Thursday, July 31, 2014

Quotation Challenge - Letting Go of What is Known

 I'm not very good at taking selfies... That's probably a good thing!
 
Yesterday, we completed a personal challenge during our weekly clinician's meeting. Now, this meeting is often a dull review of insurance policies and regulatory changes, but we try to make one week per month "fun day." Yesterday's challenges were "Two Truths and a Lie" and "Draw on Your Head." I won, mainly because I was able to connect all of my lines, and I put lots of fruit on my tree. (If you ever have to draw a picture on a paper plate on your head, make sure you include LOTS of fruit!)
 
I am a big fan of exploring creativity. In fact, I get to lead a CMTE at AMTA in November on creating therapeutic music experiences for adolescents in treatment, mainly focused on challenging participants to develop their own creativity. It is amazing how creativity can be sparked when you have to engage in a process that is outside how you usually do things. Drawing a picture on a paper plate may be a bit different, but drawing that picture on your head is an entirely different level of creating. 
 
How does this fit in with the theme of my blog? Good question. It is when I approach things in a new way when I find growth and challenge in my job. It is often challenging to let go of the way we do things in music therapy, but it is a eye-opening experience.
 
To be truly creative within music therapy treatment, I have to have the courage to leave all of my expectations and plans behind me. It is when I display that courage that magical music therapy moments happen. That's the joy of being both a therapist and a musician.
 
Time to create something. I wonder what it will be... 

Wednesday, July 30, 2014

Saying Congratulations, Goodbye, and Get Out!

Today is the day that intern #22 graduates from her internship.

She has completed her 1020 hours of clinical training, has learned everything I can teach her at this point, and is on her way out into the big, wide world.

I love being an internship director, but this is one of the most difficult parts of the job. It's hard to watch someone move on, but it is an essential part of the job of supervisor - recognizing when a person is no longer a learner but is now ready to move out into the world, and then letting them go into that world. It is time. #22 is ready to go out there and be "the" music therapist rather than the "music therapy intern."

You would think, having done this 21 times before, that this would have become an easy part of being a supervisor. Well, you'd be wrong.

I choose my interns carefully. I spend lots of time looking at the application and the reference letters that are sent. Once I feel comfortable with an applicant on paper, I require an 8-hour on-site interview to see if I can handle being with this person for a period of seven months. I rarely ask anyone to come up for an interview if I'm concerned about their application. It's not fair to expect someone to pay money to come to my area without the expectation that I will seriously consider them for the internship.

That is often the start of our relationship - that 8-hour interview/audition. I watch everything and anything that happens. How does an applicant react when one of my students screams? How does an applicant interact with my students when he or she is leading a group? How does that same applicant interact with my students when he or she isn't leading a group? Can the applicant lead a therapeutic music experience with a group of strangers and keep on pitch and play a functional instrument? Do I think that I can stand being followed by this person for seven months? All of those thoughts go through my head during that interview and audition.

Once I decide to offer the internship position, I wait in nervous anticipation. Will the applicant accept the position? How will he or she fit into the program? Is it the right decision for my clients?

Then, the intern accepts the position. We start the paperwork requirements and wait for the start date.

I always have butterflies before a new intern starts. I have found that I'm a pretty good judge of who I can work with - that interview reveals much information - but you never know what will happen once a person actually arrives. I hope that I will be a good supervisor. I know that there will be times when I fall short of doing everything that an intern needs in the moment (I am human, after all), but I make myself a promise that I will try my best for each and every trainee that starts to work with me, and I do try my best. I am also convinced that, if a relationship is not healthy, changing or ending a dysfunctional relationship is a necessity, not only for me, but especially for the health and well-being of my clients. So, I go into each internship program with caution and excitement and nervousness.

At the end of the internship position, I feel proud of what each intern has accomplished, I feel excited that they are going out into the world to do good things, and I feel sad that they are leaving. I know that our relationship will change. I am no longer teacher, mentor, coach, or supervisor. I am peer. That is a great feeling, but it requires change. Some of my former interns (now colleagues) keep in touch with me on a regular basis. Some don't. I consider some of them to be my friends. Some of them are just my former interns. There's that shift in the relationship again. I am always proud of how each intern has managed to find her own way in the world and feel pride that I may have helped her find her way in some small way.

It is time to get ready for work. Today, on the last day of summer school, I will be helping #22 close her therapeutic relationships, pack up her desk, and then move into the next phase of her life... graduate, and music therapist!


It's time to say, "Congratulations. Goodbye. Get out!"

So, go out and do great things, #22! 

Tuesday, July 29, 2014

TME Tuesday - I Have An Apple



Here is today's TME. This is a pretty simple way to work on many different goal areas simultaneously. With the addition of the beat into the environment, clients have an external stimulus to entrain to, offering opportunities for coordination of motor responses and social interaction. No singing, either!
www.musictherapyworks.com
Here's my apple!

I Have An Apple
Mary Jane Landaker, MME, MT-BC
 
Purpose: To encourage appropriate social interaction through passing and tossing an object; bilateral coordination meeting at and crossing mid-line; hand-eye coordination; entrainment to external beat; sustained attention; completion of one-step directives; completion of multiple directives

Source: Original chant and TME. © 2011 by Mary Jane Landaker, MME, MT-BC.

Materials: Large stuffed apple; external beat track on instrument or CD

Environment: Group members sitting in a circle where passing or tossing an object is easy to complete

Song/Chant/Words:
VERSE ONE
X             X        X           X          X            X                X          X
I have an apple, ripe and sweet, I pass it to Mary Jane, ever so neatly.
           X                X        X          X                X              X       X          
Mary Jane has an apple, ripe and sweet, she passes it to Kelly ever so 
X
neatly.

VERSE TWO
X                   X        X              X              X            X      X        X
Kelly has an apple, sweet and round, she rolls it to Chet on the ground.
X                 X         X              X            X               X                      X    
Chet has an apple, sweet and round, he tosses it to Mary Jane, don’t let it 
                X
touch the ground!

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.      C=show the group the stuffed apple. If desired, start steady beat (body percussion – patsch; or external beat track)
2.      C=start the chant at moderate tempo, entrained to the external beat
3.      A=assess whether group members are entraining to the beat, are chanting along, and/or are patsching
4.      R=reinforce all group members who are actively engaged in making music or entraining to the beat. Redirect group members who are not actively engaged through proximity or use of names
5.      C=pass or roll the apple to a member of the group, substituting the group member’s name in the lyric as indicated by the underlined words
6.      C=continue the chant, using first and third person tenses as appropriate for the activity of the group
7.      A=assess whether group members are able to name the targeted person, can roll, pass, or toss the apple as indicated, can catch the apple, and whether they continue to entrain to the external beat
8.      R=reinforce all group members who complete the task as presented by the therapist
9.      Repeat steps 2-8 until all group members have had a turn, until they start to show s/s of boredom, or until time is up

Therapeutic Function of Music:
Rhythm functions as a timing function for both the verbal interaction and the physical coordination. The use of a steady beat, either in body percussion or through an external beat, provides a predictable pattern that encourages group members to move in a patterned manner.

Melody
Pitch
Rhythm
Dynamics
Harmony
None – this is a chant
Verbal pitch may be varied to engage client attention
Steady beat with limited alteration to accommodate client verbal processing
Variable – adapt dynamics to engage group member attention
None

Form
Tempo
Timbre
Style
Lyrics
Strophic
Variable – adapt tempo to engage group member attention and to assist clients in coordinating movements – oral and gross motor
Verbal
Chant
Predictable – use of client name increases attention
Chart adapted from Hanson-Abromeit, D. (2010). A Closer Look at the Therapeutic Function of Music. Presentation at 2010 American Music Therapy Association National Conference: Cleveland, OH.

Adaptations:

  • Use different object – change words to make the chant appropriate for the new object
  • Use only one motion – roll, toss, or pass – throughout the TME


Extensions:
  • Use more than one object to increase complexity and to increase divided attention

Monday, July 28, 2014

Honesty Post - Looking and Looking

I'm in need of some inspirational thoughts.

'Tis the season for sunshine, high temperatures, and the end of summer school. So, 'tis my season for headaches, asthma attacks, and grumpiness. Added to everything else is the need to pack up my entire music therapy storage room and get ready to move as soon as we come back to school on August 7th. Added to that is the fact that everyone else is going to move into a newly renovated classroom, ready to go, while I get to move into yet another closet area. My room will not be finished for at least another month, if not two months. More itinerant therapy - HOORAY?? The good news is that all of my clients will be under one roof again. The bad news is that my stuff will be strewn all over the facility, so getting things ready may be a bit more challenging than it has been this year. Feel sorry for me yet?

So, I am looking for some inspiration.

I want a thought to cling to as I try to run therapy while everyone around me uses that time to loudly pack cabinets and boxes. I need something that will keep me from screaming when someone starts to complain. I also need a thought that will keep me going when I have to go in early and stay late so I can get some packing done. What is that thought?

This too shall pass?
 
It just doesn't matter?
 
Always look on the bright side of life?
 
Change is good?

Somehow, none of these thoughts are providing the inspiration that I need. So, off I go into the fray to arrive at work an hour early, stay at work an hour late, and then try to supervise quality therapy groups, all while trying to figure out how I'm going to get things packed up and moved to an otherwise unspecified location - some cabinets somewhere in the building...

Today's task? Crate all of the books that I have in one of my closets. Second, take some of the Orff instruments to the other closet so I don't have to take them on August 7th. Then, take home the antique chest that's been sitting in my office all year. I hope it fits in my little car.

Any thoughts on inspiration?   

 

Sunday, July 27, 2014

Sing A Song Sunday - Kiss the Girl

Today's song is from The Little Mermaid. With words by Howard Ashman and music by Alan Menken, Kiss the Girl is a familiar song to many Americans. Since it is over 20 years old, the song has become part of the musical vocabulary of at least 3 generations of clients. Its an easily recognized song and is strongly correlated with the movie which is both a good thing and a bad thing.

I use this song as either a background figure, to spur movement, or to establish or strengthen a therapeutic relationship. Many of my clients seem to be stand offish until we sing a song together. There seems to be a bit of respect given when they notice that I know every single word to their familiar and preferred songs. Using preferred music is always a good way into building that relationship.

Here's the song chart...
 What songs do you use to start interaction with clients?

 

Saturday, July 26, 2014

The To-Do List

www.musictherapyworks.comBoth of my horoscopes this morning encourage me to make a to-do list and ACTUALLY do what is on the list! I guess I will do so.

A couple of caveats here...
  • I like making to-do lists
  • Most of the stuff that is on my list is going to be cleaning stuff
  • I don't live by my horoscope, but I do pay attention when the two that I have on my news feeds say about the same thing...
The list is primarily going to be composed of household chores. Yesterday's list had a crucial item on it - sending off the giveaway materials to the giveaway winner, Christine. One medium flat-rate box later, the compendium of materials is on its way. Today's list will be a bit less crucial and more flexible, but still very important!

Here's the starting point of the to-do list for today.
  • dishes
  • laundry
  • craft room organization
  • finish a crochet basket
  • make a gift for my graduating intern
  • vacuum
  • bake potatoes
  • organize my school stuff so I can take it back to work once the new music room is completed...
During the attempt at completing this list, I will spend some time on Pinterest, wasting the time that I have available. I will watch endless episodes of my current television seasons while trying to accomplish these tasks. There will be little music played - it doesn't work as a background motivator for me. I may sing a bit (I do that lots of the time!), and I'll be constantly distracted by my feline who is currently rolled over on the ground inviting tummy rubs and trying to convince me that the first thing on my list really doesn't have to be done. (She is such a bad influence on me! That's right, I blame my cat when I don't get things on my to-do list done. Poor Kitty!)

It's time to get started on my list.

I'm going to start with the dishes. While the dishes are going, I'm going to start in one corner of the living room. I think it will be the corner in the office area. Once that corner is finished, I will spread my motivation (hopefully) to other areas in the room.

Time to get started.

Friday, July 25, 2014

Quotation Challenge - Thoughts that Spur Other Thoughts

"Compassion is not a relationship between the healer and the wounded.
It's a relationship between equals.
Only when we know our own darkness well can we be present with the darkness of others.
Compassion becomes real when we recognize our shared humanity."
- Pema Chodron
 
(Apologies to the original author of this quote as I am unable to replicate the letters exactly as they were originally presented.)
 
Wow.
 
This was in my Pinterest humor feed today. I'm not sure why a person thought it was humorous, but it struck a chord with me. I talk to other music therapists about being human and recognizing that humanity on a regular basis, especially when interacting with our clients. This thought reminds me that is important to not only understand that I am human, but that understanding my humanity is essential to being an effective therapist. 
 
I often talk to therapists who start off many conversations with the phrase, "I should have done..." I often wonder why we, as a bunch of people, feel that we should be able to see the future. Why do we put expectations of perfection on ourselves? We are just as human as anyone else.
 
I have to know and understand what I bring to every therapeutic relationship before I can be truly authentic as a member of that relationship. I also need to be able to understand myself well enough so I can make informed decisions about whether I can be part of a therapeutic relationship with each client. When my humanity interrupts my ability to interact, I have to excuse myself from the process.
 
I also cannot pretend to understand everything that my client is going through - I do not have the same experiences, but I can realize that my own experiences have contributed to my personality and to the person that I am. I have to realize that I am flawed and continue to need work in order to address those flaws...celebrate those flaws...accept those flaws.
 
"Compassion is not a relationship between the healer and the wounded.
It's a relationship between equals.
Only when we know our own darkness well can we be present with the darkness of others.
Compassion becomes real when we recognize our shared humanity."
- Pema Chodron
 
 

Thursday, July 24, 2014

Daily Practice

www.musictherapyworks.com - music, therapy, and me blogI am getting ready for a performance on my cornet in about a month. Now, I haven't played my cornet on a regular basis for several years (let's try since college), but I do play every so often and my lip is in pretty good shape. This task is a labor of love for a family at the church where I work. There is a young man who plays the trumpet who is willing to do special music, and his mom asked if I would play with him. I agreed. So, now I need to get into the habit of daily practice.

When I was just learning how to play the cornet, I was required to practice every night after dinner. I looked on it as a chore some days, but others gave me pleasure. I learned to play in those after-dinner practice sessions. When I went to college, cornet-playing was frowned upon in the dorms, and I switched my musical focus to voice, so my nightly routine changed significantly.

I've found that everything that I love is the result of daily practice.

Writing? My challenge this month is to write in this blog every day. It is a challenge to come up with something that interests me, but the nice thing about a blog is that I get to write about anything and everything. I think I'm getting better at it. The more I try, the more experience I have.

Music therapy? Practice definitely makes being a music therapist easier. I think my interns realize that about three months into their internships. All of a sudden, the job becomes less of a chore and more of a therapeutic process. I can see it in their development and know that my own development mirrors theirs, even after 20+ years of being a therapist. Good music therapy has to be practiced. You cannot simply talk about being a music therapist and be a music therapist. You have to continuously practice to keep your skills up and going.

Creativity. You absolutely cannot turn on creativity like a spigot. It has to be practiced. Practicing creativity is easy if you can get over the first hurdle - that of just starting. When I feel creativity-starved, I try to make something - music, a crocheted basket, an instrument bag, a file folder activity, a Christmas present for a loved one, something. The most difficult part is just getting started.

I forgot to practice my cornet yesterday. I have placed the instrument on my bed so I won't make that mistake twice. I have to get into the habit of daily practice so I can play along with the 13 year old on August 17th. 

Wednesday, July 23, 2014

Change is... Good?

If you are a long-term reader of this blog, you know that my facility is undergoing significant changes in how we do what we do. If you are new, here's the simple scoop. We are renovating our school area. This has led us to an entire year of being a split community, limited team contact, and itinerant therapy for all departments. This is coming to an end this school year, but not quite yet.

The kicker of this entire thing is that, after years and years of going things one way, we are changing EVERYTHING about how we do what we do!

This is causing panic.

Along with the new building format, our leadership decided it was time to get our teaching format into the 21st century. We're going to make our educational programming much more like educational programming in the other schools here in the Midwest. Many of our kids will have different teachers for different subjects. Some will change classes in a central hallway. 

The changes are coming, and the panic is starting.

I'm a person who likes change, but only when I'm part of the decision-making process. If it affects me, I like to talk about it before it starts. I like to know the reasons why, and how it will work. I also like contingency plans for what we'll do when wrinkles in the plan happen.

I am firm believer in the concept that if something isn't working anymore, then it needs to be changed.

As such, my therapeutic persona and practice has undergone many changes in my years as a professional therapist. Part of that is due to gaining more experience in working with my clients - I can tell you that all kids with diagnoses on the Autism Spectrum do NOT like music or rhythm, no matter what textbooks tell you. Individuals are just that, individuals. You have to get to know each person individually in order to interact with them in a therapy setting. As my experience has changed, so has my philosophy of music, therapy, music therapy, and my role in the profession. I hope that the growth that I've made has made me a better therapist over the years.

I often have to stop myself and remember the things that are my foundation. Music is an important experience for everyone. Music should be accessible to everyone. Music is a valuable treatment modality in the hands of a trained therapist who is able to adapt and manipulate the music with the client to move the client towards his or her treatment goals.

When I start to get bogged down in the need for better visual aids or in the day-to-day routine, I stop and think about what is most important...my clients. I hope this will never change.

Tuesday, July 22, 2014

TME Tuesday - Overview of all the Tuesdays...

It's REALLY hot here, and I haven't had the inclination to sit and do work on TMEs this week, so here are the links to all of the TME Tuesday posts that I've done. If you have something that you find interesting or want more information on, please let me know. You can email me through the website.

Not bad for an idea that started three months ago...

If any of these posts refer to things that are no longer posted on the website, let me know. I'll post the TMEs up again.

Happy Tuesday, and I hope that, wherever you are, you are cooler than we are!!

Monday, July 21, 2014

I Wonder...

(WARNING: I'm feeling somewhat unsettled and uncertain of things, so am tending to go into a philosophical state of mind...)

I wonder what the field of music therapy will look like in the year 2034.
One of my greatest wishes for music therapy is that the clients who could benefit would be able to access music therapy whenever and wherever they are. To that end, I think that music therapy will become a master's entry-level profession. I really think it has to.

I wonder what I'll be doing in the year 2034.
I'll be 64. Yikes! I hope that I will be getting ready to retire from my full-time music therapy job to go into semi-retirement. I hope I will still be working with clients and fellow music therapists at that time. I also hope that I will have won the lottery so I can afford to retire. That last one probably won't happen...

How will music therapy change in the next 20 years?
It amazes me how much music therapy has changed in the last 20 years. Our way of sharing music, thoughts, and techniques has changed significantly as technology has changed. I have moved from cassette tapes and CDs in books and books to one small device that holds my entire music library. I used to have to go to the library to find information. Now I just go to my little computer and look it up online. What will happen in the next 20 years? Will all music be available via small devices that we take with us everywhere? What will we know about music and the brain that we don't know now? I can't wait to find out!!

That's all I'm wondering about right now. Gotta go to work, so see you tomorrow for TME Tuesday! 

Sunday, July 20, 2014

Sing A Song Sunday - Peter from Peter and the Wolf

www.musictherapyworks.com

I picked up a Sheet Music magazine from the 1980's this morning for Sing A Song Sunday and found one of my favorite pieces of music inside, Peter from Peter and the Wolf by Serge Prokofiev. Hooray!

My family had a copy of the 1960 recording of this piece by Captain Kangaroo (AKA Bob Keeshan), and my brother listened to it over and over again. My sister and I also listened to it, but my brother really loved the piece. As I was looking over some of the information that's out there about the piece, I found that it was composed in order to encourage children to listen to music, especially classical music. Originally performed in Moscow on May 2, 1936, the piece has been performed, recorded, animated, and acted every since. This piece of program music presents a story.

What I like about this piece is that each character in the piece has a different instrumentation making it easy to identify each character. The differences in timbre make it a bit easier to identify what is going on in the story.

As I've been thinking about clinical use of this music, I hit upon a restructuring idea for my students working in areas of trauma-sensitive care. The programmatic nature of the music could be used to change the story making it more personal for each client. Start with six characters in the trauma situation and assign a musical theme to each character. Use the music to write the story. Who is the "hero" in the story? Who is the "threat?" Who are the people that accompanied the hero in his or her quest? What does the "hero" have to do to close the situation? Can the situation be closed?

I'm going to post this and think about how I could use this with my particular clients.

How could you use this piece therapeutically? Let me know!


Friday, July 18, 2014

The TME File - My Bag of Tricks

When I was a lowly freshman in my undergraduate program, more than 2 decades ago, my professor started me off on a habit that has served me very well over the years. We had an assignment to develop 25 Therapeutic Music Experiences (TMEs) - by the way, that's what I call them now, we called them "applications" in the olden days - for a variety of clinical populations. We had to think of applicable therapeutic goals, how to arrange the environment, and how to run the TMEs themselves. I remember it being an arduous task. We all took most of the semester trying to figure out how to write these note cards. This project became the beginning of my TME file. 

When I went to my internship, my internship director required that I develop 50 more TMEs. Her format was a bit less formal than what I had learned at school, but it fit in really well with what I was used to doing at school. I added to what I already had and kept it going as part of my professional practice.

I still have those cards and have moved my process into the 20th century (Yes, I know that we are currently in the 21st century, but I'm not quite where I want to be with the TME file yet...). I have a database and everything!
 
My current format for TMEs is based on the information that I gathered during my first attempt at developing clinical ideas. I've added to it, shifted it around, and eliminated things as they have become irrelevant, but the basic structure is still the same. I find that simply writing down my ideas strengthens those ideas in my head. I also find that I can refresh my sessions by flipping through old ideas and rediscovering TMEs that I've used and forgotten. This is my greatest tool for music therapy, my TME file!!

If you are interested in seeing my format, use this link for a blog post to the format. If you have questions or want more information, please let me know. You can contact me via contactus@musictherapyworks.com.

Anyway, I have worked with music therapists who do not write down their ideas for sessions. That's fine. Everybody does their own thing when it comes to music therapy. For me, however, placing things in a written format helps me to organize my thoughts. 

I use my file as a storage place. There are half-formed ideas, snippets of melodies, songs that started off one way and ended up as a completely different thought, and there are cartoons, news articles, and other things that seemed appropriate at the time. About a third of my TMEs are on my old note cards. The rest are stored on several jump drives so I won't have to start over again unless I get hit by a electromagnetic pulse. (Please don't do that to me, universe!) I love having everything that I may want to do with a client in my hands.

DISCLAIMER: Just because I like to write TME ideas down does NOT mean that I only do things that I have in my file with my clients. Many of my experiences with clients are improvised and then written down later (if I can remember them later). 

It's time to update the file format. I'm trying out some ideas for how to make the TME file a bit more searchable and more accessible to me wherever I am.

How do you organize your ideas? Does anyone else have a TME file?

Thanks for reading!