Hanser Handbook Flashcards
Referral to MT
- MT outlines features of services, expected outcomes, and the profiles of prospective clients
- once referral is made, the presenting problem is identified and translated into an overall goal for therapy
First Session
- begin to build rapport
- more information is gathered
- learn client’s interests, abilities, and talents
Assessment
- analyze nature of presenting problem
- identify strengths and limitation
- review client’s musical background, abilities, preferences, and creative interests
- provide an overall picture of their current status
Goals, Objectives, and Target Responses
- re-examine the overall goal
- therapist may modify intentions for treatment based on assessment
- set specific objectives along the way to reach goal
- target responses further define the objectives in order to facilitate identification of these behaviours
Methods of observation
- frequency
- duration
- interval
- planned activity check
MT Protocols
- therapist develops a protocol based on assessment data and evidence base for particular music-based interventions
MT Treatment Plan
- navigational chart for therapist to follow
- sequence of objectives outlining a successful course for therapy
- design determining treatment effectiveness is selected at this point
Implementation
- therapist records progress on an ongoing basis, considers supervision and professional consultation, and revisits therapeutic relationship
Evaluation
- comprehensive analysis
- conclusions and recommendations for future action in a final report
- MT ends treatment program and begins another by defining new areas for change
Standards for referral
- utilize or develop appropriate referral protocol for population
- evaluate the appropriateness of a referral for music therapy services
- prioritize referrals according to immediate client needs
- educate staff, treatment team, other professionals regarding appropriate referral criteria for music therapy
Why refer when a multisensory approach to learning is indicated
MT involves the senses and movement in space and time
Why refer when there is physical inactivity or limited mobility
- can be administered at bedside without demanding anything from client
- can be used with clients with severe physical challenges or conditions
Why refer when there is limited cognitive capacity
- MT can be suitable for individuals that find verbal therapy unproductive or who cannot participate in therapies that require higher order thinking or intellectual capacity
- musical experiences generate new behaviour through learning, functionality, and insight
Why refer when confrontative therapies are inadvisable
- MT’s techniques are non-invasive and offer people opportunities that are failure free
- The environment is non-threatening and sage
Why refer when compliance is a problem
- element of fun attached
- most people find MT enjoyable while benefiting from it
Why refer when it is challenging to get along with others
- facilitates social interactions
- well-suited to group therapy and family therapy systems
Why refer when there is limited self-awareness
- positively influences self-awareness and self-esteem
Why refer when traditional treatments fail or are contraindicated
- referral is made to MT as a last resort
- other therapies have caused negative side effects
Why refer when there is a need to find meaning or spiritual significance
- encourages a chance of a flow state
Aims of a first session
- establish strong therapeutic presence
- observe conscientiously
- taking mental/written notes of client’s responses
Objectives within the first sessions
- develop rapport
- build therapeutic relationship
- gather information
- observe
- further define the problem and goal
- outline responsibilities of client and therapist
Four major components of therapy that affect outcomes
- extra-therapeutic factors
- expectancy
- specific therapy techniques
- common factors
Assessment domains
- cognitive
- communicative
- emotional
- musical
- physiological
- psychosocial
- sensorimotor
- spiritual
Types of assessments
- diagnostic: informs or supports clinical diagnosis
- interpretive: explains problems relative to particular theory or clinical perspective
- descriptive: attempts to understand clients in reference to themselves
- prescriptive: determines treatment needs
Standardized tests
administered and scored by a qualified professional or identified others
Norm-referenced tests
compare individual or group scores with averages and other measures of central tendency derived from a wider, selected sample of task takers
Content validity
degree to which the test is related to the outcome or domain that it intends to assess
Criterion-referenced validity
how well the test predicts behaviour and may be calculated by comparing its results with those of similar standardized measures
Construct validity
degree that the test represents certain concepts, attributes, or theoretical foundations
Test-retest reliability
comparing test performance in replications of the same test at least twice
Interrater reliability
agreement between observers of the same behaviour or response. more than one person to score or record behaviour, reducing the potential bias of a single observer
Advantages of music-based assessments
- non-threatening and anxiety-free testing
- liberate clients from atmosphere of typical testing environments
- musical engagement can be a projective test
- observations provide more direct evidence than would be obtained by asking clients how they would respond to a given situation
Projective test
uses music as a metaphor for what is happening inside
Frequency recording
- used to measure the strength of discrete behaviours
- a record of how many times the behaviour occurs
Discrete behaviours
- have a start and end point
- can be separate responses
Response rate/percentage
amount of times the client responds correctly divded by the number of times the therapist offers a stimulus
Duration recording
- length of time the behaviour lasts
- how long one smiles, cries, holds a note on an instrument, etc
- using a stopwatch
Interval recording
- employed when behaviour is not clearly discrete
- involves determining whether or not the target response has occurred during a brief interval of time
Planned activity check
- requires observer to record the number of group participants engaged in the target response at the end of a predetermined observation interval
Time sampling
- therapist chooses a limited time just for observation, and just for recording
Reliability in observation
- second independent observer is brought in to record target responses simultaneously
- reliability coefficient above 85% is acceptable for behavioural measurements
Reliability coefficient
- (agreements/agreements + disagreements) x100
- agreement: number of times target behaviour is observed by both
- disagreements: number of times target behaviour is observed by only one person
Baseline observations
- set of target behavioural observations that is indicative of functioning without therapeutic intervention
- observe behaviour over a period of time
- record observations until a relatively stable level of responding is noted
Functional analysis
- observing behaviours and conditions surrounding target response
- applied behaviour analysis technique
- observe events that precede onset of problem, events that immediately follow problem behaviour, and frequency/duration of problem behaviour
Antecedent stimuli
events that precede the onset of the problem
Subjective observations
- consider the interpersonal connections made in therapeutic relationship and the therapist’s clinical judgement
- report each type of observation separately; they contribute to understanding your client as a whole
- state the sources of one’s interpretations and identify how conclusions are drawn
Defining target responses
- must be a clear observable behaviour
- principle indicator of change
- parameters must be precise enough so that two observers would be able to agree if it has occurred
Response definition/behaviour descriptor should include
- a descriptor
- boundaries of the behaviour
- observational information
- borderline responses
Short term objective
- relates to overall goal but can be accomplished in shorter and more reasonable length of time
- achievement of objective symbolizes a turning point in therapy,
Long term objective
- timeline can vary from a couple of months to a lifetime
- offers a broad perspective for therapy
- incentive for change outside of therapeutic context
- meeting this objective indicates therapy will likely cease
SMART goal system
Specific Measurable Achievable Realistic Time frame
