TME Tuesday: Taking Something and Developing Ideas

Last week, I started to describe how I strive to think about the stuff that surrounds me at my job. I started by describing my ground rules -

• No idea is "wrong."
• No list is ever completely finished.
• Clients will change my thoughts through their own contributions and use of the materials.
• Watch how other music therapists use their materials for more ideas.
• Generic TMEs are perfectly fine - for example, a "Novel Instrument Exploration" TME works really well for all sorts of instruments.

Then I started to describe my process. It is time to further develop this into a series of posts. If you want to read more, here is the link to the first post in this new series.

Once I have finished up the sensory exploration and listing, I start to brainstorm some treatment domains that go along with the information that I have collected. The last example, the rhythm sticks, offer plenty of opportunities for use in music therapy sessions. One of the reasons that I am writing about all of this is that interns often come to me with the mistaken expectation that you have to have a song for rhythm stick use and you can only use that song with rhythm sticks. Nothing else. The other side of that mistaken assumption is that you cannot use rhythm sticks unless you use that particular piece of music.

If you are a music therapy student right now, hear these words...

You can do more than one thing with any material/object/instrument.

There you go.

Off soapbox and continuing with the information that I have started here.

I start to list the treatment goals for the object selected, in this case - rhythm sticks. Now, I have separated my treatment domain areas into six categories for the ease of my own use and categorization. These are not the ONLY or even the BEST treatment domains - they are just the ones that I use.

Motor - For some reason, I always start with the motor domain. So, with rhythm sticks, we have grasp/release pattern development, hand strengthening, fine motor skills - palmar and pincer grasps, gross motor skill development - depending on use. We could include patterned movements here - sequencing, but I will probably include those skills in different areas. We can also include hand-eye coordination, and movement across several planes on the list.

My other categories include Academic/Cognitive; Social/Communication; Emotional/Behavioral; Musical; and Other. I go through the brainstorming process for all of these domains and continue to make a list. At the end of the process, I have a completed chart.

Let's go into a clinical scenario. Client walks into a session. I've planned using the cymbal and my cymbal song to work on grasp, hand-eye coordination, and movement through different planes. We are also going to address weight management and strength building. The plan is for the client and me to move the cymbal around us while the other of us hits the cymbal. The problem?? The client is more interested in the rhythm sticks this time around instead of the cymbal that she couldn't stop playing during the last session. Do I give up on the goal and objective of the session? Do I force the client into playing the cymbals like I have planned? Do I adapt what I have and replace the words "cymbal" with "rhythm stick" and proceed as planned? Of these options, I find the last the easiest to accomplish, and why not? Why not change and adapt my plan to what my client is interested in? The only difference when you use the rhythm sticks versus the cymbals in this clinical scenario is that the sticks are significantly lighter than the cymbals. If strength training is the primary goal for this client, then use both - the rhythm sticks and the cymbals and then switch.  Use your client's interests to maximize their skill development. You can move the rhythm sticks the same way that you can move a cymbal. Instead of singing the word, "cymbal," you can substitute "rhythm sticks" or "sticks" into the same song. There you go.