Teach Your Children Well

February 13, 2014

I mentioned in the previous post that I have recently begun working with an early-childhood music program. O.M.G.

If you have been reading my blog for any period of time, chances are you have noticed that I work with adults. The end. I have not, since practicums in school, worked with anyone under the age of 18. So, naturally, when I was contacted by this business, I decided it was a good idea for me to jump in to work with non-adults by working with people who require me to be an entirely different kind of facilitator in a musical setting: Toddlers.

These are typically developing kids, and the music program is more of a world music and art exploration class, which is actually right up my alley (I love world music).  Parents are always present (though some have more than one child in attendance) for the entire 45 minute class, which helps with the wrangling and herding of the masses, and there is a ten minute art portion where an art teacher brings in some very creative things for the kids to paint with (on various surfaces – last week, they were painting on snow!) and they paint to whatever musical theme is explored that day. The classes run from September to June.

The first class (I keep wanting to say “session”) was a disaster. There were five children (all with parents present) and they were EVERYWHERE! The room had several structures, toys and props that were left out, which provided huge distractions, so I was definitely leading the parents in music for most of the time while the toddlers moved about the room so fast, I barely had time to get over to them with my guitar before they were on their way to another area.

The second class was better, as the administrators decided it might be helpful to remove some of the more distracting items from the room beforehand, and I actually had the attention of some of the kids!

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The third and fourth classes were both really nice, even with larger numbers of kids, and I find myself now enjoying not only the sessions, but also the minimal but necessary preparation before sessions – making playlists for the world music listening/art/free movement aspects of the class and learning SHORT songs and movement exercises that go with the premeditated world music and art themes – and getting to know the little ones. I can see, only in a few short weeks, that some are learning from our classes, those little sponges, and becoming more comfortable with me, which I appreciate, because they seem to be actively attending and participating more.  For a take-away, here are the last four mini session/lesson plans:

Waltz theme

Play “Blue Danube” before class while kids explore

  1. Learn names/introductions
  2. Greeting song
  3. “On top of Spaghetti” with Instruments
  4. Put away instruments
  5. “Chim-Chimeny” with pom poms
  6. Put pom poms away
  7. “Daisy Bell” with bells
  8. Put bells away
  9. Free movement with Scarves to “The Christmas Waltz” and “Lara’s Theme”
  10. Put away scarves
  11. Painting with coil whisks to “Waltz of the Flowers”
  12. Put away paints
  13. “The More we Get Together” – movement exercise
  14. Goodbye Song

Hawaiian Theme

Play Hawaiian music playlist* before class while kids explore

  1. Learn names/introductions
  2. Greeting song
  3. “Spread a Little Aloha” with shakers
  4. Put away shakers
  5. “Little Grass Shack” with instruments
  6. Put away instruments
  7. “I’ll Build a Bungalow” with pom poms
  8. Put pom poms away
  9. Free movement with Scarves to playlist*
  10. Put away scarves
  11. Playlist – painting with flower shaped sponges
  12. Put away paints
  13. “Lovely Hula Hands” – movement exercise
  14. Goodbye Song

Hawaiian Music Playlist

Pili Me Ka’u Manu – Israel Kamakawiwo’ole

Lovely Hula Hands (Instrumental) – Hawaii

Honolulu – Hawaii

Somewhere Over the Rainbow/What a Wonderful World – Israel Kamakawiwo’ole

 Southern African Theme

Play Southern African music playlist* before class while kids explore

  1. Learn names/introductions
  2. Greeting song
  3. “Hakuna Matata” with instruments
  4. Put away instruments
  5. “Izika Zumba” with shakers
  6. Put away shakers
  7. “Lion Sleeps Tonight” – puppets/animal sounds
  8. Put away puppets
  9. Free movement with scarves to playlist
  10. Put away scarves
  11. Playlist – painting with animal figurines’ feet (animal tracks)
  12. Put away paints
  13. No More Monkeys – movement exercise
  14. Goodbye Song

Southern Africa playlist 

Streetbeat – David Hewitt

Mbube – Mahotella Queens

Langa Mo – Aura Msimang

Kalimba – Dr. Victor

Sangoma – Bakithi Kumalo

Hendry – Tarika Sammy

Hello Hello – Mose Se Sengo

Cold Weather Theme (originally Icelandic, but no appropriate Icelandic music exists that I felt comfortable playing for toddlers)

Play Cold Weather playlist* before class while kids explore

  1. Learn names/introductions
  2. Greeting song
  3. “Frosty the Snowman” with instruments
  4. Put away instruments
  5. “Let it Snow” with pom poms
  6. Put away pom poms
  7. “Snow is Falling” – to the tune of “Frere Jacques” and with hand and body movement
  8. Free movement with scarves to playlist*
  9. Put away scarves
  10. Playlist – painting on fresh snow with brushes (blue and purple paint)
  11. Put away paints
  12. Goodbye Song

Cold Weather Playlist

All Souls Night – Loreena McKennitt

Dedicace Outo – Dead Can Dance

Between the Shadows – Loreena McKennitt

Crow Wing – Nakai/Demars

Tango to Evora – Loreena McKennitt

On the business side of things…I’m not getting paid my regular rate (what I make is based on how many kids are signed up in advance and then how many drop-ins there are, which all varies) and while that’s definitely not my favorite part of this experience, I decided before I even started that I would think of this as a class I am taking, since this is decidedly not my population (toddlers) or area of expertise (teaching). So, when I look at it that way, I am getting experience working (not as an MT) with a group of people that is COMPLETELY out of my comfort zone in almost every way, and I’m getting paid to do it, which is awesome.

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Learning to Fly: Part Deux

January 3, 2013

In September, I started a new chapter in my professional life.  With the help of a few wonderful colleagues and advocates, I was able to create an internship program based around the hospital system I work in, and let me tell you – it has been a whirlwind.

My two interns have just completed the third month of the six month program.  Yikes! How did the time go by so fast?

I’ll tell you how.

Pre-Internship

Before the internship was able to start, the universities and the hospital had to come to a contractual agreement.  This took a while. The issue was: the hospital I am working with has recently decided that it does not provide criminal record checks (CORIs) to interns.  The schools my interns are from also don’t provide criminal record checks.  Luckily, the memo didn’t get passed along to HR at the hospital, and the person in that department ran checks for us before I knew that CORIs were the main hold up. We eventually got everything straightened out, but the person in the legal department in charge of the contracts had not known that I had a relationship with the hospital prior to this, (or that project supervisor, S – a unit manager, was on my team) and had let the contract sit on their desk for over a month before it was sent to the administrators for signing.  The interns started a week later than expected, because in order for me to even set up hospital and behavioral health orientation for the interns, the contracts had to be signed.  In order for the interns to even start observing on the medical units and psych units, they had to go through said orientation and turn in their proof of immunizations, behavioral health and student rotation forms (this is something nursing students fill out so that the powers that be know where they’ll be, how often, and for how long), and get ID badges (which was a trial in and of itself).  It was painfully frustrating.

In the time that I was waiting with bated breath to hear about the contracts, I had to create a schedule for the interns, a list of assignments and readings, make a contract, sit down for IIPs (Individual Internship Plans), talk with liasons from both schools about the contracts and liability insurance, check with every single facility I work at to make sure it was okay to bring the interns with me (there are 12 facilities), send memos to the medical units explaining the brand new music therapy program to staff, and do some sessions to acquaint myself with the medical units and staff.  It was a lot of work, but I have to admit, getting my ducks in a row felt good, and with any luck, my experience this time around will make everything easier next time.

Then there was the actual internship.

Month 1 – First, we had two weeks of orientation.  This consisted of the interns coming with me to every place I go, observing and participating, engaging in discussion before, between, and after sessions, and doing various assignments. After they completed behavioral health and medical orientation, as well as the required immunizations and hospital forms, they were able to observe me facilitating bedside MT in the hospital.  After learning how to document, lead sessions in the hospital, and after a hefty amount of observing me in group sessions, they began to lead on their own.  This happened just in time for me to get violently ill and lose my voice (which I wrote about in THIS post).

Month 2 – The interns got their feet very wet leading sessions as a duo (without my direct supervision) in the hospital, and leading my groups while I quietly observed their progress.  There were a couple of misunderstandings and some personal issues that came up, but it was all productive, and all a great lesson in how to work and communicate effectively with others.  Both interns chose topics for research study – one created a survey to find out how staff is benefiting from the music therapy program (indirectly and directly), and the other is conducting research to find out what the most popular interventions are, depending on demographic information.

Month 3 – Both of the interns solidified their final projects – One intern will be starting a music therapy program at two facilities with emotionally disturbed children and adolescents, and will be meeting with the coordinator to nail down details sometime in the next two weeks.  The other intern is starting a pilot program on the hospital’s pediatric unit.  We met with the unit manager to discuss logistics, my intern sent out emails and memos to the unit managers about the program so that staff is informed, and after a relatively easy process, it will begin this coming week!  We found out about a month ago, however, that in order to conduct research having anything to do with the hospital, the interns must propose the research to the Institutional Research Board which requires six additional steps/forms/written work!  Eek!  The Board doesn’t meet until mid-February, so there is time, but it was an unforeseen obstacle.  I guess this is all a learning experience!  At least I have my trusty project supervisor, S, to guide me through the maze.  Another fun and exciting thing that happened during the third month, is that my wonderful boyfriend (a professional photographer) did a photo shoot for me!  One photo of all of us in transit is pictured above (courtesy of Chris Conti Photography).

The interns have been home for the holidays for two/three weeks, and while it has been nice to have a little break between groups, there is still a lot to do, so I’m looking forward to getting back into the swing of things on Monday.  It’s amazing how productive I have let myself be, and how well this has all worked out.

Now, onto the National Roster application…

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If you have any questions about the process, please don’t hesitate to ask!  “Like” Bostonmusiclady on facebook to get more updates.

Learning to Fly

September 16, 2012

I apologize in advance that there are a few capitalized phrases.  Rest, assured that I am not yelling at you.

Hi there!  You MUST be wondering where I have been.  For a moment, I was trying to reach a crazy goal: Write 100 blog posts by Labor Day.  I never actually thought it was possible, and now I’m happy to announce that I have…REALISTIC EXPECTATIONS.  I did not meet my goal.  Oh well.

What I have been doing is A LOT OF LEARNING.

A few months ago, I was approached by a colleague about taking on an intern. I am never one to turn down opportunities, and I have enjoyed supervising students for several years, so I said “sure!?” not knowing exactly where, when, or how this was all going to happen.  A couple of weeks later, the same colleague called me and asked if I could take another intern?  Sure! Why not.  I asked my problem-solver unit manager at the geri-psych unit how she would feel about interns, and after the enthusiastic response, I had a better idea of what I was in for.  This woman is a huge advocate of MT and is the reason I have most of the jobs I have.  She has also been trying, for some time, to find a way to provide music therapy, hospital-wide.  This was it.

So here I was a few months ago, ignorantly blissful and assuming this was not going to be hard.  I was wrong.  This is hard.

Here is what I’ve learned:

1. Bureaucracies are very difficult to work with.

2. These things take a lot of time (but if you have a person on your side who gets things done, it is a little speedier).

3.  In order to do an internship in a hospital, one needs to get immunizations, have contracts signed, do orientation, do criminal record checks, have liability insurance, have contracts signed, do orientation, have contracts signed…Have I mentioned that contracts are somewhat important?

4. The internship director (me) has to do a lot of preparation to make everything happen.

5. Funding doesn’t grow on trees, but if you can get paid to supervise somehow, it’s better.  if not, you adjust what you had planned.

6. Relinquishing some control is very important, though not easy.

7. Sometimes plans change – go with it.  And don’t cry.

8. In my case, applying to have a National Roster internship (and getting approved) will make things a lot easier next time.

9.  Asking for help is okay.

10. Being organized is key.

I will be applying for National Roster status shortly, and I was happy to notice that I meet the criteria! In the meantime, my interns start tomorrow, and I am thrilled to be starting this program!!

Wish us luck!

Never on Sunday

February 12, 2012

I wrote about my new schedule in a previous post, and while this may not be helpful in a very practical way for anyone reading, I thought I’d give everyone whose schedule is unideal for them, a little dose of hope and insight.

When I began working as a music therapist in the summer of 2006, I began with one hour of work.  It was on Sunday.  I gradually filled in my schedule over time with various regular part-time work, and per-diem contract hours – three of which also managed to snake their way into my Sunday schedule.  There were some weeks at the beginning where I would work for 13 days in a row before having a day off, and I took so many Sundays off for family gatherings, weekend trips, holidays and weddings, that I could almost see actual dollar bills flying out the window.  It was not working for me.  I have some friends who work on weekends, and that seems to work for some of them, but I have learned, as part of a mission to be more balanced, that having one day off a week is not healthy for me, and because of the amount of events that are scheduled on weekends, is is not good for my wallet either.  For those of you who are self-employed with a comfortable hourly rate, picture the paycheck from 4 hours of work.  Multiply that by 12 or 13 (or more) and subtract that from your yearly income.  OUCH!!  And that’s just from Sundays.

Anyway, after five and a half years of Sundays, last weekend marked the first in an endless series of Sundays where I will no. longer. have. to. work. I woke up late, ate a leisurely breakfast, took a five mile run, took my dog for a thirty minute walk, painted a picture, paid some bills, blogged, and then my boyfriend and I had a friend over to watch the Superbowl.  It was everything I thought it would be.  Almost.

The thing that I didn’t expect, was that I wouldn’t know how to utilize all my newfound free time!  After my run, walk and subsequent shower, I had no idea what to do with myself for the three hours until the big game (which I really couldn’t care less about) and it made me tense.  I asked my bf what I should do, and his suggestion was for me to paint (I used to do this all the time).  I haven’t painted in so long that I forgot it was a option!  Painting, making homemade cards, writing, composing, coloring and drawing were things that I only had one day to do, and usually that day would be taken up with hours of hiking in the woods with the dog, trips to the grocery store, cleaning the apartment and making meals.  I enjoyed those days, don’t get me wrong, but I definitely forgot about all the OTHER stuff I used to enjoy, that I really haven’t had any time for over the past five and a half years.

I realize that this is a wonderful adjustment to have to make, but it’s still an adjustment, no matter how ecstatic I am to be experiencing it.  I expect that adjustments are a constant part of our lives, and that the better we deal with them, the happier we’ll probably be.

In one of my facilities, I work with well elders.  Some of them have a zest for life and have come to accept their disabilities or hardships as inevitable while still carrying on an optimistic and realistic existence.  Others remain in the past, however, pining for their younger days, and having quite a hard time with the realities of aging.  This may be a repetition from a previous blog post, and I’ve been told that I should “wait ’til you’re MY age,” to go jumping into an attitude of invincibility toward the frustrations of aging,  but I like to think that my positive outlook and my awareness of what will eventually happen to me will prepare me for the less pleasant adjustments I’ll need to make later in life.

Now back to the good adjustments, and my second Sunday off…

Try to Remember

February 10, 2012

I have publicly reminisced quite a bit about an AL I used to work at that was designed specifically for people with dementia.  There are two units, one early-mid stage and one mid-late.  When I left, I had a hard time explaining to the early-mid stage residents why I was leaving, what I was leaving for, and where I was going instead, so I haven’t gone back.  While I missed them a lot, I didn’t want them to go through the good-bye all over again and feel deserted, so I never visited.  Since then, I have been supervising students at this location (without being an employee there) and we have a fabulous time on the mid-late stage unit, which is coincidentally the only floor which fit into my hectic and scattered schedule.  Until now.

Today I had my first session on the early-mid unit in almost two years.

Two residents, both of whom have non-Alzheimer’s type dementia, remembered my name.  I was shocked.  One other resident, who I was once very close with, and who was my original Jewish music and language influence, didn’t seem to remember me at all, which I wasn’t surprised or hurt about.  Before the session (which happened to be based around drumming – I can’t get away…) I said to the entire group, “My name is ____, and I actually used to work here a long time ago, so if I look familiar, that’s why.”  Out of the corner of my eye, I saw this resident, G, looking at me and nodding her head enthusiastically.  I felt relieved for some reason – not that it would matter if she hadn’t recognized me – and it made my day.

What made my day even better after that, was at the beginning of our drumming group hello song, “Funga Alafia,” when the three residents (including G) who I had known two years ago remembered the words without so much as a tripped syllable.  I taught them that song four/five years ago, and they still remembered it after possibly not hearing it for two years.  The brain is an amazing thing.  Everyone else in the group eventually picked up the melody and lyrics as well, but it was G who surprised me the most.  We did the “Great Day” song which I posted about here, and she remembered my lyrical adaptations, and the rhythmic cadence following each verse.  We did a sculpting exercise (which I’ll post about in my next group drumming series post) and despite an obvious decline since I last saw her, G was able to participate fully and without prompts, as if the last time we had done that kind of thing was last week.

My favorite thing about today, was that it reminded me of a myth that needs major busting:

“People with Alzheimer’s can’t learn new things.”

Ease on Down the Road

January 18, 2012

In two weeks I’m leaving a job I’ve been at for four and a half years.  It’s at a nursing home in the Boston area and while I love the residents I work with there and have become very attached to some, it’s become a twice-weekly reminder that we do not care for the elders in our country with the right priorities.

There are other reasons why I need a change, but that’s all I’ll say for now, because this post is actually about the transition I am helping to create with the music therapist who is taking over my position.

I gave almost three months notice, and while I’m no Mother Teresa, I admit I feel some responsibility, not only to the residents I work with but also to the person replacing me, to ease everybody into my absence smoothly.

So…for the past few weeks, my lovely replacement has been attending my groups, meeting my clients, learning their favorite songs and asking priceless questions about technique and interventions, as well as exhibiting a wonderful personality that fits into the group dynamics well (If you’re reading this, L., I really mean it).  What’s interesting about all of this is that she wants feedback, which I am comfortable giving because of my love for supervision and, I feel like I’m training someone, which wasn’t my original plan but seems to be working out quite well for everyone involved.

Today she and a Master’s level expressive therapy student (who has been observing my group for several months) led the entire session and my residents really seemed to enjoy it. They have always loved it when I’ve had students in my groups and I think the fact that a familiar face (ET student) will still be there after I leave, and that my replacement is able to spend so much time with them before I leave, is hugely helpful for them.  Some of them have known me for nearly five years and have voiced their sadness that I’m leaving, but seeing them so enthusiastic and open to the new MT makes me feel like a giant load has been lifted off my shoulders, and makes me feel less like I’m abandoning them.

When it’s time to ease out of a job, thinking about everyone involved may be inconvenient for us, but it’s worth it for them.

My advice is this: When quitting a job, if it’s possible for you to prepare your clients, co-workers or supervisors for your absence with good feelings, peace of mind and a smooth transition, do it.  It makes all the difference in the world.

 

I’ve been telling my self for years that I don’t need an advanced degree.  Here’s what my monologue usually sounds like:

Picturing all the future reading I'll have to do hurts my head...

“I’m a clinician.  I’ve been working on building a client base forever, and  the people who work with me have passed my name to others and know what my skills are.  If I got a Master’s, the only thing that would be different is that I would have a Master’s!   At this point, for the population I work with, I can charge pretty much what I want per/hour, so my pay wouldn’t increase, and all it would do would create more debt in my debt-filled life.  ALSO, since I would want to keep working, getting a Master’s would basically be like going to work all day and then also working all night.  Is it worth it?  I’ll revisit the idea in two years.”

 

Here’s a little update, and some things that have changed since the last time I ranted at myself about not going back to school:

I have realized that I don’t necessarily always want to ONLY be a clinician.  I want to teach college students. I want to counsel people with aging family members, learn more about gerontology, and learn more about my own field so I can better do my job.

Most of those things require me to get a Master’s degree, but where do I begin?  Based on my statements prior to this paragraph, there are many possibilities.  Do I want to go to school part time?  Do I just want to take one class per semester and just chip away at the degree?  Do I want to get a Master’s from an inexpensive online program to save myself the debt, or do I want a brand-name school to teach me?  What I’m finding is that there are more questions than answers at this stage of the game.

Any advice?

Our Lips are Sealed

December 31, 2011

Part of the fun of meeting famous people is that you can tell everyone that you met them, right? Well, not if you work at a health care facility where they are admitted and you are under strict ethical and legal restrictions prohibiting you from mentioning anything at all.

I met someone famous recently at one of my many contracted facilites. I know all of you reading this want me to tell you who it is, and believe me I want to. I just can’t. I can’t even tell you if it’s a male or female, what their age is or why this person is famous. Bummer. But… rules are rules, and if we didn’t keep these secrets, you know that pretty soon everyone would know not only the physical whereabouts of the person, but also private medical information about the person.

I certainly don’t want that to happen.

This doesn’t just happen with the rich and famous, however. I work at a psych unit near where I grew up, so occasionally someone I know will be admitted to the unit. The first time it happened, I was very freaked out, but I kept my cool and only said hello to the person. I didn’t look at the person’s chart (I was curious about the dx but didn’t give in to temptation) and I decided I would only have a conversation with that person if they approached me. Another person was a family friend, and I had to approach the person to let them know that I wasn’t going to look at his/her chart, let alone tell my family about it (I “found out” later from the fam that this person had been there).

In past posts, I have been very careful to keep people’s information a secret. I use clients’ first initials, but sometimes I change the initial depending on the setting. I may mention diagnoses at times, but because I don’t mention the person’s name or the names of the facilities I work, it is almost impossible for anyone, anywhere, to ever know who I’m talking about. The world of HIPAA regulations and patient confidentiality makes it illegal for me to talk about patients in a casual sense, but I’m wondering where the line is.

I was recently at the annual AMTA (music therapy, not massage) conference and attended several sessions where other professionals mentioned names (first names), diagnoses, facilities and generally private information about individuals. These were anecdotes about our work, and while I’m not offended or bothered by the way in which some of my colleagues mentioned their clients by name, I have to assume that the clients may not have appreciated it had they known. Was it okay because it was at a professional conference? Was it okay because most of the people in the audience were music therapists? Had the presenters gotten permission to use the names of their clients at the conference? All good questions, some of which I wil never know the answers to. I am only concerned because of my own boundaries and personal ethics.

Something else came up recently, also at the conference, that is currently haunting my blog and may be one of the reasons that I haven’t been posting as much recently (sorry, faithful readers!). My (very cautious) internship director of old is publishing a book of some past interns’ weekly anecdotes about clients who taught us something. I was notified that one of my “patient highlights” was in the running to be used in the book, and is it okay if they use it (?). Of course it is. Would I have ever known that it was mine if I read the book without being asked? Probably not. Would I have cared? Probably not. Is my name on it? No. Was my patient’s name on it? No, but his diagnosis was and the unit he was admitted to in mid 2006. Even though this patient has long since been discharged from the hospital, and no real identifying information was given in my paper, the people working on this project had to ask permission from the hospital to use the information that was there.

Question: If that project is following ethical and legal guidelines, then how ethical is the information I put in my blog?

I hadn’t thought about this until the conference, but I haven’t been able to get it out of my head. Because of this, there are three or four posts “on deck” that I haven’t posted because I’m worried about being unethical. I did go to a “privacy in social media” session at the conference hoping to get some validation or at least some clear guidelines, but it was just about facebook’s ever-changing privacy settings, and professionalism on the web, not ethical boundaries in social media. New regulations and ethics considerations have arisen because of the world’s use of the internet and social media to talk about formerly unknown or uncommon topics. Is the information I’m giving too telling? Is a client going to find my blog and know I’m talking about them? What is the line between presenters at conferences talking about their clients using first names, ages, where the client resides and diagnoses and me writing about my clients in a profession-based blog? I haven’t decided yet. Any thoughts?

Let’s go back to my famous person from the first paragraph. Something that has made this all more difficult is the fact that other people, other clients at this place, know who this person is and have told their family members of my client’s whereabouts. The family members come in for a visit and seek my famous client out to chat. These family members don’t have as great a responsibility to my clients as I do, so who’s to say that they’re not going home to their spouses, friends and coworkers and letting them know who they met earlier that day? In this case, does it make the boundaries more relaxed? Does this mean that eventually it will be okay for me to talk about it with my friends, boyfriend, family and coworkers? If it ended up in the news, would it be okay then? What about if I was finding out about this from random people I meet? There are such gray areas surrounding the topic of client confidentiality, and it seems like no matter how hard I try, I can’t understand where certain lines are – not only in blogging – though if I have a nagging question about whether something is ethical, I generally put that post on a shelf and wait for an answer from somewhere.

What about clients who have passed away? Their obituaries are in a dozen newspapers all over Massachusetts stating where they lived for the last ten years of their lives, who their family members are, sometimes what they had been suffering from, and their age and background. At what point would I be allowed to talk about the person as a person, instead of an initial, if ever?

I don’t need to talk about my clients – any of them. All I want is to talk about instances that may be of interest and provide education to other people in my field or a similar one, but is my desire to share useful information compromising my ethical standards and boundaries? I am very intentional about how and when I share information, but is that good enough?

When and how do the gray areas turn into something clearly defined? What can we ethically say in conversation and/or public forums?

Discuss (for real).

Georgia on My Mind

November 30, 2011

Foreword: Before I go on to rant and rave, I must apologize to all my faithful readers (some of whom will appreciate this post more than others) for being MIA from blogland for the past two weeks.  There really isn’t an excuse other than, “getting back into the swing of things after being away was harder and more overwhelming than I thought it would be.”  So I’m sorry.  And I’m back.

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Welcome to Atlanta, where the playaz play.

For starters, I thought about using the song “Welcome to Atlanta” by Jermaine Dupris as my blog post title, but upon looking up the lyrics, decided against it.  Good call.

Last weekend I was in a place where no one asked me what music therapy means – where drums, maracas, guitars and everything in between seemed to be everywhere and not looked at by passers-by with questioning eyes – the AMTA annual conference.

Since I became board certified and joined AMTA (the American Music Therapy Association) five years ago, I have gone to four national and four regional conferences.  Conferences are energizing, motivating and often a good time to catch up with MT friends who live far away.  This year, the conference was held in Atlanta, and I must say, even though I wasn’t able to go to the Coca-Cola museum [insert animated sad-face emoticon here], it was a great time.

Here are some things I learned and re-learned:

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Reunions are important.

Not only are reunions enjoyable for many reasons, but they are also great networking opportunities.  My internship from years ago has a reunion every year at the conference, and I always get new ideas, meet new people and make new professional connections.  Regarding the fun of reunions – one particularly enjoyable part of reunions (for me) is seeing all of my past students who are all entering or leaving their internships (a little shout out, past students – great to see you in GA).

Sessions led by non-MTs are a toss-up.

In two presentations I attended, it was suggested that music has an effect on our brains.  (!!!!!insert sarcasm here!!!!!) This is true.  This is also the most obvious fact, ever, to music therapists, and really doesn’t need to be reiterated at a music therapy conference, to people who learned that in the first semester of college. I was also informed that the way to find work in mental health facilities is to volunteer at different places for a half-hour or an hour per week.  (!!!!!insert palpable silence and blank stares here!!!!!) We make music therapy our careers.  This is not only a thing we love to do and are passionate about, but it’s also our job.  We have to make money doing it, or we can’t pay our bills.  Not to say that there’s anything wrong with volunteering in the more general sense of the word, but since half of the country thinks music therapists are uneducated volunteers, it would probably be beneficial to our field if we got paid for what we did.  That all being said, doing a promotional session or in-service at a facility certainly doesn’t hurt, but that’s purely for marketing and not meant to be the final solution. There was also a session where I felt that I was being sold a product,  instead of being taught about real-life applications, and in the hour that I remained in the meeting room I not only didn’t hear or see the product used, but I felt like I was being preached at about music therapy and its significance in health care.   We are music therapists, and we were being told how important music therapy is.  Talk about preaching to the choir…

7:30 AM is too early [for me] to be learning.

If you have been to MT conferences, you know that getting sleep while still going to sessions and enjoying all of the later-night festivities is very difficult.  There is music happening literally until 2 AM some nights, and there are parties, reunions, concerts, performances and open-mic/cabaret events to invest energy in.  7:30 AM is too early, in that regard, but the issue with starting sessions later every morning (there aren’t 7:30 sessions every day), is that the conference is only a few days long, and because it’s expensive to attend, I want to squeeze as much learning in as possible.  Getting enough sleep never happened at conference this year, and I realize that it’s okay because… Note to self: conference isn’t a vacation or a time for rest.  It is fun, but it is not a relaxing or restful time.

Location, location, location (does matter).

In the past six years, four out of the six national conferences were held in the mid-west. They were all in great cities, don’t get me wrong, and I still learned a ton and managed to have a great time with my friends I never see in two of those mid-western hubs.  I know that the mid-west is in the middle of the country, and that conference location bids are a factor, but it just doesn’t seem right that the scale has been tipped in that region’s favor, even considering the prices of certain locations. And…next year, the conference is an hour west of Chicago.  Mmmkay.  On a happier note, last night I had the pleasure of experiencing Pittypat’s Porch (a great southern restaurant based on a character in Gone With the Wind) which was an appropriate way to end a nice weekend in a fun city.

Keynote speeches are usually worthwhile.

Kenneth Bruscia – a guiding presence in the field of music therapy and the author of books that we all read in college, was our keynote speaker this year (that introduction was just for you non-MTs).  Not only was he funny at all the right times, but the content of what he was saying was valuable and also easy to grasp.  What I learned from Kenneth Bruscia, is that thinking of music therapy sessions in only one way is dangerous and counter-productive.  We all have to be more flexible in our expectations of how sessions are supposed to go, or our clients won’t benefit.  There was more to his speech, but that’s a little teaser for ya.

Lifetime Achievement takes a while.

I am blessed and fortunate enough to have been mentored and taught by two amazing women who have also won lifetime achievement awards from AMTA (one of whom won the distinction at this conference!).  When I think of all both of them have accomplished, I am humbled, and I realize that that kind of recognition only happens after years of really hard work, motivation and passion.  Regardless of a Lifetime Achievement Award,  I hope that in 30 years, I am able to look back with no regrets and be proud of myself for all that I’ve accomplished.  Someday…

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This conference also taught me several different clinical methods and interventions regarding the populations I work with, and brought me some insight about the end of life and it’s profundity (as I realize some of my more recent posts have been somewhat dreary) as well as some new ideas and a much needed kick in the tuchas regarding my contracting business and a project I’m working on (If I told you, I’d have to kill you).  Even if I don’t go every year, conference is always exactly what I need when I do go, and it usually happens during a time that I need it the most.
Thanks, Hotlanta AMTA conference, for being exactly what I needed.  I learned a lot.
Oh, and P.S.  Ben Folds was at the conference.  Yup – we’re just that cool.

No matter how many times you experience it, and no matter how old you are, loss is still a giant bummer, and with loss, sometimes emotions get the better of your decision-making skills.  When one has a family member who is declining, there is usually a perpetual feeling of loss (usually accompanied by some kind of guilt) and sometimes that emotion becomes very counterproductive for everyone involved.

I’ll start with an anecdote:

Several months ago, a man stopped breathing immediately before my music therapy group.  I have told a short version in another post, but I actually found out today that there was more to the story than I was aware of.  The man was a “full code,” which means that whoever was around was required to do as much as humanly possible to keep him alive in the case of cardiac or respiratory arrest.  He was an older man, maybe 80 years old, who had moderate-severe dementia and was in poor physiological health, and his daughter (also his self-assigned Health Care Proxy) had decided, in the absence of a living will for him, that she wanted her dad to live as long as possible. When EMTs and nurses were unable to resuscitate this man after trying for 20 minutes, his daughter berated, blamed and yelled at the nurses and EMTs for not doing everything they could to keep him alive.

I don’t know this woman, so there could be other issues at play, but I do know that screaming at the people who tried to save your father seems like a grief response.  In talking with a colleague in SNF-land this afternoon, I gained some insight into the process.  She suggested that I mention the responsibility that people sometimes feel for their loved ones when they are declining.  It is my guess that the woman who yelled at the nurses and EMTs was actually not angry with them, but maybe was angry at herself for not being able to keep him well or alive.  Maybe she hadn’t had time to say goodbye and she felt guilty for not visiting enough.  Maybe she was terrified of the grief that would descend in the event of his death.  Whatever the reason, though, she made decisions for him that weren’t actually for his welfare.  Not only was he older and in poor health, but the very process of saving an elderly person’s life with CPR and defibrillators can actually do more harm than good – they can come away with further brain damage from a lack of oxygen or cracked or broken ribs, not to mention the emotional stress.  Here are a couple of facts for your information:

90% of elderly patients who have cardiac arrests die despite CPR.

3% of elderly patients with dementia who undergo CPR leave the hospital and some of those suffer anoxic brain damage. (http://www.uaelderlaw.org/advance/4.html)

Would you want to be saved?

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As individuals with our own opinions, ideals, morals and values, there is no right or wrong answer, there is only a right or wrong answer for each of us.  We have the right to make decisions for our futures, and we need to take advantage of that so that someone else isn’t making decisions that aren’t right for us.

In the previous post, I discussed Advance Medical Directives and how helpful they are in assuring us that our wishes will be carried out even if we aren’t conscious or oriented enough to make decisions for ourselves.  Sadly, even living wills aren’t a guarantee not only because of guilt and grief, but also because of oversights and medical intervention, which I won’t go into.

When we write and sign living wills, the people we give copies of them to are equally as important as the actual legal documents.  This is because people become emotional, irrational, guilty and resentful surrounding loss, and sometimes make decisions based on their own feelings instead of what’s best for their loved one, themselves, the rest of their families, and the country as a whole.  People sometimes can’t emotionally carry out the actions designated in a living will and and up going against the person’s wishes because of their own guilty feelings or hesitation to let go, so it’s important to have other people aware of your needs as well as your Health Care Proxy and Power of Attorney.  Not only this, but we can’t possibly think of all of the potential scenarios that could lead to someone needing to make a judgement call, so often, someone has to make a choice anyway, regardless of how careful we are in writing our living wills, but it’s worth it to try as hard as we can so the burden isn’t placed on someone else

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Last year, my grandfather died.  He was 93, had vascular dementia and was unable to walk toward the end.  When my mom and her sisters made the decision to follow his advance directive’s orders, it seemed very obvious to me that this was the right thing to do, but he wasn’t my dad.  I loved him, and he was a wonderful grandfather, but there’s something about a parent/child relationship that is different than anything else.

Despite my many attempts to ease her mind, my mom still feels guilt and regret sometimes for not being able to do more for him toward the end (she visited him almost every day, but always felt guilty when she wasn’t able to).  She knew in her mind that letting him go was what was best for him, first and foremost, but in her heart, she felt like she had killed him.  Since he passed, we have talked about her feelings a whole lot, and she has definitely been able to move forward, but it’s taken a while.

I think it always does.