music, therapy, and me

Yesterday was another rough day for my session - not for the ones that my intern ran, but MINE! I am starting to feel that this is a personal vendetta from my clients, but I know that is ridiculous. Today, I am heading into a full-moon (don't doubt, scoffers), upcoming winter storm, short-staffed, mess of a job to lead three groups. I am hoping that they will be at least a bit receptive to music therapy today. We have two other groups to go through - my intern will lead one completely and will do as much of the second as possible! In another setting event, I got home to a home without power - on webinar night. I was able to start a communication chain but had to cancel because I was unsure if the power would be on at webinar time. Sigh. At one point during my ONLY group session yesterday, there were two kids in crisis, one kid taking a break, and all sorts of situations happening. We had a new staff member in the session - don't even know the person's name - who did not app...

A friend of mine messaged me yesterday to ask me how things were going, and I started to cry. Yesterday was one of those days where clients who used to love being in music therapy were ripping things off the walls, breaking the thermometers, and destroying things, all while trying to hurt me. Actually, it was just one client, but still, it hit me deep. We are very short-staffed at the moment, and the only staff members that were present are not ones that I know. I have no idea if they were trained in our crisis management system or not. All I know is that they did NOTHING to help me out. This happens every Tuesday, and I am exhausted by the situation. The student refuses to talk to me or to use the program that the student has agreed to use. This happens regardless of what we are doing or the sounds we are making which makes it seem personal. The student will bring in noise-cancelling headphones and then destroy them rather than wearing them. add in the fact that the student makes thre...

I am very tired. Some of this is due to the increase of medication that I have had to take due to my seasonal allergies, but I think most of the tired feeling is from frustrations and challenges at work. That's right. Work is affecting everything that is going on in my life. This isn't a big surprise to me, but it may be to a new professional out there. What happens at work can affect what happens at home and the opposite is also true. What happens at home can affect what happens at work. I cannot completely separate my work life from my other life - it is just not completely possible. Trying to deny the effect of work on my non-work hours just leads me to constant stuffing and avoidance behaviors - neither of which are good for me. It is time for active solutions to this problem. I cannot control how my clients react to what I present. All I can do is present my expectations and my requirements to them in a consistent manner each and every time. I will script my re...

In the past two weeks, I've had very few positive sessions at my facility. My students are struggling, our mostly new staff members are struggling, and I am struggling to get anything accomplished. I am feeling like a failure as a therapist because I haven't had a day go by where I wasn't physically assaulted by a client for simply requesting that they remain safe in my therapy space.  Here's the deal, folks. Music therapy is not always comprised of "happy people making happy sounds." There are times when you have to deal with humans at their worst, and it is not fun. These times, though, are the times when music can be most powerful and the role of the music therapist is the most important. Sure, any therapist can enjoy their job when everything is going right, but it takes stamina and realism and dedication to stick with a difficult client during a difficult time! (I currently have about 100 clients going through difficult times, so I am feeling like ...

Yesterday was a very bad day. I had to write up eight students for severe behavior incidents, I need to write one more (at least), and I left the job feeling like a failure. After all that, I was doing my bus duty job and one of my co-workers found the arm from my Darth Tater keychain. I didn't even know I had broken it off, and there it was! That was the absolute last straw, and I ended up crying tears of joy and frustration in the hallway in front of five co-workers! What a day. I think I am going to spend my planning and preparation time sitting at the piano, transcribing songs that I've used in recent sessions. I want to be writing three therapeutic music experiences every week - getting them into my database and using them as well - but I haven't been writing things down very much. I think I'll take my jumpdrive to the laptop and sit in my big, beautiful music therapy room, and just sit down and compose some music. My Fridays are predisposed to chores like ...

I struggled with the same four clients yesterday that challenged me last week. The problem? Giggling, running around the room, and doing things expressly asked not to do is SO much more reinforcing than anything I have to offer that nothing gets accomplished except for lots of chaos and mayhem. Now, I've been through situations and classes like this before, but none of us were prepared for this type of response from these students. It is all because we have a new student in the class. This student was originally in a classroom where no one would respond when he got squirrely. Now he is in a class where EVERYONE responds when he gets goofy. They all join in! It goes from engagement to out-of-control in an instant. There are very few indicators that the kingpin of this particular response has any signs of approaching overstimulation - it just happens! BAM! So, yesterday's session included having assigned seats, but students could see each other, so I was not really able to ...

I work with some challenging clients. Every student who attends my school has been sent to that school program because they have failed in every other school environment. This often means that the group sessions that I have to do are full of kids who have learned to avoid undesirable tasks through aggression, tantrums, self-injurious behaviors, running away, and doing all sorts of things in order to gain attention or leave uncomfortable situations. Classroom groups are determined by people who never have to work directly with the students, and often group members are not very compatible with one another. At the moment, I have several groups that are complete messes. Imagine a group of 12 kids, ages 7-21 (yep, you read that right - we have that range of ages in the majority of our classes right now). Staff members are in all sorts of training at the moment, so there are never enough staff members to cover our basic ratios of staff to student interaction. Add to the environment the...

I had a small triumph yesterday.  I don't think that anyone else in the room even noticed it, but I used music to calm a very agitated student in one of my sessions. It took some time, it took some deliberate application of music, but you know what?  It worked. I used every tool at my disposal - repetitive music, using my voice to replicate the volume of the vocalizations happening, singing reflective statements and redirections, still engaging all of the other students in something therapeutic while this was happening, and embedding specific cues in both the musical phrases and the sung lyrics. By the end of the very turbulent session, the client was sitting quietly and was no longer hitting self or others. There were six staff members in the room who were completely unaware of what I was doing and how it was working. In fact, they spent most of the time in the room chatting with each other about specific things. (I am going to have to do some training with those spec...

The therapy week is finished. The therapy week is finished. Ooh, I like saying that this week. The therapy week is finished. (By the way, while I am reading that in my head, there is a soundtrack that goes along with it - music is played by a full orchestra and has majestic chords and cadences...hmm.) The therapy week is finished. I do twenty music therapy groups per week. Sixteen of these groups are convenience based, meaning that I have absolutely no say in who is in which group. Four of those groups are organized by the art therapist and myself which allows us to arrange our clients based on level of independence and appropriate relationships with others - that's the system I prefer, but the other teachers struggle with the idea that they can split their classes up into other groups - it's a control-type issue. Blah, blah, blah - long story short, I often feel like my services are viewed as babysitting/entertainment by some of my co-workers. Yesterday afternoon was a...

I had to take a sick day today. It is Day FIVE of the new school year, and I am already needing to be at home, dealing with my health, rather than being at work, where I belong! I am absolutely disgusted with myself and with my body right now, sitting here, four hours later than I usually blog because of my body. I am feeling guilty and sick - never a good combination. Yesterday was a bad day. It started with complete exhaustion and ended up with four out of my six group sessions requiring behavior management assistance that kept clients and others safe. Kids were screaming, staff were stressed, I felt ineffectual - it all added up to a loud, nonproductive day in the music therapy room. It took all the effort I had to go to work yesterday, but I went. I came home yesterday feeling completely wiped out. I was dwelling a bit more than usual on the bad sessions that I had led, and I was just exhausted. I tried to stay awake until the bedtime that I want to have, but I think I feel a...

Yesterday was a horrible day. I have a feeling that this is going to be the way Tuesdays and Thursdays are going to go for a while due to the classes that I see on those days. My afternoons now have three groups in them, and the groups are not the easiest groups to see. I tried REALLY hard to see those groups in the morning when they are less tired and cranky and a bit more ready to engage in therapy. At this time, I think therapy will be just separating kids from each other and keeping them from engaging in social interaction. They just cannot seem to be in the same place for more than 2 minutes. I left work with the news that we are now replacing 4 of our 12 teachers in the next month (if we can find folks to take those teaching positions). More upheaval for my students who do not deal well with change to begin with. More upheaval for me and my co-workers. We already had a new teacher beginning, a new Speech-Language Pathologist, and a new COTA starting in July - now we get to add ...

Yesterday was a day full of screaming, clients acting up and acting out, and general chaos. Actually, that was only the first session, but it felt like the entire day. It was quite funny to watch the kids take advantage of cranky staff members and the opportunities presented by their peers. One had a hissy fit when I asked him to look next to him and let me know if there were any cards on the floor. Full-out tantrum. Ridiculous. When they left, I had to go into the next session immediately, so I didn't get much time to process the events of the day. I'm behind in my notes, and I'm trying hard to keep a bunch of cranky people in the room during music therapy sessions. I know that this isn't all my fault (I've been hearing very similar stories from people all over the facility), but it really does feel personal at times. My goblins start, especially in the car and when I'm trying to sleep. "You should be able to engage all clients at all times." ...

This was a rough week. It started with a day off - which is always nice - but that meant that we all went back to four days of being a bit off. The iPod had a meltdown, stopped talking to the computer and then stopped talking to me. Middle school clients were rioting, fists were flying, screaming was happening everywhere, but definitely in the music therapy room. There was some consolation in the fact that middle schoolers were screaming everywhere, but it didn't make things any quieter in my small, acoustically difficult space. What are your biggest group therapy challenges? How do you engage diverse clients into a common therapeutic music experience? I know what I usually do in these situations, but my current methods of interaction just aren't working these days. My philosophy about this is if the  clients aren't fitting to the current treatment service delivery model , then you change the delivery model to fit the clients. I spent the entire afternoon thinking ...

I had to apologize to several teachers this week. I am going to take about 55% of the responsibility for these apologies, and I am going to blame the full moon for the 45%. (I love when I can blame SOMETHING on moon phases!) My session contour was really poor this week. I tried to find an arc to my sessions, but my students went up and up and up and did not come down again, no matter what I tried with them! I first heard the concept of "session contour" from one of my music therapy professors. If I wanted to do so, I could probably figure out who first used the term, but I don't really want to delve into layers and layers of research at 5:14 in the morning, so I am just going to stop with the person who first told me about the concept. "Session contour" refers to how a therapist organizes the musical elements of his/her therapeutic music experiences (TMEs) to move clients from one emotional/behavioral/energy/arousal level to others during the session time.  ...

Yesterday, I screamed in the middle of a music therapy session. This wasn't a rant or bearing instructions, it was just a horror movie type scream. I typically save those types of emotional outbursts for after difficult sessions, but I went with my gut during said difficult session when almost all of my students were screaming at each other, flinging obscenities, and trying to beat the snot out of people on the other side of the way-too-small room. I closed my eyes, took a deep breath, and let it rip! I opened my eyes and saw a bunch of confused, but silent faces looking at me. My next words probably weren't the best, but they just slipped out. "Now you are listening." Okay. My best moment as a therapist? NOT AT ALL! I am not encouraging you to use the primal scream as a therapeutic tool, but there are times when it works. Luckily for me, this time it worked. We all practiced using our coping skills of breathing, ignoring, and counting numbers b...