Music Therapy

Rapport: I Don’t Trust You, and That’s Okay

Posted on by tabathatillman

Hello everyone! Today I wanted to share some music therapy knowledge that has not only helped me in the workforce, but it has also helped me in life in general. Today’s we’re going to talk about rapport. Building rapport is something that music therapy students start hearing about from their very first music therapy class, and it’s basically the foundation to any sort of therapy actually being able to work.

According to Dictionary.com, Rapport is a relation; connection, especially harmonious or sympathetic relation. The concept behind this is that in order to actually work on things with a client, you first need to form a connection with them. The therapist has to build trust with that person. I’ve found that music makes rapport so much easier to build because connecting through music is such a powerful thing. It begins with something as simple as listening to the preferred music of those that you’re working with. Once you find that common ground it’s a lot easier to get to know them, because the music breaks down a barrier. From there, it just takes the therapist being open with those that they’re working with and not trying to force anything.  The key is to be warm and unintimidating.

So we’ve covered the first half of the title of this blog, but let’s look at the second half of it. Some clients are really hard to build rapport with. It’s ok not to trust your therapist. Some people begin trusting a therapist within the first month of working with them, while others might take a few months to warm up to a therapist or could perhaps never even warm up to the therapist. I want to stress that this is okay. It is possible to work with a therapist and have them give you some tips to help your life, or work with you on specific goals, without every actually trusting them to share your deepest issues. I hope that most people can get to a point where they can share things, but it’s okay if they can’t.

For example: If someone, let’s call her Petunia, is dealing with stress, a music therapist can work on stress management in music therapy sessions. A music therapist can use music to work through some of her stress in the session, but a music therapist can also help Petunia come up with some coping mechanisms to help with her stress. These are the things that a music therapist can do without Petunia actually telling the music therapist what the root of the stress is. If Petunia were to tell the music therapist what the root of the stress was, then the music therapist would have the chance to better cater the treatment to Petunia’s needs, but if that rapport isn’t building quickly, the music therapist can still help until it does.

Now, I also want to explain how this carries over into our everyday life. You see, in life you’ll meet some very open people that will tell you their entire life story from the moment they meet you, and you’ll also meet some people who might not tell you anything super important about them until after knowing them for about three months. It’s the same concept as a therapist building rapport. When you’re getting to know people, you can’t expect them to bear their soul with you from the moment you meet them. Some people take longer to warm up to than others. There are a lot of people that don’t get this. Rapport can make or break relationships with others. If I don’t trust you/have a close relationship with you, and you try to ask me personal questions about my life that I don’t think you have any business knowing, then I’m probably going to shy away from you. It’s important to build trust with those that you are getting to know and not try to step over any boundaries until you feel like you and that person have a good relationship established.

Has anyone every had an instance where someone tried to talk to them about stuff that you just didn’t feel like you had the established rapport to talk about? I know I have! This is key to really understanding friendships/work relationships. It seems like a no brainer, but it’s something that we really do tend to struggle with at times. Anyway, feel free to drop a comment or ask me any questions about this topic. Thanks, Tabatha

 

Music Therapy with Dementia

Posted on by tabathatillman

As many of you know I recently began my private practice. God has been so faithful in giving me facilities to work with. I don’t have a full schedule, but I’m slowly gaining more facilities to work with! I am working with a lot of facilities that care with individuals with dementia. I began my music therapy journey because I saw the impact that music had on my grandmother when she was battling Alzheimer’s disease. I always thought that this population was my calling because I have such a passion for it, but I’ve recently realized that it isn’t as easy as I thought it would be.

You see Dementia is an overarching term that describes different symptoms in relation to a decline in cognitive functioning. Dementia is like any other disease or disorder in that it doesn’t look the same on every person that has it. You can read tons of books on a disorder and it still won’t prepare you for the moment that you actually encounter someone with that. I’ve always know this, but now I am really witnessing this first hand.

Every person and group of individuals with a memory disorder have different needs, so it can be hard to coordinate a music therapy group that meets everyone’s needs. As dementia progresses, it becomes harder and harder to engage those that you are working with. When you’re working with a group week after week, you can actually see the progression of the Dementia. One week a person is active and following you without any hesitation, but as the weeks go on they stop playing along and you’re having to go over to them and help them play along to the music.

It can be very sad to watch a loved one go through this, but that is why I think it is so so so important for individuals with memory problems to have music therapy. When people begin to digress in their cognitive functioning a lot of people think that they become unable to do things, but music changes this. In working with dementia, I have taught them a new song that they have been able to retain from week to week. I have found ways to engage individuals that at the beginning weren’t engaging. Sometimes this means I have to stand in front of them and help them, while other times it just means finding an instrument that they are particularly fond of and making sure that they have that every time we play. Something that I can always count on is that songs of their youth will always bring bring a response. They can’t help but sing along. When I plan my session, I try to find different ways to engage and challenge those that I’m working with. We work on motor skills, cognitive abilities, communication, and so much more. The more we work these areas of the brain, the longer they get to hold onto to them. You can’t stop the progression of the disease, but there are some ways to slow it down.

If you or a loved one suffers from Dementia or Alzheimer’s, I highly recommend looking into a music therapists. If you have questions about Alzheimer’s or Dementia, I highly recommend checking out the http://www.alz.org. I would love to answer any questions that you have, so please feel free to drop a comment below. -Tabatha

Music Therapy Private Practice

Posted on by tabathatillman

As many of you know, I’ve been on the journey of starting a private music therapy practice since the beginning of January. I was board certified on January 4th and I was officially licensed on January 29th. You can technically begin forming your private practice before you get board certified and licensed, but I wanted to wait until I had the certification and license before I began the paperwork. I highly recommend doing this, because you need copies of these documents to do the final step of the private practice legal papers.

Once I had my certification and license, I picked a business name and made sure that it wasn’t a registered business name that someone else had. Following this you have to reserve the name and register it with this secretary of state. These documents will take a week or two to process. Once you have this part set up, you’ll need to go to the IRS website and register for an Employee Identification Number (EIN). Once you fill out the information for the EIN number you can get the number immediately (And definitely do it through the IRS website. Other sites will charge you to register you for one, but it’s a scam. It’s free!). Most people think that you only need this number if you’re going to have employees, but this is a lie. If you have a business, you need a business bank account, and you can only open one if you have an EIN. You’ll also need this for some of the upcoming paperwork. Once you have these things, you need to find where in your city you need to go to to get a business license. In Augusta, you have to go down to the municipal building. Some cities have their paperwork online, but others do not.

When I went down to the municipal building, I had to get paperwork for a special permit and the paperwork for a business license. Now when you have a business, it must have a physical address. If you’re contracting, like I plan on doing, then your physical address will be your office, usually in your home if you’re just starting out. If you’re renting your current residence, then you’ll need to have the special permit signed by your landlord stating that you can have your office in your residence. This paper will need to be signed and notarized and turned back in. Now the fees that come with this vary depending on what you are doing. If you just have an office then the fee will be pretty low, but if you plan on working with people in your residence, then you will have to pay a higher fee. Once you turn in this paper with the fee, then you can also walk next door and turn in your business license application. Your business application will need to be notarized, but they will be able to do that for you if you don’t know a notary. The business application should only take about three business days to process, but mine took a lot longer. I had to make many phone calls due to my paperwork being misplaced by the office. If you plan on having music therapy in your business name, then you’ll want to bring a copy of your license and board certification when you turn in your business license application. The city wants to make sure that they aren’t letting someone unqualified run a therapy business, and as music therapists we don’t want people doing this either!

So after eight business days, I finally got my business license and Harmonic Progressions Music Therapy, LLC is officially up and running. My next step is to find facilities to contact that might want music therapy and see if they’re be willing to meet with me so that I can tell them how their facility would benefit from music therapy. As I go through this process, I’ll share all that I learn. Also, if you’re wondering what the specific cost of opening a private practice is, I have a range of cost listed here.If you have any questions, feel free to leave a comment below.    -Tabatha

 

What Makes Music Therapy, Music Therapy?

Posted on by tabathatillman

I recently had a conversation with a music therapy professional that left me pondering many things. I was looking for some guidance on my private practice, and I ended up talking to a person who has spent years teaching music lessons as her music therapy private practice. Anyone who knows me knows what I feel about lessons (and if you don’t I’ll explain over the course of this blog).
Music therapy is when a music therapist works with an individual/group in order to use the therapeutic qualities of music to achieve personalized goals. This means that a music therapist will asses a person and figure out what they need help with. The categories that most music therapists assess are Communication, Academic, Musical, Motor, Emotional, and Social. In order to work with someone, a music therapist must identify that the person is lacking in one of these areas, and once this happens, the music therapist will find ways to use music to meet these needs.
I always get very frustrated when people talk about music therapists teaching people how to play an instrument. I am very bad at teaching people how to play instruments, and that is the reason why being a music educator never crossed my mind. Are lessons music therapy? Lessons can be therapeutic, but it goes back to what I said above. Teaching someone how to play an instrument has to have a therapeutic purpose. Let me share a few examples of how this can work.

1. Lessons are often used with persons with disabilities. A lot of people with disabilities live their lives being told that they can’t do things. Music therapist often use adaptive lessons to give them a sense of accomplishment that they don’t usually experience in their daily life. Music lessons with disabilities work on motor skills, cognitive skills, and it can even be helpful with emotional skills in this situation. There are other areas that music lessons can be used for, but they very from person to person.
2. Lessons can be used with Veterans. In my internship we used lessons to develop a coping mechanism. Learning how to play an instrument gave the Veterans something to turn to when their PTSD got too bad or when they were up and couldn’t turn their brain off. In the VA setting lessons are typically used to benefit someone’s emotional being, their communication, and their social life.
3. Lessons can also be used in the hospital setting to help with pain management. There’s nothing that helps distract a person from what their going to than having to focus on an instrument. In this setting this works on Motor Skills, Emotions, and can even help with Academic Skills.

Now you’re probably wondering how lessons can do all of this so let’s review that. Lessons help with communication, because there’s a lot of communication that goes into learning the instrument. Yes, the therapist explains and shows how to do a lot, but the client must be able to communicate their struggles and ask questions to learn the instrument. This can also open the door by giving the client someone to trust, which can lead to them communicating a lot of other things with the therapist. Lessons can help with academic because it takes a lot of thought to learn an instrument, and if the patient really enjoys it, then it can be used as a reward to get them to do any work that they need to do. Learning an instrument helps with motor because every instrument involves Gross Motor Skills in using the arms and then fine motor skills in using the fingers. Lessons work on the emotional level because it works as an outlet. When someone is angry or sad, they can represent these feelings in the instrument. Therapists often gauge where clients are emotionally by how they play. Instruments can help the social domain because the therapist gives the client someone to socialize with. In the VA, most people who learned the guitar were later put into the guitar group for socialization.
So as you can see lessons can be a very beneficial music therapy intervention, but it only works as therapy when the therapist and client have goals that they are working on and continue to work towards those goals. Once the goals have been met, then it’s probably time for the therapist to re-evaluate and see if there are other goals that can be worked on, or it might be time to terminate the therapy. Unlike normal lessons, music therapy lessons can’t last forever and they won’t last as long as the parents are willing to pay. I hope this helps some people better understand music therapy and the function of lessons!
-Tabatha

Don’t Close the Door

Posted on by tabathatillman

It’s really funny how life works sometimes. These past few weeks have been a roller coaster. As you can tell from my last blog post, I decided that I wasn’t going to open a private practice due to finances and not having a place to work from. Well, things have changed and I am opening a private practice to do some contracting work in the Augusta area. This a scary endeavor to embark on, but I’m doing it. After I figured out all of the legal processes I would have to go through to start a private practice, I started to feel like it wasn’t worth it. I wasn’t even willing to look at any other options. I was disappointed and I lost sight of everything.
I spent the weekend and the following Monday looking for any job that I could apply to. Activities therapist, mentoring, activities assistant, ect. I even went through a phase of debating if I should go back to school to get a Master’s degree in something more marketable. When I think back on that moment it absolutely breaks my heart. On this entire journey of becoming a music therapist I never once thought about doing something different. I knew without a doubt that this was the calling that God put on my life and I was going to fulfill that calling, but here I was giving up on it. Here I was being disobedient and telling God no.
Well, let me tell you what God did in this time. God sent a company to the CBMT website looking for a music therapist in the Augusta area. That company contacted my internship supervisors and they send them in my direction. They contacted me saying that they wanted to contract with me to provide services for someone in my area. If that wasn’t God reassuring me that a private practice in Augusta is my calling, then I don’t know what that is. So now I’m back on the path God wants me and I’m feeling rejuvenated and confident.
Once I received that email I was overjoyed, but also so disappointed in myself. I could hear God speaking to me and saying why did you turn away in the first sign of trouble? I didn’t have the answer. That’s my nature. When things don’t go the way that I plan, then I want to just give up and move onto something different. It’s time to work on myself and change this nature of mine. I know opening a private practice won’t be easy, but I can’t give up. I’ve already started the steps, so there’s no turning back now.

I’m finding so much support in Psalm 46:1-3

God is our refuge and strength,a very present help in trouble. Therefore we will not fear though the earth gives way, though the mountains be moved into the heart of the sea, though its waters roar and foam, though the mountains tremble at its swelling

I know that God will be by my side through this journey. I hope to use this verse to remind myself not to turn my back when I’m overcome with fear. In those moments of fear, I should run to God rather than running away. If there’s anything in your life that you’re struggling with, I hope that this post might give you come comfort. Remember God always has a plan that is far beyond what we can imagine for ourselves.
-Tabatha

So you want to open a private music therapy practice.

Posted on by tabathatillman

Recently, I finished my music therapy degree and got my board certification. It’s such an exciting time in your life when you finally finish school…until it isn’t. Once I passed my boards, I had to get licensed in the state of Georgia. That part wasn’t too difficult, but I’ve been planning to open a private practice once I got this done and I’m realizing that it’s a lot more difficult than I thought it would be. I’ve read articles and purchased books on how to do it, but now I’m realizing that I can’t do it. None of my resources have talked about the price of opening a private practice, so I’m going to share that with you.

Before I continue, I want to put in a disclaimer that I am absolutely not a professional on this topic and I highly recommend meeting with a business advisor or someone else who has opened a private practice. Also the cost listed below are strictly for Augusta, Georgia. Know that they’ll vary from state to state and city to city, but this should give you an estimate of how much you need.

So my original plan was just to be a private contractor. I thought that I could just talk to facilities and get them to pay me to come for a few hours a week to provide music therapy services. Well this is not the case. When you’re contracting you have to contract under someone. This is typically your own personal business or a private practice. This is the rule of thumb for tax purposes. You have to be working under an official business registered with the state that you are in, otherwise you could get into a lot of legal trouble.

So let’s talk about how to open your business. When reading you’ll see a lot about opening an sole proprietorship or a limited liability corporation (LLC). I was looking into an LLC so that’s all I can talk on. You first have to come up with a name and register it with the Secretary of State this will cost 25.00. Then it costs 100.00 to open an LLC. I thought that wasn’t too bad, but you also need an EIN number. It does not cost any money to obtain this number as long as you file for it through the IRS, but if you go through any other websites they will charge you if they have to file it for you. Once you get these things, you also have to get a business license. Before yo can register for a business license, you have to purchase a special permit. The special permit will cost you 150.00 if it’s just a place that you’re using as an office space. If you plan on working with people in your residence, then it can cost you 300-400.00. Then a business license will run you anywhere from 50 to 400.00 depending on where you live. The city you live in determines the price. The business license where I live was about 113.00.

So this is where I’m at right now. I’m thankful that I was able to learn all of this within a month of my internship ending because now I can come up with a game plan. Just know that the private practice route sounds like a good and simple idea, but there are so many hoops to jump through to do this and you also need a good amount of savings to start one up. You also need a good accountant to help with your business because not only will you need to pay quarterly personal taxes, you also need to pay business taxes once a year. I wish I had a document that listed all of this out before I formed the idea of opening a private practice. People don’t talk about the nitty gritty of opening one, so here it is! If you have any questions about this, please feel free to comment and I’ll respond as soon as I can! I wish you the best!

-Tabatha

Music Therapist and Music Therapy Students: Where Should we Draw the Line?

Posted on by tabathatillman

Something that I really love about the music therapy profession is how hard everyone works for it to be recognized as a valid therapy. We spend four years in school studying and then 6 months in an internship. After that we have to pass a board certification exam and depending on what state we live in we might have to obtain a license to practice in that state. People have worked so hard to progress our field to where it is today and it is amazing to see, but there are some things that I’ve seen recently that don’t really sit well with me.

I’ve seen a lot of shared videos about the power of music and I absolutely love  it. It’s making people aware of the power that music has, but what is it doing for our profession. I know that there are a lot of different people and organizations that go around to different facilities and provide music for the residents there and I think that’s great. I also think it’s great that a lot of us are sharing these videos, but let me propose a question. Why would these facilities pay a music therapist when they have volunteers that come in and sing to the residents of these facilities? I know your response will be well they aren’t the same thing and I know they aren’t, but the people running these facilities don’t know that. So many people think that music therapists just go in and sing songs. They don’t realize that every song is hand selected to serve a specific purpose. They don’t understand that we do a thorough assessment before we begin treatment. They don’t understand anything about music therapy, but they do understand money and a lot of places don’t want to spend money where they don’t have to spend money.

Now I’m not writing this to make you feel bad about sharing these videos. I’m writing this to make sure that we’re aware of the impact that these things can have on our field. Yes we should be happy that these people are experiencing music, but we also have to remember that music is very delicate and that a lot of these people don’t have the training to use it in the ways that we do. My husband has been working for a TV station and this man sings in nursing homes and he told everyone that he likes to call it music therapy. If this man does that how many of people do this? I’m so thankful that my husband is a huge advocate for the music therapy profession because after the show he made sure to go up to the man and explain to him that he can’t call what he’s doing music therapy. The man didn’t realize that there was an actual music therapy field. So next time you see a video showing the power of music, appreciate it and enjoy seeing the power of music, but also think about what these videos do for the field of music therapy. Feel free to leave a comment about this, I’d love to discuss this topic with you!