music, therapy, and me

When I am writing music, I tend to do one of two things. I either start with a specific client in mind and write for that client's goals and objectives, or I start with an idea and let the idea grow regardless of the clients that I am serving at the time. I spend time with lots of hypothetical clients - thinking about the vast number of clients and their unique goals as I develop songs and therapeutic music experiences (TMEs). Today, though, I would like to start with the first focus - that of a specific client and his or her or their goals. Currently, I am sharing a wall with a class of students who are experiencing lots of life and school changes. Two students have transferred from residential care to home care and are now day students. One student is brand new to the classroom. Another student recently left the class. All of these changes have shifted the dynamics in the classroom group, and old behaviors of concern have reemerged as well as finding new behaviors to contribute. ...

I had a discussion with a colleague yesterday about the challenges that I am facing in my music therapy clinic right now. This colleague shared that the same things were happening in their environment as well which was a bit validating. It was nice to know that the patterns that I'm seeing in client behaviors are not specifically linked to music therapy or the current change in session leadership that is happening but is more general than that. When these seasons of treatment happen, and they do happen, I spend lots of time engaged in self-reflection. This is both good and bad for my state of well-being because I end up taking things personally that are not personal at all, and I eventually come to the conclusion that I am making progress with my clients. I just have to shift my definition of what my clients need from me to something that is less long-term in perspective and is more immediate. My afternoon groups often come to me after being in PE. Now, I'm not sure what ...

The cat is typing this morning as she walks back and forth, trying to get my attention. She is not usually eloquent, but she is insistent. I was going to title this post something pithy like "Finding a Song," but she has a different idea. Apparently this will be titled, "iuuuuuuuuuuukfgvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv." Letting the cat type probably isn't the best idea for this Friday morning, but it has been a challenging week, so my brain isn't working the way it should be.  I went to work yesterday after two days at home with a horrible dizzy spell associated (I'm hoping) with an infection. I'm on anti-nausea medicine for the dizziness, but it is still affecting me. When I went to work yesterday, I met a new student who came to music therapy with our Behavior Specialist in tow. Now, our Behavior Specialist is a nice guy, but he really just doesn't get music therapy or the interaction behaviors that often emerge in therapeutic e...

There was a question about working with persons with the diagnosis of Oppositional Defiance Disorder (ODD) on one of my social media links, and a friend of mine tagged me to respond. I started to think about the folks that I know who have come in with this label, and how I worked with them. In my years of working with children and adolescents with a variety of concerns, I have found that the way I work with those with the initials ODD as part of their mental and developmental health diagnoses is not that different from how I work with those without those particular letters. When I start to sit down and think deeply about what I want the therapeutic relationship to look like, I want my clients to make decisions about their own treatment. I want my clients to know that they have a say in what we do, and how we do it. I want to foster a mutual respect for the clients who come to music therapy with me. To that end, I find that there are times when my clients don't want to do what I h...

I started the day yesterday with no idea what I was going to do in my group sessions. Let me explain a bit about what it is that I do. I provide 60 minutes of music therapy for every classroom per week so "teachers can get their plan time." There are no other guidelines offered by my administration, so I have freedom in what I do with my students when they arrive. I just have to keep them for 60 minutes. I have some basic treatment guidelines, but nothing really very formal. Music therapy is considered an "educational enrichment" service at the school - something offered for the benefit of students, but without requirements to be tied to the IEPs of clients (fortunately - I don't think I could handle attending 110 IEPs every year and the paperwork would be extremely daunting - ugh). My basic treatment guidelines are to address impulse control, social interactions, appropriate communication of wants and needs, and frustration tolerance/coping skill development....

This morning, I put my iPod on shuffle and took the first song that popped up. (By the way, it happened to be I Like to Move It as performed by Reel to Reel - this is going to be too easy!) I was thinking that I would take any song and demonstrate how I could make it meet client goals and present levels of performance. For me, this process always starts with the clients. Let's say I am working with a group of older adults who are in post-stroke rehabilitation treatment. Everyone in the group has upper extremity range of motion goals. This song comes on, and I have to make it something that encourages progress on my clients' goals. (By the way, this song is almost too easy for this group. I'll do another, more difficult group in just a bit.) There are a couple of things that complicate the use of this song with this group. First of all, it is out of most of the music preferences of the group. It will probably not be extremely familiar to all of my clients, but the song...

I am tired of my Thoughtful Thursday topic, so I am going to vacate it for a while. I haven't remembered to write on different quotations, so it should be easy to let this topic go the way of Sing A Song Sundays and Song Synthesis Sundays. I will be Thoughtful NO MORE!! So, that leaves me with another dilemma - what should I write about right now? This dilemma always starts after the opening paragraphs. The questions start - "Is this interesting enough to me to continue writing?" "Does this have anything to do with Music, Therapy, or Me?" "Should I just skip today completely?" Then, I usually settle into a topic or an idea and start to write. As I wrote a couple of weeks ago, I am in the termination process as a client (for, really, the first time in my life). I am down to the last session next week, and I am experiencing separation pangs and simultaneous excitement. I am both very proud of my progress and scared to death that I am going to do some...

The termination process has begun. I've only ever been on the client side of termination one time before now, when I was in counseling during my junior year of college, and that really wasn't too bad. The expectation was that the counseling would stop when the semester ended. I knew it at the beginning and didn't really notice any termination techniques during that time. I'm noticing now. I think I have about three more weeks of physical therapy left before I am finished. No one will really say anything about timelines (which I hate), but the insurance company has authorized treatment through my six-month post-surgery appointment at the beginning of June. So, the physical therapist has started the topic of termination. I bet that most of his clients don't realize what is going on, but I do. I have experience being on the other side of things. You start to talk about how far the client has progressed. You continue with discussion about how to maintain the level r...

I hopped over to Music Sparks , JoAnn Jordan's very engaging website, this morning to read about her ideas for developing session plans for challenging times . I was heartened to read that her ideas are very similar to my own when it comes to planning sessions - check it out - and her post started me thinking about what I do when it comes to session implementation. What do you after you have designed the plan? So, this is kind of a continuation of the ideas that JoAnn shared. What do you do after you've designed the plan, the session has started, and the client is sitting in front of you, waiting for the next thing to do? One of the things that I like about music therapy is that the therapeutic medium itself, music, is easily adapted to fit many different situations, responses, and needs within the moment. Many music therapists instinctively alter musical elements in order to assist their clients in engaging with the medium during each session. We often play our music at ...

One of the pods at my school has figured out themes for each month, and, after years and years of asking teachers to give me some guidance about what they are talking about in the classroom, one of the teachers FINALLY did! So, I know what they are talking about at some time during this month!! I'm taking advantage of that fact to coordinate a part of my music therapy treatment for these classroom groups. There are four themes each month. For January, we are focusing on Kansas (because we have to celebrate Kansas Day by the 29th - state mandate), Winter, Letters, and something else that I wrote down at work and have planned, but cannot remember right now... [head hung down in shame]. This week we are doing Winter and the something else I cannot remember right now. (NOTE: I think it is traveling in air vehicles...) I am not a therapist who likes to plan out a script and follow it regardless of what the clients are doing. I am a therapist who likes to have basic ideas of how I wi...

If you've been reading this blog for the past year and a half, you know that my facility has been undergoing renovations. One of those renovations was the construction of a new music therapy space. Yesterday, I moved everything but my computer into the new music therapy space. I start treatment in the new room today, and I get to be the first therapist to do music therapy in my new room today. This is an important thing for me. I digress - I spent yesterday moving things (yet again) and placing them in the cabinets from the old music therapy space. I have brought some stuff home - unfortunately - but almost everything that I need is in the cabinets ready to go! I am also ready to go. This past year has been challenging on many levels. I now know that I can be an itinerant therapist, even though I prefer not to be moving around all the time. I know that the space that I've "been given" (seriously, that was the quote!) is going to be inadequate for the types of th...

Today's favorite thing is also something that stresses me out at this time of year - less than 2 weeks until the AMTA annual national conference. This year's excitement and stress is happening just on schedule, and I am in the throes of dreams, trying to figure out what I want to say to folks, and stressing that I am going to miss some of the meetings that I'm supposed to attend. Here are my top ten reasons for attending the AMTA national conference every year: 10. Time Away From Work - It is really nice to spend some dedicated time away from my clients and from the other stressors at work. I am often so busy that I don't even think about work - it's a nice change of pace. 9. Networking - I find it very interesting to meet new music therapists, and conference is the time when I personally meet people I already know from other places. I don't often meet my social media contacts (since they live around the world) in person, but there is a greater possibility ...

I am currently in a bit of a stress-cycle induced by renovation, schedule changes, ineffective communication, extra work responsibilities, and kids who are extremely confused by their new classes, classmates, and schedules. I am having some trouble keeping track of what day it is. This is not unusual when I'm in the center of a scheduling vortex - and my schedule may change yet again - I can't seem to get to the place of habit when the schedule changes every 10 minutes. So, today is Wednesday, I think, and I'm trying to get ready for my day. I hope the schedule I am thinking about is the actual schedule that I have to do. I guess I'll find out. I am a person who thrives on structure. I need and want a routine. Now, once that routine is established, I love some unpredictability within that structure. I have no problem going with the flow and improvising therapeutic music experiences (TMEs) once I know that I need to be in a classroom from 10:45-11:45 and have som...

I am still updating my digital copies of CDs that I have stored around my home. I went through each album stored on my computer, and then started to go through the books and books of CDs that I have here. I am actually looking for one particular song, requested by one client (over and over and over again). I am pulling out CDs that I don't remember seeing in my music library. (I am going to go off on an iTunes rant now. If you are a fan of iThings, you may want to skip this paragraph as I am sure to offend you in my intense confusion and hatred of all iThings.) One of the things that drives me crazy about iTunes is that it often misnames the tracks on my CDs. Someone somewhere entered the playlist into the database wrong and it stays that way forever! I am not sure how to fix it, but it really puts a crimp in my music-searching skills! I do not remember having this problem with Windows Media, but maybe it was present there as well. I must say, iTunes does recognize more of my obs...

I am full up of the music therapy goodness that happens often for me - it is a refreshing change from the goblin-filled thoughts of a day ago...   Yesterday was a good therapy day.   I actually had a chance to run music therapy groups (with drums) during my day, and I spent some time with some great kids! It was the perfect way to banish that shoulda goblin from the forefront to the background (but he hasn't left entirely yet...). We used a variety of drums yesterday in my two groups. With my students, I typically do not do anything really fancy with them until we can entrain to a steady and common beat. This is always an interesting exercise. Some of my students entrain quickly and easily - others do not. It seems that most of my nonentrainers are higher functioning, need less supports, and have diagnoses on the Autism Spectrum towards the Asperger's range. Sometimes they seem to be fighting the urge to entrain to a beat. If I change my pattern to match theirs, they cha...

Today I am taking a brand new, 3-ring binder into work. There. How is that for thrilling news?? I am going to use the 3-ring binder to organize my internship stuff. All the stuff that I give to interns will be freshly organized into a new folder. The old folder is worn out and cracking at the seams. It needs some updating, so out with the old, in with the new. Sometimes, it's the little stuff that really makes a difference in someone's life. I have a young man who has finally started to realize the importance of communicating what he wants and needs. He has experienced the "A-ha" moment when he realizes that what he signs is meaningful to others. If he doesn't know the sign for harmonica, he is able to mimic what he needs to do in order to play the harmonica. COMMUNICATION! He is a signing sponge right now - pulling out pictures and looking to me to give him words (which I can do with my 20-year old ASL vocabulary and a signing dictionary!). He seems thrilled ...

There are times when every group of people becomes a challenge for the person tasked to be the leader. In my opinion, the mark of a great leader is the ability to find a way to bring the group of distinct personalities into cohesion - by any means possible. You cannot just shrug your shoulders and state, "That's the way this group is always going to be." I currently have one EXTREMELY challenging group (fortunately, the other 10 groups that I work with are currently pretty cohesive for the moment). Here is the situation: Four students - three males, one femaie Diagnoses - Pervasive Developmental Disabilities; Classic Autism; severe emotional disorders; severe behavioral disorders Lots of staff support - this sounds good, but sometimes it's more of a hindrance than a help! Group session - the attitude is that kids MUST have group treatment in order to give teachers planning time. 50 minutes - always broken into short therapeutic music experiences (TMEs) Group ...

It is early on Monday morning, and I am wondering what the week will bring. It is the first entire work week after two unnatural weeks - the AMTA conference week followed by a 3.5-day work week. It has been a long time since I have been in my music therapy clinic to see all of my clients. I am approaching this week the way I approach most weeks - with an open mind and limited plans. I enjoy the thought of a wide-open week. What music will we make this week? How will I get my clients towards their therapeutic goals? Who will challenge me? Who will I challenge? What paths will we take to get where we want to go? Oh, the questions are never ending! When I was a novice therapist, I functioned the way I had been taught to function. I designed session plans and followed those plans as much as possible. (Now, in the interest of complete honesty, I never really thought of those plans as scripts - I was able to go off-script if clients needed it, even as a student music therapist!) I felt...

How do we let others know about the importance of music therapy? We music therapists do not always do a very good job of letting people know why we are more qualified to use music as a therapeutic medium than the other folks out there. We aren't always articulate enough about what we can do that others cannot. For me, as evidenced in my most recent post, this all comes down to an awareness of the therapeutic elements of our medium - music. How can I be an appropriate advocate for music therapy in any environment if I do not understand my medium? I hope that music therapy students have a chance to think about why it is important to change the tempo of a song to engage their clients' attention. In my experience, we often get out of our initial training as music therapists with very little opportunity to think about the crucial elements of our music. My interns often do not seem to be aware of the needs of their clients when presenting singing TMEs (therapeutic music exper...

Several months ago, I spent lots of time talking about professionalism . My posts on Sept. 23, Oct. 30, Nov. 6, and Dec. 23, 2011 were all centered around my relationship with a difficult co-worker, one who attempted to bully me and who was not an appropriate teammate at all. That co-worker was fired on Friday. As I have been thinking about the past 10 months and the utter lack of professionalism that has led me to my various rants, all I can think now is, "I knew it!" I get strong feelings about some people at times. When I have such a visceral reaction to a person, I try to figure out why I am responding so strongly. Past encounters have demonstrated that my intuition is a good indication of who to spend time with and who to avoid. Unfortunately, a creepy feeling about a person is not enough to convince others about possibilities. That intuition is a good thing as a therapist - a lousy thing as a co-worker. As a therapist, intuition assists me in figuring out how t...