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Behavior Management: Positive Reinforcement

In the first month of my music therapy internship with Therabeat, Inc. I have had the opportunity to work with a wide variety of people of different ages and diagnoses. While every session is unique, I have seen one very important commonality that is always present: positive reinforcement. Positive reinforcement is an important and effective behavior management technique that we use in every session. The definition of positive reinforcement is “the contingent presentation of a stimulus following a response that increases the future probability of that response” (Madsen & Madsen, 285). The idea behind positive reinforcement is that we reward positive behaviors in the hopes of increasing the likelihood that they will repeat.

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Behavior management can be a difficult art to master, and developing a positive approach to behavior management can be an even more challenging task. Yet, developing and using a positive approach to behavior management is an essential part of being a music therapist. In a setting where you are working with clients toward meeting specific goals and objectives, knowing how to control and shape the behavior of your clients in a positive way is crucial. Anyone who works with children- teachers, parents, therapists- could benefit from a well-stocked file of knowledge on this topic.

Behavior modification is based on cause-effect relationships. What consequence does a child associate with a specific behavior? Therefore, positive reinforcement is all about pairing positive “consequences” with desired behaviors. Earlier, the definition of positive reinforcement mentioned the presentation of a “stimulus”; this stimulus could be any kind of reward such as verbal praise, a smile or nod, or even a token such as a sticker or lollipop. (In music therapy, we like to use music as a reward!).

Choosing which kind of reward to use will always depend on the individual. “Reinforcers must be chosen with specific individuals in mind...something that functions as a reinforcer for one student may not necessarily function for another” (Madsen & Madsen, 285). Of course, we always want to make behavior modification as easy and manageable for ourselves as possible; so, if mere verbal praise is enough to motivate a child, then stick with that! However, some children do not respond as well to verbal praise; for some children, a pat on the back is not as motivating as a trip to the prize box. It is important to think about the individual when considering your choice of reinforcement. Figure out what motivates the child and use what works best!

    Another important aspect of behavior management to consider is your schedule of reinforcement. When you are first beginning to target a certain behavior, the more praise the better. “Initially, it is far better to give too much reward than not enough” (Madsen & Madsen, 57). During this time, children are functioning on external motivation; their behavior is motivated by the reward they expect to follow it. However, the goal is to encourage intrinsic motivation to take the place of external motivation as the primary reason for a behavior. So, how do we achieve this transition from external to intrinsic motivation? Considering your schedule of reinforcement is the best place to start. While at first, we may reward a behavior every single time it happens, we eventually want to start thinning our frequency of reinforcement. As we begin the process of thinning, our schedule of reinforcement will change from a fixed schedule to a variable one. This means that rather than presenting a reward every time a behavior is displayed, we only present the reward sometimes. By giving rewards randomly, we are teaching the child to “go for longer and longer periods of time before receiving payoff” ( Madsen & Madsen 73). When you have reached a variable schedule of reinforcement, a naturally occurring reinforcer will eventually take the place of the need for an external reward. When this happens, the child has become self-motivated and has transitioned from an external motivation mindset to an intrinsic motivation mindset.

    Another useful tip for developing an effective positive behavior management strategy is to make your praise as specific and individualized as possible. For example, consider a child who shakes her maracas up high after being asked to do so only once by the music therapist. Rather than saying “good job”, the music therapist could say “Sally, I love how you followed my directions so quickly!”. That way, the child knows exactly what she did correctly and exactly what she should continue to do in the future.

Positive reinforcement can be a very effective tool in group settings as well. Consider a preschool classroom that has been handed egg shakers. Many of the kids are shaking loudly and are not waiting for directions, while a few children are waiting patiently with their egg shakers on the floor.  Rather than calling out the children who are misbehaving, the music therapist could say, “I love how John and Sam are waiting patiently with their egg shakers on the ground; they are ready to be good listeners.” By doing this, the music therapist calls attention to the positive behaviors rather than the negative ones, hopefully encouraging the other students to change their behavior in the process.

    As you can see, developing a positive and effective approach to behavior modification is no easy task. It requires practice, hard work, and consistency. However, putting in the time and effort is well worth it when we begin to see positive, functional changes in the behavior of our children. It is important to remember that every child is different and every situation is unique, but maintaining positivity in all things will benefit not only the child but us as well!

 

-Alaina Brommer, Music Therapy Intern

 


References: Madsen, C. K., & Madsen, C. H. (2016). Teaching/discipline: a positive approach for educational development (4th ed.). Raleigh, NC: Contemporary Publishing Company of Raleigh, Inc.

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Harmony Kids Music Class: learn by playing!

This January has marked two years as part of the Therabeat team. One of my greatest joys has been teaching Harmony kids music classes. Every Tuesday morning I am met with the sweet faces of tiny ones ready to learn. Except, they aren’t aware that they are learning--they come to play, and that is exactly the goal!

 

 

 

 

 

 

 

 

We build our Harmony kids curriculum to foster learning, growth & development, and interpersonal skills through musical play. We accomplish this by planning classes that are interactive, structured, and give time for free exploration. In every class, we want to get your little one moving, singing, playing instruments, and playing with their peers.

 

 

This Spring, we are offering two different classes for you and your little one as we break in our brand new group room in our new clinic!

 

 

Stories & Songs: Mondays 11:00-11:45

 

Ages 0-5

 

This is our newest offering! This class will focus on fostering a love of language and the telling of stories. Each month, we will focus on the reading of 1 cherished story book. Your children will get to know these stories through focusing on themes and concepts in the story through movement, singing, and instrument play. This class will  be taught by Hayley Echols, LPMT, MT-BC.

 

 

Music & Me Family Class: Tuesdays 11:00-11:45

 

Ages 0-5

 

This class is perfect for the whole family! In this class, we will sing, dance, and play instruments! We will be focusing on the play of 1 instrument family each month to learn age appropriate concepts, foster the love of music, work on fine and gross motor skills, and learn how to play with others. This class will be taught by Perry Wright, LPMT, MT-BC.

 

 

Call 770-345-2804 to sign up for class today and join the fun!

 

 

Registration is $55/month per child. Worried that you might not be able to make every class? Don’t worry! Although we suggest coming consistently to one class, you are more than welcome to come to either Monday or Tuesday Class in order to makeup classes.

 

 

We can’t wait to see our new group room filled with bright faces ready to engage in music!

 

 

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Music Therapy with Generalized Anxiety Disorder

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     Anxiety related disorders are being diagnosed at higher rates than ever before. 18.1% of adults in the United States are diagnosed with Generalized Anxiety Disorder making it the most common mental illness in the U.S. Unfortunately; only 36.9% of those suffering are receiving treatment. (Anxiety and Depression Association of America) 

 

    In 2015, Gutierrez and Camarena completed a study on using music therapy with generalized anxiety disorder. They took a slightly different approach than previous studies by including active and receptive music therapy interventions. The receptive interventions meant the participants weren’t involved in the music making. During the active interventions they used their voices, bodies, or musical instruments to participate in the creation of the music.

 

     The study utilized receptive MT first and focused on stimulating patients to identify their problematic symptoms. The music therapy then shifted to active while the participants engaged in emotional expression exercises.  Lastly, the music therapy was used to address issues such as self-esteem and assertiveness before final processing and conclusions.

 

    This study found that those participating in music therapy alongside their conventional pharmacological treatment had significant positive effects. Their anxiety significantly decreased on two different assessments used by the researchers.

 

     This study is unique in that it specifies how music therapy was used throughout the progression of the sessions. Music therapists can use this information to inform their clinical choices and better serve their patients.

 

 

-Lauren Booke, Music Therapy Intern

 

 

Gutierrez, Octavio Flores, & Camarena, Victor Andres Teran. (2015). Music therapy in generalized anxiety disorder. The Arts in Psychotherapy 44, 19-24.

 

 

 

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Songwriting in Music Therapy

 

            When people think of Music Therapy, writing songs with deep emotions is the first thing that comes to mind. Expressing deep emotions through the practice of songwriting is a technique that is used in a Music Therapy session.  However, there are many ways to use songwriting in a session with a variety of diagnosis. In the podcast, “Music therapy and neuroplasticity: Rewiring the brain through therapeutic songwriting”, they discuss three different scenarios where songwriting was used in a music therapy session.

            The first scenario was a client with a traumatic brain injury. The client had aphasia, the loss of the ability to understand and express speech, and dysphasia, the inability to correctly form words. The client was able to communicate with a picture book but felt it made her diagnosis obvious. The client was able to sing because that portion of the brain was not damaged. The music therapist took phrases the client would need in everyday life and put it to a melody line. The client would learn the phrase, practice the phrase, and then test it out in the appropriate setting.

            The second scenario was a teenage girl who also had a traumatic brain injury. After the injury the client communicated with one word answers and would not reciprocate conversation; her parents wanted her to ease back into high school. The music therapist had the client write a song about a topic most teenage girls wish to talk about: boys. The music therapist ask the questions: who, what, when, where, why, and how; these helped facilitate the songwriting process. Once the song was completed the client then had points to talk about in conversation with other girls her age.

            The final scenario was a group setting of high school students who did not have particular friend group or a club they were a member of. These students went through a group songwriting process lead by a music therapist. At the end of the process the students recorded a music video and performed two flash mobs; one flash mob took place in police office. After the students danced with the police officers and sang their original song one student stated that the police have never had a good memory of the police and now that had been changed.

            These are all various scenarios that use songwriting as a therapeutic technique to help achieve a variety of therapeutic goals.

 

 

        -Dana LaValley, Music Therapy Intern

 

Music therapy and neuroplasticity: Rewiring the brain through therapeutic songwriting. (March 25,

         2017). Collective Music Therapy. Retrieved from: 

         https://m.soundcloud.com/collectivemusictherapy/cmt-podcast-ep15

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The Dangers of Unreliable Sources

When I typed in “Music Therapy” to Google, one of the first articles that came up talked about the “dangers of overestimating music therapy.” This immediately caught my attention and I was curious to see what context this article had been written under. The article discusses the “Alive Inside” documentary from the “Music and Memory” program. This raised some red flags for me for a couple of different reasons.

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The biggest thing is that “Alive Inside” is not clinical music therapy. It is pre-recorded playlists administered by a nursing home employee through headphones and an iPod. There is a lot of confusion about this because music therapists and renowned supporters of music therapy appear in the documentary. The American Music Therapy Association created a fact sheet outlining the differences between the music and memory program and clinical music therapy. They spell out the differences in how music is experienced, what training is required, how outcomes are reached and advantages to both programs. They conclude that, “Music and Memory and Music Therapy are complimentary. Both Music Therapy and Music and Memory serve to maximize the amazing power of music to reach deeply into the lives, minds and hearts of those who often cannot be reached in any other way.” So, while music and memory is not music therapy, they don’t completely oppose it. The key is knowing the difference and being able to advocate for clinical music therapy when others are using the term inappropriately.

It also was surprising to me because the author of this article must have not done a lot of research before writing this article. If he would have gone on the AMTA website, he could have quickly learned that clinical music therapy is done by board certified professionals. He calls it music therapy, which is deceiving to people reading the article that also aren’t aware of the music therapy profession and board certification required to practice. As music therapists, we must advocate for our profession and have to educate others that have received incorrect information. This article, like many others, unfortunately pushes our advocacy efforts back and makes our uphill climb even harder.

Lastly, it makes me worried that this is one of the first exposures to “music therapy” someone may have when looking to learn more by going to the Internet. Many people will never have a first hand experience with music therapy and are forced to rely on online sources. While there are a lot of reliable sources out there, there are also always going to be unreliable sources as well. All we can do is educate others and advocate every chance we get for the amazing profession of music therapy.

All of this to say, be careful about your sources of information and never stop advocating for the field of music therapy!

 

-Lauren Booke, Music Therapy Intern

Article: “The Dangers of Overestimating Music Therapy” Steve Swayne

 theatlantic.com

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