MU158 - Professor Klinck PDF

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Warning: TT: undefined function: 3201/15/Music Therapy Process (RAGTEC)Training received, accreditation (initials after their names- MMT/Master of Music Therapy, RP, MTA/Music therapist accredited?) Various sources Facility protocols Initial snapshot ReferralAssessment Their abilities (physically, s...

Description

01/15/19 Training received, accreditation (initials after their names- MMT/Master of Music Therapy, RP, MTA/Music therapist accredited?)

Music Therapy Process (RAGTEC) Referral • Various sources • Facility protocols • Initial snapshot Assessment Determine approach, and client's needs (if music therapy is even a good fit for them- one on one or group). Coming up with a treatment plan. What needs are assessed. • Their abilities (physically, socially, psychologically) • Issues (i.e- stroke= paralysis on one side of their body, how much of their abilities are affected), Musical (skills, preferences, responses to music- detect sound, moving to music) and non-musical abilities (memory, coordination) • Atmosphere (tense, members present) • Tools (surveys, tests, assessments of certain abilities) ○ Assessment form can be description based answers Goals, Aims and Objectives Goals- Broad, client-centered, with their input (i.e- promote expression of feelings) Objectives- Specific, more tangible steps to progress towards goal (i.e- participating in songwriting, analysis and discussion over 5 sessions). Sorts of techniques incorporated into therapy process Treatment Plan and Implementation • Recommendations • Session format • Duration (sometimes dictated by facility, maybe not, depends on flexibility and mandate given by facility to meet needs of client) • Techniques (song writing, lyric improv, music listening & relaxation) ○ Verbal techniques? (Responses?) • Documentation (check progress, patterns in client to make...musical map?) Evaluation Ongoing or final (assessing and evaluating, adjust as you go) • If someone moves, dies, etc (how client progressed towards goals) Closure Prepare client for closure to avoid feeling of abandonment, navigate through transition • If goals have been met, client’s condition changes • Revision of goals if needs has changed • Client may be moved to another therapist • Recommendations for further treatment Therapist themselves may need to cope with the loss of a client/many clients

Models and Methods of Music Therapy What is a Theory? Theory: Way of thinking about what we do/what we know (overarching theory) Shaped by practice and research Nature of MT Theory • Music Centered

• Therapy centered • MT centered

What is a Model? Comprehensive system of practice (less philosophical) Includes: Theoretical principles, general goals, clinical uses, methodological procedures and techniques, specific roles of music and the therapist, expectations for the process, competency or training req. Importance of Context • Time (age/stage, client populations, stage of therapy process • Place/setting • Therapeutic framework of the setting • Theoretical orientation of the therapist

What is a Method? • A system for conducting therapy • Specific strategies/techniques • 4 MT Methods outlined ○ Improvisational ○ Composition (song writing) ○ Receptive (Therapist will make music, client responds in non music making ways, maybe verbally, body movements, etc) ○ Recreative (pre-composed and re-creating)

Improvisational Models of Music Therapy Creation of music happening spontaneously, models differ in terms of verbal interventions. • Improvising is employed as a primary therapeutic experience • Sessions are open ended (arc, flow, being in music) ○ Specific models ○ Creative Music Therapy ○ Aesthetic Music Therapy ○ Analytic Music Therapy ○ Free Improvisation Music Therapy ○ Interactive Music Therapy

Improvisational Model: Nordoff Robbins, aka Creative Music Therapy • Paul Nordoff and Clive Robbins (one interacting musically, another assisting with music

playing. Drawing client into interaction) Two-therapist model Original client population: Children with special needs Enjoyment, expression and communicative musical skills Clinical improvisation and active music making Emphasis on documentation (all sessions recorded, analyzed) Dubbed Creative MT because: expressive freedom, communication inter-responsiveness, decrease negative behaviours • Session format: Individual and group • Humanistic Approach (think Maslow’s Hierarchy) • “Music Child” (can be reached through music, is a part of every being that responds to music experience • 3 phases: Meet (musically), evoke (musical responses, stimulate client to produce their own sounds and musical ideas) and develop (skills, expand their opportunities for expression) • • • •

01/17/19 Tuesday- Test on readings in syllabus. M/C, T/F style questions. • Six main areas of music therapy practice (as outlined by Bruscia) are… • Music therapy at the primary level nearly always involves the integration of two areas of practice and is reconstructive in nature: T/F Thursday- Assignment due. No citations, kind of informal. Include title name and no. Bring a physical copy to submit.

Improvisational Model: Aesthetic Music Therapy (AeMT) • • • •

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Background: Dr. Colin Lee (2003) Aesthetic experiences in music are central to the therapeutic process Primarily improvisation approach Musical dialogue is at the core between client and their music making and the client and the therapist Musical processes ARE clinical processes (making music and finding meaning in music is worthwhile, don’t need verbal/mediated processing) Emphasis on clinical musicianship for music therapist Clinical application of seminal works and orchestral instruments Thinking architecturally (Focusing on musical structure and how we use musical form, how we bring in structure to provide moments of safety for the client) Clinical improvisation (form) Analysis • Music notation • The generative cell (emphasizing analysis, cell in a small cluster of notes that we can expand on) • Indexing (being a way to document session)

Improvisational Model: Free improvisation therapy • • • • • •

Juliette Alvin More instrumental rather than vocal Receptive and Active techniques No rules, structure of theme Client can leg go of the instrument Original client population: Children with special needs

Improvisational Model: Analytical music therapy Potential for growth • Mary Priestly • Student of Juliette Alvin • Use of words and symbolic music improvisations (clients would be talking while improvising) • Purpose of exploring the client’s inner life and providing the inclination (potential) for growth • Origins in psychoanalytic thought (therapeutic relationship) • Typical client population: Adults with mental health challenges, psychiatric care, incarcerated

adults, adults seeking emotional wellness • Maybe not so much children because of the verbal communication • Typical session format: conversation, improvise together, discuss improvisation

Improvisational Model: Interactive music therapy

Emphasis on caregiver with person in therapy • Dr. Amelia Oldfield • Collaborative work with family and children (caregiver can draw from techniques and seek to

use them outside music therapy) • Client population: Children with mental health issues and/or special needs • Musical relationship is very important • Client and their person who’s in the session (encourages parent to also interact) • Client and music • Client and therapist • “Focus is sometimes more on developing interactive patterns, which can then be transmitted to

the child and [parent] rather than the main focus of the therapy being on the child and myself.” (Oldfield, 2006, p25)

Psychotherapeutic Models Psychotherapy • • •

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Reliance on relationship that develops between therapist and client Music psychotherapy Music experiences and interpersonal processes to facilitate therapeutic change Music and verbal Goals/psychological changes that are necessary for the client • Music listening is the main… with verbal discourse as needed Levels of psychotherapy practice Music as a psychotherapy (just music) Music centered psychotherapy (conjunction with verbal discourse to interpret, guide, etc) Music in psychotherapy (use of both, alternately or simultaneously to gain insight, think analytical) Verbal psychotherapy (primarily dialogue, with music used to enrich discussion) Transformative Therapy: In experience of music making, engaging, listening → Change Insight Therapy: May not look through issues through medium other than words (Music in psychotherapy/verbal) Life changes result from experience of from insight

Music Psychotherapy: Group Analytic Music Therapy • •

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Not very suitable for those not cognitively aware Words and music are equal? Background: Ahonen Group format clients • Closed groups, not anyone can enter. • All senses involved • Clients need to be capable of symbolic thinking and communicate that (i.e- abstract thought) • Differentiate between fantasy and reality • Group as a whole creates matrix for...asdfghjkl… (can last for years) “Road to the unconscious” • Images that come to mind→ pathway to unconscious material that can become conscious and worked through Musical Images Techniques • Music listening, improvisation Non-directive (whatever comes up in opening discussion) or theme-centered (people coping w/ cancer/ PTS) Typical session format: discussion, therapeutic music listening or improvisation, break; free

floating spontaneous discussion and/or further improvisations • Group runtime depends on group needs

Music Psychotherapy: Vocal Psychotherapy • • • •

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Can help client reconnect with what they’ve lost, accompany them through trauma in the past Dr. Diane Austin Importance of the voice as an instrument (voice resonates inwards to connect to body, voice resonates outwards to connect to others) “The process of finding one’s voice, one’s own sound, is a metaphor for finding one’s self” (2008 p.21) Specific vocal interventions • Use of breath • Toning • Chanting • Vocal improvisation • Free Associative Singing (therapist will speak in first person to mirror and validate what client says?) Roots in Jungian psychology and trauma theory

Music Psychotherapy: Guided Imagery and Music (GIM) and the Bonny Method • Developed by Helen Bonny • Exploration of consciousness • Altered states, unconscious material • Music listening and processing model • Sequenced classical music programs • Discussion→ induction→ music listening (chosen by therapist to help client work through

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space indicated in discussion)→ review (verbal dialogue processing what’s come up in listening) Imagery, emotion and music • Sensations, imagery, metaphors Self as a source of healing (healing process is self-directed) • Hold space for client Client and Therapist as traveler and guide Specific training- 3 levels Different terms/practices: BMGIM, Group GIM, Bonny Method, GIM, Non-GIM

1/22/19

Test Review • • • • •

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MDHPR Areas of practice Medical Deductive Healing Psychotherapy Recreational Defining area of practice: Context comprised of various factors (client's needs/goals, determining factors), client- therapist relationship, facility guidelines, qualifications of therapist (specific qualifications- psychotherapy) AAIP Levels of practice (surface to in depth) Auxiliary Augmentative Intensive Primary

Medical Models Music Medicine • Aims: Relief of stress and pain (nonpharmacological), promotion of well-being (can be used by

non-music therapists) • No focus on musical relationship • Adjunct to medical treatments • Receptive music listening (pre-recorded music) • Background/entertainment/pre-selected programs/vibroacoustic treatment • Specialized equipment (vibroacoustic chairs/bed)

Medical Music Therapy • • • • • •

Therapeutic process, applied by Music therapy Music and therapeutic relationship Diverses MT experiences (improv, receptive, techniques, compositions, etc) Assessment, goals, evaluation, process Aims/focus may be broader, more holistic Supportive, equal partner (with medical treatment), primary mode (comprehensive)

BioMedical Music Therapy • Developed by Dr. Dale Taylor • Objective explanation and understanding • The brain • Brain decodes and converts information and experience • Information storage and recall • Music involves nearly all areas of the brain • Music perception involves both hemispheres • Functions of the central nervous system (nervous system receives stimuli, we respond through

motor movements) • Interdisciplinary approach and research

Basic Tenets and Perspectives 1. 2. 3. 4.

Brain as center of control Music processing by and through the brain Positive effect on neural function, hormonal activity and immune/regenerative processes Perception, relaxation (lower heart rate), brain chemistry (increase serotonin, dopamine, decreases negative brain chemicals), imagination and emotion, cognitive development, rehabilitation (functional neuroplasticity: brain has function to heal itself in some form, finding another route, neural pathways)

Neurologic Music Therapy Developed Dr. Michael Taut Music perception, brain, behaviour Research-based system Standardized clinical techniques • Therapeutic Music Interventions (TMI) • Interventions used for 3 types of training • Sensorimotor (Rhythmic Auditory Stimulation) ○ Assisting clients with initiating movement • Speech and language (Melodic Intonation Therapy) ○ Used for individuals who’ve had trauma to the brain/eyes, learning to speak again • Cognitive (Musical Attention Control Training) ○ Focus attention and divert attention with musical cues • • • •

Other Current Models and Theories Community Music Therapy • Big names: Pavelicevic, Ansdell, Bruscia, Stige, Ruud • Working with communities as opposed to in; community as client as opposed to addressing • • • • •

individual alone Health-promoting musiking Collaboration, adaptation, flexible spontaneity Performance (and/or recording) Linking individual and community, private and public and political Qualities of CoMT • PREPARE (Stige & Aaro) • Participatory ○ Partnership collaboration, mutuality • Resource-Oriented ○ Personal, relational, community • Ecological Quality ○ Reciprocal relationships Performative • ○ Human development, promotion of health, collaboration (individual and society). • Activist ○ Social change • Reflective ○ Local knowledge, research knowledge→ Central ○ Multi-level and multidisciplinary • Ethics-Driven ○ Rights based, values • Format

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○ Different types of practice Role of therapist is less traditional Collaborative music making Performance is integrated much more (connecting individuals and community) Ripple effect (music radiates from its source and affects everyone within community) Projects/Programs ○ Music of Life program (Musc Therapy Community Clinic in South Africa)

Philosophical Models and Theories Music Centered Music Therapy • • • • •

Term music centered music therapy coined by Nordoff and Robbins Also used by Helen Bonny regarding GIM Musical components in clinical music Musical outcomes and processes Music as the CORE

Music Centered Practice: Rationales and Implications • • • • •

Client’s experience in music is primary Musical goals are clinical goals Enhancing client’s involvement in music Personal process and musical development Music participation is rewarding • Experience of the musical process IS therapy

Philosophical Model: Cultured Centered Music Therapy • Big names: Stige, Ruud, Bruscia • “Frames” of history/environment/language/belief/value, neverending frames that evolve through

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people through moment to moment interactions. Helps us make sense of our world, always influenced by something “Reflexivity” identifying your frame of reference in relation to someone else’s, hold space for your client and their space of reference “Local VS General knowledge” Music Therapy as situated practice (has always embedded in culture and social context) • Broader, bigger, contexts Culture specific and culture centered Therapist can facilitate a space for client to engage in rather than engaging in music with the client Format • Standard format and exceptions (Western Medical models) ○ Traditional models may work, but doesn’t work for everyone • Rethink format? • Ask questions

Philosophical Model: Resource-Oriented Music Therapy Rethinking client therapist relationship • Big names: Schwabe, Rolvsjord • Addresses power imbalances (more in therapeutic relationship of client and helper) • Distinguishing features • Nurturing client resources • Equal collaboration • Client decision making

○ Focus on strengths

Philosophical Model: Feminist Music Therapy Big names: Baines, Hadley, Curtis, Edwards Complex interaction of oppressions Understanding patriarchal cultures/societies Many approaches, perspectives, theoretical traditions Personal and sociopolitical transformation Overarching principles • Personal is political, egalitarian relationships, valued perspectives • Applications • Combination of music and verbal processing • Lyric Analysis • Songwriting • Music performance, composition and recording • Music-centered relaxation, music and imagery • • • • • •

Anti-Oppressive MT Practice • • • • • •

Emphasis on social justice, social change, growing in music therapy Dr. Sue Baines Power imbalance and oppressive structures Emphasizes social justice and change Address issues within socio-political reality and context Inclusion of client’s expertise Broader training for therapists (better adapt to clients with diff needs, context, etc)

Methods Methods (specific tools we draw from within models, actual music making/listening) • System for conducting therapy • Specific strategies/techniques • Improvisational Methods • Receptive Methods (client respond without using music) • Compositional Methods • Re-creative Methods (pre-composed music)

Method: Improvisational Methods • Spontaneous creation of music (singing of playing) • Variations • Instrumental/Vocal Non referential ○ Not in reference to anything, making music for the sake of making music ○ Client isn’t trying to represent something non musical ○ Can be free or structured • Instrumental/Vocal Referential ○ Trying to portray something non musical • Song lyric improvisation • Conducted improvisation • Techniques • Mirroring, Matching, Reflecting, Grounding, Dialoguing

01/29/19

Conducted Improvisation • Example: Conducting volume and groupings during drumming improvisation • Possible goals? • Which clients might this be effected with?

Structured VS Free Improvisation • Structured: Might use form and structure • Elements of comfort and security, venturing out for little bits at a time • Free: No set rules or guidelines

Improvisational methods • Spontaneous creation of music (singing of playing) • Variations • Instrumental/Vocal Non referential • Song lyric improvisation • Conducted improvisation • Techniques • Mirroring, Matching, Reflecting, Grounding, Dialoguing

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Receptive Methods Any kind of music can be used Client LISTENS Responds silently, verbally, or other modality (movement, art, etc) Variations Somatic listening (Entrainment) • Matching rhythm and tempo of music to someone’s body rhythms (i.e- breath) ○ Non-verbal interaction, validates someone’s state/way of being • Changing rhythm/tempo of music affects body rhythms ○ I.e- Deeper/steadier respirations, ease shortness of breath, enhance relaxation/sleep, or increase alert/energy Action listening Song Music Reminiscence Song Lyric Discussion

Recreative methods • Learns, sings, plays or performs precomposed music • Structured musical activities and games • Variations • Instrumental re-creation (playing an instrument) • Vocal re-creation (singing a song) • Performance (formal, informal, group performance)

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