Monday matters: Losing clients

I have been a recipient of clinical supervision for about two years now. Because I do not work with other music therapists, and because I was starting to burn out working the way I was working, I found a clinical supervisor with whom I have been speaking on a weekly basis. In many of my conversations with her, I ask her for advice, support, sometimes validation, a new direction to take, and often how the quality of the music being shared between my client and me is indicative of progress or resistance (which is not to say that resistance is not progress). Over the past year, I spent most of my time with my supervisor talking and sometimes playing through my work with a particular client. Finally, last week, this client really opened up and I felt an enormous shift in the session. I was both electrified (this is how therapy really feels) and terrified (repeat: this is how therapy really feels) by this change. I believed in our process at that point– that all of the work and supervision and consideration regarding this client mattered. We had moved into another level of work.

The next day, the client was pulled from music therapy because apparently this person’s other therapists reported progress, too, and inexplicably for that reason, music therapy was no longer needed.

I could not believe it. I still cannot.

Here are three steps I’m taking to deal with this blow:

  1. Talk with my supervisor.
  2. Write about it, create about it, play about it. Consider my feelings about this abrupt termination. Recognize that this was a therapeutic relationship in which I was a member, and that I can be upset by the fact that my opinion about this sudden termination didn’t change what happened.
  3. Find peace with it somehow. We’ll see how this turns out.

I wonder what steps I’m missing. This is the hardest termination I have experienced yet.

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Looking for a peer support group? If you’re in the Minneapolis or St. Paul area, and you are a board-certified music therapist, feel free to connect with me and I will let you know about our group.

Monday Matters: Seeking partners

Months have passed since I’ve written. Fortunately, though, I’m back at it (I hope). I attended my first American Music Therapy Association National Conference that concluded just yesterday, and I am home and feeling energized and somewhat overwhelmed.

I like to write. I always have. But I don’t want to be the only one who does so on my site. I want writers. (Compensation and perks can be negotiated.)

I’m going to post only once per week. At the beginning of the month, I’ll offer a writing prompt. I’d love to read what music therapy and expressive arts therapy students, interns, and professionals have to say in regard to the prompt. I’ll review the pieces, let you know my thoughts, and put it out to a different audience than you might have yourself. You might have read a guest post by Lindsay Markworth, MMT, MT-BC in the past.

Also, Sound Matters Music Therapy, LLC, is seeking qualified sub-contractors to work in the southerly suburbs of the Minneapolis area. Please contact us for details.

There is a Minneapolis-based peer group of board-certified music therapists meeting again this month. Please let me know if you have any interest.

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.

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: Go to the book

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.

Writing prompt: Define vision

I venture to guess that almost everyone in any profession or occupation has some semblance of a vision for himself. Over these past few days, when it’s still well below freezing and even degrees below zero here in Minneapolis, I’ve had some trouble getting ahead of my day. One vague goal I have (I call it “vague” because I don’t really know how to measure it) is to design my day and not let it and all its circumstances drag me unwillingly all the way to bedtime. Sometimes this happens. I suppose having a young baby has something to do with this, but nonetheless, I want to be the designer.

What is my vision? I’d been out of the habit of writing down my schedule and my goals and my lists and my innumerable want-t0/need-to-dos. I’d been typing them into my phone or my Google calendar. While this is functional, I don’t experience the act of planning and seeing as I do when I write it down. This week, I’m trying to get back into the habit of writing. Journaling is still a far-off activity at this point, but even writing out what I want to do with my day is serving me well. I haven’t clarified my vision for my business yet, even though Empower U Academy has challenged its members to do so. I have vision for my clients, but for my career as a whole? I have not written it out.

This being said, my writing prompt for March is to define your vision. I invite you to write one sentence, one paragraph, one page, or more, if you’d like. This doesn’t have to be pertaining specifically to your professional life. This can be even a very short-term vision. There is so much writing out there about finding your vision, so let this be some practice for that act. Contact me with your submission. Have it in to me by March 15.

Find January’s guest submission here.

Monday matters: A pairing

I’ve written about the role of patience in music therapy sessions before, and I’ve come up against it again. I find it exceedingly difficult to manage the juxtaposition of task management and creation of therapeutic space. Therapeutic space is vast and filled by the client and all of the people, things, and ideas he needs to bring with him; task management is all of the noise and pieces that clamor around outside, hopefully serving to keep out extraneous bits from getting where they shouldn’t go. The session inside the space needs to be as quiet as it can be before the client enters.

How in the world does one keep these two parts of the self-employed therapist life living harmoniously?

Meditate, if you can.

Dump the thoughts onto paper before going into a session.

Breathe.

Talk to other therapists.

Accept imperfection, but expect improvement.

What is your definition of therapeutic space?

*In last week’s post, I mentioned my three priorities for the week. Gladly, I accomplished them all.