I’ve been looking at Kenneth Bruscia’s Defining Music Therapy (second edition) over the past few days in order to research a little for a project a colleague of mine and I are doing. I am, again, struck by how lovely vision (and clarity of said vision) can be. For more than a year, I’ve been transitioning into and therefore learning about another way of practicing music therapy. Should you happen to own this particular Bruscia book, I’m specifically interested in pages 116 and 117. Page 116 lists some of the clinical goals of improvisation:
Establish a nonverbal channel of communication, and a bridge to verbal communication
Provide a fulfilling means of self-expression and identity formation
Explore various aspects of self in relation to others
Develop the capacity for interpersonal intimacy
Develop group skills
Develop creativity, expressive freedom, spontaneity, and playfulness with various degrees of structure
Stimulate and develop the senses
Develop perceptual and cognitive skills
I am especially drawn to his first, second, third, and sixth bullet points. Nearly all of my clients do not use speech, and, in music, I am hoping to facilitate a “channel of communication” (page 116).
To you readers who are not music therapists: Do any of these goals surprise you? How so?
To you readers who are music therapists: How do you remember this text? I’m back in love with it.
I have always had a tumultuous relationship with music. I started playing violin before I was able to form memories, and grew up with music as an integral part of my life. I burnt out on it in college, even though I was studying vocal performance. I graduated in three years, mostly because I wanted to be done and get on with it, whatever “it” turned out to be. I stopped playing violin for a few years. Only recently, since I’ve been in Minneapolis, have I played it with any frequency again. Now I use music as a tool for others. I haven’t though I use music for myself. I’ve resigned myself in the last few years to thinking of music as a job, albeit a creative and fulfilling one. I have had trouble really identifying myself as a musician. I’ve always thought that I would have to know more in order to identify as one. I’d have to be better able to work with music theory. I’d have to know about more bands. I’d have to write a certain kind of song. Essentially, I’d never be able to truly be a musician, because I don’t have the time, energy, or interest to be or know all these factions of music.
Only this week have I had something of a revelation in regard to my relationship with music. What if I re-position myself? What if I acknowledge that the way I compose my music, the way I play, and certainly the way I sing and use my voice to connect with others really is music? I don’t write songs in the traditional way. I don’t analyze fugues (anymore). I don’t remember a whole lot of the music history I once learned, even though I did find it fascinating. But I do engage with my own music on a daily basis. I use music as a means to communicate and find meaning where I can’t otherwise. I use music to soothe, calm, excite, and energize. I use it to regulate my own energy. I use it in myriad ways, really, and I find it emerges in very natural, unique expressions, given the needs of the circumstance. I do use music. I use it for others and for myself. I take this opportunity to re-create what music is in my eyes.
Do you have trouble identifying yourself in a way that you think you should?
We’ll be having another peer group meeting for those Minneapolis and St. Paul board-certified music therapists who are interested. Our next meeting is Monday, November 25, at 7:00 PM. Please contact me directly for more information.
While I am working through this long transition into process-oriented music therapy, I’ve come up upon some obstacles and struggles along the way. Luckily, I have a clinical supervisor with whom I can voice my frustrations with the fact that I think I’m not doing it right at times. In the times I feel this, I can remind myself to come back to the client and come back to what is happening in our therapeutic relationship in that session and to come back to being truly client-centered by listening.
In the past two weeks I’ve had two sessions with one client that have been both difficult for me as a therapist as well as enlightening. This client and I have known each other for months now, but only very recently have I felt that progress is being made. My focus with this client is to provide ways in which she can communicate her needs to me through the use of music and musical instruments. This client does not use speech, but has solid receptive language skills. Oddly enough, these past two sessions have had a fair share of silence and space. I can sense resistance on my client’s part. I can sense that the client is contemplating how to respond to my questions of her. I can sense more now because I’m allowing for that time to elapse. I am hoping that I listening in a more effective manner. Perhaps this is why these sessions have been so challenging for us both.
I was under the impression that my summer scheduling would be much easier, but I am wrong. The logistics of configuring schedules is really difficult, especially when I’m also integrating maternity leave at the end of the summer.
Because of my pregnancy, I am shifting around a few roles I have as a music therapist, and transitioning a few clients and groups to other therapists. I haven’t had too many instances in which I’ve terminated therapeutic relationships. I told one of my groups today that I would be leaving and that another therapist would be taking over for me, and the reaction was surprising.
Clinical termination and transition
“I don’t like change. I like you,” was one of the comments today that came from a client in a group that I will be transitioning. I held her hand and agreed with her that change is difficult. I assured her I would see her one more time. I felt guilty. I didn’t anticipate the group’s reaction correctly. A few of them seemed genuinely disappointed. I’m not sure why I thought the transition would be simple, but apparently I thought it would be less emotional. This being one of the first groups that I’ve transitioned or terminated, I clearly have a lot to learn, considering there are so many people in the mix.
Professional termination and transition
I have also decided to step away from being a guest blogger on Child Development Club as I have too little energy to adequately contribute any kind of quality writing.
I’m hoping that I will find space in the upcoming months to fill in more projects, but at this point, my biggest challenge in my professional life looks like it’s going to be dealing with termination and transition.
I am working with two clients who have both, over the past few weeks, been really interested in writing and illustrating. One client created a short songbook, complete with his own illustrations. Half of the songs are original, and one is even in another language (his stuffed animal’s). The other client is now on chapter three of what seems to have the potential for being a multi-chaptered story, as she calls it.
With both of theses clients, I am fully supportive of their exploring other creative modalities. I bring in the music part of our therapy by asking how one of the characters sound, and then encouraging the use of an instrument. I do this in different ways with either client, of course. I am impressed by the dynamic quality of the story that one of the client writes. I also love the creativity that the other brings to his own songs. Clients like these are ever-amazing me.
I wonder if any of you have ever paired music with creative writing. How did you do it?
As much as I enjoy and appreciate themes, I’ve never been one to work inside them. This being said, the “Monday matters” posts are an attempt to focus myself on a topic throughout my working week.
Finding consistency clinically
I’ve been working with two different populations over the past year or more. I work with groups of young children, ages infant to five, and I work with children and adults with developmental disabilities. Providing consistency plays a role in my work with both of these populations. With the children, my hope is to instill a structure that begins with an opening song, then moves into vocalizing and/or singing, then movement, instrument play, and closes with a similar closing song from week to week. In working with my other clients, my idea of consistency is personalized per the needs of each client. Some clients need a more rigid routine than others, and providing them some flexibility and autonomy inside that routine is sometimes a challenge I have. Other clients always request a certain song that I consistently provide. However I think the most important way in which I am consistent with these clients is that I try my hardest to be present, be open, and be aware each time I see them. These are important factors in my practice of consistency.
Finding consistency professionally
I could be doing more here. But, I’m trying to be consistent about organizing the peer supervision group here in Minneapolis. We’ve been meeting regularly since I was in my internship. I could definitely be working more toward CEUs and trainings, but at this point, I’m not.
I wonder about the ways you find consistency in your work week, either with clients or in business.
Several of the clients I see have autism. Some use speech to communicate, others do not. Some find the ability to express their needs through various gestures, some sign language, and other physical indications; others do not. Some of them have a combination of verbal and physical communication. Most of my clients with autism, however, find ways to express themselves within and through a musical medium.
By providing a client with a variety of instruments, both melodic and rhythmic, I find that I can notice a trend in the way he or she plays an instrument. Choosing melodic over rhythmic might give me some insight into a client’s emotional state; perhaps this client is feeling a need to explore different sounds within this timbre. Maybe he has more expressive tendencies at this time that only a melodic instrument can allow. If the client is playing in a very high register, I might believe that he is expressing happiness; in a low register, maybe the client feels sluggish or down. I may interpret the choice of a rhythmic instrument in a variety of other ways. When the client plays with staccato strikes, I might believe he is angry or frustrated. If the client’s tempo is quick, with light strikes, I may think he is feeling anxious or scared.
The information that is relayed through music will usually facilitate a better understanding on my part of a client’s emotional state. Musical conversations can at times ensue, but other times a client might need to simply vent to me. My job is to absorb all of this information and find the best way to validate and support this musical expression, and continue to do so throughout all of the transitions and various challenges my clients might face.