Friday, July 31, 2015

Favorite Things Friday - Nothing To Do

This is Day 2 of my 11 day Fall Break. I have nothing that I have to do outside of my house. There are no phone calls to make, no tasks that HAVE to be done, and no trips scheduled for today. It is an unusual event, but does happen to me occasionally.

Since there is nothing that I HAVE to do, my to-do list is sparse. I like it that way. I can get other things finished. Right now, I have three things on the list - none of which MUST be done today, but that won't keep me from doing other things as well.

I spoke to a bunch of music therapy folks about self-care last night. I always talk about the importance of finding your own pattern of self-care activities and awareness in order to help stave off things like compassion fatigue, secondary trauma, and burnout. It is important to be pro-active when it comes to self-care so you don't have to be as reactive if something happens.

For me, at least two days of "nothing to do," plays a big part in my self-care pattern. There is something refreshing about not having to do anything based on someone else's schedule or demands. If I want to bake brownies, I can. If I want to play video games all day, I can. If I want to sleep the day away and stay awake all night, I can. There is something quite soothing to this introvert's soul to be completely without expectations. This type of day offers me an opportunity to refresh my energy and interests in my way. After some time with limited expectations and responsibilities, I will be ready to get back into a routine.

I hope that you, dear reader, have a chance to have nothing to do.

I'm going to see what this day enfolds...

Thursday, July 30, 2015

Currently, I am...

Reading: Harry Potter and the Order of the Phoenix - I read these books about once a year, and I am in the 5th book right now. I enjoy these books, even though I have read them over and over again. I like the stories.

Playing: On my computer - Windows 10 is here, and, so far, so good. I am trying to figure out where things like my game tiles have gone, but everything is working pretty well. My screen goes black occasionally, but it does come back. We'll see about all of this...

Thinking: About the to-do list that I have to accomplish during this Fall Break. I get to check some things off which is nice!

Feeling: Tired, nervous, ready for a break

Watching: NCIS Season 11. Not-so-Secret: I am a binge-watcher. I've been watching one of my favorites, Mark Harmon, for the past several weeks. I am now in Season 11 and am mourning the fact that I will have seen all of the episodes in about 14 more views. What will I watch next? Maybe I'll start over!!

Listening: Squeaky fan in the back room and the NCIS soundtrack accompanied by the clicks on my keyboard...

Planning: My trip to the Worker's Compensation doctor today as well as what I am going to do in the next 24 hours.

Eating: Nothing yet, but I am thinking about the frozen burrito in my freezer, but will probably skip that in order to maintain good bowel manners during my doctor's appointment (I'm a nervous patient and don't need additional setting events to add to that).

Drinking: My staple, water!!

Loving: Vacation!

Hating: That it's only 11 days long!

Looking Forward: Figuring out what we're going to do with my knee.

Dreading: Finding out what we're going to do with my knee.

Waiting For: The sunrise. I hope it will be a good one today.

Dreaming About: Music therapy in the future... what will music therapists be doing when I retire? Students will be learning music from my generation - Take On Me, things by groups like Wham!, Air Supply, A-Ha, Adam Ant, David Bowie, Aerosmith, Metallica... the list goes on! No You Are My Sunshine for my generation!

Wednesday, July 29, 2015

The Last Day of Summer...School

This is it. The last day of summer school has finally arrived, and it is time to finish up the school year. One more day of group treatment and then it's time to focus on some self-care.

My vacation plan has changed. I was hoping to go camping for a bit or spend some time at the lake just spending time in nature and enjoying the sound of water, but my plan has changed. Now I'll be spending time at the Worker's Compensation clinic, trying to figure out what will happen with my knee. Navigating the sand at the lake is out of the picture, and the camping thing is complicated when you cannot tote or fetch things from one place to another. My self-care will have to take another path this time around.

Today's plan is to run four group sessions, figure out the Master Schedule for 12 days from now, and generally clear up the clinic space. I need to remember to bring the guitar back home for this break. I have some songs to compose for the next round of sing about songs due to be released in early September. The composition process is not difficult, but it does require the guitar and the keyboard for me to be complete and successful. Once I get back home, it is time to sign-up for insurance for next year (we get to do this online this year rather than having to meet with the school district HR department - hooray!). Tomorrow's plan is starting to take shape as well. 

The plan for tomorrow includes going to yet another doctor to start this process of trying to get treatment AGAIN. We should be able to move forward this time since the MRI is finished and we now know what is happening within the joint. I hope I will know what is next for me after about 10:30 tomorrow morning. After I get back home, it is time to putter around the house until 7pm when the next intern webinar starts (self-care!). 

It's time to get started on my today to-do list, so, see you!

Tuesday, July 28, 2015

TME Tuesday - Nana Hannah's Piano

Today's Therapeutic Music Experience (TME) is centered around a book, Nana Hannah's Piano, written by B. Bottner.

I don't use books very often. My clients don't really sit and listen well, but there are some books that work. This book works best with my middle schoolers. If you don't use books in your therapeutic process (for either TMEs with clients or for inspiration for TME development), you are missing out on a great resource for clients of all ages. Books can often address difficult topics in ways that clients will accept rather than the discussion from a therapist...


Nana Hannah's Piano TME
Mary Jane Landaker, MME, MT-BC



Purpose: To illustrate music as life-long leisure skill; sustained attention to task; reading comprehension; executive function

Source: Bottner, B. (1996). Nana Hannah’s Piano. G. P. Putnum’s Sons: New York.  TME development © 10/3/2014 by Mary Jane Landaker, MME, MT-BC

Materials: Book; OPTIONAL: reading comprehension questions (printed so group members can see); paper and colored pencils for optional extensions

Environment: Group members need to be within earshot and easy viewing of book and therapist

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.      C= show the book cover to group members and direct them to sit
2.      A= assess which group members are able to complete directives
3.      R= reinforce group members who complete the task. Redirect those who do not sit
4.      C= read the story
5.      A= assess whether group members are watching the therapist and/or the book
6.      R= reinforce group members through verbal praise and side-talking for listening and watching
7.      C= Point out parts of the book that are interesting. For example, make comments similar to, “Which baseball team does Nana Hannah like?” “How does she feel when her team loses?” “What does Sonny do to help her feel better?”
8.      A= assess which group members answer questions
9.      R= reinforce correct answers and redirect incorrect answers

Therapeutic Function of Music:
In this case, music provides the subject matter rather than taking an active role in the presentation of the story.

Adaptations:
·        Skip pages if group members do not seem interested or able to sustain attention to the entire story

·        Make a song or place a rhythmic beat behind the reading to encourage entrainment and possibly increase retention of material

Extensions:
  • Write a song to go with Sonny’s adventures
  • Discuss life-long leisure options for each group member
  • Use worksheets to identify leisure options for group members, especially those who have difficulty making decisions about what they like to do.

Worksheet Questions for Nana Hannah’s Piano

What is the name of the boy?

What does he not like to do?

What does he like to do?

Why does he have to stay with his grandmother?

What is his grandmother’s name?

What activity do they like to do together?

How does the boy help his grandmother feel less disappointed when her team loses?

What song does he figure out?

Do you think the boy will keep playing the piano?

Monday, July 27, 2015

The Aftermath of Accidents

I was injured by a client 10 days ago. I am currently steeped in the process of getting diagnoses and treatment through Worker's Compensation (an interesting thing here in the States that means that the insurance of employers pay for injuries to employees that happen on the job). I've been seen by two doctor-types and have had an MRI of my knee. I've been told that my ACL is completely ripped, so Arnold the Immobilizer and I are going to continue to be in a relationship for quite some time.

My father is angry. He is angry with the client who caused me to be hurt. He is angry with my supervisor. He is angry with the Worker's Compensation people in general, even though they haven't done anything to me yet. I suspect that some of his anger is directed towards me and my situation, but he would never actually confront me about his anger. There is a bit of helplessness in there as well - he can't fix this for me. I will always be his little girl, you know.

Me? I have my moments of anger about this, but most of the time, I am resigned. There is no use in thinking about the "woulda, coulda, shoulda" situations and the goblins they bring up. I have my moments of depression as I contemplate what is ahead of me, but I also know that this type of injury is not uncommon, so it should be able to be fixed - That's a good thing in all of this.

Another good thing about this is that my profession, music therapy, is not dependent upon working knees. I can still run webinars, sessions, training, and can still write TMEs even with a bum knee. I can still sing and play the guitar with my clients. I can't dance with them, but I can be part of the session and encourage them to engage. If I can drive (which I can, albeit with pain, but I can do it), I can get to work, and I can do what I love to do!

So, in this aftermath, I resolve to do what I have to do to get my knee back to full function. I resolve to help my father process this event and to help him see that it is not life-ending, just life-altering. I resolve not to let the depressive moments take over. This was an accident on my part. It hurt. It continues to change my life, but change is not bad. It is a reality. It is my reality, so onward! 

Sunday, July 26, 2015

Synthesis Sunday - Transformation Into Supplemental Sunday

I spend a bit of time every day thinking about what I want to write on this blog and what to send out into the universe. It's always an interesting experience to sit down and write something. Sometimes what I write makes it to this blog, but often, I go through several iterations of topics, paragraphs, visuals, and organization before I have something that I settle on.

These Sunday posts are often the most challenging for me, especially with the current title, Synthesis Sunday. At first, the title was meant to spur me into reading music therapy things - texts and articles. It worked for a bit, but now I am not really into reading about music therapy (the urge comes and goes - right now, it's gone!). I've had other Sunday themes - Song Synthesis Sunday and Song Switch Sunday - as well as this one, but I think I'm in the need for another theme for these Sunday posts.

Here are my rules - There must be alliteration! Whatever I do, I think post themes need alliteration. That's why TME days are on Tuesdays and Favorite Things are on Fridays. It's just the way I am. Alliteration organizes my thoughts. Silly, hunh? Well, it's just me.

Next rule - I have to be interested in what I'm doing. There is nothing worse than feeling stuck in a situation that you cannot get out of. That's why I have to freedom to change things here on my blog and on my website. I've been stuck doing things (projects, theses, proposals, sessions, ah, the list could go on and on), and I do not like being in a situation where I cannot be creative! Therefore, I get to change things as often as I want here. I have full control and the ability to make things interesting to me.

So, I am now in a place where it is time to shake things up a bit.

Words - song, staccato, slurp, Snickers (ooh, I am already in the mood for chocolate at 5 am, that does not bode well for the day), symbol, supplemental (I like that one for now!! I've got it!)

Next week will be Supplemental Sunday. "What is that?" you may ask? One of my most recent interns stated that her educational program called visual aids "supplementals." For the near future, I will post something that I've made to enhance my music therapy sessions or TMEs on these Sunday mornings.

I started a new one yesterday during Creativity Camp! It will be ready for pictures by next Sunday! To start us off, though, here is a picture of a former supplemental/visual aid that's been on this blog before...
www.musictherapyworks.com
 

Saturday, July 25, 2015

Camp Starts in 3 Hours!!

I am just on the edge of my seat excited about Creativity Camp 2015! It starts in three hours and will be something...

www.musictherapyworks.com
My "helper", treats, and one of the Creativity Camp projects!
I am heading into this webinar for music therapists and MT students/interns the way I head into many of my sessions - I have an idea of what I am going to do, but am viewing that idea as a possibility rather than an actuality. I've sent out "get ready for camp" letters to participants with the activities to choose from, and we'll see what participants actually want to do once we get started. 

I am hoping that this will be a time for collaboration, creativity, and networking for all of us at Camp. I've got my mini M&Ms for sustenance and my "helper," Bella, who will probably insist on sitting in the middle of all of the things that I need to do during this webinar!

Aah, Cat.

Before I start Camp, however, I have a meeting for the Online Conference for Music Therapy. Things are hopping along with this part of my music therapy professional life. The next conference will be on February 6, 2016. Our keynote speakers are scheduled. We are accepting proposals for concurrent sessions, and we are expanding what we offer to the international music therapy community. There are many, MANY things happening in this organization that will continue to grow music therapy relationships and services for people around the world!!

There are many things happening in the world of music therapy these days. I am fortunate and honored to be part of some of the things that are going on. I encourage you to find your niche in the music therapy world and enjoy it! There is something for everyone out there in the music therapy universe. 

By the way, if you are interested in the Online Conference for Music Therapy, check out this link. You can find information on the 2016 keynote speakers, the Call for Presentations, and more on that site. We also have opportunities for sponsors, volunteers, and more things come up all the time! Let us know if you'd like to join us!!

Friday, July 24, 2015

Favorite Things Friday: MRIs

This may seem strange to you, since I have spoken about my medical related anxiety disorder, but I really enjoy Magnetic Resonance Imaging (MRI tests). I have one today, but I'm not anxious about it all. I am actually looking forward to this test, believe it or not.

I had my first MRI when I was 16. It was a horrible situation that ended up completely different than the initial diagnosis (thank goodness) but I became fascinated with the entire process once I was in the device. 

Way back in those days, MRI machines were brand spanking new and extremely expensive! The hospital where I went for my test was part of a group of hospitals who had pooled together their monies so they could buy an MRI suite that traveled from hospital to hospital. When my doctor thought I had a brain tumor (long story, but I didn't), my hospital had the suite, so we went from appointment to hospital pretty much immediately.

When we got there, I checked in and asked the lady at reception if my mom could come into the suite with me (since everyone knew about my anxiety issues - we came prepared). The lady called the MRI folks. "Your next appointment was wondering if she could bring her mother with her." "How old is the client?" "How old are you, honey?" "Sixteen." "Sixteen." "Oh my goodness, she's just a BABY! Yes, she definitely needs to bring her mommy with her!"
Apparently everyone else they had seen was an older adult, so a teenager was a definite novelty for them. So, Mom and I went into the trailer and got ready.

I was apprehensive - I went into the trailer thinking that I had a brain tumor and my mind was going absolutely everywhere. I was tense, I was scared, and I was in a strange medical situation. Then the test started.

I was enthralled.

The basis of rhythm as a diagnostic tool hit me deeply. At 16, I knew about music therapy, but all I really knew was that there were people out there who did music therapy. So, a medical test that used rhythm expanded my ideas about what music therapy could be. The rhythms that I was bombarded with during that 90 minutes made me think about other things that rhythm does. I was able to think about that while in the MRI tube staying completely still.

My brain started to organize the patterns. I was singing songs in my head that matched the rhythm and tempo of the MRI machine. It was difficult to stay still, but the rhythms filled up my brain so I could stay still. As the test concluded, I had a specific song in my head. The same song was playing on the radio as I walked out. I have no idea if I could hear the song from the suite or not. The entire situation was strangely provoking and stimulating at the same time.

I am still enraptured with these types of tests. It thrills me that the human body responds to rhythm and tones on a cellular level. I'm actually looking forward to this procedure today to diagnose the damage to my knee so we can move forward.

(If you are interested, I did not have a brain tumor. The indicator that my doctor had seen, along with the onset of my balance disorder, led me into many years of ophthalmology appointments, significant tests to rule-out other conditions, and an eventual diagnosis of a birth defect and Meniere's Disease. I'm thinking this upcoming diagnostic process should be much simpler than that one was. The best part about the MRI way way back? My doctor told me that my siblings could NEVER accuse ME of being brainless! He had seen pictures of my "beautiful brain!" He knew our family REALLY well!!)

So, I'm going to leave for the hospital in a couple of minutes to go into my second MRI. I hope I will still find it fascinating and will be able to relax enough to enjoy this process yet again.

Happy Friday!

Thursday, July 23, 2015

Favorite Thing...Rats, It's Not Friday!

This has been a week out of time. You know the ones - the weeks where you aren't quite sure which day it actually is because things get scrambled in your schedule, so you don't actually do what you usually do on each day??? This week has been all scrambled and mixed up. What a mess...

I was almost ready for a Favorite Things Friday post today. I was looking around for something that is one of my favorite things (by the way, I'm running out of things to talk about on Fridays, so the theme may be changing pretty soon). I knew it wasn't Friday. After all, I'm getting dressed into my uniform for work, but my brain was thinking "Friday, Friday, Friday." If it actually was Friday today, I would be getting ready for a trip to my least favorite city (when it comes to navigating) for an MRI. So, here I am, on a THURSDAY, trying to come up with something to talk about.

One of the things that I try to do in this blog is to give a glimpse into the everyday life of a music therapist (me). Sometimes I write about music therapy things, issues, questions, and conversations. Other times I write about the minutiae of my life as a music therapist, so things do not always center on music therapy techniques or therapeutic music experiences (TMEs). Today's post will be one of the "this is a glimpse into my life" kinda posts.

I got hurt at work about a week ago. It was a client-incident and led to something popping in my knee that has kept me from walking, standing, or moving the way I usually do. I feel like a much-older woman as I hobble from place to place, have to use my transfer skills (learned from my mother, the Occupational Therapist, who knows how to transfer folks), and am constantly adjusting my IMMOBILIZER (I'm thinking about naming mine since it's now my most constant companion - what do you think about Arnold?) so I can move even a little bit. I am having to change my way of doing music therapy. I can no longer be a dancing participant, so I have to watch while my students dance and jump. I'm getting real tired of being hurt, but I know that I have to be patient.

My disordered week is completely related to this injury. I had an interruption of my plan for the weekend, I nearly forgot an intern webinar last Thursday evening, and took a day off on Monday for medical reasons. So, my first day at work this week was Tuesday, not my regular Monday. Every thing has been a bit out of whack, including myself!

It's interesting what clients notice versus what staff members notice about the people around them. Most of my clients notice that I am sitting on a chair right now instead of the floor. Several of them notice that I am wearing a skirt (the better to manage Arnold (hmmm, that sounds a bit hinky - I think I like it!), and others move along completely oblivious to others. Most of the staff members are in the oblivious category - they get offended when I don't leap up to physically assist a client (I'm not allowed to and it's killing me!). There have been complaints that are easily squelched when they see Arnold, the immobilizer.

Injuries happen. They happen to all of us at one time or another, and it's important to figure out ways to do your job, even when you are hurt. This is not a career-ending injury for me - I can still do music therapy - but it might seriously alter how I do this particular job. I cannot be alone with a kid right now since I cannot guarantee that I can do everything possible to keep that kid safe. Things may have to change, but I am flexible.

I will move into this day, trying to accept my new reality, and to continue to do my job. Tomorrow, I take another (huh) step towards a diagnosis and treatment process. Arnold and I will spend some more quality time together, trying to get around, slowly but surely. It's nice to have someone that supports you in your everyday activities...

Be safe out there, therapists! 

Wednesday, July 22, 2015

Crocodiles

My apologies to the person who took this photograph. It is from National Wildlife, August/September 1999 edition, and from an article entitled "Okefenokee Swamp." I do not have the credit for either the author or the photographer, so this is all the information that I have. 

I keep a book of images. It's just magazine pictures that I've collected over the years. The images have to intrigue me in some way. Sometimes it's humor that draws me in, sometimes not. This was an image that isn't humorous, but it's fascinating to me for some reason.

What do I do with these images? I use them as inspiration for writing. Today's blog post is brought to you via this image because I am a visual person who uses pictures to think through things. These are often the inspiration for songs that I write for no reason other than needing to write a song. Those types of songs don't often make it into therapy, but they act as a therapeutic outlet for me, so they are therapeutic in nature.

I think this particular picture called to me today for the simple reason that the image offers so many levels of complexity and offers me food for thought.

Here's how I'm processing things right now (and maybe how I'm processing my own life through this visual as well).

This image offers a glimpse into the life of this group of crocodiles (I think they're crocs, blunted nose and all - they may be alligators, though). They are swimming in a group. There are many levels of croc bodies here. Crocs swimming over crocs, going in all directions. They seem to be peaceful, but we all know their potential. You can see arms and legs, but not many of them. Just lots of crocodile heads moving from one place to another. Everybody has a place to go, but no one seems to be too much in a hurry. They just seem to be going somewhere. I feel peace in this picture.

So, how does this correlate to my own existence? 

As a therapist, I think of this group of animals as the issues that my clients bring into every music therapy sessions. We all bring in our crocodiles - worry, anxiety, past trauma, current issues - sometimes they swim along peacefully. Sometimes they don't. Sometimes one of those crocodiles gets agitated for some reason and then the rest of them start to twitch, move, and share in the agitation. Once the frenzy is over, the entire group is able to calm again, but you have to survive the frenzy. It is difficult to separate one crocodile (issue) from the bask or float (the name for a collective group of crocodiles). When one starts, all join in. The issues we bring into a session are like that. A song might stir up the anxiety crocodile which, in turn, starts the trauma crocodile to twitch, which stimulates the fear crocodile...

There should never be a time when a therapist tries to avoid stimulating the crocodiles, but the therapist needs to be able to handle the frenzy that happens. (This is where continuing education and professional supervision fits into a therapist's life - being able to handle what each client brings into the music therapy session.) There are times when I accidentally agitate the trauma crocodile and the crocodile that actually snaps at me is the refusal croc. I may have stirred up something and the manifestation is something completely different. The responses look very similar, much like the picture of these crocodiles. There are some individual differences, but they are not often easy to see.

It's my job, as the therapist, to try to figure out which crocodile is starting the frenzy. 

I'm off to stir up some crocodiles today. (It is Wednesday, after all.) Let's hope that they will simply bask, but if they don't, let's hope that it will be easy to determine which crocodile sets off the entire bask. If not, let's hope that I will gain some insight into each group of crocodiles that my clients bring with them.

Tuesday, July 21, 2015

TME Tuesday - My Favorite Chord Progressions

I'm taking the easy way out today. Rather than giving you a Therapeutic Music Experience (TME) like I usually do, here is a list of the chord progressions that I use during most of my improvisations. Please use them to write your own music - there are some good ones in there...

I, vi, IV, V7 (of course!)
I, I7, IV, I, V7, IV7, I (again, of course!)
I, IV, I, IV, ii, V7, ii, V7, I
i, iv, v (yep, I REALLY mean the minor v - good modal sound)
I, V, IV

Sorry for the brevity, but I'm trying to go back to work today after an injury, so am going to try driving the distance with a ruined knee. I need enough time to try it, see if I can do it, and then hobble into the music therapy room which is destructed after the incident where I got injured...

Ah, the life of me...

Monday, July 20, 2015

Soft Kitty, Warm Kitty

I'm a big fan of the Big Bang Theory. I love Sheldon's sick song, Soft Kitty, and I sing it to others when it's called for. My favorite use of the song in the show is when Penny is injured and makes Sheldon sing the song to her because "injured and drugged is a kind of sick" (or something like that). Not only does she make him sing his song to her, but she makes him change it. It becomes a round and demands participation from both parties to make it work. From then on, Sheldon uses the round idea when he is with his friends, but not with his mother. He wants his mother to sing it to him the way he always has heard it - just her singing to him when he doesn't feel well.

It amazes me how songs become inexorably linked to situations, people, and memories. I am fascinated with how we can remember obscure jingles for products long gone, even when we don't intend to remember that information. The music seeps in and stays.

What is it about music that makes it stick? There are lots of studies out there that attempt to explain it, and I read through them, one at a time, attempting to fully understand our therapeutic medium and our brains. Maybe I'll know why someday, but I'm not sure that I'll be around long enough to know what happens in the brain when music is in the environment. Who knows?

For now, I'll spend some time with my own "Soft Kitty," singing to myself because "injured...is a kind of sick."

Happy Monday, all!

Saturday, July 18, 2015

It's Almost Time For Creativity Camp!

Next week is Creativity Camp 2015. We're going to make some things next Saturday - things that any music therapist can use with someone in their caseload. We're going to compose, write therapeutic music experiences (TMEs), and make some visuals and materials for use in music therapy sessions. I'm developing my camp schedule right now for my campers.

For me, making things is part of the fun. I like drawing (I'm not a professional artist, by any means, but I like to draw things), and I like writing songs and TMEs for my clients. I enjoy being creative in the company of others. There is something inspiring about seeing what others do when given a starting point for creativity. The best thing is that their starting point is often my ending point, so I get more ideas when others take mine and adapt them.

If you are interested in signing up for Creativity Camp, there is still time. Details are at this link on my website. See you then? 

Friday, July 17, 2015

The Best-Laid Plans - A Not-So-Favorite-Thing-Friday

You know how you go through a day with a certain plan?

You start off thinking that things are going to progress in a specific manner. You're going to drive to work, get kids of their buses, do some music therapy, put kids back on their buses, and then go home again to start your weekend? Yep. That was the plan for yesterday. Then there were plans for today, tomorrow, and Sunday. Good plans.

The plan didn't work out as planned at all. First of all, it ended kind of abruptly when I got pushed during a safety assist with a client and something in my knee just popped. Second, I never plan on spending time in an emergency room, but there wasn't really any other choice. Third, I never planned on almost forgetting the interns who were waiting for me to start a webinar about Time Management and Organization that completely slipped my mind as I was hobbling about on my non-operational knee feeling sorry for myself. Once I finally remembered that it was Thursday night, I had to hobble to the wired internet connection (the better to stream a webinar with, my dear), wait for everything to hook up, and then apologize profusely to the confused folks who were waiting and wondering. (Did I mention that I was so disorganized that I FORGOT the webinar on Organization???? What a great example I'm being this time around! Ugh.)

Right now, there are many unknowns for what's going to happen due to this injury. The ER couldn't do anything except tell me to get an MRI. I had to be driven home since I drive a car with a manual transmission and couldn't depend on my knee for any type of weight bearing. Right now, I'm waiting for the school district office to open so I can get some guidance for how to proceed in my treatment. Then, I am sure that I will have to get creative on how I'm going to get to go where I need to go today.

It's a good thing that I have Fridays off during the summer, but I didn't plan on doing all of this on my day off, and I had plans for this weekend.

Isn't that the way things go? Make plans for the weekend that require physical work and bust out your knee so you can't walk on it without significant rods supporting it. So much for making new bookshelves and digeridoo this weekend. If I can't drive, I certainly can't do any traipsing around Home Depot carrying 2X10 shelves and PVC pipe pieces. Oh well.

The good thing about this situation? I will get to know the Worker's Compensation system from the inside out. I will find ways to get things done that do not require me to drive. I will figure out how to do my job when I'm not at full body strength. Fortunately, my job as a music therapist is not dependent upon working knees. 

I don't know if I can get myself to work on Monday, but I will try.

I am fortunate that my job doesn't require me to walk right now. I can do almost everything without needing to move, but individual sessions will have to be delayed since I cannot guarantee that I can do everything to keep my clients safe. That will give me more time to think, compose, and make up my schedule. In short, I will be a basket case within a week.

Pity party over. It's time for self-care of a medical sort. I need to call the district, figure out how to get an MRI, and get that done. I need to know answers and will try to get them figured out.

Plans change.

Thursday, July 16, 2015

Session Contour - One of Those "Important, But Difficult to Learn" Things

I hopped over to Music Sparks, JoAnn Jordan's very engaging website, this morning to read about her ideas for developing session plans for challenging times. I was heartened to read that her ideas are very similar to my own when it comes to planning sessions - check it out - and her post started me thinking about what I do when it comes to session implementation. What do you after you have designed the plan?

So, this is kind of a continuation of the ideas that JoAnn shared.

What do you do after you've designed the plan, the session has started, and the client is sitting in front of you, waiting for the next thing to do?

One of the things that I like about music therapy is that the therapeutic medium itself, music, is easily adapted to fit many different situations, responses, and needs within the moment. Many music therapists instinctively alter musical elements in order to assist their clients in engaging with the medium during each session. We often play our music at tempi that match indicators displayed by our clients. We slow down when our clients appear to need slower tempi. We speed up when our clients show us different behaviors. We match our music to their moods, behaviors, and requests. I call this practice "session contour."

Like I said, many music therapists do this instinctively. You walk into a room filled with clients who seem tired. Your session plan includes dancing to upbeat music. At this point, you have several paths you can take when implementing your session. You can run your session, using the upbeat music exactly as planned, and see what your clients do. You can change your session plan completely, abandoning what you had prepared. You can alter the music for dancing, still using the ideas of movement, but maybe slowing down the tempo and maybe adapting the targeted movements. All of these examples are part of session contour.

Session contour includes all of the musical elements that are available to us as musicians, therapists, and the lovely combination of the two, music therapists. When I sit in front of any client, I have many decisions I can make regarding pitches, tempi, melodies, harmonies, chord progressions, rhythms, meters, modes, lyrics - all of these elements affect my session contour. The image below demonstrates my thought process when I start to adapt the music to fit the client.
www.musictherapyworks.com
When I start to change these elements, I am affecting how my client experiences the music we are making. I can adapt music to make it more accessible to my client. I can adapt music to make it less accessible for my client. Changes in these musical elements provide the foundation for session contour.

Session contour is closely related to the ISO-principle - the act of making music match indications that clients display during interactions. You use the ISO-principle to construct your session contour, looking both at where the client is when it comes to behavior indicators and where you want the client to be at the end of the session on those same behavior indicators. (If you are not someone who feels that behavior is an indicator, please know that we all read behavior from our clients in some way. You do not have to be a behavioralist in order to look at how people present themselves, communicate, and engage.) 

At the end of all of this, you have to remember that all of the session plans that you can write are, at the end, simply suggestions or possible strategies until the client walks into the therapeutic space. I can plan any and every session under the sun, but the client is the one who determines what I do during my sessions... AND THAT'S THE WAY IT HAS TO BE! If I walk into a session with my beautiful plan and do not spend time adapting that plan to my client, the session is a wonderful performance, but may not have as much therapeutic relevance as it could.

For me, music therapy is half structure and half improvisation.

I have to have a plan when I organize my music therapy day. This is where session planning is essential. BUT, I also have to incorporate the interests, attitudes, long-term goals, and immediate needs of the client who walks into the session from their own experiences and with their own plans. This is where improvisation (flexibility) comes in. Without the foundation of a plan, therapists may not address long-term goals (which, to be perfectly honest, is the only reason that anyone goes into therapy to begin with - completing long-term goals) and leave the client without opportunities for growth.

In my opinion, the best therapists I have ever known have been able to find a balance between therapist-direction and client-direction during a session. It is something I strive for during every session. Sometimes, I accomplish a good balance. Sometimes, I don't. I continue to strive.

Thank you, JoAnn, for your stimulating post. Thank you, everyone else, for reading. Feel free to comment on any and all thoughts presented here...

Wednesday, July 15, 2015

Care of Self - Important

Self-care. It's a thing that I spend quite a bit of time thinking about, especially on days like this when I am really looking for an excuse to stay home and chill out in front of the Air Conditioning rather than going to work and have a session with a group of kids that don't like music therapy and an Air Conditioning System that can't keep up with the demand. Part of my hesitation comes from the one group that I have today that challenges me over and over again, and the rest comes from the temperature of the past two days.

It's been hot. It's been humid. It's been miserable, and add onto all of that the inability of any of us to go outside and get rid of our energy, and it's been a rough week. It is now halfway over (one of the best tools for self-care during the summer is the four-day work week!), and the heat has broken a bit. The humidity hasn't, but at least the heat is going to diminish.

So, what am I going to do for some self-care today? First of all, I'm going to work. It is the responsible thing to do since I haven't spent any time preparing to be gone. I'm not sick, I'm just hot (temperature-wise). When I get home, I'm going to figure out something that'll be a treat for me. I won't know what it will be until that time. 

Do something for yourself today. Happy self-care!

Tuesday, July 14, 2015

TME Tuesday - Perfect Day

Today I need some pep. I need it from somewhere, so I'm going to use one of my favorite pep-inducing artists, Hoku, to manufacture some much-needed energy. If you don't know about Hoku, don't feel bad. She was a flash in the days of Britney and N*Sync, but she had some catchy tunes that just resonate with me. My favorite? Another Dumb Blonde, but today's therapeutic music experience (TME) is based on another song of hers that you have probably heard, Perfect Day.

Here's the TME.
www.musictherapyworks.com 


Purpose: To expand abstract thought concerning leisure activities; social interaction; musical expression; leisure skill awareness; impulse control; receptive language; expressive language

Source: "Perfect Day" as written by A. Armato & T. James. Lyrics © DOWNTOWN MUSIC PUBLISHING LLC, Warner/Chappell Music, Inc., Universal Music Publishing Group. Track duration: 03:29. Performed by Hoku. © 2013 TME Procedure by Mary Jane Landaker, MME, MT-BC

Materials: Song recording; music listening device; electricity; lyric sheets; OPTIONAL: guitar, prepared fill-in-the-blank sheets and pencils/pens or dry erase lyric strips for word replacement

Environment: Group members near to therapist and listening device to be able to hear song and sing, if desired. Group members may also need to be close enough to the therapist to see lyric strips (if used).

Song/Chant/Words:
Legally Blonde Soundtrack or available on iTunes.

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.      C= start recording of song. If using them, pass out lyric sheets or place lyric strips on ground for group members to see
2.      A= assess whether group members are listening to the music – are they moving to the beat? Are they signing with the performer? Are there other indications of listening present?
3.      R= reinforce group members who are attending to the music through verbal reinforcers or non-verbal reinforcers. Redirect other group members through pointing to words or moving closer and singing
4.      C= When song is complete (or before if necessary) ask the group to relate the song story.
5.      A= assess whether group members can identify the theme of the song as a “perfect day” where the singer can do things that she likes to do
6.      R= reinforce correct answers. Redirect group members who offer incorrect answers and ask them to clarify their answers
7.      If needed, listen to the song again, repeating steps 2 through 6.
8.      C= ask group members to describe one aspect of their idea of a “perfect day.” Aspects may include any or all of the following as well as additional suggestions:
a.       Place
b.      Food
c.       Time of day
d.      People around
e.       Things to do/activities
9.      A= assess whether group members can complete the request
10.  R= reinforce all answers that complete the question originally asked
11.  C = offer suggestions of answers if group members appear confused
12.  Repeat steps 8-11 until group members appear to show s/s of boredom, inattention to task, and/or time runs out

Therapeutic Function of Music:
The recording of the music is upbeat, perky, and offers a good accompaniment pattern to the theme of the song. The music illustrates the content of the lyrics. The song is familiar to people who have watched the movie, Legally Blonde. When played live, the therapist is able to adapt the pitch, dynamics, tempo, timbre, and lyrics to accommodate the needs and preferences of the clients in the group.

Melody
Pitch
Rhythm
Dynamics
Harmony
Covers an octave; repetitive
Variable based on client preferences and needs

4/4; some syncopation
Variable based on client preferences and needs

Major tonality; V,ii,IV,I (Appears to be in the key of G but starts with a D chord – in key of D the chords would be I, ii/V, IV/V, V)

Form
Tempo
Timbre
Style
Lyrics
AB with bridge
Original recording approximately 120bpm; Variable based on client preferences and needs

Variable based on client preferences and needs

Popular rock of the 2000’s
Discuss the concept of a perfect day; Can be changed to reflect client preferences
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 original lyrics with accompanying instrument to encourage gross motor movement

Extensions:
Ask individual group members to write verses or entire songs that apply to their idea of a perfect day  

Enjoy!!