Sing A Song Sunday - The Time Change Song (Fall)

Protocol Development 101

One of my professors is big into the idea of "protocol development" as an important element of music therapy as a recognized profession in the allied health field. The idea that what we do as music therapists can be replicated by any music therapist once the protocol has been developed, tested, and refined. I have always been a bit confused by this idea - the way she sees it does not make sense to me, but I am starting to understand the concept in my own way. I'm also coming around to the opinion that established, evidence-based music therapy protocol are important to the field and to my own practice.

This lightbulb going on over my head has been forced upon me due to my circumstances at my place of employment. We have one class of adolescents with complex issues including intellectual, developmental, psychiatric, and physical conditions. The majority of the clients have a diagnosis on the Autism Spectrum. Most of them are functionally nonverbal. They all have associated diagnoses based on traumatic experiences. They are a wonderful group of individuals - none of the group services that they receive are successful.

This particular group has challenged myself and all of the other service providers at my facility. The majority of sessions and services provided are in classroom group format due to the large caseload and limited time available for individual sessions. Therefore, the way I provided therapy had to change to accommodate 10 students who did not interact with each other.

Our first session with the new protocol happened on Thursday. I went back to a protocol that I had developed for one child with a diagnosis on the Autism Spectrum and adapted it for use with more students. The premise is this:

1. Adolescents, such as these students, do not respond well to being told to sit and listen
2. I do not like having to physically manage student behavior to ensure safety
3. Choice is important
4. Small groups provide opportunities for individual attention
5. Short applications/Therapeutic Music Experiences provide for focused and targeted therapeutic interventions
6. Paraprofessionals who are busy administering a station are not engaging in confilct spirals with students
7. Reset periods allow students to shift attention away from concentration on staff-initiated activity
8. All students can participate in all applications/TMEs how they prefer

The first session went as I had envisioned it. Students were engaged in the stations. Some wandered around their station area - perfectly fine for me - others engaged quickly in all stations. In order to decrease the amount of auditory stimuli, only one station involved active musicmaking. The other stations were music themed or sensory in nature. Paraprofessionals were engaged in learning how to administer the stations rather than following students around attempting to control their participation in the applications/TMEs.

The next session is on Monday. We will see if the success that I felt we accomplished on Thursday can be replicated. More information on testing and refining the protocol later.