Monday, February 27, 2012

Thinking about Music Therapy

What is music therapy?

When you really start to think about that question, you find that there are any number of answers to what appears to be an easy conversation starter. In the almost 19 years that I have proudly worn the title of Music Therapist-Board Certified, I have pondered this particular question many, MANY times.

I have never really come up with one answer to this question. Music therapy treatment is often only linked by the fact that there is a client, a therapist, and music present. A music therapy session led by me, using music common to many of my clients, will be completely changed by the client present. In addition, the therapeutic process is changed by things I bring into the session, things that the client brings into the session, and by the music itself.

It is interesting, isn't it?

How do you define something that exists in a moment? How do you define something that changes all the time?

I think this is one of the fundamental difficulties of music therapy as a therapeutic profession. Music therapy is not something that can be scripted into a predictable outcome every time. We can make some educated guesses, but the music itself is not a prescription. I think the difficulty that we have getting the recognition that we often want is that we cannot define ourselves in concrete facts or terms. It is apparent to most people who know a client and see the client in a music therapy session that music therapy is a valid treatment process that encourages engagement and interaction as well as growth toward targeted goals. It is not apparent to many others and is often not easily replicated, unfortunately.

So, music therapy with client "Q" is completely different from music therapy with client "Z."

Please don't feel that this is a criticism of music therapy - it really is not, in my humble opinion. It is one of the benefits. I am pleased to be in a profession where I can engage a client with a diagnosis of Asperger's in an Orff instrument improvisation for 30 minutes, and then move into a session with an adolescent centered around emotional expression and songwriting. I am also proud that I am equipped to work with many different people in many different settings on many different goals and objectives.

Every so often, folks on the music therapy listserv start a discussion about defining music therapy. We often end up in a heated exchange about what we should include in the definition. I think that the lack of ONE definition is one of the things that makes music therapy continue as a profession - we can be many things to many people, and we often are!

Bravo, fellow music therapists! Sing your song!

Saturday, February 25, 2012

Blocked

I usually have plenty to say on any number of topics, but for some reason, I have been staring blankly at my blog screen for the better part of a day. I have started over 5 different topics, but none of them have piqued my interest much past 2 paragraphs.

So, today's blog entry will be about creative blocks.

They happen to us all at one time or another. My current block is directly attributed to my current state of health - not well. After the Online Conference of Music Therapy, I crashed and crashed hard. My lungs are full of gunk, and I have a cough that just won't quit. Blech. As a result, I find myself processing information much more slowly than normal. Producing information is an even more difficult situation. 

I am confident that my blockage will go away as soon as my breathing issues disappear. There are times, though, when I get into prolonged periods of creative blockage and have found that I can usually jump start my creativity through several techniques.
  1. Write something silly. I randomly draw a word card and write a song about that word - whatever the word happens to be. I have songs about Snickers bars, chewed gum, and other silly topics.
  2. Follow strict rules for composition - I limit the number of notes that I can use in any composition.
  3. Go modal - remember those modes that we learned WAY back in our first degree program? They work very well for startling you into something new and creative.
  4. Go shopping for something you have never used before. I love the Dollar Tree and go there often to help me create something new for my clients. Currently, I have a series of large pictures with writing lines on them - a school house, a pencil, a crayon, and a piece of notebook paper. I am currently staring at them and trying to figure out what I am going to do with them. I mean, besides the obvious use of writing out song lyrics. 
  5. Improvisation with clients. I love to go into a session with a half plan and a plan to improvise. I get into the groove that the clients produce and then let sounds and music flow.
This upcoming week, as I am getting through the course of antibiotics and attempting to control my cough, I will be trying to get my creative spark going again. While I don't know if this creativity will transfer into interesting blog posts, I hope that it will.

What types of things do you do when you find yourself stuck??

Tuesday, February 21, 2012

Inspiration from the Most Interesting Places

There are many places where I find inspiration. I enjoy walking through the Dollar Tree, especially through the toy section, to find ideas for Therapeutic Music Experiences (TMEs) for use with my clients. I look through coloring books on a regular basis to find visual aid ideas. I spend time looking through my music library for more ideas.

This weekend, I was inspired to write a new song, "Everybody's Everywhere," by something that was said by a presenter during the Online Conference for Music Therapy (OCMT 2012). Roia Rafieyan mentioned that at the beginning of some of her sessions that "everybody's everywhere." This led to a poem which will be lyrics for a new opening song. I'll publish it later on my website, www.musictherapyworks.com, when it is fully developed.

I also found inspiration in a different place. It came about in a strange way...

My toilet has been overflowing occasionally. I came home on Friday evening and found that things had overflowed all over the bathroom hallway carpet. Now, Friday was the night of OCMT 2012 - I was on the organizing committee and was presenting, so had things I needed to do. I spent lots of time sucking up water from the bathroom hallway and then Lysoled the entire place.

Now, I apparently am allergic to the scents that Lysol uses to mask the smell of Lysol. I started wheezing, so had to move my bed from the bedroom (near the hallway) to the front room. 

Don't worry, the inspirational part is coming soon.

The evening progressed well, and I finished my presentation and laid down in the front room. When I opened my eyes, I found myself looking at a series of paperback books that I had purchased, used several times, and then placed at the bottom of a shelf.

Suddenly, I remembered all of the music that I had in those books. Inspiration central!

I am spending some time at home right now due to bronchitis and am using that sick time to write down ideas using music from these recently rediscovered books. I will spend some time flipping through these pages, rewriting words or developing things to do with the original songs. Who knows how many of these ideas I will actually use with my clients, but I will have them written down, so I may find a use for the TMEs at some future time, at some future date.

I often find that I get stuck doing the same things with my clients without remembering all of the other options that I have available to me. It is moments like these that I am thankful for all of the TMEs that I have written down over the years.

Who would have thought that a leaky toilet could lead to the development of new things to do in music therapy sessions?

Sunday, February 19, 2012

Community

It is important to be a part of a community.

This weekend, I spent time involved in the second annual Online Conference for Music Therapy. I was part of this conference last year and decided to continue this year as treasurer and a member of the organizing committee. The reason I enjoy being a part of this group is the sense of international community in music therapy.

The last 36 hours have been spent sitting on my stool in front of a community of music therapists from around the world. With webcams, microphones, and high-speed internet services, you can communicate in real time with real people and get insights into music therapy that you have never considered before.

I was reminded about how much I feel alone as a music therapist at times. At work, I am unique (except for interns who enrich and renew my music therapy community). I work at a church as a music director - most of the people there do not even realize that I have another job that pays the bills. When I start to describe what I do, most folks seem to stop listening when I say that I use music to help people reach their goals.

It was tremendous to sit and listen to therapists that I really respect and revere talk about how they struggle with some of the same issues that I struggle with. 

Community. It makes a big difference.

Thursday, February 16, 2012

Getting Kids to Giggle...

There is nothing better for me than the moment when a kid starts to giggle in music therapy.

Last Wednesday, I was faced with a dilemma. There were 8 kids in the music room between the ages of 8-14 years, we had finished my entire plan for the day, and we still had 15 minutes left of music therapy. I was mentally flipping through my bag of tricks to see if I could find ANYTHING to keep these students occupied as they started to show signs of disengaging from me. Yikes!

Quickly I asked them to raise their hands in an attempt to reengage their attention to me and to musical elements. We did a quick stretch and then, BRAINSTORM!

I showed them how conductors control the music of their ensembles and then allowed them to direct me. One person was the conductor and another person chose the song for me to play. Once they figured out that I would start and stop on cue, the giggles started.

It was contagious.

The first student didn't know what was going to happen, so she started off hesitantly. She raised her hands, and I started to play. She stopped moving, and I stopped playing and singing. She eventually realized that she was the one controlling the music, and I had a control-freak on my hands.

We spent the rest of the session taking turns and sharing the power of conducting.

We also spent the rest of the time giggling.

The therapeutic music intervention offered here was not planned or complex. It was simple and yet it addressed many of the skills that my students need to learn. We engaged in a social interaction - between me and each student as leader-follower, between students as co-conspirators; we engaged in impulse control - how difficult it is to wait for someone else to give us permission to move and play; we worked on gross motor development; we addressed emotional expression; we developed our therapeutic relationship through musical interaction. Whew. There was a lot going on.

The most important thing to me, though, was the giggling.

Take some time to laugh with your clients.

Sunday, February 12, 2012

Little Steps

Recently I have discussed that I am trying to make some subtle changes in my life. I am trying to find things to throw away, donate to others, and repurpose in my life. I am trying to listen to new music everyday, and I am getting myself closer to some professional goals that I have had for a long time.

Yesterday I took a small step towards my goal of organization in my home.

I moved my DVDs and my DVD storage shelf (5 feet by 8 feet shelving that I made from 2X4s) from the front room to the back room. Does this sound like a lot of work? Not really. Now, remember that I am a pack rat and know that I LOVE movies, so trust me when I say that the task was pretty monumental. I moved seven shelves' worth of DVDs (81 DVDs each) from the front room to the back room. I then had to manipulate the shelving unit around the front room, the desk in the office, down the hallway, and into the back room. Then, I found another obstacle - the ceiling fan. I stopped to think the process through and eventually figured out how to maneuver myself and the shelf into place. I reloaded the shelves and, voila! I now have all of my movies in place.

Now, that is not all that I did yesterday, but that was the best thing that I did towards my personal goals all day.

How does this relate to music therapy? Good question.

I suppose a good therapist is always aware that there are things that need to be addressed and worked on. A good therapist understands that he/she is not perfect just like the clients that seek therapy are also not perfect. A good therapist also assists his or her clients in celebrating the small steps taken towards a goal and recognizes his or her own small steps towards goals. A good therapist is also not afraid to own his or her faults and imperfections.

A small step yesterday may lead to a bigger step today.

Saturday, February 11, 2012

Obwisana

This last week I spent much of my music therapy time engaged in a song called "Obwisana." This song was introduced to me by an intern, and I just rediscovered it in a book that I absolutely love called The Melody Book. The Melody Book was compiled by Patricia Hackett, and I happen to have found a copy of it that was published in 1983. It is prohibitively expensive ($118 marked down) on Amazon.com, but I found a VERY used copy on eBay several years ago and only spent $35 on my copy.


Anyway, I started to brainstorm ways to use the song with my students with developmental and psychiatric concerns. I made Obwisana my therapeutic music experience (also known as TME) of the week.

I often find one TME that I run with all of my groups during the week. I adapt or extend the TME to accommodate clients' levels of function, attention to task, or interests, but I use the TME in all 14 of my group sessions. This week it was time for Obwisana.


(By the way, you can find a copy of the TME plan as well as a link to a YouTube presentation on my website, www.musictherapyworks.com

Here is the complete link: http://www.musictherapyworks.com/therapeuticmusicexperie.html)


I started the week with my gathering drums and my first sensory-focused group. We sang the song and drummed together - something that is VERY difficult for us to do as a group. Other groups passed shaker eggs around the circle. Yet other groups played elimination games and became community beat keepers. It was amazing how my group members took the game idea and transformed it into something unique and amazing for themselves. Each session was a marvel for me as the "therapist" as I introduced the idea and then watched my clients make the experience their own.

By the end of 14 sessions, I had many different ways to use the same song.

Tuesday, February 07, 2012

Music Therapy Moment

This music therapy moment brought to you courtesy of student "Z."

Yesterday my day started with a group of students from our "low-density, high staff" room. These students are mainly on the end of several spectra - autism spectrum, intellectual disability spectrum, behavior concern spectrum, etc. You name it, they function on the outsides of all spectra.

My music therapy philosophy with these students is to increase their interaction with both the music and with me as the music maker. We start each session with a short opening song, greeting each other appropriately, and then we move into an equally short therapeutic music experience (TME for short). We then take a musical walking break. After a time, we sit again and complete another TME. We follow that TME with another walking break and repeat until the session is over.

These students have been in this form of treatment since the beginning of December, and I have found that I have been able to address each of their individual needs better than when I was trying to treat each of them in different group therapy formats. There are, however, times when I realize that we all have so much to learn.

Yesterday, Z was sitting next to me. Now, he usually spends as much time away from me as possible, alternately staring and glaring at me from his place by the wall. He came in, all the spots were filled but the one next to me, and he responded well to my verbal and gestural prompt to sit. I sang the opening song and went into my first TME, group drumming to the song Obwisana. (This will be on my website by Sunday, February 12th - see www.musictherapyworks.com for the TME plan and information on how to find the song along with all of my uses for the song). It came time for our first walking period, and Z decided that he wanted my whistle box.


Now, I have a simple rule in the music room - you ask before you touch.


Z hasn't figured out that I expect him to ask for something before he touches it. He grabbed the box, I told him "no," and he grabbed my hair. I assume that he thought that I would give him what he wanted if he hurt me.


He was wrong.


Z was not allowed to use the box without asking. He was not allowed to continue to hurt me, and I kept reminding him that hurting people did not get him what he wanted at school. The problem is that I think he does get what he wants when he tries to hurt people at home - it is easier to live with him if you just give him anything he wants.


Anyway, I continued to redirect his hands and his "words" to ask for the whistle box. He didn't, so I kept the box to myself.


He calmed and completed the rest of the session without difficulty.


For me, the experience of yesterday's session reinforced several thoughts and practices. First, behavior management comes down to two things - negotiable behaviors and non-negotiable behaviors. Hair pulling is a non-negotiable. Using words of any kind is a non-negotiable behavior. Asking before you grab something is a non-negotiable behavior. Second, the challenges of working with people are what keep me in the profession of helping people. Third, I will DEFINITELY give Z a chance to use the whistle box during the next session as soon as he asks me appropriately!

This music therapy moment was brought to you by my student, Z.

Sunday, February 05, 2012

Trying Something New

Lately I have been feeling restless.

When these feelings sneak up on me, I have to stop and evaluate what is going on. Sometimes this means looking for another job, sometimes it is as simple as changing my hairstyle, and other times it means that I am frustrated with everything that goes on in my life. I am REALLY hoping that this can be solved pretty easily, but who knows.

Anyway, in order to try to shake up my feelings of restlessness, I am trying to do something new. Actually, I am trying to do several things in a new way.

  1. BUSINESS: I am going to focus on my business plan in the next 3 months with the goal of accomplishing my dream of offering online continuing music therapy experiences to music therapists. At this time, I am hampered by a lack of funds to pay for the application fee, but I think I can swing it after 3 months of couponing and limited extra expenses. It is amazing how $250 is a huge cut in my entertainment budget, but in these financial times... you know the rest of that sad song.
  2. PERSONAL: I started an art journal with my most current intern. I generally journal via this blog or in one of my many book journals, but I often journal sporadically in those formats. The art journal is my way of trying to keep a chronicle of happenings in a nontraditional format. The rules are simple - I open up to any page, put the date on it, and then go. I can draw, write, make word pictures, anything at all.
  3. MUSICAL: I am archiving all of my music onto a large drive on my computer. It is amazing how much music I have collected in my 19 years of practice. I am challenging myself to listen to new music daily - most of it from my music library - to keep myself connected to musical expression from others and to inspire my own musical expression.
I am also focusing on changing my physical environment. As I have mentioned before, I am a pack rat, so I am challenging myself to clean up, throw away, and donate parts of my life to various places around me. Sigh - this one is very difficult for me, but I hope to persevere. There is a newly designed Star Wars bedroom in my near future. I just have to get there! (Yes, I am THAT much of a geek!!)

It is a good feeling to think about shaking up my existence here on planet earth. Off to try something new...