blissmusictherapy.com Blog

Today, I’d like to share with you a new way to check in with your weekly clients. So far, I’ve done this one with teens in an outpatient setting, who were struggling with anger, depression, and anxiety. This check in invites one to go over the last seven days in his mind and if it was an “uplifting” day color it up to a number from 0-10 in one color and if it was a “challenging” day, color it in a different color, again up to a corresponding number. What has been truly eye-opening for my clients (and myself!) is that inevitably there were some real suckers of days, but there were also a larger number of uplifted days. And so far, the ratio is usually tipped toward uplift.

This has reportedly been eye-opening for the client who is feeling really down and thought of the entire week as, “the worst week ever!”  Many of us characterize our days or weeks as black or white. This exercise is an excellent way to be reminded of what made us feel good and see that, “wow, I had three brown days with low numbers, but I also had four blue days that were all sevens and eights.” Next, you want to get yourself or your client to remember what made their highest numbered day so uplifting. Then, ask her (or yourself), how can you claim responsibility for that goodness that you felt?

If you are a clinician, you can use this to explore cognitive distortions, positive coping strategies, and ways to anchor one’s self, positive choice making, and taking responsibility for ones feelings, thoughts, and behaviors.

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Every so often, I am given the privilege of being contacted by a current student who came across my website and wants to know more about what I do. Here is a sampling!

Edited from interviews with Toni Ramos and Candice Abdurahman:

1. Why do people choose music therapy, or is it something you suggest after assessing a client and their issue(s)?

It really depends on the population. For people who are in hospice or are in a regular medical hospital, often a referral will come from a social worker who knows that the patient likes music, is social, and would like someone to come by with a guitar for socialization, pain management, or diversion/distraction. It is important to remember in this case that the music therapist is not a performer, but a musical clinician trained to provide musical interventions that achieve specific goals.

For a child with special needs, music therapy may be referred because 1) the child responds positively to music, and 2) the skills of playing a drum or instrument would help that child maintain basic life skills, such as lifting a fork to feed himself. Also, music is good for motivation, but can also be used for learning, such as how most of us remember our ABC’s.

For me, at the hospital I work at, my job title is music therapist, so the patients come to my group and it is considered part of their treatment to try it.

In private practice however, I am much more discerning. I have a group wherein the teens have signed up knowing that it is a “rock therapy” support group. In other sessions, I bring in music to work on relaxation techniques, self-esteem, self/body awareness, and positive coping. Also, music making and learning can be used for the examination of thought distortions, which would fit into a cognitive behavioral treatment plan. For a couple or family, music making can be very effective at getting the clients to work together, work on being heard, being harmonious, and working on attachment.

2. What are some of the challenges music therapists face?

As a music therapist with a dual degree in marriage and family therapy, I find that a lot of adults are resistant toward using music in their treatment and don’t respect the music as therapy. Whereas, the view on using it for children or teens is much more open and understood. So, respect for the power of sound, music, and vibration to be powerful healing entities, is a challenge.

3. What do you think the future holds for music therapy?

I believe that in the next couple of decades, with the partnership with music neuroscience, and the increase of music therapy in the media (recent movies such as It’s Kind of a Funny Story and the Music Never Stopped, books including Jodie Picoult’s new book as well as the well received books by Daniel Levitin and Oliver Sacks, news about Gabrielle Giffords having a music therapist), music therapy is going to become more respected and will develop into a more understood field. I believe that using music, sound, and vibration, will be found to be cutting edge as well as thought of as returning to ancient shamanism. Both ideas will be embraced and used in modern medicine and psychology and for overall wellness.

4.  I noticed that you do the yoga drumming on the weekends. Is this considered a spiritual type of therapy and do you do any type of spiritual work with your clients?

I do not consider YogaDrum therapy. It is a community wellness event. We are not working as therapists, rather, as facilitators for a public event. To me, some of what I do is spiritual, but it depends on the client with regard to how overt that spiritual approach is. If I’m working with a group at a hospital, I use very secular language to try to make what I’m doing accessible to everyone. If I’m working one to one with a client who has religious or spiritual familiarity, then I might use language that is more spiritual and in line with what they believe in.

5. What is the most rewarding aspect of your profession?

Being present when a door in someone’s mind opens, a sadness leaves, or they experience nirvana while playing a drum for the first time.

6. What theoretical orientation do you use to do therapy?

Mostly, Cognitive and Dialectical Behavior therapy. But I do a lot of interpretation of art, visualization, I use movement and body awareness, imagery, and of course human and instrument sound.

7. How do you choose which intervention or therapy to use to treat a patient?
There are some basic CBT (Cognitive Behavioral Therapy) skills that are useful for most clients, such as exploring thought distortions and challenging thoughts. But it really depends on what the client is working on. For couples or families in which there is a lot of conflict, using “I” statements and working to identify and accurately express feelings is important, as well as the development of positive coping skills and creating structure within the family schedule, so I will work on these goals, which are very CBT.

If a teen has low self-esteem, is depressed, and is using self-hating language, then in a session, I might do some movement, such as having him stand up, crouch with his hands on his knees and have him push into his feet to help him feel grounded and get in touch with his “core.” Then practice saying a positive affirmation and draw attenting to the confidence heard in the voice as he says that affirmation. So in this case, we are working on grounding him, building his sense of self, having him feel his body, and beginning to rebuild his sense of himself and his self-esteem. If he’s in my teen rock therapy group, then I assign him a job to do on a song, then he has a purpose, something that he’s responsible for. So I’m doing a lot of mixing in this scenario with some yoga-ish mindfulness stuff, CBT, and some good old music education type work.

8. Last question–Do you have any suggestions for a student who has just received their bachelor’s degree?

If you want to pursue being a therapist, get a job as a mental health worker at a hospital or group home. This will give you a great experience of what mental illness looks like and how to work with people who experience it.  You may also try volunteering at a hospice. There are a lot of different populations that you can work with in mental health, you may think that you have no desire to work with one, then you find that’s your favorite population to work with.

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