November 15th is #EUMusicTherapyDay to mark this our music therapist and founder Amelia Clapham shares what a day in the life of a music therapist at Ace Music Therapy is like. Amelia describes a Tuesday working in the community with children who have life limiting illnesses.
I leave home and head to London for my first client. On the drive there I mentally prepare myself for the session remembering what we had done in the previous session and what the therapeutic goals are.
I arrive at the client’s house, take all my instruments in and set up ready for the session.
The session starts, it’s a half hour session with a child under 5 who has a life limiting illness and spent a lot of her life in hospital. The child is non-verbal and in a wheelchair and the session focuses on getting her to interact with me musically and developing her communication skills. I notice she makes clicking sounds using her mouth, so I repeat these sounds back to her accompanying myself on the keyboard and we are able to have a musical conversation as she stops her sounds to listen to me and carries on when I stop. In addition to this I also sing her some nursery rhymes and notice as her body language changes and she appears more relaxed in her chair. I also offer her the tambourine, which she plays a little by moving it around on her wheelchair tray, and I give her the wrist bells which she can play by lifting her arms up. We finish the session with a goodbye song. This child has had seven sessions so far, and she is getting used to the hello and goodbye songs, so she anticipates the ukulele by lifting her arm up in preparation to strum the strings for goodbye.
After the session I feedback to mum about what we have done, book in her next session and pack all my instruments away.
I get back in the car and reflect on the session. I spend time writing up my notes, including what the client did in the session, anything specific I noticed about her mood or body language and also include comments about how I felt during the session as this is important for therapists to consider when working with clients. I also think about relevant theories, specifically around child development and how these are informing my approach with this client.
I head to my next visit, this time at a school to see a young boy who has complex health needs and Global Developmental Delay. On the way there I mentally prepare myself for the session, remembering what we had done the previous week and what we will do today. This child requires quite a lot of structure so I usually go in with a plan, although as music therapy is so client led, this client will often take me in a different direction, and I will follow him.
I arrive at school, sign in and set up my instruments in the music room. Luckily the school has a piano so I do not need my keyboard but I take my guitar and a range of percussion instruments including the coloured bells, shekere, djemebe, xylophone, click clak, cabasa, frog guiro and ocean drum. Offering the client a wide range of choice.
Supervision is something all music therapists have, it is essentially a safe space where we meet with another therapist, discuss our work and chat through how we might improve our sessions/any challenges we are having with clients.
The session begins. I work with the client on developing his attention span, trying to engage him for the maximum amount of time possible. I am also working to develop his communication skills as when I first starting working with him, his teacher explained how he does not really use words. I noticed in sessions how he can be very communicative through his singing, so we use a lot of songs, providing him lots of opportunities to ‘fill in the gaps’ in the songs. We also share several improvisations allowing him to express himself through music. The session finishes with a goodbye song which this child very much enjoys singing.
I write up my notes, once again thinking about what the child did in the session, how he appeared, how long his concentration was maintained for. I also note any changes in his mood and any particular songs he initiated. I reflect on how I felt during the session and anything specific that struck me.
I head to my third visit, at another school, this time to see a young boy who complex health needs including kidney failure and epilepsy as well as behavioural issues. Once again on the way I prepare myself mentally for the session thinking about what we had done the week before and what we would do this week. I consider thoughts from my supervision session I had had the previous week (supervision is something all music therapists have, it is essentially a safe space where we meet with another therapist, discuss our work and chat through how we might improve our sessions/any challenges we are having with clients. Supervision is a key factor of the music therapy process and it helps us to inform and develop our practice).
I arrive at the school, sign in and take my instruments up to the room. This time I have minimal instruments as I find “less is more” with this client. I have a guitar, a djembe, ocean drum, tambourine and xylophone.
The session starts. A nurse is present in case the child has an epileptic fit. In this session I follow the client around the room, singing about what he is doing. We share some interactions on the djembe drum and he invites he to play by placing my hands on the drum and we play together. I notice how the client’s mood shifts over the course of the session, he is very interactive at the starts and struggles to focus and by the end he is lying on the floor, appears quite relaxed as I sit next to him singing in a lullaby style. At the end of the session the nurse comments on this shift in behaviour.
I write up my notes, reflecting on the session as with my previous clients. I pack all instruments back into the car and head to my last session of the day, this time at a child’s house. Once again I use the drive to mentally prepare myself for the session.
I arrive at the child’s home and set up my instruments on the floor. This client is a girl with complex health needs and limited communication. In sessions we are working to develop her confidence in using her voice and also develop her motor skills – using her hands to play the instruments. The sessions will be finishing soon and Grandad comments on how she sings a lot more now as a result of the music therapy and he feels it has really helped her.
During the session we sing hello, I encourage her to use her voice to join in. We do some turn taking on the bells. We play a nursery rhyme, this child is able to follow numbers so she plays along with me as we sing Baa Baa Black Sheep. Following this we improvise together on the keyboard. We do some structured activities including choosing different instruments to play and singing about them and also doing a conducting activity where we take it in turns to conduct each other, using non-verbal cues to instruct the other person on what instrument to play and how to play it.
The session finishes and I discuss it with Grandad. I pack up my instruments and get back into the car, ready to write my notes.
I write my notes, reflecting on the session, and then I head home.
Amelia Clapham runs Ace Music Therapy which currently operates in London, the south-east and Northampton. It is in the process of becoming a Community Interest Company, a not-for-profit.