Monday, June 27, 2011

Brought Down By a Bug...or Something
So, I woke up early this morning with a very upset stomach. I took some antacid and went back to sleep. waking up several times during the rest of the night for more antacids.

This morning, I got up with every intention of going to work. My stomach was upset, and the illness seemed to transfer down into the intestines as well. I tried very hard to get to work today. I even got to my car and about 3 miles away from home before the stomach stuff reared its ugly head, and I felt that I could not face an hour's drive feeling nauseous.

Now, I am a person who firmly believes that you should stay home if you are sick. If you are in any way contagious, then you have a responsibility to others to keep your germs to yourself. (I don't think I'm contagious, by the way.)

I decided that there needed to be some time to sit and try to stay quiet today rather than attempting to sing with my mouth open, breathing on my clients.

I hope it will be a quiet day at work. I worry when I am not there that I will be on a very long list. This list will be long because there are many folks gone on vacation this week. I knew that this morning which is why I tried to go in to work. I also worry about my equipment being used by folks who do not know how much it costs to replace said equipment.

Self-care for the therapist is something that most of my interns do not know about when they get to me. We discuss it often during their internships, especially when interns appear to be stressed out with their assignments. We talk about the need to take time to take care of yourself. We talk about being realistic as human beings - we are not perfect, and we need to recognize this fact in order to be effective therapists.

I have seen many good therapists burn out of the therapy profession because of unrealistic expectations of themselves as ubertherapists. They appear to believe that that they have to do everything for everyone perfectly all of the time. 

Now, I tend to be one of those people. I am more likely to do something that someone asks me to do than to say "no" to their request. I have always tried to do things perfectly - I am a perfectionist, but I have learned the hard way that I cannot achieve perfection in all things. I can only do the best I can.

On days like these, my body sends a very strong message to my perfectionistic personality. 

STOP!!

I have learned that it is better to address these issues when they first rear their ugly heads than it is to try to ignore them. If you ignore issues, they start to grow, kinda like a monster in a nightmare.

So, I am home today, writing this blog entry, trying to calm my upset intestinal tract, taking the very strong hints that my body is giving to me. Taking this time now will make me a better therapist tomorrow.

Saturday, June 25, 2011

I wonder...

What is so difficult about behaving ethically?

I am peripherally involved in a situation where a music therapist has behaved unethically in both her therapeutic services and in her professional relationships. The situation is ridiculous to say the least. None of the things that have happened are things that should have happened.

I am human. I make mistakes and have to apologize on a pretty regular basis. I sometimes snap when I should think, and I often rush into things that I shouldn't.

I try to be ethical in my dealings with others, not only in the professional world, but also in my personal life. This attitude comes not only from my ethical training, but also from my morals and upbringing. I was taught to think about the feelings of others. I was taught to see beyond myself and to see how my actions could affect the lives of other people.

I think it is a societal epidemic that people are out for number one and only number one. The issue seems to be that people think they should get what they want when they want without regard to what others want or need.

"Who cares if this hurts someone else. I will get what I want and that is okay." This attitude is prevalent in my clients, children and adolescents with developmental and psychiatric disorders, but is also becoming more prevalent in general society. We seem to be back into an egotistical, feel-good cultural epidemic that makes it easy to justify bombing people who live where we want to live, get what we want whenever we want it, and to threaten people if they do not do what we want them to do.

How can you ever justify taking something from another person? How can you ever think that bullying another human being would be acceptable? How can you defend a position that you can tell others what to do without doing the same yourself?

Why?

My pledge is that I will re-read the AMTA Code of Ethics this month. I will strive to act ethically in all of my dealings with my co-workers as well as with my clients. I will do what is right, even when others do not. 

Will you make a similar pledge?

Friday, June 24, 2011

Constant Assessment

During music therapy sessions, I often find myself assessing everything that is going on...music, client responses, my responses, sounds, communication, movement, breathing, and the environment.

I believe, in order to be a good music therapist, a clinician has to be shifting and changing all the time. This is true within the session as well as outside the session. Anytime a therapist feels that he or she can predict what is coming next, he or she is falling into a trap. The one thing that I know without fail is that clients will surprise you every time.

Every time I start to feel like I can predict what a client's response to music will be, the client reacts counter to how I expect. This is a wonderful reminder of how to remain client-centered at all times and keeps me on my toes. The joy of being in the moment of the musicking overcomes all of the plans that I make. When I relax and am truly client-centered, the music experience is profound.

Saturday, June 18, 2011

Online Conference for Music Therapy 2012

We had our first organizing committee meeting today. I am NOT the co-chair. This is a good thing since I cannot give as much attention to this situation as it needs. I will continue to be in the financial end of things (this has been a learning experience that I am gleaning much from) but will have some help - Thank goodness!

We do not have a theme, but we did narrow the time of the conference down to a month in 2012. Now we are going to start the process of planning. Keep us in your thoughts as we sally forth... 

Friday, June 17, 2011

Second Week

The second week of summer school is typically more difficult than the first. During the first week, everyone is happy to get back into the routine of classes, lessons, sessions, and swimming. Getting up early is not a problem since we get to go to school!

By the second week, getting up on time has lost its novelty. School is no longer fun but a chore again. Kids are cranky when they have to wake up at 7:15.

This week marked the start of adaptive music lessons in the music room. Kids came from many of the classrooms to learn about piano, drums, guitar, and music video making. I reserve these experiences for my higher functioning, more verbal students. They are not eligible for individual therapy since they are able to verbally process the information presented in art therapy (I know, it's a confusing situation, but that's the way things are at my facility). Everyone seems to enjoy music therapy, though, so I open my room up to students who are more likely to learn some music theory and instrument skills. We work on very basic skills.

My individual sessions also continued. These are with lower functioning clients who do not verbally process. I love these sessions. Students direct the musical intervention, and I direct the therapeutic intervention. I spent some time this week playing the piano, recorder, trombone, and organ. In addition, I watched Blame it on the Samba and Little Toot from Disney's Melody Time. I figured out how to make a master schedule for my principal and avoided her as much as possible (she drives me crazy!).

I ended the week feeling more frustrated than last week. This is a typical response. I am also hormonal, arthritic, and it was a full moon.

Next week I will write goals and objectives for all of my individual and lesson clients. These will be in addition to the goals that each student has for group music therapy sessions. I will also design a bulletin board for the front school entrance, keep up with documentation, play music, and make things for my clinic. It will be a good week, especially since it is only 4 days long. What a treat! 

Sunday, June 12, 2011

First Week - Jitters and Joys!

This was the first week of summer school and a radical change in my treatment strategy for my students. For eight months now, I have been on a crusade to provide my clients with more individualized therapy services. The crusade was interrupted by a personnel squabble. I have prevailed and have now been able to decrease the amount of time that students spend in music therapy groups. I had my first week of individual sessions.

The week started off with a whimper. Don't you love it when people don't bother to read their emails carefully? Teacher 1 frog-marched a kid down to the music room for a session and then had to march him back again. Lessons did not start this week, as shared in not one, not two, but THREE different emails! Now, teacher 1 tends to be very concerned about her own details, but not as interested in information from another. Most of the other sessions went off without a hitch.

I had an internship applicant who arrived on Tuesday for her audition. This applicant does not have any kind of professional clue - she stated that she was going to be my intern rather than expressing interest, called me by an incorrect name, asked for an application and then told me that she already had a copy. She overreached during her audition piece - messed up barre chords and got flustered - I'm not sure about her. She did come up with some insights into several of my students which is a plus in the audition category.

I saw 75 students in group treatment and 21 students in individual/dyad sessions this week. I learned more about my students in individual treatment sessions than I have during their group treatments. We played drums, guitars, and the pianos. We listened to music, sang all kinds of songs, played games, and talked about our preferences. Students started to indicate emotions through musical play. One student was spinning in a chair, fell over, and came over to the piano when cued. He started to bang on the piano. I echoed and expanded on his banging, and he started to change and shape his play to match mine. This is a student who does not communicate anywhere - he has started to communicate in music.

Today I made a mandala about my week - here it is.
 

Tuesday, June 07, 2011

Back to the Grind

I went back to work this morning ready to get started. I arrived at work an hour early (not really all that unusual for me) and got ready to go. The maintenance department cleaned the carpet during the break, so things were not quite in the right place. I spent some time putting things back and then tackled the 109 emails that had been sent to me. I got ready for the day and went out to get kids off the bus.

Kids got off the bus with big grins - typical for the first day back to school - and walked in without a problem. I finished bus room and went back to the music room. Recently, the principal has decided that the data that we currently take as part of our treatment is not enough, so I received my own spiral notebook (illegal, by the way) so I can take additional data.

Now, I am all for data collection, but there needs to be some reason for taking the data. That has not been explained and all of the hoopla is an invented situation to keep a "favorite" on staff. I find this sort of thing to be a waste of my time as a therapist and will probably not use the book as I am supposed to. Oh well.

Anyway, back to my day.

I had five individual sessions with students who had never been in individual treatment with me before. Most of these students were kids on the autism spectrum who have significant communication deficits. I did some improvisation on the piano to reflect what they were doing in the room. Some students started to engage with me musically, playing the piano or moving in patterns to make specific music patterns. 

My intern applicant seemed to think that things were pretty cool. I think I will probably offer her the internship, but we will see.
 

Monday, June 06, 2011

Back to Work

Tomorrow I go back to work after a nice, long vacation. I have spent the 18 days of break just relaxing. This has been a good break. Long enough to get bored with not being around people and ready to get back into the daily routine of therapy.

Tomorrow will be a day full of new experiences. I have significantly changed my schedule and treatment format from the schedule I have had for the past 6 years to what it was when I first arrived at the facility where I work. I will be increasing my individual and small group treatment and decreasing my group treatments. This pleases me greatly, but it does present some challenges.

My clientele has changed in the past four years. The students that attend my school are primarily children who are dually diagnosed. They have a developmental disability such as autism spectrum disorder or intellectual disability and an additional diagnosis on the psychiatric spectrum. The students are more actively aggressive than the students of five-six years ago. The length of stay is shorter, requiring more intensive treatment in a shorter period of time.


I have felt that group treatment has been adequate, but not as effective as individual interaction with my students. There is something about being engaged in a 1:1 interaction with a client that is more appropriate than a 15:1 interaction.

When my treatment format changes, everything changes. My goal and objective requirements have changed. I have to justify why I choose the students that receive individual treatment to the powers that be. I also have to rearrange my treatment area to accommodate individuals - increased opportunities for communication of wants and needs, new routines, ways to challenge students to experiment with music, and many other things.

This is my last day of vacation. I am going to spend it getting ready to go back to work tomorrow. I have several projects to do - communication board, music lesson folders, file folders to laminate, and sessions to design. I have to get ready for an internship audition for tomorrow. I need to load up the car with all of my stuff. I'm excited to get back.

Can't wait!!

Saturday, June 04, 2011

Insights into Me

I feel that I am pretty self-actualized. I know my strengths, my weaknesses, and my areas of focus. I have come to the conclusion that I cannot do everything, and that is fine (most of the time). 

I still have my moments of insecurities, my "I should" moments, and my times when I feel inadequate as a therapist. I think these moments help me to strengthen my skills and attitudes about being a therapist. I have a chance to reflect on myself and my skills as a therapist - I try to take advantage of these moments.

Here are my strengths:
  • Genuine interest in music as a therapeutic medium for persons with developmental issues and psychiatric concerns
  • Constant questions about music as a therapeutic medium
  • Enjoys music
  • Enjoys people
  • Creativity
  • Flexibility
  • Goal-oriented
Here are some of my weaknesses:
  • Perfectionist
  • Tries to take over the world
  • Wants more opportunities to help others
  • Time management
  • Procrastination
There are many, many more.
I guess the most important aspect of being a therapist is that you recognize and then address your strengths and weaknesses. Many therapists appear to believe that this can only be done in a therapeutic session. I think that the requirement of seeking outside supervision is not necessary for those who are able to provide some of the benefits of supervision in other ways. I have my friends, my family, and my co-workers who assist me in finding my way through the complex situations of being a therapist.

Friday, June 03, 2011

Mandala

Lately, I have been attempting to increase my supervisory techniques to help me with intern supervision. One of the things that I have attempted are mandala, much-hyped by several of the more vocal internship directors who prescribe to a more psycho-dynamic form of therapy than myself. I do not think that I am doing these as prescribed by those IDs, but I am enjoying the process and the learning experience.

I am currently completing eight-point mandala. I start with a small circle and then draw eight radiating lines from that circle. I think I really like the discipline of mandala the way that they were described to me.

My mom, my source of all things, is really into Zentangles. She starts with a square and then draws lines. She fills in the space with shapes, colors, and forms. I have not been able to be that free with my mandala yet. There is a form of mandala called Zendala, which combines both of the concepts. This is also too free-form for my comfort level at this time.

I wonder what one of those more psycho-dynamic therapists would think of my mandala. I like the symmetry and repetition of the patterns that I draw. I enjoy the discipline of starting with a central idea and then watching that idea grow and change as additional layers are put on. Here is one of my mandala. Thoughts about this?
Central idea, then things adding on in one layer at a time.

Wednesday, June 01, 2011

Thinking about Stuff

Oh, dear. Here is a veritable word salad of thoughts, ideas, concepts, and random moments. My apologies to begin with...

I have been on my own on vacation for the past twelve days. I have spent lots of time in my home cleaning, sorting, and tossing things out. I have been overwhelmed at times, sad at times, frustrated at times, and downright bored at other times. This is what vacation is for - to refresh and be ready to get back to therapy.
I have six days left to continue to refresh and renew my therapeutic energy. I am sure that many therapists in the music therapy world would feel that I need supervision of a professional type, but I think that this time on my own is more effective for me than going into a counseling session. I have always been a introspective person. I feel that I can work through issues that affect my therapeutic relationships with the supports that I have available to me. My family, my friends, and my co-workers offer me opportunities to discuss therapy and other issues. I do not feel that mandating professional counseling in the guise of "supervision" is an appropriate requirement for music therapists. There are many other, VERY loud therapists out there who vehemently disagree with me.
My argument comes from a purely financial position. I cannot afford to be in supervision/counseling. I can't afford to buy meat next month if I want to drive to work daily. I am simply not able to go to an outside person. I probably never will be able to that.

I've been thinking about other things in the silence of my home.

More later...