5 Reasons Why You Need To Process in Music Therapy

I was off listening to a terrific podcast on processing over at the Music Therapy Round Table (and I highly recommend you go over and give them a good, solid listen). Well, I wanted to make a comment, but it turned out to be, like, six paragraphs, so, um, I figured I'd better head back to my own blog home and write it all out here and link it back to the hardworking Round Table folks: Kimberly Sena Moore, Rachel Rambach, Michelle Erfurt, and Matt Logan! 

As Michelle mentioned (either in the Round Table podcast or the Music Therapy Pro podcast), this business of processing (especially in clinical supervision) is kind of my "thing" (which makes it all sound a little...suspect) (but, really, it's not). I mean, if we're going to be honest (and I think we must), this whole blog is about me processing my experiences as a music therapist. 

I'm determined (determined, I say!) to convince the  music therapy world that we need to make processing a regular part of our work routine. And, yes, I'm sure I've probably said all this before, but I'm saying it again. And this time I'm going to try to be more succinct (stop snickering, I can do this). Okay. Here goes:

5 Reasons Why You Need to Process in Music Therapy:   

1. Processing helps you move your work to a deeper level.

Put simply: processing helps you move beyond observation to trying to understand what you’re seeing, experiencing, hearing, noticing in a session. Matt Logan wisely pointed out that a part of processing is looking at the relationships between the therapist, the client(s) and the music. It's so easy to get caught up in “what do I do? What should I do next?” and completely forget to look at what’s there in the session in a deeper way.

 2. It helps you gain a better understanding of what you're doing and why. 

Thinking through your sessions and trying to understand what happened in your sessions helps you get a stronger grip on the ever-present question:

 What is music therapy?

The longer you practice, the more your understanding of the work you do evolves and your answers to that question change and grow more meaningful. Processing asks you to consider: what is the role of music in my work? What is therapy? Who are the people I'm supporting? 

The more deeply you understand your work the better able you are to communicate why a client, a facility, an organization, a state, a country, the world needs music therapy.  

3. We all have feelings about our clients, and it's important to consider their impact on the therapy process. 

You have feelings about your clients, I have feelings about my clients. It's a normal part of therapy called countertransference. It doesn't matter who you work with (infants right on up through elders) and it doesn't matter how long you've been working and it doesn't even matter what approach you use. It's all part of the process. 

And the things is: just because you aren't necessarily having strong feelings or reactions you might think of as being "negative" (sad, angry, frustrated) it doesn't mean that your feelings aren't getting in the way of your clients' growth. Of course, I'm not saying that they are - just inviting your awareness that they have the potential to do so. 

I'll use myself as an example:

When I pause and reflect on the folks who are in my caseload, I notice there are some clients who stick with me all the time, because the work with them is difficult (or because they appeal to me in some particular way), there are some folks who I avoid thinking about, some who I forget about entirely, and some whose sessions I truly enjoy. 

Processing helps me step back and look at the larger picture of what’s happening. Otherwise, I can easily get bogged down in the "session notes version" of things (you know...what happened first, then what happened) and never move beyond it. 

Processing means I start to be curious and ask questions: 

Hm, why do some of my clients appeal to me more than others? Why do some not? What is it about some people that makes me completely forget about them until I see them in a session? Why is a particular client frustrating me so much? What's my role in this? Is s/he reminding me of someone else in my life? Is my complete joy in working with a particular group of clients making it hard for them to explore feelings of anger they may be feeling toward me (whether it's about me or not)? Is my discomfort about a specific topic obvious to my clients to the point that they're they avoiding looking at it to "please" or protect me? 

4. Processing helps you realize that music therapy doesn’t usually happen in one single session 

Well, okay, depending on where you provide services, sometimes it does. In general, though, processing helps you start to put things together (from one session to the next, over a period of time of working with someone, etc.). If you’re someone who tends to use an activity/therapeutic music experience approach, it’s important to think about what’s going on from moment to moment in a session that you might not have thought to look at. A process paper can help you do this and encourages you to ask questions, such as:

What happened? What patterns am I noticing in our sessions?  Then you move on to: What was I hoping to do with this particular person/group? How did it go? What do I think about that? 

5. Processing with a clinical supervisor helps you see your blindspots.

You don’t see your blindspots. That’s why they’re called blindspots. You don’t know what you don’t know! And, like anybody else, you don’t think to ask yourself something you wouldn’t have thought or known to ask yourself.

And that's okay! That's why there's such a thing called professional clinical supervision!  Yaaay!

Processing with a clinical supervisor helps you begin to see things you might not have looked at before. It doesn't mean you're a bad therapist. It just means that having an extra set of eyes and ears (who happen to have more experience) will help you think about things you hadn't thought to think about before. (Shout out to Michelle Erfurt for your great point that you didn’t really look at stuff to the extent you did until you had supervision!)

So, lovely music therapists: What new and unexpected thoughts are you thinking about your clients and about your work? 

A book chapter, a presentation, and an interview

Whew! What a fascinating and busy few months it's been! 

Aside from my usual and intense immersion in work, there have been some nifty things happening. Here's what's been up:

First, I am extremely honored to be a part of a new book, edited by Sue Hadley, who is one of the people I greatly appreciate and admire, because she's willing to talk about the stuff nobody else talks about. This time she's talking about race and culture in terms of how it's experienced by music therapists. Here's the description of the book from Barcelona Publishers:

Experiencing Race as a Music Therapist: Personal Narratives is a compilation of critically engaging narratives that grew out of conversations with 17 music therapists living in different parts of the world, from various “racial” groups, about their experiences of their racialized identities in the therapy setting. The music therapists describe the raced and cultural contexts in which they were born and describe the racial demographics of the places they have lived at various times in their lives. The countries in which the individual music therapists spent their formative years include Australia, Canada, Iran, Japan, Korea, New Zealand, Puerto Rico, South Africa, the United Kingdom and the United States, with many of them also having traveled to other countries. The music therapists discussed their specific experiences of their racialized identities when they were studying music therapy and how they experienced their racialized identities in their professional lives. Many of them also described the differences they were aware of in terms of how they experienced themselves as raced or how they experienced the therapeutic relationship when they were working with people of their own “race” compared with working with people who were from a different “race.” From these narratives, we can see that our life experiences shape how we understand ourselves and others, our assumptions and biases, and the effort with which we form relationships with different groups of people. The music therapists in this book have shared their experiences in the hope that we can learn how to sit in our discomfort, without judgment, lowering our defenses, in order to learn more about ourselves and others, so that we can deepen our understandings and our relationships across racialized lines.

I've been slowly reading through the narratives, and they are engaging and thought-provoking. I encourage you to check out this book. It is a wonderful invitation to deeper reflection and conversation about a topic that does not generally come up in our field.

Second, I spent a lot of time trying to organize a presentation I did for the most recent Mid-Atlantic Regional music therapy conference, "Countertransference Songs: Another Way to Listen" (you know- countertransference- one of my favorite topics!). Here is how I described the session:

Far from simply being a means by which to convey skills and the general expression of feelings, music can be used on another level to better understand our clients- especially those who don’t use speech as their main communication modality. Paying attention to the music that emerges in sessions- for example, the sounds we typically use in response to particular clients, or songs that suddenly pop into our minds as we work intensely with someone - can offer us another avenue by which to understand what is going on within the therapy relationship.

Starting from the premise that the therapy relationship is the healing element, the focus and, more significantly, the work of dynamically oriented music therapy is to look at and explore the relationships that develop between the therapist, client and music.

As active participants in the therapeutic relationship, music therapists experience a range of countertransference responses when working with clients, some of which are explored in supervision and some in personal therapy. In this presentation we will start  from the assumption that countertransference includes all of the feelings, reactions, fantasies, thoughts and ideas the therapist experiences in relation to clients, either in response to how a client/group is perceiving him/her, or based on the therapist’s own personal history. Of course, one of the ways countertransference may be expressed within a music therapy relationship is through the music.

Two case studies will be presented, the first of which will describe how musical countertransference became apparent within the context of the type of music improvised in a client’s sessions. The second will follow a lengthy series of countertransference-generated songs that emerged as a part of the therapy relationship. In both cases, exploring the therapist’s musical responses moved the therapeutic process toward deeper understanding of the clients’ internal worlds.

I actually only ended up presenting one case study (since it had all the elements I described). The biggest challenge was trying distill many years worth of therapy (and tons and tons of examples) into 90 minutes! 

As often happens, in the process of reviewing the (volumes of) notes and the songs and the music that came out of this man's sessions, I gained a lot of insight into some of the ways my countertransference reactions caused me to miss some aspects of what may have been going on with him at various points in the therapy. 

Honestly, there was just so much, and it's such a complex topic, I'm wanting to present this material again within a longer context (meaning, maybe a CMTE proposal is in order). 

Meanwhile, the third exciting thing was being a guest on the music therapy world's answer to The View- yes, I got to chat with the lovely ladies of The Music Therapy Roundtable! I mean, look! They even have their very own mug (and, see, they sent me one too). How cool! Heck, how organized! 

I got to blather on and on with Rachel Rambach (of Listen & Learn Music fame) and Michelle Erfurt (the original Boom Tote designer herself!) - their third partner, Kimberly Sena Moore was in transit so she couldn't join us - about one of my other favorite topics: professional clinical supervision! And you'll be thrilled (I'm sure) to know that I discovered I have a shocking tendency to rely on the word "um" while being interviewed. Oy.

And, if you've taken it to the next level and you're a Music Therapy Pro subscriber, you can listen to yet more of my incessant chatter on their Pro podcast. 

So that's what's been happening in my land. I'd love to hear what's going on in yours! 

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!

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.

Supervision: Part II: Peer Supervision

(This is the second part of the article I wrote for NJAMT News on professional clinical supervision for music therapists. The first part is here.)

Supervision: Part II: Peer Supervision

Roia Rafieyan, MA, MT-BC

The previous article looked at professional clinical supervision, addressing common misunderstandings about the role of the supervisor and describing what one might expect when one seeks the services of a clinical supervisor.

Another avenue for growth as a professional music therapist is peer supervision. This article will discuss the benefits of this way of learning and offer the author's experiences with her peer supervision group as one example.

What is peer supervision? How is it similar to/different from supervision with a clinical supervisor?

In contrast to professional clinical supervision, where a therapist with more experience acts as a mentor to another music therapist or a group of music therapists generally for a fee, peer supervision refers to both formal as well as informal connections between therapists who draw on each other's strengths and abilities as a means of developing their competence and effectiveness as music therapists.

Peer consultation/supervision can be as simple as posting a request for information on a music therapy email list or having a conversation with a trusted fellow clinician about a particularly difficult case. Some music therapists choose a more formal option. This involves working with a consistent group of people setting aside a specific time and place, agreeing on areas of focus and having a mutual commitment to ongoing professional growth. This piece will focus on my experience as a participant in a formal peer supervision group.

Where does it happen?

Our group chose to alternate meeting at the work sites of two of our members. Having enough physical space and access to a variety of instruments was important to us because we all felt a strong desire to use music-making as a part of our process. Just as significant was the need to find a central location since the group was spread out over a large geographic area.

How often? How long?

While meeting once a week or twice a month would be ideal, peer supervision groups can meet as often as is practical. The best our group was able to accomplish was to meet once a month. Meeting for about an hour and a half seemed to be a reasonable timeframe for our group which ranged in size from three to five people. This allowed each person to present case material and look at issues and gave us an opportunity to use the music to explore various aspects of our selves which affected the way we work with our clients.

What happens in a peer supervision group?

The group will develop its own rhythm. Ours gathered, checked in with each member, trying to find a common theme and come to a group consensus regarding the issues we wanted to focus on for that particular meeting. If no theme emerged, we did some musical exploring and improvising, starting with where we were and how we were feeling about our work. The music helped to initiate discussions through the act of listening to each other, analyzing our own musical experiences and observing the group process. Sometimes this would lead to more music-making with a more specific focus.

Different groups, because they are made up of different music therapists, will choose different approaches. While it could be a simple as a sharing of ideas and resources for music therapy experiences, it can also be a deep as supporting members to cope with profound feelings of helplessness or secondary traumatic stress and burnout.

How does this process help us increase our effectiveness as music therapists?

Music therapists have a unique opportunity to develop the skill of self-observation and to experience first-hand the dynamics and processes involved in group work when they engage musically and verbally in a self-examining peer supervision group with other music therapists.

By exploring our own feelings about and reactions to the work we do with our clients and our work situation(s) using music, we learn how to better engage our clients in a similar process. This enables us to become more effective in our work.

Helpful tips (based on our group's experience):

§ Let one or two people take responsibility for initiating, organizing and maintaining the group.

§ Meet in music therapy rooms in group members' workplaces (with permission) because it gives access to a variety of instruments (melodic and non-melodic) as well as freedom from distractions. It also provides the space needed to work.

§ Establish a date for the next supervision group before the end of each meeting (or set out a long-term schedule). This helps to create a commitment to the group and to the process. It is also helpful to send out email reminders.

§ Do not allow the group time to become a gripe session about how awful workplaces can be. Use music to explore and identify areas in which your own resistance may make it difficult to understand and support your clients.

§ Look for common themes in the stories that you share, or begin by improvising music based on what is currently being experienced by group members.

§ Watch out for the tendency to avoid using the music and to steer clear of difficult topics.

In summary a peer supervision group is one in which a group of professional music therapists come together on a consistent basis, and they use the skills they have to help each other grow as music therapists. By engaging in this process they are able to learn to be self-examining and may then, by extension, be able to take their work with clients to a deeper level.

Resources

Music Therapy Supervision (2001, Barcelona Publishers; M. Forinash, Editor) has three chapters describing peer supervision as well as experiential music therapy groups.

Chapter 12: Peer Supervision in the Development of the New Music and Expressive Therapist (E. Baratta, M. Bertolami, A. Hubbard, M. MacDonald, and D. Spragg) Chapter 14: Experiential Music Therapy Group as a Method of Professional Supervision (G. Langdon)

Chapter 15: Peer Supervision in Music Therapy (D. Austin and J. Dvorkin).

Additionally, of course, there are the many remaining chapters which focus on supervision of students during practicum experiences and internships, professional supervision, and institute training/supervision.

The Dynamics of Music Psychotherapy (1998, Barcelona Publishers; K. Bruscia, Editor) is a helpful read. While the chapters don’t specifically address clinical or peer supervision, there is a clear focus on the dynamic processes of therapy, and there are a number of chapters which focus on uncovering unconscious countertransference reactions to clients and working with elements of resistance within the therapist.

Online resources

“Models of Clinical Supervision” by George R. Leddick: http://www.ericdigests.org/1995-1/models.htm

“Peer Consultation as a Form of Supervision” by James N. Benshoff: http://www.cyc-net.org/cyc-online/cycol-0801-supervision.html

“Peer Group Supervision”- presents a model of peer supervision for those in the business world as well as in social services. It lists six phases of peer group supervision. Some of the ideas may be useful in getting your own peer supervision group started: http://www.peer-supervision.com/index.html

Specific to a particular approach to psychotherapy, but it could be very useful: http://www.contextualpsychology.org/running_a_peer_supervision_group

Supervision: Part I: Professional Clinical Supervision

Here's the first part of an article I wrote for the 2009 Winter edition of the NJAMT News (NJAMT is the New Jersey Association for Music Therapy):

Supervision: Part I: Professional Clinical Supervision

Roia Rafieyan, MA, MT-BC

 What is “clinical supervision”?

“The focus of the supervision relationship is to address the complexities involved in helping supervisees in their ongoing (and never-ending) development as competent and compassionate professionals.  Supervision is a relationship, one in which both supervisor and supervisee actively participate and interact.  It is a process of unfolding- not simply following a recipe, but engaging in a rich and dynamic relationship.  Supervision then is also a journey, or odyssey of sorts, in which supervisor and supervisee learn and grow and from which both will very likely leave transformed in some way.”  (Forinash, 2001, “Overview” p. 1, in Music Therapy Supervision (Forinash, Ed.); Gilsum, NH:  Barcelona Publishers)

 We all receive some form of clinical supervision when we are students- either in our field placements or as a crucial element in our internships.  Many of us, however, are unaware of the benefits and availability of clinical supervision once we are finished with our schooling and begin our professional lives.

With the advent of licensure and an increased need for accountability, along with a desire to deepen understanding of music therapy and the various approaches which make up this complex field, supervision has begun to be recognized as a necessary and important part of the process of becoming a practicing music therapist.  

Common misperceptions about supervision:

§       The clinical supervisor will criticize me.

Some music therapists see supervision as being a continuation of their school experience, and they are concerned with being judged (i.e., expecting an encounter similar to that of being graded in school on their skills).  This is an unfortunate misconception. In fact, clinical supervision offers less experienced music therapists the chance to explore and develop their own professional identity. 

§       I’m finally on my own, and I want to try out some of my own ideas. My supervisor will expect me to do exactly what s/he does/says.

Supervision often involves learning from a music therapist whose work is admired and, at least initially, emulated.  Ideally, however, the supervisee is supported as s/he begins to discover and try new or different approaches that are adapted to his/her own personality and style. 

§       My supervisor will give me activity ideas.

In fact, the supervisory relationship is a rich resource, well beyond that of simply sharing ideas for new activities and music experiences.  A skilled clinical supervisor will help the music therapist to process difficult sessions (or relationships with challenging clients) by actively engaging the supervisee in music-making and self-examination.  The use of music during supervision serves as a way to model different ways to use music therapeutically.   

§       My supervisor will have all the answers.

Clinical supervision often follows a developmental process (not unlike the process found in providing music therapy) in which the supervisor offers guidance, not criticism.  It’s a relationship, and it develops in much the same way any therapy relationship develops; however, the focus is somewhat different than in therapy.  It is not uncommon for music therapists to wish for or hope that their supervisor will be able to offer them answers to their most challenging work situations.  One of the ways the clinical supervisor will help is by validating the music therapist’s experiences, reframing a particular problem, or, at the very least, helping to formulate new questions.

(Note: The chapter “Parallel Experiences” by J. Dvorkin and R. Rafieyan [in Inside Music Therapy: Client Experiences, edited by J. Hibben; 1999, Barcelona Publishers] describes the developmental process in the supervisory relationship as it parallels the music therapist’s developing relationship with one of her clients.) 

Who gets clinical supervision? How does one go about finding a clinical supervisor? 

Students get clinical supervision as a part of their schooling.  Professionals, at any point in their work, may choose to receive supervision.  Generally, the supervisory relationship is one in which the supervisee pays the supervisor for the service s/he provides.  Some music therapists work within a creative arts therapy department in their facility.  As such, they may receive clinical supervision within the context of their job.  Others may work under social workers, psychologists, psychiatrists, or psychotherapists.  Again, they may receive ongoing supervision as a benefit of their employment. 

Most music therapists, however, tend to feel somewhat isolated in their workplace, often being the only person providing this specialized service.  Furthermore, while professionals outside of the music therapy field may respect and even be intrigued by this specialized form of work, they may not fully understand what it entails, and they may not be able to offer the kind of support which may be needed. 

Some clinical supervisors advertise their availability in regional and state music therapy newsletters.  Another way to find a supervisor is to contact a music therapist whose work you admire and ask if s/he would be available to provide supervision.  Fees are generally negotiable, and most clinical supervisors will charge about the same fees a music therapist receives for providing private individual music therapy services.  

Additionally, there are ongoing music therapy supervision groups. These are different from peer supervision groups in that they are led by a clinical supervisor who is paid to offer this service.

Who provides clinical supervision?

Clinical supervisors are generally music therapists who have advanced training and experience.  Within the music therapy field, there are a number of specialization areas (Music Psychotherapy, GIM, Nordoff-Robbins, Neurologic Music Therapy), and those seeking further training in these areas will often have supervision as a component of the learning. 

It may be helpful to note that clinical supervisors explore countertransference material which the supervisee brings to the supervision session. At times an issue may warrant further exploration which may go beyond the boundaries of the supervisory relationship.  When this happens, an effective supervisor will refer the supervisee to seek his/her own personal psychotherapy (some opt to receive music therapy from another therapist), thus maintaining the boundaries of clinical supervision.

 What does clinical supervision look like?

As you would imagine, clinical supervision is meant to be an interactive process.  Ideally, when supervision is done live, the supervisee is able to explore the clinical issues using music. Generally, the supervisee brings material from his/her work to the session (this may include, but is not at all limited to, work with particularly challenging clients, uncertainty as to how to proceed with a group, strong angry reactions to a co-worker or client, fears of burnout, secondary traumatic stress reactions, difficulty using music, finding oneself attracted to a client, etc.).  

The clinical supervisor helps the supervisee by creating a therapeutic framework within which to understand what s/he is experiencing as a therapist, what her clients(s) may be experiencing, how the music can be used, etc.  How this happens depends, of course, on the needs of the supervisee.  This is why the supervisory relationship is of such importance.  Without the relationship, which provides a solid base, it is difficult for the supervisee to feel safe in exploring all aspects of the work of therapy. 

The second part of the article (which I'll need to finish writing soon) will address peer supervision for music therapists.