I’m a Believer (in the transformational design model)

As music therapists, advocating for the profession is an incredibly significant aspect of the job. While it’s nice to be considered a “happy music person,” there’s much more to the job description than just playing feel good music for others all the time! Now enter *drum roll please* the Transformational Design Model.

The Transformational Design Model (TDM), designed by Dr. Michael Thaut, provides a system for translating the scientific model to functional music therapy practice, specifically in regards to Neurologic Music Therapy. There are five steps to the model including:

1. Diagnostic and functional assessment of a patient or client (find client strengths and weaknesses)
2. Development of therapeutic goals/objectives
3. Design functional, nonmusical therapeutic exercises and stimuli
4. Translation of step 3 to functional therapeutic music experiences (incorporate music interventions to address the goals)
5. Transfer the therapeutic learning to functional, nonmusical real world applications (generalize)

Piggybacking off the song “Believer” by Imagine Dragons to list the 5 steps of TDM during symposium

The TDM is beneficial because of its functionality. It provides the ability for music therapists to address a client’s nonmusical goals (ex: social, emotional, cognitive, motor skills) with music interventions. In other words, TDM provides a model for music therapists to efficiently translate the scientific model by applying music to achieve the therapeutic goal. The TDM is significant in terms of advocacy because it puts the focus in the specific goals and objectives of a client, which can be assessed and measured, and less on the music activity presented. Music exercises that are isomorphic, or similar in structure, to non-music exercises are incorporated into a session so the goals (socialization, mood vectoring, gait training, etc) can be addressed and interventions chosen by the therapist are validated.

Here are examples of an activity-based approach in comparison to one based off of the TDM:

1. ACTIVITY BASED APPROACH: The music therapist chooses a popular song that the client knows. After choosing the activity, the therapist then decides that playing the piano can be helpful in improving finger dexterity and fine motor skills which can be beneficial for the client to improve upon.
2. TDM APPROACH:
   1. The music therapist assesses the client’s strengths and weaknesses, noting that the client appears to have minimal dexterity.
   2. The client shows need for improvement with muscle tone, fine motor skills and coordination with the fingers and hands.
   3. The MT may collaborate with other disciplines to determine if they have similar goals for the client and how they are addressing said goals in their therapeutic practice.
   4. At this point, the MT decides that incorporating a piano playing activity in the session plan may be a beneficial intervention for reaching the client’s goal/objective.
   5. The MT can then generalize ways for the client to apply the skills learned by playing piano in the session to the client’s daily life.

As music therapy is an evidence-based practice, the TDM is a model that helps make sure the goals and objectives of each client that need to be addressed are actually being addressed in the therapeutic setting.

Thaut, M. H. (2008). Rhythm, music, and the brain: Scientific foundations and clinical applications. Abingdon: Routledge.

Until next time,

Katherine

Transforming your Interventions: The Transformational Design Model

The Transformational Design Model: 

Have you ever felt lost for how to address a certain goal with a client? Maybe you’ve never worked with that population before, addressed their specific goals, or are simply at a loss for inspiration? This past week I learned about one of the most useful models to make sure every intervention is functional and effective, called The Transformational Design Model (TDM)!

The Transformational Design Model, developed by Dr. Michael Thaut is a system to help therapists translate research into functional clinical practice. It ensures that each intervention is backed by research and intentional goals, which in turn brings the best results for clients! This model also ensures interventions are generalizable back to the clients daily life, which is an essential part of the process. It emphasizes a patient-centered rather than discipline-centered therapy and also helps music therapists to avoid two weaknesses: 

1. An activity-based approach in which generic musical activities are adapted to therapeutic goals 
2. The use of therapeutic music techniques that address therapeutic goals very broadly and generally, and are only weakly related to functional therapeutic outcomes

There are five parts to The Transformational Design Model: 

1. List the client’s strengths/needs
2. Write out one goal/objective you would like to focus on (based on their needs) 
3. How this goal/objective would be addressed by a non-music therapist (speech therapist, physical therapist, teacher, etc.)
4. How could you add musical stimuli to that exercise? (don’t just write a music experience-add music to the experience above). 
5. How could you generalize back to the normal environment? (fade the music)

Example TDM: 

1. Strengths & needs: Client has great rhythm and songwriting skills, and loves creating new songs. Client needs improved emotional awareness and coping skills for handling difficult emotions
2. Goal: Increase ability to calm down when upset 
3. Non-music therapist: Drawing out what how to calm down, writing a poem or brainstorming ideas 
4. Create a songwriting intervention centered around coping strategies and ways to calm down when upset. Music helps to concrete these ideas in one’s mind and makes them easier to draw from memory when a situation arises. 
5. Generalization: Create in session scenarios to practice calming down and using techniques written in song. 

 

This model is so helpful for going back to the basics and making sure that your interventions will make a real impact on your client! 

I hope this model is helpful for you!

• Audrey Cosgrove, MTI

No Therapy Is An Island

You’ll hear music therapists tell you time and time again, “Music therapy is an EVIDENCE BASED field!” What we do it backed by empirical research, and we’re very proud of this fact. However, the fact that the field is supported by research showing the efficacy of using music as a therapeutic tool for accomplishing non-musical goals does not make music therapy a lone-ranger in the world of therapies. There’s a key phrase I used in the previous sentence: “non-musical goals”. This means that the goals we are addressing in music therapy are similar to the goals our client’s are working on in their other therapies (speech, occupational, physical, behavioral, and cognitive rehabilitation therapies, etc.). So, in the Neurologic Music Therapy branch of our field, in particular, when setting up our interventions for addressing a non-musical goal, we like to use a model called the Transformational Design Model (TDM).

Transformational Design Model! It sounds like a superpower. And in a way, it is. It’s the superpower model that transforms non-musical interventions into musical interventions. Because music therapy has the same functional structure as other therapies, music therapists use this model to see where the overlap is with other fields, and then how the addition of music to a treatment intervention can benefit the client. But wait, there’s more! This superpower model transforms the functional music intervention into functional, non-musical real-world application. In short, we’re not going to let you walk around singing the steps to making conversation. We’re going to help you generalize the information you learned through music, so that when you apply it to everyday life, you’re doing it in a socially acceptable and sustainable (functional) way.

I know you’re dying to find out how one mere mortal can acquire such a superpower. Well, lucky for you, we can let you in on the bare bones of the model. I take myself through these steps every time I develop an intervention for a client, and it helps ensure the quality and efficacy of my interventions. Ok, are you ready to be transformed?

1. Asses the client’s strengths and needs
2. Develop the goals and objectives
3. Research how a non-music therapist addresses this same goal and design a functional non-musical intervention
4. Translate step 3 into a functional musical intervention
5. Transfer step 4 to functional, non-musical real-life application

This model is a superpower not just in the fact that it transforms a non-musical skills into a musical experience and then back into a non-musical skill, but also in the fact that it allows multiple therapeutic fields to see their overlap. The more therapists from varying fields can work together, the more well-rounded the treatment plan becomes, and the more the client will benefit. Go transform something!

-Chiara