Seeing the Entire Picture

Things are not often what they seem at first glance.

This thought is just as true in the therapy setting as it is in any other situation or circumstance.

This week has been an example of looking deeper into situations that are one thing at first glance, but are something else entirely at the second glance.

I have the privilege of being a music therapist at a psychiatric residential treatment facility for children and adolescents ages 5-22. It is part of a larger program that offers educational and residential services for persons with developmental delays and disabilities from infancy to age 3 and ages 5 to end-of-life. (We do not serve kids from 3-5 due to an educational mandate in our state.)

Kids come to my music therapy room with a variety of letters put very carefully into Axis boxes. Axis I diagnoses are often from the world of psychiatry. Axis II diagnoses are often developmental in nature, and Axis III diagnoses are other health diagnoses. It is not uncommon for a seven year old child to arrive at the facility with strings of letters indicating different diagnoses - ADHD, OCD, ODD, RAD, ID/MR, ASD, PDD-NOS, the list goes on and on.

When you start to look at these letters, you often get one picture of the child. This is not the entire picture.

The trick to seeing past the initials to the child is to stop looking at the initials first.

When I receive an admission notice for a student, I scan it, looking for any and all references to music. (These are often in the section entitled, "Successful Calming Strategies," and are never more than just, "listening to music.") After that, I stop reading.

My students attend group music therapy once per week for a standard group session. We start with an opening therapeutic music experience (TME) which I use as an assessment time. We then move into other TMEs designed to address such goals as impulse control, social interaction, and expressing emotion in an appropriate manner. When I first meet a student, I pay close attention to that student during the first session. I am looking to see if the student connects with me through the musical intervention. This very tenuous description of "connection" is not easily observed unless you know what you are looking for. For some of my kids, connection is simply eye contact. For others, it is volunteering for a turn during the opening TME. For yet others, it is singing along with me to songs that are original to me and to Lakemary.

This initial session gives me lots of information about the child as a human being, not just a series of diagnoses and initials.

There is more to each person than ever meets the eye, or the paperwork.

(By the way, the picture at the beginning of this entry is a shot of the roof of the opera house in Sydney, Australia. If you look to the left, you can see the heads of the school children that were there when my sister and I visited after the 2005 World Congress of Music Therapy. Doesn't much look like a roof, does it?)