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As I am spending time revamping and revitalizing MusicTherapyTime as a platform, I am very interested in learning more about what type(s) of content would be the most helpful to YOU. I have primarily used this website and blog over the past 7 years for my own agenda, but I’d love to learn more about what is the most helpful and relevant to the music therapy community. While I’m working on things, please feel free to fill out my 5-question survey. This information will be used to better cater and develop content and resources. As always, please feel free to reach out to me directly at erin@musictherapytime.com for any specific requests, needs, or ideas or leave a comment below.

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Recommended Music therapy Resources

I’m not sure if you’ve noticed, but I haven’t been fully present on this platform over the last two years. As one Instagram follower lovingly put it a number of months ago, “Wow…it’s been awhile.” I’ve gone back and forth trying to pinpoint what exactly has been challenging about this particular space for me. Depending on the day, it’s a different answer. I’ve jokingly referred to this platform as a “dinosaur,” meaning that blogs were pretty extinct even back when I started this website over 7 years ago. I haven’t really strayed from the fact this blog serves more of a purpose for myself than it does for others – but I recognize that the occasional person finds some value in something that I’ve shared. For those reasons alone, I can’t quite give up on it but want to instead strive to revamp it.

I often have more ideas than time to execute and that is likely my biggest challenge over the last two years. I won’t deny that pandemic fatigue has also played a significant role. There are a number of things I think would be great to feature about music therapy, to help educate others, to provide resources for students and new professionals, and to simply help us share and connect. I want to spend some time actually flushing those ideas out and creating and see where that ends up landing.

So please know that I am working; I’m creating; and I fully expect to return in a more present state in the near future. In the meantime, while musictherapytime is a bit “under construction” I wanted to share with you some resources I’ve found to be immensely insightful, helpful, thought-provoking, and inspiring over the past year. May you find what you need to from these resources as well.

*Disclaimer: All information below is my own synthesis of sources that have been recommended to me or found independently. If you feel I have misrepresented or mis-credited content that is yours, please contact me at erin@musictherapytime.com so that I can rightly update my recommendation.*

For Tech Help: The Tech Nook: I learned about this website while attending the SERAMTA conference this past spring. Not only do I think this resource is helpful, it is essential for the modern music therapist and is filling an enormous gap in our clinical training. If we’ve learned nothing else since 2019, we’ve learned that embracing technology is of the essence for our work in music therapy. This resource is not only helpful as it stands but it goes on to offer more in-depth help if you want private tutoring. The site is collaboratively-based and is jam-packed with incredibly knowledgeable and experienced music therapists who offer their specialized skills through free videos and guides. Even if you visit the site to learn about a specific skill (e.g. audio engineering) you are bound to walk away with additional knowledge about another technology avenue (e.g. podcasting or video production).

For Therapeutic Interventions: (and other relevant information to early childhood musicking): The imagine magazine: editor-in-chief: Petra Kern. If you are looking for evidenced-based resources for techniques and interventions to use with any of your kiddos who fall into the early childhood age, this is the place for you. While a subscription will you provide you access to all issues, there are a number of issues available via open access. Many issues feature various themes and the content can range from short idea-sharing to more in-depth clinical techniques and research. This is often a great resource to help jump start your own brainstorming or to find additional ways to adapt your clinical ideas. It can also teach you about experts in the field to whom you can likely reach out if you have a specific clinical question or to find additional resources to help continue to learn about specific topics.

For Improved Musicianship: Music Therapy Guitar Boot Camp by: Make More Music, LLC & University of Louisville Music Therapy Clinic (aka: Chris Millet). I cannot recommend this course highly enough. Having been playing the guitar for the last decade there are still so many skills I want to develop. I did not need to think twice before signing up! This course has historically been 6-weeks in length and looks to challenge your thinking and perception of guitar playing within music therapy as well as for you own personal use. This course is helpful for students, interns, new professionals, and seasoned professionals and is likely all the inspiration and motivation needed to work on those guitar skills you’ve always wanted to improve.

For Medical Knowledge: Pediatric Music Therapy: created by Amy Love: Geared towards those who are, or want to be, working in pediatrics, this resource is full of medical knowledge applicable for music therapy. Having learned a number of things independently about the medical world, Amy created a place for music therapists to come and expand their skills for the medical setting. Not only are there many resources on the website, but Pediatric Music Therapy has a very active Instagram and Facebook page, where other medical music therapists are often featured. This is a wonderful source to follow to help feel connected and stay current. Additionally, many of Amy’s resources also count towards CMTEs!

For Expanding Repertoire: Clinical Bopulations: Created by Gabby Banzon & Allyson Rogers: Need a place to learn about new music you can use clinically? These podcast hosts (who now include more than just the original creators) look to find new music/artists and discuss the potential of that music in your therapeutic work. This is a great listen for wanting to learn more and expand your rep knowledge but the hosts also help you feel more connected to the world of music therapy, especially if you work independently. These hosts have done an amazing job of hosting guests on their show (including Ben Folds!) in addition to discussing new music with one another. Full disclosure: I learned about the above recommended Tech Nook while listening to a conference session hosted by this same group in regards to podcasting.

For Laughs & Validation: Music Therapy Memes: created by: Kaylin Parsons: Do you ever feel like there are aspects of your work as a music therapist that no one understands? Look no further than the Instagram account of MusicTherapyMemes. Each Monday you can expect to feel validated towards big, small, and silly aspects of your job and often accompanied with a good laugh. I admire the creativity and wit of any meme account, but certainly memes specific to music therapy are going to go straight to my heart (and funny bone).

For Weekly Inspiration: Matt Logan’s Friday Five: It’s so nice to have something come to your email inbox weekly to help provide you with inspiration, information, and other helpful tidbits. I’ve been following Matt Logan’s newsletter for a few years now and each week provides something totally different. While not always exclusive to music therapy, Matt Logan shares a number of interesting things that can help you in your music therapy work, or simply give you a respite from your every day routine. Sign up to the newsletter at the link above!

For Connection: The Music Therapy in Pediatrics Facebook group and the AMTA Peds Workgroup: I have said over the last couple of years that the only reasons I keep my Facebook active is for marketplace and for music therapy Facebook groups. One of the groups I find to be most relevant to my daily clinical work is the Music Therapy in Pediatrics group. This is a group where you can seek ideas and experiences of other pediatric music therapists. What also comes out of this group is the AMTA Peds Workgroup – a group of pediatric music therapists who meet and gather resources, evidenced-based information, and pediatric music therapy ideas. This information is collected and published in the What’s Poppin’ in Peds publication. Follow their Facebook page or join the group to receive notice of their quarterly publications.

For Growth: Liberated Learning: created by Kerry Devlin. While there are a number of pertinent topics we all can continue to learn about and grow from, I recently learned of Kerry Devlin’s Instagram account where she strives to educate others on how to dismantle systems of oppression – particularly ableism. Not only can you easily learn from her digestible posts, Kerry also offers continuing education to music therapists and educators on inclusivity in the classroom and therapy space. A post that particularly stood out to me was unlearning professionalism, which I found to be very thought-provoking and an excellent lesson for me personally. I am looking forward to learning more from Kerry.

To Watch: Music Therapy Ed Now: created by: Danielle Remek: I am thoroughly enjoying watching how students and other professionals are using social media platforms to educate others about music therapy. [They are ultimately what make me feel like this blog is a dinosaur!] If you are currently a student, I recommend following this account as they often feature other students or interns in their takeovers and also offer a lot of great information about internships. This particular account was recommended to me by a current intern and I am really here to say that I’m looking forward to watching where this account (and subsequently these new professionals) go!

If you have additional recommendations of great music therapy resources out there, please let me (and others) know by leaving a comment!

May you continue to learn and grow and challenge yourself.

Music Therapy and Acute care rehab

Part 2 of Collaboration in Medical Music Therapy

One of the more recognizable aspects of music therapy is the ease in which it connects with rehab therapies. This is likely because rehab therapies exist in a number of settings outside of the inpatient, medical world and because music therapy can adapt rehab goals within music. For many music therapists, MT is a part of the rehab team because it is a natural fit. Music therapists consistently mold ourselves to fit existing healthcare teams and structures. We can do this because music therapy is adaptable. This adaptability gives us opportunity to exercise special skills that coincide with whatever team we are on, whether it is behavioral health, family support services, spiritual care, rehab therapy, or whomever.

Regardless of the team you are on, its important to determine what makes your work similar and what makes your work unique from your teammates. I have found it incredibly rewarding to build relationships with different disciplines by simply addressing their humanness first. In a fast-paced hospital setting, it can be challenging to get to know people outside of your team because most disciplines are running from patient to patient to provide care. Rehab therapists are no different. It can take time to get to know rehab therapists as people first because they are often have hefty caseloads each day and not ample amounts of time to spend getting to know you.

It can also require a lot of confidence as a music therapist to stop a rehab therapist in the middle of their schedule to have a quick chat or advocate for a co-treatment session. I have found myself to be incredibly intimidated by a number of rehab therapists because I’ve found their knowledge, expertise, and understanding of their specialized skillset to be inspiring. I’ve also been nervous that very confident rehab therapists would be unwilling to take my own expertise seriously. What I have personally found to be the most effective has been to ask questions. Communicate an interest in learning more about their skillset as it relates to your shared patients. Share what you have assessed about a patient and ask what they think. Do they have advice of things you could incorporate into your sessions that help work towards their rehab goals?

I specifically recall a situation with a PT in our NICU who has amazing insight and skill. I was very intimated by them and nervous to co-treat. One day, I was working with an infant we share and was struggling to provide them with appropriate positioning. Our PT was nearby and saw me struggling and came in to assist. I was very nervous that they would tell me I was doing something wrong and subsequently ask me to leave. But I immediately spoke up and said, “I know that this infant is arching and having difficulty regulating right now – what should I do?” The PT then gave me a condensed lesson in positioning and we had a wonderful conversation. I felt empowered with new knowledge and, I believe, the PT felt more comfortable knowing that I was going to listen to their suggestions and honor their expertise.

With increased confidence and knowledge of how MT can support these disciplines and their specialized goals, the easier it can be to begin to build relationships and ultimately create very collaborative networks across the hospital setting. Below are just a few examples of ways MT can collaborate with each discipline.

Music Therapy and Physical Therapy

One of the more obvious ways to co-treat with Physical Therapy is through a neurologic music therapy approach. Many of these interventions can be planned ahead of time for patients and in conjunction with a physical therapist. But sometimes the best interactions and collaborations happen when it is unplanned, and MT and PT simply arrive at a patient’s room at the same time. When this happens, check in with PT regarding their goals and quickly assess the situation to see how you might support them. The rehab goals become the current patient need. The rehab goals are the music therapy goals. Pack your cart each day to ensure that you have enough adaptable items to be prepared for moments like these!

PT is often focused on the big picture. They might say – I just want him to stand for 15 minutes with assistance – which gives you tons of freedom of how you will spend those 15 minutes. What songs can you play to hold this patient’s attention and engagement so that they are not aware of how long they’re standing? Or perhaps the big goal is to increase range of motion with the patient’s legs, in which case you can utilize an NMT intervention – therapeutic instrument playing – to engage flexion and extension of both legs.

Maybe a patient is preparing to take a walk around the unit and you can support a number of functional movements, least of which is the walking itself. The complexity of your support can range from a fully executed Rhythmic Auditory Stimulation (RAS) intervention to smaller components of the intervention to support the situation; clinical details pending. It is not unfamiliar to find yourself needing to walk backwards around a unit, playing the guitar, and encouraging/supporting gross motor movements. As you prepare for increased opportunities with PT, make sure you have practiced your flexibility – both physically and musically! Supporting gross motor movements requires a music therapist to have mobility, adaptability, and physical preparation.

Music Therapy and Speech and Language Pathology

Speech and Language Pathologists have a wealth of knowledge that extends past working on obvious speech/communication goals. Because speech and language are neurologically complex functions, and because music can address those neurologic components, collaborative efforts between MT and SLP can be incredibly fulfilling for both parties.

One of my favorite calls to receive from an SLP is to assist with a patient’s tolerance of a speaking valve on their tracheotomy – most often a Passy-muir valve. Using a speaking valve requires a different functionality of speaking, which might take a different period of adjustment for a patient. Often older patients have a more difficult time and can benefit from distraction of the length of time they are wearing the valve, or provides them with a specific length of note to hold while singing, or cues them to breathe and vocalize.

Other opportunities to engage with SLP relate to feeding, especially within the NICU. MT can support infants’ feeding by assisting with reinforcing non-nutritive sucking (often supported by the Pacifier Activated Lullaby Device) or even by providing live music during breastfeeding. Even if you cannot be present during feeding times, looking to your SLPs to gain more information about an infant’s suck-swallow-breathe coordination and self-regulation can be great objectives to incorporate into your MT session and later be able to report back your observations for how the infant responded.

Whether you are supporting speech, language, feeding, or any other motor function that is related, look to your SLPs for their expertise in this area and remain confident in your own expertise. Ask questions, seek information, and offer ideas. These therapists will likely take advantage of what you have to offer.

Music Therapy and Occupational Therapy

Whereas PT might look at the larger picture of functionality, and SLP might look at a specific challenging area, Occupational Therapy brings the whole picture together. I appreciate the ways in which these disciplines balance each other out and support one another to address the whole person. When I think about the rehab therapy team, I see music therapy as threading itself between all three disciplines to support however necessary.

OT is a great collaborative partner to have as a medical music therapist. OT is familiar with looking at the big picture with PT and zeroing in on the smaller details to assist with the overall functionality of the patient. OT can easily see how and where music therapy can assist and can be excellent advocates for your work. MT and OT co-treatments can be incredibly fun because many OTs are often very creative! OTs are not afraid to get into the nitty gritty of the music therapy session and are usually over the moon when you provide special equipment like adaptive mallets.

Co-treatment sessions with OT are some of my most favorite sessions because you can take a step back and allow the OT to provide much of the physical assistance that you might give a kiddo during a session. MT can focus entirely on the music during the session and be very aware of planning how the music can drive cues, prompts, or movement. When OT is present, everyone can more easily get down on a play mat, or be up in a supported upright position to increase success. In these sessions, patients have greater accessibility towards the activities within the session. OTs benefit from these sessions by often having less to plan or prepare for therapeutic activities and often increased success towards their rehab goals.

I could write many more anecdotes and examples of the collaborative opportunities that exist between music therapy and the rehab team, but the essence of these brief snippets are that the opportunities are limitless! If it seems overwhelming to start, choose one discipline to learn more about and focus on getting to know one or two of those therapists. Just like with nursing, getting to know the person as best as you can (while adhering to a fast-paced schedule) is first and foremost the best way to connect with another professional.

As you build a relationship with that first or second therapist, they will likely share their experiences with their team members, who in turn might reach out to you to collaborate. The rehab team values the recommendations they receive from one another and once they are able to experience the potential of these collaborations with music therapy, you have it made.

Be open to flexibility, adaptations, and creativity. Once the rehab team learns of your willingness to support their goals and then witnesses the power of that teamwork, they will always be open to the collaboration, whether it is planned or unplanned. Be the extra support they can rely on when they need it most.

Collaboration in Medical Music Therapy

One of the unexpected blessings from all that has occurred over the past year has been the amount of time to myself. I’m not talking about the time spent self-quarantining. I’m talking about the number of months I’ve been able to independently return to the roots of music therapy. There are always unexpected benefits to being forced to stop and reduce your load – even if that wouldn’t be your first choice in the moment. The primary responsibility that was suddenly removed from my workload a year ago was serving as an internship supervisor. Much of my day-to-day work for the last few years has been in providing supervision and training to interns, often overlapping in timelines and set on a fairly continuous loop. With our internship indeterminably paused, I suddenly found myself with so. much. time. I thoroughly enjoy having interns, but when an intern is constantly at your side, many professional opportunities and experiences either get missed or given to the student. One of these opportunities was in building new or stronger relationships with other disciplines at our hospital and co-treating frequently.

My personal philosophy of music therapy is that it works best in conjunction with others; whether that is the client themselves, a family, or a treatment team. At our hospital, we strive to offer our interns as many opportunities as possible to co-treat with our incredibly diverse multidisciplinary team. One of the drawbacks to this however, is that interns are still learning. When you have newbies leading the way, co-treating doesn’t always go the way it was expected. We are incredibly lucky to be a teaching hospital where the majority of the staff enjoy teaching others and are therefore incredibly patient. Not to mention, our incredibly gracious patients and families.

For the first time in awhile, co-treating returned to it’s stablest collaboration between professionals. Suddenly, I was making frequent morning calls to set up scheduled times to work with different disciplines in our collaborative approaches to patient care. Many times these calls led to a domino affect where Physical Therapy (PT) might have coordinated with Occupational Therapy (OT), and OT wanted me to overlap with PT, but before Child Life (CL), and after Respiratory Therapy (RT). But don’t forget that the Hospital Schoolteacher (HST) needs to connect with the patient and family after the medical team has rounded and before PT begins. If that sounds like a pretty packed schedule for a pediatric patient it certainly is, but that is a normal day in much of the hospital setting. What is particularly powerful about this series of events is that music therapy belongs. It is not the afterthought discipline that squeezes in somewhere, but is instead a thoughtfully planned part of the treatment plan for the day.

So, how do you jump from being a brand-new team member, trying to advocate for the start of a program to being a called, consulted, and scheduled part of the treatment team?

By building relationships.

Part 1: Music Therapy and Nursing

If you were to prioritize any particular relationship to build in the hospital setting, it should definitely start with your nurses. Just like with any other field or discipline, certain types of personalities are drawn to different areas of the hospital. Certain specialities and acuities require unique skillsets. Figuring out what types of people are drawn to certain units/clinical areas is a great first place to start in determining each unit’s culture. For example, it is probably not surprising to learn that nurses in the neonatal intensive care unit are extremely protective. They care deeply about their babies and care for them with such gentleness and compassion it is as if they these babies are their own. Unsurprisingly, they can take a bit of convincing that their baby will not experience harm when left in the hands of others.

Nurses notice the details and the medical team looks to them for the ins and outs for how their patients are responding. Nurses are strong advocates. If something is not right with their patient, they speak up. They call; they inquire; they resolve. They take pride in their patients’ successes and they grieve for the challenges and losses. Nurses lessen their boundaries so that their patients feel comfortable knowing who is taking care of them so intimately.

Nurses can become your number one fan – but only after they witness and experience the complexity and dedication of your work. Nurses are not going out of their way to skeptically question you or prevent you from doing your job. They are protecting their patient. Instead of providing education about what you are there to do with your patient, ask them how they think the patient is doing. What have they noticed? What could the patient benefit more from? What do they think the patient needs right now? Incorporate the nurses’ perspective and expertise into your advocacy for utilizing music therapy with this patient.

Invite the nursing staff in. Offer to help them with whatever they were planning to do with the patient rather than immediately promoting your goals/objectives. One of my favorite ways to collaborate with nursing in the NICU particularly is assisting with hands-on-care. At scheduled times of the day, nurses provide all of their care at once to limit the amount of times the infant is touched, stimulated, and prevented from sleep. Wonder why a nurse seems annoyed that you are providing music therapy at this time? Perhaps it’s because you came 30 minutes after hands-on-care was completed and now the baby has been prevented from a nap. Much of NICU music therapy can be provided in collaboration with hands-on-care – even if that means you are singing to a baby while their diaper is changed, dressings are changed, sites are cleaned, etc. How does music therapy help during hands-on time? How often does hands-on care become so much less stressful for baby and nurse because MT was there to support everyone?

What else is great about this collaborative time, you might now be asking? More often than not, there are clinical situations that come up unexpectedly that allow you and the nurse to bond. Just a few weeks ago, I was providing support during hands-on when an infant’s gastrostomy (g)-tube fell out. That’s right – it just simply fell out. The nurse was really caught off guard and had my extra two hands not been there already providing hand-over-hand movement with baby to “The Itsy Bitsy Spider,” the situation would have been even messier than it already was. I ended up providing assistance for an additional half hour to this nurse who otherwise would have been scrambling for help or to complete everything independently, but all the more stressfully. Now, this particular nurse and I have this story as a shared moment that we have referenced since then and have a stronger association with one another.

Ultimately, we have shared memories that have started a foundation for a relationship.

We are all humans, regardless of our discipline and our training. Oftentimes the medical setting is incredibly intimidating – especially for new music therapists or those new to this population. I have found that the best advocates for music therapy in the hospital setting are those who have directly felt their own work supported and have been able to witness the positive responses because of the collaboration. Additionally, get to know them for more than just their nursing work and share details about yourself. When nurses know you as a person, it is so much harder for them to decline your advocacy or rationale for the work you plan to do with their patient. They trust you as a person and therefore will trust you to also take care of their patient.

But don’t worry – if you need them, they will only be in the room next door.

How to continue to adapt (when you’re likely pretty burnt out)

I used to journal often. I had beautiful penmanship and a writing strength that could withstand sitting at my desk for hours. I relished the nonjudgmental outlet of documenting my thoughts and feelings that later turned into time capsules where all memories could be relived. I haven’t really felt a desire to journal for the better part of the last decade. Some might argue that this space is a new journal, but I’ve otherwise felt no other draw to continue the act of daily journaling.

But it’s a weird time. Our shared chronic and heightened stress across the globe has me much more tightly wound than I can ever recall feeling. I recently discovered that my baseline stress level is now so high and so normalized that even the slightest of increased stressors can set me off into a panic attack that sends me to the doctor; ultimately indignantly arguing with my primary care physician that I *know* what-my-panic-attacks-are-like-and-this-was-not-one-of-them. [Fun fact: panic attack symptoms can change over time and with age].

What I do think is helpful is to normalize what others may be experiencing and to simply say, you are likely not alone. Here are some things I’ve either thought about or acted on intentionally over the last couple of months in order to adapt.

  1. Recognize and accept your moments of countertransference. Wowzers. I don’t know about you but I have never combatted countertransference to the level I have this year. Ask any of my previous interns – I normally have a pretty tough therapeutic exterior. Working in a highly acute pediatric setting has never truly shaken me up as much as it has in the last year. A kiddo having an anxiety attack? Welp, here comes mine…. A family sharing their difficult decisions about their loved one’s care? Dang it – now I’m in tears. Experiencing countertransference does not make you a bad therapist. As long as you recognize it in the moment and you act intentionally, it is normal. If you are tired, stressed, or confused about your own life and experiences, it’s only natural that you wouldn’t have the same level of “tough” exterior as you might normally.
  2. Which leads us, of course, to your coping skills. Let’s face it. What’s worked in the past probably isn’t working any more. And it’s likely pretty frustrating. I am a fairly avid gym-goer, which I’m no longer doing to the level that I once did. Not exercising was hurting me mentally to the point where it was hurting me physically (see aforementioned panic attack). We are all learning how to adapt our previous coping skills and exploring new coping skills. Like with anything, it’s okay if things aren’t working or you are experiencing setbacks with new strategies.
  3. Many people are trying new things like therapy or clinical supervision. Most of us need both. Personal therapy is our space to divulge and work through personal and professional matters and the complexities of their interplay in our lives. Clinical supervision is our opportunity to discuss music therapy-specific cases, feelings, and questions about our work. We all benefit from either opportunity and we might be finding that we need both more than ever. During a time when we are forced to be isolated from one another, it is okay to disclose that you need more ears to hear what is going on with you personally and professionally and insight to be gained around that.
  4. Sometimes, we might find that grace and mantras might be a simple way to give ourselves some of that insight. I’ve recently found myself ending my work day with, “I’ll try again tomorrow.” Often I’m stating this aloud to others in the room as a joke but it usually feels true. Many days are spent feeling like I didn’t accomplish what I set out to do, or I was unhappy with the work that was done. But if I tell myself aloud at the end of the day that I’ll try again tomorrow, that simple act makes me a feel a whole lot better. I feel a greater sense of grace for myself and my humanness, which doesn’t always come easily.
  5. And finally, looking for small pockets of hope. Despite the many difficulties, there are still areas to find hope. I find great hope in a number of things occurring in our world, in my professional life, and personally. The importance is not in finding them to share with others but in identifying them for yourself. What continues to give you drive and resilience? Draw on those pockets of hope to allow you to continue to do the work that is most meaningful to you. And if you find yourself struggling with that today, just remind yourself, “I’ll try again tomorrow.”

The Heart of Music therapy

A couple of years ago, I was approached by a film producer interested in documenting and telling short stories about wellness. His goal was to tell stories of wellness and integrative medicine from a variety of perspectives and music therapy had captured his interest. I spent a number of months working back and forth with him and his team, discussing music therapy and wellness from my perspective and what I thought was important to tell. In order to best communicate what I thought was most valuable to share, I began to write patient stories from memory. I found that it was easier to send snippets of meaningful moments from music therapy sessions to his team in between our scheduled conversations. I didn’t know how else to communicate the complexity of the experiences I had had. The project with this documentary team never panned out for a variety of reasons – but one reason in particular seemed clear: the vastness of music therapy cannot be documented within 3-5 minutes. Not fully, anyway.

Returning to work after being furloughed was not an easy preparation or flawless transition. No matter your role or your specific experience, being asked to not return to your job is an immediate reduction to your self-worth. I spent a lot of time during my furlough focused on what the bigger picture was of what I wanted and how to best use that unexpected time. I also gave myself a fair amount of grace to relax and mope. During my moping phases, I questioned my efficacy as a music therapist and my professional priorities often and from every angle. When friends and family would ask what I thought I would do if asked to return to my job, I kept coming back to the heart of my work – serving people in the way I best know how to do.

When I eventually returned to work, I set new boundaries and I made clear statements. I was open and honest about my experience of being furloughed, but I moved forward. I refocused my presence on my patients and their families and I began to hear their stories again.

As I was preparing for an in-service presentation this week, I opened our team’s music library to search for some patient recordings. I became a little lost in the weeds of organizing things when I found myself immersed in our collection of Heartbeat Songs. A Heartbeat Song is an intervention employed to build legacies with patients and families and is often used to document a journey – whether it be a difficult treatment, like cancer care, or to preserve the memory of someone at the end of their life. Music therapists record the heartbeat through special stethoscopes and often will pair a cover version of a significant song chosen by the patient and family while using their heartbeat to serve as the drumbeat.

When I joined the team, I remember being so overwhelmed with the concept. I didn’t know how to introduce the idea of recording a heartbeat of a dying patient to a family member and the editing process seemed time-consuming and daunting. Eventually I became comfortable with the intervention, ultimately focusing on re-educating staff about how to maximize the intervention’s benefits throughout a patient journey and not just as a final offering at the end of life. To me, the Heartbeat Song was another patient story waiting to be told. I wanted to ensure that we were not telling stories of a death, but instead, of the life.

As I sat listening to these various Heartbeat Songs, I was flooded with the heart of music therapy in a more tangible way than we often get to experience. So much of our work is in the moment and is ultimately fleeting. We remember the stand-out moments throughout our career, but we forget so many things. I opened the patient stories I had written two years ago and was immediately contented. I document patient “stories” every day in the medical records but I don’t often revisit stories of the work that I did in a narrative form. Here were clear examples of music therapy making an impact on someone and more often than not, on many someones.

As I continue to journey back through my own memories and begin to consider what these patient stories can offer to others than myself, I will share a simple one here from years ago so that maybe you too can find some contentment.

Hospice Care – 2013: Woody was a gentleman who lived in an upscale nursing home in Orlando. I was referred to Woody to help with socialization, relaxation, and motivation to interact and engage. Woody was known to our hospice staff and his nursing home staff as being reclusive and isolative. Woody was unable to get out of bed on his own and rarely agreed to leave his room. Because of his difficulty with getting out of bed, he tended to make excuses to not do things for himself. Woody was estranged from his family and was largely alone. I believe he had one family member or friend who occasionally visited and offered support, but had withdrawn throughout the years due to Woody’s difficult temperament.

In my time with Woody, I offered many of his favorite songs, typically patriotic, but most specifically the Battle Hymn of the Republic. I had never known how many verses there were to that song prior to working with him but I now have them memorized. Woody had played the clarinet in his high school marching band and loved marching songs. Woody also loved classical music, which is often difficult for me to replicate on the guitar at the bedside. There was, however, an upright piano in one of the living rooms, only a few doors down from Woody’s room. For a few weeks, I coordinated with Woody, his nursing home staff, and our hospice team to get Woody out of his bed, into his wheelchair, and down the hall to the piano. For weeks, I arrived at Woody’s room, expecting him to be ready (having communicated with the staff earlier in the day), and he was still in bed. Woody took a few weeks to work up the courage to get out of bed. When we finally made it happen, I provided some classical pieces on the piano, but mostly Chopin, as that was one of Woody’s favorites.

Woody only made it out to the piano one time. Although we continued to offer that service, he chose to remain in his bedroom. We continued to sing Battle Hymn of the Republic at each visit until he died. Woody continues to stand out to me in memory because the power of his love of music inspired Woody to step out of his comfort zone. I remember playing Chopin on the piano rather poorly at the time, and feeling guilty for that, but for Woody, this was his only instance of hearing some of his favorite music, live, at the piano at the end of his life. Even when reflecting now, I am humbled by how the intentionality and simplicity of the music moved Woody.

May the stories our patients tell remain at the heart of our work in music therapy.

If You’re Not Essential, You’re Not a Failure

“And now here is my secret, a very simple secret: It is only with the heart that one can see rightly; what is essential is invisible to the eye.”
Antoine de Saint-Exupéry, The Little Prince

In my last post, I wrote about our ever-changing need to redefine how we think about this concept of “being essential.” A month ago, I was grappling with the difficulties of making changes towards how I provided care to patients and families. I was grieving the loss of the normalcy of my job and wrestling with the various ethics of how to continue to provide care. I was challenging myself to think about music therapy in out of the box ways and brainstorming ideas to present to my hospital. With each new change or ask of me, I would do my best to roll with the punches and keep moving forward.

That is, until they asked me to stop working at all. I’ve been furloughed for a week now and the number of emotions I have felt have been limitless. In less than 24 hours of receiving the news, I went through all stereotypic stages of grief only to find myself experiencing it all again the very next day. In my final two days of working with patients and communicating the temporary change of services to staff, I felt self-doubt, anger, sadness, jealousy, exhaustion, and a fair amount of countertransference. At the end of my final day before being out of the office for an unknown amount of time, I was physically ill from the stress and emotion. 

I communicated the updates to my family and friends, but I wrestled with how to share the news with my music therapy community. So much of what I write about and gear presentations towards is advocacy for our profession. I couldn’t shake this feeling that I would be letting people down by sharing that despite all of my “talk”, at the end of the day, I had no “walk.” I was also overwhelmingly embarrassed by my furlough. The rational side of me understands how unfair and unjustified that emotion is considering the staggering number of people who are also currently unemployed, but the emotional side of me knew I needed to honor my feelings. I am a human being who is allowed to have emotional responses to a significant change that was completely outside of my control.

As I’ve been attempting to process through this feeling of embarrassment, I’ve recognized that like many others, I am an achiever. Much of my professional life is focused on creating goals, working towards them, and attempting to accomplish those goals. By having someone else choose for me to not work, I suddenly have less to “achieve” or rather, what I can achieve is drastically altered and minimized. So much of what I am able to achieve has always been in my control.

With this loss of control, I’ve been left instead with self-doubt, questioning my abilities, and a lot of attempts to rationalize things independently. The difficulty with these negative thought-processes is that they are not founded in anything factual or justified. Instead, they fuel the negative feelings until I begin to ruminate to the point where I’m not able to accomplish anything, eventually heightening my embarrassment.

Ultimately, my embarrassment has created a barrier. Experiencing self-doubt and grief often leads to building a wall to protect oneself, and I’m not afraid to admit that my barrier may take a while to break back down. This will be evident in how I feel returning to work in the future, but is also during this current time as I continue to see other music therapists adapting and achieving successfully and beautifully in all corners of our world.


One of the things I’ve been attempting to do for myself  is increase my time spent meditating. In a recent meditation, I was struck by the quote from The Little Prince stated at the beginning of this post. The meditation discussed a concept that our hearts and minds are often separated in the decisions that we make. It challenged me to open up a deeper connection between my heart and my mind so that decisions I made would more equally weigh the desires of both. An example of this would be that if you took a job for the financial security but you found no joy in the job itself, this could signal a disconnect between your heart and mind. Conversely, if you only took a job for its joy without also considering your financial obligations, this could still cause you trouble down the line. Having a greater awareness of this heart and mind connection is not easy but it has value.

I think much of what is being decided in our world right now is based from the mind. We have facts, figures, and hard data to help determine what needs to be done. But how much of the heart is being set aside in order to preserve the safety of our world? I don’t disagree with decisions made based in fact but it leaves me to wonder what the ramifications might be for ignoring the heart for so long.

I believe I am beginning to understand the big picture as to why my music therapy program specifically was furloughed. I am lucky to have a very fact-based thinker in my home to help guide me in thinking more globally and with a business mind. What I cannot rationalize at this time, however, is what the ripple effects of this particular decision may be. Although we constantly advocate and educate about our work and its worth, much of the day-to-day value of music therapy cannot be easily measured quantitatively.  This ultimately impacts business decisions made by the mind, no matter what we do or say, when the heart is not weighed equally.

For now, I will continue to do my best to share both the value of music therapy from the heart and the mind. I will continue to do my best to walk the walk and talk the talk. Like with anything else in our lives, sharing the losses is much more difficult than sharing the joy. May we all find value in what is essential to our hearts and minds, even if it is invisible to the eye.

Keep Thinking Essentially

The concept of being a healthcare worker is a strange one. When a crisis hits, most people run away, but a healthcare worker runs towards it.

In unprecedented times like this, what it means to be a frontline person is evolving daily. A couple of weeks ago, just as COVID-19 was entering the U.S., I had decisions to make about my personal travel plans to Washington state. The anxiety I was feeling leading up to the trip was likened to what we Floridians feel the week leading up to a hurricane.

I had not felt this level of anticipatory anxiety since Hurricane Irma. This type of anxiety is so specific to natural disasters like hurricanes because we know just enough to be fearful but not enough to know how everything will turn out. Will I find a safe place to evacuate to? What should I take with me? Will I have a home to return to? With a hurricane, this anticipatory anxiety lasts about a week and is exacerbated by people rushing to grocery stores, long lines at gas stations, businesses boarding up, and streets becoming eerily deserted.

But then the hurricane nears, you ride out the storm and it’s eventually over in a matter of days. Your anticipatory anxiety becomes immediate and present and then you ultimately feel the knot in your stomach loosen. During a hurricane, as a healthcare worker, I have additional anxieties at work due to specific responsibilities that require me to make personal sacrifices including my comfort, my family, and my home in order to continue to provide care and to serve others.

It makes sense that in light of everything occurring in our world with a pandemic that I would continue to make sacrifices in order to continue to provide care, especially when working in a hospital setting. But what do you do if the care you provide is not essential enough to warrant continuing to serve others in order to preserve their safety and yours? 

Many of us are being asked to change what we do. I’ve found that in addition to feeling a constant sense of anticipatory anxiety I’ve also felt incredibly “in the grey.” Every decision I was making was in a grey area and what I decided today might be found to be incredibly wrong the next day – and I needed to be okay with that. I also felt a discomfort that I could not identify for a full week. When I finalized realized what I had been feeling I understood it to be a sense of uselessness.

I am a healthcare worker used to feeling the desire to run towards the crisis – not to stand down. Sure, I don’t administer medications and generally don’t provide CPR (although I could), but my purpose is meant to serve others. Suddenly I was questioning every aspect of my job, weighing the pros and cons of the safety of my patients while considering my role within the global perspective. These daily decisions I suddenly was being forced to make, along with the rest of the world, began to lean my work towards becoming less and less essential. Many days I found myself sitting at my desk utterly dumbfounded and grieving how to accept my non-essentialness when every day I advocate for how essential my role is.

Music therapy is not exclusive in this. All of us are being forced to reevaluate who we are and the length of time we are being asked to do this is entirely unknown. So how do we remain essential when deemed non-essential? This question is not how we convince our jobs that we are essential (that decision is made for us) but instead how we remain in a mindset that we are essential and our work/roles are worthwhile.

Keeping an “essential” mindset requires us first to have acceptance. I have to accept that my job as a pediatric music therapist is not the most essential role at my hospital. But I also need to accept and hold on to the fact that my role is worthwhile. Despite whatever changes will continue to come down the pipeline, I can still find valuable parts of who I am as a person and skills I have to help someone somewhere.

We also have to accept that we are more than our job. I love my job and the work I do, but I am first and foremost Erin, a human being. That means we also have to be accepting of grief. As humans being asked to be flexible, make drastic changes, and cease everything that is important to us means that we will grieve and that is okay. Once I realized that what I had been feeling was useless, the first thing I did was say to someone else, “I am feeling really sad about feeling useless. I don’t do well with feeling like this.”

With grief also comes fear, which is the core component of anxiety. In order to overcome our collective anxiety we need to identify positive coping skills. We are seeing people reach into positive coping skills across the world including reaching out to one another, brainstorming creative ways to remain connected, and turning to and sharing our music.

Together we can remain essential, despite our non-essentialness. Ultimately, we need to remind one another that we are not alone in feeling this way. Continue to create, share, support, and connect.

Be well and stay healthy.

 

 

 

 

Your Ideas Are Worth Something

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I had an opportunity recently to listen to to a talk by Ira Glass about his work in journalism and in telling stories. I’ve been a fan of “This American Life” for a number of years, especially during my time working in hospice care and needing something other than music to listen to during my car rides between clients. What I’ve always loved about the radio show was how multiple stories could be told within the hour, related to a theme despite how different the stories could be from one another. Ira Glass has been traveling the country over the last couple of years doing the same thing, telling stories about his career, all related to the things he’s learned along the way.

I didn’t experience anything truly revolutionary while listening to his advice but I did hear a number of things that I’ve heard elsewhere. People who have “made it” in the world often encourage people to continuously put out content, no matter whether you think it’s “good” and to keep trying to get your work in front of others. This is essentially the advice Ira Glass gave throughout his talk and specifically to people when they asked similar questions on how to get started in their career. Because it is similar advice I’ve received and heard from elsewhere, it must hold value.

I’ve been writing about my experiences as a music therapist for almost 5 years. To be clear, I don’t write about these experiences for anyone. I do it for myself. I do wonder along the way what information is helpful to others but it doesn’t define what I write about or why. I enjoy being able to process through my professional experiences and interactions with clients through writing and to keep my own “scrapbook” of sorts. What has occurred throughout the years though has been an interesting connection with people from all over. I’ve had students reach out to me with specific questions, colleagues share their thoughts about my stories, and non-music therapy professionals reach out with collaborative ideas. This concept of “put out as much content as you can” has resulted in a lot of really enjoyable connections with others and a true learning experience.

I recently had an opportunity to talk with a colleague about what it means to be an expert and how you become one. They expressed a frustration with not knowing how to get yourself out in front of a group of peers to share your thoughts and contribute to the conversation what you think is valuable. There was talk about other peers who are names you recognize in the field and what it might have taken for them to reach that destination in their career journey. What I challenged in that moment was later affirmed by Ira Glass – get yourself in front of others and share the information or the content that you think is valuable. If you believe that what you have to say is worth something, share it. It’s true that what you share might not be well-received. In fact, it might be criticized. This does not mean that the risk is not worth taking.

There’s definitely a balance between creating content, ideas, or products because you love to do it and creating these things in order to sell them. I think of the people I know who are professional musicians and visual artists in addition to music therapists, and we all do these things because we love it. I started this website because I love to write and it was a fun adventure to tell stories about music therapy. After a few years, my website began to receive a little more attention because things I had written about resonated with others. This is when I received an uptake of emails and questions from people seeking advice. It was in this moment where I had to evaluate how much time I was willing to dedicate towards something that was originally my own fun past-time and how much engaging in these conversations was depleting me. There were a number of instances where I simply did not have the energy to respond at all and I let those communications fall flat.

This was the moment where I had to decide where my balance lay. I decided that what I had to say about music therapy seemed valuable to others. This kind of statement is an incredibly difficult thing for many people to admit and certainly many people in the field of music therapy. It feels prideful to say, “my experiences and thoughts are worth something” but it’s true. When I first started responding to the various emails and questions I received, I offered those thoughts and time for free. I very much felt like I wanted to help support the students and those trying to find their place in the world and so I considered my assistance from a pay-it-forward mentality. It took me a long time to realize that I was already providing a lot of expertise for free through my website and my internship.

When I then started to respond back with an explanation of how I could provide my time and assistance but with a fee, I think it took a lot of people by surprise. Many of us in the field are in it because it is a helping profession. Asking to be reimbursed for your time, planning, and knowledge seemed like a taboo aspect that could alienate a lot of people.

In keeping with Ira Glass’ advice, keep providing the content, putting yourself out there, and trust in the worth of your experiences. I was happy to be patient and to continue to receive radio silence from those who were not willing to provide me any compensation, after all – this was all extra work for me! If no one wanted my experiences that badly, it truly would save me a lot of valuable time spent doing other things I love.

It feels very bold to tell someone that you think your thoughts and time are worth something. It also feels bold to continually put your content out for the world to see and critique. But if this is where you feel you have something to contribute, be willing to take the first step and determine your boundaries. What are you willing to share for free? What might require more time, energy, and thought and thus deserve compensation? How do you envision the differences between the two unfolding? Be willing to explore these thoughts. Don’t be afraid to try something even if it’s never been done before or it goes against the norm. For all you know, the world has been waiting for exactly your idea.

Back to School: Philosophical Approaches

Back to School

#4: Philosophical Approaches

One of my favorite aspects of training interns is assisting students in defining their professional identity. As a music therapy student, you are taught the various ways in which one can practice music therapy but are often only exposed to a couple of approaches. Each therapist has the opportunity to define who they are as a professional and how they approach their work with their clients. Often these approaches evolve over years and require a lot of self-reflection and awareness to define to yourself and others.

For students, internship is your first opportunity to truly test your foundations as a therapist. It can often feel confusing, overwhelming, or even opposing to your mentor’s feedback. Certainly, like-minded individuals tend to cluster so you may find that your mentor(s) have similar thoughts and ideas about how to approach something whereas other areas feel less straightforward.

I have a slight advantage to viewing this particular topic openly because I view my therapeutic approach as being: eclectic. I find value in a variety of approaches and recognize their importance for a number of situations. There are certain approaches to music therapy that I lean more heavily towards, but I adhere to the belief that particular approaches are more evidenced-based for certain situations. Therefore, I’m likely to alter how I provide therapy based on the needs, assessment, and goal-areas for each situation.

For example, how I serve a premature infant in the NICU might be considered fairly behavioral. How I serve a teenager on a general medicine unit who has a mental health disorder might be more person-centered or even within the cognitive-behavioral realm. Alternately, how I assist a kiddo with a traumatic brain injury would be addressed through a Neurologic Music Therapy framework. If I were working with someone with sickle cell disease, I may come from a more biopsychosocial model to address pain management. Additionally, I would likely blend all of these (or more) at once to address the whole-person.

Another way an eclectic approach is described is: integrative. Integrative is a term that really resonates with me because it depicts integrating various factors together in order to achieve a more “whole” approach. I personally aim to assist someone as a whole-person as well as help the medical team work towards their goals for the patient. Often these two aspects don’t always align, which is where I feel most comfortable inserting myself to assist.

Approaches, philosophies, and frameworks all mean the same thing, and there are a multitude that a music therapist can draw from. It is undoubtedly overwhelming to find where you fit. Various music therapy programs align with certain approaches and you may find that your own identity is shaped by the mentors who help teach you. What becomes confusing for students is the belief that they have to approach their music therapy practice exactly the same way as their mentors. This is not true! Mentors may challenge your thinking or ask you to re-frame ideas for certain reasons, but most mentors are hoping that you can discover independently how you’ve been called to practice. Anyone will be their most effective version of themselves if given the opportunity to be who they are individually.

It took me awhile to determine who I was as a music therapist. I had very strong mentors who taught me great lessons. It was easy to assume that I should be exactly like them because they were great therapists. As I began to be more independent and rely on my own self-reflection, I found that who I was as my own individual was even greater than who I was going to be if I copied my mentors. Sure, there are a number of aspects about my identity that are similar to them (it’s impossible not to be) but there are other things that I practice differently. It is one of personal goals to constantly be evolving my identity, which will ultimately only add more mentors to my life.

Trust in yourself as a student or new professional that being open to the possibilities of who you are and can be will help determine your approach to music therapy. You may find that some aspects require a “trial period” of sorts, whereas other aspects are completely natural. Regardless of your journey to your music therapy identity, the world will be better off having your unique self in it.