Saturday, February 27, 2010

Therapeutic Three




I've been thinking about the therapeutic triad lots lately, pondering the ways that the three elements of music therapy act, react, and interact. This philosophical exercise of mine is one that allows me to deepen my understanding of music as a therapeutic medium, keeps me engaged in the therapeutic process even when I a participant in the music therapy exercise, and allows me to further infuriate other therapists who do not view music therapy the way I do.

In my work with novice therapists, e.g., interns, practicum students, etc., I often find that they do not have a grasp on how the therapeutic relationship begins and develops. They are either skewed heavily on the therapist side, offering scripted therapy experiences that do not allow for client direction, or they are completely client directed with no thought about what the therapist should bring to the experience. It is very rare for someone to be skewed towards the music.

Need I point out at this point that we are MUSIC therapists and should be using music as our unique tool?

How does one start to think of the music therapy relationship as a therapeutic triad?

Saturday, February 13, 2010

Teaching therapy

I am taking a break from being a teacher/trainer. As ,much as I love being an internship director, I find that there are times when I just need to be the therapist. It has been over 3 years since I have been completely alone in my music therapy clinic. Eight interns later, I am ready for a break!

I find that some interns are easy to teach. They think like I think, learn how I learn best, and just seem to have an inherent bent towards therapeutic interaction with my particular clientele. Those are the interns that are simply a joy to point in the right direction and then watch them fly away.

Then there is the other brand of intern. These interns are challenges in many ways. Sometimes they do not learn in a way that is easy for me to understand. Sometimes they are not interested in being a music therapist, but have to because of their families. Sometimes they come to me thinking that they have learned everything there is to know about music therapy and I am not going to get them to learn anything new. These interns are energy sappers.

When faced with intern of the latter breed, I often find myself feeling more tired, irritable, and uninterested in being an effective teacher/trainer. My first experience with supervising a difficult intern was one that I will never forget.

This intern was "the superstar" in her academic program. She could do no wrong and apparently told her professors how to work with kids with autism. She was an excellent performer, but seemed to expect kids with autism and behavior disorders to sit and listen to her as she sang them complex songs or expected them to pretend to be bugs. (It is my suspicion that she had interacted with kids on the Asperger's side of the spectrum rather than kids on the Autism side.) She did not understand that her expectations were a bit high for her current population.

I spent the fourth month of her internship feeling burnt-out. I dreaded going to work, was in a slight depression, found myself in a creative block. Nothing got me out of the funk. I had decided to resign from my job at the next contract year since I was not happy. Then, my intern called in sick.

I had a wonderful day. I led sessions with all of my clients, wrote several new songs, talked to the intern who had just started her internship, and went home feeling great. No signs/symptoms of the depression I had been feeling. As I was driving into work the next morning, I thought, "I really hope she is sick again today." I gasped and realized that there was a relationship problem rather than a burn-out situation. I took steps to change the relationship that morning.

Many times, I find myself so preoccupied with how I am going to teach an intern a specific skill that I forget that I have to keep challenging myself to grow as a therapist, a musician, a professional, and a human being. I find training interns to be the best and the worst part of being a music therapist. Often, those feelings occur simultaneously for me. When I find myself thinking that I am burning out at my job, I decide to take a break from being a trainer.

When I started as an internship director, I found that I was only able to train two interns before craving time off. In the past several years, interns have been coming to me fast and furious. I accepted interns nonstop until now. Now I am tired.

I'm taking a break.

I know I will be returning to being a teacher/trainer. I cannot stop that part of my life completely because I love that mentor process, but it is time to reestablish my identity as a therapist rather than a supervisor.

Off we go...

Thursday, February 11, 2010

Snarkity, snark, snark, snark!
Why do we insist on picking at each other?

There is a controversy on the listserv - AGAIN - about professional supervision. I find it interesting that there is a population of music therapists appear to feel that they are the only folks who can survive as therapists, and then only when they follow their tenets. The rest of us are merely "activity" therapists, providing our clients with sing-a-long therapy rather than in-depth, meaningful music experiences.


There is a very different set of expectations for therapists based on philosophical views.

Why can't we all just get along??

Monday, February 08, 2010

The Therapeutic Function of Music
So, why music anyway?

I ponder that thought often during my day. As the daughter of an Occupational Therapist, I often have ideas for interventions that do not need the structure of music to be therapeutic. I am challenged to see if the behavior of my clients changes when music is in the atmosphere or if they would complete therapeutic goals and tasks in the same manner without music. Sometimes, it is difficult to know.

But, I am a music therapist rather than an OT (a fact that my mother laments). Therefore, all of my interventions should be musical in nature if not in substance.

I am getting ready to revamp my internship to increase intern awareness of the therapeutic function of music in sessions. So, I am challenging myself to start thinking this way as well.

So far, I have come up with several questions that spur my thinking on towards therapeutic rationales for music in therapy. They are as follows:
  1. Why would you need music to complete this goal/objective? (Do you need music?)
  2. Does a change in the music offered during the intervention lead to changes in client responses? If so, what elements lead to that change?
  3. Are there specific elements of music that need to be consistent or replicated each time the intervention is presented?
  4. Are there elements of music that can be adapted?
  5. What is the most important element of music in the intervention?
Random thoughts for a random time. Changes are in the air...