The End of a Good Thing
Anyway, I am watching the last episode of the fifth season of this particular show. Everyone of the main characters looks like they will die in their pursuit of their cause, and it is moving towards a somewhat satisfying conclusion (I forget exactly how it ends, so I'm really involved with this particular episode). Oh - there goes one of the characters...
My involvement with this particular show leads me to think about other endings in my music therapy life. (Oh no, another one of the characters is sacrificing himself for the good of the cause...okay, no more comments...) At my job, termination procedures are rare. My clients are often here one day and gone the next. Ending music therapy services happens on a regular basis, and there is no way to close the therapeutic relationship.
There was a comment on on of my social media feeds about a client abruptly ending services and what is the ethical response to a decision made by a client not to continue. It made me start to think about endings and how they happen.
It is not the responsibility of the therapist to keep clients in therapy. That is a choice of the client, so the therapist has to accept that decision, even when the therapist does not agree. Sure, we're taught that we need to complete the therapeutic relationship, prepare our clients for our departure, and go through a process (my physical therapist did a CASEBOOK termination procedure with me - made me giggle when I recognized what he was doing) of closure, but there are situations where what we are taught just does not work.
Is it wrong that some music therapists only see their clients once for treatment? Not at all. The expectations and procedures change to accommodate those types of interactions within the therapeutic space. What it means is that the definition of therapeutic relationship has to change to accommodate the form of therapy.
My clients stick with me for a time (but never a known quantity of time), but the relationship will end with little to no input by me. My definition of what termination is has changed from what my professors insisted that I do to something a bit less structured. I have to expect that each session will be my last with any and all of my clients, because it very well may be. This makes things like long-term goals and consistent treatment schedules difficult to achieve, and that is fine for the type of therapy that I am tasked with doing with and for my clients.
The end of music therapy treatment is just as important as the beginning, but I think the emphasis on termination procedures is more for the therapist than for the client. In my clients' cases, people come in and out of their lives all the time. They do not have much permanence when it comes to relationships with other humans, and they really don't seem to care much about whether the music therapy intern is leaving at the end of the month. They are more focused on whether they will still get to play the guitar. People come and go, but someone needs to have the key to the guitar cabinet - as long as someone can give them access to what they want, they really don't seem to care who it is. This attitude can be somewhat disconcerting to those of us who are carers, but the fact is that my clients often cannot let their guards down enough to care for every person who enters and leaves their lives. It is too much energy.
So, the end of therapy often means just that. It ends. I have many other television shows that I have loved that others have not, and those shows just ended. They left me with more questions than answers and extreme feelings of frustration because they just...stopped. Ending therapy in the way that it happens in my music therapy life often feels the same way.
When I find myself unable to do things the way my professors told me to do things, I've learned to adapt to my situation. This may be why I do a closing song where I say goodbye to each client at the end of (almost) every session - needing a sense of closure to our time together just in case our relationship is severed. It may have something to do with my documentation format - narrative notes for every session. My situation dictates other things to me as well - the way I do informal assessments for every client during every session and very few formal assessments the way I was taught to do assessments.
With the type of therapy format that I am required to do, I am able to find some sort of satisfaction that my clients received the therapy that I can provide to them while they are with me. Sure, it may not be textbook, but it is what works for my administrators, for myself, and for my clients. So, when the end of therapy happens, my client can move into the next life circumstance without me.
The end of a good thing can be a good thing.
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