Friday, May 28, 2010

Looking Forward

One of my favorite songs right now is an arrangement/medley of I'm Yours and Somewhere Over the Rainbow sung by the acappella group, Straight No Chaser. It is a bouncy arrangement and keeps me smiling as well as increasing my energy level.

When I look back over my music preferences over the years, they share several elements in common. The first is the lyrics. I am genuinely affected by lyrics. There is something about words that stick with me. The second is a melodic and harmonic structure that accentuates the lyrics presented.

For me, music needs to be a complete entity. You cannot separate the music from the words. It is not something that can be done. Music is a combination of notes, counterpoint, chordal support, and words that convey a message. I am not a big fan of music without words.

I had a wild hair a while ago about the importance of tempo in music preference. It stemmed from several interactions that I had with several clients during music therapy treatment sessions. One client was a woman who was in late stage dementia. I was acting as the music therapy supervisor for a beginning music therapy student. I have limited experience with music therapy with older persons, so was enjoying the opportunity to watch as the process of music therapy was started with this client. I had noticed that she had good days and bad days - defined by me as her level of active participation in the music interventions presented. Some days she would drowse during her sessions. Other times she would look at us and make statements. The statements were often not related directly to what was presented, but we were able to adapt our experience to accommodate her communications.

On one particular day, her student music therapist was using the keyboard during an intervention. The rhythm function was playing, providing the SMT with a steady beat for her singing and improvisation - a tool for the SMT to assist her in her rhythmic awareness. The tempo of interventions varied and so did the level of interaction from the client. During a rhythm instrument application that did not require a set tempo, I asked the SMT if I could experiment with the tempi. She generously gave me permission, and I started to fiddle with the tempo.

I discovered that the client interacted with her therapist when the tempo was set at a metronome marking of 80 beats per minute. She would sit up, make eye contact, and engage in verbal communication with her therapist. If the tempo changed either up or down by 5bpm, she would slump in her chair, close her eyes, and cease all verbalizations. We tested this over several sessions before concluding that her preferred tempo was 80bpm.

Now, I started developing a theory. If one client had such a reaction and response to one tempo, would other clients demonstrate similar changes in behavior?

I took the idea back to my full-time position as a music therapist for children and youth with developmental and psychiatric concerns. In my work with persons with autism, I have found that they often respond to certain songs differently than other songs. I started to pay attention to the tempi of the songs that elicited different behaviors. I found that they all appeared to have a tempo preference.

I have not been able to quantify this observation, but I am interested in looking at this concept more thoroughly in the near future. I am trying to figure out how to test this theory with my groups of clients. This is my plan for the near future.

I am looking forward to finding if my current students also have preferred tempi. We shall see.

Tuesday, May 25, 2010

Day 5...

The fifth day of the Summer vacation has started off in an auspicious manner. The cat, not enjoying the fact that I was finally starting to get into the groove of sleeping in and relaxing, decided to eat a plant and upchuck on the bedspread. I hope this is not a portent of what is to come.

Progress has been made on the craft room. I have removed lots of the plastic shelving that has stored junk, so there is more room to move. I have sorted through years and years of accumulated paperwork, memories, and junk. I will be tossing things into the trash bin today. What a rejuvenating feeling!

There is still more to do, but I have a nice start going.

In addition to clearing out the junk room, I have been organizing my thoughts about music therapy. One of my former interns announced that she is now selling insurance in addition to working in music therapy part-time. It is difficult to watch as music therapists cannot afford to be music therapists in this current economic climate. I am fortunate that my job is considered important to my facility and will continue to be a job, even when faced with economic issues. I cannot imagine having to find another supplemental job to remain financially solvent.

There has been lots of discussion about "the land of 5000 MTs" on the listserve lately. People bemoaning (wow, I've used lots of large words in this entry) the fact that AMTA membership has not increased even though numbers of graduates continues to increase. People danced around what I think is the crucial issue. We, as educators and internship directors, are not preparing students for the actual job market. We do not include business courses as part of the curriculum, we continue to prepare students for established positions rather than contracts, and often have issues with changing our ideas about the realities of music therapy rather than what we want to believe.

I know that my interns are primarily not working as music therapists right now. Out of the 16 students that I have trained, I believe that no more than 6 are working as music therapists at this time. We discuss the fact that there are music therapy jobs available, if you are able to relocate. Most of my interns have not been willing or able to relocate; therefore, they have had to pursue other professions. They all state that they wished they could remain music therapists full time, but just cannot in their locations. I am saddened as they are all good therapists who would be valuable team members in any position. We often talk during their internships about my perception of the job market for music therapists. I may be right, or I may be wrong. It is difficult to tell from my sheltered position as a full-time music therapist.

It is rough out there as a music therapist. Right now, music education programs are being cut, so music therapy programs are eliminated as well. Music therapy is considered a luxury rather than an essential treatment modality. I think this is one reason why we do not increase our membership numbers.

Another reason is lack of preparation for the responsibilities of the job of music therapist. I was well prepared by my academic program to be an employee. I am a good employee and function well within the environment of a facility. I am not prepared to be a contract or private practice music therapist. If I lost my current job, I would have to look for another established position rather than go it on my own as a private practitioner. I do not know anything about self-employment taxes, business plans, etc. I believe that most educational programs do not prepare students for the realities of being a private contractor.

Yet another reason, in my opinion, is the continued feelings of isolation. There are few therapists who work in a facility with more than one music therapist. It is hard to go it alone. We also do not appear to adequately prepare professionals for burnout.

Monday, May 24, 2010

Day 4

It is the fourth day of my vacation. I have tackled the craft/junk room in the back of my home and am currently in the middle of sorting, trashing, and donating materials and junk that I have had for many years. In addition, I am trying to make that space more functional.

I guess, in a way, I am using this break to do the same thing. I am throwing out my therapeutic "junk" and am making myself more functional as a therapist. I am taking out my attitudes, skills, opinions, and questions, dusting them off, and reorganizing them.

Attitude reorganization tasks:
  1. "I can fix everything." There is no way that this can happen. There are things that are not my responsibility. I have to take responsibility for only the things that I can change and let the rest go.
  2. "I should be..." The problem with this one is my attitude towards life. I am a perfectionist who strives to do the "best" in everything. I often judge myself harshly and have a difficult time just relaxing and allowing myself to be at rest.
  3. "Music is solely my domain." I find this attitude easy to reorganize since I do not believe that music therapists "own" music. I feel that music can be used to elicit responses by everyone. If an occupational therapist sings to engage a client's interest in completing tasks, why would that be wrong? I use musical instruments to address issues with fine motor control.
New attitudes:
  1. I will take care of what I can. The only things that I can change are those things that are part of me. I am not the counselor, therapist, or mother of my co-workers. They are not my responsibility.
  2. I will do what I can when I can.
  3. I will support music use by people who are not music therapists. I will encourage music as a medium, explaining the difference between music therapy and the use of music, but supporting the use of music in other areas and locations.
Off to rearrange the craft room some more.

Friday, May 21, 2010

It's here...Finally.

I am on vacation for the next 17 days. I have some things to do, but most of my vacation goals have nothing to do with music therapy.

Priority one is the craft room. Actually, a more accurate description of that place is the apartment black hole. It is my hope that I will have a place to work on my crafting projects, on my visual aid development, and on my sewing.

This break offers an opportunity for me to refresh my enjoyment of music therapy. It will work. It always does.

Tuesday, May 18, 2010

Reflecting over the year

The end of the school year is the most important ending for me. As a therapist who works in a school setting, the end of May allows me to reflect on another year gone and over. The calendar year ending is irrelevant to me as a school therapist.

I enjoy the end of the school year. We work year-round, so this ending is really just a formality, but it is still an ending. We have a two-week break before the summer session begins, so I have a chance to sit at home and breathe deeply.

This year, 2009-2010, has been an interesting year. Our principal is in her second year of leading us, we have had a couple of crises in the residential side of our program, and people have had a difficult time adjusting to changes that have occurred in the past nine months.

I, personally, have had an interesting year as well. I have completed the training process of my 15th intern and decided to take a break from training. I am working towards my last remaining projects for my Ph.D., and I have taken on new professional responsibilities on a national level. All of this has taken some adjustment. I am enjoying the new challenges and am attempting to find my center in the mad rush that surrounds me.

As a therapist, I have found this year to be draining. Part of that drain has been working with interns who have needed lots of assistance in finding their way through the last learning process of their education. Another part of that drain has been caused by co-workers who are burning out of their jobs. As a therapist, I am often the person that hears about everyone's issues and problems. I rarely hear about the good things that happen. I have had to engage in cognitive retraining of my thought processes in order to remain therapeutic.

My mantra for Lent was "look for the silver lining." I had to search for positives in all situations that caused negative feelings in me. I kept challenging myself (and continue to do so) to remain positive in all interactions with others, especially those that were difficult. I have had limited success.

In the vein of looking for the positive, let me list some of the good things that happened this year:
  • I survived another year with a pastor who has told me that if I disagree with her, I am a minion of Satan - seriously, she did!
  • My interns have graduated able to demonstrate most of the AMTA professional competencies
  • I have transitioned from being a committee member to being a committee chairperson
  • I have started my competency projects for my Ph.D. program after spinning my wheels for three years
  • My health is good
  • I still love music therapy, even after 17 years in the profession
  • I am taking a break from training interns in order to be refreshed when the next two interns arrive
All of these things and a 17-day break from work, too. How lucky can one music therapist be??

See you soon.

Wednesday, May 12, 2010

Longevity

I am part of a young profession. I do not mean that music therapy is not an established profession with a research base, but I mean that the majority of people that are in the music therapy clinics and jobs of today are young. As a Ph.D. candidate who does not intend to move into a university teaching position, I have often faced questions about my resistance to moving out of the clinic.

I find that new professionals often believe what they learned in their university programs, chapter and verse. I know that I did. I graduated, went out into the real world, and expected everything to work exactly like my professors and internship supervisors told me. It did not work that way. I lacked the ability to shift my expectations at the beginning of my career. It was a skill that I learned after some time. I had to adapt and develop my own way of approaching music therapy in order to survive as a therapist.

Breaking away from what I was told to expect was the best thing that I could have done, I believe. I believe that this is why I am still content to be a music therapist in the clinic, working hard to stay there. I love using music as a tool for assisting clients in moving towards their nonmusical goals. The act of using music as a tool works well because I have opened myself up to all the possibilities rather than the only things that I was taught.

Now, the issue that therapists are talking about right now is why most of our professionals are young. There really isn't a clear answer. Think about it. Why did you stay in a profession where others did not? I stayed because I love music therapy. I have always felt that I would only be a music therapist as long as it was fun.

I guess others do not find the joy in the job that I find. That is fine.

Monday, May 10, 2010

Eleven Days and Counting...

We have ten more days of school left for the 2009-2010 year. Music therapy sessions are taken up right now with graduation song rehearsal, talent show panics, and a little bit of therapy going on. There are times when I get caught up in the excitement of the end of the school year, and there are times when I just sit and think about how much there is to do before the summer session starts in 27 days.

In eleven days, I will be on vacation, A break, a rest, a time away from the rest of the world. I will have completed another school year, another year of church choir, and another year of working towards my Ph.D. I have made good progress this past year in both my professional and personal goals.

In the next ten days, I have to keep myself focused on the kids that I work for. Their treatment is, as always, more important than getting the words completely right during graduation. It is more important than whether I put everything back in its place in the music room and is more important than my vacation.

It is important to address the challenges that they have in their lives. It is important to have fun while doing that, and it is important to continue to challenge them to grow as human beings. We have some things to face in the next couple of weeks. Some kids will be discharged and others will not. Some will go on visits to their families and some will not. Some will have appropriate behavior levels and will earn trips and activities, others will not.

Focus on therapy,

Focus on the kids for ten more days.

Then, blissful lack of focus for 17 days.

Saturday, May 08, 2010

Taking a Break

It is almost time for my annual summer break. This year, I get 17 days of freedom as I have some vacation days stored just for this occasion. The fact that this break starts on my 40th birthday offers me some time to contemplate the inevitability of growing older as well as to refresh my therapeutic "juices."

I have always been interested in the concept of burnout. This is especially true as I work with people who are in a period of burnout and who attempt to expose the rest of us to their way of thinking. I occasionally find myself souring to the idea of working a) as a therapist, and b) at my particular facility. When this happens, I have to take a break.

My breaks take several forms.

Often, I stop eating lunch in the staff lounge. My very wise professor once told me, "if you enjoy your job, stay out of the staff lounge." The lounge is the place where disgruntled employees go to gritch and complain about everything that is wrong with their lives. Often these employees are not satisfied with their lot in life and want everyone else to know it.

I also go on self-imposed retreat breaks. The upcoming break is one of those retreats. I am going to stay by myself, cleaning, organizing, chasing the cat, and taking naps during the day. What a luxury! I will interact with others when I want to rather than on a daily basis. I enjoy these self-imposed retreats and look forward to doing nothing and getting bored with being home. I find myself at the end of the break getting ready to go back to work.

I am not to the point of burnout with my job or with music therapy, but I do need time away from my co-workers. So, the self-imposed retreat.

Techniques I have learned in my 17 years as a therapist to combat burnout:
  • Be aware of your moods - if you are getting overly emotional about something, you may need a break
  • Do not assume that things are always your fault - sometimes they are not
  • Use your sick time when you need it
  • Figure out how you can change things within your own practice to combat routines
  • Talk to someone about how you feel about your job
  • Be aware of your relationships, both professional and personal, and how they affect your professional life
Any suggestions for others?? Let me know.