and vicarious distress. Give artists a debrief after difficult sessions, plus supervision through the host service. Carnegie Hall offers ongoing consultation to partners [source: Handbook for consultation; the rest is synthesis].
Scope creep, where the project is treated as therapy. Keep the arts-activity framing. If a parent needs therapeutic songwriting or infant mental health work, refer them to a registered music therapist or a parent–infant clinician [synthesis].

Sources

Web pages and reports:

Evaluation report and trial:

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