I had the pleasure of presenting a workshop at the recent 32nd International Symposium on Child Abuse in Huntsville, Alabama with my colleague Angi Gibson, LPC. The topic was generated after I noticed that therapists from a variety of different disciplines utilize popular music as a listening tool in their therapy sessions. I presented from the music therapy perspective on the use of popular music for meeting the adolescent client where they are “at”, listening, lyric analysis and the possible contraindications that one might encounter when using music in the course of trauma focused therapy for child abuse. It was so much fun to hear how other professionals in the counseling, social work and child protective services world utilize popular music with their clients. I was happy to share the time with such a wonderful group of helping professionals. The room was packed with many eager to make more connections with their clients and children in their care. Amazing group of people and wonderful experience.
The wonderful team at http://www.musictherapyed.com/blog/ invited me to do a webinar about my work. It is available online here:
Tania Cordobes, MMT, MT-BC shares her expertise in working with children who have experienced trauma, and what YOU can do to best support your clients and their family members within this population.
Air date: February 1, 2016
One of the most important skills you can teach someone who has suffered trauma (abuse) is the ability to regulate affect. The same goes for a non offending family member or parent. One of the tools that I like to use in the ocean drum. I like to use the Remo brand ocean drums. I have a large one and a smaller one. I think one of the first things some therapists might lean towards when dealing with controlling affect or mood is the use of soothing music or nature sounds to help a client relax or regulate. One of the caveats with this is that if the client has any anxiety that tends towards the “free floating” kind, the loose mental state of music that is considered in the “relaxation” genre may actually feel unsafe and ungrounding. The use of the ocean drum is a great solution for that issue. The client will still get to experience the sounds of the ocean with this very important added element : control. The client will be creating their own sounds using the ocean drum which provides the ability to maintain physical control over the drum itself thus giving the client control over the sound. The fact that the client is using their arms and hands to manipulate the drums while they are listening to the sound they are creating is both relaxing and grounding at the same time. I really prefer this method for relaxation for clients who are dealing with anxiety as opposed to the non-participative relaxation to music.
Please enjoy this post by my guest Judy Simpson, MT-BC
“We are…MUSIC THERAPISTS!”
Judy Simpson, MT-BC
Director of Government Relations, American Music Therapy Association
When I started my career as a music therapist in 1983, it was not uncommon for me to describe my profession by comparing it to other professions which were more well-known. If people gave me a puzzled look after I proudly stated, “I use music to change behaviors,” I would add, “Music therapy is like physical therapy and occupational therapy, but we use music as the tool to help our patients.” Over the years as I gained more knowledge and experience, I obviously made changes and improvements to my response when asked, “What is music therapy?” My enhanced explanations took into consideration not only the audience but also growth of the profession and progress made in a variety of research and clinical practice areas.
The best revisions to my description of music therapy, however, have grown out of government relations and advocacy work. The need to clearly define the profession for state legislators and state agency officials as part of the AMTA and CBMT State Recognition Operational Plan (http://www.musictherapy.org/policy/stateadvocacy/) has forced a serious review of the language we use to describe music therapy. The process of seeking legislative and regulatory recognition of the profession and national credential provides an exceptional opportunity to finally be specific about who we are and what we do as music therapists.
For far too long we have tried to fit music therapy into a pre-existing description of professions that address similar treatment needs. What we need to do is provide a clear, distinct, and very specific narrative of music therapy so that all stakeholders and decision-makers “get it.” Included below are a few initial examples that support our efforts in defining music therapy separate from our peers that work in other healthcare and education professions.
• Music therapist’s qualifications are unique due to the requirements to be a professionally trained musician in addition to training and clinical experience in practical applications of biology, anatomy, psychology, and the social and behavioral sciences.
• Music therapists actively create, apply, and manipulate various music elements through live, improvised, adapted, individualized, or recorded music to address physical, emotional, cognitive, and social needs of individuals of all ages.
• Music therapists structure the use of both instrumental and vocal music strategies to facilitate change and to assist clients achieve functional outcomes related to health and education needs.
• In contrast, when OTs, Audiologists, and SLPs report using music as a part of treatment, it involves specific, isolated techniques within a pre-determined protocol, using one pre-arranged aspect of music to address specific and limited issues. This differs from music therapists’ qualifications to provide interventions that utilize all music elements in real-time to address issues across multiple developmental domains concurrently.
As we “celebrate” 2014’s Social Media Advocacy Month (http://musictherapystaterecognition.blogspot.com), I invite you to join us in the acknowledgement of music therapy as a unique profession. Focused on the ultimate goal of improved state recognition with increased awareness of benefits and increased access to services, we have an exciting adventure ahead of us. Please join us on this advocacy journey as we proudly declare, “We are Music Therapists!”
Please enjoy this post by my guest Dena Register as we kick of our Music Therapy Advocacy Month.
Declaring Our Independence
Dena Register, PhD, MT-BC
Regulatory Affairs Advisor, Certification Board for Music Therapists
The end of the year always brings with it a great deal of reflection. It feels good to look at the accomplishments of the year at its close, set new intentions and imagine new heights for the year ahead. My own professional reflections for this year brought the realization that over the last eighteen years I have enjoyed a rather diverse career in music therapy with roles as a clinician, educator, consultant and professional advocate. One of the most interesting components of wearing so many different “hats” is trying to imagine how those you are working with perceive music therapy.
There is a constant effort to try and imagine how I can best help others understand what music therapy is and the many benefits for our clients. I feel the need to have an analogy for every situation, description, and population. I can’t imagine that I’m alone in this challenge. I know many music therapists that adapt in this chameleon-like fashion when it comes to how we describe our life’s work. We build rapport with our various audiences by searching for some common ground or understanding to use as a point of departure in hopes that they will have that magical “A-ha!” about the many benefits of music therapy. While these experiences help us develop remarkable skills in story sharing and empathy, we are constantly altering the description of our professional identity in order to help others understand us. This task is a complex one for professionals and is one of the challenges that both students and new professionals find difficult to navigate early on in their careers.
I get to teach a class in philosophy and theory of music therapy. Over the last several offerings of this course the students and I have spent hours exploring what music therapy has in common with other therapeutic and creative arts professions. Each semester produces fascinating discussions, diagrams and reflections on the shared aspects of our professions and, more importantly, how music therapy is notably distinct from any other profession or practice. Successful participation in our profession is reliant upon years of skilled musicianship, and a balance of both scientific and artistic knowledge and understanding. It is highly unlikely that an individual who does not have any prior musical training can make their way through varied and rigorous coursework of a music therapy degree and successfully complete the academic, clinical and musical requirements needed.
In the sixty-plus year development of our profession we have learned to be both flexible and savvy in our descriptions of music therapy. These well-honed skills have built a foundation for our profession to grow and expand in ways we didn’t think possible. And, in most recent years, our advocacy efforts (http://www.cbmt.org/advocacy/state-recognition/) have brought us to a place of greater acknowledgement and public awareness than we have ever experienced before. What comes next? It is the era of INDEPENDENCE.
With an increased focus on research about the numerous impacts of music as a therapeutic medium, greater access to quality services by licensed professionals and continuously growing clinical offerings music therapy is positioned for continued, exponential growth. Now is the time for continued clarification to others regarding who we are as a profession as well as our unique qualifications. In 2014, it is imperative that we declare “I am a music therapist” (http://musictherapystaterecognition.blogspot.com) and understand how to articulate our unique qualifications and distinctions from our other therapeutic partners. How will YOU celebrate your ‘independence’ this year?
About the Author: Dr. Dena Register is the Regulatory Affairs Advisor for the Certification Board for Music Therapists (http://www.cbmt.org) and an Associate Professor of Music Therapy at the University of Kansas (http://music.ku.edu/programs/memt/faculty/register/). She can be reached at firstname.lastname@example.org
Employing songs into a session is common practice among Music Therapists. Budding MT’s spend countless hours learning to play volumes of songs as part of their training and internships. In turn, song lyrics are a great way to gain immediate insight into a client’s emotional landscape. Aside from the basic goal of “emotional expression”, the client’s use of song lyrics can open up new therapeutic discussion and opportunities for the music therapist to assess, evaluate and create new interventions. Teenagers are particularly interested in songs and song lyrics. You may find that your teen clients bring in entire playlists of songs to soundtrack their lives, or certain events in their lives. The qualities intrinsic in the music (for purposes of this discussion I refer you to Leonard Meyer’s “Emotion and Meaning in Music”) support the use of song lyrics and popular songs with the teen population. What comes to mind to me today as I blog is to divide dealing with song lyrics into three categories. This isn’t exhaustive but it is a start:
1. Reframing – engaging the client in looking at the author’s perspective in several different ways. After printing the lyrics, use a highlighter for client to mark meaningful lyrics for them and use these to engage in discussion. Finding themes in the client’s highlighted materials can provide insight to help facilitate further discussion and to help the therapist move into another music therapy intervention building on that progress. It would not be uncommon for a session to wind up revolving around one highlighted word, for example.
2. Rewriting – re-write the song’s lyrics to fit the client’s own experience. Some client’s will prove very adept at this. Others may need your assistance to varying degrees. One way to assist is to treat it like the old fashioned “mad libs” and have them fill in the blanks for nouns and verbs. You could also use syllable counts to weave together words and phrases. Take it a step further and play the song (use your guitar, piano, or uke) for client and engage them in singing. Be sure and find the key that best fits your client’s vocal range so that the experience is successful for them. You can take it a step further and provide the client with an instrument (melodic or rhythmic) so that they can improvise with you in a section that you create for them to do so. You may find that the re-writing experience opens up the door for further development of original songs and music that client creates in response to this initial experience. This is one avenue where the music therapist can take active music making in many different directions for a client, based on the treatment objectives and goals.
3. Repurposing – there are many other ways to use songs with meaningful words, which brings us to the area that Unkefer (1990) describes as “music and other arts”. You can use the words to create a collage, sculpture, journal pages, illustration of the lyrics (have the client gather their songs into a journal and create illustrations for each page), while the music is playing have the client write poetry or a letter or create a dance/movement piece to interpret the lyrics. There are a million different ways to go with this method of using song lyrics and as a music therapist you may know therapists from other disciplines who particularly use these methods for their clients.
L.B. Meyer (1956). Emotion and Meaning in Music. Chicago: The University of Chicago Press.
R. F. Unkefer (1990). Music therapy in the treatment of adults with mental disorders: theoretical bases and clinical interventions. pp. 164. music combined with other expressive arts. Schirmer: Macmillan.
Feelings cards can be a great help in assisting your clients to identify, express, and explore feelings. In turn, clients can learn to vector their moods or regulate their affect when they better understand their feelings. I like to keep an assortment of cards handy for my clients. There are a million ways to use the cards. One nice way to use them is to assist client in mood vectoring (Neurological Music Therapy Intervention category – listed under MPC or Music Psychotherapy and Counseling ). “Mood vectoring uses music performance to address issues of mood control, affective expression, cognitive coherence, reality orientation, to facilitate psychosocial functions” (definition is taken directly from the NMT Medical Coding and Record manual – you will find it on page 20). Mood vectoring is basically a technique that employs the iso-principal to help clients regulate their affect. Improvisation is a useful method of treatment I use to employ the use of mood vectoring is the MT studio.
The reason this is helpful with clients who are recovering from abuse-related trauma is because affect dysregulation is a typical problem that clients contend with and must be addressed in treatment. Affect dysregulation can happen for a variety of reasons as a result of abuse.
Affect regulation is a symptom that can be dealt with in a variety of ways. Initially, it is best to deal with this symptom through the use of teaching basic music -assisted relaxation skills and ensuring that the client is able to rehearse and repeat the use of music-assisted relaxation in order to understand the way they can regulate their own physiology. Affect regulation is taken to another level as the client reveals triggers (reminders of the abuse) and is able to attach emotions to the experience and gain mastery over the affect associated with the emotion.
The idea: In a therapeutic situation when it because clear that client needs to gain the skill to regulate affect associated with emotions, (for example, if the client is experiencing a lot of triggers and is responding with emotions that feel out of control) I place the cards on the table and have the client choose a manageable number of cards. Some can only manage 2 or 3 cards and others can manage 5 or 6. Once the client has chosen the cards I have them place the cards in order of intensity. Using that order of intensity, therapist guides client through an improvisation with the cards. I employ the use of “therapeutic givens” (See Bruscia reference below) to guide the experience: Client may choose every aspect of the improvisation intervention including instrumentation, tempo, volume, pitch, etc.. Therapist allows client to be the “leader” and therapist offers support for the client. Therapist uses a “therapeutic given” by letting the client know that they will musically support the client (using methods of support outlined by Kenneth Bruscia’s Taxonomy of 64 Clinical Techniques in ) so that the signal to end each emotion or the entire intervention is understood by therapist and client.
The experience is designed to give the client a sense of mastery over the level of intensity of their emotions, showing them that they have the ability to regulate their affect and express their feelings in a way that doesn’t harm anyone (including themselves) and that they can do so in a variety of situations. You may want to experiment with the intervention a little by having the client go in different order to explore how the intensity is when reversed or mixed up (because life is never in the correct order – right?). The idea of rehearsing this procedure, intervention or protocol is consistent with methods of NMT in that the rehearsal is building new skills, new neural pathways. You can rehearse the mood vectoring in response to client-identified triggers, which helps transfer the client’s skill into daily life.
Bruscia, K. (1987). Improvisational Models of Music Therapy. Springfield, Il: Charles C Thomas Publishers.