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Music Therapy: A Fieldwork Primer

br2007_086Borczon, R. M. (2004). Music Therapy: A Fieldwork Primer. Gilsum, NH: Barcelona Publishers.

The field of music therapy has significantly grown in the past, and although the number of publications on music therapy itself has increased, the literature on music therapy education and training has not grown to the same extent. This is surprising, considering how important we think education and training are in preparing students to become confident music therapists and eventually better serve their clients. Borczon’s book, Music Therapy: A Fieldwork Primer is therefore quite significant, in that it focuses our attention on publication needs in the areas of music therapy education and training.

As beginning therapists, students can have difficulty knowing what to observe in their field training, and can become overwhelmed when conducting music therapy sessions independently for the first time. Preparing students for their fieldwork experience represents a real challenge for their teachers and supervisors. Based on his 25 years of experience as a music therapist and his experiences as a music therapy educator, Borczon introduces the possibility of providing written guidelines that can benefit students, educators, and supervisors.

Borczon’s writing style is personal and easy to understand. The book contains an introduction and nine chapters. Two chapters are written by other music therapists. Concepts, practical strategies, and pertinent information are included. Borczon uses the chapter summary efficiently and emphasizes important points by highlighting them in enclosed boxes throughout the book. In addition, some directions and structures are addressed by using bulleted points.

Borczon begins the book by describing his own personal experience as a fieldwork student. It is intended as a “roadmap” to help students in their “journey towards becoming a good music therapist.” In the introduction, Borczon shares his own experience of going through what he calls Pre-Session Operational Anxiety (PSOA). He identifies two reasons why music therapists could experience a great deal of anxiety. First, it is because of their responsibilities as musicians. Musicians are expected to perform well. Secondly, it is because music is the primary modality in music therapy. In both cases, “Mistakes are bad.” With this in the forefront of their awareness, students experience great anxiety. Borczon encourages music therapists to “Stay open to challenges because they lead to growth” (p. xii).

Borczon identifies several goals during fieldwork. They are: expanding who you are, learning how music is utilized with diverse populations, learning helping skills along with your musical skills, and growing as a person.

In Chapter 1, Borczon addresses Attributes of a Music Therapist. He encourages the students to think about “Why are you in music therapy?” He firmly believes that this is the first step for the students to become “a good music therapist.” He introduces the personal qualities that music therapists should have, as they are defined by the American Music Therapy Association.

The title of Chapter 2 is The First Encounter. In this chapter, Borczon discusses the preparation that students need prior to the first music therapy session with the client. It is apparent that the more the student prepares, the less anxious he/she will become. The author assures the students that the client and the student therapist will survive through this first session.

Chapter 3 came out of his class discussions with the students about the experiences they have had with the clients. As he states, “Very often the music therapists get caught up in the activity or plan of the session and can be blind to what the clients really need at the moment of intervention” (p. 36). The author believes that the client is “the best teacher” as they often teach the music therapists how the music therapy should proceed. He encourages flexibility in the students’ interventions or treatment approaches, and suggests they be exploratory and free from rigidity, as the client is the one who can show what their needs are.

Chapter 4, Talking as an Intervention, introduces practical interventions that are useful for student therapists. As beginning therapists, they might be unsure what to say and how to say it. Borczon states, “Clients are always giving you information. Even if it seems resistive and counter productive, it is still information” (p. 61). In this chapter, he presents various verbal techniques, examples and interventions. Verbal interventions for the students can be as difficult as musical interventions. Verbal techniques covered include: verbal reflection of feelings/music, restatement of content, noticing the incongruence, using your own words sparingly, it is ok to be silent, and the modulation through process. He also encourages the students to develop their own intervention styles. This chapter also includes how to bring closure to a session.

Chapter 5, Various Intervention Strategies for the Difficult Client, is written by a few authors. This chapter is organized by using a description of a specific situation and offering various verbal or nonverbal approaches to handle the situation. Since each client can be dealt with in a unique way and we serve a variety of populations, it is impossible to cover all of the approaches. Therefore, these are the starting points that focus on, but are not limited to, children with special needs. Borczon includes resistive behaviors, self-stimulating behaviors, violent behaviors, aggressive behaviors, lack of motivation, etc.

Chapter 6 contains the methods of Documentation. As a novice student therapist, documentation does not necessarily come naturally. Therefore, the author explains each aspect of the documentation process, particularly what to include and what not to include. He defines the difference between goals and objectives, and discusses referral, assessment, treatment planning, data collection, progress notes, narrative notes, and termination notes. As a method of documentation, the SOAP style is introduced: S: subjective, O: objective, A: assessment, P: plan.

In Chapter 7, Borczon deals with Beginning to Build Your Style. He believes, “Being a person who wants to help others is at the core of your style” (p. 123 ). Building one’s style will take time and necessitates doing some work. It may involve reading theory, finding a mentor, observing, experiencing, and reflecting. He continues, “In your development of style, you will see that ultimately who you are as a person, your life, your experience, and the nature of your clients have a part in defining unique style” (p. 125).

Chapter 8 is written by Holly Baxter, a music therapist. It contains a discussion about how students benefit the most from supervision. It is certain that “Developing and maintaining a strong supervisory relationship is key to your success” (p. 127). She also discusses common ground and uncommon ground, supervision style, various forms of supervision, live and videotaped supervisions, and self-critique and evaluation. She emphasizes that in order to have effective supervision, the students must be willing to learn and filter information appropriately.

Chapter 9, “Words of Experience” is written by Borczon as well as other music therapists. The music therapists are asked to answer the following question: “If you had the opportunity to pass on something to a developing music therapist, what would you say to him/her?” Many of them suggest that it is important for students to get in touch with their own need for playing music and to seek continuing growth. In addition, the author suggests that the students read this advice very slowly. He hopes that the readers will be able to give “the same gift” some day.

Borczon emphasizes that it is important to remember that every musical response of the client is “a valid response” and it is important that he/she does not get emotionally involved in a reaction from a client at any level. Rather the students should be an observer of the response and try to find meaning in the response.

Given the intent, scope, and developmental level of this book, certain topics are not covered, and would therefore have to be addressed directly by the student’s teacher or supervisor, as the need arises. These include: how to develop one’s musical skills, how to interact with the client’s family and other professionals, how to participate in supervision, how to terminate therapy with the client, co-leadership and team work, and transference and countertransference. Additionally, more clinical examples would have been helpful.

Though Borczon consistently tries to use “student” language, I would have preferred the word, “confident” therapist instead of “good” therapist, to avoid the connotations of being evaluated and to avert anxiety. As the author emphasizes, “mistakes” are necessary in the course of the training, and I would not want trainees to think they are “bad” therapists because of their mistakes.

Overall, this book is very informative and practical. The specific examples and instructions are clear and helpful. It is a good starting point for students to gain pertinent information regarding fieldwork. I would recommend this book to any student, educators and supervisors in music therapy.

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