Tuesday, August 27, 2013

Music and Relationships

Little girl, what attracts you to music? 
Hello friends! Vivian Hsu here. Thanks for following our music therapy blog after our study abroad trip to Thailand. In this last blog, I am going to tell you what happened after this trip.
When I got back to Taiwan for the rest of my summer break, my heart was filled with complicated feelings. I was sad to leave this beautiful country and beautiful people, but excited to tell my friends about all my adventures and clinical experiences in Thailand. I could not wait to see my family and my friends in Taiwan. One of my college classmates in Taiwan, who read my previous blog post, asked me if I would like to see a little boy with autism. She had been teaching this student piano lessons for three months, and she found this clever child seemed to have trouble sitting for a 30-minute class.
I said, “Yes. Let’s make an appointment to interview this boy and his parents.”
In Thailand, I worked in the oncology unit in Siriraj hospital. Some patients really needed music while they were waiting for their chemotherapy treatment. Music healed them. As a music therapist, I had no hesitation in responding to all the requests from patients because everyone has the needs of improving their quality of life and everyone can relate to music in some way. 
Doing Music Therapy with lovely preschoolers in Taiwan
Without my experience in Thailand, I might have thought “am I eligible to do an individual session without a supervisor?” However, I have gained confidence in my facilitation and therapy skills, and knew I could do this. I talked to this boy’s Mom on the phone; she was very interested in having her son take some music therapy classes. 
Yes. It was a music therapy “class”, not a “treatment.” It is not common for Taiwanese to admit their needs of therapy, but they love to take all sorts of lessons in order to develop both mental and physical health.
Through the phone interview, the Mom was worried about her son’s limited attention span because he was going to preschool after this summer.
“I felt embarrassed when I took him out in public”, his Mom said. At that time, I did not realize how serious this situation was for his Mom.
In our first assessment session, I observed that Antony (nickname) is a very clever, energetic and curious 5 year-old boy, who is diagnosed with autism. We went through more than 10 music therapy interventions in our 40-minute session. He responded to music naturally by memorizing new songs immediately, singing, and playing the melody along with me. He often sat close to me and wanted to touch and play all the instruments. However, his Mom interrupted during almost every application.
“Antony, STOP!”
“Antony, DON’T TOUCH IT!”
“Antony, SIT STILL.”
“Antony, DON’T ASK TOO MANY QUESTIONS.”
“Antony, YOU PLAY THE WRONG NOTES.”
When Antony received the warning, he just looked at his Mom and waited for the punishment. He lost interest in continuing the intervention because he thought his Mom was unhappy. He did not even know why his Mom stopped him, but he was able to recognize her anger by her tone, so he stopped participating. 
I knew the first thing I should address was not Antony’s short attention span, but his Mom’s anxiety. I talked to her after the session. She told me what I did was totally unexpected. She just wanted her son to sit and listen to music so that he could improve his attention span. Stopping and warning her son was her job in both his piano lessons and occupational therapy treatment in order to make classes flow smoothly.
“You are too young. You don’t know how to make my son follow your directions. But I know how to control my son’s impulse,” she said.  
I explained to her that music could be used to treat and improve physical and mental health, as well as aid in social, spiritual, and intellectual development. Through interesting interventions, Antony could not only expand his attention span, but also improve impulse control by improving his self-regulation skills. Music context could even provide Antony ideas about what to do in different settings, such as restaurants, school and home. I also told her what my job as a music therapist was, to provide very specific kinds of help to clients. I could incorporate music to occupational practices to make it more interesting.
She only needs to trust the powerful effects of music as therapy.
“Trust music and your son.” I told her.
Hey friends! There are so many ways to say hello! 
She told me she would think about if they still needed music therapy before she left.
After few days, she contacted me and said they would like to continue music therapy sessions. She agreed to wait and see how music affects her son. I also promised her I would set boundaries with Antony at the beginning of the session, so she did not need to worry that I would affect her behavior management routine in the other classes.
There were some significant changes that occurred in our second session. Antony started to make eye contact with me, so he got to choose some instruments he wanted to play. He was very focused on listening to the directions through music, so he was able to make music with me. He stopped throwing instruments back into the box while I was playing a soft and slow clean up song. He had a chance to show that he understood the concept of division through music. That completely surprised his Mom.
I immediately reinforced him right after he performed appropriate behaviors.
“Mom, Miss Hsu told me that I am a good student,” Antony said.
This was a huge encouragement for him. He did not need a lot of reminders or warnings anymore to act appropriately. That was also a primary goal for this client. Furthermore, the relationship between him and his Mom improved through their interactions in the music applications. 
This special song is just for you. 
Every client is special for me. The trip to Thailand totally changed my perspectives on music therapy. As you can see, my definition of music therapy has been revealed by my clinical facilitation. In this case, I used music experiences and the relationships that developed through them, therapeutically. My definition not only reflects my personal philosophies and professional identity, but is created to answer every individual client what music therapy is.
Music can empower and strengthen individuals in ways unimagined. I found how both of my knowledge and experiences fit together when cultural and social considerations are added to the mix. I will keep working on my definition of music therapy consistently. The trip to Thailand was unforgettable and wonderful. Dr. Register opened my mind to new horizons of music therapy. I am still working on defining music therapy, but my philosophy of music therapy has already come out--- MUSIC and RELATIONSHIPS. 

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