Back to reading: More thought on music therapy assessment

Yesterday I started to read some of Tony Wigram’s article, “Music Therapy Assessment: Psychological assessment without words,” published in Psyke & Logos in 2007. I’ve been working with instrumental responses with some of my clients, but also, of course, with their vocal responses. Wigram cites J. Alvin’s list on vocal responses to include, “evaluating the significance of the voice as a revelation of personality,” as well as “evaluating the placement, projection and quality of the voice” and “control of pitch and intonation” (Psyke & Logos, 2007, 28, 339). I absolutely do these things. Nearly all of my clients do not use speech, and I consider the way they use their voice (even if that use is very limited).

How do you consider responses? Do you look at one — instrumental, vocal, or behavioral — with more weight?

Monday matters: Assessment

Assessment is a practice that continues from session to session and moment to moment. Formally, assessment happens at the beginning stages of treatment. In order to evaluate a client and his or her state on a meaningful level, assessment has to recur; it’s just that sometimes it isn’t termed “assessment.”

One of the facilitators of the clinical improvisation course I took at our Great Lakes Region conference sent along an article on assessment called “Music Therapy Assessment: Psychological Assessment Without Words,” by Tony Wigram. The article, published in Psyke & Logos in 2007, looks at the reasons behind assessment, and how assessment can be defined and categorized. Admittedly, I’ve not read the whole article yet, but I was struck by one list that was shown (page 339). Wigram shows music therapy pioneer Juliette Alvin’s lists for assessing responses to music therapy. Specifically, the list “instrumental responses” was what I enjoyed the most; I’ve been working with instrumental responses with some of my clients a lot lately, and this list helps me clarify even better what I have been doing. Some items on the list include, “the clients’ understanding of cause-effect relationships on the instruments,” “whether obsessions or compulsions are expressed through the instruments,” and “whether instrument playing is purposeful or random” (Psyke & Logos, 2007, 28, 339).

Of course there are several other items on the lists that I consider to be really important, but these are some that I might look at with some more care.

What kind of assessment tools do you use? I’m curious.

Writing prompt: Consider your theoretical orientation

This past Saturday, I attended a fantastic presentation called “An Overview of the Theories that Inform Music Therapy Practice,” given by Kathleen Murphy, PhD, MT-BC and James Hiller, PhD, MT-BC. Many students and interns were in attendance, but many professionals were there, too. Drs. Murphy and Hiller touched on five theoretical orientations in only an hour and a half, really delving into only two of the five. They discussed the role of the client, the role of the therapist, and the role of the music within the theories. The approaches that were considered at length were the behaviorist approach and the psychodynamic approach, because these two theories are quite different. Other theories were humanist/client-centered, music-centered, and cognitive-behavioral theory. As much as I am enthralled with the psychodynamic approach, I think I actually work inside the humanist orientation given my clientele. I found the whole presentation and break-down of roles within each theory to be clarifying.

My writing prompt for April is to consider your theoretical orientation, or combination thereof. One point the presenters made was that a therapist cannot consider himself “eclectic” without a foundation in one orientation.

Feel free to send me your words. I’ll look them over and have them up by the end of the month. Write on.

Monday matters: Own the music

I’ve just returned from my regional music therapy conference, held in Rosemont, Illinois. We got home earlier today, and I went to see clients this afternoon. Surprisingly, I’m tired.

I attended a number of fascinating presentations, but the most immediately applicable in terms of functional knowledge that I employed even today was the CMTE (continuing education) course on clinical improvisation. Of course we spent time developing our technical knowledge of modes and how to easily access them on piano (among myriad other techniques), but what I found the most useful, confusing, and encouraging was the time we spent translating our goals into music-centered goals. In other words, how, in the music, would we clinicians know a goal has been met? How would the music achieve the goal? How would the accomplishment sound? Music therapy cannot be compared to any other therapy, because the music in music therapy is an entity and a language all in itself.

One of the conversations had in this course was surrounding music therapists’ definitions of our work, especially when we’re describing our work to someone who assumes we are music teachers. “Music therapy uses music to achieve non-musical goals” is a succinct and often-used way to speak about our therapy, but is it really accurate? Why do the goals we address have to be “non-musical?” How can we own the music in music therapy?

What are your thoughts? I would love to continue this conversation.

Missing voice

I have entirely lost my voice. I woke up this morning with nothing. I tried to make a phone call to cancel one of my sessions, and was embarrassed that it sounded like a prank call; I’m sure the person on the other end was confused by the silence.

I spent the day working on e-mails and organizing my Dropbox folders. I follow Michelle Erfurt‘s Project Professional Update, and had hopes of tackling her newest e-mail inbox challenge, but did not. Alas, I did get a few hours’ worth of administrative tasks accomplished.

I hope I find my voice tomorrow.

Back to coursework: Wigram’s IMPROVISATION

I have written before that I am in transition between working in two different music therapy approaches. I’m trying to become more and more comfortable with the process-oriented approach (which, in turn, leads me to feeling a lot of discomfort within sessions, but this could be a topic for another day). When I’m working with my clients now, I use a lot of improvisation. My principal instrument is voice, but I tend to use a variety of rhythm instruments with many of my clients.

I have some small groups of adults, with whom I am working on group improvisation. Today, I look back at Tony Wigram’s Improvisation, published in 2004. One goal I have in working with one group is to develop a stronger sense of cohesion in order to improve some social skills. Wigram writes about “rhythmic dialogues” on page 167. This kind of dialogue is something I’m hoping to facilitate.

He writes:

Important potentials when trying to develop rhythmic improvisation are:

  • improvising using a rhythmic figure, but without pulse;
  • improvising with the same rhythmic figure using a pulse;
  • rhythmic dialogues — where a rhythmic theme is used to build dialogue between two players
  • establishing a pulse but without imposing a meter on it where random accents can disrupt any sense of meter;
  • establishing a steady pulse with a meter where the accents can accentuate the meter…

I use the dialogues, as I mentioned, the most, and then maybe the first two bullet points as well. Sometimes I’m able to experience a nice back-and-forth with this group, which is encouraging.

How do you feel about this book? Do you use rhythmic thematic improvisation or melodic thematic improvisation most often?