Kim (2013) discussed analytical music therapy-oriented supervision (AMTOS) that focuses on increasing therapists’ awareness of culture-related transference and countertransference, identification and alleviation of any cultural conflicts, and managing acculturative stress. The author’s statement about AMTOS being particularly effective for supervisees undergoing the process of cultural learning and assimilation into the American culture makes sense to me. Being a music therapist and also a naturalized US citizen immigrated from Russia, I personally understand some of the traumatic aspects of the immigration process and the dynamics of acculturative interplay which entail mastering new verbal and non-verbal communicative means, cognitive-emotional restructuring, and behavioral adaptations (Kline, 2007).
The notion of cultural conflicts for supervisees and cultural differences in therapeutic methods, such as improvised movements, particularly struck a chord with me. I was born and raised in the Urals, the region of Russia where West meets East geographically, and where a unique cultural medley has been created over a thousand years of history. The soundscape of the region was saturated with the integration of western classical music and folk tunes based on Slavic and Eastern traditions. Impromptu dancing in the community and family gatherings was a big part of the culture. National psyche was reflected in mythology and literature rich with stories and songs about moral inquiries and soul searching.
The acculturation process for me coincided in time with music therapy training and I found my cultural background beneficial in the process of adaptation to the American culture. Conducting research on the trauma of immigration and culture-centered music therapy, suggested by my undergraduate teacher, was helpful in resolving the inner culturally-based conflicts naturally occurring in the process of cultural learning. The acculturative change turned into a long journey of self-discovery. Based on personal experience, I can say that self-awareness became the main key for both, successful assimilation into the dominant culture and emerging as a music therapy professional.
Kim (2013) emphasized that self-awareness is an essential part of music therapy training and referred mainly to analytical music therapy. Developing self-awareness is not necessarily a prerogative for music psychotherapists and those who seek advanced professional training (AMTA, 2013b). Although entry level professionals are ethically bound and qualified to practice music therapy only on a supportive, activity-oriented level (AMTA, 2013c; Wheeler, 1987; Wheeler, Schultis & Polen, 2005), by definition, they enter in therapeutic relationship with the clients; therefore, they are not exempt from the phenomenon of negative countertransference. According to Bruscia (1998), every therapist regardless of orientation or goal of therapy has an ethical responsibility to avoid negative countertransference. The only antidote against negative countertransference is the therapist’s ongoing introspection from moment to moment within a therapeutic session (Cartwright, 2011; Egan, 2010).
According to Camilleri (2001), increased self-awareness manifests in one’s music. In a music therapy session both the client and the therapist actively project themselves into music creating a space within which the music stimulates, brings about, expresses, processes, and alters emotions. Musical self-awareness helps the therapist to be empathically attuned to the client’s music and clearly, with no confusion, hear the musical metaphor of the client’s emotional state (Pellitteri, 2009) and the culture that the client brings into the therapeutic relationship (Clark, 2003; Egan, 2010). The therapist’s ongoing self-reflexivity process is a component of inclusive cultural empathy (Pedersen, Grethar, & Carlson, 2008). Current requirements in undergraduate music therapy education address the need for music therapists to develop their own cultural awareness that is a part of personal self-awareness (AMTA, 2013a).
Kim (2013) discusses experience-oriented and countertransference-oriented supervision as two main principles of Intertherapy to increase self-awareness, as well as the importance for therapists to experience music therapy for themselves. Supervision is a critical component of clinical training. It is a complex interactive learning experience that includes teaching, modeling, observing, shaping, coaching and evaluating the skills and behaviors of students which tends to be personal and directed toward self-awareness because it requires involvement of the whole self (Forinash, 2001; Edwards & Daveson, 2004). Forinash (2001) emphasized that an additional, “therapy-like” role of the supervisor within a supervising relationship is to facilitate self-awareness in the supervisee. Gardstrom & Jackson (2011) emphasized the risk of dual relationship between students and faculty, and separated supervision from personal music therapy in that music therapy is “a systematic process of intervention wherein a credentialed music therapist helps a client to access, work through, and resolve personal/interpersonal issues primarily through music interventions” (p.232).
Supervision, personal music therapy, and experiential learning are the methods that music therapy educators and supervisors typically employ to address self-awareness through the entire curriculum of music therapy training. Experiential learning occurs through direct and immediate encounters with a phenomenon in contrast to traditional, didactic means such as reading, thinking, and observing. According to Murphy (2007), experiential learning adds to students’ professional and personal self-understanding through weaving together cognitive insight and emotional understanding. Since “each experience within a given class and across the curriculum gradually adds to the students’ understanding of themselves, they are able to understand how music therapy can work in the lives of their clients” (p.54).
The main goal of educators and supervisors is to help students develop their clinical skills, “with personal development in areas such as greater self-awareness appearing as a secondary gain in some, but not all, cases” (Gardstom & Jackson, 2011, p. 244). Therefore, there appears to be no required class credit focused on developing personal and professional self-awareness in the undergraduate music therapy curriculum.
Learning in the music therapy field happens just like cultural learning--by being submerged into a specific cultural ecosystem. Learning engages the entire person: the body, the mind, and the affective domain (Prefontaine, 2006). Personal resistance occurs in both, cultural learning and clinical music therapy training. Self-awareness is a key tool in dealing with adaptive resistance that is a part of the clinical growth process. Too much resistance can inhibit the personal and professional growth required in the acquisition of clinical skills. According to Edwards & Daveson (2004), when a student is unable “to demonstrate awareness or insight into their own behavior and the effects of their behavior on others, she may be unable to accurately assess the impact of (…) music therapy intervention in a clinical context” (p. 73).
Too much resistance also inhibits the acculturation process and successful assimilation into the host society (Kline, 2007). The fact that cultural learning and learning in the field of music therapy happens in a similar way, through environmental and relationship factors, makes AMTOS successful in promoting cultural integrity of music therapists. Self-awareness is the key to resolution of inner conflicts through which attitudinal and behavioral modifications happen and new meanings are learned. Dileo (2000) called self-awareness a personal psychological competence that is “as important (or perhaps even more important) than knowing on intellectual levels” (p.44). This competence helps an individual to survive and thrive within any cultural environment. Thus, I agree with Kim (2013) that AMTOS is effective in promoting cultural sensitivity and cultural integrity of a music therapist because developing personal self-awareness is the main goal of AMTOS.
American Music Therapy Association. (2013a). AMTA professional competencies. Retrieved from http://www.musictherapy.org/about/competencies/
American Music Therapy Association. (2013b). AMTA advanced competences. Retrieved from http://www.musictherapy.org/members/advancedcomp/
American Music Therapy Association. (2013c). AMTA code of ethics. Retrieved from http://www.musictherapy.org/about/ethics/
Bruscia, K. E. (1998). Defining music therapy. Gilsum, NH: Barcelona.
Camilleri, V. A. (2001). Therapist self-awareness: An essential tool in music therapy. The arts in psychotherapy, 28, 79-85.
Cartwright, C. (2011). Transference, countertransference, and reflective practice in cognitive therapy. Clinical Psychologist, 15, 112-120. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1742-9552.2011.00030.x/pdf
Clark, J. (2003). Reconceptualizing empathy for culturally competent practice. In W. Shera (Ed.), Emerging perspectives on anti-oppressive practice. Toronto: Canadian Scholar Press.
Dileo, C. (2000). Ethical thinking in music therapy. Cherry Hill, NJ: Jeffrey Books.
Edwards, J. & Daveson, B. (2004). Music therapy student supervision: Considering aspects of resistance and parallel processes in the supervisory relationship with students in final clinical placement. The Arts in Psychotherapy, 31, 67-76.
Egan, G. (2010). The skilled helper. Belmont, CA: Brooks/Cole, Cengage Learning.
Forinash, M. (Ed.). (2001). Music therapy supervision. Gilsum, NH: Barcelona.
Gardstrom, S. C. & Jackson, N. A. (2011). Personal therapy for undergraduate music therapy students: A survey of AMTA program coordinators. Journal of Music Therapy, 48(2), 226-255.
Kline, O. V. (2007, March). Immigration as a traumatic experience: Implications for culture-centered music therapy. Paper presented at the conference of Western Region American Music Therapy Association Music therapy: Crossing oceans, Honolulu, HI.
Murphy, K. (2007). Experiential learning in music therapy: Faculty and student perspectives. In A. Meadows (Ed.), Qualitative inquires in music therapy: A monograph series, 3(2), (pp. 31-61). Retrieved from http://www.barcelonapublishers.com/QIMTV3/QIMT20073(2)Murphy.pdf
Pedersen, P., Grethar, H., & Carlson, J. (2008). Inclusive cultural empathy: Making relationships central in counseling and psychotherapy. Washington, DC: American Psychological Association.
Pelliterri, J. (2009). Emotional processes in music therapy. Gilsum, HN: Barcelona.
Prefontaine, J. (2006). On becoming a music therapist. Voices: A world forum for music therapy, 6(2). Retrieved from https://voices.no/index.php/voices/article/viewArticle/255/199
Wheeler, B. L. (1987). Levels of therapy: The classification of music therapy goals. Music Therapy Perspectives, 6(2), 39-49.
Wheeler, B. L., Shultis, C., Polen, B. (2005). Clinical training guide for the student music therapist. Gilsum, NH: Barcelona.