How to be together

We sat together yesterday, our group of seven, on a Monday afternoon. And the curtains in the room were open to the afternoon sun, closed as the sun blinded us, and then open again to watch the beautiful dark frames of leafless trees against the pink and yellow and blue sky as the sun began to set. And, with the early evening news as a background, we noticed, for ourselves and with each other, our music was made of...

...sound and silence,

terror and safety,

change and consistency,

feeling frozen and being in motion,

comfort and discomfort,

certainty and uncertainty,

sleeping and awake,

light and dark,

presence and absence,

judgment and acceptance,

loud and quiet,

intensity and gentleness,

curiosity and detachment,

containment and freedom...

And then, this morning, I read and listened to this gorgeous conversation between Krista Tippett and Ann Hamilton. When Krista asked her what questions we should be asking, without hesitation, Ann responded:

"...how to be together. I mean, isn’t that — that seems like the biggest question. How to be together." (Ann Hamilton) 

Yes! And yes again!

There are so many who believe music therapy sessions with people who don't use speech as their first language are about "playing for your clients." In fact, it is about

listening, 

noticing, 

playing,

 experiencing,

 being

 and wondering 

together.

"...when you’re making something, you don’t know what it is for a really long time. So, you have to kind of cultivate the space around you, where you can trust the thing that you can’t name. And if you feel a little bit insecure, or somebody questions you, or you need to know what it is, then what happens is you give that thing that you’re trying to listen to away. And so, how do you kind of cultivate a space that allows you to dwell in that not knowing, really? That is actually really smart, and can become really articulate? But, you know, like the thread has to come out, and it comes out at its own pace." (Ann Hamilton)

It's that time again (and not a moment too soon!) - A guest post from Judy Simpson

January marks the beginning of our annual Social Media Advocacy campaign, spear headed by the incomparable Kimberly Sena Moore. This year I'm feeling a particularly strong affinity for our theme, which is exploring and honoring our unique identity as music therapists, as I'm finding myself in the distressing position of having to fight to keep a long-term music therapy position in our facility, a battle which we may be losing. 

I will be working hard over the next few days to clearly and succinctly articulate to the state decision-makers exactly what, how and why the Music Therapy Unit offers the men and women in our developmental center something they are unable to get from any other service. While I'm doing that, I'm truly grateful to Judy Simpson (who has written a guest post honoring this month) for helping me get started by so beautiful saying...

“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!”

About the Author: Judy Simpson is the Director of Government Relations for the American Music Therapy Association (http://www.musictherapy.org). She can be reached at simpson@musictherapy.org

 

"What's your story?" 2013 Social Media Advocacy Month

It's Social Media Advocacy Month again, and this year we're talking about connections and the stories we share about music therapy. Or, put another way, we might say we're looking at how our stories define us and then help us to connect with each other. 

Whether or not we're aware of it, we're always telling stories. Stories help us describe (among other things) what we do, who we are, what we believe, how we've come to be, who we've come to be. And stories connect (and sometimes disconnect) us to/from ourselves, to/from our history, our families, our friends, our clients, our communities, our cultures. 

For this moment, let's focus on the stories we tell ourselves. Let's consider the stories we choose and use to help us form a professional identity.

The way I understand it, our identity as music therapists is a compilation of the many stories we have about ourselves: as musicians, as people, as therapists, as family members, as community members, as service users, as learners.

In the process we consider our beliefs about music, about therapy, how we define music therapy, what we understand about health/illness, how music fits into health/illness, about our clients, our biases, what it means to help someone else, what is/isn't helpful, what is meaningful, what we embrace, what we avoid. 

And our stories evolve even further as we give thought to how we choose to present our professional selves/stories to our clients, to our places of employment, to supervisors, to potential users of our services, to curious people, to lawmakers, to our larger communities. 

All of these elements start with the stories we tell ourselves. 

To that end, I'd like to share a list of questions I put together a few years ago for a presentation I did for a self-care series at the Kardon Institute for the Arts.  My hope is the questions will help you become more aware of your own stories, how you decide which stories you'd like to share, how you choose to share them, and with whom. 

What does it mean to be a music therapist? 

• Who am I, or who do I think I need to be as a music therapist? How have I constructed my music therapy identity?
• Do I think there's a "right" way or a "wrong" way to tell my stories as a music therapist?
• What does it mean about me if I present myself in the "wrong" way?
• How much does my history/personality/temperament influence who I am as a music therapist?
• How comfortable am I when I feel I have to defend my role as a music therapist? In sessions? At work? In team meetings? What if someone doesn't like my story?
• How comfortable am I with regard to my skills as a musician, my skills as a therapist? And does that level of comfort (of lack thereof) have an impact on my identity as a music therapist? In what way(s), if at all, does this change my story?
• In what ways do my clients’ needs and expectations of me shape who I am as a music therapist? How do we weave our stories together?
• What do I believe makes someone a “good” music therapist? 
• How do my race, culture, gender, sexuality, abilities/disabilities inform who I am as a music therapist?
• How do my beliefs and/or prejudices with regard to race, culture, gender, sexuality, abilities/disabilities impact my work?
• How do I feel/respond when someone outside of my field defines my profession or makes assumptions about music therapy? What happens when someone else tells my story? What if our stories conflict?
• How has my identity as a music therapist changed and evolved as I’ve moved through my 20, 30s, 40s, 50s, etc.? What are the ways in which my story has changed as I've grown through significant life changes (marriage, birth, loss, death, serious illness, natural/human made disasters, etc.)? 
• If I am a music therapist practicing in a culture that is not my culture of origin, how has this affected my identity as a professional?
• How committed am I to a specific identity or role (or story) I play as a music therapist? Am I comfortable expanding my identity/role? Is it okay to change the story? Under what circumstances? 
• How much of and which aspects of our clients' stories are okay for me to hear? And which aspects frighten me or make me uncomfortable? 
• What roles do I unconsciously assign to my clients?
• How do my beliefs about what constitutes music therapy affect the stories I tell about being a music therapist?

 (Copyright 2010 Roia Rafieyan)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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.

Bringing it all back to "Do"

I live in New Jersey, and everywhere I went during the two weeks after mega storm Sandy (work, the grocery store, the library, the gas station), people asked me, "Did you lose power?" 

And I was struck by the metaphor contained in the question: "Did you lose power?" 

People in this area experienced, quite literally, being- let alone feeling- "powerless" (on a lot of different levels). They struggled through "power failure" and had to wait for their "power to be restored." 

Many of my students at Montclair experienced "loss of power", leaving them sounding  somewhat rattled when we returned to class. A music therapist I know described her disabled clients' distress as they coped with yet another storm requiring their temporary relocation to safer and warmer living quarters (we had Hurricane Irene last year, along with a freak snow storm at the end of October, both of which caused a lot of power outage and flooding). 

In pondering our collective experience, I got to thinking, as I tend to do, about how this connects to our work as music therapists- how we react to the unbalancing effect of going through a frightening experience such as a major hurricane (for example). 

As I played around in my mind with this idea of power loss and restoration, I thought about how we in music therapy are, essentially, working in a musical way to restore power, intra- and inter-personally. 

And, sure, this may be sort of a weird way to say it, but, if I were to say this using musical terms, I guess I'd be saying that in music therapy we're working toward "bring(ing) us back to 'Do'." 

[A special thank you to MJ Landaker for her recent post about the important connection between music theory and music therapy. It certainly helps to understand why music is so "powerful" (if you will).]  

10 thoughts about music therapy advocacy- Part 2

I'm thinking that it might be helpful to know where I'm coming from in terms of music therapy advocacy as I share this list of thoughts with you. After all, you may be wondering what the heck qualifies me to preach at you about becoming an advocate? Here are some of the things I've done over the past twenty-three or so years:


During my time as a music therapist I have spent a lot of years as an active member of my state organization, the New Jersey Association for  Music Therapy (NJAMT). I was originally asked to join the board because I was a member of the former American Association for Music Therapy (yes, back then there used to be two associations, and they merged in 1998). I continued to serve, becoming Secretary, Treasurer, President, Newsletter Editor and ending as Public Relations co-chair. I am no longer active as a board/committee member, but I maintain my connection to NJAMT as the listserv coordinator. 


While I was President of NJAMT I also served on the NJCATA board (that would be the New Jersey Coalition of Arts Therapies Associations) as the music therapy representative for a period of time. I've helped to organize Music Therapy Day in New Jersey (which we have been holding in Trenton in the State House), and we organized a celebration of  30 years of music therapy at the facility where I work. 


As a performing singer/songwriter, I've talked about music therapy when I've had gigs, and I regularly find myself engaged in conversations about "what is music therapy" when I meet new people. These days I share stories about my work with you, kind readers. 


So. Yes. I've spent a good portion of my music therapy life advocating. I feel strongly about the work I do, and I care a great deal about the people I work for, namely my clients. With that in mind, here are my thoughts about what is helpful as we learn to become advocates:


1. Connect with other music therapists. Join a peer supervision group, connect through various social media outlets on the internet, or simply get to know the music therapists in your geographic area. I'm lucky. New Jersey has a lot of music therapists, and we have a fairly strong community, but we work at it, because it's important to us. Doing this type of work with a group of like-minded people standing next to you is a lot easier.


2. Know who you are and what it means to you to be a music therapist. It's very hard to advocate for yourself and for your clients if you don't know who you are professionally and why what you're doing is important. Really work at developing an identity for yourself as a music therapist. And I don't mean branding (although at some point that's important as well). What I mean is figure out your beliefs: about music, therapy, about what works for you and what doesn't, your approach, and hone your skills.


3. Be really good at what you do. By this I mean, find yourself a clinical supervisor. Yes, I know I sound like a broken record, but it's that important and that helpful. If you decide to get peer supervision instead, challenge yourself to go deeper- even if it means getting your own therapy- music therapy if you can. Look at your own issues. Figure out what issues and blocks come up for you when you're providing music therapy services, and work on them. This makes you accountable. 


4. Learn everything you can about the population with whom you're working.  Try to get as deep an understanding of the group of people you work with every day, and, as much as possible, try to learn from the people who experience the condition/illness/life experience. Learn what the issues are from their perspective, and then make a point of figuring out why music therapy is important for this particular group of people. When you have an idea of what someone's actual lived experience is like, you will be a more respectful and effective music therapist. And, by extension, you'll be a more effective advocate for your services (to people who may want to use your services, to facilities that may hire you, and, eventually, to legislators). 


5. Chat with people about music therapy. If you're a performing musician, you have a perfect forum for talking about music therapy (and sometimes a captive audience). Talk about what you do to high school students who are musicians. Tell people what you do when you're getting your hair cut. I mean, really. The possibilities are endless.


6. Answer questions about music therapy. Because I have a website or two, I get a lot of emails from high school and college students who are writing papers about music therapy. Do your best to be helpful. Sometimes people I've met (or relatives of people I've met) are considering the possibility of becoming music therapists. If they live nearby, invite them to come and observe you in your work (get permission from your clients/facility first, of course). 


7. If your state has a music therapy organization, join/volunteer. If not, start one. True, it's been a while since I was a very active member of NJAMT, but it was, and continues to be, one of the best decisions I made as a music therapist. It helped me to develop my skills as a leader, as a public speaker, as an organizer. It connected me with a lot of really great people, and it gave me a sense of being a part of something (which can be important, especially if you happen to be the only music therapist at your facility). It gave me the opportunity to do a lot of things I didn't think I could ever do. Your state organization keeps you up-to-date on what's happening with regard to legislation and can provide you with training so you know how to go and talk to your elected officials about music therapy.  They can be a resource for jobs in your state (or in a state in which you might want to relocate). 


8. Don't burn yourself out on advocacy. This may sound like kind of a strange thing to say after a big long pep talk, but it can happen. You can be all gung-ho for a long time, and it's great when you can do that! But you can just as easily burn yourself out without noticing it. And that's no good for anyone. So make sure that you have a life outside of music therapy as well. One of the best pieces of advice I got was when I observed my first music therapist ever. She said to make sure you always have somewhere to play your own music. Cultivate the many other things you love to do- cooking, hiking, reading, kayaking, sky diving...whatever excites you and lets you have your own personal identity as well. 


9. Sometimes in spite of your best advocacy efforts, things don't go as you hoped. It's the truth. Being a music therapist can sometimes be very frustrating. One of the most devastating experiences for me was spending twenty years at my job talking about music therapy, doing presentations for administrators, making sure people had information about what a qualified music therapist is, what skills we have, what training we have, and on and on. And one day, one of the other departments decided to hire a person who is not trained as a music therapist to work in a music therapy title and to "do music" with our clients. And there wasn't a blessed thing I could do about it. (Mercifully, the guy is really cool and never calls what he does music therapy, but that doesn't mean that the rest of the staff understands that he's not a music therapist.) It's important for you to know: it happens. It happens a lot. And when it does (because it will), you go back to the support system you've developed. You re-connect with the community of fellow music therapists and allies. Because you will need them. 


10. In spite of it all, love what you do. Celebrate when your clients take little and big steps. Theirs are the faces you'll see in your mind as you tell people what it is you do. Feel a passion for getting to be someone who gets to connect with people and who uses and plays music for a living. Because that is living. 


And, ultimately, that's what it's all about!

What is advocacy and why do we do it?- Part 1

Advocating for music therapy is, at its most basic, about telling people who we are, what we do, where we do what we do, with whom and how. It can be as simple as meeting someone at a party and responding to "what do you do for a living?" with "I'm a music therapist." And it can be as complex as working with legislators to get licensure for music therapists in your state. 

The reason we spend so much time advocating for music therapy is so that, when you and I are a lot older music therapists (and that's not to say that I'm not seriously getting to "older music therapist status" at a rapid rate here), when we say "I'm a music therapist," people will say "oh, my child is receiving music therapy services" or "I work with a music therapist in the hospital where I'm a nurse" instead of the blank stares that I used to get when I first started out back in 1987. 

In fact, the reason some of you younger folks (you know who you are) have even heard of music therapy is because there are a lot of us older folks (ahem) who've been talking about what we do for a long time.

Now, as more people are starting to learn about music therapy our focus as a profession has been turning toward gaining state recognition for what we do. After all, people who use our services (heck, sometimes music therapists use our services!) need to know they're receiving music therapy from someone who is trained, qualified, certified, and, in some states, licensed. 

Another thing we're working toward is third party payment. While there are some music therapists who are getting reimbursed by insurance companies, it is still extremely rare. Creative arts therapy providers will become a lot more accessible to those who need them when health insurance companies add "music therapy", "dance therapy" and "art therapy" to their lists of reimbursable services.

On another level, advocating for music therapy services is about creating jobs and opportunities for ourselves. We know why what we do is important, and we want to educate the people who could use our services. It also means helping the public to distinguish between music therapy, provided by a trained, board-certified music therapist, and the therapeutic use of music, provided by talented musicians who are sensitive to the needs of others.  Sometimes advocacy is about making sure we're appropriately compensated for the services we provide. The fact is that music therapists in many work situations are vastly underpaid in comparison to other allied health professionals. 

So, as you can see, advocacy is an important enough element that we need to, literally, build it into our work. In Part 2, I'll address some of the things I think are helpful as we engage in this process. 

How wonderful that you're here!

Image via WikipediaWe music therapists are always trying to define what we do. Or, more specifically, help other people understand what it is we do. We write books and articles about it, we blog about it, we put together podcasts- all in an effort to convey to the masses a sense of what makes us go into this profession that seems to defy description!


But, if someone were to have asked me yesterday "what is music therapy and how does it work?", I would probably have said that it's about inviting people to be present to each other, and we use the music to help make that happen. 


Mondays are long days. For me, I go into work a little later and stay a little later. And, I think we can all agree: it's hard for any of us to transition into a Monday, which is, for most folks, the beginning of the work week. And I would say that it requires even more fortitude to get into the Monday spirit of things after a particularly long Thanksgiving weekend, which, of course, marks the beginning of the (dreaded) holiday season.


While staff frantically decorate the cottages and prepare for Open Houses (where everyone's family is invited to come and visit and there's food and music and merriment and so forth), my clients prepare for the annual anxiety of "will my family be coming to spend time with me this year?" 


So, this is a bit of the sense I got when I showed up to work with the group yesterday (Monday) afternoon- "the group" being ten men and me. 


Oh, where to begin? 


Well, let's see. There was a whole lot of messing with chairs (that would be P), switching of seats (that would be R), tossing instruments, trying to pick up instruments and then getting stuck on the floor and needing help to get up (that would be T), repeatedly rearranging and fixing the curtains so the sun wasn't blinding us (um, well, actually, that would be me), coming in, turning off the lights, and then leaving (that would be K), coming in, crying and starving to death and then leaving (a different K who does use some speech), and on and on, all accompanied by a low moaning (courtesy of J), the periodic fist to the head (of B), and the festive crashing of the tambourine (P again).


Can I get a witness? Anyone? Anyone?


Uuuhmmm. Now what?! (And if any music therapist tells you they know exactly what to do when their clients are all freaking out at the same time...just so you know- They. Are. Lying!)


I managed (do not ask me how) to get my thoughts together enough to be aware of the fact that, while the guys were all there, they weren't really There. Nobody was listening to anyone else in the room, we were all kind of...everywhere, but none of us was present to the experience of being in music therapy. 


I pointed this fact out to the guys (who, God bless them, heard me above the drama-filled din), and I asked them, "Gentlemen. What can we do here? How can we use the music? How can we use our thinking, to get ourselves to be here in this room, in music therapy, together? Why don't we just work on that, so that if we do nothing else today, we'll know that we cared about each other enough, that we mattered enough to each other, to notice that we were all here together."


Enter music. 


I moved over next to B, because I didn't want him to be hitting his head, and offered him my hand (he took it). He had been vocalizing while he was hitting himself, in a kind of a hum. So, since I couldn't play guitar with only one hand, I invited the guys to find some kind of way to hum with B to help him settle down.


I started to hum (in B's general key), and it didn't take long at all before the men found ways to join in with their voices and actions. J moved his arm, every few measures, up and then down to the beat. P, in spite of his tambourine prowess (and he really does rock on the tambourine) used his voice- which has more of an "oh" and "ah" quality. Yet another K quietly chimed in on the cabasa he was holding. R stopped moving around and sat, listening, with his eyes closed, breathing deeply. 


B calmed down and kept singing (but stopped hurting himself), so I was able to make use of both of my hands again. I played a very simple progression on the guitar- kind of an Asus4, Cmaj7, to D/F#, B, E (sometimes major and sometimes minor), and I repeated it as we sang and came together.   


It was lovely. 


There was smiling. The moving around and in and out stuff stopped. There was presence. We were looking at and acknowledging each other. 


We managed to be present in the session and we used the music to make it happen. The definition of music therapy on a Monday afternoon. 


And what makes this way of using music so cool is that this particular piece of improvised music  could only have happened on this day and with this group for it to have had any meaning. Taken out of context, it might sound okay, but it will never have the same impact as it did yesterday afternoon as we all sat quietly, after we finished, even after we sang goodbye, nobody wanting to leave quite yet, watching the sun set together.

So you want to become a music therapist...

Image by doug88888 via FlickrI, rather regularly, receive emails and blog comments from people who are interested in becoming music therapists.  And I regularly send back big, long emails with information I hope they'll find to be useful. Well, suddenly, one of my slower neurons fired, and I thought, "why on earth haven't you written a blog with this advice in it, so you don't have to keep repeating yourself?!" 


Somewhere a dog barked. 


Aaaand, we're back.


Okay. So you want to become a music therapist. Fabulous! And you want to know what it will take, what kind of advice I can offer, whether you'll ever have an actual salary, what to write for that research paper that's due in 13 hours...and so forth.


(Stand back. I'm about to jump into list-making land.) (Actually, even though my blog posts aren't usually in list form, I have a deep and abiding love of lists.) (But I digress.)


1. It helps to be a fairly good musician.That said, it also helps if you learn to play guitar and piano.
Different schools that offer music therapy as a major have different requirements. I think, ultimately, the more skill you have as a musician, the more you have to offer your clients. If you're busy focusing on yourself trying to play a song or a particular instrument, you're no longer focusing on your client, and that sort of defeats the whole purpose of therapy. You know? You don't have to know how to play guitar and piano before you go to school, because that is part of the music therapy curriculum. Those are, however, two instruments that are used an awful lot in the course of a music therapist's day/week/life, so it's worth getting to a point where you're relatively comfortable with them.


2. And, while you're at it, get comfortable with using your voice.
When I first started out as a music therapist I was really shy, and I found it difficult to sing in front of anyone. Mercifully, I managed to move beyond that. We don't have to be brilliant singers, but it's important to carry a tune and be comfortable improvising and playing around with vocal sounds. I still remember a client I worked with who tore up an entire room and threw my entire music cart on the floor. For a good solid year I had to go and do his sessions with nothing but me and my voice. 


3. Be careful of your "helpful" intentions. 
When you're trying to figure out what you want to do with your life, it's not unusual to think, "you know, I really want to do something that helps people." We all have our reasons for wanting to somehow be useful in this world, and they're all valid and important. When we come to a profession like music therapy, though, I think it's important to be mindful of the various implications of being "helpful" (in terms of power, control, what it means to be "the helped", etc.). Because Norman Kunc and Emma van der Klift said it a lot better already, I  highly recommend reading their article, "Hell-Bent on Helping: Benevolence, Friendship, and the Politics of Help". It will, I hope, give you a whole new perspective on being "helpful".


4. Learn to pay close attention. Notice stuff.  
So much of my job is about paying attention. Whenever I have students come to do their practicum experiences with me, I have them fill out an observation form that I developed. It's an insanely complicated form, because in a music therapy session there is so much going on at any given moment and on so many levels. You have to be aware of your client (s), the music, yourself, the environment, the history...there's a lot of stuff happening. This is what makes music therapy so completely fascinating! You can practice at an activity level and be quite effective, and you can also decide that you want to go deeper and explore the therapy relationship, the dynamics within it, and how it's all expressed within the music, and that's really nifty as well! 


5. Expect that this will be a life-long learning experience. 
Music therapy is a growing and evolving field. Because there's so much to know (and you can't cram it all in at school!), so much to pay attention to, and because you can work at a lot of different levels, there's always something new you can be learning. For that reason, getting professional clinical supervision in music therapy after you've graduated is extremely helpful to your growth as a new clinician. Moreover, there are lots of trainings that music therapists can take to deepen their knowledge/skill in specific areas (GIM, Nordoff-Robbins Music Therapy, Neurologic Music Therapy, NICU Music Therapy, Hospice Music Therapy, Austin Vocal Psychotherapy, and I'm sure there'll be more sooner or later). 


6. Get used to advocating for yourself. 
Music therapy isn't the huge mystery it once was. These days when I say I'm a music therapist, people are way less likely to say "a what?!" than they were back when I first started out. Now I'm usually greeted with something along the lines of "oh, how cool!" As nice as that is, people often think they know what we do, but they really don't. Co-workers who've known us for years may still not have a clear idea of what happens in a session. I'l be straight with you: It can be quite frustrating when you see that someone who hasn't gone through the years of training you have is calling him/herself a music therapist (or being called one by the media). It can be even more challenging when supervisors, colleagues, and various other people/organizations who fund our services (who aren't music therapists) feel compelled to tell us how we should do our job.  Having said that, I would still maintain (and I think my music therapy colleagues would agree) that being a music therapist still far outweighs the difficult stuff. 


7. You'll need to figure out a semi-quick way to explain what it is you do for a living. 
Given that you'll have to spend some time advocating for yourself and showing people what music therapy is, it's important to have your "elevator speech" prepared shortly after you graduate from your program. I usually tell people I use music to listen to people. That usually makes them curious enough to want to know more. Then, depending on how much time they're willing/able to spend, I can expound until they're sick of me. Ahem.  


8. It's not likely you'll be rich beyond your wildest dreams, but you can definitely make a living as a music therapist.
A few months ago, our Rabbi at work asked me, as nicely as he could, on behalf of one of his congregants, "can music therapists make a living doing this work?" I assured him that we could. We can find jobs (we've been doing a lot of advocating- trust me), we can get health benefits, and we can make enough money to live peacefully. We'll never get the kind of money that, say, a computer programmer or a financial analyst would make, but most of us aren't starving. And if this is truly what you want to do, then you should do it. [2024 Update: Having written this some time ago, I want to acknowledge that these days it may be a bit more of a challenge, given the financial realities of the current day. And a lot of younger music therapists have expressed dismay when they can't find full-time jobs, they can't afford housing, and they are often expected to have a Master's degree. This is decidedly problematic, and I will not deny the situation can be quite frustrating. At the same time, there are also a LOT more music therapist-owned businesses, and people are actually familiar with music therapy (or know a music therapist) (of have had their own music therapist) (or have at least heard of it). So, I believe, still, with some flexibility, you'll probably be able to find a job. It may not be where you hoped/expected to work, but it may end up being the right place. Or, like many people do nowadays, you can get some experience and move to an employment situation that feels more in line with who you are.]


9. Get used to not knowing what's going on and sometimes being uncomfortable or awkward. Or at least come to terms with it. 
I would have to say that it's rarely dull being a music therapist. Sometimes your clients will do unexpected sorts of things, or you'll find yourself dealing with really uncomfortable feelings. And sometimes you can go for a really long time and not be at all sure you're on the right track with a client/group. Again, this is what makes this work so fascinating and so completely worthwhile! It's difficult when your own issues are triggered, but, heck! Your issues will be triggered no matter what you do. You may as well have an interesting job within which to notice them. 


10. Consider getting your own therapy (or your own music therapy, if you can). 
Being a therapist is hard work. Being a client is also hard work. If you've never gone through  your own therapy, and if you've never struggled in a big way with your own problems and emotional baggage, it will be hard for you to have a real understanding of what it's like to see yourself in a new way (which is not always a pleasant experience at first). Making changes in our lives is something most of us resist mightily. Looking at our resistance- ugh! It's not always fun. It's a long, bumpy road. And we ask our clients every day to allow us to stumble along that bumpy road with them. We owe it to ourselves and to our clients to at least bring along the map we saved from our own journey (even if they decide to take a different route). (Okay, I'm getting a bit nuts with the metaphors here, but you get the idea, yes?)


So there you have it. That's the list I have going in my head when people ask me for advice on becoming a music therapist, and now here it is! In blog-land! And if any of you music therapists out there in the world have other advice to offer, bring it on!


The good news (well, to me anyway) is this: I worked as a music therapist for 34 years. Even on the worst of days, I have never regretted my decision to do this work! Much good luck to you as you go forth and consider whether or not the life of a music therapist is one you'd like as your own.

1/26/10 Quote- Developing a relationship through music with someone who doesn't use speech

Image by alles-schlumpf via Flickr

I am slowly reading through a book called, "Music Therapy: Intimate Notes" by Mercedes Pavlicevic (1999, Jessica Kingsley Publishers). It describes, of all things, what it's like to be a music therapist in relationship with one's clients. 

Hmm. Where have I heard that before...

Anyway, I'm not sure why I haven't looked at this book until now. It's been around for ten years. I guess books come in to your life when you're ready for them. 


So I just finished the first chapter. Each chapter seems to be organized around a particular story shared by a music therapist. Mercedes Pavlicevic then adds her comments. 


Which is great, because her comments are beautifully put.


Here, for example, are some excerpts in which she very nicely describes the process of building a music therapy relationship, clarifying for readers (presumably not music therapists) what has just been shared in the story and why it's significant:

How do you respond to a child who does 'nothing'? The void that he presents, and his absence from the music therapy room, challenges a deeply natural aspect of human communication: that for communication to happen between people, we need the responsiveness of another person, we need them to show their responsiveness, whether in speech, movements or facial expressions, and we ourselves need to have a sense of their sensitivity to our influence- to mutual influence. We cannot communicate with someone who does not show any signs of being susceptible to us, influenced by us; who appears vacant.

She goes on to say:

     Communication between Oksana and Daniel is a two way process: Daniel begins to vocalize and at first he makes occasional short sounds. Oksana vocalizes too, but not just in any way: she listens to the quality of his voice, how short the sounds are, how high or low they are, whether she can hear any rhythm, any shape in what he does. And she adapts her own vocalizing in a way that is related to him, to his sounds. This is the beginning of interpersonal influence. She is influenced by what he does and by how he does it- no matter how tiny and apparently haphazard his sounds are at first- and her sensitivity to him sounds in her voice. He hears this, and feels her awareness of him in the song that she is singing, and in session four, this triggers something in him. Suddenly, he begins to vocalize much more intensely: he makes longer sounds, and immediately she responds, matching his longer, more intense sounds. In these moments, Oksana and Daniel connect with one another in a way that they have not been able to until now. What is interesting here, though, is that Oksana does more than just match, or mirror what he does. She begins to extend what he does.

     This is crucial: in order for Daniel to extend himself, to grow, to develop, he needs to be shown where he can go with his voice. Now that he and Oksana have 'met', now that each has a sense of the other, through their vocalizing together, Oksana keeps close to what Daniel is doing: she continues to match his singing closely. In this way, he knows- he has a sense- that her singing is related to his. And when she does a bit more- sings for longer, or louder, or quicker- he then hears where he needs to go in order to remain connected to her. (pp. 20-21)

Is that not gorgeously and articulately said?


She so nicely captures why it's so important to have a relationship with our clients. Without the relationship, there is no investment or interest in, heck, no meaning to what we present in a session. 


The very last sentence says it perfectly: "...he [Daniel, the client] then hears where he needs to go in order to remain connected to her [Oksana, the therapist]." 


In other words, the relationship now matters to Daniel, and he now has a reason to learn new things and a context within which he feels acknowledged and heard so he can feel safe enough to venture outside of himself. 


And, that, my friends, is music therapy. 

12/22/09 Quote- a patient defines music therapy

Florence Tyson is one of the foremothers of music therapy. And, happily, I've been at this long enough to remember her presence at  conferences back when I was a baby music therapist (she died in 2001).


Her book, Psychiatric Music Therapy: Origins and Development, (1981) has a quote from a patient at the Creative Arts Rehabilitation Center (which has since closed). I put it up over my desk at work, because I think it captures the essence of music therapy so beautifully. Evidently, Florence Tyson felt the same way, because she included it in her book (pp. 71-72).

In music therapy, the music therapist, by the very nature of musical accompaniment, makes a profound psychological statement to the patient. He says: 'With this musical experience I will journey with you from the beginning of the piece (your struggle) to the end (transformation). I will go with you through anxiety, rhythm difficulties, fantasies, whether you finish or not. I will listen to you speak, even musically.' The good therapist becomes aware of this statement and when warranted becomes a guide, brother, sister, the good friend. There is the basic reality of patient and therapist coming together, one human to another. 

With accompaniment assured, the patient can explore strengths and weaknesses, realize his or her own potentials, and define problems. A patient even may become, in a monumental step toward maturity, responsible for his or her course. This reality also may occur in a highly structured session as long as the structure is always realized by the patient to be directed toward his growth, stability and self-discipline -- as long as the demand aims at the patient's eventual responsibility and individuation.

I think that pretty much captures it, don't you?

Okay, so maybe it's not SO bad

I think it helped to acknowledge how frustrated I was feeling with the guys, because as soon as I was able to do that I felt a lot better.  I managed to settle myself down enough to ask myself some of the power and control questions.  

I had to put some thought into why I sometimes seem to need music therapy to look a particular way (or my clients to behave or respond in a specific way) in order for me to decide that I’m doing my job properly.  The thing is...when you work with someone for years and years, as I have, there’s not going to be a lot of noticeable change.  It’s not that what we do doesn’t matter- it may in fact matter quite a lot.  It’s more that, after a while, the changes are a lot more subtle.  And, as I’ve said before, to change too much within a system which is set up to discourage change is, well, frustrating.    

I suppose this goes back to the thoughts I shared with regard to having an effect.  I’ll probably end up repeating myself (what can I say?  I’m in my 40s now...I’ve started to repeat myself already), but there are times when it can be hard to know if music therapy  is having an effect (more to the point, a positive effect) on my clients.  Don’t get me wrong- there are times when it is very obvious that it really matters that I’m there.  It is, however, possible to go for quite some time where nothing much seems to be happening in a session, and I start to wonder, “is there something I’m missing here?  Am I doing something I shouldn’t be doing?  Am I doing too much?  Are my clients doing too little?  Is it legitimate to call this music therapy when this person refuses to use music most of the time?”  

Sigh.  If only there were easy answers. 

Well, if being in music therapy is a place where my clients can come for a period of time and just be (as in be themselves or be mellow or be mad or be downhearted) and have someone (okay, me) be with them, then I can consider that part of a good day’s work. 

What the heck is a music therapist anyway?

Every day I go to the institution where I work.  Many of the people I serve, who live there, have autism and everyone has some sort of intellectual and/or developmental disability. Most of the people I provide services to don’t use speech to communicate or they use very few words.   I’m their music therapist.  

Many people don’t know what it means to be a music therapist or to do music therapy.   That’s okay, because there are probably a lot of us who work as music therapists who don’t know what it means to be a music therapist either.   I’m not saying that to be rude or disrespectful.  There’s a lot to know about music therapy, and I’m realizing that it takes an entire career to learn it.  I’ve been at this for twenty years, and I still think there’s a whole lot I don’t know.

Anyway, in a nutshell, a music therapist is someone who uses the various elements of music (for example, rhythm, timbre, melody, harmony, lyrics, etc.) in the process of helping someone to change or grow in some way (for example, emotionally, behaviorally, physically, etc.).   

Music therapists can practice at the Bachelor level of education, but many of us have opted to get Master’s degrees and beyond.  In the United States we take an exam which, when we pass it, designates us with the credential MT-BC (which means “Music Therapist-Board Certified”).  We’re expected to maintain that credential by going to conferences and engaging in continuing education.

We have studied our major instruments, and we are proficient (hopefully) on piano and guitar as well.  As it happens, my major instrument is guitar.  We use our voices, and we use a variety of percussion instruments.  We can pretty much use any instrument therapeutically, and I would have to put forth that we’re limited only by our skill and imagination.  In addition to music, we study the major psychotherapy approaches, group dynamics, and human development along with learning specific music therapy styles and methods.

I completed my studies at Temple University and Drexel’s Hahneman Creative Arts in Therapy program.  So that’s the general overview of how I got to be here.