Song With A Client - Taking Shenandoah to the Next Step

This week has been a week of song Therapeutic Music Experience (TME) Development. It has been an interesting time as I have been trying to figure out how to put what I do when I'm developing song-based TMEs into a fixed format that is understandable to others. It's more difficult than you would think to actually do that.

So, yesterday's post was about taking a song, parsing it out, and then deciding how it can be used in music therapy treatment. I got as far as the parsing of the song, and then had to stop because I didn't have a particular client in mind. So, today I am going to take it into the idea of how to use the song with clients.

Hypothetical client #1 - female, 18 years old, labeled as having a non-specified intellectual disability in the mild range of function, presents as very high-functioning (diagnosis of ID/DD is suspected to be false), additional diagnoses of Oppositional-Defiance Disorder, Conduct Disorder, Attention Deficit-Hyperactivity Disorder, and Post-Traumatic Stress Disorder based on past sexual abuse.

Music Therapy Session Observations: Client missed first two music therapy sessions after her admission due to extreme non-compliance with transition to music therapy. Reason unknown to the therapist - observed that she did not appear to like any transitions and would become violently aggressive when asked to move from one location to another. When she finally did attend a music therapy session, started the session in escort position and loudly announced, "you can't make me participate." In subsequent sessions, she has become an active participant in TMEs, but always engages in verbal criticism of peers, staff members, and therapist. Appears to have some difficulty with appropriate peer interactions and often criticizes and chastises peers for interrupting the therapist, while interrupting the therapist. Has expressed preferences for popular musicians - hip-hop artists. Has stated that she wants "help relaxing."

Possible uses of song Shenandoah with client:

• Due to stated need for assistance in relaxation, use song as is to prompt or cue deep breathing and progressive muscle relaxation. Therapist will start in active role, offering directives and assistance in developing specific skill during non-agitated moments. Therapist will also assist client in developing awareness of when to start the use of the song and the relaxation protocol in other areas - residence, classroom, other locations outside of the music room.
• Write personal song lyrics to express emotions and/or situations in past that may have led to relationship issues - piggyback onto melody to prompt slow breathing and processing of information contained within the lyrics.

There, of course, are many ways to use any song within the therapy session. These are just a couple of examples of how I could use this song with a client in one of my music therapy sessions. Another client who walks into music therapy might be a candidate for using the song as a motor entrainment cue - using the alternating rhythms as a way to elicit motor movements - could alternate between lower and upper extremity movements - all lower extremity movements on 4/4 measures, all upper extremity movements on 3/4 measures (just an example, folks!). Yet another client may like to use the song to practice vowel vocalizations. There are unlimited ways to use this song with clients, because there are unlimited clients out there...

Thank you for indulging me as I have been working through all of this. Let me know if these ideas make sense to you. Thanks!