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Have you ever interacted with a client who strongly objects to certain textures, avoids being touched, or displays strong sensitivity to light or a reflection? What about a child with the opposite response? One who doesn’t acknowledge touch, sound or different stimuli? Or how about a client who craves sensory stimulation, like feeling a lot of pressure on the body, listening to loud noises, or enjoying bright lights? Responses such as these may be indicative of Sensory Modulation Disorder.

Written by Carol Stock Kranowitz, “The Out of Sync Child” explores sensory processing disorders (SPD), one of which is sensory modulation disorder. According to the book, SPD is “the inability to use information received through the senses in order to function smoothly in daily life.” Considered an umbrella term, SPD encompasses a variety of neurological disorders, including sensory modulation disorder. Sensory modulation disorder is the “problem of timing in the central nervous system” which can influence inhibitions; this can in turn impact one’s threshold for sensations which can cause overresponsivity, underresponsivity and sensory craving behavior.

Overresponsivity in a child with sensory modulation disorder is the result of hyperresponsive sensations coming from one or several systems. This can result in a child appearing irritated, annoyed, or threatened by particular sensory stimuli. A child with an overresponsive response to sensory stimuli may also be considered a sensory avoider due to the amount of sensory input the child takes in which can make the child avoid situations where sensory arousal may occur (ex: a light touch, his/her reflection, or a loud noise could make the child have a meltdown, become defiant, or even withdraw completely from the situation).

Underresponsivity in a child is a lack of ordinary arousal of sensory systems, which can result in a child responding less intensely to sensations than neurotypical children. A child with an underresponsive response to sensory stimuli may be referred to as a sensory disregarder because of difficulty achieving alertness or arousal in the presence of sensory stimuli. The child may appear withdrawn or may not even recognize sensory stimuli (ex: no response to loud noises, difficulty understanding nonverbal gestures, lack of hunger signals).

The sensory craving child needs far more stimuli than other children and may not recognize when they have had enough sensory stimulation. The child may be attracted, or even addicted to, stimuli such as bright lights, touching certain textures, listening to specific sounds, or places that are busy such as crowds. For a sensory craving child, wanting more and more sensory stimulation is normal and it may be a challenge for the child to know when enough is enough.

So, what does this mean for music therapists? It is important to recognize when, or if, we see sensory modulation disorder characteristics in our clients. It is likely that a child can be a combination of sensory modulation types. For example, a client may be underresponsive to a particular sensory stimulus, such as loud sounds, while being sensory craving for another stimulus, such as reflective surfaces. We can use this information to inform our decisions as music therapists in regards to improving a client’s sensory regulation and also allowing the child to have the most opportunities for success in achieving their goal. If a child craves tactile stimulation, perhaps allow the child to sit on a tactile spiky cushion or incorporate the cabasa while addressing a therapeutic goal. For a child who has difficulty regulating proprioceptive input, you could have client hold weights or heavy instruments during the session. For a child who has trouble regulating vestibular sense, you may consider incorporating movement through the session or allowing the child to be spun in a chair periodically to receive that sensory input. Perhaps a child is overresponsive to visual stimuli; this child may need lights to be dimmed or even turned off in the therapy space, and visual distractions may need to be hidden away as best as possible. If a child is overresponsive to loud noises, lower the dynamics of a song or instrument to encourage the child to continue participating while still providing music stimulus. It may also be necessary to sing a cappella without an accompanying instrument to further decrease the amount of auditory stimulation. (It is also important to note, though, that sometimes quiet in a music therapy session may be necessary to regulate the client if the auditory stimulation proves too overwhelming!)

If you’re interested in learning more about SPD or the neurological disorders that fall under SPD, feel free to read Out of Sync Child!

Katherine

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.

Katherine

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!

Katherine

by Megan Miller, MT-BC

Group social skills interventions are a great opportunity for our students to practice social skills they are learning in individual sessions! This is why MTCCA partners with Banding Together to provide free, music therapy groups for young children through young adults. So we decided to take a closer look at a research study that analyzed the effectiveness of group social skills interventions on social functioning for people with Autism Spectrum Disorder (ASD). *Check out the citation for the full article at the bottom of the page and give it a read as well!

This article took a closer look at 18 different group social skills interventions by completing a meta-analysis, and the findings were quite interesting. These interventions treated people ages 5-21 years old with a formal diagnosis of ASD, Pervasive Developmental Disorder, and Asberger’s Syndrome. They measured outcomes using parent, teacher, and self reports on social functioning. Altogether, these three categories showed that group social skills interventions showed a “medium effect” on social competence, meaning that these interventions were moderately effective! 

While a moderate difference may not sound too exciting, it can be a big deal. Most of the assessments used in the study measured skills used in everyday life, not just in the group interventions. This means that any difference reported had an effect on a participant at school or home, positively impacting their ability to interact with others. This is great news! In addition, participant ratings on their own social competence revealed that group social skills had a “large effect,” or made a big difference, on social competence. Parent and teacher reports agreed with this as well.

However, the article showed that there are some things we need to consider when we are designing group social skills interventions for individuals with special needs. Although these participants gained knowledge about social skills in these groups, they reported their actual social behaviors did not change as much. This is a big problem because we use group social skills interventions to actually help people with their social skills. That is the whole point! This is why providing opportunities for application of the social skills in music therapy groups is very important. 

Lucky for us, music therapy is a great tool for applying previously learned skills! Group drumming is an excellent example for how music can help a participant with social awareness. During this music experience, participants are following nonverbal cues, watching the leader, and maybe even taking leadership roles themselves. The music and rhythm provide cues for things such as when to play or how loud to be. These are all skills that we use in everyday social situations. So if you are using music therapy groups or social song stories to teach Social Thinking©️ concepts such as following the group plan or expected and unexpected behavior, be sure to give your participants opportunities to put these skills into practice, whether it’s with group drumming or another creative music experience! 

Leaving this post a little overwhelmed? Here are three main takeaways from the original article: 

  1. Group social skills interventions had a moderately positive impact on social functioning.
  2. Participants expressed improvement in understanding social concepts, while reporting not as much improvement in the actual application of these concepts.
  3. When designing group music therapy experiences, providing opportunities for the application of learned social skills is essential.

Be sure to follow the citation below and read the full paper if you are interested in learning more! 

Reference

Gates, J.A., Kang, E., & Lerner, M.D. (2017). Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis. Clinical Psychology Review, 52, 164-181.

Hello everyone! I can’t believe it but I am already at the end of my internship! This has been a goal that I have had for so many years, and I am so excited to finally be at the culmination of my education! I am so thankful for this experience that I have had, and so grateful to take all of my learnings with me.

Here are my top ten learnings from this time:

1. Spending an entire session on sensory integration and calming down is not a waste of a session!

I know so many clients that need to feel centered and calm when it comes to sensory stimulation and that absolutely nothing will get done if they are over or under stimulated. It is just as important to help our clients get what they need at that moment, and learn how to calm themselves down and self-regulate. This is not a waste of time!

2. Growth happens in the scariest places

The Most Famous Inspirational Quotes - OMG Cheese

I remember the first time I was asked to cover a group for another therapist all on my

own. I was terrified and not sure if I would be able to do it! I remember feeling insecure

and nervous about my capabilities, but in the end the session went amazing! It is such a good feeling when you step out and try something new, and it goes amazing! It brought me so much confidence both in the skills I already had, but also in the benefit of trying new things. I love seeing how I am now confident leading sessions for clients I do not

know, because I have had the opportunity to step out of my comfort zone.

3. The power of themed sessions!

I never thought about using themed sessions outside of specific holidays before internship, but it has turned out to be one of the best ways for me to plan! It makes it so much easier to narrow down your session ideas, keeps things unique and interesting for your clients, and helps with things like reality orientation for your clients and understanding what is going on in the world around them.

4. The brain is incredible

WOW there is so much I didn’t know about the brain before coming to internship! Learning about neurologic music therapy and the power of music in the brain has been astounding. Neuroscience is amazing. There is so much we don’t know yet, but there is so much value in understanding the research behind what you are doing so that you can use those tools to focus on exactly what will work for your clients. I have learned so much about the brain and how I can use this to directly influence change and growth for my clients!

5. The power of singing a capella

As a vocalist, I knew my voice would be a strength of mine in sessions, but I did not realize how useful of a tool this would be, mostly because I don’t have to carry an instrument around with me when I sing! My instrument is a part of me, which makes it so easy to focus entirely on the client and what they may need in the moment. Singing a capella is also so beneficial for transitions between interventions in group sessions. I have found it very effective to sing the melody of a song for a “Name that tune” exercise in between interventions. This keeps clients engaged, but keeps my hands free to gather up or pass out instruments during transitions.

6. Time Management is essential

Internship can be really overwhelming and busy, but I found that setting myself up for success with good time management was the best way to keep myself from becoming too worn out. At the start of busy days I would take a few minutes to write down the top three things I wanted to accomplish that day. From there, I would make a list of other tasks that were less essential but I still wanted to get done. By creating a strategy for my little chunks of work time throughout the day, I was able to manage my time very effectively.

7. It’s not the end of the world

It’s easy to feel frustrated or upset when a session doesn’t go as planned, but I have learned to realize that this is a time of learning, and my supervisors know that I don’t know everything! Giving myself grace and understanding when I mess up and being okay with failing has been so healthy for me during this time. It’s okay if you mess up! It’s not the end of the world! “Failing” at something is one of the best ways to learn.

8. Don’t be afraid to take action

A huge learning curve for me, especially at the start of my internship, was to trust my gut and step in if I could see a client struggling or becoming overwhelmed. If you see a client becoming overstimulated or you can see a client may become aggressive or anything of the like, especially in a group setting, trust that you have the tools to do something about it before it escalates, and have the confidence to take action!

9. Be open to change and new ideas

When I first moved to San Diego for my internship, I was positive I wanted to go back home to Washington state after I finished my internship, but as time went on I realized that I wanted to be open to more options! It is so important to learn to be open to life changes, especially in a career like music therapy that can change so quickly! Being flexible and willing to try new things in your career will take you far!

10. You can totally do it!

I remember freshman year of college hearing that I would have to do an internship after college, and it seemed daunting and impossible. It is so easy to look at the mountain in front of you and think there is no way you can do it. I learned to take it one step at a time! Even if it seems overwhelming, just take the next step towards your end goal and you will be successful! One step at a time.

Thank you for reading my blog posts for the past 6 months, I am so thankful for the opportunity to share my learnings with you!

Audrey Cosgrove, MTI

One of my favorite things to share is session plan ideas, because I know how valuable it is to have new ideas and get inspired by what others are doing! I have been using these interventions with a few of my groups and they have been really successful! Here are some ideas for your own session plans: 

 

Question of the Day: Where Do You Want to Travel? 

  1. MT uses a melodic cue to prompt the question to each client individually 
  2. “Where Do you want to travel?”
  3. MTI will sing “Conversations”, and ask each where they would like to travel
  4. Adaptation: MT can use a visual with photos of different options for answers for nonverbal clients

 

Songwriting: In the Jungle

  1. MT introduces and sings song “In the Jungle” with group 
  2. MT explains that we will be rewriting the song with different places and different animals to make our own song 
  3. MT gives each client the opportunity to pick a location and an animal to fill in blanks of song 
  4. Group sings new verse together 
  5. Example: 

 

In the ________________________

The mighty _________________

The ____________ Sleeps tonight 

 

  1. Places:  
    1. Jungle
    2. City
    3. Forrest 
    4. Dessert 
    5. Rain-forest 
    6. Arctic 
    7. Ocean
  2. Animals: 
    1. Peacock 
    2. Elephant 
    3. Puppy 
    4. Bear 
    5. Lion 
    6. Dolphin 
    7. Polar Bear

 

Sing-A-Long with Instruments: Song choice: Travel Themed

  1. MT prompts one client to pick a song from the song choice visual (photos representing each song)
  2. Group sings song and plays instruments together 
  3. Song options: 
    1. She’ll Be Comin’ Round the Mountain
    2. A Whole New World 
    3. Home on the Range 
    4. Fly Me to the Moon 
    5. This Land is Your Land
    6. I’ve been Workin’ on the Railroad

 

Relaxation:  What a Wonderful World 

  1. MT prompts group to take deep breaths all together 
  2. MT sings What a Wonderful World, prompting client to continue deep breathes 

 

Attention: Travel Visuals Listening

  1. MT passes out pictures of different travel items to each client (passport, globe, suitcase, car, airplane, etc.)
  2. MT prompts group to listen for their object for their chance to hold it up for the group
  3. MT sings song  “We’re Going on a Trip” (any melody or words works for this intervention. One option that works well is using the melody of “She’ll Be Comin’ Round the Mountain”)

Travel Attention Song:

We are going on a trip 

Together today 

We have lots of things we need to bring along  X2

 

We need a SUITCASE 

To pack all of our clothes 

Who has the suitcase 

Lift it in the air! 

We need a PASSPORT 

So we know where to go 

Who has the passport 

Lift it in the air! 

We’ve got a SUITCASE and a PASSPORT 

(song continues with each new item added on and then reviewed)

3. MT sings this song until all items have been done

 

I hope this helps you think of some new ideas for your session plans! 

 

See you next time!

Audrey Cosgrove, MTI

The Transformational Design Model: 

Have you ever felt lost for how to address a certain goal with a client? Maybe you’ve never worked with that population before, addressed their specific goals, or are simply at a loss for inspiration? This past week I learned about one of the most useful models to make sure every intervention is functional and effective, called The Transformational Design Model (TDM)!

The Transformational Design Model, developed by Dr. Michael Thaut is a system to help therapists translate research into functional clinical practice. It ensures that each intervention is backed by research and intentional goals, which in turn brings the best results for clients! This model also ensures interventions are generalizable back to the clients daily life, which is an essential part of the process. It emphasizes a patient-centered rather than discipline-centered therapy and also helps music therapists to avoid two weaknesses: 

  1. An activity-based approach in which generic musical activities are adapted to therapeutic goals 
  2. The use of therapeutic music techniques that address therapeutic goals very broadly and generally, and are only weakly related to functional therapeutic outcomes

There are five parts to The Transformational Design Model: 

  1. List the client’s strengths/needs
  2. Write out one goal/objective you would like to focus on (based on their needs) 
  3. How this goal/objective would be addressed by a non-music therapist (speech therapist, physical therapist, teacher, etc.)
  4. How could you add musical stimuli to that exercise? (don’t just write a music experience-add music to the experience above). 
  5. How could you generalize back to the normal environment? (fade the music)

Example TDM: 

  1. Strengths & needs: Client has great rhythm and songwriting skills, and loves creating new songs. Client needs improved emotional awareness and coping skills for handling difficult emotions
  2. Goal: Increase ability to calm down when upset 
  3. Non-music therapist: Drawing out what how to calm down, writing a poem or brainstorming ideas 
  4. Create a songwriting intervention centered around coping strategies and ways to calm down when upset. Music helps to concrete these ideas in one’s mind and makes them easier to draw from memory when a situation arises. 
  5. Generalization: Create in session scenarios to practice calming down and using techniques written in song. 

 

This model is so helpful for going back to the basics and making sure that your interventions will make a real impact on your client! 

I hope this model is helpful for you!

  • Audrey Cosgrove, MTI

Valentine’s Day is just around the corner, so it’s  a great time to share some fun Valentine’s Day Interventions and exercises.  I am so excited to get the chance to do some themed sessions for Valentine’s Day, it is such a fun holiday!

 

Songwriting: I Love the Mountains

Materials: Songwriting sheet (for lyrics), heart tree and hearts (made via google images-see image below), expo marker, visuals for non-verbal clients

Goal areas: emotional expression, decision-making/choices, social connection with peers

  1. Music therapist introduces and sings song “I Love the Mountains” with group and prompts group members to sing on “Boom-de-ada” portion or play along on instruments
  2. Music therapist shows group “Heart tree” to place hearts with what clients love
  3. Music therapist asks group what things they love, using visual of options to prompt answers, especially for non-verbal clients
  4. Music therapist writes down client response on a heart, and prompts them to place it on the tree
  5. Once all hearts have been filled and all clients have answered, music therapist puts these into song “I Love the Mountains” 
  6. Music therapist sings song and acknowledges what each client said (if done in a one-on-one session

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Social Skills Hearts:

Materials: social skills hearts (made via google images and text-boxes), tambourine or other container to pass, bluetooth speaker 

Goal: social skills, social interaction, making choices/decisions

  1. MT puts hearts with social skills questions written on them inside of a tambourine 
  2. MT plays the song “Count on Me” by Bruno Mars on bluetooth speaker 
  3. MT prompts clients to pass tambourine around the circle.
  4. When the music stops, whoever has the tambourine draws a heart out of it and answers the question inside 
  5. This continues until all clients have answered a question/drawn a heart
  6. Adaptations: : for non-verbal clients, create a visual with photo options for answers to each question, so that everyone can participate! You can also use a microphone to motivate verbal responses from individual clients, or have verbal clients ask the question to their friend to promote socialization. For individual sessions, clients can drum along or play an instrument with the song until it pauses, and then choose a question.

 

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Heartbeat Instruments: Attention

Materials: instruments, colored hearts taped on instruments

Goals: Attention, color-matching, cognition

  1. MT passes out instruments to each client, with different colored hearts attached to each. 
  2. MT prompts group to listen for their heart color for their chance to play/have a solo
  3. MT sings song to the tune of “She’ll Be Comin’ Round the Mountain”

If you have a RED heart play your instrument

If you have a RED heart play your instrument

If you have a RED heart x2

If you have a RED heart play your instrument

  1. MT sings this song until all colors have been done
  2. Adaptations: Provide opportunity for clients to make a choice for what color is chosen next (visual for non-verbal clients)

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I have also used the song “Side By Side” to work on lower body movement (PSE), because this song is great for prompting side steps! For upper body, a great song to use is “Can’t Help Falling in Love with You” because it is in ¾ time signature, making it great for smooth fluid movements! Below are some other song ideas to use for Valentine’s day.

Song ideas for Valentine’s Day:

  • Can’t Help Falling in Love With You: Elvis Presley 
  • You’ve Got a Friend in Me: Toy Story
  • With a Little Help From My Friends: The Beatles
  • Can You Feel the Love Tonight: The Lion King
  • All You need is love: The Beatles 
  • All I Have to Do is Dream: Everly Brothers
  • My Funny Valentine: Babes in Arms
  • Bicycle Built for Two (Daisy Bell)
  • Love Me Tender: Elvis Presley
  • Side by Side: Patsy Cline
  • You are My Sunshine (Valentine)

I hope those ideas give you some inspiration! 

-Audrey Cosgrove, MTI

 

As a requirement before starting my internship at The Music Therapy Center of California, I was required to take the “Clifton Strengths Finder” test. At the time, I didn’t realize how beneficial and insightful this test would be for me. I have always been a fan of any sort of personality test, but this one gave me a new kind of understanding about how I work best and what I am good at. Clifton Strengths Finder is an online test you can take that gives you your top 5 strengths out of a list of 34 options. Your results are personalized, and it gives you lots of information on each strength. My strengths are: Discipline, Empathy, Achiever, Communication, and Woo. 

After starting my internship, I have found that understanding my strengths and how I work has been more useful than ever. First, both discipline, achiever, and communication have been very helpful for my internship, as they all provide me with the drive to get things done in an orderly manner and efficiently in some way. I am driven by accomplishing tasks, getting things done by (and often earlier than) due dates, and checking off my to-do list. In terms of internship, this has been extremely helpful as I am able to stay focused on my tasks and get things done quickly.  

Next, Empathy has been very prevalent as I am working with all sorts of different people. It is so valuable to have empathy as I work with my clients, because it helps me to understand how they may be feeling and what they need. I feel as if I got more than my allotted amount of empathy. I feel deeply for people and want to help them in whatever way I can. Looks like I went into the right career! This has also helped me to see how I can work well in a team, as I want to be supportive and caring towards others I am around.

Lastly, my strength of Woo has been very helpful for me to understand during this time in my life. During internship, you are meeting so many people, that for some it could be overwhelming and exhausting. For me, I LOVE meeting new people and finding ways to connect with and understand them. I am not intimidated by strangers, and I love striking up a conversation with those around me. I have noticed during my internship that I have felt a strong desire to get to know everyone around me very well, and to understand who they truly are. I love knowing more about people than just the surface level, and my tendency is to desire that they would want to know me too! 

After researching my strengths more and understanding what they mean in my personal life, I have also come to realize that almost all strengths can have a negative and a downside, that you must be aware of. For me, I realized that with discipline, communication, and achiever, I can become so addicted to working and getting things done, that I have a hard time slowing down and resting. I even sometimes work during my lunch break, because I love shrinking my to-do list and feeling like I got something worthwhile done with my time. For empathy, I realize that sometimes I can feel for people so much that it can overtake me, or cause me to lose focus on what I am doing. My feelings can get in the way of my ability to work or accomplish a goal. I need to stay centered and not let my empathy become out of balance. Empathy is a two edged sword. Lastly, being a woo, I can sometimes be so focused on winning someone over, that it can become unhealthy. It has been helpful for me to see that as long as I understand my strengths and how they could become negative, I am able to keep things in balance and remain healthy and positive. 

Understanding yourself and your strengths and your weaknesses can be an extremely enlightening thing. I have found that this is especially prevalent during internship. This is an intense and changing time in my life, and this has magnified my strengths in a new way. It has been a really important time of self-discovery for me so far, and has helped me to understand how I work best on my own as well as on a team. 

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I would highly suggest looking into your strengths if you haven’t already! 

https://www.gallup.com/cliftonstrengths/en/254033/strengthsfinder.aspx

See you next time!

-Audrey Cosgrove, MTI

I’ve learned so much during my internship at The Music Therapy Center of California.  I wanted to share a few highlights in this blog post.

  1. Visuals, visuals, visuals!

I hadn’t made any visuals for clients before internship.  Visuals were extremely helpful when teaching social concepts such as appropriate behavior, practicing academic concepts such as number and letter identification, allowing nonverbal clients to communicate choices using a visual menu, or creating adapted lesson materials such as color-coded staff paper.  Here’s an example of a visual I made to go along with the “Super Student” song for a client:

super student

  1. Write songs for clients!

I wrote my first songs ever during internship.  I learned in school that preferred music is always best, so I didn’t consider writing new songs unless using a songwriting intervention.  However, because children with autism tend to process singing more accurately than speech due to right lateralization, song is often an effective way to teach concepts.  Clients often need personalized materials in order to meet the goal and generalize it outside of therapy. I found there were many songs I could adapt or just change the lyrics (aka piggyback song) to work on the client’s specific goal.  For example, here’s a piggyback song to the tune of “We Are the Champions”:

Conversation Champion

G                 Bm      Em     C   D
We’re in a conversation
G               Bm   C E
Our topic is _________
Am
Gain a friend’s attention
D7
Ask them a question
G
Listen to the answer
C7                                     D7
And ask another question
G
Or make a comment!

 

  1. Parachutes for all!

I used to think that parachutes were only appropriate for children.  However, I found that my adult day program and memory care groups loved waving and watching the parachute.  It’s a sneaky way to get clients move their upper bodies or practice spatial concepts such as up and down or left and right.  Parachutes are not just for kids!

parachute

  1. Power of humor

Humor is a great way to keep clients young and old engaged.  I found that silliness can help young children meet their sustained attention goals, and clients who are tired of working on the same skills may enjoy the novelty silliness provides.  Additionally, you can use jokes or funny sayings that relate to upcoming holidays to assist with reality orientation.

  1. Self-care may change

Internship is very different from student life.  Because there are different demands, I found that I had different needs to address in my self-care.  For example, as a student I had to intentionally seek out quality time with friends because I spent a lot of time studying by myself.  However, when I started internship, I was around other people all day. In internship, I found that I needed more alone time to recharge and function at my best.

  1. Positive redirection

I did not use positive redirection before internship.  I learned that clients are usually more compliant when you tell them what they can do rather than what they can’t do.  When positive redirection does not extinguish maladaptive behaviors, then I consider another approach such as setting a limit.

  1. How to give sensory input

Initially, I was majorly intimidated by providing clients with tactile, vestibular, and proprioceptive input because I didn’t ever need to touch the clients in practicum at my university.  I learned that it can take some trial and error to meet each client’s needs in any given moment of your session.

  1. Kazoo is your friend

I’d like to learn violin, flute, cello, banjo, and many other instruments.  I could use them for name that tune, or just to change the timbre in my sessions.  But until then, I play kazoo.

  1. Caveat to the iso-principle

In school, I learned to always use the iso-principle (musically meet the client where they are at, then slowly shift to where they need to be).  However, I saw that when a child with autism screams because they are overstimulated, playing loud music will only make the situation worse. In that case, it’s best to bring out calming stimuli.

  1. Wake up your clients

Julie taught me that it’s usually best to wake up your older adult clients in memory care if they fall asleep, gently getting in their proximity or tapping them on the shoulder.  They can sleep during almost any other part of their day, so participating in cognitive, speech, and sensorimotor interventions is better for their health and quality of life.

 

Those are 10 of the many things I learned during internship.  What did you learn in your internship? Let us know in the comments below!

-Molly, Music Therapy Intern