TME Tuesday: Writing the Procedure Part of My TMEs...

Now, I make no secret of the fact that I am dedicated to MY way of writing things into therapeutic music experience (TME) plans in my life. I make my interns use my form as a way to indoctrinate them to MY way of thinking about how WE should (goblin alert) be producing materials and ideas for each other to use in music therapy settings. I share MY way of doing things with others as often as I can, so I am hoping that MY ideas have spread to other people in ways that help them plan and implement strong TMEs. There you go.

This dedication to a particular process is something that is a bit pedantic, but it is also how my brain organizes TMEs, so it is what it is. I do not insist that others do things exactly like me (except, of course, for my poor interns during their first four months with me, but I don't insist that they do things MY way after they turn in their TME assignment file in month four), but I do find immense value in my way of doing things.

When I was a student of music therapy (a long, LONG time ago), I had to write task analyses for assignments. You know the type of assignments? Write down the steps to make a peanut butter and jelly sandwich. I don't remember if I was good at those assignments or not, but I know that I did not link the idea of task analysis to writing TMEs for the longest time. My session plans for my clinical practica were returned to me over and over again for not being correct. That was all the feedback that I received - "This is not correct. Do it again." There was no feedback about why it was not correct, so I just kept trying and failing. I would literally use the one example that we were given as my model, and I still failed. Over and over again. It wasn't until the summer between my junior and senior years that I realized what they wanted from me that I had not been able to conceptualize before...

I remember waking up in my room at my parents' house after a good night's sleep and before work thinking "FLOW CHART." Those two words revolutionized how I approached writing my procedure sections for my practica assignments, and I had figured out how to produce what my supervisors had wanted all along but had not been able to teach me!

So, now I write flow charts, and that organizes my brain so it can conceptualize how a particular TME is going to proceed.

It all comes back to the concepts of flow charts and task analyses.

I am a visual person, so the idea of a flow chart helped me understand what I was going to replicate in words. I was able to sketch out a flow chart and then translate it into prose for my supervisors who did not think the way that I think. I was able to organize my thoughts into my way of doing things, and it was revolutionary for me as a therapist! I understood what was needed and was able to do it! Hooray!

Now, I always feel like I have to put in some caveats in this part of my talk. Caveat #1 - this technique may not be what your supervisor wants you to do during your practicum training. It may not be something that works for you as a professional. It may not match the types of experiences that you provide for your clients. That is fine. You need to do what you need to do. For me, this works. Caveat #2 - There is no shame in doing what you need to do. Just because I talk about what works for me on my blog does not mean that it is music therapy canon. You don't have to do what I do at all. I just like to talk about it, because it was such a turning point for me as a therapist.

So, how does this translate into a therapeutic music experience? Here's what I do:

1. I use a letter-coding system to help me organize. C=cue or prompt from the therapist to the client; A=assess client responses/reactions as desired or undesired; R=redirection or reinforcement from the therapist to the client - by the way, this is the place where I can really see my behaviorist training come out the strongest.
2. Each C has to have an A and a R. At least one of each per situation.
   
3. These are all based on my contributions to the procedure. It is the only thing that I can predict or plan. Client responses are varied and unpredictable and endless, so trying to predict their responses to write down into a procedure makes absolutely no sense to me. I focus on what I am doing rather than on what the client will possibly do during the TME so I can focus on what I need to do. The "A" part of the procedure is where I am figuring out if I need to demonstrate something better so my clients will engage. I then continue to revise until my client completes the desired task/outcome. By focusing on what I can bring into the TME, I find that my focus changes to be more client-based rather than plan-based.
4. I go through the steps of each TME to see if I can replicate the experience in a way that would make sense to a music therapist who had never seen this TME in action before.

Here is an example of a TME procedure section for a TME that I am writing for my latest sing about mini edition - sing about october 2021.

1. C=start singing song while placing visual aids in clients' visual field.
2. A=assess whether clients are watching, singing, or displaying other attention behaviors.
3. R=reinforce clients who are actively engaging through including their names and compliments into the song. Redirect clients who do not appear to be actively engaging through using names and proximity prompts while continuing the musical stimulus.
4. C=sing verse, adapting words to include names of specific clients and providing directives for how to complete task.
5. A=assess whether clients attend to verse of song.
6. A=assess whether clients complete task as directed.
7. A=assess whether clients are engaged in any sort of musical interaction during the verse.
   
8. R=reinforce clients who complete tasks as directed. Redirect clients who do not complete tasks with sung prompts only.
9. Repeat steps 4-8, changing prompts, client names, and other elements as appropriate for group members' goals and objectives.

Just a quick example. If you would like to see more of these procedure sections in fully developed and tested TMEs, please consider subscribing to my sing about mini editions for the low price of $9.00 per month. It is almost the fifth, which means that the next edition is about ready to hit in-boxes! Join now to get ideas for October 2021!! (Back issues are also available if you need ideas for August 2021!)

I hope these glimpses into the way I do things helps others figure out their ways into this profession and some of the responsibilities that we have to our clients. Remember, though, that MY way is never THE way. Find your own way into what works and makes sense to you!!