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Monday matters: Consistency

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.

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Two small business resources

I drive a lot. I try to write all of my progress notes between clients and sites, and to do that, I use my iPad. Just in case you out there who are in private practice and who drive do not know about Evernote, I’ll take this moment to say that it’s been really handy for me. I have a number of notebooks where I keep my categorized notes, and they’re all filed and synchronized between my iPad, iPhone, and laptop. That’s it. That’s the most appealing aspect of it– its synchronization.

Though I’ve had my Square account for months, I’m just now finding it useful. I find a satisfaction in going to the bank and depositing checks, but it does take time and scheduling. Square frees all of that up, and deposits on the next day.

I wonder what other apps or methods you private practitioners use for notes, paperwork, and payment.

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Monday matters: Finding patience

Patience happens to be both difficult for me to practice and elemental in working as a music therapist.

Finding patience clinically

One of the clients I see every week has drawn out of me a need to practice the patience with which I struggle more often than not. To be clear, I loosely define patience as listening to the client and supporting the client in the time frame he or she chooses. I try not to expect a behavior or a reaction or a vocalization in any given circumstance. However, I am not always aware enough to realize that what has happened with a client historically isn’t necessarily going to happen again. Two of the last sessions I’ve had with one particular client has proven that. Instead of enthusiastically engaging with an instrument as is normally the case, this client met the instrument and me with silence. Silence has its own set of challenges for me, and though I’m learning to embrace it more and more, I think I still find it threatening. Doing something seems to be so important, and silence doesn’t look as though something is being done. But it is. And in these silences, I had to remind myself of patience and presence, and being open to the client.

Finding patience professionally

Now that I am more than halfway through my pregnancy, I’m having to practice patience in determining my case load. I’ve decided I’ll need to pare down in some areas but build up in others. These decisions induce a lot of anxiety– again, I feel that I need to have it all done already– but on a very regular basis I have to remind myself to be patient.

I wonder if there is anyone else who struggles with practicing patience, clinically or professionally.  

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So many books and articles to read

I have always wanted to be an avid reader. I introduced An Article Monthly Project months ago, and I did find that making the time to read the articles was satisfying. But, it did not last.

One good book I am reading (in pieces) is The Dynamics of Music Psychotherapy, edited by Kenneth Bruscia. I’m quite sure many music therapists either own it or have heard of it, but it seems to be a good one to go back to whenever I so need.

If there so happens to be someone out there who wants to discuss any of the chapters, I’m all for it. 

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In process

Over the past few months I have been shifting the way I think of music therapy and my philosophy of my practice from outcome-oriented to process-oriented. These months have brought such an interesting struggle. I am really fortunate to have found a clinical supervisor who is supporting me in this transition. This change has introduced a number of obstacles, none of which I would be able to navigate successfully without support. All sorts of questions have arisen for me as I’m working through the change, and I am led to believe that the questions aren’t ever going to come to an end. They just may be of a different nature. I think the questions are what is so appealing as well as what is so scary about process-oriented therapy.

This week I’ve come to decide that I need to find my connection in regard to the way I’m practicing, and to recognize that it is itself a process. I have experienced a share of challenges to this orientation, and though I believe in the validity of music therapy as a whole, I cannot switch off the way I provide the best care so that I may sidestep an obstacle. Sometimes connecting to a philosophy such as I am doing now is difficult. But, I already feel more genuine as a therapist, which will in turn benefit my clients.

Here’s hoping that the path keeps winding, but at least smoothes out a little! 

I wonder if anyone else has ever had a transition like this.

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Monday matters: Finding connection

Finding connection clinically

I had one client today with whom I had a lot of trouble connecting. I brought her favorite instruments. Though she is non-verbal, she is often quite vocal, and she seemed to be engaged vocally at the beginning of the session. Then, she turned away. She didn’t take any instrument to play, nor did she use a certain iPad app that she’s historically seemed to love. I asked her to sign “all done,” or to tell me she was through with certain experiences in another specific way. She did neither. Most of the session, she kept her body turned away from me.

Writing about it and reviewing it now, I think I would’ve best served her by listening to her more actively. Like I said, she was vocalizing at the opening of the session. Not until we had only 15 or so minutes in our session did I truly engage with her vocally. Then, she turned back toward me. Then, she made some eye contact. Only then did I feel we had connected. I believe she felt more heard at that point.

Those first minutes were difficult. I attempted to be silent in order to see if she would choose an instrument without any kind of perceived pressure from me. I attempted asking her questions and giving her two ways to answer. But, in the end, our connection was fused when we sang together.

Finding connection professionally

I have hopes for the peer supervision group we have here in the Twin Cities. Those hopes include having a stable space where we can come together as professionals and ask our questions and receive honest advice or validation. I also hope that we use music to improvise together, to share songs, and also to address specific needs that are happening in our clinical lives. Perhaps at some point we can host speakers. Finding this type of professional connection would be so very beneficial, at least for me, being in private practice. 

I wonder if anyone out there has anything to say about finding connection.

I’m writing in terms of clinical and professional connection, but I’d love to hear input on other kinds of music therapy-related connection.

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Accommodations and change

I have had to change the way I interact with some of my clients, mostly because I am not as able to be up and down off the floor anymore. To accommodate this, I used a table and chairs in one of my sessions yesterday where normally there is a pretty bare space for therapy to take place. Once my client saw these new things in the therapy space, he simply picked up one of the chairs and walked it down a hall and into another room. I followed him, of course, and asked that he take the chair back. We got ourselves back into the space, but my client really disliked the presence of the table. I moved it to the side of the room where it was still functional but not as much a focal point, but my client was very unhappy regardless. I provided him space and silence before creating a song about the difficulties and discomfort that lie within change and newness. He seemed to listen to the words; he was still and his gaze was focused, and after I sang it through two times, he said, “Ready,” and we moved into our greeting song.

No two sessions are ever the same, nor do I expect them to be. I attempt to provide a consistent physical environment for my clients who are most sensitive of change, but I simply did not give the amount of consideration to the additions that I should have given. I am hoping that the change in my own physicality will be gradual enough that there won’t be any resistance from my clients. I have a few months to see about that.

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In honor of National Autism Awareness Month: What music expresses

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.

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Upcoming meeting

There is a small group of music therapists in the Minneapolis and St. Paul areas that meets on a (relatively) regular basis. If you happen to be a board-certified music therapist in our area and are interested in a peer supervision group, please feel free to contact me directly about joining us.

Our next meeting is Wednesday, April 24, at 7:00 PM. Our agenda is still yet to be entirely determined, but we each will provide five or more songs of one genre that we happen to use often; we will more than likely play whatever instruments we all decide to bring; and we will spend time catching up with what’s new in the last few weeks. 

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Welcome, Spring! An update from Sound Matters Music Therapy, LLC

Ah, yes. I have been away for quite some time. Frankly, this Winter offered me too much to combat, and some things– like writing as much as I really want to do– fell by the wayside.

However, I plan to be back here on a regular basis. I truly believe that the darkness and the cold of Winter tore apart my ability to create a cohesive work day. Now that the sun is out (even though it was at freezing temperatures today), I am feeling rejuvenated.

To serve as a brief update, I will say that I found out that I am going to be having a baby at the end of August; our MinnTwin Music Therapist Group has met once to discuss the happenings of the Minneapolis area music therapy scene; I have moved residences (and therefore offices); I am continuing to write as a guest blogger at Child Development Club; I was in a car accident that took me out of work for one week (which could’ve been much, much worse); and I am finding more stability in my definition of my practice as a music therapist.

Find my last blog posts at Child Development ClubChild Development Club. 

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