What’s Next? To Infinity and BEYOND!

So I’m done with my internship,  had a wonderful time at AMTA11, but what’s next? That’s a question I think all new professionals ask themselves. The first thing that crosses my mind- “I’m free!” And it’s true, for the first time in my life I can do whatever I want, choose my path, and plan my future.

“The Eclectic Guitar”  has been in action since April, 2010.  Since then, I’ve connected with various students, interns and professionals and offered insight into the student, then intern world.  Even though now i’m neither, I still have some tricks up my sleeves.

“The Eclectic Guitar” is being completely re-vamped!  I have some really exciting things planned (courtesy of my flight from Atlanta to San Diego), and I can’t wait to get them launched.  Stay tuned- in mid-december i’ll be releasing an exciting announcement across all my social media platforms that explains what i’m up to.

Something is ‘a brewing!’

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An Internship Highlight

I’ve cleaned out my cubicle. Today marked my final day and exit interview for my internship with MusicWorx inc. in San Diego, CA after 1,088 clincial hours. Where do I even begin? Words can’t even describe how fast my internship experience has gone by.  Wasn’t I just driving across the country to get here? Better yet, wasn’t I just applying for internships? Even though it has gone by so fast, I look back to the beginning of my internship and it seems like a completely different time.  The growth I’ve seen in myself both as a therapist and a person really says something about the experiences I had throughout my time.  I also had the unique opportunity to work with three different teams, seven wonderful young therapists, learning something from every person.  My patients and clients were the most beautiful people I’ve ever met.  They reminded me why I wanted to be a music therapist in the first place.   I know that every day I spent doing this work was wonderful and meaningful.  I went home everyday with a smile on my face.  I feel like a well-rounded, determined therapist, and I’m so excited to step into the professional world and get my career off the ground.

I would first like to summarize the populations I experienced and the work I did with them:

Medical

General Hospital: Surgical Acute, Sub-Acute, Oncology, Neurology and Intensive Care

I facilitated bedside and group music therapy sessions with patients throughout the full six-month period.  This has involved collaboration with registered nurses, social workers, physical and occupational therapists, as well as physicians.  Duties included charting in the hospital charts, using a MusicWorx documentation log, and entering data into the computer.  Goals with medical patients included relaxation; pain, anxiety, and nausea management; psychological, family, and comfort support; fine and gross motor movement; cognitive stimulation and orientation through reminiscence; speech initiation; emotional expression/release. I primarly tended to referrals on both the Oncology and Cardiology floors.

Children’s Hospital,  Cardiology Unit, NICU

Observation of ten bedside music therapy sessions within two weeks.   Referrals were obtained through interactions with Child Life Specialists and Registered Nurses.  Goals included reduction of anxiety, socialization, creative expression, family support, fine and gross motor movement, emotional expression, and normalization of the hospital environment.

Wellness

Center for Integrative Medicine – Lifestyle Change Program

I co-facilitated weekly music therapy sessions for adults prone to heart disease, type A personalities as well as those in need of lifestyle change, wellness facilitation, and disease prevention.  Sessions were held weekly throughout the full six months.  Interventions focused on promoting self-awareness, enhancing creativity, and providing relaxation and stress management techniques.

Breast Care Center, Cancer Support Group

I co-facilitated throughout two, six-week series on music and medicine for a cancer support and wellness group.  Experiences for the support group focused on promoting wellness through creative expression, relaxation and stress management. Provided tools for group members so that they may implement them into their daily lives.

Parkinson’s Exercise Group

I co-facilitated with physical and occupational therapists a twice-weekly music-centered exercise group for older adults with Parkinson’s disease.  Neurological Music Therapy techniques were used, incorporating a variety of instruments along with exercise and stretching and cognitive stimulation, to promote physical wellness. The last 15-minutes of the group were focused exclusively on music therapy goals.

Pulmonary Rehabilitation Group

I co-facilitated a two, four-week series for adults in a pulmonary rehabilitation group.  Experiences for this group focused on using the harmonica and breathing exercises for breath support, rehabilitation for effective respiration, relaxation and music making.

Substance Abuse

Adult Drug and Alcohol Abuse Group

I facilitated music therapy sessions weekly for residents in a 28-day inpatient substance abuse treatment program.  Interventions focused on learning alternative coping skills, creative expression and creating a sense of community amongst group members.

Adults with Developmental Disabilities      

Individual Music Therapy

I led and led one-on-one music therapy sessions for an adult client with Rett’s Syndrome during the first 2-months of internship.  Interventions focused on increasing sensory orientation, facilitating motor movement, relaxation and end-of-life and comfort support.

Center for Adults with Devlopmental Disabilities

I led and co-led group music therapy sessions for adults of varying developmental disabilities, including autism and deaf and blindness, for the first three months of my internship. Interventions focused on communication with staff and peers, increasing choice-making skills, facilitation of motor movement, direction following and increasing attention.

Older Adults

Senior Living Residency and Memory Locked Unit

I facilitated music therapy sessions with clients in an assisted living facility five times during internship.  Interventions focused on active listening, therapeutic singing, memory recall, instrumental improvisation, and motor movement.

Hospice

Hospice and Palliative Care Nursing Facility

I facilitated individual and small group (2 roommates, family members and staff) music therapy sessions with clients in an acute care inpatient hospice for the duration of my internship.  Interventions consisted of therapeutic singing, music making, song writing, music improvisation, cognitive functioning, and normalization to the hospice environment all focusing on comfort support, emotional expression, psychosocial and family support.

Other

Parent and Child Bonding Groups

I facilitated and co-facilitated bi-monthly music therapy to teen moms and their babies.   Groups focused on socialization, creating a strong bond between the moms and babies, gross/fine motor skills, and cognitive skills.

Homeless Program

I facilitated and co-facilitated bi-monthly recreational music making groups for women and men who are homeless throughout all six months of internship. Groups focused on comfort support, emotional and creative expression, as well as recreational music making.

Women Victims

I co-led and led group music therapy sessions for homeless, abused, and/or battered women during my last three months.  Interventions used in the group provided opportunities for individual empowerment, self-awareness, stress-reduction, group support, and emotional release.

Military/PTSD/Substance Abuse

I co-facilitated music therapy sessions for a cohort of military men dealing with PTSD and substance abuse as part of their recovery program.  Interventions focused on self expression, stress managemnet, effective tools for emotional release and group support.

Resounding Joy, Inc.

I participated in a 12-hour training course for volunteers with Resounding Joy.  I mentored Joy Givers thorughout this experience.

6+ Professional Presentations and Public Drum Circles

Internship Project

My internship project dealt with the creative vision, compilation, editing, lay-out design, formatting and marketing of a book entitled: ‘Six-Month Chrysalis.’ This book included stories and higlights from all 109 past MusicWorx intern’s, an introduction and conclusion wrote by myself, study questions for professors and universities to utilize, and an index for easy population search.  Beginning stages of the project consisted of organizing all patient highlights digitally, compiling all different devices holding highlights, and creating one master list.  The file system for patient highlights was also edited for future organization of the highlights.  Finally, researching printing possibilites, coming up with marketing strategies for the publication, sending out release forms to former interns and evaluating end-stage edits of the book.

Case Study

My case study was completed throughout my internship.  It focused around the utilization of the iPad within various populations.  I conducted seven sessions where the iPad was incorporated: Adolescent, older adult group, child with Dandy’s Walker syndrome, older adult in hospice care, adult with leukemia in a long-term hospitalization, and classrooms of adults with developmental disabilities.  Different applications were brought into the sessions to observe responses to the device.  Results demonstrated benefits and positive results from the implementation of the device.

To all current students and interns:

1.  Take each day as it comes.  Internship goes by SO fast.  Really embrace and learn from each and every day.

2.  You’ll get out of your experience what you put into it.  Push yourself every day, step out of the box, and stretch your limits.  It’ll be worth it.

3.  Remember to breath.  As I ALWAYS tell my patients: “When we are in high stress situations we forget to breath; take time to center yourself, reflect on what’s important and breath.”

Thank you so much to my wonderful support system throughout this experience: My AMAZING internship director, my supervisors, my wonderful team(s), and most importantly, my patients.  You have shaped me into the therapist I am.  

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Walk the Line: Tips for being HIPAA Conscientious While Posting on Social Media Sites

Check out my post I wrote for the MusicWorx Inc. blog. 

Many have heard of it, some have not.  HIPAA is an acronym that stands for Health Insurance Portability and Accountability Act.   If you have ever been actively involved in a hospital or facility, these letters have been screamed at you.  “I just have to make sure that, no matter what, all the information regarding my patients and clients remains confidential, right?” Right.

Music Therapists are beginning to expand their online presence through various social media sites (i.e. Facebook, Twitter, LinkedIn, blogging). However, it is important to be conscious of what your putting up on your sites.  It makes me cringe when I see colleagues posting pictures, updates, thoughts or stories that border the very thin line between okay and violation.

Here are a few tips to ensure that you’re not crossing that line:

  1. When in doubt, leave it out.
  2. Remove any identifying information- Just remember: NOLF (Name, Occupation, Location, Facility).
  3. If you wouldn’t want the public to know it about your mother, don’t share.
  4. All photographs, video, drawings, art, poetry MUST have a waiver signed by the patient allowing you to use/share.
  5. Every time you’re writing something, double-check. Ask yourself, “Am I violating my client’s privacy by saying this?”

Keep this in mind: Would you want information about your upcoming surgery, intimate moment with your therapist or struggles posted online for hundreds of people to see? I don’t think so.

In conclusion:

DO NOT assume that people cannot infer who a patient is.

DO NOT assume your patient “won’t mind if I talk about this.”

DO use your moments of learning for reflection and teaching moments.

DO trust in a mentor so that you may process any exciting or difficult sessions (sticking to HIPAA protocol of course!).

DO put disclaimers in blog posts and updates letting your audience know NOLF has been changed to protect confidentiality.

DO get permission from patients and clients to share those “WOW” experiences.

Check out the original post at www.musicworxinc.com/blog


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Six-Month Chrysalis

For the last 5 months, as part of my internship, I have been diligently working away at my newest project.  It’s entitled: “Six-Month Chrysalis” and its a 12-chapter book which features over 100 stories, insights and confessions from over 15 years of music therapy interns.

Not only is it a great coffee table book for the music therapist, it will be a excellent learning tool for professors at universities, and a resource for students and new interns.  Topics such as “death and dying, “personal and professional growth” and “dealing with declines,” are split into chapters as a means for reflection.  The book provides great insight into the life of an intern, soon to be professional, and the types of scenarios and situations one may encounter.  The book will feature a series of questions for study purposes or reflection, as well as an index split by population for easy reference.

I’m VERY excited for the launching of this book.  It’s going to be a beautiful contribution to music therapy literature, as it houses the most intimate moments and learning curves from current interns, and now successful professionals during their internship experience.

The book will be introduced at the 2011 AMTA Conference in Atlanta, GA. Check out some selections of the book during regular exhibit hall hours at the MusicWorx Inc. booth(#404) from Thursday, November 11th through Saturday, November 19th! Put your name in for a drawing and have a chance to win one of three raffled copies! The “butterfly” is set to launch in early Spring 2012!

**All names and likenesses in the book have been removed for the confidentiality of our clients and interns.

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Ladies and Gentlemen… I give you… The HAPI drum.

Have you heard about the HAPI drum? If you have, great. If not… you have to check this thing out.  I’ve been shamefully hoarding it from my co-interns for the last month.  I’m constantly blown away by it’s sound, meditative abilities, portability and most   importantly- client responses to it.  It has great versatility between individual sessions and groups and is easily adapatble to all sorts of interventions.  I’ve been primarily using it for relaxation, imagery and bonding among group members.  It’s a wonderful tool to have in your cart and totally worth the investment.  The HAPI drum (pronounced ‘happy’) is made out of molded steel and comes in a variety of keys (I use the A-minor).  The slim model is much lighter than the original drum and is easier on the music therapists back.  It is struck with rubber mallets one at a time or simultaneously (I’ve seen it played with fingers but I don’t recommend it- ouch!).  You can find more information about the HAPI drums here: http://www.hapitones.com/.

I had a wonderful experience with a client who loves the HAPI drum. Here is their story.   

C is a delightful woman with a pleasant personality and an inviting smile.  She welcomed music therapy right away and spoke of how much she loved music.  After our initial session C had opened up about many family memories certain songs evokes, shed a few tears, and reminisced about her favorite childhood memories. 

When I came in for my follow-up session with C, she was out of breath; irregular breathing, very shallow.  I introduced the HAPI drum to her and said I thought it would be beneficial for us to do a deep breathing, relaxation exercise to help regulate her breath and bring her to a more relaxed state.  C took to the sound of the drum right away; she closed her eyes and entrained her breath with the drum and followed my verbal ques.  I noticed her rate of breathing slowing throughout the exercise.  At the conclusion of the intervention, she smiled and said, “Wow, that really works.”  She spoke slower and it was observably noticeable that her body and breathing had relaxed and normalized.  As part of the facilitation, I took C through some imagery.  At the conclusion of the session she spoke of vivid colors of red and gold she visualized.  She disclosed that the colors began to move in until they were the pattern on her favorite sofa at home.  The sofa sits in the middle of her house, and when family or friends come to visit, they all gather her around her in this common area.  We joked about how she was “the queen” sitting on this couch in the middle of the room.  She smiled and said how she could feel how the couch felt and how it felt to lay/sit on it and how it was so great to get out of the room for a while.  C said she would love to share the sounds of this instrument with her daughter… we made plans to record different sounds/songs during our next session.  As I was charting in the nurses station, C’s nurse came right over to me.  She said that while I was in C’s room, she was watching her vitals.  She noted excitedly that her heart rate and blood pressure decreased throughout our session and stabilized by the time I left.  She turned to me and another RN and said “that’s crazy how that works.”    

(all names and information have been changed to product client confidentiality)

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If At First You Don’t Succeed.

Let’s talk for a moment about the scariest things we can think of…. spiders? heights? the boogey man?… how about walking into a session with 30 brand new clients…with a flawless session plan… opening your guitar case, and realizing your A-string has totally kicked the bucket… and you have not a single spare.  You know that really uncomfortable feeling when the room is dead silent, and everyone is waiting for you to start… and all the while your brain is sweating trying to come up with a last minute plan of attack.

Yes, this happened to me. How did you guess?

“Take a chill pill! You totally got this.” That’s what I tried to tell myself as I rummaged through my collection of intruments.  But you know what?  I did.  

Music therapists have a little bit of a stigma attached to them.  We always have that shadow following behind us (yes, i’m referring to the guitar that proudly stands a good foot taller than us on our back).  It’s literally our life support in many cases (pun intended).  Now don’t get me wrong- the guitar is a wonderful, powerful tool that we utilize… but would it hurt to step outside of the box and explore other things we have to offer.  For new professionals and especially students this sounds TERRIFYING.  But trusting in our therapeutic ability AND in our musicianship is KEY.

Did I feel exposed and vulnerable without my guitar for 50-minutes? YES

Did it force me to step out of my comfort zone and explore some new ideas and techniques. YES

Did I crash and burn? NO!

Some lessons I learned:

  • Always carry a spare set of strings in your case. (Although I probably would not have had time to even change them- there is nothing like getting glared at by a group of older adults).
  • Challenge yourself to try something new- the results just might surprise you.
  • Trust in yourself and your abilities.  I think you’ll surprise yourself.
  • You may get WAY different reactions and outcomes from your clients by trying something non-traditional. Kimberly Sena Moore, MT-BC, talks about stepping outside of the rule book here http://www.musictherapymaven.com/do-we-learn-our-greatest-lessons-from-our-clients/.

I hope my terrifying moment has encouraged at least one other to step out of the box ( I even pulled out my iPad- the ladies thought it was a riot!). If you try something new- let me know how it went! I’d love to hear your stories.

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Death, Dying…and those other things we don’t like to talk about.

One thing school doesn’t necessarily prepare you for? Dealing with patients who are rapidly declining. It can be extrememly heart wrentching and emotional for everyone around them- including you, the therapist.  Today was one of those days.  Not only did a patient pass away moments after I was in the room with them, but a patient I felt a huge connection with last week has since declined to a nearly delusional and comatose state.  I left my morning sessions feeling emotional and off balanced.

How do we deal with moments like these… especially students and interns who are still fresh in the field?  Even for a seasoned professional, days like this can have a real impact.  At times it can be a real taboo topic to admit you have a connection with a patient, that you felt something, and that you’re having a hard time separating that from your personal life.  It has to leak into it somehow, right?… we’re only human afterall.

So here is my conclusion:

  • Life happens.. it’s how you handle it that’s important.
  • It’s ok to ask for help and admit you need someone to talk to.
  • Human connection is inevitable- but that’s what is also so incredible about our job as a music therapist
  • Separating home from work is critical- but it’s also ok to let those experiences teach you a lot about life and yourself
  • It’s all part of growing as a person and a professional
Effectice Coping Strategies:
  1. Journal, write, play music, do a mandala- express what you’re feeling and process it
  2. Talk to someone you trust so you can process what you’re feeling
  3. Know your limits
Rough day- but many more wonderful one’s to look forward to.

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