Wednesday, April 27, 2011

Who's in charge here?

I realize this is going to sound like I'm ranting. And not only that, I'm fairly certain I'm going to sound judgmental. And you know what? Maybe I am. This issue is so profoundly important that I think it deserves a bit of a rant, so I'm going to ask you to bear with me today, because this is serious.

It's not exactly news to anyone that I work with people who have intellectual and developmental disabilities (many of whom also happen to have autism and many of whom do not use speech). When I'm talking about clients (below), I mean it to apply not only to doing music therapy with folks who have a whole bunch of labels, but I'm talking about working as a music therapist in general.

So, why am I carrying on? Let us commence with the rant now, shall we?

I have an important question I want us to consider: Is it our clients' jobs to listen to us? Or is it our job to listen to our clients?

I ask this, because I've been noticing what seems to be a tendency in music therapists to go in to a new session and expect their clients who have severe disabilities to just do what they ask them to do. As in, "here are the planned activities/events, and here's what I think you ought to do. Your job, client of mine, is to perform these tasks/activities. And my job is to get you to do that. Period."

Well. Okay...but...

Let's pause a second and think: whose need are we here to meet?

If we want to teach our clients to be better listeners, are we modeling that by listening to them? If we want to help our clients to be be better at paying attention, how willing are we to pay attention to them? If we want people with significant disabilities to engage with us, what steps are we going to take in order to engage on their terms? 

If we can't understand the language someone is speaking (particularly if their language does not contain words), are we truly serving that person when we expect him/her to do what we ask before we even make the effort to try to learn about who they are?

Again I ask the question that my college music therapy professor asked us all the time: whose need are we here to meet? And is that need best met by our coming to our clients in a music therapy session and expecting that they will do what we'd like them to do? 

Or is that need best met by asking that person to help us learn about who they are (even if they don't use speech to say it) and then creating the musical space within which our client can find a way to communicate and then making a point of hearing it?

We are music therapists. Let us honor that fact and work hard to develop skill in the art of listening. 

Let me end by saying this: when we work with folks who confuse us (and even if we think we know what's going on), the first place to start- always, always, always!- is by paying close attention and listening as hard as we can! 


Becoming Dr Doc said...

you betcha.

Listening and responding is the way to go. Also one of the hardest skills to learn - to put away our own needs and ego and really tune into our clients.

In my opinion the best way to be with others no matter who they are is to really listen and respond to what is happening

Laura Cousins said...

There's something negative about the word "rant"; you sound like you are demeaning yourself and your opinion when actually you are expressing something FUNDAMENTALLY IMPORTANT. And sometimes these things do sometimes need to be reiterated, Roia. So, you're fulfilling a pressing public need :-D

I used to think that my lack of formal training as a music therapist was a terrible hindrance to me but reading what you say makes me re-evaluate that to an extent; listening and responding is the only way I know to proceed when I am working with vulnerable and especially non-verbal people. The only damn thing I know how to do is to "be there", musically, with these people. I can create a kind of musical friendship, if you want to call it that, but the only method I've got with which to do that is to listen, and respond. If my clients then listen to me and respond in turn, I am basically doing cartwheels all down the corridor. One tiny moment of musical connection can sustain me for days afterwards :-D

Roia said...

@Dr Doc and @Laura I would agree it's a rather hard skill to learn. While I think listening is something that we're taught as students (without it actually being specifically stated), there seems to always be this sense of "this is the case *except* when you work with people who have intellectual and developmental disabilities or autism." Then the training seems to shift to one in which we, as music therapists, go in with a whole "here's your list of problems, and here's how we're going to fix them" agenda. I know this because when I started out as a music therapist that's what I did.

As such @Laura, I think part of my feeling a bit like I'm ranting (which, if my dictionary serves me, is really just a lengthy and impassioned speech) is the frustrating fact that it took me a long time to get this as well. And I suppose my hope is that, in this day and age of blogs and progress and so forth, there'd be a greater awareness that people with disabilities and/or autism need to be listened to and heard.

Tamara G. Suttle said...

Roia! Yes yes yes! And, this tendency to . . . be heard rather than to listen extends so far beyond music therapists and those with intellectual and developmental disabilities! You are right that it is both difficult and necessary to set aside our own wants / needs in order to listen to our clients' wants / needs.

Sometimes, I chalk this need to be heard rather than to listen to be about a therapist's inexperience. I remember when I was just starting out that I would go into my sessions with a complete agenda . . . for what we were going to address, the order in which it would be addressed, and each of the interventions that I would use, etc. It was, in fact, about my fear.

Now that I think about it . . . I think that inability to listen is always about our own stuff - whatever that is - fear, control, inexperience, etc.

Thanks for putting into words what we all need to be reminded of . . . over and over again.

Roia said...

@Tamara G. Yes, you're absolutely right about it being all of our stuff extending all over the therapy, uh, playing field. Reason #4006 why we should all make sure to look at our stuff in our own therapy and in clinical supervision. Thanks for checking in!

Lisa Bender said...

I heartily agree with this post. That is all. : )

Roia said...

Fair enough @Lisa. Thanks for the support!

Anonymous said...

I came across this post via music therapy maven and I am so glad I did! This describes so well what I try to do in all of my sessions. And it reminds me why The patients I work with bring something different each and every day. I do my best to not assume I know what that will be. Thank you for sharing your 'rant'. Well said! -Melissa

Roia said...

@Melissa How cool that you stopped by (I'll have to thank Kimberly for kindly sending people this way). I particularly like your saying, "...the patients I work with bring something different each and every day. I do my best to not assume I know what that will be." Now it's *my* turn to say well said back at you! So glad to "meet" you.