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 and Medicine: Thoughts from a Critical Care Nurse

A few weeks ago, I had the great pleasure of connecting with Sunnie S. on Twitter. Sunnie is a critical care nurse in a hospital, and she also happens to be a great person willing to share her thoughts with me about the use of music and music therapy in the hospital.

“I want to explain that I see music therapy as the use of music at any time to the benefit of a patient. I work night shift, so there are not MTs around in the hospital, but they are on dayshift. I definitely think that the use of music therapy is a collaboration between the MT and the RN and the patient.”

The therapeutic use of music can come from other medical professionals, too. That’s what’s great about music – it’s so adaptable to many different experiences.

Sunnie’s hospital has a TV channel that plays relaxing music with nature scenes 24/7 and she tells me, “As a nurse, I use it a lot. For patients who are confused, having an exacerbation of their dementia, anxious, angry, nervous, etc., I find that using the music helps as a distraction point for the patient and they are able to stop focusing on whatever is ailing them in that moment.”

In addition to receiving music therapy from MT-BC’s, and therapeutic music experiences from the nurses, 

Sunnie tells me, “In our hospital, we also have Healing Touch practitioners and Massage Therapists who come to assist our patients, they also use music with the patients. When I speak with my patients after a healing touch session, they tell me that the music is so helpful, because they are able to clear their minds and ignore all the noisiness of the hospital around them.”

Additionally, Sunnie feels that music therapy “works with young, old, any age patient really. I find that using music therapy as a complementary therapy is beneficial to my patients. It allows them to de-stress and be distracted which takes the focus off their illness and gives them permission to focus on themselves. I also encourage my patients to bring in their own music (i.e. if they feel Led Zeppelin is healing to them, then by all means we are going to listen to some Led Zeppelin).”

The music therapy research supports the use of Led Zeppelin (or Frank Sinatra, or Eminem) in the hospital, too. Music therapists use a fun little term called “patient-preferred music” to describe this. Basically, whatever music a patient or client already has the strongest connection to tends to yield the best therapeutic outcomes.

Another music therapy technique is called “procedural support,” which is when a music therapist assists another medical professional, such as a doctor or a nurse, with a difficult or painful procedure by reducing a patient’s experience of pain and by helping to keep the patient calm or distracted.

Sunnie has seen this music therapy technique at work. “During my clinical rotations in nursing school, music therapy was used in conjunction a lot in pediatrics for procedures like IV insertions and NG tube placements. Now that I work in adult populations, I see it used in procedures (like Interventional Radiology) where the patient is semi awake for the procedure. I see that it helps the patient to remain calm and relaxed in a foreign environment.” (Music therapists call that last part “normalizing the environment.” Hard to focus on how freaky a hospital room can be if someone is belting out your favorite song in your face.)

I was also excited to hear that music is not only being used to benefit the patients Sunnie sees, but also the hospital staff. “I also think that music therapy is beneficial to staff. We use the music channel at night when it’s been busy to help us focus and find a peaceful center amidst a chaotic shift.”

I can imagine that it’s a good thing for everyone - patients, nurses, and doctors -  when the medical staff feels focused and centered!

Thank you again, Sunnie, for being willing to share your thoughts and experiences with me! (You can follow Sunnie on Twitter!)

If you are a professional from any other field (medicine, education, speech therapy, etc,) and would like to share your thoughts on music therapy, please feel free to drop me a line!

Saturday Shout Out: Justin Roberts!

Today’s Saturday Shout Out goes to my favorite kindie (that’s kid’s music + indie) artist, Justin Roberts!

Several months ago, I was thinking about how more toddlers seem to be into Justin Bieber than traditional nursery rhymes, and how I felt about that as a future music therapist. I started to think about the themes in all the children’s music I had heard so far and how they were all inadequate to broach some of the serious, real-world issues I know children sometimes confront in music therapy.

Out of sheer curiosity (or was it desperation?), I Googled “serious children’s music.” I found this article and I was totally blown away. I started listening to Justin Roberts music on YouTube, and that was followed by downloading as much of it on iTunes as my college budget would allow.

A quick evaluation of his lyrics reveals the themes are often ready-made for music therapy sessions. The music is also as satisfying, complex, and varied as children’s music ever gets. To put it simply, his music may be for children, but it’s in no way childish.

I have created some examples of how Justin Roberts’s music might be used in music therapy with children.

On his newest album, Lullaby, the first track, Count Them as They Go would be great for music-assisted relaxation, using imagery or Progressive Muscle Relaxation. This track would also be great for having clients draw to music.

Easier to Do would work well for lyric analysis. You might ask clients, “What is hard for you to do right now?” “What is something that used to be hard but now is easier for you to do?”

Nothing on You, Heart of Gold, All For You, Polar Bear, No Matter How Far, and Lullaby all contain loving messages from caregivers to children and could be used in a family therapy type session.They are also gentle enough they might be used by music therapists or parents alike in the NICU.

From other albums, songs like I Chalk, Taking off My Training Wheels, Giraffe/Nightingale, and Backyard Super Kid are all excellent for validating a child’s unique talents and abilities and for helping them to build self-esteem. Giraffe/Nightingale would be great for a group lyric analysis, and Backyard Super Kid might be perfect for a child who is hospitalized for medical or psychiatric reasons. Piggy-back songwriting can be used to customize the lyrics for each client.

There are so many more uses for Justin Roberts’s music that I couldn’t fit them all in one blog post!

His music covers nearly everything that is childhood, from the silly to the serious.

My personal favorite is Sandcastle. The song speaks of grief and loss with a very-age appropriate, relatable metaphor. It is excellent for processing grief with young children and can be adapted with fill in the blank song-writing.

And, just in case music therapists needed another reason to love Justin Roberts, he has links to chords and lyrics for his albums Meltdown! and Yellow Bus. 

Music therapists, have you ever used his music in a session? Would you?
Be sure to like Justin Roberts on Facebook and follow him on Twitter!

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.