Emotional-behavioral disorders (EBD) is an umbrella term that encompasses a vast range of diagnoses. In the educational setting, this term is used to describe a child or adolescent whose behavior is viewed as disruptive and whose actions inhibit the individual’s academic performance (Jacob, 2018). The emotional component of EBD is that the child/adolescent is unable to effectively control their emotions. Examples of emotional disorders include anxiety disorders and depression. The behavioral component is thus the manifestation of emotional dysregulation. Behavioral disorders include oppositional defiant disorder (ODD), conduct disorder (CD), and obsessive-compulsive disorder (OCD). Symptoms displayed can be categorized into externalizing behaviors and internalizing behaviors. Externalizing behaviors include acting out, fighting, using inappropriate language, destruction of property, and other deleterious behaviors. Internalizing behaviors are focused inward and may include being withdrawn, exhibiting nervousness, physical symptoms such as headaches and stomachaches, changes in sleeping patterns, and changes in eating patterns (Jacob, 2018).
Since each individual is different and thus displays symptoms differently, it may be difficult to pinpoint which disorder a child or adolescent may suffer from. This may be why EBD is used as an umbrella term to describe multiple diagnoses (Jacob, 2018). Although there are common behaviors displayed, each child/adolescent requires individualized attention and care in regards to treatment.
An emotional-behavioral disorder affects virtually every facet of a child/adolescent’s life, including school, family, and community functioning and performance (Bakken, Obiakor, & Rotatori, 2012). A common thread amongst children/adolescents diagnosed with EBD is their lack of social skills. They are unable to form and maintain interpersonal relationships with both school-aged peers and adults. This incapability can present a major challenge in social development and emotional wellbeing.
Behavioral theories suggest that human behavior is shaped through conditioning and observational learning (Gfeller & Thaut, 2008, p. 225). A main premise of behavioral theories is that an individual is more likely to display a certain behavior if it is consistently rewarded or reinforced. A child or adolescent may be inclined to display a disruptive behavior if it is constantly acknowledged by their teacher or caregiver. Positive Behavioral Support (PBS) is a range of preventive and positive interventions designed to create a supportive and successful environment for individuals who demonstrate behavioral issues (Adamek & Darrow, 2018, p. 196). The ultimate goal of PBS is to improve the daily lives of individuals in all settings, such as school, home, and community (Adamek & Darrow, 2018, p.196).
Positive Behavioral Support (PBS) utilizes three features: a behavioral assessment, comprehensive intervention, and lifestyle enhancement (Adamek & Darrow, 2018, p. 196). Similar to music therapy treatment, the assessment stage of PBS involves tracking the child or adolescent’s problem behaviors by observing the frequency and factors leading up to them. A comprehensive PBS plan involves altering the individual’s environment in order to remove triggering stimuli, teaching new skills to replace problem behaviors, and minimize natural reinforcements for inappropriate behavior (Adamek & Darrow, 2018, p. 196).
Behavioral techniques can be used in the music therapy setting to promote appropriate, desired behavior among children and adolescents with an emotional or behavioral disorder. Utilizing behavioral strategies in music therapy sessions allow for the client to make progress towards more appropriate behavior in unique, engaging ways. Participating in music-based interventions serves as a distraction from displaying inappropriate behaviors. For example, providing a child or adolescent with an instrument to play may counteract their ability to interact negatively with peers. Secondly, learning to play an instrument or read an instrument requires the child or adolescent to remain focused and engaged. By learning a musical concept, the child or adolescent exhibits appropriate behavior such as remaining seated, holding an instrument, and/or reading music. Finally, music can serve as a contingency for displaying appropriate behavior for a specific length of time. Once the specific time length of desired behavior is reached, the music therapist could reward the client by incorporating the client’s prefered music into the session or allowing the client to play their prefered instrument choice.
Music therapy sessions implementing behavioral strategies would involve structure and expectations set by the music therapist. The music therapist can set the expectation for the session by creating the session’s schedule at the beginning of the session and implementing a reward chart. If the client completes a set amount of interventions during the session, they will be rewarded with a prefered music activity. For example, if the client’s goals measure fine motor skills and remaining on-task, the client would be rewarded after sitting at the piano for a determined time length and isolating their fingers to play piano scales or a piano piece. If the client completes this intervention, the client could be rewarded for their positive and appropriate behavior by being given their prefered instrument. For example, if the client’s prefered instrument is the drum, the client and music therapist could engage in an improvisational intervention that provides the client with an opportunity for self-expression and autonomy by assuming the lead role in an intervention that they favor.
-Jasmine Bailey, Music Therapy Intern
References
Adamek, M., & Darrow, A. (2018). Students with behavior disorders. In M. Adamek & A. Darrow (Eds.), Music in special education. The American Music Therapy Association.
Brigham, F.J., Bakken, J.P., & Rotatori, A.F. (2012). Families and students with emotional and behavioral disorders. In J. Bakken, F. Obiakor, & A. Rotatori (Eds.), Behavioral disorders: practice concerns and students with EBD (pp. 207-231). Emerald Group Publishing Limited.
Gfeller, K., & Thaut, M. (2008). Music therapy in the treatment of behavioral-emotional disorders. In W. Davis, K. Gfeller, & M. Thaut (Eds.), An introduction to music therapy: Theory and practice. American Music Therapy Association.
Jacob, L.M. (2018). Emotional and behavioral disorders. Salem Press Encyclopedia of Health. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=1&sid=feb9e3e5-0cf8-435f-b0ec-7c7493b6d4b2%40sdc-v-sessmgr01&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=93787442&db=ers