Frontline Support: Responding to the COVID-19 mental health crisis in South Africa through online arts and music therapy — Carol Lotter, Nethaniëlle Mattison, Calsey Shroeder & Anja Pollard

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Frontline Support: Responding to the COVID-19 mental health crisis in South Africa through online arts and music therapy

Carol Lotter, Nethaniëlle Mattison, Calsey Shroeder & Anja Pollard


COVID-19 rendered South Africa reeling from the ramifications of the pandemic. Lockdown restricted movement, placed significant strain on healthcare workers, and profoundly impacted the socio-economic state of the country. Increased unemployment, reports of gender-based violence and suicide threats were among some indications of a resultant mental health crisis. In response, Frontline Support (FS), a collaborative volunteer-based arts therapy initiative was established. This report presents the documented process of establishing and implementing FS. The concept and structure of the organisation as well as the triage and treatment intervention are described. Descriptive statistics drawn from triage data, a client evaluation, and a therapist survey, as well as the themes emerging from the thematic analysis thereof are presented. The inclusion of two vignettes, drawn from documented clinical case studies, illustrate the online therapeutic offering of FS. A summary of quantitative data includes: the triage allocation, number of clients accessing FS, breakdown of sessions and geographical reach for the period March 2020 to July 2021. The thematic analysis of the client evaluation yielded five themes: i) Perceived personal gains through online therapy, ii) Enhanced personal insight, iii) Clients’ experience of the therapist, iv) Difficulties experienced by clients, and v) Reflections and recommendations. The therapist survey yielded the following six themes: i) Access and awareness, ii) Client access to and engagement with therapeutic arts resources, iii) Possibilities and restrictions of the Online Platform (OLP), iv) Arts therapies techniques adapted for the OLP, v) Therapists’ challenges, and vi) Establishing and maintaining the therapeutic relationship. The discussion reflects on the benefits, challenges and learnings of FS, and concludes with recommendations for its ongoing development, sustainability and accessibility within South Africa.


COVID-19, online music therapy, Frontline Support, mental health


Carol Lotter PhD, University of Pretoria; BMGIM fellow (AMI) and registered with the Health Professions Council of South Africa. Carol is the Arts Therapies coordinator and co-directs the Music Therapy programme at the University of Pretoria. Her teaching focus is on clinical studies and primary research interest is in adult mental health. []

Nethaniëlle Mattison is a board-certified music therapist based in South Africa, Johannesburg. She is also the founding member of Frontline Support. Her passions relate to creating and facilitating access to mental health care for members in marginalised communities and thinking creatively about how the online platform (teletherapy) can be utilized to do so. []

Calsey Schroeder is a board-certified music therapist based in South Africa, Potchefstroom. She completed her BMus, Honours and Psychology degree at the North West University in 2018 and continued to further her training by completing a clinical master’s degree in Music Therapy at the University of Pretoria. She aims to approach her therapy holistically, working with the individual in relation to his/her environment and context. She is the Africa student representative for the World Federation of Music Therapy Association and facilitates a variety of international music therapy and research related projects. Her passion includes psychiatry, global mental health and advocacy for interdisciplinary work between the arts therapies and other health professions. She is also involved with the International Association of Music and Medicine student task force and hope to further interdisciplinary interactions within the health system []

Anja Pollard is a certified music therapist, who holds degrees in music (BMus), psychology (BA Hons.); and a master’s degree (MMus) in music therapy. She is also a fellow of the American Music and Imagery Association and has contributed academically to the fields of Music and Music Therapy as supervisor, examiner, and guest lecturer at The University of the Witwatersrand as well as the University of Pretoria. She is currently a member of The Pretoria Cochlear Implant Unit’s rehabilitation team, pioneering music rehabilitation after cochlear implantation in the South African context and is a volunteer therapist for Frontline Support. In her private practice, she aims to promote mental wellness through the creative arts. Anja is also an active musician, singing in the Pretoria based Vox Chamber Choir and appearing as a professional saxophonist. []