Adapted Music Lessons vs Music Therapy Sessions

Here at the Music Therapy Center of California (MTCCA) we do not only offer music therapy sessions but also adaptive lessons. But, you may be wondering, how are adaptive lessons different than a music therapy session, and what makes lessons adapted?

While both an adaptive lesson and a music therapy session will need to consider the student’s ability level, the focus  of each are entirely different. While the goal of a lesson is to learn an instrument, the goals of music therapy sessions will vary (e.g. speech goals, attention goals, etc.). Adaptive lessons are also different from traditional music lessons. The way in which musical concepts are tailored to fit the student’s strengths, needs and ability levels, Where the outcome of an adapted lesson is focused on learning and playing an instrument, outcomes of music therapy sessions are non-musical and focused on the process, not the product.

When a student has special learning needs and abilities, it’s important to find someone who knows how to present concepts in a way that will ensure successful experiences. Teaching adapted lessons is not unique to just music therapists. However part of the training that a music therapist receives ensures that they are well equipped to consider the diagnosis, learning needs and best practices to help students be most effective.  A music therapist will also likely have more experience incorporating multiple senses and techniques to present music concepts in a more creative way to further the ultimate goal of learning the instruments.

At MTCCA, our approach includes a multimodal and nontraditional approach to teaching. For example, lessons may include a variety of different instruments and a faster pacing of songs. If the student has challenges with fine motor skills such as finger strength and dexterity, skills necessary to play the piano, desk bells, can be a fun way to approach this skill with each finger in isolation (bells are played by pressing the button on top of the bell). Or having a student play finger cymbals or castanets, along with a preferred song, can build finger strength and develop a pincer grip (a skill necessary for writing). Once these “warm ups” are practiced, the skills learned can be transferred over to the piano.

-Noriah Uribe

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I lost it! It’s gone!: Voice-less music therapy

I lost my voice entirely for three full days, however, like in the theater, the show must go on and the job must still be done. Despite not being able to vocalize anything above a soft whisper, I still had clients who needed services. Although not an ideal situation, sometimes things are out of your control. However, thanks to the support of a few wonderful supervisors and co-workers I was able to adapt and create voice-less sessions. I wouldn’t recommend losing your voice as a music therapist, but do as I say and not as I do. So, in case you have the unfortunate fortune of this 

happening to you too, I thought I would share a few tips I 

learned.

  1.    Recorded music is your friend

As music therapists we know that live is almost always better, because we can manipulate it for our needs on the spot. However, recorded music is better than no music. It will provide a steady beat and will likely give you different timbers than you can provide on your own. So play a game of name that tune or pass out instruments and rock out to an exciting song, with a bit of hidden exercise built in. Instruct clients to follow the music as you stop and start or get loud and soft. A little pre-recorded music can go a long way.

  1.    Drum roll, please!

Drum circles are great for all populations. They encourage prosocial, motor, and cognitive functions. So, take time to drum to a few pre-recorded songs. Maybe it’s a song that relates to the season or a holiday coming. Try rhythmic imitation or build group cohesions as everyone follows a leader who changes speed or stops and starts.

  1.    Yay for TIMP and PSE

If you are familiar with Neurologic Music Therapy (NMT) techniques, I would recommend using TIMP and PSE. No verbal explanation or continual prompting is needed to implement this technique. As long as a beet is present and clients can visually track your movement, the intervention can be carried out.

  1.    Embrace your inner mime

Because you will not have no way to communicate verbally, body language will be everything. Big body movements and exaggerated facial expressions will aid in your success. Having signs or something to write instructions on isn’t a bad idea too.

-Noriah Uribe

Piano for the Music Therapist: A crash course on simple accompaniment patterns

I’ve always enjoyed the piano and revere it as one of the most beautiful instruments. Nonetheless, it is one that I am nowhere near mastering. However, this past week I was able to attend a workshop for the music therapy team at MTCCA for the piano taught by Jay Jay Lim, specifically on how to expand our repertoire for simple left hand accompaniment patterns (see photo below). We were taught several different patterns in multiple styles that could easily be modified to teach a client in an adapted lesson, or utilized by a music therapist in a variety of ways (e.g. played during a drum circle or for improvisation). Jay Jay did an incredible job at conveying how straightforward, yet effective, a few different accompaniment patterns in anyone’s toolkit can be. *

I was reminded of how something as small as having a variety of rhythms and melodies to play can enhance a client’s experience through giving them more choices and continuing to hold their interest and attention so that sessions can always progress.

IMG_1882After all, it is all about the client. As music therapists, it is our job to support our clients and help them to grow. We can offer that support and growth in musical form by providing an interesting piano accompaniment backing a song they have been working on singing to improve articulation or respiratory strength, and building confidence through that experience and process. Through this workshop my aspirations were re-ignited to continue to grow and cultivate my skills with piano so that I can be a well-rounded therapist who is able to effectively use the piano to help facilitate growth with my clients.

-Noriah Uribe

*I’d encourage you to check out the wonderfully talented Jay Jay and the work he does at Greene Music Education Center

L.H. Piano accompaniment

Haaaave you met Music Therapy?

You know when you hear someone say, “If I had a nickel for every time I’d heard that…”
Well, at the risk of sounding cliché, if I had a nickel for every time I heard something like, “Music therapy? What is that?” I’d have… more nickels.
The funny part is, even though I’ve run across countless music therapy questions during my school and intern careers, I haven’t always felt satisfied with my quick explanations. If you think about it, you only have a small window of time to capture your inquirer’s attention and leave them with a good first impression of music therapy. That’s a lot of pressure!
Fear not, music therapy friends. I have compiled some of my favorite tips, imparted upon me by some wise music therapists, for being an effective liaison to the world of music therapy. By following the presented steps, you should walk away from each of your introductions to music therapy feeling confident that you made a positive impression on your audience, established yourself as an informed authority, and that you contributed to the health of the music therapy discipline in general. Nice job.
Side note, if you feel so inclined to share or reuse the infographic, please refer credit back to The Music Therapy Center of California.
Happy music-making!
~Esther
Introducing MT Infographic

Neurologic Music Therapy (NMT) …Demystified: MACT

Musical Attention Control Training: MACT

What is MACT?

Musical Attention Control Training, or MACT, is the use of music experiences and/or musical elements to practice a specific type of attention.

To really understand MACT, we’re going to take a closer look at the “A” in that acronym, for attention.

 Attention is the selective awareness of or selective responsiveness to the sensory environment around you. The ability to choose where you focus your attention is the first step in the learning process, and we all differ in our abilities to control our attention. The good news: we can develop attention control skills like building blocks through structured practice! We can conceptualize the types of attention as a pyramid, starting with focused attention as the base:

 

 

What does MACT look like in a music therapy session?

Music therapists tailor MACT exercises to suit their clients’ interests and clinical needs. As a result, MACT can look very different from session to session or client to client. MACT exercises may entail the use of many different music-based therapeutic music experiences.

For example, music therapists may facilitate sustained instrument-playing incorporating preferred and (the ever tricky) non-preferred instruments. Alternatively, a sustained attention exercise may call for the client and therapist to play instruments while the client adjusts their playing style (e.g. fast vs. slow, loud vs. soft, high vs. low, etc.) in response to musical cues (ideally without verbal prompts) from the therapist. A music therapist may target selective attention by introducing extraneous sound “distractors” to a music experience and challenge the client not to respond to (e.g. turn head to look at) the distractors.

Alternating attention exercises may require a client to shift their attention between two tasks, like tracking visual notation (e.g. sheet music) and playing an instrument simultaneously. At the end of the day, MACT could refer to a wide range of active or receptive music experiences, as long as they are designed to practice one or more types of attention, and utilize music as a delivery medium.

How music makes it work:

Active and receptive music experiences share powerful patterns of brain activation in the bilateral frontal lobes, brainstem, and attention systems in the cerebral cortex. This overlap ensures that the attention skills practiced with music will translate to other contexts, like school or vocational skills. Furthermore, music experiences like instrument-playing, singing, or improvising are often intrinsically motivating, allowing music therapists to get our “foot in the door” to engage with clients and bolster attention skills. Finally, music, as an organized auditory stimulus, brings timing, grouping, and temporal organization so that attention can be sustained and strengthened over time.

 

Thanks for reading!

~Esther

Goals for goals!

Step one to helping our clients achieve their goals is writing a great goal for them to be successful! This can be a tedious job, as goals and objectives are intended to be precise, detailed targets. There many components to a solid goal, and each are equally important and serve a unique role. There are goal-writing checklists that can be adapted to any client and population to help us create goals that are rational and intentional.

The SMART goal checklist guides the writer through the major pieces of creating a goal. According to SMART, goals must be Specific, Measurable, Achievable, Relevant, and Time limited. The infographic below provides a bit more information about each part.

SMART goals

Let’s look at the following goal:

By December 2018, Client A will improve cognition skills by improving sustained attention through playing an instrument for 2 consecutive minutes without stopping in 3 out of 4 trials with minimal prompting (no more than 1 verbal, gestural, or physical prompt).

First is the time deadline, which is when the goal is to be achieved by. This could vary by setting. Hospitals might have shorter time frames, schools will probably line up with IEPs. In this case, the client and therapist are aiming to achieve this goal in December of 2018.

After assessing the client, we identify the specific goal area (e.g. cognitive, motor, speech, etc.), and add details of the desired skill/behavior. Do we want it to increase, decrease, maintain functioning? This describes the what of the goal. In this case, it’s cognition skills through sustained attention.

Then, we can look at the how. How are we going to help the client achieve this goal? What means of exercise or intervention will we use? And how often will they participate? Out of how many trials will they be successful? This is where we think about measurability and achievability. Here, the how is ‘playing an instrument for 2 consecutive minutes.’

Along with these components, we must also include our type and level of prompting. The prompting in this goal would be ‘minimal prompting’, and the three types of prompts to choose from are verbal, gestural, and physical. Don’t forget about the option of independency! Our purpose is to help the client achieve the highest level of independence possible, so aiming for independence is the ultimate achievement.

“Big goals are important. You should always have a clear vision of where you would ultimately like [the client] to be. But be sure to set a number of smaller goals along the way. Accomplishment drives ambition.”

– Beau Taplin

– Patty

Top Internship Learnings

Even though in some ways the 6 months felt like it flew by, I have learned so much it can be hard to put it into words, or even recognize some of the changes because my learnings have become so much a part of my daily routine as a music therapist. Below I am sharing just a few of my learnings:

I’ve learned through this internship that I have a unique ability to personally connect with others and this is also one of the parts of being a music therapist that I enjoy. I have always been interested in a career where I get to help others find success and that was one of the main reasons why I was so interested in working with students with special needs. I have also found through this internship that I am not only interested in working with people with disabilities but also older adults with memory impairment. Part of helping to guide a person’s successes is getting to know them or their family members and what their goals are. Being able to find what they respond to best is important and is a skill that I have seen grow during my internship. I feel more confident creating individualized interventions for clients, and I now have the techniques to adapt in the moment when necessary.

Secondly I have been excited about how much my repertoire has grown throughout this internship. Because I have had the opportunity to work with clients of different diagnoses and varying ages I have at least started to dip my toe in many genres of music, which I think will help me as I continue on my journey. During college classes we often had to memorize songs for tests or for practicums and I was able to do it, but I found in my internship that this skill became easier because I was using the songs I wanted to memorize on a daily basis and I felt much more successful. This skill is important because it allows the therapist to fully connect with the client and not be distracted by looking at the music or trying to remember what chord comes next. Especially in a group setting it is helpful to have music memorized because then the therapist can have more opportunities to connect with each client on an individual basis, which allows for the therapist to move around the room more. I realized about 4 months into my internship that this skill was improving and it was very encouraging me to see my progress from the beginning of my internship.

It is sometimes hard to articulate all the progress I have made, but I am so thankful for an internship where I was able to learn so many different aspects of being a music therapist.

 

Emily