Structure in Music

            This week, I will explore the last of the 3 foundational principles of music therapy: “the utilization of the unique potential of rhythm to energize and bring order”. Many people who suffer from physical, mental, or emotional impairments struggle to perceive or understand their internal and external environments, which may result in the inability to control behaviors or respond to stimuli in appropriate ways. Music, being an extremely structured and organized form of expression, can be an effective tool for helping individuals establish the order that is so necessary to their well-being. According to Peters (2000), music can help “attract and sustain attention, elicit and organize response, and provide an example of ways to make beauty and order out of chaos” (pp.59). Music therapists have the opportunity to carefully choose, manipulate, and organize musical elements in a way that encourages clients to move from a state of chaos to a state of order.

Firstly, music is a multisensory experience. From the sound waves to the physical vibrations, music can be experienced through numerous sensory channels. Because of the multisensory nature of music, it attracts the attention of individuals rather easily. Furthermore, it can sustain that attention due to the fact that music is a real-time experience that requires “moment to moment commitment” from participants (Stevens, 2000, pp.60). For example, the sound of a xylophone being played by a music therapist may draw the attention of a child. Once the child decides to pick up a mallet and play the xylophone herself, she must continue playing in order to continue receiving that auditory input; if she stops playing, the music stops. As summarized by Stevens (2000), “after the rhythms, sounds, and melodies attract and individuals attention, the time-ordered structure and experience of music help hold that attention, providing an environment or structure in which growth and learning can occur” (pp.60).

Furthermore, the multisensory nature of music gives clients many opportunities to become involved in the experience. Individuals can respond to music through “auditory, visual, tactile, and kinesthetic channels” (Stevens, 2000, pp.60).  These responses can include anything from turning a head towards the source of music, picking up a mallet and hitting a drum, vocalizing with music, to dancing or moving to a steady beat. There are countless opportunities not only for music to reach clients but for clients of all abilities to respond. A client who may struggle with one particular sensory mode may be able to receive stimulation or respond through a different sensory mode offered by music. Music is versatile, accessible, and adaptable, which makes it an efficient therapeutic tool.

For many of the children I work with, flexibility and creativity are two major goal areas. Musical improvisation is a great way to encourage spontaneity and exploration within the confines of a provided musical structure. For example, the music therapist may play a chord progression on the guitar as the child engages in improvised play on the xylophone. The music therapist is providing structure both melodically and rhythmically with the guitar which makes the child feel more comfortable with exploration. Although the child is creating music in the moment, he or she still feels contained by the therapist’s musical accompaniment.

The structured and orderly nature of music makes it a natural and efficient choice in therapy. There is so much opportunity for growth and development within the confines of music, and that is what makes music therapy such a beautiful and effective experience! In the words of Stevens (2000), “for the child whose world is often a confusing chaos, the order of music is a welcome structured experience in which the child may feel free from confusion and safe in the ability to predict the activity and the person associated with the music” (pp.60).

-Alaina Brommer, Music Therapy Intern

References

Peters, J.S. (2000). Music therapy: an introduction (pp. 59-60). Springfield, IL: Charles C. Thomas.

When Work Feels Like Play

Self-Esteem in Music Therapy

The second of the three foundational principles of music therapy is the bringing about of self-esteem through self-actualization. One underlying goal that we are constantly working on with our clients is increasing self-esteem. In order for children to be able to relate successfully to other people and become functional members of society, they must first obtain a certain level of self-awareness and confidence.

Two pioneers of the music therapy field, Paul Nordoff and Clive Robbins, explain the process of developing self-esteem through music as the “awakening of the music child”. They define the “music child” as the innate sensitivity to music that is present in every human being. Essentially, there is a “music child” hidden in each of us that has the potential to connect with and grow through music. They explain that the awakening of the music child through active music-making “increases the individual’s self-awareness and allows an individual to discover meaning and joy in the therapeutic experience, which leads to developing communicative intention in his or her musical response” (Darrow, 2008, pg. 64).

Music is an extremely versatile tool that is an effective medium through which to develop and foster self-esteem in children. Firstly, music is a means of self-expression. Since it can be both a verbal and nonverbal form of communication, it provides many opportunities for the expression of emotions and feelings. Perhaps a child comes to music therapy after a long day at school; the child is feeling frustrated because he has been unable to understand the academic concepts taught in his classroom. During improvised instrument play on the xylophone, the child plays extremely fast and loud; he is able to release his feelings of frustration through instrument play. Music is a safe and non-threatening way for children to engage in emotional expression.

Secondly, music activities are “very adaptable and can allow for success at many different levels of achievement”(Peters, 2000, pg. 60). For many children, music is something that is not only enjoyable, but it is something in which they can succeed. A child who struggles with academics or communication or socialization may find great solace in the feeling of accomplishment they enjoy when they engage in music. As music therapists, it is our job to set our clients up for success. We craft each intervention with the clients’ abilities in mind, ensuring ensure that they will experience some level of success in each session. When teaching new skills, we begin with low expectations before we begin to challenge the client. By allowing them to experience initial success, we increase their self-esteem and the likelihood that they will re-engage in the future. We use prompts, cues, visual aids, and even adapted instruments to give support to our clients and guide them toward success.

Lastly, music therapy provides a safe environment in which the clients can explore their talents and abilities as they learn more about themselves and begin to develop self-esteem. In music therapy, we often provide our clients with opportunities to make choices. Giving children the opportunity to be in control in a safe environment will help them build confidence in their leadership skills. Perhaps we ask a child if she would like to play piano first or drums first; neither answer is wrong! The child gets to make a choice encouraged by the knowledge that there is no wrong answer. Consider a drum improvisation between a therapist and child. The child gets to choose if he will drum fast, slow, loud, or soft, and the therapist matches his choice. By constantly providing our clients with choices, we are helping them become more comfortable with independence. They can learn to make decisions and take the lead in a safe environment with the guidance and support of a therapist.

            Twice a year, our clients have a chance to perform in a recital for their friends and family. This is a culmination of the practice and process of engaging in music therapy interventions. By performing in these recitals, our kiddos have a chance to showcase their abilities they have worked on so hard on to achieve. Each recital, we see the confidence and self-esteem grow in our kiddos as they create and present wonderful music for the community to see!

- Alaina Brommer, Music Therapy Intern

References

Darrow, A. (2008). Introduction to approaches in music therapy (pp. 64). Silver Spring, MD: American Music Therapy Association.

Peters, J.S. (2000). Music therapy: an introduction (pp. 60). Springfield, IL: Charles C.    Thomas.

Interpersonal Relationships Through Music Therapy

March is Music Therapy Awareness Month! In honor of this, the Therabeat Team is spreading awareness by answering the questions: what is music therapy? why is it effective? I will be dedicating the next few blog posts to the three principles that form the foundation of music therapy and help to explain why music therapy interventions are so effective. According to Gaston, the “father of music therapy”, the following 3 principles are the primary source of direction in music therapy:

1. The establishment or reestablishment of interpersonal relationships

2. Bringing out self esteem through self-actualization

3. The utilization of the unique potential of rhythm to energize and bring order

For this week’s post, I will discuss the first principle: the establishment or reestablishment of interpersonal relationships. One of the criteria for becoming a functional member of society is developing the ability to successfully relate to those around us. This can be a difficult skill for anyone to learn, but especially for those who struggle with developmental delays or other disabilities. Luckily, many of the skills we use in human interaction can be accessed through music! In the words of Gaston, “Music, by its very nature, draws people together for intimate yet ordered function” (Peters, 2000, p.60).” In music therapy, we create musical experiences between two or more people (either client and therapist or client and other clients). These musical experiences provide opportunities for clients to explore communication and interaction.

There are several reasons that music is an effective mode to foster important interpersonal skills. Firstly, music serves as a unifying influence. When multiple people are making music together, the music serves as the common experience. This unifying experience can open the door to the establishment of relationships.

Secondly, music creates a non-threatening environment. For some kids, social interaction can be scary and unnatural, but playing a drum with another child is fun! Music is a safe, familiar medium through which we can practice and develop interactive skills. Music is something that is relatable and enjoyable to most people, which is something we can take advantage of as music therapists!

Lastly, music can provide many opportunities for nonverbal communication, which can eventually lead to verbal communication. Musical imitation, for example, “initiates a nonverbal form of communication, perhaps, an approximation of positive interpersonal interaction” (Hanser, 1999, p.62). As a child bangs a drum loudly, the therapist matches with a loud choppy strumming pattern on the guitar. A musical interaction as simple as this can be the beginning of the formation of an interpersonal relationship. By matching and imitating the musical choices of the children, we are validating their contributions to the musical “conversation”. Experiences such as this can build trust between the therapist and client and can also instill a sense of confidence in the child.

I had the privilege of seeing this principle at work last week during a session between one of our music therapists and a child with Autism Spectrum Disorder. Children with ASD often struggle with developing appropriate social skills and establishing meaningful connections with others. In this session, the music therapist and child created a musical puppet show together during which the child had the chance to improvise a song. As the child made musical choices in the moment, the therapist supported her musically on guitar. The therapist’s guitar music provided structure amidst exploration and spontaneity. This improvised song was a musical experience that brought unity and synchronicity to the therapist-client relationship. As the client continues to partake in musical experiences such as this one, she will begin to transfer the skills she is learning through music to non-musical situations and to relationships outside of the music therapy session.

This is just one example of the many ways we use music to help our clients learn to establish interpersonal relationships each day. In summary, “through participation in carefully structured therapeutic group music activities, individuals can gain insights and skills that will help them relate more successfully, appropriately, and responsibly towards others” (Peters, 2000, p.61). Stay tuned for next week’s post on Principle #2: bringing out self-esteem through self-actualization!

-Alaina Brommer, Music Therapy Intern

References

Hanser, S.B. (1999). The new music therapist’s handbook (pp. 62). Boston: Berkeley Press.

Peters, J.S. (2000). Music therapy: an introduction (pp. 60-61). Springfield, IL: Charles C.    Thomas.

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.

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.