Thursday, June 30, 2016

Impulsiveness

In my professional life, I work with many clients who have difficulty with impulsiveness. Some flit from place to place, topic to topic, activity to activity in mere seconds. Some move from positive interactions with others to negative interactions with others in the blink of an eye. My clients often don't have much awareness of the consequences of their behaviors until they have gone through the behaviors. After the fact, they can process through the ramifications of their actions, but they have no future thought when it comes to decisions that they face.

I was impulsive yesterday.

I was driving home after an okay Wednesday (hooray!!), and I became very homesick. I haven't been home in 18 months which is an extremely long time for me. I didn't have a choice about traveling because I had to go to surgery, recover, and find some financial footing after dealing with Worker's Compensation and salary implications. ANYWAY...

The wave of homesickness just plain old took over. So, I started making plans. If I started driving on the last day of the next summer session, I could be home in 29 hours. I was very pleased to make my plan for streaking across the country in my little car. I got home and looked on the website for a flight. I found one - for less that it would cost me to drive! I booked it without telling the folks at home that I was going to do it. That is a level of impulsiveness that I rarely show.

Now, I know, I could have been so much more impulsive, but this was very spontaneous for me. I decided I was going, I wasn't going to worry about the cost, and I was just plain old taking the time to take care of me. The fact that I found a plane ticket for - get this - $211.20(!!!!) made the trip a fact rather than an impulse! That makes me happy.

The plane ticket has been purchased. I have the receipt in my email inbox. Now I get to do the things I like best. I get to prepare. I like planning and now I have a direction for the short break that I have starting tomorrow. I am going to clean the house so the pet sitter can find the cat when she comes over to cuddle. A goal! Hooray!! A trip! Hooray!! Cheap ticket! Hooray!!

There are times when impulsiveness leads you to bigger and better things. Does this mean I am ready to leave life and my doctor and stuff and move right now? Nope, but I am reminded that being spontaneous can bring about care for self in a way that planned self-care cannot.

Over the 18 months, I've had to plan everything. I've had to be very careful about how I spent money because I was hurt. I've had to stay at home because I was unable to bend my knee enough to get anywhere. I had a physical therapy schedule that precluded any type of trip. I've had to stop doing things that I love because I wasn't physically able to do those things. All of that has stopped so I can take some risks and be a bit more spontaneous now...but I am out of practice.

I took a big step yesterday, booking that trip without having all the ducks in a row.

Onward - here's to being a bit impulsive!

Wednesday, June 29, 2016

There's Always Something...

I am starting to fill up the gaps in my music therapy schedule with individual music therapy treatment times. This is a great feeling. I'll start individual treatment on July 11th when we come back for our second session of our Extended School Year. I'll get things going for three weeks, reevaluate, and then start up again when the regular school session starts.

I am excited about getting back into this type of therapy. I've missed it, but there's something else going on.

I'm a bit scared.

You would think that my 23+ years of being a therapist would make things lots easier for me to jump back into this type of therapy interaction, but I am a bit scared still. I think most of these feelings have to do with forced light duty and almost a year of being out of my comfortable routine. I know that some of these feelings are rooted in fears of being hurt again. I don't want to be hurt again. I know that many of these feelings are somewhat irrational, but they still need to be acknowledged and addressed as I move from one state of being to another state of being in my role as therapist.

My rational mind keeps trying to rein in my emotional mind.

"You did this for 22 years before being hurt like this. You can do this job. The statistics and odds are in your favor. Why are you so whiny?"

My emotional mind, as usual, goes full out emotional!

"But, but, but, this year has been so difficult! I can't do this again, ever, ever, EVER!! I won't, and YOU can't make me!!"

So, my brain goes into an internal war that just leads me into stomach gurgles, a need to prove to my emotional brain that I can do this, and do this well, as well as trying to figure out what's happening within myself.

I will spend this next week getting myself ready for whatever happens during music therapy sessions. I will build up my trust in myself through practice and experience. After the first session, the rest will be easier. Taking the first step is the hardest for me.

I know that this is part of recovery. My rational mind knows this. My emotional mind will catch up. It will work.

Meanwhile, I'm working on something I'm calling "Music Therapy Morsels." Intrigued? Keep an eye out on this blog, on the website, and on the Facebook page!!

Tuesday, June 28, 2016

TME Tuesday: Everybody Loves Saturday Night - A Musical Piece Without TME

I am sitting here, wondering what in the world to write about today, and suddenly I remember that it's Tuesday! Hooray!! It's a TME Tuesday post. No more thinking required!

Here's a song that I just love.

Saturday night. What a wonderful concept!
 
Now, just in case you are looking at the languages written here with a critical eye, please know that I learned this from my ID who had written these down. This is a card that I wrote down during my time as a Rehabilitation Therapist (Music), but I learned the actual song at my internship. (All of that information is actually included in these pictures...)

So, what could you do with this song during your music therapy session?

I use it (or have used it...it's been some time since this song came up on my music therapy repertoire radar...I should use it in therapy again...hmmm) in lots of different ways. I spend time using the song to structure making music, to reinforce leisure choices, and for entrainment purposes. I change the musical elements to reflect what is happening in the music therapy session.

When you hear a new song, how do you listen to it? I usually listen first to the music and the lyrics. Then, when I listen to it again, I have my therapist ears on. I start thinking.

Would my clients like this song? Is is appropriate to use with them? What goals/objectives could it address? What else could I do with this music? If I switched this element, what would happen to the music offered during the session?

After all of that, I use it and see what happens in the therapy session.

Enjoy your Tuesday - we are one more day closer to Saturday Night!

Monday, June 27, 2016

I Try to Post Every Day...

...but there are some days when there just isn't anything to say. I'm beginning to believe that this is one of those days.

My only thought is that of dread. I am not dreading the time spent with my clients. I enjoy music therapy with my clients. 

I am dreading the afternoon of sitting in the dark, constricting room that is my music therapy room. Does anyone else not like their space? Mine is small. It is dark. It has only one small window that doesn't let any type of light into the room. It is painted gray. There is barely enough space for the clients that have to come into to the room, and there is no space for line dancing or marching, running, or jumping.

When I start to feel this way about my space, I leave it. Today, however, I need to stay and make some changes.

I am getting ready to start individual sessions again. This has been something that I have sorely missed and have been looking forward to for almost a year. Over the past year, my music therapy space has morphed into a group room. The setup is not all that convenient for individual sessions, so it's today's job to move things around the room to make things a bit more accessible for individuals but to still indicate a barrier for groups. Ugh.

I hope this will be an easy process, but I'm not sure. I think I will move the drum set from its cramped position in the group corner to by my desk. If I do this, I could keep the set up and accessible all the time.

The piano is a problem. Right now, it barricades most of the cabinets and my desk area from wandering clients who do not need to be over there during music therapy group sessions. For the drum set to work, it would have to take over most of the barricade job. But then, where should I put the piano? I need it more during my individual sessions than during group sessions, and I don't want to get rid of it, but it is bulky and in the way. 

So, it is time to figure out what I want to try next and just go boldly into a new plan.

I have to remind myself that it is not permanent - nothing is in my room except for the stereo placement, the cabinet location, and my computer setup.

Maybe I will get some Command strips and rehang the artwork that I had in my old room. Looking at those things would bring some sunshine back into what I consider to be a gloomy room.

Okay - here's the plan.

I will move everything in my room this afternoon. I will take things out of the cabinets. I will move everything away from my desk. I will try things out. I will move things more than once. I will stay until I can get a semblance of organization, and then I will try things out for the rest of the week. Then, I have a week away from the entire thing. Then, individual sessions!!!

Wow, for a day where I didn't think I had anything to say, I certainly said plenty.

Happy Monday, folks.

Sunday, June 26, 2016

Supplemental Sunday: Unfinished Projects

Just in case you were wondering, I didn't write anything yesterday. I went to the lake instead and enjoyed the early morning out by the water...ah. Self-care.

Anyway, I am currently in the throes of clearing my house. This is always an adventure in history, as I tend to be a piler of things rather than a tosser of things. I found, in my excavation, this visual that I had put together several years ago for a Therapeutic Music Experience (TME) and for a specific client who has since left. Here was the idea.

This is a mountain. It will stand on its own on the carpet, but I also have a way to help make it more sturdy. It is meant to go with the visual aids that I've drawn for a camp song I learned forever ago - Once An Austrian. There are many links to this song on YouTube, but none of them are the version that I learned, so I'm not going to choose one for you. Sorry.

The different parts of the sequence song are available for adding to the mountain. At the time, I think I was thinking that I could velcro things to the mountain, but now I'm thinking that popsicle stick puppets could be more fun. The popsicle sticks could be painted and then velcroed to accommodate changes in what goes over the mountain.

I love when my brain clicks into creation mode. We could also use this as a visual for the song, The Climb, by Miley Cyrus. We could make our own icons and place them on the mountain (using tape or poster putty) to indicate where we are on our own personal climbs. Hmmm.

Other things we could do with a mountain - The Bear Went Over the Mountain, Valderi, Climb Ev'ry Mountain, Ain't No Mountain High Enough, and others that haven't floated to the top of my Sunday consciousness yet.


I'm going to finish this up, put it in a folder, and put it into my idea box. Happy Sunday! I'm off to do laundry,

Friday, June 24, 2016

Watching Others to Learn More

I admit, I can be the person who just stares at strangers when out in public. I prefer it when I am outside and can watch others from behind my Dollar Tree sunglasses, but I am that person. I observe.

I spent the morning at my local Firestone shop getting the tires rotated and the oil changed in my car. Then, I went to the Dollar Tree and shopped a bit. I had a chance to observe other human beings interacting with each other.

I love the opportunity to watch people interact. Today, in the hour I spent with the folks at the tire store, I saw interactions that ranged from the familiar to the friendly. The front office folks were friendly to all of us, but there were definitely some folks that had more of a relationship formed with customer and staff. Those folks were greeted by name, joshed around with a bit, and greeted with a clap on the shoulder. The rest of us were greeted with a smile, a friendly greeting, and some light conversation about our cars.

After my car was finished, I took myself to the Dollar Tree. I love that store. When I arrived, there were no cars in the parking lot (extremely unusual). There were two employees sitting outside, smoking, and as I walked towards the store, another car drove up. An older woman (one of the type that I want to be when I grow up) popped out of the car, walked jauntily to the door, turned and looked at me and said, "I wanted to be first." She then laughed, put her arm around me, and invited me to enter the store with her. I did so. Her interaction was contagious. When I checked out, she was right in front of me and asked if she needed to stay until I was finished. We laughed. She waved to me when her car was leaving and I was walking to mine. Instant connection - brief though it was, it was important.

I watch others to see how they interact with the world. It helps me to figure out how to approach my own world. It also helps me to work with my clients who don't always interact in predictable ways.

One of the things that I've noticed during my people-watching habits over the years is that "we" as a society tend to get snippy when "we" think "we" are not getting our way. The best place to see this type of rude, snippy behavior is at the airport gate.

Have you ever noticed that "we" all take any type of interruption to our travel extremely personally? My last trips were in February 2015, and all of my flights had some sort of delay or complication. The gate agent would say something like, "Ladies and gentlemen, our gate has changed. Please proceed to gate 45 for our flight." Then, everyone would start complaining, going up to the gate and complaining that "we" had to walk. It wasn't right. "We" were inconvenienced, and it was the end of the world.

I usually try to stop by the gate and thank the gate agent for making sure that "we" knew the information that "we" needed to know to get to our destination. They smile tiredly, but you can tell that's it never enough to help assuage the attitude that "we" project for something that is not that agent's fault.

This thought process invades my interactions with my clients. Many times, my clients respond and react to things that are not within my control to fix. Often, those things are not things that the client can control or fix either. At those moments, it's important to remember that civility doesn't take much effort and can help to find a solution without inflating a situation any more. 

I know that it's difficult to always remain civil, especially when I am frustrated, but it's the way I can contribute to the world. Calm in the face of frustration, working towards making the change I want to see in the world, and being kind to those who convey information but do not make the decisions. I take out my frustrations here on my blog - lucky you!! (Imagine a smiley face emoticon here - your choice of which one you want to imagine.) 

I hope to go to the lake tomorrow for a bit of time. If there are other people there, I will watch what they do. If not, I will enjoy the serenity.

Be kind, folks. Save your angst and ire for those who truly need it, not for the person who has to tell you something you don't want to hear. That's it. End of rant...   

Thursday, June 23, 2016

How-To Be "Therapist"

I'm writing a bit these days, coordinating several new projects, and that is leading me to think lots about the process of doing music therapy. I'm talking about the "how to" do bits and pieces of our job rather than the "why we do." Somehow, the "how to" helps me figure out the "why I do" part of my role in this world.

Anyway...

I have always been interested in "how" we do the things we do, not just the "what we do" elements that are out there. I want to know why the therapist chooses the music, song, chord progression for improvisation during an interaction with that specific client. I want to know if there is conscious thought about what the therapist is doing or if the therapist goes into the interaction instinctively. I want to know the "whys" behind what we do with the clients in our care.

I suspect that we don't always have the answer to the question "why?" Here's where the "how" helps me to inform the "why." I know that I started my career with a beginning to the question of "why," but it didn't really arrive until my internship. My ID, Sheryl Kelly, was good about sparking the idea of "why are you doing this with this client?" She made me improvise and changed my thinking about what that term meant. My thoughts on the "whys" of music therapy interventions really firmed up during graduate school. I had enough experience with the "what" happened in music therapy to start understanding the "why" it happened, informed by the "how I did things."

Is this confusing? Probably. I'm a bit confused myself!

Simply put (well, an attempt anyway), I want to know if you "feel" that you should do a particular song/therapeutic music experience, or if you base your idea on your philosophy. Are you following a script? Are you following your instincts? Are you following a prescribed program developed by someone else? Are you just randomly trying things out?

There are times when I do most of the former situations. There are times when I follow a script. There are times when my instincts take over. I don't ever use prescribed programs (one of my faults - I don't view curriculum as THE way to do things, but just as a beginning), but I randomly try things to see what will happen next.

Even though there are times I'm not thinking about things BEFORE I do them, I have a good foundation in the "how" specific elements of music work with many of my clients, and that foundation informs my "why" I choose what I choose to do. 

My foundation is the science of music and its effect on human beings. For me, the music is the center of my therapeutic interaction with clients. Therefore, I think long and hard about how music may affect my clients' progress towards their individual goals. I identify ways to adapt the music, deepen the experience, and/or strengthen the relationship through the therapeutic triad of therapist, music, and client.

I feel that, since I have this foundation, I am a better therapist. I understand my treatment modality as much as I can, and I keep learning more about how music affect human behavior every day. I doubt I will ever stop learning about or being intrigued by how music works in our brains and bodies.

Here's hoping I don't.

Wednesday, June 22, 2016

The Second to Last Stop on This Injury Journey

If you've been someone who reads this blog every single day, then you know that I was injured at work last year (almost a year ago now). I was involved with a client who left supervision, barged into the music therapy room, tore up my expensive keyboard, and engaged in aggression. During my attempt to assist the client in staying safe, the client pushed me, my knee twisted, and something popped. I went down.

Turns out, I completely tore my left Anterior Cruciate Ligament, and my life has changed since that time. You wouldn't think that something as small as an ACL could affect many things, but I'm here to tell you that this injury has changed lots of things in my life.

Enough dwelling on the past. It's time to look at the future.

Today, I get to take CPR and First Aid. I have been certified in CPR and First Aid since I was 14 years old, and this is the first time in a long time that I haven't been a card carrying member of those who can assist others. I was told that I couldn't take the class because I was unable to kneel for long periods of time. Now I can (albeit with my brace, but still - better than before). So, I had to let my certification lapse.

When I was cleared for full duty (with my brace) earlier this month, I asked my supervisor if I could go back into what I consider a full-time therapy schedule, taking individuals and small groups again. She told me that the regulations stated that all staff had to be CPR certified. So, I started hounding the new training scheduler for a date.

Today is that date.

At 8:30, I will start my class. At the end of the day, I will be fully trained in all the things I have to be able to do in order to get back to my schedule.

(Interestingly enough, I didn't have to let my Safe Crisis Management training lapse - I attended all recertification trainings and, even though I was unable to physically participate, being there counted. So, I am able to assist clients when necessary.)

I have been craving a return to a regular schedule all year. Group music therapy is something that I enjoy, but individual therapy is something I love. To have been denied the opportunities for clients that I've seen over this past year has been excruciating for me. I am now sitting in my group sessions and planning who I'll take with me to do more music therapy, and I know that I'll be able to do so next month!!

I don't have many open times for individual students, but I am going to make room for as many as possible. In August, when we return to our regular school year, I'll have 26 individual/small group times! There will be adapted music lessons every morning. Music therapy sessions will happen in between group sessions, and my days will be full again. I will no longer sit and try to find things to do - I'll have LOTS of things to do!!

One of the things that I've learned during this entire process is that there is no guarantee that things will ever stay the same. You may be thinking, "well, duh," but I've never had a situation where I was so compromised that I was unable to do my job, so this has been a lesson that I hadn't learned until now.

I still have visual and physical reminders of my injury and subsequent surgery. I have a limp when I start to walk after sitting for a time, but that goes away after I walk for some time. I still have a stiff knee and it doesn't really feel "the way it used to," but this is the new normal, and I guess I'll have to just learn to live with it. 

This is the second to last stop on this journey. The last stop will happen in December when I go back to the surgeon and physical therapist for a final round of testing and then a release from care. I am ready.

It is time to get dressed and get ready for this day of training. I am hoping that my knee will cooperate - I REALLY WANT TO GET THIS FINISHED SO I CAN MOVE ON!! (Yelling intentionally implied here to convey my strong desire!)

Thanks for reading through my ups, downs, and ramblings.

Tuesday, June 21, 2016

TME Tuesday: A Brand New Idea - Still In Development - Improvisation

I was sitting in the hallway yesterday, doing my early morning hallway duty, and staring at my session strategy sheet trying to figure out what I was going to do with my clients this week. I had only one idea, and it certainly wouldn't take up an entire session, so I needed some other ideas.

I understand the situation here - my post from yesterday included a brief tangent into my views of session planning being just a starting point - but yesterday I didn't really even have much of a starting point for my session plans for this week. So, I sat.

While I was sitting there, I had a spark. Why not improvise? It's silly that I have to plan my improvisations sometimes. Many times, I don't plan my improvisations, but yesterday, I felt the need to plan the improvisation. I decided that I was going to pass out a variety of pictures and we were going to make up a song on the spot. I framed it as a "silly song," and it went pretty well.

The clients that I am using this idea with come from four classrooms. They range in age from 6 years to 20 years. They have differing levels of  communication skills, but most of them do not communicate verbally. They attend large group music therapy sessions and are often crammed into my music therapy room with limited space to move. There are a couple of outlying clients who really don't belong in those classrooms, but that's their educational placement, so I have to work with the group I've got, not the one I want. Most of the students have been attending music therapy group sessions for a long time. There is one student (out of 42) that I haven't met yet, but all the rest I have treated before for varying amounts of time.

What I like about planning improvisation time is that I can decide what elements will be improvised and what elements will be planned. In this case, I decided to use pitch and rhythmic structure as planned elements. I chose the key of D - my home key - and a rock format. I adjusted the lyrics, melody, harmony, tempo, and style based on information that my clients gave to me. Kids took a pretty passive role in this TME. It was their job to hold up pictures that they wanted me to include in the song. Some of them also sang bits and pieces of the song, adding to the improvisation. All vocalizations were included into our musical piece.

It was fun. Our song stories included dinosaurs, bumble bees, lightning storms, butterflies, tennis rackets, and lots of other things. As we do this more, I believe that my clients will get more interested in what is happening and will add more and more, taking the job away from me and making the improvisation their own. I had three who were starting to be the musickers yesterday. They were starting to take away the power of being the primary music maker away from me. That's what I want. I want them to put me out of a job.

Next time I try this (later this morning), I am going to do the same thing that I did yesterday. I want to see how all of my similar clients respond and react to this idea. Then, I will know how to further develop this idea into a therapeutic music experience (TME).

Monday, June 20, 2016

What To Do Next? A Time Filler TME!!

I have a bunch of Therapeutic Music Experiences (TMEs) that I use as time fillers. You know the kind of TME I'm talking about. The ones that are always available, easily expanded or shortened to fit the time left, and ones that everyone knows or can learn in a very short period of time. These are the TMEs that I pull out when everything in my session plan has been finished and I still have time left. Some are songs, some are games, some are completely improvised, and some include relaxation techniques.

What I've found, over the years, is that session plans never go exactly as planned. Sometimes, one TME lasts much longer than planned. Sometimes, you go through every idea that you have plus some and still have time left over. So, I have time fillers.

(I've learned that session plans aren't really plans at all but more like strategies or possibilities.

No matter what I, the therapist, sit in my office and plan, my clients change what happens during the actual session. Each client brings his or her own expectations, responses, and preferences into the session, and I can't always predict what will happen during our time together. That's one of the good things about music therapy. Each session can take it's own path.

I've also found, that when I try to force a client's responses into my idea of what the session should be, the session is not as effective as it is when I combine their ideas with my own.

For me, that's what therapy is; taking my ideas and the ideas of my clients and melding them into a shared experience that benefits their therapeutic progress.)

Time filler TMEs include quick singing games (fill-in-the-blank or sequence songs), large group games (Look Around the Circle and Who Do You See?, Elimination, or other games that include acknowledging others in the room), and/or silly songs (I Like To Eat, Boom-Chicka-Boom). There's always dancing to fall back on if nothing else will fit into the time left over.

One of the things that I do on a regular basis is sit down with my idea box and database to brainstorm all the ways I can use a song, or an item, or an idea. When I do this, I write down ALL ideas, no matter how ludicrous they seem at the time. There is NO WRONG answer or idea. When I decide to take something out of the cabinet to use, I go back to the idea list and remind myself of all of the ideas that I had about using the item. Then, during sessions, I have a fresh list of things to do and have the option of many different time fillers.

My strategy sheet for an item/instrument/material/visual aid/etc. includes thinking through things and options using all of the treatment domains that I have used over the years (How can I use this in a way that promotes motor development? How can I use this in a way that supports academic/cognitive development? Social/communication? Emotional/behavioral? Musical?) Then I brainstorm the songs that can go with those things to do. I often do the same thing starting with a song and leading the other way around.

This week, as I go into my sessions with my strategy mapped out, I'll be looking at ways I can include different elements of what we've already done into our sessions. I don't have many things that I'm using this week, so most of my time filler ideas will be sung rather than instrument-based. I abhor halting therapy while I root around in the cabinet to get something out, so I try to make sure that I don't have to do that...ever. What I've got out is what I will use in my session.

Some of my groups will take all of the session time without needing anything to fill time. Other groups will need time fillers, and yet other groups will not fit any of the plans that I have in my head but will make me find a completely new plan.

Whatever happens, I think I'm ready.

Have a great week, all.

Sunday, June 19, 2016

Supplemental Sunday: Update on the Box Idea

I am trying to figure out what to write about today. I haven't used my creativity to make anything this week, so there's nothing new to display. I improvised quite a bit this week, but like all of my improvised songs, the music is fleeting.

Oooh, I could update you on how the boxes are working in my sessions.

If you remember, I spent time at the beginning of this month talking about using color-coded boxes to help with group treatment. The boxes, in four different colors, contain emotion choices, emotion strips, and any other visual aids that I need during sessions. The idea is to give kids lots of choices for communicating their emotions and to help decrease the wasted time taken in passing one option around a group of 12 kids.

We started using them two weeks ago.

There are good things and bad things about the boxes.

First, kids are starting to get used to how to use them. Some of my students don't understand that they only need to finish one sentence and they complete all of the emotion strips. Others are still a bit resistant and will push the board/folder away. I will change how things are presented for those kids. The number of choices may be too much for them to sort through. Or, they just may not want to communicate with me. Either way, I will change procedures just a bit.

Second, most of my kids don't seem to care about the skin tone of the picture, but some do. One of my young men sorted all of the pictures by skin tone. He doesn't necessarily choose his emotion picture based on his own skin tone, so I know that he is looking at the emotion picture rather than just choosing something that looks like him. 

Third, the 3mm laminating film works fine on the folders, but it's a bit too flimsy for the emotion pictures. I may need to re-do things using a thicker laminating film to increase durability of the moveable pieces. Time to go back to Lamination Depot for some new film. Come to think of it, I have some samples in my sample box, so I can try out the thicker laminate to see if it will do what I want it to do.

The boxes are working. Most of what happens with these boxes are what I anticipated happening, but there are some differences. That's part of the journey of creation and discovery - finding out how clients like to use things is a big part of the fun.

This next week is our Musician of the Month reveal week, so I don't have anything to put into the box other than the emotion pictures. The week after that is firework improvisation week, so I'll find some pictures to go along with our improvisations. We're also going to do some firework countdowns, so number boards would be good to have in the boxes. Hmm. My creative spark is starting to light a fire. Color-coded number boards...I could do lots of different things with something like that...


Saturday, June 18, 2016

The Creativity of Others

I love getting ideas for therapeutic music experiences (TMEs) from other therapists. I've always required my interns to share their TME files (one of their assignments) with me when they are finished. After all, I've always shared mine with them, so turn about is fair play, right?

Anyway...

I am a proud subscriber to Music Therapy Mailings, an idea started by Rachel See and continued these days by Tracy Reif. If you haven't tried this out, just know that it's a lot of fun. I subscribe, and then I get stuff! Sometimes the stuff is focused on self-care. There are always materials and things to do with clients, but it's up to me to take those materials and make them therapeutic - to turn them into TMEs.

It's fun getting things in the mail, first off. Second, there are different things every month, so I get new, fresh, and creative ideas from those envelopes.

When I get my stuff, what do I do next?

I first take stock of what's in there. Second, I start to think about how to use the materials with my clients. The things that come in my envelope spark new TME ideas for me, and I start to write them down for my TME file. Sometimes I get lots of new ideas. Sometimes I don't. That's the nature of my particular brand of creativity.

Here's a picture of this month's loot! Check it out!!

musictherapyworks,com; music therapy resources; music therapy mailings

If you're curious, I get no benefits, perks, or kickbacks for anything that I mention on this blog. I simply have fun talking about the things that I enjoy using and getting.

Enjoy!

Friday, June 17, 2016

I Need Some Music

This has been a strange week in many ways. It's been a week of emotional responses, political rhetoric, high temperatures, more political rhetoric, and therapy. I am thankful that my work week is over right now so I can just take some time and sit back and ponder what's been going on.

So, I am here, sitting and thinking about things. One of the things that I've felt compelled to do is to avoid all news outlets. Each time I turned on my favorite radio news station, I was bombarded with repetitive information and LOTS of misinformation. I had to turn it off. I simply cannot go through tragic situations as many times as the media seems to want me to. I can't go through the same situation over and over again. I don't.

Instead of listening to the radio, I've been listening to sitcoms on my iPod or listening to my favorite songs playlist (12 hours of music and more to come). This has been good for me because I have been able to use my favorite music to help me feel and regulate emotions. I've done the "switch the song until the music just feels right" thing as I've been driving around the state of Kansas. I've spent time making my own music in response to what's happening around the world. Nothing spectacular has come out of all of this - I've written no major concerti or anything, but I've found solace in creating and engaging in music.

We also drummed this week. It's amazing how much emotion you can channel when you are hitting the heck out of something. Feeling frustrated by the government of your state? Imagine faces on your drum heads and express that frustration through hitting the drum repeatedly. Wild drumming with a bunch of kids can often lead to primal vocalizations along with the drumming. (We did some screaming, much to the dismay of the paraeducators in my groups. They just don't understand that you sometimes HAVE to be loud, even when you are inside.) 

The frantic need that I felt to make and immerse myself in music this past week has subsided a bit. I am starting to feel that I am ready to move back into the world of news, but I will enter that world with caution.

I work with lots of clients who have the diagnosis of Post Traumatic Stress Disorder, and I understand the idea of secondary trauma. I have a touch of PTSD response and reaction to specific situations myself and have learned to avoid trigger events or incidents. Sometimes though, it is difficult to avoid triggers, especially when those triggering events are repeated over and over again everywhere you go. So, I turn to music to help me deal with the emotions and the information overload.

I am glad that there is music in this world. I am glad that there are music therapists in this world. I am glad that music can fill the spaces left behind when things happen to each of us.

I need some music, and I will find it.

Thursday, June 16, 2016

But I Went Anyway

I really didn't want to go to work yesterday, but I did. I was the semi-responsible, cranky therapist yesterday who went to work and did my job. My cranky attitude did have one benefit - I FINALLY got a time to take CPR/First Aid, so I should be able to start individual treatment sessions in July!! Hooray!!

Today has already started off a bit better. I awoke at the same time I did yesterday, but didn't feel the need to stay in bed. I got up, took my shower, and am now writing...at my usual time...with lots of time in front of me. I will be getting myself a big glass of ice water here in a couple of seconds - be right back. Ah, better.

The high humidity and heat that's upon us this day affect me in ways that reach all parts of my life. When things are humid, I ache. My legs, especially, ache all up and down. The joints ache which makes the muscles work differently, and then the muscles ache. I stagger and hobble around all during these hot, sticky days. On these days, my asthma flares up and complicates my breathing. I feel like I am constantly struggling to suck air into my lungs, even after taking all of my medication.

All of these things affect my therapy interactions. It would be ridiculous to pretend that what is going on in and around my body doesn't affect how I respond to the people and situations around me. I am human, and I bring human emotions, responses, and reactions to every session.

What is most important is how I end up responding during sessions when I am affected by things that happen outside the session or inside my own body.

Here are my strategies for the days that I just don't want to do anything.

First step: Acknowledge what is happening. I spend some time responding to my situation before clients arrive. I work through my emotions and try to figure out why I feel the way I feel.

If my clients ask me how I'm doing, I tell them honestly. I will disclose that my body hurts because of the weather. I will let them know that I am grumpy. I believe that acknowledging what is happening in healthier than trying to pretend otherwise. 

I don't disclose things that are personal in nature - my clients never need to know when I am worried about my financial situation or family interactions - but I do let them know what effect I experience due to what is happening. They are already aware of my emotions and acknowledging those emotions helps my clients recognize their own emotions and be a bit more comfortable with sharing them with me.

Second step: Adjust session plans as needed. If I have a migraine, I need sessions to be quieter than usual. I may need to put the instruments away and break out the rain sounds. Other times, having the drums playing loudly in my environment helps with the pain - it takes it away.

I have a policy that I never tell my clients what we are doing in sessions - I have many reasons for this that I've probably shared here before and will probably share at some point in the future - mainly because I never truly know everything that we are going to do and because I need the flexibility to change things to accommodate client needs. So, my clients never really know what was supposed to happen. That allows me to adjust things as much as I need to for personal reasons or, more importantly, for client-driven reasons.

Third step: Take time to be mindful. I laid on the floor between sessions for a time on Monday and focused on my breathing. I know that anyone peeking into my music therapy room would have thought I was either sleeping or had collapsed due to my positioning, but it was important to take some quiet time for myself before sessions to help me acknowledge what was happening inside my body and then to work on shifting my focus from me to others. I didn't take long, only about 5 minutes, but that time really made a difference in my motivation and energy.

Fourth step: Make music just for me. I had a group that had to cancel due to staffing issues yesterday, so I played the piano and sang during their session time. It was heavenly to choose music that spoke to me and to breathe through the songs. That extra hour helped me to use music to self-regulate. I firmly believe that music therapists should use music for therapeutic purposes in order to best understand how music affects our clients, so I take a chance to do so when I need to do so. For me, the best therapeutic use of music is to make music. I don't do as much of it as I should/could (goblin!), especially at home, but I am remembering the benefits available to me and am taking advantage of the piano at work.

So, I am going to head out into this muggy, hot, and jam-packed day to do my job. I still don't feel very well, but my attitude is much better, so it is easier to head out that door and get into the car. I will continue to use my strategy and move through this day.

Wednesday, June 15, 2016

I Don't Want To Go!

Ugh. I have to go to work today and do music therapy. 

Most of the time, this is a good thing, but I'm just not really feeling it right now. This is probably due to several things. First, no one in my family is having to work right now - they get to hang around the pool, go to the beach, and go do touristy things whenever they want. Second, it is hot and sunny here. I don't do very well on hot, sunny days. The humidity just wears me out and makes me hurt everywhere, so I don't look forward to heat advisories and high humidity. Third, I am tired. Just plain old tired. There is no good reason, but I'm tired.

So, today it is taking an effort to get myself up and out the door. I will be fine once I get started, but I'm not getting started easily.

The day started before my alarm light went off. (I can't use an alarm clock because they startle me too much. Imagine every day starting with a startle reflex. It's not pretty, and the cat hates when I bolt out of bed, scared!) So, I was awake before the light turned on, but I wasn't happy about it. Once the light went off, I laid in bed for an extra hour just reveling in the fact that I didn't really have to get up yet. Of course, that made everything else an hour later, but that's a natural consequence to taking an extra hour to relax - your schedule gets changed.

Anyway, I am here now, writing about this and looking at the clock. I will be "late" to work this morning. I put "late" in quotations because I am never really late. I will actually show up at work at the time I am supposed to arrive daily rather than my usual earlier than early arrival time. I have already finished 2/3 of my documentation for sessions from yesterday, so I have very little to do once I get to work.

Session plans are finished. We are going to drum today in all of my groups. We probably won't drum for long. My students are currently tired as well. They go swimming at least every other day, and they get exhausted. We'll drum a little bit and then move into some other TMEs.

I return to the clinical team meeting this afternoon. It will be an hour of things that have little to nothing to do with me, but I go because I need a place to be represented. I haven't been to the meeting for the last two months because I had physical therapy appointments. I'll be going again now that I am released from PT. 

Today, I am going to take a songbook to work so I can play the piano. Playing just for me helps to lift my mood and makes me feel a bit more settled in my own skin on these bright, sunny, hot and humid days. So, I will take in my Rise Again Songbook and play through as many different songs as I want during the day. I'll immerse myself in musicking and use the music to vector my mood on this day of great reluctance.

Tuesday, June 14, 2016

TME Tuesday: I Don't Like

Have you ever noticed how many songs there are about things we like? Here's one where we get to state and celebrate the things we don't like. I have the sheet music, if you'd like it. Just leave me a comment, and I'll send it to you. Otherwise, take the idea and make your own song!!

Therapeutic Music Experience
Mary Jane Landaker, MME, MT-BC
I Don't Like


Purpose: To provide opportunity to express emotions about things not preferred in musical format; to engage in conversation about opinions; receptive language; expressive language; attention to task; leadership development; creative expression of emotion and opinion

Source: Original song. © September 17, 2012 by Mary Jane Landaker, MME, MT-BC

Materials: Guitar or Keyboard; OPTIONAL: pictures of desired and undesired objects or experiences

Environment: Group members in location where they are able to see and interact with the therapist easily.

Song/Chant/Words:
In minor key
i           v     i          v                i           v     i                 v
I don’t like eating veg’tables. I don’t like anything at all.

i                                          iv                                       v                       i
There are many things that I don’t like real well, and I will say them all!

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.      C=start singing song, replacing underlined words in song with personal dislikes, modeling desired behavior
2.      A=assess whether group members are singing along
3.      R=reinforce all attempts to join in the music making process through verbal and nonverbal means. Redirect attention of group members who are not attending to the task
4.      C=repeat song, changing lyrics again to reflect other things not preferred.
5.      Repeat steps 2 and 3
6.      C=offer leadership of singing experience to group members
7.      C=continue to provide accompaniment to group members who act as leaders
8.      A=assess whether group members volunteer to lead the singing
9.      R=reinforce group members who act as leaders
10.  Repeat steps 1-9 until group members start to show s/s of boredom, disengagement, or when time runs out

Therapeutic Function of Music:
The music provides a socially appropriate outlet for expressing dislikes of objects, situations, and other thoughts. By putting these expressions of negativity to music, group members can offer insight into their preferences and non-preferred things in manner that should not be socially inappropriate. The music contains several elements that can be easily adapted to accommodate differences in processing speed, articulation, and other elements of participation. These elements include timbre, pitch, dynamics, tempo, and lyrics. All of these elements can be changed to provide group members with success during the TME.

Melody
Pitch
Rhythm
Dynamics
Harmony
Minor key, mostly downward to illustrate frustration musically
Variable to accommodate group members’ preferences
Macrobeat
Variable to accommodate group members’ preferences and needs (sensory and attention needs)
Minor

Form
Tempo
Timbre
Style
Lyrics
Variable – due to improvised nature of lyrics and experience
Variable to accommodate group members’ preferences and needs (sensory and attention needs)
Variable to accommodate group members’ preferences and needs (sensory and attention needs)
None
Variable to accommodate group members’ preferences and needs (sensory and attention needs)
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:
·         Offer pictures or word cards with preferred and non-preferred items

Extensions:
  • Start discussion about opinions and facts