Tuesday, May 31, 2016

TME Tuesday: Lonesome Traveler

I am feeling a bit lonely these days, and I am reveling in the feeling! This is why regular doses of time alone is so important for me as a therapist. I am getting tired of being by myself, so I'll be able to go back to work with a ready attitude. This therapeutic music experience (TME) offers an opportunity to reflect on being alone while traveling.

Therapeutic Music Experience
Lonesome Traveler
Mary Jane Landaker, MME, MT-BC

Purpose: To stimulate discussion about traveling, being alone, and other topics; to encourage entrainment to an external stimulus; social interaction

Source: Hays, L. (1950). Lonesome Traveler. TME development and procedure © 2015 by Mary Jane Landaker, MME, MT-BC

Materials: OPTIONAL: accompanying instrument; rhythm instruments for group members

Environment: Group members where they can hear the song leader.

This song has been covered by many different groups. Here is a link to the performance by The Weavers: https://www.youtube.com/watch?v=w5vmDL85vt4

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.      C= start singing song.
2.      A= assess whether group members start to demonstrate awareness or entrainment behaviors during the song.
3.      R=reinforce all attempts and efforts to sing, to move, and to engage during the song presentation.
4.      C=choose whether to sing the song in its entirety or to stop singing after one verse and a chorus. Ask group members to analyze the song lyrics.
a.       Have you ever traveled by yourself?
b.      Have you ever felt like the singer in this song?
c.       Where have you traveled?
d.      How have you traveled?
e.       If you were going on a trip right now, where would you want to go?
f.        How would you get there
g.      Advanced question: Do you feel like you have the freedom that the singer is looking for?
h.      Other questions as appropriate for the group members
5.      A=assess whether group members are able to answer the question.
6.      R=reinforce all responses.
7.      C=sing song again, encouraging group members to sing along.
8.      A=assess whether group members can sing along.
9.      R=reinforce all attempts by group members to sing.
10.  C=ask group members to change the lyrics to illustrate their lives.
11.  A=assess whether group members are able to complete task.
12.  R=reinforce all responses through singing the song again and changing the lyrics to match what group members suggest.
13.  C=continue until group members have one turn each, start to show signs of boredom, or time runs out.

Therapeutic Function of Music:
The repetitive nature of the song makes it easy to remember and replicate. The upbeat tempo encourages entrainment and movement to the music. The lyrics repeat, offering several opportunities to engage group members in verbal interaction and singing.

Primarily step-based; repetitive pattern
Variable based on client needs and preferences
Variable based on client needs and preferences
Variable based on client needs and preferences
Minor format – i, IV, V – modal harmony

Verse - Chorus
Variable based on client needs and preferences
Variable based on client needs and preferences
Repetitive; offer a story; easily varied to accommodate group members’ contributions
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.

·      Rewrite the words to illustrate what group members experience in their traveling to and from treatment or in the community.

  • Ask group members to write about their own travelling experiences.


Monday, May 30, 2016

The Meaning of Memorial Day

It is Memorial Day here in the States and is the day that we've dedicated to remembering those who have died in service to their country in the armed forces.

There is a difference between Armed Forces Day (the day we recognize all those currently serving), Memorial Day (see above), and Veteran's Day (the day we recognize all those who have served in the past). I think many of us do not really understand the function of these days in our country's history and tradition. I have to admit that I am one of those people.

My grandfather on my Mom's side was a veteran. He was in the Army during World War II. He didn't much talk about his experiences; at least, not with me. The other person that I know who has served our country in the Armed Forces was my cousin who was in the Navy for a time. Since they are veterans, the meaning of the other two days has been pretty much lost to me until this year.

Now I know the meanings of these days, so I can appreciate them a bit more.

Remember those who have paid the ultimate sacrifice in service to our country. It is their day.

Sunday, May 29, 2016

Supplemental Sunday: Rules for Making Visual Aids

I spent most of Friday morning pulling together some visual aids for my clients to use once we get back to music therapy sessions. I love making things that I can use in my music therapy clinic, and I enjoy watching my clients use them later. As I was taking pictures and getting things ready for the final presentation (which isn't finished yet), I thought about the little tips and techniques that I've learned from others and developed myself (through lots of trial and error!) over the years.

If you are interested in getting into the visual aid making side of things, the first thing you need to do is to gather your materials. Here's a list of things that I recommend that you get for easier assembly of visual aids:
  1. Several pairs of scissors - You need one pair for cutting paper, another pair for Velcro, and (if you are a scissors fanatic) another pair for cutting laminate. Believe me, having several pairs will make your life easier as you will not be gunking up the paper scissors or dulling the laminate scissors. Decorative blade scissors are also fun to provide some variety in textures.
  2. Self-adhesive Velcro - I am coming around to the idea of spending more money to purchase the Velcro dots, but I've always just cut my own pieces. Cutting my own leads to gunky scissors, so I also have some Goo Gone to help get rid of the adhesive - hence the reason I'm thinking I should start buying the coins - no more gunky scissors.
  3. Card stock - this makes all moveable pieces sturdier. I always use card stock to back any of the pieces that are to be manipulated by clients. I both print directly onto the card stock (get a strong printer) or on paper and then backed with the card stock. I recommend lots of different colors when you are purchasing stock.
  4. Copy paper - again, lots of different colors make things more interesting. This is used for all the pieces that stay on the folder or that are not manipulated and for transfer onto card stock, if needed.
  5. Laminator - I cannot stress this enough - GET A GOOD LAMINATOR! If you are at all interested in making your own visual aids, spend a bit of money to get a laminator that will allow you to laminate file folders as well as small pieces. I have one from Fellowes that I absolutely love. It takes the 12X18 inch menu lamination film that I use for file folders, but it also laminates business card sized pieces. Believe me, the cost of a good laminator more than makes up for itself in convenience, ease of access, and availability.
  6. Laminating film - I get my menu sized film at a place called Lamination Depot. I also get 9X11 film there as well. These are the two sizes that I use most often.
  7. White-Out/Liquid Paper - Mistakes happen. Embrace them, but have lots of correction fluid on hand.
  8. Markers/Colored Pencils/Stickers/Rulers/Pencils/Good Erasers - These things make things look pretty.
One of my cutting boards
I also have several other tools that I love to use, but that aren't essential to the process. I use several bladed cutting boards and a corner rounder. I like round edges rather than sharp edges, so my corner rounder gets a workout. I use the cutting boards to trim the file folders. They do not get completely covered unless I trim off about 1/4 of an inch, so I trim off the extra part of the front of the folder so everything will be laminated. Then, I use the corner rounder to make everything look purposeful.
Photo Stickers

My other cheat tool is to use photo stickers to stick layers of visual aids together. I also use them to tape the different pieces to the laminate so things don't slip during lamination. I hate it when I laminate things that don't stay where I put them.

This week's projects included making some generic storage folders for my group therapy boxes (you can see one of them in the green folder example). 

I also made some color-coded "I feel" indicators for inclusion into the boxes. There are six of each of my box colors - green, red, blue, and purple. These go with the emotion pictures that I've been writing about for some time now. I have sets of emotion pictures that are also color-coded (this will help me keep things sorted later on). Those sets have their own folders (also color-coded). The intent is to have the client look at the emotion word choices available, choose one or two, and then share their emotion with the group.

I also worked on the Rock Band project. I spend one week per month talking to my clients about musical instruments. We've been through the instrument families, so now we are moving on and talking about instrumental ensembles.

I found some clip art of the four major instruments in rock bands - guitar, electric bass, drum set, and keyboard/synthesizer. I copied them, cut them out, and backed them with card stock (again, color-coded for sorting purposes). I traced the shapes onto one piece of paper and then wrote descriptions of the instruments onto the piece of paper. I also put small "v" indicators where I'll put the velcro pieces (if I don't do that during the design phase, I forget that I need space for the velcro).

The basic idea is to match the shape to the shape, but I can also use these with my other clients as well. We can discuss the different parts of the rock band while also talking about what we have already learned - instrument families, how to play instruments, what role each instrument plays in the band, and whatever else comes up.

The last project was a series of Yes/No or Stop/Go indicators.

Everything is now laminated and is being cut out and Velcroed for use in a week. I am always excited to finish projects, but I am always more excited to share them with others - clients, fellow therapists, others! Happy Supplemental Sunday!


Friday, May 27, 2016

Knee Deep in Laminating Film

Since I am currently at home for Summer Break, I am catching up on some of the projects that I've envisioned over the past couple of months. 

I finished a series of theme folders based on the TMEs that I've used for four classrooms at my workplace over the past two years. The folders have the topic listed on the tab and then a sheet of paper that has the TME ideas written on it. In addition, I put the masters of any visual aids that I've made or found so that they are all together. Right now, the folders are very basic, but they will grow as I use them more and more.

I am working on my emotion sets. I have all of the emotion PECS ready to be laminated, and now I am finishing up the storage folders. I received my order of Pentaflex folders (in five different colors - including purple, but not orange!), so I'll be able to start putting together my color-coded boxes with the color-coded visual aids. I have some rock band folders to put together into finished products and an idea for movements as well.

While I'm at it, I think I'll start making some the visual aids for the take-a-chance packets I want to make for AMTA and regional conferences.

I bought a bunch of laminating film from one of my favorite websites - Lamination Depot. If you are in the laminating film market, check them out. I get lots of good film at pretty cheap prices, AND they ship things really quickly. (I don't get any type of kickback for endorsing products - these are my opinions and experiences only.) I now have all of the laminating film that I could possibly need to use over the next week.

I have my cutting scissors ready, my velcro cutting scissors ready (NEVER the same pair!), and my materials assembled. It's time to dedicate some time to making these ideas into realities!

(I'll post pictures on Supplemental Sunday of both the process and the finished products!)

Thursday, May 26, 2016

Take It Easy, Termination Won't Hurt a Bit

I am tired of my Thoughtful Thursday topic, so I am going to vacate it for a while. I haven't remembered to write on different quotations, so it should be easy to let this topic go the way of Sing A Song Sundays and Song Synthesis Sundays. I will be Thoughtful NO MORE!!

So, that leaves me with another dilemma - what should I write about right now? This dilemma always starts after the opening paragraphs. The questions start - "Is this interesting enough to me to continue writing?" "Does this have anything to do with Music, Therapy, or Me?" "Should I just skip today completely?" Then, I usually settle into a topic or an idea and start to write.

As I wrote a couple of weeks ago, I am in the termination process as a client (for, really, the first time in my life). I am down to the last session next week, and I am experiencing separation pangs and simultaneous excitement. I am both very proud of my progress and scared to death that I am going to do something to mess up the work I've put in the last 10 months. I am cycling between being ready to get my Monday and Wednesday afternoons back and wondering what I am going to do on those same afternoons. I am proud that I have improved so much in the past 5 months, but I am wanting more. I want to know what is going to happen after termination.

My therapist is following the pattern well. He has started to just check in with me during my workouts rather than hovering during every exercise. I've been overseen by interns, by athletic trainers, and by anyone passing by. He checks in with me at the beginning of the session and at the end of the session. He offers reminders of how far I've come. He's encouraging and answers my questions but keeps talking about the end of this routine. He is confident that I will be able to pass the skill tests I have to pass in order to get off of light duty. He also thinks that I will be using my brace at work until my annual post-surgery check up in December.

I have been going through the ACL replacement physical therapy protocol. There are benefits to protocols including that of having objectives to accomplish in order to determine completion of treatment. This is handy as I think I've made it to those objectives. (I am not privy to the particulars of the protocol, so I am not sure what those objectives actually are, but my PT is clear - I've reached them.)

I think that, in this way, PT is a bit easier than Music Therapy. It is rare that I treat a client who has a specific goal that can be accomplished through a set pattern of tasks and objectives. My goal for physical therapy? Return of physical function to my knee at the highest level possible for me. My goal in music therapy? It might be more complex.

When I start treatment with a client, I do an assessment. This gives me an idea of how to proceed with the client's treatment plan and possible goal areas. If a client is referred for a specific reason, it is easier to determine the treatment path. If a client just shows up in your clinic (like in my job situation), the treatment path has to be determined. There are so many things that music can help with that there are an unlimited number of pathways to termination.

I have always been a fan of the "fade to function" school of thought. There should always be a therapy ending point to therapeutic interaction. This ending point should also be known at the start of therapy to make the interaction time-framed. In my work situation, termination from services is not determined by me. It is often determined by outside agencies such as insurance companies. As a result, I often see progress but not completion of objectives. It is my job to help my clients find the tools and strategies that will get them to their objectives. I would love to be able to use an entire treatment plan for all of my clients, from assessment to goal completion to termination of services, but that process is often interrupted by people who are not immersed in therapeutic intervention.

As I am preparing to move from client to PT graduate, I am thinking about my interactions as a therapist with my clients. I do not have the luxury of tested protocols (and I really don't want any as I feel that music therapy should always be an individualized process) that outline specific completion benchmarks, but I can work on the establishment of tools and strategies with my clients. Knowing that their length of treatment is unknown, I will be changing how I approach individual music therapy treatment towards coping skill development and strategy building for each person who comes to my music therapy room.

This experience of being a therapy client has been extremely good for me as a therapist. I hope to keep the perspective that I have gained over the past 5 months to continue to inform my music therapy practice to help me be a better therapist in the future.

I'm not ready.

I'm ready.