Sunday, November 4, 2007

Notes on power and control

The following is a handout from a presentation I did at Kardon Institute for the Arts in October of 2003.

Examining Power and Control in Music Therapy with
People who have Developmental Disabilities

In order to become more aware of the beliefs which you bring to your work, consider the following questions:

What are my beliefs about music therapy?
•What does my idea of the "perfect" music therapy session look/feel like?
•What is my expectation about what occurs in a music therapy session?
•How do I respond/react when reality doesn’t meet my expectations?  
•Do I choose to receive supervision?  When issues come up for me, do I address them in my own therapy?   
•What sort of theoretical approach do I use?  Do I use activities?  Do I use a behavioral approach?  A psychodynamic approach?  Am I product or process-oriented?
•Does music therapy “fix” people?
•What aspects of music therapy are healing?

What is my belief about the role of my clients?
•Should my clients always "listen" to me?  What if they don't?  What if they choose to not attend sessions?  How do I respond?
•What happens if my client is "acting out"?  How do I perceive it?  As manipulation?  As a way to gain control?  As a way to communicate?  Do I need to see it as being "good" or "bad"?
•What kind of language do I use to describe my clients- especially those who have severe disabilities (i.e., “I work with MR/DD’s” versus “I work with people who have developmental disabilities”)?  
•Do I talk about my clients in terms of their diagnoses and symptoms?  Or do I see my client as a person first?
•What if what my clients want for their lives is different from what I or their service team wants for them?
•How do I respond when a client has a “crush” on me?  Or wants to give me a hug?
•How do I feel about working with clients who are “clingy”?  How about those who are “hard to reach”?
•Do I arrive on time to sessions?  
•Do I start to speak in a higher-pitched “tone” (as if to a child) when I am addressing someone with a developmental disability?
•What are my “triggers” (i.e., the things to which I tend to react strongly)?

What are my beliefs about myself as a music therapist?
•What do I believe my role as a music therapist is?
•What does it mean about me if my session doesn't go as I planned?
•How do I deal with my agency's expectations and ideas about what my role should be?
•What time of day do I function most effectively?  What time of day do each of my clients function most effectively?
•How do I feel about having power?  Do I like to be in charge?  Do I avoid being in charge?  
•How do I feel about compliance and non-compliance?
•Where do I stand/sit in relation to my client(s) during the session?
•How much (physical) assistance do I offer (i.e. to clients who are unsteady?  to hang up coats?  In toileting?, etcetera)?  
•How frequently do I intervene (i.e. When someone is struggling with feelings?  When clients are aggressive toward themselves?  Toward other group members?)?  Do I have a need to “make it better”?  
•Do I feel pressure from my clients to “make it better”?
•How do I handle days when everything seems to be going wrong? (In my sessions?  In my life?)

What is my belief about the role of the music in the therapy session?
•Do I see music as the therapy?  Or do I see music as a way to develop and express the therapy relationship?  Or do I see music as a separate entity to be projected upon?
•Do I recognize that a relationship exists between the client and the music, as well as between myself and the music, both of which are crucial relationships to address, acknowledge and analyze?
•Is it important to me to plan out the entire session?  Or do I have a general idea of where I want to go within the session (i.e. based on goals for my client and how the particular person uses music)?  Or do I follow my client's lead most of the time?
•How do I feel about silence?  Can I tolerate my client's need to not make music?

What is my belief about the experience of making music during the session?
•Do I play the whole time?  Or do I leave musical space for my client?  Who is doing most of the playing?  What if my client wants to play the whole time?  Without me?
•How does it feel for me when my client expresses very strong feelings in the music (or in words)?  And if the strong feelings are directed toward me?
•Are my own musical needs being met outside of the therapy session?  Or am I inadvertently getting my musical needs met within the session(s)?  Do I know what my musical needs are?
•Are there certain types of sound/music I avoid?  Are there certain sounds I gravitate toward?  
•Do I have a need for the music to sound a certain way?  
•How comfortable am I in my own music making? Do I always use the same instrument?  How do I feel when I use an instrument to which I am less accustomed?
•How do I feel about improvising?  How do I feel about my voice?  

Interesting things to read:
The Dynamics of Music Psychotherapy Edited by Kenneth Bruscia;  1998;  Barcelona Publishers;  Gilsum, NH;  ISBN#:  1-891278-05-3

Cognitive Counseling and Persons with Special Needs:  Adapting Behavioral Approaches to the Social Context by Herbert Lovett ;  1985;  Praeger Publishers;  Westport, CT;  ISBN#:  0-275-91651-0

Violence and Abuse in the Lives of People with Disabilities:  The End of Silent Acceptance?  by Dick Sobsey;  1994;  Paul H. Brookes Publishing Co.;  Baltimore, MD;  ISBN#:  1-55766-148-0

Power Tools:  Thoughts about power and control in service to people with developmental disabilities by Dave Hingsburger;  2000; Diverse City Press Inc.;  Eastman, Quebec, Canada;  ISBN#:  1-896230-18-0

The Ethics of Touch:  Establishing and Maintaining Appropriate Boundaries in Service to People with Developmental Disabilities by David Hingsburger and Mary Harber;  1998;  Diverse City Press, Inc.;  Eastman, Quebec, Canada;  ISBN#:  1-896230-12-1
Handbook of Mental Health Care for Persons with Developmental Disabilities-  1999 Revision by Ruth Ryan, MD;  1996;  The Community Circle Publications,  1556 Williams Street,  Denver, CO  80218;  (303)316-8794

Thinking About Institutions:  Milieux and Madness by R.D. Hinshelwood;  2001;  Jessica Kingsley Publishers;  London;  ISBN#:  1-85302-954-8

Interesting Internet Resources (Where you can find the article “Hell-bent on Helping:  Benevolence, Friendship, and the Politics of Help” by Emma Van der Klift and Norman Kunc) (The Center for Human Policy has interesting articles.) (Where you can find the Pennsylvania Journal on Positive Approaches)

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