Music Therapy Questions Posed by Students

img_2134In December, I had the privilege to speak with some high school students from Franklin, Wisconsin about music therapy. I was contacted by a teacher who had seen my TEDx talk and was showcasing music therapy to his students as a career path. He asked if I would be willing to video conference call with them in order to allow them to ask me more questions about my career.What I found to be amazing about the student Q&A was their thoughtful consideration of music therapy. What they had observed and learned about music therapy from my TEDx talk was much deeper than I could have ever imagined. Although I can’t recall every question asked, I was able to remember some of the ones that stuck with me.

Here’s a glimpse into what we discussed:

What does music therapy look like in other countries? For the most part, I was unable to answer this question, only having been a music therapist in the U.S., but it left me considering what music therapy does look like in other countries. When you consider music therapy in other countries, you have to consider what music is like in their culture, and how the music can be used as a tool. Generally, the idea of music therapy remains the same, while other factors will vary, including healthcare, cultural music and instruments, family roles, sense of community, etc.) If you’re interested in reading more about separate countries, the European Music Therapy Confederation has a nice overview of music therapy in many European countries here, or you can read more about other country’s music therapy associations found on AMTA’s around the world section.

What happens if I play another instrument, other than voice, guitar, or piano? Can I still be a music therapist? Music therapy is about using music as a tool. Although you must be proficient in voice, guitar, and piano, you can absolutely use another instrument as part of your tool belt. Studying music therapy allows you to learn how another instrument can be used safely and effectively. I know music therapists who’ve used their violin, clarinet, flute, cello, and other instruments within the context of music therapy. Often, music therapists are also called upon to use their instruments for music performance reasons, including funeral services, marketing events, or to lead staff morale-boosters. Other times, music therapists often continue participating in community ensembles in order to keep their chops up on their main instruments.

Did your family inspire you to become a music therapist? Did you know any music therapists before you became one? My family has always been musical, and they certainly helped inspire me to become a music therapist, but I never knew any music therapists until I went to college. There were many musicians with whom I grew up who inspired me to use music in a different way than music performance, which I can now see how it lead me towards music therapy, but there were not any music therapists employed in my hometown. I was unable to observe any until I was already in the degree program. Although for some people this might be a terrifying thought, going into a college program without any shadowing experience, it is totally doable. You will learn so much in your first semester that you will easily be able to determine if it’s the right path for you. I also know many people who started out as music therapy majors who quickly decided that was not what they wanted to do, and that’s okay too!

Are there particular songs or music that you use to help people feel better? First and foremost, therapy is about the individual. During a music therapy assessment, you learn about the person and their needs and work to identify an appropriate and effective plan for them. For some people, hip hop makes them feel completely relaxed. For others, hip hop is irritating and grating. What makes someone feel better is totally dependent on their music preference, and there’s research behind why music preference is different for everyone. Part of a being a music therapist is knowing how to manipulate the music in ways that will be effective for the moment. There are certainly many songs that many people like, but there is no prescription for specific songs for a specific need.

What is your favorite age to work with? All! I find value in working with all age ranges and it’s fun to have a variety. Working with kids often allows for high creativity and excitement because kids are naturally curious about the world. It is fun to engage with kids, challenging them to work on their developmental goals within the music, and exploring their needs. Kids expect you to be the expert in everything, and you should definitely present yourself with confidence and a willingness to improvise, both musically and professionally. On the other hand, adults are also awesome to work with because they offer a very different kind of therapeutic experience. You are able to engage deeply with them in insightful conversation and on a level not generally experienced with kids. Adults also expect you to be the expert, but there’s more of a give and take in the therapeutic relationship. Adults require a different kind of creativity, and certainly still call for great flexibility as the therapist. All in all, it keeps things fresh being able to alternate between the two.

What is the best and worst thing about being a music therapist? One of the worst things about being a music therapist is working with tough cases. It is hard to be a part of someone’s support system who has been sick for a long time, without a lot of relief or improvement. I saw this a lot in hospice care, but I see it more in mental health. It is very difficult working with people who simply do not have all their needs covered. As much as you take care of yourself, leaving your work at work, the tough cases still creep into your home life and often catch you unaware. It can be very challenging to not take things personally, or to not continue to worry about someone long after they’ve left your care. But on the other side, it is incredibly rewarding to offer peace and relief for someone who has been dealing with such difficulties. Each day offers at least one element of joy experienced through the music in connection with someone else.

You said in your TED talk that music can be harmful. What kind of music is harmful and why? This was such an excellent question, I feel I need to answer it with more consideration. Stayed tuned til next time with a much more descriptive answer!

I’d love to hear if anyone else has thought of other questions either from my TEDx talk or from some previous posts here. Comment below with any additional questions and I’ll answer them to the best of my abilities. Thank you to the students in Franklin, WI for their thoughtful questions and being willing to engage in such a great conversation!

 

Being a Music Therapist with Shortcomings

Working in mental health, I don’t disclose a lot of personal information about myself to my patients. This population already deals with a mixed-up understanding of personal boundaries. It’s part of who I am as a therapist to define what I do or do not reveal about myself that keeps these boundaries therapeutic. The question I never answer is, “How old are you”? It seems like a harmless question, and I really don’t mind people knowing my age, but as the therapist, it’s important to me that my patients understand structure and boundaries. My response is as polite as possible, often joking with them, but what I’m really assessing is:  Does this information change the therapeutic relationship and/or the therapy itself? Usually, the answer is no, so I keep that information to myself.

But what if the answer is yes?

Two and a half years ago, I was diagnosed with Type 1 diabetes (T1D) as an adult. To say

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Just a glimpse into a few of my T1D medical supplies

that it came as a shock would be an understatement. T1D is an autoimmune disease and has nothing to do with your health, fitness, or your lifestyle as is commonly misunderstood. Doctors/scientists do not know where the disease comes from. All they know is that certain maladaptive cells in my body decided to attack themselves in my pancreas, so now it no longer produces insulin. Insulin helps to breakdown the glucose (sugars/carbs) in your body to provide it energy. If glucose is not broken down in your body, it leaves the system without being processed properly, and your body begins to break down the fat storages instead. When this happens, it leaves you feeling hungry, tired, sick, weak, thirsty, and unimaginably irritable. You lose weight, your vision blurs, and your health becomes dangerous.

When I was diagnosed, I was scared but relieved to have an answer. Mostly though, I was angry that I had yet another thing I needed to advocate for. I’m pretty sure I immediately told a friend, “I am not going to be a poster child for this disease. Do not make me stand up and give a speech about it.” My entire career is already a thing for which I am passionate and requires me to continuously explain what it is, and advocate for its awareness. In my mind, there was no room for both music therapy and T1D. They both require the same amount of exhaustive explanation. I could not believe I would have to spend my life not only explaining my career to everyone I meet, but also my health. So, I made a very clear boundary between the two, and put T1D towards the back of my persona. I am a firm believer in person-first language and I applied this to my own thinking. I am not diabetic. I have T1D. Diabetes is not who I am as a person, it is an element of my life.

Having dealt with this chronic disease for only 10% of my life, it has clearly required some adjustments. One of my biggest adjustments has been to realize that I am not invincible. As a therapist, it is a difficult thing to accept that we cannot help everyone and that we have our own limitations. Our passion is to help others by sharing the tools (music) that we have in order to help people heal. As a new professional, you become much more aware of the elements of your patients that could be potential triggers for your own emotional and mental issues, and where your boundaries lie when working with them. If you don’t realize these areas, then you are not able to be objective in treatment, and you set yourself up for the possibilities of transference and/or counter-transference. Working in mental health, I was surprised at the number of patients I received who also had a diagnosis of T1D. Unfortunately, dealing with a chronic disease over a lifetime can make you much more susceptible to mental health disorders, specifically depression. Having patients come in for mental health issues as a result of their T1D is not uncommon.

“Diabetes isn’t just a physical challenge with serious implications; it’s also emotionally demanding and can be extremely difficult to navigate mentally.”

-Beyond Type 1

Just like everyone else, I have my good days and my bad days. Some days I feel much more resilient in my own health and my mentalities, and I can easily interact with my patients without a second thought. Other days, I have to turn to my coworkers and say, “I can’t. I need a little extra help today”. I have to accept my vulnerability as a person and know that I am not invincible. I often say, “Everyone has something”, whether that’s an illness, a traumatic history, or a mental health issue. Regardless, you have to realize where your own boundaries lie.

For me, I do not share my T1D diagnosis with my patients. That is generally not information they need to know in order to benefit from music therapy. But sometimes, it comes up. The worst thing about T1D is that you cannot be prepared for it, despite your preparation. As I deal with my own coping skills for this disease and figure out better management, different issues arise unexpectedly. In music therapy, my job is to constantly be assessing. I’m assessing my patients, their environment, the music I’ll be using, how I will be using that music, my responses to my patients, and on and on. That in itself is a lot. But sometimes that work gets interrupted by T1D, despite my preparation and my prevention of disease difficulties.

I might I get low blood sugar immediately before a session, which means I’ll be late in order to treat it. Treating low blood sugar requires 15+ minutes of my time and cannot be ignored or postponed as it is extremely dangerous. Sometimes I get low blood sugar in the middle of my session and my brain becomes foggy, my motor skill reactions are delayed, and I feel like I’m “stuck” in motion, all the while still being in charge of facilitating a session. Other times, my obnoxiously loud insulin pump alarm goes off in the middle of group, and I have to either excuse myself without explanation, or apologize to the group for sticking my hand down my shirt in order to get the pump out and turn the alarm off. When these things happen, I have to simply accept that I am human. More specifically, I am a human with a fault, just like my patients, and the rest of the world.

Know that being a music therapist, or a healthcare professional of any kind, does not mean you are above your patients, or unlike them. We all have something. It takes practice, patience, and a little bit of courage to be honest in order to identify your balance as a professional and as a person. I wouldn’t go as far as to say this is my music-therapist-living-with-T1D-poster-child speech, but part of my acceptance of myself is in acknowledging my uniqueness  (despite the fact that I’d rather not be this unique). Recognize that you can not only #livebeyondtype1 but that you can also be a music therapist with shortcomings. Successfully.

Be the Expert in Your Own Thinking

Recently, I went back and began to re-read older posts of mine, surprising myself with some of my own words of advice that I had forgotten over the last year of blogging. I found that many posts surprised me so much that I almost didn’t believe I wrote them, just because they still applied to many things I was dealing with now, and were important for me to hear. I also began to look more closely at the data and stats of this blog. Often, I found that many of the posts I thought would be relevant did not get the viewership I expected. Conversely, posts I wrote that I didn’t consider to be as important were shared the most. This told me that I’m never going to be able to guess what thoughts of mine will be the most helpful to others.  Despite this revelation, when I’m stuck in a creative block, I’m continually questioning, “Who is even reading this, and what do I have to offer to them?”

When I was last at Berklee, preparing for my final year in my Masters program, we heard a lot of discussions about owning the fact that you are the expert regarding music therapy, despite what you may think or feel. I certainly can be stronger in that mindset, but I also think this ownership applies to your own thoughts, opinions, and ideas. You are the expert in your own thinking, and it’s up to you to determine how you share this thinking with the world. Sometimes I’m unsure of what I post here, often taking a risk at sharing my ideas and thoughts. However, I’ve come to realize that I shouldn’t put so much pressure on myself. The thoughts and opinions I present here are mine only and require you, the reader, to use your own critical thinking to determine how you can use my ideas to help formulate your own. An expert is someone who has comprehensive knowledge of something, which means you should take in as many resources as you can to help you define your own ideas.

I’ve received a few emails from people who have thanked me for my TEDx talk or for my blog in helping them better connect with music therapy. Each email I receive is a heartwarming surprise and I’m grateful to those who have reached out. What I loved about these particular responses below were that people identified how my music therapy thinking was affecting theirs.

If you consider that we’re all connected somehow – when you change a single person’s world, you’ve already changed the whole world. And that’s exactly what happened to me when I watched your video. Thank you so much.” – MT student in Brazil

What I have learned so far about this career, I realize it is not the profession to get rich, but it seems so rewarding to help people with music, and make a difference in their lives!” – Future MT student in Colorado

I love reading about what you do and the experiences and activities and sessions you’ve done. They really provide me inspiration to explore my own ideas and creativity…. I wanted to email you to let you know that you have impacted my career as a music therapy student and I am quite thankful.” – MT student in Pennsylvania

78681It is not often that you get to experience people’s responses to something you have created. This is incredibly cool to witness since music therapy advocacy is one of my passions and it’s truly humbling to think I’ve influenced someone else. What these responses say to me is that creativity stems from your ownership of your own expert thinking. Who’s to say that your ideas or strategies are wrong? Sure, maybe they need re-working or support from an outside source to refine your ideas, but own them as they are. To me, creativity is trial and error.

We need these up and coming music therapists to creatively determine how they will change and affect the world through the use of music. We need people in general to own their ideas, share them loudly and proudly, and be willing to take a risk and possibly fail, all for the sake of creation and ingenuity. Be the expert in your own thinking because no one can define yourself and your ideas quite like you can.

How to Become a Music Therapist

As a result of my TEDx talk, I’ve received emails from a lot of people asking me how they can become a music therapist or go about a career change. What an awesome response from people! Initially, I attempted to respond to each email, but realized this is probably a better platform to answer those questions. So, if I have not responded to you, I apologize, but hope this answers your questions. Please bear in my mind that these suggestions are based on my own experiences and understanding, and you should take that for whatever that’s worth.

Music therapy is certainly an interesting field in that many people venture into this career from a variety of backgrounds, experiences, and ages. The way in which you can become a music therapist will depend on your previous education and your musical level. In order to be a practicing music therapist, you need to complete the right course of music therapy education for you and successfully finish a 1200 clinical hour internship. Once those are complete, you are then eligible to sit for the board-certification exam (MT-BC) and can begin practicing music therapy!

The question I receive most often  is, how do I get on a music therapy career path? This question depends on a multitude of factors, but really boils down to what is your current education level and musical background? The American Music Therapy Association has a great resource to answer this question more fully, but I’ll reiterate the basics here.

Best Screen Shot

Once you’ve determined your route, it then becomes a question of what program is the best fit for you. This could mean considering many angles, including:

  • Geography
    • Not only consider if it is the right geographic location for you, but is it in a city that supports music therapy? This could contribute to the number and variety of practicum opportunities available to you.
  • Program and school size
    • Growing your clinical abilities requires a lot of supervision. Consider how a program size may affect the amount of supervision you receive from faculty and mentors.
  • The school of music or music department’s program itself
    • Is it classical performance based or more eclectic in styles? What is the better fit for you musically?
    • Will you be challenged as a musician to build flexible and proficient musical skills on your main instrument and more?
  • The music therapy faculty
    • Do their bios inspire you?
    • Is their experience and knowledge of the field obvious?
    • Have they contributed to music therapy research, projects, or served as committee members for our national organization?
  • The style of music therapy taught
    • There are many schools of thought within music therapy, and some schools feature a particular school of thought (Neurologic MT, Nordoff-Robbins, etc.). Do your research on how they might differ from one another and what may speak more to your passions and drive.
  • Music therapy curriculum
    • Research what is expected of AMTA accredited programs.
      • How many clinical trainings will be required of you?
      • Are the course offerings innovative and comprehensive?
      • Are there multiple faculty members providing a well-rounded foundation of knowledge and experience?

There are certainly many aspects that can help inform your decision (not to mention all the regular considerations for choosing a university). Some aspects will weigh more than others for you, and the good news is that no one graduates knowing it all, regardless of the program you graduate from. Make sure to look for schools offering accredited music therapy programs through AMTA’s accredited universities list.

The last question to consider is: I’m interested in this career, but how do I know music therapy is the right fit for me? Ultimately, only you can answer that question but there are some aspects you should seriously examine. I love the points Roia makes in her blog post here and I’ll add my two cents.

  1. You should be a flexible musician. Yes, you should be a strong musician before you enter into any training as a music therapist and you should bear in mind that in order to pass your exam, you must be proficient in guitar, voice, and piano. But, that doesn’t mean you can’t also have a different major instrument. Music therapy is about adapting music in therapeutic and effective ways to meet the needs of the client. The world is your oyster as far as the tools you use, but you’ll learn how to appropriately use a variety of instruments in effective ways, including your own major instrument. [My major instrument was classical voice. Do I often sing soprano arias to my patients? Not usually. BUT, I do know how to adapt the instrument I was trained on to use it when I need to. Have I used my classical soprano voice in sessions? Absolutely, when the time called for it.] Also, you must be flexible in accepting and offering all styles of music, despite your personal preferences. What speaks to you may not be what speaks to someone else.
  2. You should have care-giving qualitiesDo you care deeply, and ultimately want to help others? Are you altruistic, kind, and have genuine interest in others’ well-being? Do you have the patience to work with the toughest of situations, people, and circumstances? Are you curious, aware of others’ needs, and flexible? These are all qualities that can be refined and built upon, but will ultimately need to become like second nature.
  3. You must be open to failure, challenges, heartbreak, and disappointment. With anything in life, times can get tough. Within music therapy, the amazing responses from clients outweigh the difficulties, but they still exist. It may take years of working with one client before a particular breakthrough. You may lose a patient to a battle of disease. You may fight for a long time to create a new music therapy program at your dream facility. You may spend your entire career explaining what it is you do. You must know when you begin that music therapy isn’t easy. But it’s worth it.
  4. Lastly, you must love music. This seems fairly obvious, but it’s so important. You have to love music so much that immersing yourself in it day in and day out does not become a burden. Sure, I’m often tired of music, but it doesn’t mean I can’t come right back to it the next day after a bit of a break. You have to be passionate enough about continued music discovery that you are continually re-discovering and creating new ways in which you can use music therapeutically. You have to be determined enough to endlessly challenge yourself in becoming a better musician. You must be open to hearing others’ opinions about your music and the ways in which you can reach someone better through your musicianship. Lastly, music must continue to be your therapy. Ami addresses the importance of avoiding music clinification here, but the idea is that you must continue to feed the fuel of your music passions so that music itself does not lose its power for you.

Maybe that was more information than you wanted. Maybe that was everything you needed to hear to validate your decision in entering the field. Know that everyone’s path to music therapy is a little different, but anyone will tell you it is a career worth altering your path for!

Feel free to shoot me any more questions I did not address. Welcome to your music therapy journey!

 

Mental Health Session Ideas #2

It’s been a few months since I’ve shared some original intervention ideas for mental health. Within the music therapy world, we don’t often have the opportunity to share ideas and build off of one another. I think it’s important to create a resource for other music therapists to see each other’s work and ideas, which is the purpose of my Ideas & Resources page. Any of my ideas below, I give you permission to use because it is important that we support one another. Plus, I often find that I need inspiration and new ideas to spark my own creativity when I’m feeling burnt out on particular session plans and interventions. For those of you who aren’t MTs, consider this an inside look as to what some music therapy groups look like and their purposes.

INTERVENTION RESOURCE #11


Draw What You Hear

Goals: To increase creative expression; self-awareness; communication skills

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My current playlist

Intervention: I begin this session by asking patients to rate themselves on their ability to listen. I prompt them with instructions to listen to 6 different instrumental songs of varying styles and sounds, each for approximately 3 minutes. I provide each patient with a worksheet, divided into 6 rectangles. I instruct them to take time to listen to the music and to either draw, write, or journal things they hear within the music (using one rectangle for each song). Since the music is instrumental, this idea is more abstract and uses imagination and close listening. Patients are provided with coloring/writing utensils and informed that there are no “correct” ways to go about this exercise. Patients are asked to be quiet and respectful throughout the exercise.

Considerations: Consider choosing instrumental songs that are mainstream enough that capture patients’ attention, but are not distracting or overly familiar (e.g. Pierrot Lunaire would not be appropriate or comforting). Some suggestions include score music from Disney Pixar movies (I am quite partial to “Define Dancing” from Wall-E) and other familiar orchestral works like Gershwin’s “Rhapsody in Blue”, Copland’s “Fanfare for the Common Man” and the like.

Adaptations: This is an idea that I came across a few years ago but have no idea where from. I first used this idea with pediatrics for creative expression but realized it is an important exercise for adults in psychiatric care. Simply choose age-appropriate and complex music to make this a worthwhile exercise. I would not use this with adults actively responding to internal stimuli (hallucinations, delusions) or with a history of dementia. [Or, I would adapt appropriately and change the takeaway and goals of the intervention].

Takeaway: After patients conclude listening to the excerpts, I then ask them to share what they came up with. Each patient takes a turn sharing, and often sparks comments or conversations between peers about the work they created. Facilitate this into a conversation about how we each hear and perceive the same information differently. Ask them to assess their listening skills compared to others in the room and how this might speak to some of their relationships or they kind of listeners they seek in their lives. We end by circling back to their assessment of their listening skills and leave with the question of what they could do to be a stronger listener.

INTERVENTION RESOURCE #12


Hand[s] in [Our] Pocket[s]

Goals: To increase self-awareness, emotional expression, autonomy, self-esteem

Intervention: This intervention relies heavily on a crowd-favorite, “Hand in My Pocket” by Alanis Morissette. I begin this session by asking patients to think of things they consider to be “in their control” and “out of their control”. I use an activity handout found in the resource Life Management Skills VI by Kathy L. Korb-Khalsa & Estelle A. Leutenberg that is in the shape of a blank hand. I ask patients to list the things that are in their control inside the hand, and things that are outside of their control outside of the hand. We then brainstorm a group version of this list and write it down on the whiteboard. I transition into a lyric analysis of the song, “Hand in My Pocket”, which includes themes of acceptance, moving forward, change, and control. I then give patients a lyric substitution worksheet and encourage them to think of their own version of a verse of the song, asking them to first identify something that is out of their control, and then something that is in their control as their way to cope. Example: “I’m broke but I’m happy” might be re-written as “I’m hurt but I’m coping”. Here’s a version of one group’s substitution.

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Lyric substitution writing process

Considerations: Patients often focus on their challenges and write two negatives in a row (e.g. “I’m broke but I’m unemployed”), so be sure to stress that they write the challenge first and then the way in which they’re coping with that challenge (“I’m broke but I’m loved”).

Adaptations: Have the patients write a group version of the lyric substitution to relieve the pressure of coming up with 6 of their own re-written lines of the song. This allows patients to determine only one line of the song within a group version.

Takeaway: Patients leave with a sense of self-worth and are often extremely proud of the group collaboration on their lyric substitution. It also challenges them to consider things that are within their control and aspects of their life they have the ability to change.

*This is by far my favorite session plan at the moment!

INTERVENTION RESOURCE #13


Handbell Choir

Goals: To decrease isolation, increase group cohesion, listening and communication skills

Intervention: Currently, I use this idea on our geriatric unit as a way to reminisce about being in a band/choir or taking music lessons. For those who did grow up involved in music, it is a nice way to revisit that feeling of being in an ensemble, and for those who do not, it’s a way to be included in something they hadn’t tried before. I use the West Music desk handbells and structure the group around playing simple, familiar tunes. I set up the “music” by using color and letter coded squares that correspond to the handbells on the whiteboard with magnet tape on the back. This allows me to rearrange the notes as needed and are easy to read based on either the color or the note name. I guide patients through reading the music on the board, practicing the song a couple of times, and choosing other songs to play. No matter their skill level, this always turns out well!

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Can you identify the song?

Considerations: Choose music that is basic and familiar enough that patients can easily follow along. Try not to choose music that is too young, but stick to standards. There often may not be time enough to teach about basic rhythm, so songs that have familiar or simple rhythm is also helpful. Make sure patients are also successfully arranged within the room so that they can see the music on the board!

Adaptations: Alter your choir as needed depending on the skill level or number of patients in the group. If you have advanced patients, have patients be in charge of two bells!

Takeaway: Playing within an ensemble gives the patients a sense of meaning and purpose. It challenges them to listen to one another and recognize each bell’s purpose within the choir. Often this intervention can lead to great discussions about communication and listening skills.

INTERVENTION RESOURCE #14


Musical Coping

Goals: To increase positive coping skills, self-awareness, creative expression

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Here is my example of a completed worksheet

Intervention: This is another resource that I picked out from one of the Life Management Skills book. I liked this particular worksheet because it incorporated the idea of using music to cope paired with positive affirmations. I begin this session by leading a discussion about music as a coping skill and the benefits of music. I then guide patients through brainstorming some of the music they connect with and enjoy using to relax or to cope. I give them space to write down either a list of songs they would include on a relaxation, or “stress-free” CD/playlist, or encourage them to design the album artwork for such a CD (I also provide a list of suggested songs they can use or to spark their memory). The second part is to identify positive affirmations that they could tell themselves as they listen to their chosen music. Questions I might ask are, “What do you need to hear the most when you listen to this music?” or “What is a mantra you could repeat during a particular song to further your relaxation”? Afterwards, I allow patients to share anything they identified or created. I close the session with a brief guided breathing and music to further the example of music, coping, and relaxation.

Considerations: Patients will range in their attention and/or time with this exercise. By providing a suggested list of songs, patients who need more structure have something to guide them. An important consideration is those patients who hide behind their music. I have had patients who use music as a detriment to their health and their relationships. In one case, I suggested the patient create a list of songs that would encourage her to engage with the world. We changed her exercise to creating a”motivation playlist” where she could positively affirm herself so that by the end of the CD, she would get out of her music listening habits and engage in her relationships without hiding behind her music.

Adaptations: There are many different things you could do with these brainstormed lists. If you have the ability, you could provide actual CDs on which they could design album artwork. You could also create mix CDs for them based on their lists if you have the appropriate resources and permission.

Takeaway: Patients have the freedom for creative expression in writing, drawing, and brainstorming their ideas for this worksheet. It also gives them the opportunity to discuss their music preferences with you, the MT, and their peers. It also challenges them to reconsider the ways in which they already use music in their lives and how it can be an even more productive coping skill.


Extra: Songs I’m currently enjoying for Lyric Analyses (*some new, some old!)

  1. I’m Not the Man – Ben Folds
  2. Hold On – Wilson Phillips
  3. Burning Gold – Christina Perri
  4. Man in the Mirror – Michael Jackson
  5. Waiting for My Life to Begin – Colin Hay

A Day in the Life of a Psychiatric Music Therapist

Recently, it came to my attention that unless you are a music therapist, or you’ve worked with one, you are likely to have no idea what a typical day looks like in our work. [Thanks for the inspiration, Bob]! Today, I had the pleasure of attempting to photo document what I look like as I go about a normal day within the workplace. Unfortunately, I’m unable to share any pictures of group sessions that I facilitated due to HIPAA, but I believe I managed to capture everything else.

Feel free to journey back in time to my workday today, a regular Thursday.

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Note: This is me warming-up in the parking lot, not actually driving during this picture.

1. Warm-ups/Commute. A music therapist must start the day with some vocal warm-ups. No matter if voice is your main instrument, we use it a lot within music therapy. I find that if I start warming-up during my commute, I’m more likely to begin mentally preparing for my patients and visualizing any plans for group sessions. I also find that it allows me to wake up and look a bit more “fresh” when I arrive to work.

This is also important for a music therapist’s physical health. Recently I came down with a case of the old tendinitis because I wasn’t warming up my hands/wrists/fingers before playing guitar. Physically being out of commission drastically alters our abilities to do our jobs, so it’s important we have good habits for taking care of our physical-musical self in addition to any other self-care strategies.

2. Unpack new supplies. Today I had the pleasure of unpacking new instruments! IMG_1582Two djembe drums arrived while I was off on my weekend so I prepared for the day by testing them out and showing them off to my co-workers, 2 recreation therapists with whom I have the pleasure of sharing an office.

*Shout out to the rec therapists for photo documenting my day! You know who you are! 🙂

3. Undocumented photo: Doing the census.Yay! We begin our day by going over the census of the patients in order to see who is newly admitted, who has been discharged, and preparing ourselves to assess new patients. This requires working within the hospital documentation system and looks suspiciously like photo #6.

4. Undocumented photo #2: Attending a quick treatment team meeting. I did not want to subject all of the treatment team to a photo, so just know that we meet each morning to discuss pertinent information about any patients so that we are all on the same page in preparation for the day.

5. Packing up. After attending our quick staff meeting, I prepare myself for the day by packing up for my first group; a 45-minute group session on a 33-bed unit. I don’t know who will be coming, but attending the staff meeting allows me to gain insight and information about what to expect on the unit that day.

*Shout out to the amazing resources  that we have within our hospital pictured above and the shared closet space for Integrated Therapies (music and rec therapy)!

IMG_15986. Documenting. Every healthcare professional’s best friend. Each group session, individual patient interaction, and any other important information is documented within patient charts. Patients’ responses to music therapy (in my case) are documented in order to record their participation in groups, noted behaviors and responses, and any additional comments that help describe their progress in therapy, effects of their medications, and their interaction with the therapeutic milieu as a whole.

*Shout out to dual monitors! Worklife-altering documentation resources.

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7. Cleaning instruments. Who doesn’t love cleaning? It’s important to follow infection control protocols working in the hospital setting, even though it’s psychiatric care and not a main medical unit. You will find me occasionally cleaning my instruments on the unit after a group (especially if the instruments have really spread out around the room), but I often find it easier to clean in the closet.

*Note the gloves in use for those very high-intensity cleaning wipes. Always wear gloves when using those purple-lid wipes. (I actually have no idea what they are called even after years of cleaning with them)!

8. Session planning. Occasionally I get some time during the day to practice new songs to add to my music therapy songbook, brainstorm new intervention ideas, or compile portfolios of patient projects, like my patient original songs binder pictured below. This is a blessed, but rare time, which I always cherish. (And somehow manage to spend more time thinking versus doing). 

9. Complete assessments of new patients, finish out the day with final music therapy groups, and “other duties as assigned”. Today required collecting some more supplies, gathering resources for patients, and preparing for the week ahead. Oh, and also posing for all of these pictures! These final photos are a glimpse of what you would see if you were a patient, hospital staff member, or visitor at the hospital and came across me. Just a day in life of a music therapist carrying large, unusual equipment around the hospital.

Perhaps you’ve had the pleasure of witnessing such a fantastic way to spend a workday (in my opinion). If not, I hope this at least provides a deeper picture of what it looks like to be a music therapist, outside of the music therapy itself. Feel free to shoot me any questions about the workday of a music therapist within psychiatric care or add to the comments below!

The Music Therapy Avant-garde

Music Therapy Avant-garde (1)

In the field of music therapy, we often feel separated from other music therapists due to geography, individually pioneering new programs, or because of the nature of contract and private practice work. It is rare when we are all able to come together and share ideas, challenges, and barriers to our work. It is even more rare when any group of people can come together with seamless cohesion, respect, and support of one another. Wonderfully, this is my particular cohort of fellow students in my masters program. I can’t even begin to describe all of the inspiration, camaraderie, and overall hope for the field of music therapy that has occurred from my group.

It has been eye opening to discover how well we have come to know each other largely over online forums with only a handful of face to face contact over the past year of the program. We have banded together in our desire to learn, grow, and work towards making positive change and development within our field. If I were asked to describe each person within my cohort, I would be able to provide unique attributes, talents, and aspirations about each of them. This is how transparent we have become to one another.

The reason this is so important is that this particular week provided a glimpse into the future of our field. It showcased the potential of each music therapist individually and what we could accomplish together. Like in any field, there are waves of change and growth, and it was easy to be swept up in our combined visions. When I reflect back to how inspired I felt by each of my fellow students during our initial intensive week back in September, I am renewed with the conviction that the people I am learning alongside are going to change the world. That idea seems trite, but consider how many clients each one of us works with within a given day, and multiply that by a full work-year, and then by a career. Music therapy is burgeoning in the healthcare world, with media attention following suit. Discovering how we are going to “hitch our wagon” to this is where we are on the cusp.

Working towards changing the world seems to be my running theme this year, as it is what I unknowingly titled my TEDx talk. I shared with my cohort that it was due to them, and my advisors, that I had found the inspiration to give a TED talk, and now I find myself diving into so many things I would have never considered without their ingenious examples. I don’t want to give away too much about our goals and visions as they are, of course, a work in progress. But I will say that being together with my avant-garde music therapy group renewed a sense of purpose and drive for changing the field of music therapy.

Some people have to make changes. Some people have to brainstorm the ideas and implement them. Some people have to do things distinct enough to be a part of history. Why can’t it be us?

Contrary to Music Therapy

As a music therapist:

I strive to be: sensitive, empathetic, focused, aware, a listener, compassionate, willing, encouraging, seeking, building rapport, and pursuing.

I challenge myself to be: knowledgeable, helpful, understanding, intelligent, flexible, a great musician, and therapeutic.

I envision being: a leader, teacher, colleague, implementer, resource, expert, and team member.

I work to display these attributes by doing my job and doing it well. I push my role as a music therapist beyond my job description to widen my work boundaries. I stretch, expand, and test the limits, often for the sake of my patients and the service they deserve. I don’t do this for myself. I do this for my patients because I know how beneficial music therapy can be.

This past week I’ve been gnawing on questions of what my next steps should be in expressing to my workplace that expanding music therapy past myself and into a developing program is important for them. It is important for the patients and so it is important for the facility. Since starting my current job, I have:

  • constantly been promoting music therapy by example
  • explained my visions and goals in detail to supervisors, right off the bat
  • repeatedly hinted at the importance of hiring another music therapist
  • showcased population-specific research and discussed potential research at the facility
  • highlighted the effects and responses of my patients to team members
  • been vocal and open about my job description and responsibilities versus what services I actually provide
  • encouraged my department to started attending treatment team meetings
  • provided my TEDx talk as further education to staff
  • implemented individual sessions as often as possible without expectation
  • coordinated with staff for future lectures, in-services, and community engagement

I have been circling around and around the question, “what more can I do”? What more can I do to highlight what music therapy services can do for the hospital? How can I be more obvious in informing the staff that more can be done if there are more music therapists than myself? Why aren’t they seeing the downfalls of not having a music therapy program that provides services to all of their patients, instead of me simply squeezing in as many as I can? What else can I do to make them see that I am already at capacity for responsibilities and this is all they will be able to get?

I am already filling my time to the brim in the day. I am already making sacrifices when I can to be flexible in adding new, important responsibilities and goals. I am already being the best music therapist I can be at this time. I am already doing my job well. Why can’t my facility see what I envision for its future?

What I have learned, from conversations with my husband, advisor, and peers is that I’m not speaking their language. Apparently, I’ve been over here speaking fluently in feelings, emotions, and dreams, when I should have been speaking in business. I was in a strong mindset of, “If I do my job so well, they will jump up at once and hire more of me”. Naively, I believed this had happened to me previously when working in another company, because after 6 months of doing my job well, they did hire another MT. And they’ve continued to do so every few months since then. But what I didn’t realize before was that that previous company was already doing great business. I just happened to be there at the right time.

Apparently, my next step in advancing a future music therapy program is entirely contrary to music therapy. Advocating for another music therapy position has nothing to do with the research or the positive responses from patients. In a world revolving around feelings, I have to rely on business. This is an incredibly challenging aspect for me, as I have no background in business and certainly not the aptitude. How can I say what I have been saying all along, but this time in the right language?

This is an important area for music therapists to look into, and soon. How can we begin to be more business-minded, even outside of creating our own private practice? How can we speak the right language to a business-centered world in order to advance our profession? How can we step away from our music therapy selves in order to create more space for music therapy? Let’s figure out how we can be contrary to our natural language so that the rest of the world can see the indispensable service that is music therapy .

 

 

Discovering What is Next

Since posting about my TEDx talk last month, I have been asking myself a lot lately, “what is next”? I haven’t been thinking about this in existential terms, or even in terms related to my life goals, but instead looking more deeply into my work as a music therapist. It has even been difficult to pinpoint a topic or theme to blog about here over the last few weeks because I feel like my brain has been racing. Being in a graduate program means that with each new lesson I identify fresh goals for myself. Being in a relatively new place of work means the same. Sometimes I find it hard to capture all my ideas and goals before they are immediately replaced by even newer ideas and goals. I end up feeling overloaded with passion and drive to “accomplish“. But to accomplish what?

Clear strategy and leadership solutions

I’ve been thinking a lot about what music therapy development looks like, as far as the stages of the development process. I wanted to identify a name for the stage I feel that I am in at my current hospital in hopes of discovering how much farther I would like to go to reach what I would call “thriving”. In brainstorming some development stages, I came up with this progression:

  1. Initial Implementation & Introductions
  2. Adjusting
  3. Changing & Progressing
  4. Settling & Integrating
  5. Thriving

These are in no way official terminology for music therapy development, but more of an expression of what I have experienced. These stages also don’t necessarily follow in succession and can repeat as often as there are changes and developments within a program; such as including an internship, hiring a new position, changing hours, etc. I also think that Changing & Progressing might alternate repeatedly with Settling & Integrating before ever reaching Thriving.MTT - New Page (1)

What I find really interesting about this process is the second stage of program development, which I have called Adjusting. I’ve been at my current facility for approximately 5 months and music therapy is no longer as shiny and new as it was when I started (a characteristic of Initial Implementation & Introductions). I have repeated many session plans, patients are starting to recognize me as the music therapist, and most of the staff have heard at least half of my music therapy songbook. To put it simply, I am officially a part of ordinary hospital life.

Being an ordinary member of the hospital team is a fantastic thing to be as a music therapist, but what makes this time especially interesting is that haunting question, what is next? What are my next goals? What do I want to accomplish? This is where my brain has been and it certainly has been racing back and forth. When I started, I set specific goals for each of the first 6 months of my new program. I haven’t checked many off, but I’ve been able to look back and see how my goals have now evolved.

It could be easy for music therapists, after achieving the step of Initial Implementation & Introductions to feel accomplished and begin settling.  Creating a music therapy program and advocating for your position as a professional on the interdisciplinary team is no small feat. This is an enormous first step to pursue and achieve. But then I ask myself: how do I move into Changing & Progressing? How do I avoid simply settling become complacent? I think my hospital is Adjusting more to me than I am to it, but now it is my job to challenge my hospital to change and progress with me. What can I do next that will move me along this path towards Thriving?

This is an interesting place to be. I would like to mark off my goals for the program faster and more efficiently than is always possible within a hospital setting. Part of this process is learning who your advocates are, what roadblocks may be in your way, and how you are maneuver your way towards your next path of development. How can you advocate yourself and your profession, proving that what you provide as a team member is worthwhile enough to expand?

Clearly, I have more questions than answers, but that adds to the intrigue of this experience. Let me know if you have thoughts or responses about your experience with these different stages to program development. In the meantime, I will keep attempting to reach Thriving.

My TEDx Talk

I’m happy to announce that in November of 2015, I had the opportunity to give a talk at a local TEDx event. If you had asked me previous to the experience if I ever thought I would give a TED talk, I would have said, “Ha, sure; maybe in 20 years”. I entirely have my husband to thank (blame) for this opportunity as he was the one who saw the initial flyers advertising applications and who believed that I had something interesting to share with the community, and ultimately, the internet world.

TEDx events are smaller, independently run, versions of a larger TED conference that is held each year. TED stands for Technology, Entertainment, and Design and the program runs with the intentions of spreading ideas. TEDx events are run by an independent organization at the local level to help create a “TED-like” community. The event that I participated in took place at the University of South Florida St. Petersburg (TedxUSFSP).

The applications were due immediately upon my return from my first visit to Berklee and orientation to the music therapy graduate program. I was full of renewed inspiration for the field of music therapy and motivated by my colleagues’ achievements and contributions to the world. I wrote about the experience here. I had a lot of things to say, and was willing to go out on a limb to share it with others. I applied for the TEDx event, thinking that if nothing else, I had at least tried. When I was notified that I had been invited to speak, I was definitely surprised. I then realized that I had signed up to not only give a speech to 100 people in the community, but that my speech had the potential to be heard by people all over the world. My talk would become a part of this inspirational collection of professionals, leaders, and motivators from across the globe. My talk would be accessible to anyone at anytime.

I set out to write immediately.

What I wanted to create was something that could become a resource for music therapists. There have been many wonderful TEDx talks on music therapy by our colleagues and many of them highlight the specialties and unique abilities of these music therapists. But I wanted to provide something that explained the basics. I wanted to express why music therapy deserves to be a household name.

The act of giving the talk was a whirlwind. I had forgotten until in the moment how much I love to give in-services on music therapy and (I admit it) be on the stage. It was a wonderful opportunity to meet people, share the world of music therapy to strangers, and to hear the many other fantastic talks. It is mildly nerve-wracking to know that my talk is out there for all the world to hear and see, but I am pleased with what was expressed. I hope you will appreciate it too.

It is perfect timing that the video for my talk became available this week. January is Music Therapy Advocacy month on social media. Please feel free to share this talk with other music therapy professionals, clinicians, administrators, family members, friends, anyone! Let’s spread the word on what music therapy is, how we can better include it in our healthcare world, and encourage its inclusion as a household name.