Lessons I Have Learned… and More to Come

Our symposium this week was a little different than usual. Our newest intern began her first day today so we spent time giving her tips and ideas on getting through her time here. This was a great opportunity for me to reflect on the past two months I have been here and I realized how far I have already come and how much I have learned in such a short time. I remember feeling quite overwhelmed with the amount of new information to learn in the beginning, including all the NMT techniques, getting to know clients, the paperwork, and more. Within the last couple of weeks, I have realized how I finally feel more settled in and comfortable with everything that once overwhelmed me. Of course, there are many more things to still learn, but it was really refreshing in symposium to realize how far I have come.

I am really enjoying getting to know my clients better and I feel more comfortable leading interventions each week. I am even feeling more confident in understanding the various NMT techniques (although I think that will always be a work in progress to keep learning). It is exciting to have a new intern and I am looking forward to passing on what I have learned so far, as well as learning new things together. Internship requires a lot of time and energy, but it has been worth it to see the progress and excitement in our clients. The power of music is evident in our clients, and it is such a joy to share in the musical experiences with them and see how effective it is.

-Tara

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Techniques for Cognition

One of the main goal areas targeted by Neurologic Music Therapy (NMT) techniques is cognition. Speech and language goals may include to improve attention and perception, to improve memory, and to improve executive function. There are several NMT techniques to address these goal areas, and I will share a short summary of each of them and how they may be used:

Musical Sensory Orientation Training (MSOT) – the use of music for sensory stimulation, arousal orientation, and vigilance and attention maintenance. This technique is appropriate for young infants, unresponsive clients (such as those in a coma), and older adults.

Musical Neglect Training (MNT) – musical experiences designed to have clients with right hemisphere ischemic infarction (due to traumatic brain injury in the right hemisphere) to redirect visual attention to the left visual field, and to stimulate movement on the left side of the body.

Auditory Perception Training (APT) – to train auditory discrimination through differences, matching, and identification of sounds (such as high, low, fast, slow, long, short, and instrument identification). This technique is to refine and develop acoustic perceptual accuracy.

Musical Attention Control Training (MACT) – to establish and maintain different kinds of attention. The five types of attention are sustained attention (continuous attention to one stimulus over time), selective attention (attending to one stimulus out of several), divided attention (simultaneously splitting attention between two or more stimuli), alternating attention (switching attention sequentially from one stimuli to another), and joint attention (to alert another person to a stimulus).

Associative Mood and Memory Training (AMMT) – to produce mood-congruent states to facilitate memory recall, to access associative mood and memory networks to direct specific memory access, and to enhance learning and memory function.

Musical Mnemonics Training (MMT) – musical exercises to memorize short chunks of information.

Musical Executive Function Training (MEFT) – improvisation and composition exercises to improve executive function skills such as organization, problem solving, decision making, reasoning, and comprehension.

Music Therapy and Counseling (MPC) – use of musical performance to address mood, expression, reality orientation, and appropriate social interaction.

-Nerissa

Steps for TIMP

This week in symposium, we went into further detail regarding sensorimotor techniques. We did demonstrations of the NMT technique TIMP, where we paired up in groups to choose a specific movement exercise to target and demonstrated how we would incorporate music to encourage the target movement with clients. For example, my group chose to focus on an older adult group and targeting dynamic weight shifting, having the clients reach across their midline. Clients will reach up to the diagonal on one side and swing their arms to reach up and over to the other side. Considering most older adult groups are typically seated, this movement can exercise their upper bodies while sitting down.

The first step is to have the clients do the movement without music and the music therapist takes note of their natural tempo (speed of the movement). Using a metronome or keyboard with various styles of beat, the second step includes choosing a style to fit the song and setting the tempo to match the group’s natural tempo. Once that begins playing along with the clients executing the movement, the music therapist can implement the third step, playing the song. Due to the dynamic weight shifting movement being a larger motion, requiring more time to reach up on each side, recommended instruments to play the song on are Autoharp or piano. These instruments provide a longer range for the music therapist to strum or roll the chord with the beat in which the movement occurs. The work in this movement is in the reaching up motion, so the strum or rolled chords should occur in a low to high range to encourage the upward movement further. Clients can hold onto scarves as well, providing sensory stimulation to motivate the movement more.

In conclusion, TIMP requires much planning on the music therapist’s end, but can be quite effective when executed properly. The music therapist must be completely aware of the clients and focused on their motion and tempo, while simultaneously playing a song, with a particular accompaniment pattern to encourage the target movement. This also requires that the music be high quality, considering the music therapist cannot be focused on what or how they are playing, but rather on the client and matching them. In a one-on-one session or a smaller group, this technique commonly uses instruments as targets for the clients to hit, providing auditory feedback when executing the movements. For the purpose of our demonstration this week, we chose to use scarves instead of instruments, but both are effective. Although the planning and execution of TIMP is detailed, it is well worth it to see clients engaged in the various movements because of the exciting musical experience involved.

Presenting

Last week’s symposium covered public speaking and giving presentations. The team discussed resources for improving public speaking practice, including the organization and website Toastmasters. Toastmasters offers many free short videos and articles with different tips on public speaking and knowing your topic. I found these to be interesting and good reminders of things to think about when preparing and giving a speech. Some of the biggest points that stood out to me were:

1. Know your subject and your speech. You are the expert in your field, so speak confidently about your subject matter!

2. Know your audience and your space. Depending on the audience, the terminology you use may vary – for example, teachers and parents want to know different information about music therapy than neuroscientists would. Knowing your space is something that I had not considered prior to our discussion – what materials do you need for your presentation? How should the room be set up? Will all materials be provided or do you need to bring your own? These questions, if answered prior to the speech, will make the entire experience a success.

3. Never apologize. While we sometimes think apologizing gives us a connection with our audience, we need to own our information. Be confident in yourself and in your topic.

4. Imagine yourself giving a great speech. This is something I think about when I perform on violin – imagine myself mastering the hard parts, rather than getting nervous as they approach. I never thought of applying this to anything outside of violin performance, but it makes a lot of sense! Following the philosophy of “fake it until you make it” – if you believe that you will give a great speech, then you will!

5. Focus on your message, not on yourself. Don’t worry about yourself during the speech. Focus on the words and what you want the audience to know, and your personality will naturally shine through!

-Nerissa