Hi all,
Just jotting down some quick notes/thoughts on a topic that continuously pops up for me as a clinician, supervisor, and educator: the concept of music being used versus music being worked in in therapy. One word treats music as a thing, and the other as a verb. For me, the differences are pretty significant, and are a critical factors in establishing my identify as a music therapist. The purpose of this post is to flesh out some questions and encourage dialogue. These ideas, thoughts, and questions are by no means something new, and in fact are consistently brought up via social media.
So, as music therapists, why do we play and make music, or create music experiences with clients? Does the musical experience really matter? Is the music more about being some-thing that is sound-based and seeks nothing more but to alter a behavior (i.e. I play this and you do that. If you don’t do that, I keep playing this to make you do that because I want you to do that)? Is the music about the experience occurring between you and the client as a relationship unfolds? And if so, how can the relationship foster health?
Furthermore, is it (music therapy) about using music as a stimulus (i.e. stimulus-response based work)? Or, Is it about working in music and experiencing the things that are unique about it, i.e., aesthetic and relational elements? The “keys” here, I believe, are the words “using” and “working.” Can a music therapist do both, use and work in music at the same time? Is that really possible? Can both paradigms be blended together? Does one cancel out the other? Or are they two completely different paradigms that may only “live” on their own? That brings me to the big question that I ask my students quite often: what is the difference between a speech therapist using music to facilitate speech sounds and a music therapist working towards the same behavioral goal? Is there really a difference? They both are using music to foster a behavior. (i.e. stimulus-response?).I would say that in the example given, the speech therapist may probably be more effective in helping the client realize the speech-based goal because that is the ST’s area of expertise: speech development. That being said, however, working in music can be viewed, some say, as the something that is unique to the music therapist and his/her training because it purely deals with working within the experience of music. What this may mean is that we, just like STs, PTs, etc., can offer a unique perspective based on our discipline/medium. Thoughts?
Thanks for reading.
Best,
John
John, it is interesting that you should post this as I have been thinking about applying music to a client as a means of changing observable behaviors vs. engaging a clent with music in order to address a health need that may or may not be observable. So for example, when I go into to see a hospice patient, am I applying music to regulate respiratory rhythm or am I engaging in a music experience that may bring the patient a sense of internal peace which may manifest in any number of non-observable internal experiences or more observable outward signs. It is an interseting question, and I am looking forward to more dialogue on this topic.
As I work, and as I understand what I do as a music therapist, music is not analogous to either material medication, nor to any technical health-promoting procedure. The idea of “using” music as a tool for a dose-response is really no more meaningful than “using” human relationship. Music–like human relationship–is not a tool (an artifact utilized technically for a technical outcome), but a way of being. I suppose, for me, that is far closer to working “in music” (or, perhaps, even “working musically”) than “using music.” And if anyone “uses” the opportunities resulting from working musically, it is the client, not the therapist. The therapist does not intervene “upon” the client–the therapist intervenes to support the client’s possibilities for appropriating the benefits of the music–they are not “dispensed” by the therapist. From my perspective, in Kathy’s example, above (for example), she would be working in music (or, musically) with a client, which may include the client’s utilization of the opportunity to change respiration and/or shift any other number of relevant dimensions of her/his wellbeing (as understood within the context of who she/he is and what she/he needs within that context). Kathy cannot “control” any such outcomes, but provides opportunities for them. And “observable” often involves a greater scope than sometimes presumed–for example, one can “observe” the general shift in the client’s context, as the physical and interpersonal “ecology” of the client’s room shifts, upon Kathy’s musical presence. The client’s musical-ization (if I may!) of her/his own world is a shift, and is indeed observable, and can manifest within and across any of the more general health domains (physiological, emotional, communicative, social, etc.). But they manifest in a way that is unique to the MT’s discipline and training, and is therefore not simply something the MT “does better” than some other therapist targeting the exact same goals…the MT is providing a unique service with a unique benefit, rendering the MT an indispensable (and non-redundant) member of the larger health care team.
Thanks for your post, Brian. the MT is providing a unique service with a unique benefit, rendering the MT an indispensable (and non-redundant) member of the larger health care team.” – very important quote, especially in today’s MT place where we have a lot of MT in private practice marketing there services. Doesn’t make perfect sense to market something that is unique and, indispensable, and non-redundant? Supply and demand, yes?
best, John
I love this question and it reminds me of this quote below . I think that we do both things but it is important to understand the difference between using music as a stimulus to achieve a desired developmental outcome such as regulation or joint attention for example versus using music to support the relationship by helping a client to feel safe.Because the effect of the music only has meaning when the relationship supports it and often drives it and provides a context within which it can occur. I’m talking about a paediatric population here. Whilst music can elicit physiological responses in clients It is the relationship that encourages the desire in a child to respond and in that choice lies their growth. As a music therapist I do both simultaneously, or sometimes individually- depending on the client. Often early in the work with a child with autism I will use music to meet a child where he is at and we may be both in the music together without a previous relationship but as the work develops , the connection consistently is made by both of us experiencing the space we create together. It is a powerful experience and one that I thinkcomes with a lot of awareness required from the music therapist- to be careful with the connection.
I often get asked by speech pathologists to join their sessions even when they have an existing relationship with a child because they can’t engage the child -even with songs. The difference between us is that I can create a musical experience so the child can work IN the music rather than respond TO it. I’m yet to meet a speechie who can do this or would think about music in this way.
It is partially a question of music skills but also a question of understanding the power IN the musical frame work to emotionally/ senatorial affect the whole child. So in my practice I try to work in and with music. And it is often in the music that a sense of safety and containment allows the child to be a little bit braver and experience connection to me for the first time .
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
Viktor E. Frankl
Thanks so for sharing, Trish. I like the Frankl quote. I would say that the quote implies the 2 entitities of therapist’s music and client’s music —-> response as opposed to stimulus response 🙂
Best,
John
HI Kathy, Thanks for your post. My feeling is that working in music is a way of thinking. A way of understanding and conceptualizing the client. I do feel that this way of thinking can cross client populations. I think you present some great food for thought: “…when I go into to see a hospice patient, am I applying music to regulate respiratory rhythm or am I engaging in a music experience that may bring the patient a sense of internal peace which may manifest in any number of non-observable internal experiences or more observable outward signs.” I would think that you are engaging the client in a musical experience that provides him/her with a musical-emotional environment that follows his/her affective/emotional state that will deepen the the in-the-moment relationship (inter and interpersonal). The client’s challenge pertaining to difficulty in maintaining or regulating his/her respiratory rhythm may be constricting his ability to fully engage or experience the musical intervention in a robust manner. Thus, the “individual-differnece,” needs to be tended by the therapist as a musical-differnece. Thus, it (challenge/musical-differnece) is conceptualized musically. So, what does the client’s music sound and “look” like as a result of exhibiting challenges in regulating respiratory rhythm? (this is applicable for all of the MT methods) can you describe the client’s experience in musical terms? Then, what would the experience look or sounds like if this challenge is supported? And by supported, I am referring to musical as well as or extra-musical (e.g., physical touch, etc.).
Musical-differences should be supported within the scope of the musical experience. In other words, supporting the clients differences (in order to enhance the musical experience) is sort of a means to a musical end (if that makes sense). To that end, i would say that we provide supportive interventions in the form of the musical or extra-musical in order to foster the musical. And this, I would add, is where the therapist’s clincial expertise regarding pathology, symptoms, etc. comes to play. These areas guide and inform the musical experiences that we create.
Best, John
I was interested to read your post as this is a situation in which I am dealing with presently. A job, for which I have applied, seems to be about how music can be “used” rather than how music therapists “work in” music. The first, as I interpret it in relation to this position, means that anyone can be taught to use music to benefit residents (including nurses, recreation therapists, care-aids, etc.). The second phrasing means that, what music therapists do is unique, and specialized. By teaching others to “use” music therapy, a large motivation is saving money. Obviously, I believe that “you get what you pay for” rather than “quantity is better than quality”.
Hi John, Thanks for your post. You have hit the nail right on the head! This confusion of out identity of who we are and what we do is common. Agencies, schools, and hospitals do not know what they know. Thus, it’s our job to educate them and inform them of how our discipline may add to their team. I would say that one of the problems is that the “using” music-way, by definition, can be applied by non-MTs because it’s used as a stimus-response activity to alter a behavior. In that sense, the music and all of its compoenets are not important. Thus making it easy for non-MTs to incorporate a musical experience. They are not conceptualizing the client, musically, nor are analyzing the musical-clinical process. All of that being said, we, our profession need to make a clear detection of what we do and how we do it other wise, in my mind, we are creating our own competition.
best, john