Saturday, August 27, 2011

Through the Haze

Seasonal allergies have struck my respiratory system. I have succumbed to corn harvesting season and have had to take my big allergy meds. These are the ones that knock me down for a good 24-hours, keep me drowsy, and accentuate my Meniere's disease vertigo. When I have to start this medication, I have to plan it very carefully. Today is the day.

The way I feel when medicated gives me a small amount of insight into how my students must feel when their psychotropic meds kick in. There are those side effects that are sometimes worth it, but sometimes those effects are more difficult to handle than the condition. I know several things about my medication effects - first, they are temporary. When my body is accustomed to the medication, the side effects will diminish. Second, my need for medication is temporary - once the first frost shows up, my allergy set will change and this level of medication will not be necessary. My students do not get a reprieve or even a choice in what and how they will take their medication - they just have to do so.


My medication haze illustrates to me that my clients have to deal with these types of symptoms daily. It is no wonder that some kids require lots of prompting to respond and others cannot sit still for a moment. Chemistry can help, but it also changes things internally.


As a music therapist, I am constantly reminded of the effect of medication on my students. They often have medication changes as our psychologist attempts to find the best combination of medication and therapy to assist the students in addressing their goal areas. We often have kids who are adjusting to one medication while being weaned off another med. Their presence in the music therapy session often varies - and it's not really a big surprise why if my body goes into such a dramatic change on less than a hundredth of what they take daily.

It is important for a therapist to acknowledge the effect of medication on clients. It is more important to continue to engage the client in treatment despite the effect. When I see changes in behavior patterns, I inquire about medication changes to assist me in figuring out the reason for the changes. I still need to be the most effective therapist that I can be. Knowing that a student may not be able to focus on directions due to a change in his brain chemistry is essential information for the therapist and the student. The therapist then needs to change her expectations and therapy format to accommodate the change and to continue to challenge the client in progressing towards his goals.


Better living through chemistry...with things to think about...for the client and the therapist...internal changes that overcome external stimuli.


Hmmm....

Wednesday, August 24, 2011

Deep Thoughts...

Yesterday, my administrator attempted to be inspiring. She had been involved in an accident a couple of days before and really found it to be a life-changing experience. She felt that we needed to share in her inspiration and change our lives as well. I found myself musing on the nature of inspiration and how it is presented to others.

I think of myself as an intelligent, creative, and somewhat spiritual person. I am able to be rational in the middle of emotional situations. I feel that I am a person who can be inspired by many things - big and small situations and events that occur in my life.

One of the things that I found myself thinking while she spoke about her life-altering experience was, "I'm glad she was able to assist the folks who needed help, and she seems to have had a bit of a change in attitude." I was glad that she had experienced such a profound event and that everyone was fine.

Then, she started to talk about using her experience as inspiration for us all. This I found difficult. 

She used her experience to tell us that we should not react to her requests or thoughts. "Life is too short to worry about 10 additional minutes of the workday. Why argue? Just do it."

This was where I had to start tuning out. Her inspiration was going to have to trump any of the inspiration that I have had over the years that causes me to advocate for my profession and my clients?? Why??

Now, I understand that an inspirational moment has great strength for the person who is experiencing the moment. I also think that inspiration is not something that has great power when served as a left-over. I understand the thought of life being too short to worry about little things, but who decides what the little things are? Something little for one person may be MONUMENTAL for me! 

I have been inspired by her inspiration to continue to express my own needs in a way that expresses what I need to have to be an effective music therapist for my clients.


Monday, August 22, 2011

Do Over...

Today is a day I wish I could do over.

There really wasn't anything bad about the day, but there wasn't anything spectacular about it, either. My first two session were with kids who did not connect with me or with the music easily. It was like pulling teeth to get them to interact with me and with the music, but it was nearly impossible for interaction with both!

My four groups were fine. Kids participated in all experiences without issues. They appeared to enjoy singing about the weather, the rhythm wheel experiences, all things from opening through closing. Kids just seemed a bit "off."

Now, my analytical self starts to try to figure out what went wrong today. We had stormy weather blow in and out of the area, it is the second week of school, and all of us seemed cranky. I am going to chalk this up to a convergence of many different factors.

I wish I could wave a magic wand and start a day over again.

Saturday, August 20, 2011

Artistic Endeavors


I am trying to make something for the AMTA Silent Auction. I have never donated something before, and I am trying an altered book about music. We will see if I get it finished, and if it actually sells at the auction.

Right now, the book has been covered with paper and is awaiting frou-frou and quotations about music. I have been trying to do a green theme - I really like green, and it seems like a good choice for the book. I can use all of my green papers and ink.

I was reading a blog entry for a fellow music therapist who stated that she did not enjoy making visual aids for her sessions. I found that difficult to understand. I LOVE making visuals - the more complicated the better for me! Seeing these comments made me think about how nice it is that there are therapists who do like making visuals and those that are good at networking and marketing. We are all different on so many ways - we have different talents and skills. This is one thing that makes music therapy such a rich profession.

So, Michelle, keep on making your bags, and I will keep making visual aids. Maybe we can share sometime.

Wednesday, August 17, 2011

The Therapeutic Relationship

Yesterday was a good day for therapeutic relationship building. It is a nice thing when my nonverbal clients with diagnoses on the Autism Spectrum start to associate me with what I do.

Yesterday, 15 minutes before we were going to dismiss students to the residences, I took a student back to her classroom after her individual session. We had spent the time singing with the microphones, and she appeared to enjoy the session. We danced back to her classroom down the hallway and entered her room. One of her classmates (the "Q" from before) walked up to me, looked at me, and then walked over to the nearest picture schedule, found the "music" card, and handed it to me.

This is the same "Q" who, 9 months ago, did not display ANY communicative or interactive behaviors at all...with anyone.

I couldn't take him to the music room right then to reinforce the communicative behavior. There was no time before shift change, but I did spend some time with him in his classroom. We jumped, whistled, and made sounds for 15 minutes. He followed me around the room, holding my hands, and vocalizing. We quickly established that an upward slide whistle was a signal to jump up and a descending whistle was a signal to crouch down and get ready to jump. We played. We had fun. When he left to get his kazoo that he made in art, I left the classroom as well.

The things that "Q" has taught me over the past three months are very valuable to me as a therapist. He has shown me that individual music therapy sessions are more effective in accomplishing many therapeutic goals for children with severe autistic involvement. Group therapy has its place, but individual therapy also has value. This continues to provide justification for the big switch from group focus to increased individual focus at my facility.

"Q" has also taught me lots of other things. It is wonderful to know that a child with an abysmal history of abuse and neglect can and will thrive once in a place that can offer security, frequent and regular meals, and patient care giving. The importance of treatment in general is exemplified in the progress of this young man.

"Q" also reminds me that learning is fun, behavior is communication, and communication is a form of behavior.

It is now time to go back to work. "Q" will come to music twice today - once as a member of his classroom group, and once on his own. I wonder what he will teach me today...

Monday, August 15, 2011

Anticipation...

Today is the first day of the Fall session of school. I think I am ready for most of what will happen today, including some routine things and some brand-new experiences for myself and my students. We will see.

One of the new things that I want to do with my first big group today is a shift from the regular turn-taking opening intervention. This group of students does not "group" well. Several of the students do not feel comfortable sitting in the group's traditional circle, so they end up scattered around the room in no particular pattern. This goes against my need for organization, but I would rather be a bit needy and have them feel comfortable in the session than insist that they conform to my needs - after all, who is the therapist and who is client in this situation?? I am going to put the guitar down and use a drum for interaction. I hope that we will have a time of rhythm improvisation during the opening portion of the session, but we will see. After that, I have no plans for our interactions.

Over the years, I have used session planning on varying levels. I strive to be client-directed and try to teach that skill to my interns as well. It is important that the therapist not insist on his/her agenda to the exclusion of the wants, needs, wishes of the client. As an undergraduate in music therapy, I used to write detailed session plans that ended up being treated as scripts. I had a music therapy supervisor who would sit in the observation room and check off when I completed portions of the plan. If I varied my plan in ANY way, she would ask me to justify the changes. I often could do so. For example, I was working with preschoolers who had been labeled as "at-risk" for behavior disorders and would often rearrange the elements of my session to accommodate their behavior states. Three year-olds do not often fall into the nice plan that their therapists arrange. I think the result was better therapy and was allowed to continue in that mode as long as I could explain my rationale.

These days, we seem to turn out music therapy interns that can write a session plan but cannot deviate from that plan easily. As soon as clients go towards another thought or experience, novice interns are stuck trying to guide the clients back to "the plan." Accepting this a part of their developmental process, I allow this security blanket for a short portion of time, but soon challenge them to become more "strategy-focused" as a way to reaching my end goal of "client-focused" therapists. We start the thinking process by writing down Therapeutic Music Experiences - as many as possible, with a minimum of 75 at the end of the first four months. We parse those experiences for possible goals, materials, instruments, musical outcomes, therapeutic outcomes, and processes. We discuss how the experience will change if musical elements are changed. We make targeted observation goals for the intern to watch me during sessions and for me to observe in the intern. We break the script habit at about month 4 for good.

My planning is often just one focus experience that I use with all of my groups. I may decide that this week is an Orff instrument week. Every group will use the Orff instruments in some way. This allows me to have some structure, but also allows me to use music in a therapeutic manner, by changing the musical structure to accommodate differences in clients' behavior states. I try to think of all the materials that I need to get out before the session begins, but don't restrict myself to only the things that are out if clients need something different. I try to anticipate what will be needed, but don't always hit the mark.

As I get dressed for the first day of a new school year, I am anticipating the promise of a new start on this 19th year of professional practice. I am thrilled by the opportunity to be a therapist (not just a supervisor) for the first half of the year, and I am looking forward to my next intern who will arrive in January. I anticipate that this year will be one of challenges, joys, despairs, and laughter. I am ready.

Anticipation fills me as I walk out the door.

Happy New Year, everyone!!

Sunday, August 14, 2011

Welcome Back and Happy New Year!

Happy New Year, everyone!

I am a school therapist, so my life is very much dependent upon the ebb and flow of the school year. August always seems much more like a new beginning to me than January. So, every year about this time, I start to think about my goals for the new year. I make resolutions about my professional life and then try to obtain those resolutions. This year is no different.


This year, I will strive to do the following:
  • FINISH my schooling
  • Make long-term decisions about my future as a music therapist - here in Kansas or somewhere else completely
  • Become a pre-approved CMTE provider through CBMT
  • Develop new interventions for children and adolescents with developmental and psychiatric concerns - use them in sessions, and then give them to others
  • Avoid toxic people in my environment
  • Find interesting people to interact with outside of work time
  • Act as an appropriate music therapy internship supervisor
  • Maintain appropriate communication with other music therapy internship supervisors out there in the world
  • Sing new songs
  • Listen
  • Breathe
  • Learn
Lots to do.

As a therapist, I strongly believe in balance. My resolutions often reflect my hope for balance in my own life - professional obligations balanced with personal needs. That balance is often elusive, but very important to me.

I often feel that my clients do not have the opportunity to find balance in their lives. They are children in the eyes of the law, have been taken away from their homes, and do not get much choice in matters that concern them. I try to offer them some choice in how they participate in music therapy sessions. It always distresses me when a classroom paraeducator insists that a student participates in music therapy sessions. I do not allow that to continue because I feel that participation should be a choice. Now, having said that, I generally wait for the child to refuse, and then I get out his favorite instrument and insist that he follow directions to get the instrument, but that opportunity to choose is a method of balancing his needs to be a child/teenager and my need to provide the therapy I am paid to provide. I find that a bit of defiance is healthy for me as well as for my client as it forces me to remain client-directed and aware of the things that my client communicates to me through the music therapy session.


Balance.

Happy New Year, everyone! I hope your year is filled with happy thoughts and challenges that make you become a better therapist!

Saturday, August 13, 2011

A Return to the Electronic World

Approximately 90 minutes after my last post on this blog, my computer had a MAJOR CPU (central processing unit) meltdown and stopped working. This CPU failure led to 5 days of electronic detoxification as the computer had to go to Houston to be repaired, and I wasn't going to go to work simply to use the computer there (it really wasn't worth the gasoline or the time to go there). On Wednesday, I did go back to work for the school year orientation and found that the world went on without me.


Today, when I got the repaired computer back, I eagerly went back online. I went to Facebook, reviewed my email accounts, and then started to scroll through my favorite sites. I spent some time trolling through the blogs of music therapists and music therapy interns that are linked to many other blogs. It was an interesting exercise in the history of music therapy professionals.

I read the blogs of current music therapy interns (all from Florida State, interestingly enough - it must be an assignment). I remember that excitement. The first-day jitters or going to the internship setting - would I like it? Would they like me? Would I even want to be a music therapist when I was done? I remember my relief when my supervisors seemed to enjoy me and my skills as a novice therapist. I enjoy looking back over my journal, my session plans, and my assignments from my practica and my internship. I enjoy seeing myself from my new perspective of practiced therapist.

I also look at the blogs of therapists who are younger in the world and the profession than myself. Many times, their blog entries are about things that I have also gone through as a therapist. There aren't many therapists my age who are blogging, but I am also a fan of a couple of therapists who are my age or just a bit older. I enjoy reading their blogs as an indication of where I can go in my professional life.

Get out there. Look at the resources that are available to us as therapists. We are no longer alone in the world, especially when we can connect electronically at the blink of an eye. When I was a beginning therapist, I spent much of my time as the only music therapist. I could connect with others via mail or the telephone, but instant connection was not possible. Now, I can ask a question on the music therapy listserve and get twenty answers within five minutes. This amazes me.

I enjoy being in a global community of music therapists. I do not often take advantage of this, but I like knowing that I am one of many in the world who use music to affect change in the lives of ourselves and others. Thank goodness for these connections - all through electronic means! I am back in cyberspace and ready to connect!! Are you out there?

Friday, August 05, 2011

Finishing the Relaxation Part of the Summer

I have four days of fall break left before I return to the daily routine of the school year.

Today it is raining outside. This is the first time that rain has actually fallen on my little home since I started break some 14 days ago. The change in the atmosphere is wonderful, and I am finally feeling like autumn is coming sometime in the future.

Tomorrow I get to go to the Office Depot Star Teacher appreciation breakfast for some stale donuts, a bag full of goodies, and the chance to win a drawing. I NEVER win, but I always try. I will spend some money on ink cartridges for the computer and for some other things that I really do not need, but want. Last year I had a migraine headache come on as I was waiting for the drawing results. I am hoping that doesn't happen this year.

So, what does this have to do with anything but the "me" part of this blog??

I feel strongly that music therapists often do not have an awareness of the essential need for self-care. (I think this may be one of the reasons why we have many young professionals who leave the profession for other situations.) We, helping type folks that we are, often neglect our own need to be helped. For me, one of the best things I can do to be helped, refreshed, renewed, and re-energized, I like time to become bored with being home and away from people.

My pool of thought has been refilled with the past two weeks away from work. 

I have made plans for my therapy sessions over the next several months. I also have spent time thinking about all aspects of my life. I have made things ready for laminating for use in my sessions. I have organized parts of my life. I have determined that my predilection towards being a pack rat is part of my need to control my environment (Thanks, Hoarders!). Snark!

The end of vacation is always a good time for me. I love my job. I love my students, my sessions, most of my co-workers, and the things that I get to do during my regular work as a music therapist. I am ready to go back into my work with children and adolescents. I also am ready to spend time with students who scream, pull hair, hit others, and spend lots of time engaged in oppositional behavior. With the time that I have had away from my job, I am ready to jump in with both feet again. All the way into the deep end.

So, only four more days until I get to be an active music therapist again.

I can't wait!