In her article "On Powerlessness", Barbara Wheeler shares some of her personal experiences with powerlessness as a music therapist and outside of her professional work. Opening the topic, she describes her surroundings while writing this article: sitting in a Copenhagen airport, having missed the flight back to the United States due to a late arrival of her connecting flight. While sitting, waiting, and writing, she remembers Hurricane Katrina, its devastating impact on the residents of New Orleans, and the helplessness felt by many when governmental agencies failed to respond properly. As a music therapist, she often experiences personal powerlessness when patients at a hospital oncology unit refuse to accept music therapy treatment. Having been referred for music therapy by their nurses, they don’t give it a chance, saying they are "…too tired or in too much pain or under too much stress…" and thus reject the very thing that can improve those symptoms. Finally, she describes the Serenity Prayer used in 12-step groups as a good way of distinguishing between what one can change, and what one cannot change. There was much I learned and identified with in this article. In my experience doing practicum work as a student music therapist at the University of Louisville, I have experienced much of the same powerlessness that Dr. Wheeler describes. For example, I remember feeling powerless when a student with Emotional Behavior Disorder got into trouble before the session I led began and therefore was not allowed to participate. During another practicum experience, I remember a client reacting violently to the drastic change in medication that day. It seemed that nothing I offered in the way of music therapy would address this client's goals.
Like Dr. Wheeler, I also feel frustrated and disappointed with clients that have expressed no interest in music therapy. In my experience with selling kitchen cutlery before enrolling at the University of Louisville, I would often experience rejection, but would leave my phone number and brochure, and follow up another time. Even still, there was only a limited number of people I could sell to, just as there is a limited number of people who will receive music therapy.
The powerlessness experienced by some of our clients must be severe. While we need to honor their decision whether or not to receive music therapy treatment, I think there are ways to respond with empathy, care, and an appropriate persistence if we believe music therapy will truly be beneficial to them. Patients are ultimately powerless over death if their illness is terminal. We are initially powerless over a patient's lack of confidence in music therapy. However, patients are not powerless over how they face death, and we are not powerless in our response to a patient who doesn't show interest in music therapy.
While music therapists need to show the utmost respect to a patient who says, "No" to music therapy, I imagine that most patients rarely respond with the word "No." Dr. Wheeler describes her frustration with patients with responses such as "too tired or in too much pain or under too much stress. The reasons that they do not want music therapy are often the very things that music therapy might help—if they would only give music therapy a chance!!" But these types of reactions are different than a patient saying "No, now please get out of my room." If we believe that music therapy can reduce this patient's pain, stress, and help with relaxation, then these types of responses indicate that we have come to the right place! A way of responding to "I'm too tired" could be "Well, John, you look tired and I respect your desire to rest. But the truth is soft classical music can help you rest much more easily. May I play you some soft classical music to help you rest?" There were four parts to this type of response: First, I restated and affirmed the objection to music therapy. Second, I added, "but the truth is....", and third gave a brief statement about how a specific type of music therapy can address this client's exact concern. Fourth, I asked the client for permission to provide this for him.
I am not suggesting that a music therapist argue with or attempt to manipulate a client into receiving music therapy. But I think that "getting in the door" is just as important of a skill in music therapy as is all that happens during the session. If a client seems resistant at first, music therapists could also change the subject, and use the brief interaction as an opportunity to build rapport. Acknowledging a client's stress through our verbal and nonverbal body language, then taking note of a person in the room or picture or something of importance to that client could build the start to a a lasting bridge between therapist and client. This could be followed up with, "John, if it's OK with you, I'll stop by again sometime. Take care." "Sometime" could be tomorrow or even in a couple of hours.
These are ways in which we can show empathy, care, and an appropriate persistence in helping clients make the best choice of whether or not to participate in music therapy. Responding to clients' reluctance in this way may reduce their feelings of helplessness. A client may be powerless over his illness, but we can give him a voice and help empower him to face what's coming. We may be powerless over a client's rejection of music therapy, but we can choose to not let an initial rejection be the end of a potential client-therapist relationship. Since 2000, Dr. Wheeler has been developing an extraordinary music therapy program at the University of Louisville and music therapy services in the Louisville community. She truly knows how to "get in the door" and get things started. I am grateful for her persistence, and most likely would not be pursuing this career if it were not for her.
About Armistead Grandstaff
Biography
Music therapy student at the University of Louisville.
Response to Barbara Wheeler's "On Powerlessness
In her article "On Powerlessness", Barbara Wheeler shares some of her personal experiences with powerlessness as a music therapist and outside of her professional work. Opening the topic, she describes her surroundings while writing this article: sitting in a Copenhagen airport, having missed the flight back to the United States due to a late arrival of her connecting flight. While sitting, waiting, and writing, she remembers Hurricane Katrina, its devastating impact on the residents of New Orleans, and the helplessness felt by many when governmental agencies failed to respond properly. As a music therapist, she often experiences personal powerlessness when patients at a hospital oncology unit refuse to accept music therapy treatment. Having been referred for music therapy by their nurses, they don’t give it a chance, saying they are "…too tired or in too much pain or under too much stress…" and thus reject the very thing that can improve those symptoms. Finally, she describes the Serenity Prayer used in 12-step groups as a good way of distinguishing between what one can change, and what one cannot change. There was much I learned and identified with in this article. In my experience doing practicum work as a student music therapist at the University of Louisville, I have experienced much of the same powerlessness that Dr. Wheeler describes. For example, I remember feeling powerless when a student with Emotional Behavior Disorder got into trouble before the session I led began and therefore was not allowed to participate. During another practicum experience, I remember a client reacting violently to the drastic change in medication that day. It seemed that nothing I offered in the way of music therapy would address this client's goals.
Like Dr. Wheeler, I also feel frustrated and disappointed with clients that have expressed no interest in music therapy. In my experience with selling kitchen cutlery before enrolling at the University of Louisville, I would often experience rejection, but would leave my phone number and brochure, and follow up another time. Even still, there was only a limited number of people I could sell to, just as there is a limited number of people who will receive music therapy.
The powerlessness experienced by some of our clients must be severe. While we need to honor their decision whether or not to receive music therapy treatment, I think there are ways to respond with empathy, care, and an appropriate persistence if we believe music therapy will truly be beneficial to them. Patients are ultimately powerless over death if their illness is terminal. We are initially powerless over a patient's lack of confidence in music therapy. However, patients are not powerless over how they face death, and we are not powerless in our response to a patient who doesn't show interest in music therapy.
While music therapists need to show the utmost respect to a patient who says, "No" to music therapy, I imagine that most patients rarely respond with the word "No." Dr. Wheeler describes her frustration with patients with responses such as "too tired or in too much pain or under too much stress. The reasons that they do not want music therapy are often the very things that music therapy might help—if they would only give music therapy a chance!!" But these types of reactions are different than a patient saying "No, now please get out of my room." If we believe that music therapy can reduce this patient's pain, stress, and help with relaxation, then these types of responses indicate that we have come to the right place! A way of responding to "I'm too tired" could be "Well, John, you look tired and I respect your desire to rest. But the truth is soft classical music can help you rest much more easily. May I play you some soft classical music to help you rest?" There were four parts to this type of response: First, I restated and affirmed the objection to music therapy. Second, I added, "but the truth is....", and third gave a brief statement about how a specific type of music therapy can address this client's exact concern. Fourth, I asked the client for permission to provide this for him.
I am not suggesting that a music therapist argue with or attempt to manipulate a client into receiving music therapy. But I think that "getting in the door" is just as important of a skill in music therapy as is all that happens during the session. If a client seems resistant at first, music therapists could also change the subject, and use the brief interaction as an opportunity to build rapport. Acknowledging a client's stress through our verbal and nonverbal body language, then taking note of a person in the room or picture or something of importance to that client could build the start to a a lasting bridge between therapist and client. This could be followed up with, "John, if it's OK with you, I'll stop by again sometime. Take care." "Sometime" could be tomorrow or even in a couple of hours.
These are ways in which we can show empathy, care, and an appropriate persistence in helping clients make the best choice of whether or not to participate in music therapy. Responding to clients' reluctance in this way may reduce their feelings of helplessness. A client may be powerless over his illness, but we can give him a voice and help empower him to face what's coming. We may be powerless over a client's rejection of music therapy, but we can choose to not let an initial rejection be the end of a potential client-therapist relationship. Since 2000, Dr. Wheeler has been developing an extraordinary music therapy program at the University of Louisville and music therapy services in the Louisville community. She truly knows how to "get in the door" and get things started. I am grateful for her persistence, and most likely would not be pursuing this career if it were not for her.