Theme and Variations: Part Three - What a Client Brings to the Theme
This is part three of a series on Themes and Variations. (If you want to read part one, click here. If you want to read part two, click here.) This is a concept that I am currently thinking through, inspired by experiences at the WRMWAMTA super regional conference that occurred last weekend in Colorado, but it has been influenced by many years of theoretical exploration and clinical practice.
Today's focus? The client.
For me, the most important element of any music therapy session has to be the client. After all, without the client, there would only be a therapist sitting there, playing music for reasons that have nothing to do with therapy, just entertainment of self. (There is absolutely NOTHING wrong with making music for yourself, but I contend that without the client, you cannot be doing music therapy!)
So, we've thought about our greater themes - those which shape how we approach the things we do with clients during sessions. We've spoken about our variations - the ones that we develop through our own experiences and clinical development. Now it is time to talk about the smaller themes and variations that occur when you pull the client into the therapeutic process.
To do this, I am going to transfer the idea of themes and variations from the global music therapy perspective that I've been using to frame my thoughts into a more specific use.
Here I am, a music therapist with education, training, and experience, going into a session with a client. I bring my foundational themes into the session (whatever they are - currently, a combination of humanism, behaviorism, and sensory integration). Then, I meet the client.
There are times, no matter how hard I try, that my client will not fit within my theme expectations. I may feel that my behaviorism theme is the best approach to music therapy with a specific client, but the client doesn't respond to that theme. Instead, the client responds better to the theme of sensory integration. As the therapist, it is my responsibility to change my theme to match and support that of the client. If I cannot do so, then it is my responsibility to refer that client to a therapist who can.
Clients also bring their own themes into therapy.
I work with children and adolescents with developmental and acute psychiatric concerns. My clients do not get a choice about attending music therapy - it's part of their treatment life. Some do not want to participate.
I had one client who had to be brought to the music therapy room by being carried. She was very hostile towards me (without having met me before) and screamed, "You can't make me do this!" (add in some profanity in that statement for the full effect). I stated, "You're right. Have a seat next to the wall where you won't be stepped on." I then proceeded to ignore her, and she ignored me until we reached the end of the session. I asked her peers for suggestions for music listening since our "work" was finished. We played current hits. She perked up and actually spoke to her peers. The next session started off in a similar manner - she was carried into the therapy room, still screaming, but she didn't pretend to sleep during this session. She still refused to participate, but she was watching her peers engage in different therapeutic music experiences (TMEs). At the end of the session, when I asked for listening suggestions, she made a request. I (fortunately) had the song, and she started to sing. The next session? She led the class down to the therapy spot and participated fully in all TMEs. A couple of weeks after that, there was a new peer in her classroom. I overheard her say, "Music here is different than in any other place I've ever been. We get to choose what we listen to. It's really cool." She became the biggest fan of music therapy and would plan her aggressive behaviors around her times in the music therapy room.
Her theme started off as hostility, indifference, disruption, and fear. After some time, I think she realized that my intention was to introduce elements of my theme to her, but to allow her to change the theme to something that reflected her and what she could bring to the session. By the time she left the facility, we had found our common theme, and we had been able to strengthen that theme both as a dyad and in a larger group setting.
There are some clients where there is never a need to change a theme. The client falls into the theme presented by the therapist straight away and never needs to alter it. There are just as many, though, who never replicate the theme of the therapist. When that happens, then, it is the task of the therapist to introduce variations of the client's theme until both therapist and client can interact in a way that promotes growth and progress towards the client's therapeutic goals.
For me, this a good description of what happens when I develop a therapeutic relationship with a client. I go into the session with my foundation themes and my thoughts on variations. The client enters and brings his or her themes and variations. We then start to merge the two into a new theme and variations based on what we learn about each other. We tend to keep the same theme (goals) throughout the treatment time, but the variations within that theme are unlimited. When we exhaust our options for variations and/or the client is able to use them independently, it is time to end the musical piece and the therapeutic relationship.
Over the years, my foundational themes have been stretched and changed by the clients I have met and had the privilege of serving as therapist. The variations that they have gifted to me have enriched my theme significantly. In another manner, the interns that I have trained over the years have also altered my theme and provided me with any number of variations to my original theme. They have also changed my theme from my original to the one that I use now as my base for music therapy. Every person I meet has the potential to shape my theme, and I hope that you know that you also do this - through comments on this blog, through random discussions on social media, through in-person conversations at conferences, through participation in webinars, and through doing our jobs - you shape my theme of music therapy and show me variations I would have never thought of on my own.
Thank you.
Today's focus? The client.
For me, the most important element of any music therapy session has to be the client. After all, without the client, there would only be a therapist sitting there, playing music for reasons that have nothing to do with therapy, just entertainment of self. (There is absolutely NOTHING wrong with making music for yourself, but I contend that without the client, you cannot be doing music therapy!)
So, we've thought about our greater themes - those which shape how we approach the things we do with clients during sessions. We've spoken about our variations - the ones that we develop through our own experiences and clinical development. Now it is time to talk about the smaller themes and variations that occur when you pull the client into the therapeutic process.
To do this, I am going to transfer the idea of themes and variations from the global music therapy perspective that I've been using to frame my thoughts into a more specific use.
Here I am, a music therapist with education, training, and experience, going into a session with a client. I bring my foundational themes into the session (whatever they are - currently, a combination of humanism, behaviorism, and sensory integration). Then, I meet the client.
There are times, no matter how hard I try, that my client will not fit within my theme expectations. I may feel that my behaviorism theme is the best approach to music therapy with a specific client, but the client doesn't respond to that theme. Instead, the client responds better to the theme of sensory integration. As the therapist, it is my responsibility to change my theme to match and support that of the client. If I cannot do so, then it is my responsibility to refer that client to a therapist who can.
Clients also bring their own themes into therapy.
I work with children and adolescents with developmental and acute psychiatric concerns. My clients do not get a choice about attending music therapy - it's part of their treatment life. Some do not want to participate.
I had one client who had to be brought to the music therapy room by being carried. She was very hostile towards me (without having met me before) and screamed, "You can't make me do this!" (add in some profanity in that statement for the full effect). I stated, "You're right. Have a seat next to the wall where you won't be stepped on." I then proceeded to ignore her, and she ignored me until we reached the end of the session. I asked her peers for suggestions for music listening since our "work" was finished. We played current hits. She perked up and actually spoke to her peers. The next session started off in a similar manner - she was carried into the therapy room, still screaming, but she didn't pretend to sleep during this session. She still refused to participate, but she was watching her peers engage in different therapeutic music experiences (TMEs). At the end of the session, when I asked for listening suggestions, she made a request. I (fortunately) had the song, and she started to sing. The next session? She led the class down to the therapy spot and participated fully in all TMEs. A couple of weeks after that, there was a new peer in her classroom. I overheard her say, "Music here is different than in any other place I've ever been. We get to choose what we listen to. It's really cool." She became the biggest fan of music therapy and would plan her aggressive behaviors around her times in the music therapy room.
Her theme started off as hostility, indifference, disruption, and fear. After some time, I think she realized that my intention was to introduce elements of my theme to her, but to allow her to change the theme to something that reflected her and what she could bring to the session. By the time she left the facility, we had found our common theme, and we had been able to strengthen that theme both as a dyad and in a larger group setting.
There are some clients where there is never a need to change a theme. The client falls into the theme presented by the therapist straight away and never needs to alter it. There are just as many, though, who never replicate the theme of the therapist. When that happens, then, it is the task of the therapist to introduce variations of the client's theme until both therapist and client can interact in a way that promotes growth and progress towards the client's therapeutic goals.
For me, this a good description of what happens when I develop a therapeutic relationship with a client. I go into the session with my foundation themes and my thoughts on variations. The client enters and brings his or her themes and variations. We then start to merge the two into a new theme and variations based on what we learn about each other. We tend to keep the same theme (goals) throughout the treatment time, but the variations within that theme are unlimited. When we exhaust our options for variations and/or the client is able to use them independently, it is time to end the musical piece and the therapeutic relationship.
Over the years, my foundational themes have been stretched and changed by the clients I have met and had the privilege of serving as therapist. The variations that they have gifted to me have enriched my theme significantly. In another manner, the interns that I have trained over the years have also altered my theme and provided me with any number of variations to my original theme. They have also changed my theme from my original to the one that I use now as my base for music therapy. Every person I meet has the potential to shape my theme, and I hope that you know that you also do this - through comments on this blog, through random discussions on social media, through in-person conversations at conferences, through participation in webinars, and through doing our jobs - you shape my theme of music therapy and show me variations I would have never thought of on my own.
Thank you.
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