As part of my internship at The Music Therapy Center of California, I had the exciting opportunity to attend ACES grand opening of their Otay Ranch location which included a resource fair. ACES, which stands for Autism Comprehensive Educational Services, provides a range of services for individuals and families impacted by autism and other special needs, with a focus on Applied Behavior Analysis (ABA). They offer services in homes, centers, and the community, including early intervention, social skills groups, and support for students and educators. ACES also provides parent training and support that supports neurodivergent children and their families.
This event was a vibrant gathering of professionals from diverse disciplines, all dedicated to sharing knowledge and resources with the community.
I attended alongside Carly, our center’s Operations Coordinator, who was instrumental in organizing our presence and connecting warmly with families. While Carly is not a clinician, her role was vital in making the experience welcoming and efficient.
At our booth, I provided demonstrations of music therapy techniques, offered educational materials, and engaged with parents eager to learn how music could support their children’s communication, emotional regulation, and sensory processing. The event was an excellent opportunity to practice advocacy and community education, sharing the unique benefits of music therapy in an accessible way.
This experience reinforced the importance of outreach and visibility in the field. Beyond direct clinical work, showing up in community spaces to educate and connect helps build bridges and increase access to music therapy services
During the development of my final internship project, I had the unique opportunity to meet with Dr. Hillier at the San Diego Center for Vision Care. Though our meeting was brief, it was a focused consultation which profoundly influenced how I shaped my approach to working with individuals who have vision impairments.
Dr. Hillier’s expertise in neuro-optometric rehabilitation offered me a rich clinical perspective on the sensory and neurological complexities faced by individuals who have vision impairments.
He helped me understand how visual processing difficulties can deeply affect emotional regulation and behavioral responses. He emphasized that vision impairment is not merely a matter of “seeing less” but often involves intricate sensory integration challenges that impact how a person experiences the world and manages stress.
What I found especially enlightening was his emphasis on the value of predictability and multisensory support in clinical interventions. This insight encouraged me to think beyond traditional visual or verbal methods and to embrace auditory, tactile, and spatial modalities, perfectly aligned with music therapy’s strengths.This consultation gave me a clearer framework for my special project, Hearing the Whole Picture, where I aimed to integrate these interdisciplinary ideas into a client-centered musical experience. It reminded me that even a single conversation with an expert can open new pathways of understanding, fueling creativity and compassion in clinical work.
During the pandemic, music therapy, like most of the world, went virtual. This shift allowed therapists to continue work despite physical distancing and learn and adapt to the ins and outs of VMT through Zoom. There are still needs for VMT today, and I have had the pleasure of working with a client virtually. Here are things that I have learned to help my session flow, and things you might consider if doing VMT.
Original sound
Before your client logs in, it’s important to set your audio settings to original sound. This allows for participants to hear both your voice and your instrument in real time rather than canceling each other out or causing a delay.
Use visuals through a session powerpoint or slides
Using session powerpoints helps provide visual cues and/or schedule/structure for clients like lyrics, visual choices, or images, for clients to be aware of session flow and help therapists transition between interventions.
Be comfortable with sharing your screen.
Using session powerpoints requires the therapist to share their screen with their client through Zoom. Being comfortable with this allows sessions to flow seamlessly, especially when sharing audio or video.
Use the keyboard to your advantage
Keyboards are essential to VMT as they have several different features that help both the client and the therapist and support the flow of sessions.
Add a style : backbeats (called styles on most keyboards) add a continuous driving loop that is easily heard for both client and therapist. Backbeats can be adapted to fit different genres, time signatures, and instrumentations which apply to a variety of needs in sessions. Giving options between different style options (e.g. rock or dance beat) gives for variety and choice within the session for the client
Using single-finger chord accompaniments when leading movement interventions
Movement interventions through zoom can be difficult due to the lack of in-person modeling, the limiting view that therapists have of clients, and potential audio/visual lagging. Thankfully, most keyboards have a one-finger chord accompaniment feature.
This allows the therapist to play full chords by pressing only the root note of the desired chord. This feature frees the therapists hands for modeling movements while still easily accompanying themselves.
How to sing with someone else through zoom
Singing in unison with someone through zoom is challenging due to the audio lag between participant and host. In my experience, it has worked best when either therapist or client takes the vocal lead when singing. The client I work with experiences vocal fatigue, so I typically lead songs and implement frequent phrase fill-in opportunities.
Pause for understandings phrase fill-in
Implementing phrase fill-ins sets clients up for successful singing opportunities while avoiding the audio delay. This also functions as an indicator of client engagement or understanding.
Tips
Test your tech
Testing your audio, video, internet connection and share screen components before client login helps the session flow smoothly
Be flexible
Know how to troubleshoot for technical issues/glitches
Every Thursday, I spend a majority of my day at a retirement/memory care facility in the community. I have the pleasure of working with two memory care groups, a resident choir, and a keyboard class. This facility has introduced me to some of the kindest, funniest, most musically inclined and gentle spirited people. I have found that there is truly something special about the way music brings out the personalities and emotions of those residents living with memory loss. There is so much joy in small interactions or exchanges that remind me that I love doing what I do.
Some of my favorite moments happen very subtly amongst the memory care residents. The residents in these groups have a wide range of physical, cognitive and verbal abilities depending on their stage of memory loss. I tend to take my time interacting with those clients with further progressed memory loss, specifically those that are non-verbal and typically non-responsive in conversational situations.
In my second month, I was co-leading with a team member and she was singing the folk song ‘I Love the Mountains’. The chorus of the song has a catchy phrase of ‘boom dee ah da, boom dee ah da, boom dee ah da, boom dee ah da’ that the residents love to join in on. One of the further progressed residents that is non-verbal and oftentimes looking off into the distance during group began to light up as the group continued singing the song. I had never heard her sing or talk, even when asked direct questions and had observed her as having low engagement or response during sessions. After the 3rd or 4th repetition, her face was alive and she was singing the boom dee ah da chorus. I could hardly contain my joy!
There are several moments where clients have alertly sat up after a cat nap when they hear the group singing, and even join in themselves by singing, clapping or tapping their foot. Or moments where residents interject in discussions or songs to swear that they had met the artist that wrote it or performed it. These moments of spontaneous engagement aren’t limited to passive participation, they also come alive during more structured and interventions like TIMP interventions.
During TIMP (Therapeutic Instrumental Movement Performance) interventions, each client gets an instrument (typically a maraca, small tambourine or hand bells) and is prompted to follow along with my visual, musical or verbal movements. I have had several laughing fits when residents begin to freestyle/improvise dance moves. You would never expect to see a 90+ year old man in a wheelchair to stand up and shimmy while you’re singing ‘Shake Senora’.
If there’s one thing I’ve learned as a Music Therapy intern, it’s that sometimes the best moments aren’t the ones you expect and play for, but they’re the ones that happen spontaneously, amidst the laughter, smiles, jokes and music that we create together.
Our rapidly expanding San Diego team is hiring TWO passionate, creative, and fun-loving music therapists to join us.
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This feels like a dream, with the hope that we are givin’
Use your heart and mind, helping clients be their best
Transforming lives and watching so many progress
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Live the dream, and would a signing bonus make it better?
Want to find a place where you can really soar? Apply today, what are you waiting for?
Learn more! It’s easy as 1, 2, 3:
Send an email to Julie@themusictherapycenter.com
Attach your resume
Include your spirit animal
Start date:“Yesterday all my troubles seemed so far away”… whoops sorry, sadly life isn’t actually a musical but the position is open immediately.
P.S. Thanks to Dolly Parton’s hit song, “9 to 5” for inspiring the lyric parody above and on the following video. Note we do not own the rights to the song.
I remember when I first entered practicums for music therapy in college, I thought I would never use my clarinet in sessions with clients. As much as I love the field of music therapy, I was afraid that all of the hours and dedication spent improving technique on my primary instrument for years would have been lost. Let me tell you, that is not the case! There are various opportunities to use wind and other novel instruments in sessions to achieve therapeutic goals and I’m excited to share some of the ways I’ve used the clarinet in sessions over the course of my internship.
Name That Tune
Name That Tune is a classic and great opportunity to use a novel instrument in sessions! As the title suggests, Name That Tune is a game where you play a familiar song for the client without lyrics and prompt the client(s) to guess the name of the song. This is great to achieve cognitive goals such as improved listening and attention skills. I have used Name That Tune in group and individual sessions, and clients appear to enjoy listening to songs they know on an instrument they don’t hear very often if at all!
Call and response
I’ve used the clarinet during call and response interventions, primarily to achieve goals such as: improved listening, self control, attention, turn taking and interpersonal skills. This type of intervention can be quite versatile, as you can be the leader and prompt the client to imitate what you play or you can have the client lead on an instrument and you as the therapist can imitate. You may choose to play a familiar song and you each play a phrase of a song; for the song “You’ve Got a Friend in Me,” I may play a line of the melody on my clarinet while the client plays the rhythm of the next line on a drum. We could also just pass an improvisatory musical phrase around like a rhythmic imitation exercise (ex: “Repeat after me. Listen first, then play what I play on your instrument”).
Playing as a duet or group
Another great way to utilize a primary instrument in sessions is to play the melody of a familiar song while the client(s) accompany on other instruments, kind of like a jam session! This is a great way to improve social skills, attention skills, motor skills, and build rapport with clients. For this intervention, choosing a motivating song for the client is an important consideration because it may play a role in the client’s participation. As the therapist, you may have specific instrument(s) in mind for the client to play during the intervention to target specific muscle groups and/or achieve certain goals, but engaging in cooperative play alone may be an important area of growth for the client. Here, I may encourage the client to keep a steady beat on the drum set or floor drum (like a rockstar, of course!) while I play a song on the clarinet for approximately 2 minutes (or whatever the client’s target sustained attention goal is).
One more thing I wanted to note was that, while we are in a pandemic, we can still use wind instruments during in person sessions! As a clarinetist, I have a mask with a hole cut for my mouthpiece along with a mask on my bell so the aerosol generation is maintained in the instrument.
Me and my super cool clarinet mask ensemble!
This being said, it is also up to the discretion of the client and parents/guardians whether or not they feel comfortable having a wind instrument played in the session. If you are interested in learning more information about the aerosol generation of various wind instruments, check out this study that was published in September 2020.
I hope these ideas are helpful for other therapists who may want to incorporate their novel instruments in sessions!
Virtual team assemble! As is everyday practice now, music therapy services at MTCCA and other practices across the country are being provided virtually as well as in person. The ability to go virtual with sessions is such a special gift, especially for our music therapy groups who may not otherwise be able to meet in person due to social distancing and safety guidelines. I will say, when I first started seeing groups virtually, I was a little intimidated because of the barrier between the screen and clients. One of my biggest areas of growth was making the experience as personable as possible for these clients. For those who may feel this way now leading group sessions virtually, fear not! I have some tips that I’ve learned from my experiences that can hopefully help you out, because leading groups virtually can still be so much fun!!
Ask for the clients’ names! This may seem like a simple and obvious one, but it was something I wasn’t even considering when first leading the sessions, specifically for our senior retirement centers and adult group homes where the clients all live in the same facility. Simply asking the clients their names or having on site staff members assisting with names can really make the experience more personable for everyone involved. For example, it can assist with calling on specific people for leadership opportunities in the group and asking/answering questions. Furthermore, it helps build the rapport between clients and therapist which can aid in participation overall.
Use the staff members as models! For our clients who live in facilities, there may be multiple staff members nearby to help set up Zoom, pass out instruments, or aid clients in participating. What I didn’t consider was, what better way to encourage clients to participate than having the staff members act as models for the group?! At the beginning of the session, it can be helpful to encourage the staff members to participate through the session and then reminding them during certain interventions (such as movement or instrument playing interventions) of what to do. This gives the clients an in person model to imitate and can even help foster positive relationships with the staff members. The staff at these facilities may act as the biggest encouragement for why music therapy services should be offered, so it is important to build these relationships and show why music therapy is a crucial service for the clients!
Keep business as usual! Yes, while virtual services are not quite the same as in person (for me, the laptop screen was a barrier that challenged me at first) it does not mean music therapy services have to change or that you as the music therapist need to act any differently! With groups, there are still so many opportunities to achieve relevant goals through virtual drum circles, songwriting, improvisation, and many more interventions. Keeping a positive attitude, picking appropriate music for the group and encouraging participation through these sessions can provide a source of community and group cohesion just like any other session.
Maybe you learned something new today, or maybe these tips act as reminders for how to approach virtual music therapy group sessions. Either way, I hope these tips were helpful, happy virtual session leading!
In symposium last week, we discussed visual thinkers and chapter one of “Thinking in Pictures” by Temple Grandin. For those who are not familiar, Dr. Temple Grandin has her Ph.D in animal science, designs livestock handling facilities across the US and other countries, is a professor, and has autism. Grandin is a visual thinker, and she describes her thinking process as this: “Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures.” Pretty cool, right? In fact, many people with autism are visual thinkers and are able to think in photographically specific images. Eric Courchesne of University of California in San Diego noted that, in people with autism, “the only parts of the brain that are normal are the visual cortex and the areas in the rear of the brain that store memories,” which may explain the significance of specific images in learning and thinking.
So, what does this mean when providing clients with autism music therapy services? First and foremost, try to identify the way your client thinks; in her book, Grandin says that there are three categories of specialized brains. Besides visual thinking, there are also music and math thinkers who think in patterns, and verbal logic thinkers who think in word details. This may be accomplished by simply asking a client how they best learn (if they are verbal and have expressive language abilities), asking parents or guardians how their child learns, or learning through trial and error in sessions. The big takeaway: incorporate visuals as much as possible in sessions! It certainly does not hurt to provide more opportunities for client successes, and visuals are a great way to encourage participation and achievement of goals, especially for visual thinkers.
Often, clients with autism can identify and understand concepts more clearly with pictures than with words. Here’s a couple of ideas of ways to utilize visuals in sessions:
Example of visual schedule using Choiceworks
Visual schedules- Writing out the session schedule on a white board, using apps such as Choiceworks, or having flashcards with pictures or symbols of what comes next in the session can be helpful in providing organization to sessions and a clear and specific outline to follow. Also, I recommend using a picker wheel as another opportunity for a visual schedule because it is engaging and fun for clients to see!
Visuals with words- Accompanying social stories and songs with visuals of specific scenarios, movement flashcards with words and visuals, and word association interventions with accompanying visuals can be useful to achieve various goals and provide different avenues for clients to achieve success during an intervention. Clients with autism may have difficulty with associative thought patterns, meaning that they may associate a picture with a word that is not correct; an example Grandin uses is the association of a dog with the word “outside.” While dogs may sometimes be seen outside, there are certainly other locations dogs can be found in (houses, apartments, at the beach, and various other locations). Using appropriate visuals with words can be helpful in improving these word associations. Below are some visuals I found through this website that were perfect for clients with gross motor skill goals during the holiday season!
Examples of movement flashcards with visuals (perfect for the holidays!)
I encourage you to think about the categories of specialized brains and how you may adapt interventions using visuals to foster growth in your clients! If you are interested in learning more about Dr. Temple Grandin, here is a link to her website: https://www.templegrandin.com/
Grandin, T. (2014). Thinking in pictures. London: Bloomsbury Publishing. http://www.grandin.com/inc/visual.thinking.html
When I was a freshman in college, I remember thinking my music therapy internship was a distant bridge that would eventually be crossed in the far off future. As I approached junior year, I realized that this future was actually not so far away after all and remember feeling a range of emotions about internship. Fast forward to now, almost at the three month mark of internship at MTCCA (it’s hard to believe!), and I can say that I never would have imagined interning during a pandemic! Internship is already a huge transition and tacking on the adaptations made by COVID-19 has made this experience quite unique to say the least. This being said, I want to share some insights I have realized during these first few months that have made the transition a bit easier.
“It’s all about the mindset!”
It’s all about the mindset! I have already experienced instances where I have been challenged, whether that be learning the ropes of all the systems we use, figuring out how to best manage my time with my tasks, or just generally adjusting to this different yet exciting time in my life. There are times where I get frustrated and think, “grrr COVID, I wish I had x,y and z experiences” or I can just get bogged down in what I can’t do right now. I realize these are normal thoughts that everyone has probably experienced at some point this year, but I’ve come to realize the significance of re-evaluating the situation to remind myself that, while these frustrations are valid, I am lucky that I still get to have this internship experience. I still get to interact and engage with clients, research and data collect, learn more about the profession, and I get to learn the ins and outs of virtual along with in person sessions! Sometimes it can be scary to go out of your comfort zone and learn new things, but especially now, there are so many neat resources and ways to provide clients with music therapy wherever they are. These resources will be around for years to come so now is an opportune time to learn how to use them and put them in your therapist tool kit.
“The only way to learn from mistakes is by making them!”
Dive in! There are so many unknowns and “what if’s” in the world, and while it is especially important to be cautious and safe, find as many opportunities to just jump into whatever you can. Whether it be asking questions of your team members, saying yes to an opportunity, or just allocating independent time to learn or research, find ways to go out of your comfort zone and gain experiences. Of course it can be intimidating to go out of your comfort zone, and for me I’ve found that the scariest part of “diving in” is fear of doing the wrong thing. This being said, the only way to learn from mistakes is by making them! The interventions that don’t go as planned and the questions that need clarification are part of the learning and growing experiences that I wouldn’t have if I didn’t challenge myself to go out of my comfort zone.
“It’s important to know yourself and find what works for you.”
Find time for you! I love to check things off of my to-do list and feel accomplished when I work hard towards a goal, but especially with all the information you soak in during the first half of internship, it is important to find time to do things outside of the therapeutic setting. It can become overwhelming to learn so much in a short span of time and it is important to find avenues for self care. With the pandemic, I had consecutive months where I was out of school and working 3-4 days out of the week so transitioning to a 40 hour work week across the country was a big life adjustment. For me, self care most frequently comes in the form of getting enough sleep, calling family, spending time with friends, going on walks, eating enough, and doing yoga. It is important to learn about yourself and find what works for you.
A final honorable mention of insights I have realized is one of the most important during this transitional period and that is: you can’t control everything! There are so many things that are naturally out of the therapists’ control in private practice (changing client schedules, technological mishaps, etc.) and flexibility really is the name of the game. This is certainly true with the pandemic as well, as we all have had to make adjustments to adjust to the new normal. Taking time to remind myself that some things are simply out of my control has been helpful in reorienting my frame of mind and allowing me to come to terms with the unexpected.
While I can’t say I ever expected to be an intern during COVID, I can say that I’m so glad to be interning at MTCCA and making the most of the experiences here.
Thanksgiving may look a little different this year, but that doesn’t mean Thanksgiving and fall themed music therapy interventions have to be less fun, engaging or beneficial for clients! In fact, we have a wide world of online resources at our fingertips that are great to use during this time of year and can be adapted or modified to fit various therapeutic goals.
The first resource I want to share is a website called “Boom Cards.” I had no idea what boom cards were prior to internship, but they are a game changer especially for virtual music therapy sessions! Boom cards are digital and interactive activities where students and/or clients answer questions or participate in activities and can receive immediate feedback for their answer. I like to think of boom cards as digital flashcards, but they are much more versatile! While you have the option to purchase certain boom cards, there are many decks on the website that are free and are great quality. One deck that I’ve used recently for fall is the “Scarecrow Emotions,” specifically for younger clients whose goals are to identify emotions or improve emotional regulation. While music is not inherently a part of these activities, I’ve been able to incorporate music by putting a melody to the questions and giving directions for the activity using a simple tune (ex: singing, “The scarecrow feels angry. Which face looks angry to you?”). I also modify the music based on the emotions the scarecrow feels. For example, if the directions say to give the scarecrow a sad face, sing the directions in a minor key to keep music incorporated in the intervention and to contextualize the sounds that may be associated with certain feelings.
There are so many more (and free woo!) boom cards that can be creatively adapted for music therapy interventions, I definitely recommend taking a look through the website and seeing how you may utilize these in sessions.
Another way I’ve used online resources for virtual sessions is by having clients build their “Thanksgiving plate” using visuals and a powerpoint slide. The food visuals and vocabulary words are courtesy of another website, “Teachers Pay Teachers.” I’ve used this activity primarily to work on clients’ sustained attention but it is also beneficial in helping clients identify foods associated with Thanksgiving and improving prosody of speech. Similar with the scarecrow intervention, I created a simple tune to sing while drumming: “What shall we eat, what shall we eat, what shall we eat for our Thanksgiving feast?” I encourage the client(s) to say their favorite holiday food that they see on the slide, and drag that food onto the plate. When they choose a food, I sing and drum the syllables of that food in a natural rhythm that the word is spoken (ex: green beans is two quarter notes). By the end, the client(s) has a full plate of Thanksgiving foods that they’ve made.
I hope these activity ideas and resources may help as we continue to explore the world of telehealth and how to best treat clients virtually. Have a Happy Thanksgiving!
