In all clinical practices, students must learn to make meaning of clinical information such as, “What does it mean that the client said this or did that? What is the client’s body saying when it does or does not do this?” For music therapy students, there is the additional consideration of music, namely “What does it mean when the client plays music like this? What does it mean when the client hears this music like that?”
This has led me to wonder how music therapy students learn to make meaning of music therapy sessions, and how I can best support them in this learning process as an educator. In a recent study, I analyzed student observational logs written following clinical experiences in various healthcare settings, and identified teaching/learning concepts related to these efforts.
The results indicated that students worked to develop skills along two tracks. One track was “Music Therapy Treatment”, which included concepts related to assessment and treatment planning. Here, students learned how to understand clients’ needs in the context of both treatment and their relationship to music. Relatedly, the second track was “How to Be a Music Therapist”. This involved students in learning how to be present in client sessions so that they can respond therapeutically and musically to client responses.
As these two tracks developed, the relationship between them became apparent, and I became aware of how I had been teaching each separately without stressing their interrelatedness. For instance, treatment planning supports the pre-session development of clinical intentions based on client needs expressed in prior sessions, while being present supports in-session development of clinical intentions based on client needs expressed in the here-and-now. One can inform the other given that they focus, from different vantage points, on how treatment can be shaped in response to client needs.
Because of this complementary relationship, the tracks need to be taught side-by-side in both the classroom and clinical setting so that students can learn to make connections between them. The two questions I regularly ask myself now are (1) “How do we help students gain assessment and treatment knowledge, make meaning of it, and use it to inform what they do from moment-to-moment in clinical sessions?” and (2) “How do we help students have conscious understanding of this process so that they can articulate what they see when watching an experienced professional and what they do when they enter into professional work?”
One answer is to continue to develop, and integrate into educational processes, conceptual language that students can relate to their clinical experiences. Familiar words like awareness, intention, rationale, and structuring can support them to make connections between “Music Therapy Treatment” and “Being a Music Therapist”.
For example, one music therapy student used a practicum log as an opportunity to independently make these connections. After leading an instrumental improvisation music therapy session in an in-patient behavioral health setting, that student wrote the following:
“I tried to establish clear downbeats with the drum [intervene to structure the session], but it was difficult to hear in that room [awareness of environment]. So, I switched to a tambourine [intervene to structure the session] to try and establish a consistent pulse the clients could hear and lock into [rationale for intervention]. I was hoping that over time, the tempo would stabilize and the clients would entrain into a rhythmic groove, which usually creates a positive experience for clients [intention for intervention].”
Intuitively, the student used awareness of the environment to develop an intention for structuring the session. Had the student been taught conceptual language that provided a framework for considering how in-session interventions and treatment planning related however, the student’s last sentence might have been written something more like this:
It was my intention to help the clients stabilize the tempo so that as they played in time together they might feel a sense of connection to supportive community [objective level intention].
As such, the assignment might have deepened the student’s understanding of the ways in which the student’s in-session interventions related directly to the student’s pre-session treatment planning. This being the case, using terms such as those identified above may help students think more conceptually about their clinical work, which in turn may support them to more clearly articulate the music therapy processes, which in turn may allow them to more efficiently learn to confidently lead sessions.
Ultimately, the takeaway is that clinical practitioners not only must know about clinical treatment but also must make flexible use of that knowledge while being present with clients. The more students are taught to integrate their knowledge about treatment with their knowledge about presence in clinical practice, the more they will understand what to do from moment-to-moment when working with clients. Using conceptual language to teach students about these two aspects of practice will provide them with ways to make these important connections.
Featured image credit: Guitar by freestocks-photos. CC0 public domain via Pixabay.