Saturday, October 23, 2010

Defining Yourself...

I have found myself in the unusual (for me) position of having to completely define my purpose and role in my facility. The reason this is so unusual at my facility is that music therapy has been an integral part of the treatment of clients since the doors opened way back in 1969. Music therapy has always been a part of the experience of children and adolescents who lived at the facility. The unusual position is that the current Director of Clinical Intervention has NO clue what I do. This was illustrated in a paper that he recently gave to me.

Music therapy was relegated to one sentence in the section entitled "Recreational Activities."

When I read that, I was flabbergasted.

It explained a lot.

A bit of background information to catch you, dear reader, up on the situations that are occurring.

The first thing that has happened is that we have had a complete change in leadership at the administrative level in the past three years. We have been through several clinical directors and currently have had this clinical director for approximately a year. He has been in my music therapy room twice in that time. The first time was to tell me that one of my clients was a musical savant (I disagreed in a respectful manner). The second time was two days ago when he marched through a session to talk to me about the paper he was writing for the clinicians on staff (a group that, until recently, I was not part of) about the form of the clinical program at the facility.

Now, in July, we had a major shift from our clinicians (social workers) being a part of the education portion of the facility to clinicians (social workers, psychologists, and licensed counselors) becoming part of the psychiatric treatment side of the facility. This was not a major change for me as I am still considered an education faculty member, but it significantly decreased the amount of interdisciplinary treatment that we provided to our students. All of a sudden clinicians did not document on the common documentation files that we had established. None of the new folks were introduced to any of the education staff members, and things were changing dramatically within the treatment process. Both the music therapy department and art therapy department were left out of the loop. Apparently because both of those therapeutic formats were considered to be "recreational" rather than therapeutic.

Several weeks ago I spent time talking to my supervisor about the current situation in the therapeutic realm at the facility. I felt extremely disconnected from the rest of the therapists. I felt that music therapy was not viewed as a viable treatment modality at the administrative level, and I wanted answers about where I fit in the treatment of our students. This discussion was spurred on by a situation where the art therapist was required to cancel art therapy in order to paint a mural on a wall. All of a sudden, art therapy was not considered to be as important as painting a wall.

I received an invitation to the weekly clinicians' meeting on Monday. I will have to arrive late as I have a session during the first half, but I am looking forward to being a part of this group. There are things that obviously have to be addressed, and I am trying to give the clinical team the benefit of the doubt that they really do not have a clue about music therapy.

I received a paper entitled "A look at the clinical program at ___" (facility name removed to protect those involved with the travesty).

The paper that I received was abysmal. The level of writing (in the third draft, no less) was expected from an elementary school student rather than a PhD. Sentences were incomplete, started with conjunctions, and paragraphs started supporting one idea and contradicted that same idea at the end of the paragraph. Reading the paper gave me a headache. I was dismayed that this was the possible way my clinical program was being represented to the world. I decided at that time to write my own paper.

I am now in the process of writing a paper that includes some of the information stated in the original paper but frames music therapy as an established treatment modality with children and adolescents with behavior and psychiatric disorders. This is a challenging exercise since I am not sure what my audience wants to know about music therapy, but it is obviously necessary to defend my position as a valuable member of the treatment team. In addition, it will be an important part of my future at the facility.


Saturday, October 02, 2010

Thinking about Therapy

The definition of therapy, according to Dictionary.com, is: 1. the treatment of disease or disorders, as by some remedial, rehabilitating, or curative process; 2. a curative power or quality; 3. psychotherapy; 4. any act, hobby, task, program, etc., that relieves tension.

As a music therapist, I feel that my particular brand of therapy is that of rehabilitating rather than curative. I do not think that music therapy can cure disease or completely ameliorate the effect of a syndrome or disorder. I do, however, believe that music therapy can address issues and provide different avenues for gaining skills than other forms of therapeutic intervention.

Out of the four definitions above, I feel that #1 and #4 are the most relevant definitions for music therapists. I am not a psychotherapist. I do not practice psycho-dynamic music therapy techniques and do not feel that psycho-analytical music therapy is the philosophical fit for me. I feel that I can be a music therapist who is able to complete sessions that focus on skill development without being a psycho-dynamic therapist.

I offer my clients the opportunities to use music to learn things, to practice skills, to identify issues or difficulties in their lives.

At this time, I am working with an adolescent with a developmental disability (Intellectual Disability - mild) and several psychiatric diagnoses as well (PTSD and others). He is engaged in a songwriting/composition/performance small group. He entered the session with a song that had deep personal meaning for him. He will not share the specific situation that the song reminds him of, but he is engaging in the process of writing lyrics, singing the song, playing instruments, and interacting with the other group members. He looks forward to the sessions and reports to his teacher about the process that occurs in the music therapy room.

A psychodynamic music therapist may feel that one of the goals of the music therapy session should be for him to share the situation. I do not feel that way. My thoughts on the matter are that he will share the event or situation when he is ready. It may not happen during a music therapy session, but it may happen when he is performing or listening to the end product at a later date. I think it is more important that he is engaged in the process rather than whether he actually shares the situation with me.

There you go. Thoughts on therapy.

Friday, October 01, 2010

The importance of an hour

I am going to work a bit later than usual today. I generally get to work an hour before I am required to report, primarily because I am an early riser and enjoy some quiet time in my room before others arrive. Today, however, I needed to finish up a Netflix movie before sending it back, so I am staying at home until 6:30.

I have an hour-long commute, so I can predict my arrival at work pretty well every day. I have been tempted over the years to give up that commute and move closer to work, but I have found that I need that time to slough off my day as well as get ready for being home. I use that hour to mull over issues, practice singing, think about my life, and contemplate things that need to be contemplated.

The hour is a unit of time that defines my professional life as well. I provide hour-long and half hour sessions to my clients. I also have hour-long interdisciplinary sessions on Fridays. An hour is enough time to engage clients in musical experiences and process through those experiences. I have found that half hour sessions are not enough time to focus on what we need to address in music therapy sessions.

My extra hour is almost up. I have completed a movie, am heating up breakfast, and am watching a snarky television show. I will be going to work a bit refreshed and ready for the day.

Take an hour off every so often. Don't stress about the amount of time that there is left (the difficult part for me). Enjoy the disconnection.