It's Always a Journey: Center Updates

This week is Center week in my music therapy clinic. I have been trying to implement something a bit different from what I usually do in music therapy - just to see if it will work and to increase my treatment options.

Some setting information: I work in a residential and day school program for children and adolescents ages 5-22 who have developmental and psychiatric diagnoses. I have 112 students who come to music therapy for 60 minutes per week. All services are educational enrichment and psychiatric treatment services - nothing is listed on the Individualized Education Plans of my clients. This is both a good thing and a bad thing for my treatment service plan.

The reason I started with Centers: I was finding that my group sessions were becoming less about relationships with clients and more about filling time. I really didn't feel that I knew my clients very well because my focus was on song, song, song. I wanted a way to get to know my clients a bit better, but that is difficult in 60 minutes of group treatment with 8-13 clients in a group. I wanted to increase client choice and executive function as well as to find a way to include multiple therapeutic music experiences while encouraging client independence.

My sister does Centers in her elementary education class. She has language arts centers and math centers that the students rotate through in order to practice and master skills. I loved going through Centers when I was in elementary school - the independence was exhilarating for me - so it seemed to be something that I could work through and develop as part of music therapy as well.

The current theme: I've also come up with monthly coping skill/life skill development themes that I am incorporating during both center weeks and traditional group therapy weeks. April's themes are Life-Long Leisure and Entertainment. We are working on leisure choices and learning about options for entertainment that take us out of our living rooms and into the world. This round of centers took us into the idea of the zoo.

Remember the animal Easter eggs that I bought a couple of weeks ago? (Here's the post if you are new to this blog.) One of the centers is based on putting those eggs together. Another center is a music preference survey - kids are listening to 21 songs and choosing their preference by putting a number on a post-it note and sticking it to the cabinet. (They seem to love both writing something on a post-it note and sticking it on the cabinet.) The last center is my favorite. I have several maps of the local zoo that I've laminated. I also have four magnifying overlays. There is a worksheet about which animals my students would go visit and the ones that they are not interested in seeing at all. For some groups, we have time, and I use those worksheets for a song about the zoo. At this time, the song is improvised and covers animal preferences and the non-preferred animals as well.

Depending on the group, clients are encouraged to complete the "Must Do" tasks at their own speed. Once clients have finished at least 2 of the "Must Do" tasks, they get to do the "May Do" tasks. The two tiered center format works really well for me to accommodate the clients who finish tasks quickly and those that take their times. The "May Do" tasks are also things that I know are motivating for my clients, so they will complete the "Must Do" tasks in order to get to the "May Do" tasks.

Some examples of "May Do" tasks? Playing guitars and ukuleles. Looking at past Musician of the Month booklets. Using the blocks to construct a zoo enclosure. Making shakers out of the animal Easter eggs. Word search puzzles with dry-erase markers. Singing with me on the group carpet. When group members get finished with everything (indicated by an increase in wandering and often with an increase in volume), we go back to the group carpet for some more traditional music therapy experiences (TMEs) and finish up our time together. That's where the improvised singing comes in.

Incorporating the theme in non-center sessions: I am trying to get centers going two times per month, but I'm not quite there yet. I am also trying to keep the theme going for the rest of the sessions. Next week will probably be a Jukebox week - clients will earn "money" for completing music therapy experiences. They will then either bank their money (in the case of the groups that come to music therapy twice per week) or spend their money on preferred music or preferred instruments/materials. We'll talk about budgeting, about making choices, and about the importance of knowing how to count money. I cheat them in every money transaction - I either charge too much or I give them the wrong change. I let them know that I'm going to do that, but they have to confront me about it every time. I do this because there are people in the world who will take advantage. I want my students to be prepared and to be assertive when they need something from others. They start with me. 

Next month's theme is Saying Goodbye/Grief/Moving On. It is graduation month so it seemed fitting to discuss and explore the feelings associated with people leaving our lives for various reasons.

There are already plans in place for centers and for non-center sessions covering the theme. I'm looking forward to continuing this journey using both themes and centers in music therapy treatment.