Friday, September 30, 2016

Adapting to What's In Front of Me

I had a meltdown last night.

I was frustrated, my computer decided to keep updating itself while I was using it to host a webinar, and I sliced off the top of my pinky toe in the middle of all of the other angst. As I was trying really hard to get my computer updated and back online for the webinar, I cried frustration tears, cursed a bit (mildly - I'm still afraid of my mother coming to wash my mouth out when I cuss), and had a mini frustration fit. I was able to compose myself and move back into the idea of being a presenter once the computer started up again.

I had to remind myself to use my coping skills and that a computer that is interrupted from its job during its job is not a tragedy, it is really a gift. It was difficult to be mindful and appreciative in the situation itself, but I was able to find some humor in the situation once it was all over.

I think that being able to adapt to whatever comes is an essential skill for a music therapist. I try my best to remember that it isn't always important that my plan for something be completed, but that my client moves towards his or her therapeutic goals. I have been trying really hard to cling to a session plan these days, but I feel that I am most effective when I let my agenda go and move with my clients rather than forcing them to do what I say when I say it!

Over the years, I've developed a basic idea about behavior management - negotiables and nonnegotiables. This idea has made it easier for me to follow my clients and be flexible in my treatment planning. Nonnegotiables are the things that have to happen in order for us to complete TMEs and/or to keep safe in the music therapy space. Negotiables are everything else that happens.

My session strategy includes anything and everything that we can do that maintains our safety and the safety of others. If my client is not interested in playing the drums but really wants to play the keyboard - that is within the "negotiable" range. Changing the instrument will not threaten our safety, so why not change. Safety issues and concerns require me to intervene and become the responsible adult in the room - a nonnegotiable. 

With this idea in the back of my mind, I can adapt to just about any situation (and have - sometimes well and sometimes not so well).

There are times, however, that just call for a little frustration fit before you adapt. Darn that Microsoft!

It's Friday, all! Have a great day and look forward to the weekend!!

Thursday, September 29, 2016

Re-Boot: Thoughtful Thursday

www.musictherapyworks.com
"When you said everything would be OK, was that for you or for me?" 
(Fiore, 2016, p. 219).

I received my latest copy of the Journal of Music Therapy in the mail this week. I started my "research-informed clinician" routine to see if there was something that had direct clinical relevance to my population (there really wasn't in this edition) and then started to read for any type of import to my clinical existence.

While the research was interesting, I continue to be challenged to find things that work with my clients in my treatment modality.

Anyway...

The one thing that I came away with was the quotation cited at the beginning of this post. This was a song lyric generated by a group of campers at a bereavement camp, and it really stuck with me.

We say things all the time. As a therapist, I make statements to my clients that are probably often for me rather than completely for them. My phrases? "Ignore him," "Use your coping skills," and countless other phrases that come out of my mouth during situations. In the heat of the moment, I often find myself saying the same things over and over.

If a statement becomes so routine, is it genuine? I'm not sure that it is.

So, my goal for myself is to think before simply going into one of my phrases. 

You know, I used to sing those things. I am going to challenge myself to do that again - using my therapeutic medium to reflect and respond to my students in their emotions and moods (I mean, duh, right?). I will also try to remember to think about my responses BEFORE I make them happen - is the statement something for me or for the benefit of my client?


 
 
Fiore, J. (2016). Analysis of lyrics from group songwriting with bereaved children and adolescents. Journal of Music Therapy (53), 207-231. 

Monday, September 26, 2016

Music Therapy Pet Peeves

Admit it, we all have them. We all have something or another that just plain old bugs us about music therapy, music therapists, and/or how our profession is viewed by others. Some of them are minor, others seem major, and yet others seem to be triggers for the types of behavior that we would never tolerate in others, but seem to feel comfortable with in ourselves...

Here are some of my pet peeves...in no particular order...and just the opinion of an over opinionated music therapist who strives to understand the world around her...
  •  "Musical therapy" - This innocuous statement makes me outwardly cringe every time someone says it. I don't do therapy that is musical, I use music as the center of therapy. When someone uses the adjective rather than the noun to describe what I do, I feel like the person is focusing on the therapy more than the medium it is centered in. This is often just a misinterpretation about what it is I do and is often very innocent on the half of the person that is talking to me, but it puts my hackles up. I don't usually correct the person (that seems rude to me), but I do start to talk about how my therapeutic process is rooted in the music rather than adding music to the therapeutic process. Does that make sense to anyone other than me?
  • "Volunteering" - I get really frustrated with job announcements that expect music therapists to volunteer in an organization. If you recognize that music therapy and a music therapist is important to the welfare and treatment of your clients/patients/consumers, then you need to pay for the services...not expect that people will flock to give their services away!
  • "Do you want to do this? Okay, but I will only let you do that if you do this and this and this and this." - Seriously? If you ask someone to do something, then let them know about the requirements up front, before asking them to make a commitment. Don't ask for the commitment and then inform the person about the requirements that you have developed. When you act in a way that makes getting the first thing a condition of doing other things, you are bribing them or, worse, blackmailing them into doing what you want. 
  • "If you use music in any way with any person, then you have to be a music therapist!" - This attitude frustrates me more than just about anything, and most of these reactions and responses come from music therapists! I am firmly in the camp that music, no matter who turns it on, can provide benefits and should be available to anyone who wants it. I have spoken to music therapists who get upset when the staff members who work with their clients turn on the radio. This seems beyond silly to me. I see nothing wrong with Music and Memory programs. I see nothing wrong with music for incidental learning. I see nothing wrong with tone music. Please don't call it music therapy (that's where it starts to be a problem for me), but feel free to use that music with people who want music to be a focus in their lives. There is a HUGE difference between what an iPod can do and what a competent music therapist can do with a piece of music and a client!
  • "You aren't a TRUE music therapist unless you do music therapy the way I do music therapy." - Pllllllllbbbbbttttt! Music therapy should be focused on the client in the session, not the therapist providing the service. If I spend all of my time attempting to place my client into the mold of "client" that I've been taught about (rather than adjusting my own treatment model to accommodate that client), then I am doing the client a disservice. There isn't only one way to do music therapy. There is no perfect way to do music therapy, and my music therapy can be just as valid as your music therapy. What is most important is that the client receives benefit from the treatment, not that the treatment has a fancy name.
  • And the biggie..."happy children making happy sounds in music therapy!" - Music therapy is an iceberg. The tip of the iceberg is the "happy sounds." There is so much more that goes on within a music therapy session. I, as a music therapist, have a responsibility to educate others about what happens below the surface of things that can be seen within the session. It is difficult to convey, but if you try, you can start to educate those who cannot see. Don't get into a tilting windmills situation, but keep talking about what else is going on. Eventually people will listen and understand.
Highly opinionated, and very much my own list of music therapy pet peeves. 

Sunday, September 25, 2016

Song Lyric Sunday

I'm going to try something new this week.

I fall in love with songs based on the entire experience - the lyrics have to match the orchestration and the timbre has to support everything else. For me, songs become favorites when I feel that all of the elements of music work together to present the thought behind the song.

As a result, I tend to fall in love with specific songs and stay in love with them forever. When I hear a song that I love, the words are what draw me into the experience but the rest keeps me there - the melody, harmony, meter, chord progressions, timbre, form, style. Without the rest, the words just sit there.

Having said all that, I am going to share some of the lyrics from a song that I love. You can find all of the lyrics here

The song is "What Do You Hear in These Sounds" by Dar Williams. The lyrics that strike me the most (today) are as follows:

And when I talk about therapy, I know what people think
That it only makes you selfish and in love with your shrink
But oh how I loved everybody else
When I finally got to talk so much about myself

The lyrics go through one person's experience of being in talk therapy, but it brings out things that are relevant to music therapy as well - just look at the title of the song! "What do you hear in these sounds?"

I've been in counseling before and relate to this song because of my own experiences. It is amazing how much you can figure out if you have someone to talk to about your thoughts, concerns, issues, joys, challenges. There are times when that person is for your personal benefit. There are times when that person is for your professional benefit and development.

I've never been one to seek out professional supervision as a matter of course. I simply have not been able to afford it in the past. I have participated in peer supervision with teammates and other professionals, but nothing has ever been completely formal when it comes to working out things about my clinical interactions with others. In some ways, my most formal processing procedure is my writing - this blog is a bit of it, but most of my own processing takes place in my written journals - not for public consumption. 

Processing what goes on in a therapeutic setting is as important as what actually happened in the setting itself. That's why music therapy students and interns get to talk to an experienced music therapist about sessions - a way to start finding your processing style and insights with someone who has a different perspective than you.

Take advantage of that close supervision while you can. The reality is that many music therapists do not get supervision from another music therapist during their career after their internship is finished. My supervisor has never been a music therapist or someone who has any idea what music therapy really is. I have had to find processing supervision through different channels during my career.

Find your way. Process through your own feelings and experiences. Talk to someone about challenges and solutions. Find someone who has a vested interest in you and your health as a therapist to support you in your experiences.

I love it when a song leads into deeper thought about something that starts off unrelated and then makes perfect sense.

Thank you, Dar Williams, for helping me find a way. 

If you are interested in seeing an interpretation of this song, click here for a link to a YouTube video.

Saturday, September 24, 2016

So Far Out of the Comfort Zone

I did something today that is shaking up my view on what could possibly be. I contemplated a future with a completely new music therapy population and a slew of new challenges and possibilities. I am simultaneously excited and terrified of this situation, but I have made a commitment to me and to exploring what is possible.

Yikes! I am going to sit over here, in my corner, and just shake for a time...

For weeks, I've been talking about the need to shake things up in my life. I think this will do it - it's already making me think about our profession in a new way.

I have always made a pledge that I would examine opportunities that came my way even if I wasn't looking for something new to do. This has led me into many new experiences that have enriched my professional life. I was asked to apply for a job several years ago. The entire experience was life-changing - it showed me that I really didn't want that job! It reinforced my ideas of what I wanted and needed in a job - that job wasn't it! That was one of my most valuable lessons ever!

In 2010, I answered an email looking for someone to collaborate on an online conference. That one email led me into a job that I enjoy - treasurer and continuing education director for the Online Conference for Music Therapy, Inc. It has stretched my comfort zone when it comes to all things online, but those stretches have led me into my own path. I wouldn't be offering intern webinars right now if I had skipped over that email.

Exploration of new opportunities and ideas leads me into all sorts of things. I'm currently working on a project with a good friend of mine (who seems to stretch my ideas of what I could be on a regular basis) that will change my focus a bit as well. I am excited about things changing, but it can be scary as well.

I know that my clients often feel this way about their lives. Change is scary, so we don't always seek to change, but change is also necessary for growth.

I see the job of therapist as someone to introduce the idea of change to clients. It is important to offer opportunities and options along with some information about reality and the process. The therapist provides challenges and guidance but is not in charge of making that change happen - that is the job of the client.

Oh, I am getting into other thoughts right now.

Here's a challenge for you. If you feel in any way stuck, bored, or complacent about being in your professional role, figure out one thing to do that will scare you. Do that thing.

Join me outside of the comfort zone. You never know where it might take you.
www.musictherapyworks.com
Leave the safety zone for the unknown...
 

Friday, September 23, 2016

The Beautiful Side of Boredom

My mother has a phrase that she would pop out any time one of us would utter the statement, "I'm bored." After hearing the phrase once or twice, we learned quickly not to make that type of statement within her hearing because she would respond, "I can find you something to do."

SHUDDER!

What Mom found for us to do was usually something like mopping the kitchen or weeding the garden. It wasn't usually all that fun and did not necessarily combat the boredom issue, but it was something to do.

I believe in boredom.

I believe that out of boredom comes creativity. Mom taught me that. When bored, I can find a path out of that boredom because Mom encouraged me to do so!

I heard "I'm bored" from clients all week this week. Many of them made these statements when they entered into the session room before I was even able to do anything with them. I am wondering what is happening. Once my clients get used to the fact that they had to walk 25 feet down the hallway to get to the music therapy room, they tend to enjoy what is happening (at least, they seem to be enjoying what is happening), but the initial response is ennui.

Now, I'm not saying that it should be the goal of therapists to bore themselves or their clients. Definitely not! Even so, there is beauty in being bored with what is going on around you. 

Boredom allows us to think of possibilities. When my clients walk into the session and aver, "I'm bored," I see it as an opportunity for them to explore and figure out what will make them interested in something. It's amazing what someone can find to do when motivated to entertain themselves.

When I'm bored with my same old songs, I write new ones. When I'm bored with the same old session format, I try a new format. When I'm bored with my hairstyle, I get a haircut. Out of boredom comes something new.

I've been improvising songs all week - just as a way to shake myself out of patterns. Every group of clients had a new opening - most of them seemed to enjoy the novelty, but some of them wanted the routine of the familiar. It took some time to convince them that the music therapy had actually started, but they eventually realized that I hadn't completely flipped my lid and was still the same MJ from the week before...

It's time to shake things up at my facility. Clients are getting into uncomfortable patterns, so it's time to change things. We will see if changing how music therapy is offered will change the attitudes or patterns of clients. If it doesn't, then it will be time to try something else.

Thursday, September 22, 2016

Thursday - A Change in the Routine

I don't want to talk about much of anything today. It's going to be a different type of day. I am going to the doctor to get yet another check on my knee. I am going to work to have a group of students on a field trip instead of going to music therapy (and I am FINE with that after this week).

This week has included screaming students, a death threat from a student who was upset about the loud fire alarm, spittle flying all over the room, and a strong fist planted on my arm. Everyone and anyone has been yelling, arguing, and refusing any and all attempts at appropriate interaction. I would love to accommodate all requests to use that bathroom at the immediate second that they demand to use the bathroom, but we don't have the staff available to provide line of sight supervision to students when they all want to leave at the same time. So, the frustration mounts.

A change in routine will be good for me. I think it will be good for some of my clients as well. We all need to do something differently in order to find our center again.

Here is my different - enjoy!!

   

Wednesday, September 21, 2016

Life is Too Short

A music therapist who is also an acquaintance of mine was talking about doing nothing for an entire day. He made the observation that it was difficult for him to plan a day of nothing - no work on presentations, no catching up on progress notes, nothing at all planned...a complete day devoted to self-care and something just for him.

I can certainly relate.

I think many music therapists can relate to his conundrum. How do you get away from the job, enjoy getting away, and find something to refresh you enough to get back to the job?

For me, my issue usually comes in the form of guilt - guilt that I'm letting someone down (I'm usually not), guilt that work will still be waiting (because it always is waiting - it's work), and guilt that doing something just for me is inherently selfish. I'm learning to let those feelings of guilt start, pass through my conscious mind, and then leave me again.

I am part of a Facebook group for music therapy business owners. I enjoy reading the posts of those who are successful business owners, and I am often in awe of those clinicians who have enough business savvy to fight for contracts, schedule clients, and strive to provide services to clients all over the world. My own idea of a business is significantly different than theirs. I learn so much about business and self-care from those clinicians.

Every so often, a post comes up about some of the feelings I described earlier. Feelings of guilt due to the need to shift client sessions around or taking a day off for illness or having to cancel a client for any type of reason abound. It is oddly reassuring to know that others share many of my feelings when it comes to self-care and guilt.

Over the 23+years that I've been a professional in this vocation, I have learned that life is too short to be miserable.

This has been my mantra for years and years, through many jobs, and in many different places. When I start to feel down, I start to examine my options and increase the self-care focus. It is time for that type of introspection for me.

How will I do this? I'll schedule some time into my life for things I love - a guilt-free time just for me. I've already scheduled in some ice cream time (once I get a task done!) this weekend. I am going to revel in the fact that I don't have to attend Back to School Night tonight since I already have a Wednesday evening job. I am going to make a lunch to eat today to help me have energy for my afternoon groups.

The last thing that I am going to do for self-care is enjoy the fact that I will be going to work late tomorrow. I have an appointment for my knee that doesn't happen until 8:45 am, so I am taking a late morning. I don't know when I will post tomorrow morning, so don't be alarmed if I am later than usual. The novelty of a later morning start is something that I am going to relish.

For the rest of you music therapists out there, take time for you. Here are some thoughts for you as you think about your own self-care:

  • Schedule self-care as a matter of course.
  • Realize that self-care is at least as important as any client that you serve.
  • Make self-care time dedicated to only care of self.
  • Don't let guilt take away your focus on self.
  • If you are unhappy somewhere, change your circumstances.
  • Life is too short to be miserable. Find your bliss.

Tuesday, September 20, 2016

TME Tuesday: The Last One - The Manners Song

It's official. This will be my last TME Tuesday under this format. I have decided that it is time to focus more on other things, so from now on, you will still be able to get a TME on Tuesdays, but it will be a subscription-type thing. I'm still working out the details, so the subscription probably won't start next week, but it will be coming soon, so this is the last TME that will be released on this blog.

This therapeutic music experience (TME) is available on the most recent edition of sing about songs: sing about autumn. Click the link for more information about these TME collections. Enjoy!

Therapeutic Music Experience
Ten Table Manners for Kids
Mary Jane Landaker, MME, MT-BC


Purpose: To reinforce society expectations for etiquette at the table; To increase awareness of good manners; To prompt appropriate etiquette; social awareness; social interaction; entrainment to an external beat.

Source: Visual from iMom – 10 Table Manners for Kids. Retrieved October 29, 2015 from: http://www.imom.com/printable/10-table-manners-for-kids/#.VjiWQmv64nc  TME development and original song © October 30, 2015 by Mary Jane Landaker, MME, MT-BC

Materials: Cup, plate, napkin, fork, spoon, cup – either visual aids or real objects for use during the TME; OPTIONAL: Visual aid from iMom with list of expectations – one for every 3 group members

Environment: Group members need to be arranged in a way that will allow for them to see the therapist’s demonstration of manners.

Song/Chant/Words:
www.musictherapyworks.com
 
Table manners are quite difficult, but I guess they’re important
Table manners are quite difficult, but I guess they’re important
since folks keep asking me to –

Put my napkin in my lap,
Elbows off the table,
Sit up straight, inside voice, and use your “pleases” and “thank yous.”

Don’t forget to chew with your mouth closed,
Take “just right” bites,
Wait to talk, don’t complain, and bring the food to your mouth.

At the end of the meal, compliment the cook for the food that you ate.
Take your dishes to the kitchen when you are finished eating.
Table manners are still difficult, but I will try my best to meet them because

Table manners are quite difficult, but they are important.


Alternate lyrics - CAUTION! Only use with clients who understand that this example is NOT a GOOD EXAMPLE!!

Table manners are quite difficult, but I guess they are important.
Table manners are quite difficult, but I guess they are important.
Since folks keep asking me to –

Keep my napkin on the table,
Lounge upon my elbows
Keep head down, shout real loud, and use your rude voice.
Chew with your mouth wide open,
Stuff as much food in as you can,
Interrupt others, complain about the food, and bring your mouth to your food.

At the end of the meal, tell the cook you didn’t like the food.
Leave your dishes at the table.
Table manners are still difficult, but I will try my best to meet them because

Table manners are quite difficult, but I think I’ve got them!

Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1.    C=start singing the song.
2.    A=assess whether group members are engaged in the song by evaluating attention behaviors (e.g., eye contact, movement to the beat, singing along with the song)
3.    R=reinforce all attention behaviors through verbal and nonverbal means (using client names, eye contact, and facial expression changes)
4.    C=demonstrate unacceptable table manners with the expectation that group members will interrupt to signal recognition of inappropriate table manners
5.    A=assess whether group members are able to identify inappropriate table manners
6.    R=reinforce all indications that therapist’s model behavior is inappropriate
7.    C=ask group members to offer alternate good manners for the inappropriate manners displayed by the therapist.
8.    A=assess whether group members are able to distinguish between the model behaviors and the inappropriate table manners.
9.    R=reinforce all corrective comments from group members. Redirect other comments, shaping the expectations.
10.  Continue to sing alternate and appropriate lyrics until group members demonstrate awareness of the concept of table manners or until group members show s/s of disengagement.

Therapeutic Function of Music:
Music provides the structure for the information and is the foundation for the entire therapeutic music experience. The various elements of music can be changed to engage group members’ attention. The lyrics offer the most information as to what group members need to do.
Melody
Pitch
Rhythm
Dynamics
Harmony
Primarily scalar; follows predictable pattern
Variable based on client needs and preferences
Syncopated
Variable based on client needs and preferences
Major tonality – I, IV, V7
Form
Tempo
Timbre
Style
Lyrics
Strophic with Introduction and Coda
Variable based on client needs and preferences
Variable based on client needs and preferences
Jazz-like
Offer information about desired behaviors; can be altered to focus on specific behaviors for group members.
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:
·         Ask group members to demonstrate appropriate manners.
·         Focus on one manner at a time to reinforce appropriate behaviors at a developmentally appropriate speed.

Extensions:
  • Ask group members to take over the acting out of inappropriate behaviors during the song with the expectation that they will also act out the appropriate behaviors during song repetitions.