back again!

It's been quite awhile since I blogged. Honestly, I was thisclose to deleting this thing. After quitting my first job and staying home with my daughter, it was hard to keep things up here by sheer will. I wanted this place to document some of the struggles I have as a bilingual and bicultural music therapist trying to reach my patients but as an outsider of the workforce, I simply wasn't having any experiences to write about.

Fast forward to March of this year, when I started working part time at a local cancer outpatient clinic. Again, not a whole lot of the typical bilingual bicultural population I wanted to write about. So I again put some serious thought into just deleting this sucker.

And then.

I walk into the apheresis (stem cell collection) room and ask the patient if they would like some music therapy. At this point the nurse turns to the patient and asks in Spanish if they would like some music. Long story short, I was blindsided by a teenager who spoke no English but needed reduced anxiety and restlessness (per nurse and family). I fumbled with my iPad/songbook (viva OnSong!) and landed on some Beatles songs before my brain kicked in and remembered all the words to "De Colores." At the very least, I knew, I could play music that was in 3/4 and not 4/4 time in order to have familiar music playing, but I remembered "De Colores," and sang. And the family sang with me. And it was a beautiful thing. 

Reminded me of something a coworker said to me at my first job. "You don't have to do everything, but you can do something. And that's something."

May Hispanic Cultural Happenings in North Texas

Dallas 
May 2nd - Gypsy Kings at AT&T PAC
May 3rd
* Ballet Folklorico at the Winspear Opera House (Groupon!)
* Del Castillo and Mariachi Quetzal at the Kessler Theater
May 5th - Cinco de Mayo with Loco Gringos at the Kessler
May 10th - Spanish Speaking Amigos (this event happens EVERY THURSDAY)
May 13th - Orchestra of New Spain's Bolivian Baroque Music Concert
May 14th - Tango at Zaguan Bakery
May 24th - Popular Latino Music with Ramiro Burr at the Latino Cultural Center
May 26th - Dallas International Festival in the Dallas Arts District

La Diferencia

In getting the information for a different blog post together, something clicked for me and made me abandon that post for the time being because I just had a huge revelation. I have always talked about "bilingual and multicultural music therapy" as if they were the same thing (the title of this blog is a perfect example :). However, in researching today and in some conversations with colleagues, a bolt of lightning hit. Bilingual and multicultural music therapy are two different things and need to be delineated as such! I don't know why it took me so long to separate these two things so solidly in my head and I hope I can explain this concisely...

Multicultural music therapy is what happens when no words are spoken but the musical language of a culture is used in a therapy session.  This concept jumped out of my computer all over my face when I read an article in the Journal of Music Therapy about Juliette Alvin and her contributions to the field of music therapy in Japan.

"Perhaps one of the most valuable aspects of Alvin's clinical practice was that she clearly indicated the therapeutic value of music as a form of communication beyond human diversity. Since Alvin did not speak to the children in Japanese, there was no verbal interaction in the sessions. When reviewing Alvin's report on her sessions at the Tokyo Metropolitan Government Welfare Center for Mentally and Physically handicapped in 1969, it was discovered that she carefully explored a common denominator through which their musical communication took place. She used musical sound, which was not organized in a musical form, to elicit psychological and physiological responses from the children. This procedure offered the children a simple means of communication at their own functional levels. She also used flexible resources of music including pentatonic scales, Japanese children's songs, improvised music, and short pieces of composed music while monitoring the children's responses. In this sense, Alvin's  approach included multicultural perspectives. In her report, Alvin stated, 'I made the music speak to them in a language they could apprehend. . . . Wherever and whoever he is, music affects man in the same deep way.' 42" (emphasis added by me).

That whole article is an incredibly inspiring piece that gives a lot of insight into the whole concept of multicultural music therapy, and you should check it out. What jumped out to me is that although Juliette did not speak Japanese to the children, she was conscious of Japanese culture and implemented familiar songs as well as a familiar mode of music to communicate with them and elicit changes.

Bilingual music therapy is what happens when a second language is introduced to the clinical setting by either the client or the therapist. This could happen in several different ways: the client and therapist may speak the same language and the therapist decides to elicit a response from the client using novel musical stimuli. Or, which is the case so often in music therapy, the client and the therapist speak different languages and use both of those languages to achieve music therapy goals.

I was originally going to post about the shifting cultural climate in America, and came across this site from the census bureau. Instead of copy-and-pasting the whole thing into this blog, just go check it out and see if some of those numbers don't blow your mind.

In the music therapy world, two articles - one in 2005 and the other in 2007 - highlight the increasing need for music therapists to be bilingual:

"Of particular interest is that only 16.2% of participants reported being bilingual while 40% of participants reported serving nonEnglish speaking clients. With the growing population of nonEnglish speaking consumers in the United States, it is definitely an advantage to be a bilingual therapist. Perhaps more universities will start to require students to study a foreign language. However, this issue is of particular concern for music therapy educators as music therapy students typically have very little room and flexibility in their schedules for electives such as foreign language." (2005)  

"Respondents also indicated that although most were not bilingual (85.7%), they still worked with non-English speaking consumers (58.2%)." (2007)

Why does that even matter? 

American Music TherapyAssociation's Standards of Clinical Practice defines Spiritual and Cultural Background as “an interrelationship among a client’s musical experiences, personal belief system, and cultural background, which may be influenced by the client’s geographical origin, language, religion, family experiences, and other environmental factors.

2.0 Standard II - Assessment

2.2 The music therapy assessment will explore the client's culture.  This can include but is not limited to race, ethnicity, language, religion/spirituality, social class, family experiences, sexual orientation, gender identity, and social organizations.

2.3 All music therapy assessment methods will be appropriate for the client's chronological age, diagnoses, functioning level, and culture(s). The methods may include, but need not be limited to, observation during music or other situations, interview, verbal and nonverbal interventions, and testing. Information may also be obtained from different disciplines or sources such as the past and present medical and social history in accordance with HIPAA permission regulation.

3.0 Standard III - Treatment Planning - The Music Therapist will develop an individualized treatment plan based upon the music therapy assessment, the client's prognosis, and applicable information from other disciplines and sources. The client will participate in program plan development when appropriate. The music therapy program plan will be designed to:


3.6 Specify procedures, including music and music materials, for attaining the objectives.

3.6.1 The Music Therapist will include music, instruments, and musical elements, from the client's culture as appropriate.

From AMTA's Professional Competencies -  

18. Therapy Implementation

          18.14     Develop and maintain a repertoire of music for age, culture, and stylistic differences.

CBMT has a little bit to say about it as well in its Scope of Practice:

C. Treatment Planning

     9. Consider client’s age, culture, music background, and preferences when designing music therapy experiences.

I could go on and on here - there is a wealth of information within music therapy that supports bilingual and multicultural music therapy. There have been only a couple recent articles that discuss actual clinical practice either with multicultural populations and/or utilizing multiple languages in sessions.  What I want to know is - what have your experiences been? What do you think about all this? Do you think you can do multicultural music therapy without doing bilingual music therapy and vice versa?

 

References (not already linked)

Haneishi, E. (2005). Juliette Alvin: Her legacy for music therapy in Japan. Journal of Music Therapy 42(4), 273-95.

Silverman, M.J., Hairston, M.J. (2005). A descriptive study of private practice in music therapy. Journal of Music Therapy 42(4), 262-272.

Silverman, M.J. (2007). Evaluating current trends in psychiatric music therapy: A descriptive analysis. Journal of Music Therapy 44(4), 388-414.

Advocacy All Year Round

So hey! Janice and I indeed had lunch, and then in January I organized a meeting of music therapists in the North Texas area to hang out and talk about advocacy. What came from all of that was a HUGE amount of information on advocacy, much more than I could ever want to post here at one time.

Advocacy is not a one-time thing, it's not a just in January topic. For music therapists it comes up every time someone asks, "hey what do you do?" or "hey I know you told me before what you do, but what do you actually, like, do?" and that's the good news: Music therapy advocacy is for everyone! Even if you're reading this and you're not a music therapist, hopefully this and other blogs can give you an understanding of what it is we do as music therapists, and you can join in spreading the good word of the awesome work we do. 

It is an incredible time to be a music therapist - between the continuous news coverage we get thanks to the good work that so many are doing around the nation (see here, here, and here), and the gorgeous Oliver Sacks and his movie The Music Never Stopped last year, and not to mention all the cool stuff that comes when neuroscientists and music therapists get together. Advocacy is talking about all that right there - finding a common language to communicate to other people what it's all about. 

If you ARE a music therapist, then you know the other ways to advocate for our profession - present at conferences, maintain your MTBC, be a good example of a music therapist, hop on social networking and sing the praises of the work we do, and present at career day (bonus points for it being K-5th grade class because OH the thank you notes are glorious). That right there is enough for me right now - I'm not even doing all of the above yet and when you're early on in your music therapy career, that's great! I have such an appreciation for the music therapists who write to Congress and get cozy with the district representatives and jump up when there is a call to action. My goal is to eventually get there, and I have so much learning to do about that deep advocacy. 

It all boils down to how one represents themselves as a music therapist. Advocacy helps us as music therapists improve our game personally and professionally, and help each other along the way.

relaciones terapeuticas

Therapeutic Relationships
The #2 question I get asked ever so frequently by people that I'm not just giving the 5 second answer of what a music therapist is/does is:

"Right, so...what do you actually...like you know...do exactly...?" 

I gradually learned throughout my practicum, internship, and early professional experiences, that nothing can happen therapeutically without a properly established rapport. Developing one's own approach to clients is a very personal journey and while I'm someone who tends to just jump in and make friends with everyone there have been plenty of times I have fallen completely on my face.

How a therapist chooses to build rapport with their clients is completely individual to the therapist's personality, the setting that the therapist is working in, and the needs of the client. The relationship built has a basis in what happens during therapy but it also is the little things that occur between activities and before and after each session.

All I can do is speak to my experiences, and I know that in a psychiatric setting it meant showing up every week at the appointed hour, speaking to your clients like they were real people, and sometimes popping in to different activities throughout the week so that your face and presence would stay fresh in someone's mind. More often than not, it meant encouraging multicultural interactions (the language I spoke, ethnic instruments, childhood songs) to present novel stimuli in order to engage an individual.

In my experience in the educational setting, I worked with early childhood classrooms full of children who came from Spanish-speaking families. Each child had a different reason for being in the classroom, and I was awed at the mix of typical as well as special needs children. This was a co-teach situation in which there were three teachers, and I don't remember exactly what all their specific jobs were but I knew that one was from South America and spoke primarily in Spanish, one was from Mexico and was bilingual, and the other was a Dallas native who spoke mostly in English. In speaking with the children and their teachers, I wondered about how the language we speak to our clients affects our relationships with them, and this concept was at the heart of my master's thesis. The study itself ended up being quantitative in nature (measuring standardized test scores at the beginning and end of the year) but there were so many immeasurable experiences that I would like to eventually explore in the future. Building relationships with these kids meant making jokes in English and in Spanish, taking time to engage them and answer their questions in a way they could understand. Sometimes this meant switching languages, and a lot of times it meant asking the teachers for help. This setting was where I really developed my child's group facilitation skills, and between that and all the language swapping, I would exit the classroom absolutely sweating.

In a pediatric hospital setting it looks different across specialties. It may mean bringing in an instrument in which the patient is interest in order to engage them in a different way, presenting a new way of thinking about swallowing pills using their favorite band, or watching a whole lot of Barney on the computer. This setting immersed me fully in an eclectic approach to music therapy, where I basically had this big theoretical bag of tricks and would tailor my knowledge to the situation and the patient. It's an exhilarating way to approach therapy, because I knew that I could have a general idea of what I wanted to use and what I wanted to do with it, but more often than not the patient and their present circumstance, family, what they had for breakfast, the latest news from their doctor would throw me a curve ball. Knowing your patients, knowing what tools to use, words to say (and often, what not to say), and how you relate to their family members (HUGE when we're talking about multicultural implications of therapy and relationships) can all be factors in building that relationship. I could talk all day about this setting and therapeutic relationships and the perks of being bilingual, and you'll hear a lot about it as I flesh these ideas and experiences out.

So, there's an overview of therapeutic relationships, with a multicultural twist. Next up: goal setting (with spice!)

North Texas Music Therapy

*This is going to be a two-parter, for reasons that will become clear in a bit. So, if you're reading this before 12pm on January 17th, come back later this evening for the stunning conclusion.*

Something I love about being a music therapist in the North Texas area is the multitude of incredible music therapists who span a wealth of expertise from NICU to education to health care to hospice. A bonus is that everyone is super friendly and downright evangelical about the music therapy cause.

Today I'm going to have lunch with the illustrious Janice Lindstrom of The Music Therapy Show to discuss music therapy advocacy. Now, I thought I was going to get all up into music therapy advocacy a few years ago when I attended our regional conference in Austin, Texas. I attended a session on advocacy where a big group of music therapists went down to the State Capitol and spoke to various delegates and sometimes their secretaries about what music therapy is and why it's important. 

I mostly just listened. I felt way way WAY out of my league when it came to artfully articulating the needs and wants of music therapists across the State of Texas. And then I got overwhelmed by all those days I spent daydreaming in Texas history class and NOT paying attention to how the whole system works. I know there are phone calls that need to be made and letters that need to be written but...to whom? And what the heck am I supposed to say? I have just recently gotten to the point in my career where I think I can succinctly define music therapy, paying attention to the interests of my audience and playing up to their experiences (do you have a grandparent in a nursing home? With Alzheimer's? Do you know someone who has a child with Autism or has been in the hospital recently? Are you a doctor/neuropsychologist/social worker/grief counselor? Let's chat). Most importantly, I am crazy passionate about my field. It is just so exciting, relevant, and changing lives that I could probably talk all day about it.

But get me thinking about writing proposals or grants or letters to congresspeople and I lose my cool. It's not that I get intimidated so much by the powers that be, it's that I'm not yet confident in my own "advocacy skin" - or all of it. Yet. Thankfully, the American Music Therapy Association has incredible resources on everything that I am stymied on, and I'm going to spend a little bit of time on this blog working through it, because I think in the bigger picture of learning how to advocate for music therapy as a whole, I will be able to find ways to apply it to advocating for bilingual and multicultural music therapy, which may eventually lead to...I don't know - new music therapy jobs in predominantly Hispanic communities? One can only dream.

Kimberly Sena Moore has put together this little blurb to help get the word out about this:

Since 2005, the American Music Therapy Association and the Certification Board for Music Therapists have collaborated on a State Recognition Operation Plan. The primary purpose of this Plan is to get music therapy and our MT-BC credential recognized by individual states so that citizens can more easily access our services. The AMTA Government Relations staff and CBMT Regulatory Affairs staff provide guidance and technical support to state task forces throughout the country as they work toward state recognition. To date, their work has resulted in 35 active state task forces, 2 licensure bills passed in 2011, and an estimated 10 bills being filed in 2012 that seek to create either a music therapy registry or license for music therapy. This being music therapy advocacy month, the focus is on YOU and on getting you excited about advocacy.

I should note here that there's a huge flash-mob-blogger thing going on this month to get the word out about music therapy advocacy, and you can check out articles that have already been written on the following blogs:

Music Therapy Drumming

Notable Musique

Music Therapy = Love

Right. So...uh, I guess where do we start? How is this going to be relevant in the North Texas area? Hence my lunch with Janice as mentioned above. I'll get back to you after lunch.

desarollo

Hey! It's music therapy advocacy month again! I realize that maintaining interest and an audience is going to take more than just one post a year. Full disclosure: I started this blog whilst on maternity leave last year (hello, learning curve!) then went back to work in February, then decided to stay at home with my sweet baby around July. Needless to say, 2011 was all about hunkering down and laser-focusing on my personal life. Now that we're in 2012 and I have a handle on this mothering thing (I mean, as much as can be from totally making it up as I go along - insert appropriate correlations between improvisational mothering and improvisational music therapy - ), along with a whole lot of perspective and drive to see bilingual/multicultural music therapy expand. I also want this to be a place to start conversations, a place to support those of you who have questions and are knee-deep in experiences and wondering what to do next, and encourage each other as we deal with this multifaceted topic.

This past year has given me...well...time...to read back over the foundational texts of music therapy and view them from a multicultural perspective. In Defining Music Therapy, Bruscia says that "it is often necessary to create a definition (of music therapy) to meet the unique demands of each situation" (p2). This being a blog about bilingual and multicultural music therapy, then, begs the question, "What exactly is bilingual and multicultural music therapy?" and then "How do you practice it?" and then, "I only speak English! What do I do?"

I'm so glad you asked. 

"Music therapy does not belong to any one culture, race, country, or ethnic tradition; it is global in its conception and manifestation. It is global not only because it exists as a profession in most industrialized nations around the world, but also, and more important, because the idea of using music as a healing art has existed for centuries, and in many different cultures." -Bruscia

We'll be diving into the following areas: What it means to practice bilingual and multicultural music therapy, why it's important not only in therapeutic relationships but also at linguistic and neurological levels, and hopefully we can provide each other with practical songs, instruments activities, and a little ethnomusicology thrown in to spice things up a bit. 

BUT FIRST - I have some other posts to get out of the way...where were we...ah yes. Therapeutic relationships and individualized goals.  Stay tuned.