"NTM" TME: Goals and Objectives
I do not have formalized goals and objectives in my music therapy clinical space. This is primarily because music therapy is considered an educational enrichment service at my school rather than an IEP-based service. Basically, what this means is that I have general goals for music therapy treatment, but I do not have to work on academic goals only. My general goals are pyschosocial in nature, so almost everything that I do can incorporate those goals, and everything does.
What this means, on a practical sense, is that I often have different levels of goals for every TME that I present to my clients.
(This is something that is really clear in my brain, but often gets confusing when I try to explain it to others - bear with me.)
Every client that arrives in my music therapy room has individual goals for their own treatment process. I also have goals for their music therapy experience that I have determined. My MT goals tend to be less specific than their individual goals - this is part of how music therapy works at my facility and varies in different programs. For example, Client A may have a personal goal of increasing communication of wants and needs from 3 utterances to 7 utterances. My MT goal may be for the client to indicate wants and needs to move a song from beginning to end. There are similarities in what our end goals are, but they are not exactly the same. I know that my client has completed my goal when we get to the end of a verse of the song. I may not necessarily know if that was 7 utterances, but I can shape my song to ensure that my client has that opportunity, if desired.
(That's an entirely different topic - I need to get back on track...)
Sitting next to Client A is Client B - someone who is working on increasing sustained attention to task. Client C is working on emotion identification, and Client D is trying to maintain appropriate social boundaries. All of these clients have their own goals, and I have goals for them as well. It is somewhat difficult to coordinate all of these goals into one TME, but it can be done.
My responsibility is to design TMEs that include all of these individual goals. It can be done - we do this on a regular basis as music therapists - we incorporate multiple goals into every interaction that we have with clients - but I think we do not always understand what it is we are doing.
When it comes to the TME planning process, I have to spend time figuring out how I will incorporate all of the things that my clients are addressing within one TME. (Here's where the different levels of goals come in.) Every client has their own primary goal - for Client A it is those utterances. This is the reason that I am choosing to use the particular TME for Client A. For Client B, however, the reason that I am choosing to use the same TME is different - this is because Client B's goal is different.
I have to figure out ways to challenge each client from within their own goal area in one TME - every time I run a TME with this group.
So, for me as the music therapist, the process of goal and objective (linked to data collection and evaluation, of course) identification goes a bit like this...
TME idea - "I Don't Want To" Blues Improvisation
Concept: Clients will identify various things that they do not like to do - can be chores, places, foods, other topic areas. Clients will actively engage in turning identified dislikes into blues progression. Clients will interact with one another during song writing process and music creation.
All the Goals: Here is where I brainstorm all the possible goal areas that this TME could address.
- if we are writing things down, this could work on handwriting, letter formation, symbol notation, fine motor grasp, hand/eye coordination, sentence structure
- With the addition of instruments, this TME could encourage work on fine motor and gross motor coordination, entrainment to external stimulus, social interaction through musicking, patterning, impulse control through waiting to play when indicated, singing individually and with a group, crossing mid-line (possibly - this depends on the instrument and the way it is played)
- preference identification, making decisions, expressive communication, receptive communication, attention to task, completion of one or multi-step directives, oral communication - articulation, iconic communication - pictures, social interaction with others, asking questions, answering questions, repeating verbal information, reading written information, sequencing, short-term to long-term memory development, awareness of others, communication of wants/needs...
Now, here's where the concept of different levels of goals comes into play. All of the goals listed above are reasons why I would use this particular TME with my clients - any of them, but all these things are not why Client A is engaging in this particular TME in music therapy. Client A is working on verbal utterances, so I would choose this TME for Client A because it offers opportunities to make statements and utter phrases when cued. This doesn't mean that working on the other areas wouldn't be good for Client A, but that isn't why A is at music therapy.
In my brain, this is the difference between primary and secondary goals. Client A's primary goal is to increase utterances. Everything else that the TME offers is secondary to Client A's reason for being in music therapy. There is benefit in completing the rest of this TME but that benefit is not directly linked to why Client A is in treatment. Client B's primary goal is different from Client A's, but it's in the list as well.
So, as I go into TME development, I know that I need to offer opportunities for all of my clients to address all of their primary goals. I can then plan the TME to the specific group of clients that will be in each session.
I've got to start the process of formalizing this particular TME - it will be a good addition to my TME list!
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