Sunday, August 9, 2015

Music Therapy and Patient Centered Care

We talk a lot in music therapy about patient centered care. Makes sense right? We’re there for the client aren’t we? Well, in theory yes, but a lot of times, it becomes more focused on what we are doing as therapists. Self-centeredness tends to have a lot of negative connotation with it, but if you think about it most of what we do in everyday life in self-centered or centered around what we, ourselves, are doing. One thing I’ve learned here is that when the therapy becomes about what I am doing as a therapist, it isn’t going to be effective for the client and I’ll burn out.
Music therapy is not a place for self-judgment. Yes, you need to be self-aware, but at the end of the day it isn’t solely about the musicality. The reflection on your session should be on what occurred with the client, not with yourself. This is something I’ve struggled with my whole life. Everything has always been about what I did wrong and what I could have done better. I’m learning that this profession is not about that. It’s about the CLIENT. It has to be! I need to be competent enough in my musical skills that I will not need to worry about singing or playing out of tune. If the client benefited from what I did, then that’s all that matters. Now, if the client is not benefiting, then I need to look internally and make sure I’m doing everything I possibly can to benefit the client and adjust accordingly. Think of it like an iceberg. What you as a therapist are doing and what everyone can see is the tip of the iceberg peaking out of the water. But all of the sustenance, the bulk of what happens in the sessions, happens below the water. The research, planning, client emotions and change facilitated is not so easy to see.
We had the amazing opportunity to have a discussion with a Buddhist monk in our travels. The monk spoke about Buddhism, but we learned so much about life from their principles. To learn more about Buddhism, click here. ( One of the things that hit home for me is that nothing is permanent. Happiness, sadness, anger, fear- all are fleeting. Something to be aware of is that happiness is one thing, but being free from suffering is another. Happiness is temporary. You take a bite of your favorite ice cream and you’re happy for a few seconds,but then you go back for more. You need the ice cream to be happy again. The client may appear happy during the session, but a few hours after you leave, life is back to normal. Part of helping this client be free from suffering is to incorporate the family or caretakers. Patient-centered care isn’t JUST about the client – it's also about their support network, because at the end of the day, you’re not just helping the client... you're helping those around them too. This creates an enormous ripple effect. If you’re happy, everyone is happy – it’s better for your life.
Quality of life should always be considered when working with a client. One of the scariest, but most magical, experiences I had here was working at Sirindorn National Medical Rehabilitation Center with a group of older adults. We collaborated with a laughter therapist. To learn more about laughter yoga click here ( There was no goal, and we came up with a brief outline right before the session. It was terrifying to not really have a plan, but I realized that the ultimate goal was to improve quality of life. And that’s exactly what occurred! The clients were so happy when we left and they even came together to sing us a farewell song. I ugly cried. It was so moving. We were able to bring happiness to these clients, which improved their quality of life. It may not be permanent yet, but there are ways to work to that point.  
At the end of the day, what is most important in our line of work is the patient. Quality of life is so important because that’s what keeps people motivated. If we can bring even the briefest feeling of happiness to our patients, the ripple effect will be so strong that we will end up affecting more people than we could ever imagine. That’s what it’s all about. That’s why we do what we do.

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