Rika Ikuno's column, addressing music as an "expressive" therapy, is certainly quite intriguing and thought-provoking. As a music therapist-in-training, I am constantly working on becoming more aware of my own values, belief systems, assumptions, judgments, and biases. Not only are these an important part of who I am, but I must keep in mind that I bring them with me everywhere I go, including while I am working with clients. It is a given that not all of my clients are looking at things from the same perspective as myself; so in order better to understand my clients, it is essential that I get a clear sense of their worldview.
I would like to pose a couple of questions. One asks the following: how do we, as therapists, gain and develop these competencies so that we can get a better sense of the worldviews of a variety of persons of different cultures and populations? Ikuno discusses her story of working with a Japanese man whose functioning was gradually declining following a stroke (Ikuno, 2002). She states that, "The challenge was that nobody could clearly define how much cognitive/emotional functions remained because he was not necessarily an expressive man even when he was healthy" (Ikuno, 2002, p. 2). It appears to me that even when Ikuno worked with this man before his stroke and gradual declination of his health, she had a profound understanding and respect for him as an individual and as a part of his culture.
As a Christian working in a nursing facility consisting primarily of Christian elders, I feel that I can share in this understanding the needs and feelings of many of these people as Christians. However, once I begin work with a client who does not come from a Christian background, I can admit that it is difficult for me to understand what is important for this person and what is not. What does this person value? How does this person see the world? The same is true of working with an American client versus working with a client of a different cultural background than my own.
How can we gain competencies and build our confidence in working with clients who have dissimilar worldviews from us? We could be more open and nonjudgmental; gather resources and read history and research about various races, cultures, religions, classes, etc. in our world; and make an effort to gain real-life experiences with people of different cultures and worldviews in and outside of our community (Roysircar, 2003). Additionally, it is most important that "counselors must pursue a greater understanding of themselves and their clients so that they respect individual differences, recognize historical and current influences of the clients' group memberships, and draw on universal aspects that are relevant for their clients" (Roysircar, 2003, p. 47).
My second question is this: how is it possible to maintain that balance between focusing on the person as a part of a group or various groups (i.e. cultural, religious, etc.) versus focusing on the person as an individual, separate from those groups? I know that I sometimes have a tendency to make assumptions before I even know some of my clients, based on their religious or cultural affiliation. However, it is quite possible that our clients will not identify particularly well with those certain groups. Ikuno correctly assessed her client's needs and ways which he could express himself - often in the "not" expressing (Ikuno, 2002). This makes me wonder, outside of cultural context, how many individuals with whom I work at my clinical site just naturally are not "expressive" people? Quite possibly, it is a part of their individual personality and not their culture. I might be too quick to assume that because someone is American, she should have no problem with using music and words to express herself.
As a music therapist-in-training, I am learning how essential it is to be incredibly sensitive to all that our clients bring to the table during music therapy. We must look at an individual as an individual, in addition to being a member of various groups. After reading Ikuno's column, I also realized just how much information we can get from that unexpressed communication of our clients (Ikuno, 2003). Sometimes that moment of eye contact, or that half-second smile, or that tapping the beat of the music with one finger is enough to get a good sense of how our client is responding to the music in front of him or her. We must work with all that we are given by our clients.
Ikuno, Rika. (2002). Music as an "Expressive" Therapy. Voices: A World Forum for Music Therapy. Retrieved November 18, 2007, from http://voices.no/?q=fortnightly-columns/2001-music-expressive-therapy
Roysircar, G., et al. (2003). Multicultural Counseling Competencies 2003: Association for Multicultural Counseling and Development. Alexandria, VA: Association for Multicultural Counseling and Development.