Returning at The George Center has been something I have been dreaming of for a good while, ever since I first discovered it and started volunteering in 2014. I remember sitting in the group for Any Dream Will Do!, assisting the participants, celebrating their successes as they maintained attention for the whole activity, tapped out a steady beat, socialized with peers, or expressed themselves and contributed to a song. I went home singing the songs, thinking to myself how simple yet effective they were. Would I ever write songs like that? Scaffold and elicit such responses as I saw every Tuesday night?
I have learned a lot since then in my undergraduate studies, but now upon my return to The George Center, I realize there is yet so much to learn! What skill do I need to develop the most? Designing music therapy interventions that are not too general but help achieve my clients’ goals and objectives in a S.M.A.R.T way! (That is, specific, measurable, attainable, relevant, time-oriented).
With this in mind, I reflected on an article that I had heard of in a conference session presented by one of The George Center’s very own interns about a year ago: “A Conceptual Methodology to Define the Therapeutic Function of Music” by Deanna Hanson-Abromeit, PhD, MT-BC. It discusses the function of different elements of music – such as melody, harmony, rhythm and dynamics – in the achievement of client’s objectives. Yet in the midst of the hectic clinical experience, when we are learning the basics of leading activities and writing goals and objectives, it can sometimes be easy to forget how these essential elements of music function in treating specific diagnoses and symptoms. It requires not only an in-depth knowledge and integration of all the musical elements, but also an understanding of the needs of the populations we serve.
To bridge this gap between knowledge and therapeutic intervention, Dr. Hanson-Abromeit has developed the Therapeutic Function of Music (TFM) Plan worksheet, which she provides in her article and explains its relevance and how to use it. This worksheet is primarily intended to be a training and research tool for a student music therapist who is learning how to get the most therapeutic value out of music’s elements for a given population. Additionally, it can be useful for advocating music therapy to other medical and educational professionals. So often, music therapists must defend their practice when presented with the question, “Why music?” especially when there are so many other alternative therapies available. The TFM helps even the nonmusical reader to see the relationship between elements of music and their effect on human response (p. 26).
The first step of filling out the TFM Plan Worksheet is the “Problem Statement.” This includes the general goal desired for the client or population, such as to “improve speech,” to “improve gross motor skill,” or to “improve cognitive skill,” as well as an explanation of why this goal is appropriate. Next on the TFM are the Musical Elements: timbre, rhythm, tempo, pitch, melody, dynamics, lyrics, form, harmony, and style. For each of these elements, the MT must explain the why, what, and how under three headings. (1) “Theoretical Framework” discusses why the musical element is necessary and includes supporting research. (2) “The Purpose of the Musical Element” describes what the element will do to support the goal. And lastly, (3) “The Explicit Description of the Music Element” outlines exactly how it will be structured in a given intervention.
By the time the student music therapist or researcher has filled out the TFM Plan worksheet, it becomes clear how music uniquely functions in the achievement of the population’s specific goal. For example, if the goal is “to improve speech” in a client with Down syndrome, a completed TFM will highlight how the musical element pitch can help (p. 33). (1) Why is it necessary? Children and teens with Down syndrome tend to lack speech affect and speak in a low-pitch range. Yet, they can imitate pitches in melodies they sing (2) What will pitch do? The pitch in the melody should be in an appropriate range and should imitate the inflectional pattern of the each word. (3) How will pitch be implemented? The music presented should be between notes A3 and A4. Each pitch will reflect the inflection of each word, such as in the word “today.” The pitch for “to” should be lower than the pitch on the accented syllable “day.” The emphasized contour will help the client practice accenting the appropriate syllable, and in turn improve speech affect in daily life.
Using the TFM Plan worksheet as a guide, the MT must develop S.M.A.R.T. objectives that utilize the musical elements in optimal ways. From there, the MT will develop therapeutic interventions that give the client opportunities to achieve the objective each session. Only when these objectives are established can the therapist, client and family see measurable progress and determine whether the specific approach/intervention is effective. The TFM plan provides information that is broad enough to help create multiple objectives related to the same long-term goal.
I would really like to use this worksheet as I develop interventions with my various client groups. Being in a private practice has exposed me to more ages and populations than I have ever worked with in all my undergraduate studies, and all at once! Perhaps the greatest challenge with TFM Plan worksheet is the amount of research required to learn about the population and their needs. It can be time consuming, and no student or intern ever has enough of that precious commodity! But the quality of the intervention can be greatly improved when the student MT makes the effort to use this tool. I feel that it will be an investment in my clinical knowledge which will help me to be more effective and more instinctively use the marvelous gift of music to heal people of all sorts.
Hanson-Abromeit, D. (2015). A Conceptual Methodology to Define the Therapeutic Function of Music. Music Therapy Perspectives, 33, 25-38.