TME Tuesday: Back to the Basics - TME Development

It was move-in week in my college town, so I know that classes are getting started and students are getting back into the routine of school and all the things that come with being a music therapy student. So, if you are a teacher or a music therapy student, check out this format for thinking through how you can develop ideas for use in pre-internship, internship, and professional clinical interactions with clients. Here is the format along with an explanation. Please note that this was directed towards interns working at my former workplace, so things might not work for every population served. I think it is a good way to think through the process of doing things in the clinic, and the credit for this goes partially to me and mostly to my supervisors over the years who made me do most of these processes and thought exercises over the years. Here goes...

(By the way, comments, questions, and criticism are welcome here. Let me know what I am missing, what you have never had to do, and what you want to know more about in the comments...)

Therapeutic Music Experience Explanation

NOTE – all portions of this example are to be replicated on your TMEs. If an area is not applicable, please indicate that in the area (e.g., Song: not applicable as it is an improvisation)

 Purpose: This is where you identify all of the therapeutic skills and elements that you will be addressing. (e. g., To increase eye contact; name recognition; peer identification; fine motor control; entrainment; impulse control) This needs to be a complete list. Follow the brainstorming process explained in consultation.

 Use the following table to organize the therapeutic benefits available to clients when they complete this TME. If you cannot think of one for each box, that is fine, but try to brainstorm every possible benefit to help you think in a global manner.

Motor	Academic/Cognitive	Social/Communication
Emotional/Behavioral	Musical	Other

 Source: This is where you cite the source of the application. You need to completely reproduce all information about the composer, the lyricist, and the person that first presented the application to you. Make an effort to find the original composers of all songs – look songs up on the internet for potential source material. If the application/song is your original work, then protect yourself by affixing a copyright symbol to the music that you compose. Include a date. If there is ever an issue with someone else taking your music, you have affixed the copyright and left it with me. I can testify that the song is your original work.

 Materials: List all of the things that you (or future therapists who are replicating this application) will need during the session. Do not forget accompanying instruments, specific CD titles and track numbers as well as CD players, electricity, etc.

 Environment:  Describe all elements of how the group members need to be arranged and any other relevant environmental structure.

 Song/Chant/Words: Insert a picture of your music manuscript. If you cannot insert your manuscript, then add a hyperlink to the file so it is easily accessed by others. Also, if you cannot add your manuscript onto this page, include the lyrics and the chords to the song in this area so others can get an idea of how the music moves.

 Procedure: R=Reinforcement opportunities; C=Redirection/Cue opportunities; A=assessment

1. C=this is a cue for you – what you will do to get clients to respond, so it is indicated by the letter C. This is the section where you perform a task analysis of the application. Indicate each element needed to lead the TME through the letters indicated above. For example, if you will instruct the client to do something, write it down.
2. C=you need to think through all of the steps that you will take, that the client will complete, and the possible responses that you will have as options.
3. C=Write them down.
4. A=Most procedures are very long.
5. R=Include times that you will provide reinforcements and times when you will provide redirections
6. Examples:
1. C=start to sing song, looking at each client
2. A=assess whether client makes eye contact when name is sung
3. R=reinforce client when he/she looks at therapist
4. R=redirect client who does not look by restating name and/or moving closer to the client
5. C=change lyrics to include different movements…

 Therapeutic Function of Music: Describe why you would use music to accomplish the tasks/purposes identified at the start of the TME. What level of music therapy is occurring? Is it adjunctive, primary, intensive, or auxiliary? What elements of the music itself assist you in completing the skill development of clients? What elements of the music have to remain constant in order to be effective in accomplishing the goals? What elements of music can change to accommodate the ways clients interact with you and with the music? Can this TME be used with different forms/musical pieces? If so, what are the criteria for choosing music for this TME?

 Use the following table to identify the musical elements and characteristics present in the music. Try to be as specific as possible as you consider the music used in your treatment planning. What does a steady rhythm bring to a therapeutic intervention? What does a variable rhythmic pattern contribute to a therapeutic intervention?

 

Melody	Pitch	Rhythm	Dynamics	Harmony
Form	Tempo	Timbre	Style	Lyrics

Chart adapted from Hanson-Abromeit, D. (2010). A Closer Look at the Therapeutic Function of Music. Presentation at 2010 American Music Therapy Association National Conference: Cleveland, OH.

 Adaptations: What could you, as the therapist, do to make this TME work with different populations? If a client enters the session on his/her first day, what can you do to make sure that the client is successful? How do you need to change the TME so all of your clients are able to complete the tasks?

Extensions: Imagine that the clients are able to complete all of the tasks that you have identified in this TME in two minutes, and you still have 30 minutes left of the session. How could you change the TME to provide more practice without boring the client? What is the next step in skill development? What would be a natural “next step” to the TME.

 Telehealth Decision Tree: Is this an original song? Y  N – if yes, could be appropriate

Does this song require client choice or communication? Y   N   - if yes, then in appropriate for content creation

Does this song include visuals?   Y  N  

Are the visuals used from another site? Y  N – if yes, then not appropriate for content creation.  If no, can the visuals be used in a powerpoint presentation to share?  Y  N