music, therapy, and me

I love creating therapeutic music experiences (TMEs) that have wonderful visual aids, sophisticated rhythms, and clever lyrics. I spend lots of time coming up with TMEs for all sorts of clients and therapeutic goals. The point of today's post, though, is that those things are not essential to any thing that I do in the music therapy session with any and all of my clients. I tend to get over-focused on my cute visuals and making things to look at and to help my clients understand what we are doing, and I lose sight of what my clients really need to regulate their bodies and prepare themselves for human interaction. (I'll tell you, cute visuals are NOT what I've found to be the most needed part of all of this...) Most of the time, what my clients need is a focus on tempo and rhythm, and of those two, I've always found tempo to be more important than rhythm. When what I am trying to do is ineffective during a session, I focus on how I am using tempo and rhythm with my clie...

It is the start of the most difficult time of the year - Halloween week. Oh my goodness, there is so much excitement happening that you can cut it with a knife at my job. Kids are so excited. Staff are so excited. I am less than excited, but that's an entirely different post. From now until Winter break, we will all be in a state of emotion more than rational thought. Some of my clients will get to visit family members at least once during these months. Some of my clients will not. There will be lots of emotional outbursts, and there will be some hurt feelings. Excitement and anger will be around in equal helpings, and some of my clients will cycle between those emotions in seconds. I am already exhausted. So, what do you do when groups are full of hyper-emotional kids? You go back to the very basics of musicking. For the next several months, my therapeutic focus will be emotional catharsis and safe expression. We will do some of the things that people do during holiday seasons, bu...

I've been struggling with a specific group for a couple of months now. They were very socially aware of one another and found each other so much more reinforcing than anything I was doing in music therapy. They would enter the room, start laughing and being goofy, and they were so wrapped up in each other that I spent most of my time trying to get any scrap of attention that I could. It was difficult to corral them into any type of interaction, and I really felt lost. Yesterday, that same group had a near perfect music therapy session. I was a bit kerfluffled after the session - thinking that it was amazing how they engaged, interacted, and were focused on what we were doing. We had one small escalation where one particular client tried to get into his goofy pattern, but peers did not engage or give him attention because they were focused on what we were doing as a group. I was able to be the center of the session with one small trick - tempo. Now, I am not the miracle wor...

It's that time of year - time to get back to basics. "Basics," you may ask? "Yep," I reply wearily, "basics." This is the time of year when staff members, clients, and, oh, music therapists get restless and need some focus on what is really important during music therapy. We've had lots of changes in the past three months. We've all moved (some of us SEVERAL times) from our temporary locations into the newly renovated old school building. Classroom groups have had lots of changes lately. Kids are leaving and arriving daily, so classroom climates are changing daily. There is no clear hierarchy of student relationships, and, by the time students start to know where they stand in the pecking order, a new student arrives and throws off the entire order yet again. This confusion and difficulty with knowing how to act with peers transfers into the music therapy session. It's my job to try to provide some regularity in music therapy while st...

For the last couple of weeks, we've been engaging some of our groups in a very simple therapeutic music experience (TME). We've been using the wooden rhythm instruments and following a play and pass pattern. We establish how many beats we will play and how many beats we will pass. We then set a rhythmic pattern on the keyboard and start our pattern. We play, and then we pass, and we make an entire circle until we end up with the instrument we started with. Then, keeping the beat going on the keyboard, we process. Did we have enough time to play? To pass? How should we adapt the experience? Should we change the number of beats? Or the tempo? This has been a very successful TME for my groups - the small ones as well as the older ones It amazes me how getting back to the very basic of basics, AKA rhythm/tempo, can transform a group of individuals into a group that functions as one. The act of entrainment is a simple one, but without entrainment, a group of people doesn't w...

Yesterday was another music therapy moment. The same group of kids as the last one with several significant differences... One student was entirely out of control. He was showing signs and symptoms of tardive dyskinesia - strange facial expressions, uncontrollable behavior, physical twitches and tics, loud speech, and random comments. I asked if there had been any changes in his medication, and, yes indeed there had been. He was wild - not aggressive, but not able to focus on anything! This is the same kid who has been sitting with his head down when he feels that he is not getting what everyone else is getting. Everyone else was behaving in a typical way, but they couldn't really engage in a normal manner since this kid was so out of control. So, what to do? I went to my go-to elements of music, rhythm and tempo! The first song seemed to work in a mediocre manner, but the second was the one that changed the group dynamic. On Fridays, I do theme-based sessions that aren...

Tempo and the Music Therapist I think that tempo is one of the most powerful therapeutic elements of music. I also think that it is one of the least emphasized in our music therapy training. Dr. Michael Thaut, an eminent researcher on the effect of music on the central nervous system, emphasizes that motor functions occur within a temporal framework - coordinated in time. If you can find the client's initial tempo, you can change the speed of motor function through subtle changes in the tempo of the music presented. I believe that the same function occurs in domains other than the motor domain. I believe that there is a cognitive processing entrainment node for each person. Now, I have NO proof of this. I do not have the ability to use sophisticated imaging machinery to see if electrical impulses change to accommodate the musical stimulus or to see if matching the music to the electrical impulses can increase cognitive function, but I feel that there is something to the idea. ...

Therapeutic Elements of Music - Tempo My next element of therapeutic influence and thought is tempo. This element is probably the most important for me as a therapist. I have found that the "right" tempo makes for exemplary sessions. The first session that really illustrated this to me was with a woman with advanced dementia. She appeared to enjoy music and responded sporadically to the student music therapist's interventions. At times, she would use phrases to communicate. At other times, she would sit in her chair with her head down not responding to any intervention. I had the luxury of observing the interactions within the small room, but had the responsibility of not intervening as the therapist. The student was using a small keyboard to accompany singing, using songs that the client had responded to at different times during the semester. The student adjusted the tempo that she was using as a background figure rather than the primary musical instrument, and th...