Starting to Run
I am in a strange place in my rehabilitation process. If you don't know by now, (welcome, reader!) I had a complete tear of my left Anterior Cruciate Ligament last July. It was in a work-related incident where a client became very destructive towards my $1200 keyboard. I got pushed, I twisted, and the knee just popped. I had surgery to replace the ACL in December, and I started physical therapy in January. I've been in PT almost every week since that time. (I had to skip one week when my PT was completely booked - not my fault and the only "break" I've had since my injury.) I am currently feeling both accomplished and depressed about my injury as well as my recovery.
I think I've hit the "But I Should Be Completely Better By Now" wall in my recovery process.
I can recognize how far I've progressed in my recovery. After all, I can now bend my knee almost as much as I can bend the other knee. I walk without support (except at work where I still have to wear my brace). I can walk without a limp when I concentrate. My clients are noticing that my gait is becoming more smooth (nice change of pace, that! My kids noticing my gait rather than me noticing theirs...).
My PT seems to know that I am going through this period of time in my recovery (it probably is something that all of us go through at about 20 weeks post-surgery). He told me that I have really progressed well. I am pressing 250 pounds with my left leg right now. I am jumping, and last week started running!! I still can't do some of the moves that I need to be able to do in order to be recertified in the physical behavior management system that we use to ensure client safety, but I am allowed to try them. Couldn't do that three weeks ago. I started kneeling on Monday (in my brace, but still - hooray - I need to be able to do that for behavior management and CPR). I am able to do so much more than I have been able to do since surgery, but I am starting to be impatient.
How does this relate to my role as therapist?
The thing that is making this entire process a bit more palatable is the conversation that my PT initiated on my progress. He recognized something in me and my attitude towards doing things around the gym and was able to pull out the therapeutic relationship part of being any therapist and took the time to talk to me about my progress. That is such an important part of being a therapist - reflecting on the process and reminding our clients (who may be frustrated or unaware) of the progress that they have made towards their goals, as well as setting clear goals for when the process is over. (That is something that is missing from my therapy - I don't know when it will be over. I'm not sure what I need to demonstrate in order to be considered "rehabilitated." I know what I want to do, but I'm not sure the workers compensation folks will agree with my exit criterion. Hmmm.)
Every therapist has to realize that there has to be an end to the therapeutic process. Sometimes clients cannot or do not want to end therapy, but it needs to happen at some point. We, as therapists, have to realize that our job has to come to an end. That is the point of therapy - getting clients to a place where they no longer need us in order to do what they need to do.
This is something that is difficult for me to do based on the life circumstances of my clients. They do not often stay for set periods of time. They are often discharged from my treatment (and the program) based on things like availability of homes or insurance money or legislative decisions. These changes often occur at a moment's notice without any type of time for termination of the therapeutic relationship. I have to let many of my clients go into a world where music therapy is not possible.
On the other hand, I get to provide music therapy for each and every client that walks into our facility - there is no requirement for "qualifying" for music therapy - it is a guarantee for all of my clients. That's definitely a benefit to my job. I know that all of my clients get to explore the world of music for therapeutic benefit for at least part of their lives.
It is important for therapists to point out progress to clients. It is important to celebrate what has been accomplished and what is now possible because of hard work. It is important to recognize what music therapy can do for a client. (By the way, this is why we document and track data!!)
Go out there and celebrate that client who is now able to regulate his or her emotional response to someone else through music therapy techniques. Celebrate the client who sings during preferred music and is starting to use sentences. Celebrate the client who is starting to run after not being able to stand for a long time.
Celebrate.
I think I've hit the "But I Should Be Completely Better By Now" wall in my recovery process.
I can recognize how far I've progressed in my recovery. After all, I can now bend my knee almost as much as I can bend the other knee. I walk without support (except at work where I still have to wear my brace). I can walk without a limp when I concentrate. My clients are noticing that my gait is becoming more smooth (nice change of pace, that! My kids noticing my gait rather than me noticing theirs...).
My PT seems to know that I am going through this period of time in my recovery (it probably is something that all of us go through at about 20 weeks post-surgery). He told me that I have really progressed well. I am pressing 250 pounds with my left leg right now. I am jumping, and last week started running!! I still can't do some of the moves that I need to be able to do in order to be recertified in the physical behavior management system that we use to ensure client safety, but I am allowed to try them. Couldn't do that three weeks ago. I started kneeling on Monday (in my brace, but still - hooray - I need to be able to do that for behavior management and CPR). I am able to do so much more than I have been able to do since surgery, but I am starting to be impatient.
How does this relate to my role as therapist?
The thing that is making this entire process a bit more palatable is the conversation that my PT initiated on my progress. He recognized something in me and my attitude towards doing things around the gym and was able to pull out the therapeutic relationship part of being any therapist and took the time to talk to me about my progress. That is such an important part of being a therapist - reflecting on the process and reminding our clients (who may be frustrated or unaware) of the progress that they have made towards their goals, as well as setting clear goals for when the process is over. (That is something that is missing from my therapy - I don't know when it will be over. I'm not sure what I need to demonstrate in order to be considered "rehabilitated." I know what I want to do, but I'm not sure the workers compensation folks will agree with my exit criterion. Hmmm.)
Every therapist has to realize that there has to be an end to the therapeutic process. Sometimes clients cannot or do not want to end therapy, but it needs to happen at some point. We, as therapists, have to realize that our job has to come to an end. That is the point of therapy - getting clients to a place where they no longer need us in order to do what they need to do.
This is something that is difficult for me to do based on the life circumstances of my clients. They do not often stay for set periods of time. They are often discharged from my treatment (and the program) based on things like availability of homes or insurance money or legislative decisions. These changes often occur at a moment's notice without any type of time for termination of the therapeutic relationship. I have to let many of my clients go into a world where music therapy is not possible.
On the other hand, I get to provide music therapy for each and every client that walks into our facility - there is no requirement for "qualifying" for music therapy - it is a guarantee for all of my clients. That's definitely a benefit to my job. I know that all of my clients get to explore the world of music for therapeutic benefit for at least part of their lives.
It is important for therapists to point out progress to clients. It is important to celebrate what has been accomplished and what is now possible because of hard work. It is important to recognize what music therapy can do for a client. (By the way, this is why we document and track data!!)
Go out there and celebrate that client who is now able to regulate his or her emotional response to someone else through music therapy techniques. Celebrate the client who sings during preferred music and is starting to use sentences. Celebrate the client who is starting to run after not being able to stand for a long time.
Celebrate.
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