Iso-Principle in “Inside Out”

Over my Christmas holiday, I re-watched the Pixar movie “Inside Out” with my family. I saw the movie back in June when it first came out in theaters and, of course, loved it. I was in awe of its complexities and the profound discussion about emotions, the brain, and personalities. But there is so much depth to the plot that I gained new insights when watching the film for a second time. I can’t stop watching one particular part of the movie. I have watched it over and over, revering its perfectly described scenario of a concept I attempt to utilize daily.

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Joy and Sadness

Initially, I was caught by the main plot line that advocates for people to recognize, accept, and utilize “Sadness” in their life in order to support their life experiences and simply be a human. I’m certainly behind the boat in blogging about this idea, but I’ll recap it for you in order to make my main point. One of the central story points revolves around “Joy” and “Sadness”, both personified characters of the emotions of an 11 year old girl, Riley. Joy doesn’t understand why Sadness is a part of this girl’s life or what Sadness’ role is. Joy does everything she can to keep Sadness out of the way so that she doesn’t interfere with Riley’s happy life. However, some life circumstances lead to changes in Riley’s life, which ultimately cause changes in her feelings, and how her feelings are interpreted. In these new adventures, Joy learns the role of Sadness, and how Sadness (as well as the other emotions of Anger, Disgust, and Fear) affect Riley’s life and personality.

I think this movie hits the nail on the head for sparking conversation around the importance of all of your emotions and simply, why it is okay to be sad. While I was watching a second time, all I could think about were my psychiatric patients and all of the feelings they are often feeling at once, or conversely, not at all. At one point in the movie, Riley’s “emotion console” freezes over and no emotion is able to provide Riley direction. Riley is so deep in despair, confusion, and loneliness, she is left emotionless.

Imagine you are a patient undergoing tremendous emotional pain or disruption, whether from a psychiatric disorder, or as a result from physical trauma or sickness. How would you want someone to interact with you? How would you want them to validate and acknowledge your feelings? The clip below from the movie depicts so beautifully how I attempt to utilize iso-principle when working with patients in my music, demeanor, and listening. Watch closely to see how Joy attempts to comfort this character, and then how Sadness comforts him.

*I don’t believe this particular clip has too many spoilers, but I’m putting this disclaimer out in case!

In my opinion, Joy provides a perfect example of how we tend to treat people with mental illness (or anyone who is feeling sad/hurt/lonely, etc.). She tries to make Bing Bong laugh, she tells him to “cheer up” and be positive! Joy changes the subject, she encourages and motivates. She doesn’t listen. She attempts to change his emotion.

And then Sadness comes up and sits down. She meets Bing Bong where he’s at by getting down to his level and provides a comforting hand, which non-verbally tells him, “Hey, I’m here”. And then she does so many things we never do in difficult conversations. She doesn’t interrupt. She repeats back what she’s heard (“I’m sorry they took your rocket. They took something that you loved”). She doesn’t give him advice. She validates his emotion (“Yeah, it’s sad”). And she simply listens. Bing Bong has a good cry to recognize, accept, and validate his own feelings in order to move forward.

We then see Joy realize that Sadness has provided a role. Her emotion actually has purpose. During this interaction, Joy views Sadness as making it worse by acknowledging his sadness and disappointment, but then sees that when Joy couldn’t make Bing Bong feel better, Sadness did. My favorite part, which is actually cut off almost completely so you might miss it, is when Joy says:

Joy: “Hey, how did you do that?”

Sadness: “I don’t know…I just listened to what -”

What I believe she is saying here is, “I didn’t know what to do, so I just listened. I listened to what he had to say”.

So often in music therapy, I come across patients with stories that I simply can’t imagine. I don’t know what to say. But I can listen. I try to recall situations in my own life where all I wanted was a “Sadness” to be there and listen. I try to implement that in my own music therapy practice, to mirror that iso-principle concept of meeting someone where they are at, in order to help them move forward and heal. No progress can be made without first acknowledging the emotion at hand. We’re all human. We all have joy, anger, disgust, fear, and sadness.

 

Mental Health Session Ideas

It’s been awhile since I posted any new session ideas or resources for interventions. Last time I showcased some ideas, I was working primarily with clients with developmental disabilities. Now that I’m working full-time in mental health care, my thought processes have changed a bit. Below are some ideas I have had a lot of fun with, and have been quite beneficial and effective for my patients. If you’re unfamiliar with this MT wikia website featuring music therapy with all populations, check it out to help you gather more ideas for mental health (or any other population) that you can use or adapt. Sometimes, it simply helps to read about other MTs ideas to help formulate your existing ideas, or to brainstorm for your patients’ needs.

The following intervention ideas are ones that I utilize for a whole group session, typically ranging from 30-45 minutes, depending on the unit, with approximately 10 patients. These interventions follow after patients introduce themselves and I check-in with/assess the patients who have volunteered to attend.

INTERVENTION RESOURCE #7

Beach Ball Autonomy

Goals: Increase autonomy, mood, and expression; decrease feelings of isolation

Intervention: I took a blow-up beach ball and drew on various cloud shapes that included genres, styles, and generic artists inside each shape. I toss the beach ball to a patient and wherever their thumb lands is the song selection we do next. I allow the patient to brainstorm ideas of songs that would fit into that category so I can assess the closet type of preferred song for that particular patient. I might also ask reminiscing or get-to-know-you type questions as follow up questions for this patient. The patient also gets to decide if the group will play instruments, sing, dance, listen, etc. Each group is always a little different, but overall patients tend to love this activity. Just be prepared to lead a solid 45 minutes of singing!

Considerations: I always prep the patients with “guidelines” for play on this intervention, since some patients need more structure than others. Certain guidelines include saying the name of the patient you are about to toss the ball to, so that they are making eye contact with you. I do whatever I can to make sure no patients become upset with one another (in case a beach ball goes towards a patient’s head). Just make sure you lay the ground rules before starting this intervention!

Adaptations: Spin wheel app. There is a great app for your iPad called, Decide Now!, which allows you to make a “spin wheel”. I use the same ideas above but create a customized spin wheel as a different sensory source. The patients on our more intensive unit love the sensory aspects including the sights and sounds of the app, in addition to the increased autonomy provided by the intervention.

Takeaway: This group session is often looked at as “fun” and “entertaining” by the patients, but it’s one of the few where I rely solely on the intrinsic value of music to be therapeutic. Many patients get carried away in enthusiasm for discussing their preferred music. Some of my other group sessions, or sessions provided by other interdisciplinary members don’t always create room for this free discussion. Some patients are also happy to sit and experience the “fun” without directly participating.

INTERVENTION RESOURCE #8

Blackout Songwriting

Goals: Increase expression; decrease feelings of isolation; increase cognitive stimulation

Intervention: This intervention idea was found at this site and I loved the idea immediately. I provide the lyrics to 4-5 different song choices to patients that center around generic mental health themes, such as overcoming, support, struggles, etc. I encourage patients to take time to read the lyrics of a chosen song and to choose words out of the lyrics to create their own song, or poem. The idea is to “black out” the lyrics patients don’t want in their song, and be left with the words they have chosen to form a new song. It’s really cool to see how original lyrics can be re-written into entirely new poetry to express themselves.

Considerations: Provide examples of blackout poetry to help give patients a visual. Also consider songs that aren’t too repetitive, as the options for words to choose from would be limited. Try to also provide song lyrics that are unique but relatable so that patients aren’t distracted by the song they already know well.

Takeaway: Some patients do get turned off by the idea of re-writing original songs, so keep that in mind when assessing your group. Don’t be caught off guard if a patient says, “Who does she think she is – changing the words of a classic?!”*

*This is a direct quote from a patient a few weeks ago in response to some lyric substitution!

INTERVENTION RESOURCE #9

Musical Hangman

Goals: Increase cognitive stimulation and socialization; facilitate discussion

Intervention: This is an adaptation to your classic game of hangman. I draw a thematic picture on the board and direct patients to guess the missing word before the artwork loses all of its details. (For example, “try and guess the word before the tree loses all its leaves”. Or “before the snowman melts away”.) I choose a thematic word and find songs that start with each letter of that word. For example, the word “light” might have the songs, “Let it Be”, “I Can See Clearly Now”, “Get Happy”, etc. Each patient takes a turn to guess a letter. Every letter guessed correctly earns the corresponding song to play and sing. I also try and coordinate songs that share the same thematic idea, in addition to matching the letter.

Considerations: Change the name. I never call this game Hangman due to my client population. I usually call it a “word game”, similar to wheel of fortune. Since I never draw a picture of a hangman, most patients don’t notice I’m not calling the game what it is.

Adaptations: [Theme (word) and corresponding artwork]. Autumn (Heart) and trees; Halloween (Hopeful) and pumpkin; Thanksgiving (Grateful) and turkey; Holidays (Goodwill) and snowman.

Takeaway: This is a great recreational music therapy game that allows patients to have simple, active participation. I do this often on our geriatric inpatient group to help with cognitive stimulation and also socialization.

INTERVENTION RESOURCE #10

Blues Songwriting

Goals: To increase emotional and self-expression, increase socialization; normalize environment; increase positive coping skills

Intervention: This is simply writing the blues. I explain the background of the blues to patients so they understand the basics of having line A, repeating line A, and a subsequent line B. I encourage each patient to “state a problem” or something difficult that they are feeling “blue” about, and then state a solution, or coping mechanism to that problem. We then brainstorm how we can make those statements sound poetic in the songwriting. For the most part, simply using the statement verbatim is great for the blues. For example, “I don’t want to be in the hospital anymore” is a great line A, followed by, “Oh, because I miss my family” for line B. Patients tend to not mind that their lines don’t rhyme. After each patient gets a turn writing their “blues”, we have a continuous improvisation/sing along where we sing through each patient’s blues song as a group, following the same melody line. I also bring my iPad and give each person a chance to improvise on the blues scale keyboard on GarageBand after we sing through their song.

Considerations: Try and make the instructions clear from the beginning that the purpose of the songwriting is to state a challenge and then a solution to allow for better structure of discussing coping skills and strategies to deal with their issues.

Adaptations: “Holiday Coping ” Blues Songwriting. I have done this for the holidays with a focus on the “holiday blues”.

Takeaway: Allowing the patients a safe place to vent their frustrations with hospitalizations, or the difficulties in their life in a constructive way has very positive results. Many patients will tell me like it is, without any reservations, and often once we sing about their problems in their blues song, they appear to have less stress regarding that situation, or they are happy to have been validated in their difficulties.

Comment below if you end up trying any of these intervention ideas with your patients and let me know how they went, or any adaptations you made!

Change the Way You Think about Mental Health

With my new job, I’ve certainly been in the thick of things related to mental health. Working in healthcare related to psychiatric disorders is fascinating, as each day and experiences are fairly different. Although a patient might come into the hospital with the same diagnosis as another patient, their symptoms and traits might be very different from one another, which makes treatment pretty challenging. Every person is unique and so are their brains. Since mental health deals with the brain, you can only imagine how different every patient is from one another and how this informs how we use music therapy to help treat patients.

Recently, it has seemed like many different media outlets have focused on discussing research and new insights regarding depression. I listened to two different episodes, on two different podcast shows, that came out in the same week that focused on depression. The first show was TED Radio Hour, which featured speakers such as Andrew Solomon, who is an author and speaker about his own major depressive episodes, as well as other TED talk speakers who highlighted the various stigmas and discrepancies around mental health. Here are some of my takeaways that I found to be not only fascinating, but essential to begin implementing into my daily music therapy practice, and knowledge as a human being.

Mental health disorders are not “chemical imbalances” in the brain. I feel like I had learned in Psych 101 that mental health disorders were chemical imbalances, because of all that dopamine, seratonin, and norepinephrine dysfunction. However, David Anderson points out in his TED talk that mental health needs to be looked at from a neuroscientific approach. Mental health disorders come from a failing in brain circuitry. Our brains are not made up of “chemical soup” and it’s not the chemicals that need to be researched, but in fact the neurotransmitters and synapses. Anderson points out that the reason why so many medications for depression and anxiety don’t work all that well is because you essentially throw them onto the brain like a soup and say, “Hey, well, I hope it lands where the problem lies!” Anderson’s studies are fascinating, and if you want to learn more, listen here.

We don’t do anything to treat our mental health like our physical health.

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Physical Health
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Mental Health

Why is it that when people are undergoing mental stress and difficulties, as a society, we do not treat this as okay or acceptable? Like as stated in the info-graphic above, we never give people the time, ability, and acceptance to deal with mental health in the same way that we do with physical health. At the same time, Guy Winch challenges us in this TED talk to take care of our “emotional hygiene”. As a society, we never take do enough to practice self-care and to help prevent mental stress, which ultimately can lead to deeper mental and physical health issues.

Here are more images like the above that depict these same issues.

Although we avoid conversations about mental health, the U.S. is one of the leading countries dealing with these stigmas, as discussed in this second podcast about depression. If we don’t have conversations about how people are feeling and treat them with respect and empathy, then the questions won’t be asked to fuel the need for research, and subsequently, cures. Mental health currently deals with stigma, misdiagnoses, and hushed voices. Demi Lovato gives a great talk on the importance of speaking up about mental health, with the intentions of reform. Even if you are not one to know what to say, or how to treat someone with a mental health diagnosis, then the best thing you can do is be empathetic, as you would someone with a physical health diagnosis. The video below describes how to do this beautifully.

As the holidays come upon us, bear in mind that many people find the holiday season difficult. The National Alliance of Mental Illness came out with this info-graphic this year to help you keep in mind how you deal with the holiday blues and to practice that “emotional hygiene”.

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5 Considerations When Building MT Programs

This past month has been very focused on music therapy. Having now been at my new job for 6 weeks, my music therapy-ness has recharged into turbo speed – gathering and implementing new MT interventions, learning new songs, researching, and creating goals and visions. I have finally settled into a new routine, but I have been working endlessly not to settle too comfortably. This new job has been an amazing opportunity to educate and advocate for music therapy, and its role on the interdisciplinary team. But I haven’t forgotten my goals and desires for what this music therapy role can become in this particular job.

Working to start another music therapy program within a new position has given me many opportunities to consider priorities, understanding of hospital systems, and everyday language used as a professional. For many moments throughout the past few weeks, I have had to stop and consider, “What is most important at this moment?” It has been fascinating learning about myself as a professional and how I take the steps to advocate for what is most important to me and my role as a music therapist in a new job.

Here are 5 thoughts I’ve contemplated as I’ve begun this exploration in advocating for my role, and for the future of music therapy in this hospital program.

First, don’t be shy about your goals. At first, I thought that I should keep some ideas and thoughts to myself because I didn’t want to disturb the waters, or ruffle any feathers. But I quickly realized that if you start sharing your ideas and visions for the future of the program, the easier it will be for your peers and supervisors to understand where you are coming from, and where you are going. This will make it clearer for them the choices that you make, and it will help direct you in your everyday work. It will also prevent any surprises for your supervisors or bosses when you do suddenly drop your intentions or visions. Most importantly, this means that it will also be clearer for you from the start any obstacles or challenges you might encounter along your path towards these goals.

Second, don’t let the education slide. It is easy when you are the new person to not want to ruffle any feathers as coming off as “defensive” when someone mispronounces your professional title, (“musical therapist”), the department you are a part of (“recreation department” instead of “integrated therapies”), or what it is exactly you offer to the patients. This can be extremely awkward if you don’t fix the first time, and you have to correct a month later…. [Not that I have any experience in this…]. If you educate a team member from the start, this will help facilitate discussion about your profession and how you can effectively help your patients.

(Side Note: I received this wonderful advice from another MT recently, who said, “try your best not to come across as defensive when describing music therapy, but remember that most people simply don’t know what you do. It’s a lack of education.” Very helpful to keep in mind!)

Third, do try your best to learn the history of the program, facility, leadership, etc as soon as possible. This, again, will help inform you on any challenges you might face in working towards your goals. This is where you might learn of any past history of what has been tried before, or what has never been addressed. This is the area where you might find that no one has asked, “why?” before, and maybe you’re the person to do it.

Fourth, do try your best to go above and beyond. Other than the obvious reasons of wanting to do your best, this will help you identify your work limits. Are you considering trying to see one more patient a day? Try it. If it ends up being too much, now you know. But maybe adding that one more patient during the day didn’t take up nearly as much time as you expected and would be feasible. I tried this a couple of times, one day trying to squeeze in a one-on-one session in between a couple of groups. The other time I tried to see a unit I had never seen before, that often is neglected by the other integrated therapies due to many various reasons. Turns out, it was not so scary as I imagined. Be willing to try and discover what you can and can’t do, because this will help inform you on your limits and your abilities.

Lastly, initiate, initiate, initiate. Ahh, in so many areas – initiate. Step out of your comfort zone and strike up that conversation with your co-worker you pass in the hallway but don’t normally interact with in the therapeutic setting. Want to have a sit-down meeting with your supervisor to go over those goals you have in mind? Set it up with them – don’t wait around for them to check-in! Finally, remember those visions you’ve been dreaming about? Initiate them! Start taking the steps necessary to put them into action.

Mostly, what I have found over the last few weeks is that if I think too hard about whether or not I should do something in this new job, I lose out on the opportunity. Don’t let the little worries get in the way of what you believe should be done now, and in the future. You will never be “all the things” and you can always worry about whether or not you have enough experience, are old enough, have been here long enough, etc. Make sure you settle enough to become comfortable with who you are as this professional, but don’t settle for where you could be a year from now.

What’s The Worry About “Balance”?

Three weeks ago, I started a new job. Three weeks ago, I started grad school. Three weeks ago, I stopped sleeping. (Not really, but I certainly don’t get the same amount as I used to). While adjusting to all these new changes, I’ve been thinking about the ways in which I am supposed to “balance” my life between my commitments, family time, chores, and self-care (aka, relaxation). I moved from 0 to 60 when I started these new things because I moved from being home all of the time, to never being home. The question now is, how can I simply squeeze everything in?

There have been many discussions in the last month on trying to take on a reasonable workload in order to keep the integrity of my work in tact. This has been between me and old supervisors, new supervisors, my husband, and myself. It’s amazing how much you feel you can add on to your plate when you care about the work, and yet at some point, the fine line between managing to get everything done vs. doing everything beautifully and with grace comes to smack you in the face. Luckily, I haven’t had any falls (yet) but I’ve come pretty close.

This makes me wonder why everyone worries about having a “balance” in life. What in the world does that realistically mean? I certainly don’t feel balanced between work, school, chores, and time doing things I really want to do. In fact, if you can imagine a set of balance scales, I would be the weight hopping back and forth between each side, continuously moving, in order to reduce the chances of one side hitting the ground (aka, crashing and burning). I am never the scale itself that is balanced, I am always the weight constantly in motion. Why should I worry about my scale being stable when my focus should be on how well something is being done in my life? Quality over symmetry.

With that being said, it’s not like I’ve really reached that mindset. Intellectually, I realize that this is what I should be striving for (in my opinion) but my emotional and physical sides have yet to catch up. I’m tired. I get cranky to those I love. I cope with stress through a teary release of emotion. All the while, my brain is telling me I’m being illogical regarding this so-called “balance”. How do you change your mindset so that you can slow down in order to relish the speed at which you are moving?

I find these questions to be important because without consideration, I’m not really practicing self-care. I’m not taking care of myself in order to take care of others, and that’s the field I’m in. I’ve discovered that the current population I work with is one that I have a harder time “leaving at work” and that it’s harder to get a break from all of the preoccupation in order to focus on other life aspects. This may be in part due to my schoolwork, which focuses on asking ourselves how what we’re learning can be applied to our clinical practice with our patient population. I like having to question myself and my practices on the day-to-day basis and to include my learning immediately, but it certainly makes it harder to leave “Susie, John, and Joe” at work and to not worry about their needs and care.

How does this contribute to our desire for “balance”? It makes me want to draw clean, divided lines between everything and say, “you belong here, you belong there” etc.; but that’s not life. There will always be overlap. How do we instead move towards accepting that balance is a myth if our work is formed in a foundation of care?

Why then, do we even worry about balance? If you have the answers, let me know.

The Importance of Inspiration

This past week was one that I would consider to be emotionally and intellectually overwhelming – in the best of ways. I took a trip up to Boston to begin my orientation and introduction to the Master of Arts in Music Therapy program at Berklee College of Music. When I left home, my stomach was full of butterflies and anxiety about who I would meet, how intimidating the school and professors might be, and whether or not I would be able to successfully get around the city on time to each mandatory event.

Lately, in my daily music therapy practice, I was feeling a lull, which I previously hadn’t recognized I had been feeling. The difficulty of working in private practice, or in a facility where you are alone as a music therapist, can be taxing. There are many factors to this, which I believe I’ve made aware in different posts, but what I didn’t realize until this week was that the lull I was experiencing was due to a lack of inspiration.

When you have the privilege of working with other music therapists, you have the opportunity to bounce ideas off one another, or observe great ideas and projects taking place. When you’re on your own, you are not only the number one expert in your field, you are your own resource. Additionally, like in any other profession, you have those with whom you are more inclined to share similarities and styles, and others who you don’t quite connect with. This means that you are not always going to find the inspiration you are seeking within your established connections. At times, it is necessary to branch out and keep seeking.

What I hadn’t known until this week was that I was desperate to branch out. At the start of my masters program, I was terrified of who I might meet and whether or not I would belong there. In other words, had I made a mistake in taking this risk to continue my studies? Would I be accepted by the other music therapists? Would they be much more qualified and on an entirely different level than myself as a therapist and clinician? Would they be better musicians than myself? – I mean, this is Berklee we’re talking about!

Immediately, however, I learned that everyone else there shared these same fears. We began to get to know each other and things instantly began to fall into place. I participated in introductions and basic conversations with each fellow student and became disappointed when each conversation had to end. Very quickly I found that each person there not only shared my interests and passions for learning more about music therapy, and subsequently themselves, but they were the relationships I hadn’t realized I was missing.

Throughout the week, I was increasingly more inspired. With every student, I felt like I had found an “expert” in various elements to music therapy – such as particular populations, experiences, educational backgrounds, musicianship, music therapy philosophies, and more. All of those questions that have been tumbling through my brain over the last few years suddenly connected to an “expert” I had met. But at the same time, everyone had just as many questions, considerations, and eagerness to become better music therapists. The most revelational element to the week was discovering that even with our differences, we share the same core desire to change the current music therapy world, and the world with music therapy.

Within our week, we visited many wonderful facilities in the Boston area who have successful music therapy programs. At each facility, the story was different, but the current situation is the same. Each music therapy program is implemented into their facility with positive and successful inclusion in the care of their patients. These visits were both overwhelmingly insightful and also disheartening. But let me clarify – when I say disheartening, I mean that it is difficult for me to be aware that so often, it is a struggle to include music therapy into facilities in a way that makes it necessary. Throughout the week, we heard the phrase “music therapy is nice, but is it necessary“? Right now, the profession is on the cusp of educating and advocating the world that music therapy is not only meaningful, but is absolutely necessary for the care of every patient and client. And this idea is what we are preparing ourselves to help change.

At the end of every day, my heart was so full from the conversations, lectures, observations, and insights. I became emotional at too many elements than I would like to admit (though I know I wasn’t the only one)! I left home expecting to get right down to the book learning upon arrival at Berklee, but was completely caught off guard by the inspiration to continue pursuing my profession. Not only did I walk away with the feeling that I wanted to start learning more about myself, my practice, and my ability as a clinician, but I came home with an ambition to share with the world why I want to change it with music therapy.

Apparently, a little inspiration can go a long way.

Resources That Are Working

A.K.A. My shoutout to Pinterest

I know that it’s been summer for awhile now, and that actually, it’s beginning to draw to a close, but “summer” (or vacation) has just begun for me. The last couple of weeks have been mildly chaotic (in my brain) between trying to rearrange schedules with clients, adding more clients and students, and traveling itself. This is my first year working in private practice and it is much more difficult to take time than when I was working full-time.

With that being said, my usual work style and preparation has been altered the last couple of weeks. I’ve been spending a bit of time lately doing more “research” on new ideas and interventions. That has lead me to some great resources I wanted to share which have sparked new ideas I’ve found, adapted, and recreated. This, in essence, is my shoutout to Pinterest.

Pinterest. Obviously Pinterest is a wealth of information, but I had never used it before this year for music therapy and education related information. In preparation for creating this website, I was revamping a lot of my public social media and realized I wasn’t interested in sharing my Pinterest boards, which featured hairstyles, yoga moves, and house decorating ideas, with strangers; at least, not in relation to my professional self. I created a new account and found this incredible tool called following topics (found in your profile under “following”).

I joined Pinterest back when it was just a baby in the social media world and never checked out the new and added features as they arose. I understood that I could follow people (pinners) and specific boards, but I never knew I could follow general ideas. Maybe I’m a newb in the social media realm, but I think these kinds of changes often occur unnoticed if we aren’t looking for them.

I began to follow the following general topics: “Music Therapy”, “Music Therapy Activities”, “Music Education”, “Music Education Games”, “Summer Camp Activities”, and “Music Education Activities”. Pinterest now does all of the work for me to generate related pins (all taken with a grain of salt, of course). I have now spent many successful hours perusing my feed at my leisure, while allowing my brain to spark creativity and seedlings of ideas.

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Sometimes I walk away from planning time simply haven taken in a lot of ideas and resources without yielding anything, but other days I cannot keep up with my brain as it churns out new intervention after intervention. Oftentimes these new interventions have merely taken an ounce of the resource found, but just needed that spark to create it. Here are some top pins I have found that have spurred all types of creative ideas and continue to feed them:

1. Thefameschoolblog.com I found a pin from this site about creating a songwriting game, which I fell in love with immediately. As I continued to peruse this person’s blog, I found even more “musical games” aimed at her piano students that could be just as easily adapted for various music therapy strategies. I pinned a few more ideas I had found in addition to the original.

2.  Sesame Street YouTube Channel This has been a disappointing find for me only because I currently have zero clients where using these songs would be appropriate. But there are SO MANY great songs sung by artists and Sesame Street characters that can be used in awesome sessions with kids and even pre-adolescents (if used correctly and without the characters!). The song below is currently my favorite for the importance of social intelligence, emotional skills, and self control.

3. Wholesome Harmonies and Listen and Learn Music are both blogs created by other music therapists, whom I see pop up on Pinterest the most often. This either means they are really good at that social media thing (which they are) or their resources are very catchy and inspire others (which I believe they do). They have a ton of information on both their sites, which might take a bit of sifting through to find what might work best for you, but it’s worth it!

 

I have pinned many other ideas that are just idea seedlings at the moment. This means that I either think the idea is great as is but isn’t appropriate for my currently clients, or the idea has sparked an adaptation in my mind that has yet to be created. If you’re interested in following what I pin as time goes on, you’re welcome to follow me below. I foresee many more pinnings….

Interventions That Are Working

In the past couple of months I’ve settled into a bit of a rhythm with my group sessions at the developmental disabilities agency. The clients who participate in music therapy choose to do so each week by signing up the day before. They are free to attend every week but they aren’t required to. I’ve received approximately 50 “regular” clients who rotate in and out every couple of weeks. Each group consists of 15 people so I always have a different assortment of individuals who attend, but each face is now familiar. These clients have gotten to know me and have learned what to expect each week as far as the structure of the session. What this means to me is that I need to continue to create new intervention ideas and ways to keep each session exciting and unpredictable (in a predictable way). Below are some examples of interventions I’ve done in the last couple of months that have been extremely successful and for which the clients have shown great enthusiasm.

*These interventions are designed for adults with intellectual and developmental disabilities.

INTERVENTION RESOURCE #4

Guess Who Sang THIS Song

Goals: Impulse control, social skills; awareness

Intervention: This is very straightforward, jeopardy-style game. The object is to have clients correctly identify a song title or artist by raising their hand. Play a clip of the song either recorded or live and choose someone to answer what the song is or who sang it.

Considerations: Reminding the clients before, and continually during the game, to not shout out answers, but to raise their hand to share. When the clients are extremely excited to answer they typically lose their impulse control. I generally call on someone who hasn’t revealed the answer out loud and followed directions.

Adaptations: I have adapted this game for various session themes. One way to alter this is by playing recorded clips of the music and having the words of the song title written out on notecards, scrambled up, and posted on a board. This allows you to use more thematic music for your session without relying on whether the clients can recall the title without prompts. You can then use music that is familiar to most and have them join in singing along to help unscramble the song title from the lyrics.

This example is of love songs from our 1990's themed session.
This example is of love songs from our 1990’s themed session.

INTERVENTION RESOURCE #5

Creating a ‘Band’

Goals: Gross motor movement, attention, following directions, working together

Intervention: I asked the group to imagine that we had formed a band and each small group (approx. 3 people) was a section of the band. We were about to have band practice to learn and rehearse a new song before we performed it.

Pick a song in which you can choose repetitive words to assign to a small “section” of the “band”. I used a poster board with the selected words as a visual, but set up each section to play around the circle so that when I stood in front of them, it helped remind them it was their turn to play. We “learned”, “rehearsed”, and “performed” this song; each time improving their ability to play together, wait their turn, and follow cues.

Adaptations: The first week we did this, it was for our 1980’s themed session. I chose “Jitterbug” by Wham!. I LOVE this song for the purpose of the many onomatopoeias. I selected instruments that reflected these onomatopoeias and assigned the instruments and words to each “band section”. We did only the first verse, and chorus (live music). My instrumentation looked like this: “Boom Boom“: Drums; Bang, Bang, Bang“: Tambourine  “Jitterbug“: Kokirko, Cabasa, Seed Rattle; “Go-Go“: Rhythm Sticks; “Yo-Yo”: Handbells AND a slide whistle; “High”: (everyone plays)

This song was SO fun and worked SO well I regret every day since that I didn’t get it on video. I can’t wait to do it again!

One client didn't want to play an instrument, but instead wanted to be the coveted "poster-holder".
One client didn’t want to play an instrument, but instead wanted to be the coveted “poster-holder”.

INTERVENTION RESOURCE #6

Simple Drum Circle (With Rhythm Sticks)

Goals: Following directions/cues, working together, attention, gross motor movement

Intervention: I found two basic drum circle ideas from this blog post on Pinterest. I needed to find something that was simple enough for my clients but still challenged them to work on their goals. One idea was to assign everyone a number (1-8) and play their drum (rhythm sticks) in tempo on their number. Simply count to 8 a few times. This is challenging for them because the idea of more than one person being assigned to “number one” is abstract, so we worked on this a few times around.

The second drum circle idea is in basic follow-the-leader style. Simply have the clients “rumble” their sticks when you rumble. Move up and down to signal dynamic changes and have them end each rumble with a “clap” of their sticks. Having them change dynamic levels and start/stop together was an awesome example of attention and following directions. They loved it!

Adaptations: Obviously, I adapted the drum circle to using rhythmic sticks due to my short supply of drums and extensive supply of rhythmic sticks. I use a tubano as the drum circle leader to help with the balance of leader to group sound. Even though they aren’t playing drums, they are still always excited to participate in the drum circle.

On to creating more interventions! I hope these examples offer original adaptions to others or inspire new ideas.

Sessions That Are Working

Before the holiday weekend this past week, I had an newsworthy session with my most challenging client – let’s call her T. A few days before our scheduled session, I received an exciting text from a family member of T’s saying, “She has been waking up the last 3 mornings and verbalizing ‘mo’ for ‘Good Morning’! It has been consistent each day”! This was the best news I had received from the family since I started working with them 5 months ago.

One of the biggest challenges I have met while working with T is the complete mystery of getting to know someone and their preferences through limited eye contact, no motor movement, and no verbalizations. The best way I could make decisions was based off whether or not she laughed at a choice. Laughter had been meaning “yes” and no laughter had been meaning…? No? Maybe? Undecided? No opinion? I began to become frustrated with myself and my inability to read minds as I struggled to determine the music she connected with the best. It also happened to be that her family, aids, and past therapists were suggesting contradicting musical choices. Country? Rap. Contemporary Christian? 1990’s pop. New Age Relaxation? I have tried just about everything.

And like most humans, most days it appeared that T’s preferences changed based off of her mood. Except, how could I best determine her mood? Once, during our Hello Song, I gave her a couple of mood-based choices, or feelings, with the help of the Feelings Flashcards [which, by the way are amazing. Check them out here if you are missing a manipulative like this]. When we got to the feeling of “sad”, she laughed. Alright! She made a choice based on the above defined communication skills. But, if she was sad, why was she laughing? I could not make a determinate decision that “sad” was the feeling she was experiencing based on the contradicting facial affect and responses. So, how does that help with choosing our music for the day?

To hear that T had begun to verbalize was the most amazing news. I began to wonder how much my role as her music therapist had played into her ability to produce that “mo” sound each morning? I’ve stated in other posts that T’s progress is one that has been extremely gradual. At the end of a session, her progress is documented in the finest of details, because that is where you can see the progress. If you look generally at her goals, you might think that she will never get there, which is also what her doctors and therapists said at the beginning of her recovery 5 years ago.

With some research, I began to implement more structured beginnings to our sessions to encourage her best ability to participate fully in the interventions and exercises planned. After our Hello Song, we started with stretching/warming up. We all do this with everything else in life when working on goals, so why would I let T’s inability to stretch on her own change this? I began to notice that she often relaxed during these simple hand-over-hand stretches, occasionally appearing to drift off. Allowing her body, which is always so rigid and unable to move, to become relaxed is an important key to working towards various goals. Stretching is quickly followed by breathing exercises, which may seem complicated for someone who has little control over their mouth, tongue, throat, and body, but this is the first exercise that I really began to see her concentration and determination to focus. In our NMT (Neurological Music Therapy) styled breathing exercises, I began to receive the most sustained eye contact T has ever given me. Breathing exercises are then followed by some OMREX exercises, focusing on oral motor movement and facial shapes. For weeks, we had been working on these exercises, with very small, incremental responses.

Until now.

However, when I say T is “verbalizing”, I mean simply that she is now producing sound. It is amazing how we take our ability to communicate for granted. When that ability is gone, a moan, grunt, or audible sigh can be the biggest breakthrough. Our session last week was the most alert and enthusiastic I have ever seen T. Not only did she continue to make sounds throughout the session, but she began to slowly produce these noises on cue in one or two exercises.

I am confident that, in combination with T’s other therapies, music therapy has played a large role in her progress. Below, is one of my favorite videos that puts everything we learn in music psychology and neuroscience into simple, straightforward, layman’s terms. If you have ever been confused, doubtful, or have had reservations about music therapy, its research, and evidenced based practice, please, do yourself a favor and watch the video below.

“Playing music is the brain’s equivalent to a full body workout”. For T and her traumatic injury (TBI), her brain needs all the exercise it can get to heal and re-learn the skills she was meant to have.

How To: Start Your Own Business – The Thoughts

Two weeks ago, I announced that I was going to pursue a dream of mine by opening my own piano studio. Here are the thoughts I encountered as I went through my 2 weeks “officially” working on the steps to achieve this dream.

1. “Whoo! I announced my dream and I never imagined this many people would support my idea. How exciting”!

2. “Alright, where should I start? I don’t have a piano, a studio space yet, or any students. Hmm…”.

3. “Okay, this is actually proving pretty difficult. This is a ‘chicken vs. the egg’ type problem – which comes first? The studio or the students”?

4. “Actually, this is very frustrating. How am I supposed to find prospective students if I don’t have an official studio space? How can I sign a lease for a studio space without any idea of how many students I may have”??

5. “I am very disheartened”.

6. “Back to the drawing board, I suppose. Let’s work on marketing materials and just go-with-the-flow on not having a studio space at the moment. Lightbulb! Community boards! That’s a great place to post things”.

7. “Except, all of the community boards in the community will only accept ‘non-profit’ marketing materials. Okay, sure. That makes sense to me, except, WHERE AM I SUPPOSED TO MARKET MYSELF ON SUCH A LIMITED BUDGET”?!?

8. “Let’s try the internet. I have a smidgen of knowledge on creating a website, Google verification, and generally how to get your information as ‘top search-ability’ on Google”.

9. “…Never in my life has something felt more fruitless and futile”.

10. “Wow, the week has flown by! I should probably plan my music therapy sessions for tomorrow…”.

Needless to say, my first 2 weeks working on this new project had a lot of ups and downs. If you had asked me at the time, I would’ve said I felt more “down” than up at any given point. It was extremely difficult to determine how to prioritize the steps necessary to start this little business. I did my best to work on learning more about my website, how to market myself in the community, and researching various companies that pair students with teachers interested in taking lessons.

By the end of the week, I was fairly disheartened and knew I needed to take a break from my thoughts and considerations over the weekend. However, by a miracle (or kismet incident) I received a random email from a community member I had not yet met. This person found my email through my website/marketing materials and informed me of a sale happening where full, upright pianos were being sold very cheaply, and potentially even being given away. What?!? How can this be?! My husband and I rushed over to the sale, found a very decent piano that would be perfect for beginning and intermediate fingers and put down a $5 deposit. Five dollars! We left after placing our deposit and thought all of the thoughts….

Was this piano worth any money? We don’t have a studio space, so where can we move this piano if we come back tomorrow? How much repair does it need and is it worth the cost? How are we going to move it? How much will it cost to move it? If we move it home temporarily, will we be willing to move it again and pay for moving again? And so on, and so on. Eventually, we never made an official decision but we both knew in our hearts (while attempting to quiet our minds) that this was our kismet piano. It was meant to be, regardless.

We came back the next morning prepared to move the piano to our home (with the help of some colleagues and friends who knew how to move a piano) and then next thing we knew, there was a working piano sitting in our living room!

IMG_0988

The entire process was a whirlwind and extremely fortunate. I had been searching for similar, used pianos, willing to spend a couple hundred dollars, and we found this one at an outrageously reduced cost. Not only did we save money on the piano itself, but our friends/colleagues who helped us move the piano accepted only gas fare and lunch in payment. How did all of this happen and so quickly? Was it pure luck, fate, and/or an answer to our prayers?

I believe it was a combination of these things, but I don’t want to discount a very large contributing factor, which is to say – in short – me. I played a very large role in how this came about because I spent the last two weeks working and researching, making decisions, communicating my ideas and hopes, and pursuing perspectives from other people. Although I didn’t always have a physical result of my work, I worked endlessly on this project. I don’t believe that this piano would have been handed to me if I had simply waited around for it. I received the email informing me of the sale because I spent days working on fliers, creating business cards, emailing perspective students/families, posting my fliers, and simply telling everyone I could what I was hoping to accomplish and why. Sharing my dream with others.

I am so thankful for this community person who took the time to think of me, send me an email, and help me with this physical aspect of my dream. I don’t diminish what that simple act has done for me so far, but I also am proud of the outcome my work has produced. I’ve said it before, but it is always easy to be lost in the challenges, difficulties, and frustrations of working towards something you want to achieve. That’s why it is so important to recognize a small (or, in this case, piano-sized) victory when it arrives.