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Archive for July, 2011

Using Music in Your Therapy Process Group

Wednesday, July 27th, 2011

For social workers, therapists, counselors, music therapists, and others who provide therapeutic groups.

Recently, I took a job as a treatment coordinator at an Intensive Outpatient Program, so I’ve been working on combining my history of music therapy with now being in the position of a social worker and one who provides more typical “therapy groups.” I’ve found that adding music, even a few minutes at the end of a group, completely captivates my clients, wakes them out of drowsiness or preoccupation, focuses the most disoriented, and brightens their faces. Here I’ve provided a couple of ideas that even the non-musical clinician can incorporate using music in their sessions.

The Open Process:
Materials needed: Songbooks, guitar/piano or karaoke sing-along disc with all of the songs you have in your songbook. This link is the contents to the songbook I use: Songbook Contents; I have 78 songs in my book and it is meant to appeal to all age groups, you do not need this many, 10 songs may be sufficient. However, I’ve found that these are some favorites, so you might just pick out the songs before 2000 for working with older populations.

Conduct your open process group normally for the first two- thirds of the group, then introduce the idea of singing and listening to music for mood management. Give your group a topic and ask that they choose a song that goes with that topic, such as healthy relationships, good communication, self-love, self-care, hope, inspiration, peacefulness, etc. When a client chooses a song, process how that song demonstrates the topic that you chose. For example, if “healthy relationships” is the topic, pick a line in the song that could be said to someone to repair or assert feelings in a particular situation, you could even roleplay saying this line, or ask who a client might say that line to.

When documenting, this activity can be considered mood management, emotion regulation skills, thought management, symptom management, concentration, and reality orientation. I’ve also found that singing a song can assist with linear thinking and mindfulness.

Example of symptom management: For a client who has schizophrenia, adding music to your session can provide for some incredible things to happen. For negative symptoms, such as impoverished speech or blocked thinking, singing a song uses different parts of the brain, so they are able to think clearly through the song, sing along, and interact positively with others. For a client who has auditory hallucinations, is preoccupied, disoriented, or expresses loose associations, singing a song can focus him or her and provide for a moment of reprieve or clarity.

An Assertiveness Skills group, aka, “communication skills”:
When teaching assertiveness skills, I like to begin with the basics: “I” statements and feelings. Then I move onto the four part formula: 1) When you, 2) I feel, 3) I wish or want, 4) If you could do that then. . .

When talking about assertiveness, often you’ll have clients that are not only working on being assertive with others, but they are also working on having assertive self-talk. So we can use this formula for that as well: 1) When I think. . ., 2) I feel, 3) I want to think, 4) If I could do that then. Often, this conversation then moves into problem solving and identifying next steps in achieving a thought or goal.

After processing assertiveness, save some time at the end for exploring the voice. As we all know, many of us communicate our assertiveness toward others using the voice. For some, exercising the voice is the hardest part of being assertive. So it is helpful to encourage your clients to PLAY with their voices. One of my favorite activities for this is “drum talk” created by George Grant.

In drum talk, each subdivision of rhythm has been given a sound word to accompany it. The quarter note is a “dome,” eighth notes are “gah-get,” sixteenth notes are “chicka-chicka,” and a quarter rest is “hmm.” There are all kinds of creative things you can do with these sounds, but to begin, just have your group say each one four times (in 4/4 time), then say them all together (pat your leg at a steady rhythm, 1- 2- 3- 4, Dome- GahGet- TakaTaka- Um). It will increase your groups’ alertness and brighten their affect.

For documenting, this can be considered an assertiveness skills exercise, communication skills exercise, can be used for mood (just watch your client’s faces!) management, and can assist with symptom management similar to the example I gave above.

Try it out! Let me know how it goes and how you used these ideas!

Until next time,
Davida Price, MS, MT-BC
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Transition, Masks, and Slipknot

Thursday, July 7th, 2011

I always lose sleep and have nightmares when my life is in transition and this time around was no different. A few nights ago, I dreamt that I was in a convenience store buying knives and to test the sharpness of the knife the seller wanted me to test the blade on his face. What?? I remember struggling and tossing in my sleep, saying “Nooooo!! I can’t do that!! Why would you want me to do that to you? And my gosh, I can’t do that in the front window of a convenience store, I’ll be arrested!!”

I tried to put this dream out of my mind for days, I didn’t even want to think about it, it was so disturbing to me that I had this horrific dream. However, days have passed, I’m agonizing through the final days at one job, totally unsure of what my next job will be like, trying to maintain normalcy with private clients, terminating with piano students, staying on top of planning for yogadrum, and in the meantime trying to stay standing up while the ground shakes beneath me.

This morning, as I was coming to consciousness three hours before my alarm clock, it occurred to me that my “nightmare” of a few nights ago was not so much a nightmare, but a picture of what I’m feeling. I’m not a Freudian, but upon reflection, that dream had a great deal of symbolism relevant to my life.

The intention of testing the blade on the face of the seller was not to hurt him, but to mildly scratch the skin, something that might sting a little, but is innocuous. Obviously I do not endorse, nor would I ever actually cut a person’s face. It’s the metaphor of this that is so profound in my mind. Our faces are our identity, and my identity is shifting. I am going from being known as a music therapist, to being known as a social worker and case manager. My face is being changed, it feels like it’s being scratched, but everything underneath is still the same, and those scratches will not scar, they will heal and my identity will grow and change.

In psychotherapy, there are some wonderful ways to explore our identity by exploring the face, which is the mask that we show the world. For some of us, our face is a transparent mask, for others, it is a painted mask.

Creative Arts in Therapy: For all ages, painting a mask can be incredibly liberating, individuals can paint the outside as how they are seen, then the inside with regard to how they feel.

In music therapy, we can also explore masks.
Teens, Slipknot, and Masks:
Topic: Choices, behaviors, masks we wear, anger

Pick up a copy of Chicken Soup for the Soul: The Story behind the Song, and a copy of the song Duality by Slipknot.

In this book, you will find a short passage written by Corey Taylor, of Slipknot, on the song Duality, as well as the lyrics. Listen to the song with the lyrics, having your client underline or circle anything that pops out to him and any thought that comes up. After the song, process with your client what stood out to him and what his interpretation of the song is and why he thinks you might play this song for him. How does the song explore anger, sadness, our behavior, and how we encounter and respond to the world?

Next, read the passage from the book. Explore if this changes the clients interpretation of the song. Explore how in the passage, Corey takes off his mask and shares his real self, whereas in the picture and the song, he is literally wearing a mask and using angry sound as a mask.

You can also explore how anger is known as a secondary emotion, in other words, a mask for disappointment, hurt, or frustration (among other things). How does Slipknot demonstrate a mask of anger and when do they show transparency of themselves through their music?

I had a session in which I had a client share that Slipknot’s sound matches the intensity of his anger, which he uses as a mask to intimidate others. When he listens to the music though, since it matches his anger, it absorbs his anger, and allows him to calm down, then think more calmly and make better choices.

Be sure to explore with your client how “angry music” affects him. For many teens, this kind of music actually is constructive like it was for my client, but for others it can aggravate their anger and make them feel more destructive. Be sure your client knows how he is affected by music and how to use it most effectively.

Have a great weekend!
Davida

Davida Price, MS, MT-BC
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