Walk Like a Therapist, Talk Like a Therapist

Today's musing comes to you with an earworm, which happens to be the official term for a song that burrows into your ear and won't get out. Click the link if you dare: Walk Like a Man

As I prepare for my final semester as a music therapy student, I frequently catch myself saying and doing things that a therapist would say and do.

I cringed when I saw an alcohol ad sporting "TGI Tuesday!" because I instantly empathized with the clients I saw in practicum who were in rehab for substance abuse.

I cringe for all the ads and other examples in pop culture proudly displaying a less-than-healthy relationship with alcohol and other substances because I know how hard many of these and other clients will work to overcome their less-than-healthy relationships with their drugs of choice. I find myself wishing the rest of the world could be as sensitive to their struggles as a therapist is.

I found myself carefully assessing the family dog's state-specific anxiety and ended up sleeping on the couch with him to help him get settled while I dog-sat for my parents this summer. Then I caught myself using the iso principle to gradually wean him from needing me right next to him all the time.

Michael Westen of Burn Notice wishes everyone got Green Beret training in high school. I wish everyone had some training in verbal counseling skills and active listening.

I cringe when I hear a well-meaning but unhelpful grief platitude being sent rapid-fire at someone who is recently bereaved, and I have to stop myself from sharing the good news about Person-First Language a little too vigorously so as not to offend.

These behaviors weren't a regular part of my life four years ago.

Undertaking the degree program to become a music therapist has, I hope, made me a more careful observer and a better listener. I think it's made me think more carefully about what I say to others. It has taught me to walk the delicate line between sympathy and empathy. It's definitely taught me that sometimes the best thing I can do for those around me is to go for a run or soak in a bubble bath.

Slowly but surely, I think I am becoming a therapist!

Have you noticed these kinds of changes in yourself as you progressed from green student to professional MT-BC? I would love to hear how you walk the walk and talk the talk!

In Loving Memory & Rock On

This semester I have had the great pleasure to co-lead an intergenerational rock band, comprised of Drury University music therapy students, and members of the Missouri Institute for Mature Learners. We have a truly multi-generational spread in that group, and we are learning songs as old as "What a Wonderful World," to songs from last year like "Wide Awake," by Katy Perry.

Yesterday, I was deeply saddened to learn that one of our most dedicated and enthusiastic mature learners, B., had a massive heart attack and died.

As distressing as this news was, I was also overjoyed at the amazing music therapy connections we made with B. and his wife before he had to leave us.

At the very first rock band rehearsal, B. and his wife E. were the first two mature learners there. The first thing I noticed about B. was his smile and that he was wearing a Phantom of the Opera t-shirt, which happened to be the same Phantom t-shirt I have. That was a great ice breaker. We talked about musicals and many other types of music we both enjoyed.

Shortly, we were commiserating about how hard it can be to find good parking on campus. B. told me if I ever find a good spot and have to leave it, I should mark it off with police tape, chalk out a body outline, and leave a note saying, "This is what happened to the last person who took my spot."

Already B. was sharing great wisdom with me, and I'd known him for less than 5 minutes.

One week, the Mature Learners meeting was cancelled because of snow, but the Drury students came for rehearsal because B. and E. braved the weather. They were enjoying their time with us that much.

One of the songs on the program is Bon Jovi's "It's My Life." I am getting to teach this song to the group, and my adivsor and the group director, Dr. Natalie Wlodarczyk, discussed with me how we could vary the program a little bit more. I suggested we could make the verses of "It's My Life" a solo. I also had a feeling about who I should ask to sing it.

B. was a little unsure at first because he had never heard the song, but he promised me he would go home and listen to it that week while he read over the lyrics.

When we met again the next week, B. was on board. He loved that song! I was glad my gut was right.

B. was supposed to sing the solo with the group for the first time next week. Instead, his life journey came to an end. However, his wife called Dr. Wlodarczyk to share some things, and this is what she relayed to me.

B. had been practicing the song constantly. He felt that the lyrics really described how he had tried to live his life because he had already lived through one heart attack and he knew the odds of another were pretty good. His wife quoted back the chorus, "It's my life. It's now or never. I'm ain't gonna live forever. I just wanna live while I'm alive," and requested that the students from rock band sing this at B.'s funeral. We have also decided that the Intergenerational Rock Band concert will be dedicated to B.

While I know there will be a hole in my heart next Tuesday when I come for rock band rehearsal and I don't see B. standing in the back and beaming, I am beyond overjoyed that we could connect through music therapy and that we could teach each other something before B. died.

From B., I learned some practical parking wisdom, and more importantly, how to LIVE each day of my life because no one is guaranteed a single tomorrow.

With a little help from me and the rest of the rock band, B. discovered his inner rock star.

So, to this amazing gentleman that touched my life in such a brief span, I say, "Rock on."

How Did I Get Here?

I'm crouching on the floor, playing a guitar, while simultaneously holding and playing a set of jingle bells in my right hand. The strum pattern from my right hand shakes the jingle bells and makes them sound. I'm also singing and trying to get eye contact from an amazing little someone with an autism spectrum disorder.

How did I get here?

I never imagined I would have the desire or ability to find myself in that situation when I first began studying the flute years ago in 7th grade. Even though I didn't know it, that is indeed where my personal journey towards music therapy began. 

As a small child, I loved music and would spend hours at a time picking out tunes by ear on the family piano. I couldn't get enough. A family friend offered free piano lessons, which I took for a while, but being young and foolish, I decided maybe piano lessons weren't so awesome after all.

The summer before my 7th grade year, I heard a flute trio play for the very first time. After that, there was no going back. I had to learn how to do that. It was no longer a want, but a need.

I started private flute lessons and band that year and threw myself full force into both. If you asked me what I wanted be when I grew up, it was absolutely very clearly, "either a band director or a professional flutist."

Music education or performance were my only two options, as far as I was concerned. And, of course, I only listened to classical because pop music was "dumb" and "shallow."

Now I just laugh at my 7th grade self. (And also want to kick her for not listening to pop music sooner.)

Things continued more or less in this fashion through my sophomore year of high school. In my second semester, I was assigned to write a research paper on a "personally relevant question." So, my question was whether I should pursue music education or performance.

In my initial searching, I found the American Music Therapy Association (AMTA) website. The more I read, the more it became a moment like hearing the flute trio. I very quickly realized that this was my niche. The research paper I turned in was not about education vs. performance. Instead, I turned in a paper about the effectiveness of music therapy, the career options for music therapists, and what my personal action plan should be to send me on my way to MT-BC. I got to present my findings to my entire English class, so I was already advocating for music therapy.

That same year, I took a career and aptitude test at school. My top three results were music performance, counseling, and health care. My teacher laughed and shook his head and said, "Good luck finding one career that's all three of those." I told him that it meant I was supposed to be a music therapist.
 

Do you have a personal music therapy journey to share? Send me an email or share in the comments!

Music Therapy on the IEP: Layman's Terms for Parents As Advocates

Originally enacted in 1975, the Individuals with Disabilities Education Act (IDEA) guarantees the rights of all children with disabilities to a “free and appropriate public education.” For some excellent resources on IDEA and what all it entails, see here and here.

Any parent whose child is receiving special education services under IDEA is generally familiar with the rights and services they receive under IDEA, but it seems like the best-kept secret of IDEA is that music therapy is a related service.

This means that music therapy can be added to a child’s IEP at no cost to the family. If you know how to ask for it and are willing to be assertive about your rights as a parent, your school system will pay for your child to receive music therapy services as part of their IEP. For information and research on how music therapy can improve educational and quality of life outcomes for children with a variety of needs and diagnoses, please see: Music Therapy with Young Children

Music Therapy in Special Education

Music Therapy in Autism Spectrum Disorders

Music Therapy Research: Autism Spectrum Disorders

Music Therapy Research: Special Education

Music Therapy Research: Williams Syndrome

The basic process for obtaining music therapy services on an IEP is outlined as simply as possible below. (Credit for the following information goes to Judy Simpson, cited under “References.”)

1. Request a Music Therapy Assessment

Under IDEA, parents are an equal part of the IEP team and have the right to request assessments for related services. Parents can request an IEP meeting or can wait for the next scheduled meeting to make a request for a music therapy assessment. Parents have the right to contract with a music therapist separately for an assessment, of course, but that gives the school system the right to refute the results of the assessment. Time and expense can be saved by going through the school system for the assessment to begin with. Once an assessment has been requested, a school system cannot legally deny you one, but many may try as a way to avoid the expense of paying for services. You may need to remind the school system that you are guaranteed the right to assessments for your child and they must comply.

2. Music Therapy Assessment is Completed

Once the school system complies, they will contract with a music therapist of their choosing to complete the assessment for your child. You may want to check The Certification Board for Music Therapists to make sure the therapist the school contracts is actually a board-certified music therapist. Assessments vary somewhat from state to state, but in order for a music therapist to recommend that your child receive services, your child’s progress toward IEP goals will need to be measured without music therapy services and with them. If a qualified therapist determines that your child will make significantly more progress toward IEP goals with music therapy to the point that music therapy can be considered necessary for your child’s education, then that therapist will recommend services for your child.

3. Following Up With the School System

Again, many school systems will balk at this stage and attempt to deny access to services. This is generally for financial reasons. However, they are in violation of IDEA laws if they attempt to withhold services after a qualified therapist has deemed those services necessary. A written notice and reminder of their duty is all that is typically needed to encourage a school system to comply. However, sometimes it is necessary to enlist legal help and inform the school system that you will be seeking fulfillment of your rights through the courts if necessary. That being said, it is almost never necessary to actually go to court as most school systems find that the expense and bad press of litigation are not worth fighting. If you find that your school system is reluctant to grant you access to your rights, there are many organizations for parents of children with special needs who can provide you a lawyer at little to no cost.

A Final Note: Parents as Advocates

Parents, as advocates for their child’s rights, must drive the process of obtaining music therapy services on the IEP. This removes music therapists from a real or perceived conflict of interest in assessing and recommending for or against services. However, if you would like assistance and resources for the process, it is strongly recommended that you contact the American Music Therapy Association (AMTA) and let them know that you are attempting to add music therapy services to your child’s IEP. AMTA can assist parents by providing research and public relations materials, a letter of support addressed directly to school administrators, a copy of the letter from the U.S. Department of Education which clarifies music therapy as a related service, as well as many other additional resources. 

If you decide to pursue music therapy services for your child, I wish you the best of luck. You may find that music therapy makes a difference!

References:

Simpson, J. (2002). Increasing access to music therapy: The roles of parents, music therapists, and AMTA. In B. L. Wilson (Ed.), Models of music therapy interventions in school settings (2nd ed., pp. 3-6). Silver Spring, MD: The American Music Therapy Association, Inc.

What I Have Done With Music Therapy

This January is the third annual music therapy Social Media Advocacy Month. Part of this month-long process involves collecting stories of lives that have been impacted through music therapy.

Because of confidentiality, my family and friends can't just drop in during the day to see what I am doing as part of my music therapy practicum hours.

To join in with this month of advocacy, and to give the people in my life a window into what I do with clients, I am sharing some of the amazing things I have gotten to be a part of as a music therapy student.

I have:

Helped a man with a visual impairment and autism use his voice more appropriately (normal speaking range instead of Mickey-Mouse high).
Helped the same client learn to reach out, feel and identify objects and materials in his environment. 

Helped a woman on hospice care strengthen her larynx (voice-box) so she could continue to enjoy solid food with her husband for as long as possible. 
Helped the same woman recall and validate memories of her life using her favorite familiar music.
Helped calm her anxiety and lower her respiration rate using music.

Helped a group of teenagers with autism learn some new songs using a rock band setup, and in the process they worked on social skills, direction-following, and appropriate emotional expression.

Helped a group of residents in an assisted-living facility maintain their motor and cognitive skills, and improve their quality of life and self-esteem through the rehearsals and performances of a tone chime choir. 

Helped a child with a developmental disability access more motor skills and speech.

This is just a sampling of the ways I have been able to participate in music therapy as a student in the course of two semesters of practicum. I am truly and deeply humbled by the power of music therapy, and blessed by the privilege of working with these clients.

I cannot express my excitement to become a board-certified music therapist (MT-BC) and to get to experience music therapy moments all day, every day.

Introduction: Advocacy --> Recognition --> Access

Since 2005, the American Music Therapy Association and the Certification Board for Music Therapists have collaborated on a State Recognition Operational Plan. The primary purpose of this plan is to get music therapy and our MT-BC credential recognized by individual states so that citizens can more easily access our services. The AMTA Government Relations staff and CBMT Regulatory Affairs staff provide guidance and technical support to state task forces throughout the country as they work towards state recognition. To date, their work has resulted in over 35 active state task forces, 2 licensure bills passed in 2011, 1 licensure bill passed in 2012, and an estimated 7 bills being filed in 2013 that seek to create either title protection or a licensure for music therapy. This month, our focus is on YOU and on getting you excited about advocacy.

What music therapy stories do you have to share?

The Rough Edges and Beyond

Music therapists spend a lot of their time with people who are not exhibiting peak levels of human functioning. If you see a hospice patient who is experiencing tremendous physical pain, you see some of that person's "rough edges." If you see a client who has difficulty controlling his or her bowel movements, those are more rough edges. A child who is so frustrated at his or her communication difficulties that tantrums and violence ensue - that is also certainly a rough edge of the range of human possibility.

Music therapists see people at some of the most raw and vulnerable points in their lives, when things are the roughest. We see precious pre-term infants, struggling for a chance to live, and equally precious human beings on the other end of the lifespan who are actively dying.We are called in to assist with nearly every other rough patch of life in between.

The therapeutic relationship takes an enormous amount of trust on the part of the people we assist. Our clients must trust us enough with all of their vulnerabilities to allow us in to help. Music therapists are blessed enough to be invited in to those most vulnerable moments of human existence and to make those moments feel a little safer, a little smoother.

In fact, one of my favorite things about music therapists is our ability to see so much more than our client's rough edges. We see beyond - to potential, to creative expression, to personal growth in the face of tremendous challenges. When we look at a client, we assess and acknowledge their "rough spots" and all the areas that need improving, but we also focus so much of our energy on what each client can do.

Music is so very adaptable on so many levels. Everyone can engage in music in some way, no matter how small or how passively. How humbling. How utterly amazing.

You must be a special kind of person to expose oneself to all the rough edges of humanity, to throw oneself into the work of smoothing those edges. It takes a special kind of person to clearly see a person's limitations and to also see far, far beyond them.

It takes a music therapist.

So on this gorgeous Friday afternoon, I am thankful for all the music therapists and other helping professionals the world over who go about this work on a daily basis. May you find that you are able to see the good and the potential in every client you meet.

Sticks and Stones: Breaking the "Handicapped" Association

As small children, before we learn basic language skills, we learn to identify certain words with pictures and logos. Many of us can identify the McDonald's logo before we can print our first names. Some of us saw the "Coca-Cola" or "Sprite" logos and associated them with a general word like "soda" or "pop." All in all, these word-picture associations are powerful and deeply rooted in our earliest memories.

And that's usually not a huge problem. Quickly associating information with a basic picture is an important skill to help us navigate our world on a daily basis. The issue appears when we have made an association that can be harmful to others.

As a child, I learned that the white individual in a wheelchair on a blue field meant "handicapped." For years, I never questioned that association. It was everywhere - handicapped parking, the handicapped entrance, handicapped license plates.

It wasn't until I came to college as a music therapy major that I learned about Person-First Language and how important it is to speak about people first and their characteristics second. (For an excellent overview of PFL please see http://www.disabilityisnatural.com/images/PDF/pfl-sh09.pdf.)

Obviously, as soon as I learned about the importance of speaking about people first and disabilities second,  I made a resolve to eliminate the word "handicapped" from my vocabulary and make an effort to educate those around me. The problem for me comes from the blue and white wheelchair logo. It is so deeply engrained in my memory with the word "handicapped" that every time I see a license plate in traffic with that logo, my brain automatically retrieves that word. Each time this happens, I practice retraining myself to think or say aloud, "That symbol simply refers to an individual with a disability, not a disabled or handicapped person. They are a person first and foremost."

Who knows how long it will take me to break this automatic association formed in childhood? The point is, I am going to keep trying until I accomplish it, because as a future therapist, I choose to speak, think, and act respectfully towards individuals with disabilities.