Pep Talk

Quick update tonight. Time is flying by.

I had a great day today. Lately, I've been feeling like everyday I've been improving. I don't mean that to sound cocky, but I feel like at the end of the day I can look back and pinpoint what I did and learned that made me a better music therapist than when I started. It's an awesome feeling. It's like when you first notice the results of a work out program or diet.

I realize everyday won't be like this. In fact there will probably be days or whole weeks where I feel the exact opposite of what I feel now. But for now, I'm just enjoying the progress.

I've heard both former FSU coach Bobby Bowden and current coach Jimbo Fisher say this: "You're either getting better or getting worse. You never stay the same." I like that. It's tough to stick to sometimes, it's always easy to fall into a routine and be happy with the status quo. Trust me, it's something I struggle with frequently. So I'm going to make my best effort to keep up the progress, even when it gets a lot more difficult.

Show Your Work

No update for almost a week? What's wrong with me?

I was going to do another status update on what I've been up to (which has included some good stuff, like getting to observe speech, physical, and occupational therapists work with students), but I read an article tonight that I wanted to critique on here. It'll be a good change of pace. By the end of this week I'll be drowning in IEPs (that's Individual Education Plan) and writing goals, so I'm sure I'll have plenty to say then.

When I was in school, my math and science teachers would always tell me "show your work." I hated it. Sometimes, I could do things quickly in my head, and I didn't need to show my work. But that was the rule. The reason for this rule was that if I came up with an incorrect answer, I could see where I went wrong. This same adage can be transferred to music therapy. You must "show your work."

I found this article via Twitter. It was posted by a music therapist I follow, Rachelle Norman. Rachelle runs a private music therapy practice called Soundscape Music Therapy, running out of Kansas City.

Before reading my response, you may want to read the article. It's titled "The Illusion of Evidenced-Based Practices", by Michelle Dean. In the article, Dean takes issue with the heavy emphasis on evidenced-based treatment (EBT) in education and healthcare practices today, and how art therapy doesn't really fit into this model.

Before I begin, let me make my bias very clear. I am in full support of evidenced-based treatments. This is what I was taught at FSU, and it's what I believe is the best route. I feel that the only way you can administer a treatment fairly to a client, is to prove to them scientifically that it works.

Now I take several issues with this article. One of the first arguments Dean makes is that the success of art therapy is predicated upon the relationship between the therapist and the client.

"...when symbols or people in a relationship are taken out of context they lose their meaning...those relationship qualities that are so elusive to measure."

She claims that in order to measure the benefits of art therapy scientifically (without bias), one would have to remove the regular therapist that the client sees. Thus, the client/therapist relationship variable would be removed, and the effectiveness of the therapy would be stifled.

I take issue with this for several reasons. One is that just about every treatment and therapy you can think of, outside of chemical treatments, is reliant on a successful relationship between the client and the therapist. The health of the client/therapist relationship plays an essential role in the success of psychology, psychotherapy, speech, occupational, and even physical therapy. If you change the therapist in any of these fields, you will more than likely reduce the effectiveness of the therapy, at least until this new therapist establishes a relationship with the client. This is especially true with special needs children, who thrive on routine and structure.

All of these fields cannot simply disregard EBT and abandon having to prove and document the success of their treatments, just because they rely on the client/therapist relationship. In fact, I don't think you need to remove the therapist to scientifically measure the effectiveness of these therapies. Granted, this is a variable. It would be difficult to judge if it was solely the treatment having the positive or negative effect on the client. But you'll never be able to remove all of the variables in any kind of behavioral science. That's just the nature of the beast. There are far too many variables to control. How is the client feeling that day? Did they have breakfast? Did they sleep well the night before? You just can't control everything the way you can in a biology or chemistry lab. It's always been this way though, and that hasn't deterred behavioral science very much.

Dean also makes the argument that art therapy does not fit into the EBT model because it is very symbolic in nature. The creative expression is the therapy, and that is difficult to measure.

"Although objective observation may be desirable in evidenced-based therapies, it is not truly possible in this relational, creative, and symbolic context."

I believe this sells art therapy short. The benefits extend far beyond the opportunity for self-discovery or expression. Certainly this is very important, but look at the big picture. Look at the motor skills benefits, both gross and fine, painting has. Look at the object identification opportunities, or the academic and pre-academic lessons you can transfer into an art session. I feel that Dean is only focusing on one goal, and it's a very limited goal.

The Fulton County MT's all have a poster with their music therapy supplies that I love. It says "How can I use music to ________?"I believe the art therapy field can ask this same question: How can I use art to _______? To practice following directions, to increase social contact, to teach colors, to exercise fine motor skills, etc? Simply looking at the expressive aspect limits the field so much. It'd be like a music therapist who only ever worked on the goal of mood elevation. Just, "let's play some drums and talk about what we're feeling." This is definitely a very important goal in MT, but there are thousands of others that are equally important.

I also interpret Dean's words as saying that you cannot measure these expressive and symbolic benefits of art therapy, and I disagree with her here as well. I don't believe there is anything wrong with good 'ol self report. Doctors in the hospital use it all the time. Think about every hospital room you've been in. I know all the rooms I've seen have a Likert scale on the wall, usually numbered 1-7 or 1-10, of the patient's current pain perception. The doctor asks how the patient's pain is that day, and they let him know on that scale. The lowest number would be "little-to-no pain" and the highest would be "unbearable pain." This is a very important tool in helping doctors assess a patient.

You can use the same concept to judge the effectiveness of an art therapy session on a clients emotional state. A simple pre-post self-assessment using a Likert scale. This isn't any less valuable than any other data collected in an experiment. It's a simple, fast, and effective way to collect quantitative data on a phenomenological experience.

I don't think you'll find many music therapists who will belittle the importance and impact that the Journal of Music Therapy has had on our field. Having research support our field opens up jobs and new opportunities for music therapists everyday. It may be inconvenient at times, but the only way to protect and expand our career field is to back it up.

Show your work.

Photo courtesy of Flikr user Kevin H.

From spellin' names to Gucci Mane

The last few days have shown a HUGE amount of variety. We started off Tuesday morning observing preschoolers with developmental delays and started off today with high schoolers with EBD (Emotional Behavioral Disorder). We saw low functioning and very high functioning and everything in between.

Starting off with the preschool kids, I mean, how can you not love 'em? Everything you do and everything the therapist pulls out of her bag is so exciting and fun to them they can barely stay in their seats. Then you have a group like we saw this morning, a very high functioning high school group, with some major "cool issues," meaning "I'm not going to participate unless I deem this cool enough."

And that's not to say I don't enjoy those groups as well. I do, very much so in fact. Teenagers are a lot of fun. They like cool music, it's easy (for me at least) to speak on their terms. I just kind of feel like it adds a whole other facet to your activity planning. Not only are you having to think about your goals and how you can use music to meet these goals, but you also have to think about "are they going to buy into this?" It's a great challenge.

I thought one of the therapists we saw today had a great activity for her middle school EBD group that nailed both of these challenges. The students were making a soundtrack to their lives. They had to think of songs and music they listened to as little kids, what their parents like, what they like right now, even their 1st musical memory. They used a website to find and listen to the songs before writing them down (learning functional computer skills through music therapy? Check.)

I love hip hop and rap, so I was deemed our resident expert for this genre today in the group. I helped a 7th grade boy find some of the music he had picked out for his soundtrack, including one of my current favorites, "Lemonade" by Gucci Mane. Nothing like nodding heads with a 7th grader to some Gucci Mane to make you think "Dang, this is an awesome career field (and I'm just getting started)!"

However, the musical choices of some of the students raised a question that has interested me for awhile. What do you do about inappropriate content in the preferred music of your clients?

It's easy to find edited-for-radio songs or just edit out the questionable content on your own using Audicity or a similar program, but curse words aren't always the only problem. A lot of popular music these days deals with themes or have allusions and innuendos to violence, sex, or drug use.

You certainly wouldn't want to encourage these things, but at the same time if you put a blanket ban on ALL music containing any kind of questionable material, you may find yourself with a very small amount of client preferred music to work with. Then you risk alienating your client, or using music they don't enjoy. And as I mentioned with the teenage groups, this can do some serious harm to your all important "cool factor."

One solution I've found helpful is the instrumental tracks of songs. Then you still have the beat and music, just no words. This can actually lend itself to all new activities, like writing new lyrics to the song (maybe discussing why the previous lyrics were inappropriate and what a better solution is). These instrumental tracks are especially easy to find in the hip hop genre, as artists frequently remix songs, creating high demand for instrumental/a capella tracks.

As the therapist running the group today told me, sometimes the group doesn't even put together the innuendo. Sometimes they just take it for face value, and if you don't make a fuss about it, they'll never know. I had a teacher at FSU once who told me they were surprised to hear "Lucy in the Sky With Diamonds" by The Beatles was about drugs. Did I just blow some of your minds too? I always thought that one was pretty obvious.

I suppose it all comes down to the group you're working with. If you work in hospice, my opinion would be to go for it. If someone wants to cuss like a sailor towards the end of their time on this Earth, I say have a blast. It is palliative care, after all. Or maybe you have an adolescent group that possesses the emotional maturity to know that just because Lil Wayne says something in a song, doesn't mean they need to emulate that.

That's all I've got for now on that. What are your thoughts? Any seasoned MT's want to share their thoughts and experiences? Lay some knowledge on us newbies and leave some comments!

By the way, this was way longer than intended.

Day 1 of observations

Today began our observations of the Fulton therapists in action. Tasia and I were on the same schedule, and we live fairly close to each other, so we decided to carpool. Being that we had a 50 minute commute in Atlanta traffic, we decided that leaving an hour and half early (6:30AM) should give us more than enough time. This meant waking up at 5:45. Fun.

We hit the road at 6:30 in the morning and this is what greets us:

Gridlock. This early? Is it like this everyday? According to the radio there was a big accident on our route, which would explain 20 mile long string of brake lights. Took us 1 hour and 15 minutes to go 16 miles. Yikes. But we only ended up being about 15 minutes late, and our supervisor was very understanding.

We went to 2 different schools and saw 6 classes aging from around 1st to 5th grade. It was a very interesting experience. I really learned how important it is to have everything you need ready before hand. These groups come in practically 1 right after the other, and to keep the students engaged you need to limit downtime as much as possible. That's going to be a skill I'll need a bit of practice to master I think.

Tomorrow we get to do it all again, but with a much shorter commute this time around (thankfully. Or rather, hopefully). Time for bed.

Website Recommendation

Today I wanted to introduce the first in a series I plan on continuing throughout the next seven months of blog, websites, and other online resources that I enjoy and find helpful. I'm going to have to think of a more catchy title than "Website Recommendation" however. I could always borrow from Stephen Colbert with the "Colbert Bump", but somehow "Littlefield Bump" just doesn't have quite the same ring to it. Oh well.

First up is fellow FSU Music Therapy Intern Michelle Strutzel! Michelle and I have been in the same classes for years, and she's now in the middle of her internship in Tallahassee. She is the author of "Beyond The Music", an excellent blog full of song and activity ideas. Michelle was kind enough to answer a few questions about her blog and internship for me:

Name/Name of Blog:

Beyond the Music

Internship site:

Tallahassee Memorial Hospital Behavioral Health Center

Blog description:

Beyond the Music is a resource for music therapy students, interns, and professionals. It provides activity ideas and information relevant and adaptable to a variety of populations.

What drew you to music therapy?

It was by chance that I discovered the field of music therapy. I first came to FSU wanting to be a performance major. When I learned about music therapy through some fellow classmates at the College of Music, I quickly changed my major within two months of my freshman year. I think I was in a place in my life where I really wanted to reach out to others and help someone other than myself. With this and music as my priorities, music therapy seemed like a perfect subject to study. I have loved it from my very first Introduction to Music Therapy class.

Biggest lesson you've learned so far?

The biggest lesson I have learned is that there is always more to a person or situation than what first meets the eye. It is a challenge I face everyday to assess where a patient is at mentally. A music therapist has to be able to recognize how a patient is functioning and why it is they're functioning that way, then develop a way to improve that level of functioning. In trying to understand people's behavior, I am beginning to realize now why we are called Therapists and not simply Musicians.

Best non-MT related lesson learned so far?

Everybody needs a healthy set of coping skills. In the psychiatric population, we teach a lot about coping skills, which are techniques we use to handle difficult situations. In your career and in life, the best way to manage stress is to engage in activities you enjoy. I leave my work at work, then go home to be with my family, ride my bike, swim, or read a book.

Why should people read your blog?

People should read my blog to expand their repertoire of songs and activities related to the music therapy field.

There you have it folks! In case you missed the first two links, you can find Michelle's blog at www.beyondthemusic.blogspot.com Give it a read!

Fun times in the ATL

Not to be forgotten in the flurry of excitement that was my first day, I went to the Braves game last night with a friend of mine from FSU who now attends Emory University here in Atlanta for grad school (Ellyn, your requested shout-out) along with four of her fellow classmates at Emory. They're all majoring in things I can't even begin to comprehend or describe. Smart peeps.

Few quick pics from last night. The poor Braves got crushed, by the way. Here's to hoping for a Wild Card spot in the playoffs.

First Day is in the Books!

One day down, folks!

A lot to process today. The day started of with the commute, which I expected to take about an hour but ended up taking only about 20 minutes. I think I'm starting to figure out that in Atlanta, you either have to get somewhere an hour early, or be on time/risk being 40 minutes late. Think I'll go with an hour early.

I meet the other interns in the lobby of the school where the meeting was held. Their names are Kaylee, Tasia, and Laurie. All super nice people. We all headed down to a conference room where an amazing homemade breakfast was waiting for us (will this happen everyday? I can get used to that), made by our internship supervisor, the wonderful Amber Weldon-Stephens (who I already LOVE. One of the nicest, funniest, and most charismatic people I've ever met. Can't wait to learn from her and pick her brain.)

This is when the overload started. We got a big ol' notebook full of schedules, forms, and assignments. Add to this the fact that our supervisor (Amber) talks a mile-a-minute, and I think all four of our heads were spinning. We met principals, school psychologists, and social workers (all of whom were very nice as well.) The music therapy program, and really the school system as a whole, seems extremely well supported, which is great to see.

The basic breakdown goes like this: the next two weeks I'll spend observing. After that, I start easing into sessions (starting with 1 activity per session, then two, then three, etc.) They slowly take the training wheels off, which I like. After winter break, we're pretty much flying solo. This is apparently where it gets crazy. I'll be at four schools a week, and thankfully, I spend my entire day at each school.

After all the meetings, we went out to lunch with all twelve (TWELVE!) full time MT's in the Fulton County School System. Awesome to meet them all.

So all in all, a bit overwhelming, but definitely in a good way. I never felt like "Oh Lord, what have I gotten myself into?" but more "This is a lot, let's get to it!" I think all the Fulton MT's, and especially Amber, have something about them that instills that excitement and confidence in you. Their enthusiasm is very contagious, which is something I want to emulate. Those are my favorite kind of people. What a great way to go through life, you know? Looking at challenges as an exciting opportunity rather than an inconvenience. I think that will be one of my goals throughout the internship, to emulate that attitude. Definitely makes going through life a whole lot easier.

That's all for now! Stay tuned, I'll be starting an ongoing series soon. It will be a short profile of other music therapy blogs I enjoy. First up will be fellow FSU intern Michelle Strutzel's blog,Beyond The Music. I may do this tomorrow, but no promises. Tomorrow is the single greatest day of college football games in ten years, so I will be occupied. It may get pushed to Sunday.

Before I sign off, let's start a discussion: MT-BC's and MTI's, what do you remember about your first day of internship/new job? Leave a reply in the comments!

The power of a poster

Apologies for the short, non-music therapy related posts, but I don't officially begin my internship until Friday. I promise after that I'll have more music therapy thoughts than you can shake a boomwhacker at.

Today I had a whole day to myself. My parents left yesterday and all the roommates were at work all day. Just me, a dog, and three cats.

I only had one errand to run, so I finished my goals for the day fairly early on. This of course, led to a bit of boredom, which in turn led to a teensy-bit of homesickness (common, who can blame me? My brother and all my closest friends live 5 hours away, my girlfriend 7 hours, and my parents 8 hours.)

So I decided to stay busy and continue the room set up. One of the first things I decided to do was put up a poster. But not just any poster. Oh no. The 2010 Florida State Football poster. (which, by the way, they completely ran out of. I only have one thanks to my awesome-former-boss Lisa. Shout-out!) Right away, I felt better.

Now, you could blame my borderline unhealthy obsession with all things FSU for this, and you'd be partially correct. But more than that, I think the familiarity of the poster made me feel so much more at home and comfortable. Here I was with a million things running through my head about loved ones, my internship, finances, etc. and the poster served as my therapy for the day. A piece of home to hold onto.

So the lesson (or "transfer" if you'd like) for the day, fellow interns, is to never underestimate the power of the poster. Or perhaps it's not a poster for you, but some other piece of home that brings you comfort. Putting something in your living quarters that you had back home can be a big boost to your morale. And my recommendation is to put it up right away. Nothin' beats home, so bring home with you.

Quick Update

Quick update tonight, I just got moved up today. Just two things to say so far:

1) If you ever want to feel very materialistic, may I suggest moving? Nothing makes you feel like you have far too much junk than having to pack it into a car.

2) It's jacket weather already in Atlanta in the evenings! Very refreshing.

More updates to come, thanks for reading!

Welcome!

Welcome to MTI in the ATL! My name is Andrew, and on September 10th 2010, I will be starting a 7 month internship with the Fulton County Schools in Atlanta, Georgia.

This blog will serve as my senior project during my internship. My hope is that music therapists (interns, students, and professionals) and non MT's alike will find it to be a valuable resource.

I'll spare you the details of my life story (you can read all about that under "About Andrew", a fascinating read, to be sure) and jump right into my vision for this blog. I want this blog to serve as a tool for other interns or those getting ready to intern. I plan on covering everything; from the big issues to the mundane.

So some days you'll find activity ideas or great song suggestions for sessions. Some day's you'll find tips for finding a place to live, cheap dinner recipes, or ideas for experiencing your new city. I have plans for interviews with other interns, professionals, and whoever else is kind enough to let me pick their brain as well.

But I would also like this blog to serve as a place for me to write down my thoughts and experiences during the next 7 months. I know for me, and I imagine for most other interns, starting this journey will be one of the most challenging transitions in my life. For the first time in my life, I won't be living the "student life". And trust me, I adore the student life (no class till 10 and I'm done at 2? Woohoo!) But alas, that's all over now. Just like that, it's time to move to a new city and work 40 hours a week. Time to buy some more ties and dress socks. When you've been a student for the last 17+ years, that can be scary! So I fully anticipate this experience to be as challenging as it will be rewarding.

With that in mind, I also want to be as "real" as possible with my thoughts here. I don't want to just blow smoke. When I have an awesome day, one of those "ah-hah!" moments, I'll write all about it. When I have an awful day, one of those "why didn't I get a business degree?" moments, I'll write all about that too (depending on how football season goes, there may be some Sunday morning "I can't believe we lost to so-and-so" moments as well). I want to be as honest as possible, because that's what I wanted to read and hear about the last few years as I thought about my internship.

So enough with the rambling! Let's get started! I've got some great ideas that I can't wait to dive into. So thank you for joining me. Please, leave lots of comments! I crave feedback. And if you enjoy what I put here, please pass along a link along to others! The greatest reward I can imagine getting out of this blog is to have someone enjoy it enough to share it with someone else.

That or a sweet job offer when I graduate...