15 Years in Music Therapy: A Personal Reflection
Written by Alecia M. Meila, MM, MT-BC
Every five years, board-certified music therapists must go through a recertification process. This means that during each five-year cycle, a music therapist must participate in continuing education opportunities for credits, such as attending workshops or conferences, reading and reviewing literature, supervising students, or presenting at conferences and workshops themselves. Every five years, the Certification Board for Music Therapists reviews the therapist’s credits and issues them a certificate valid for another five years. This process ensures that all board-certified music therapists stay current on research and best practice, so they can provide high quality services to their clients.
This year marked my third certification cycle as a music therapist, and as I organized and submitted my credits for review, I thought to myself:
“There is no way I’ve been a music therapist for fifteen years.”
(This is particularly wild to think about because I am only 26 years old and no I will not be taking questions at this time thank you.)
While it feels like I blinked and the time passed, fifteens years isn’t a short amount of time to work in a field and hone a craft. Below are some reflections of my time in the field and things I’ve learned over the years.
One Time When I Thought I Knew What Music Therapy Was, and It Was
When I first heard about music therapy, I didn’t have a full sense of what it was, other than “using music to help people,” which is something that was very appealing to me. With such a broad definition, there was no way for me to be wrong about what it was. In this case, what I thought music therapy was turned out to be exactly that, only deeper.
The profundity of the therapeutic use of music sometimes gets lost in the shuffle, but once I began to understand how (and why) profoundly music alone affected people’s neurological and biological functioning, behavior, and the social and emotional interactions people have with themselves and others, the quaint phrase “using music to help people” was as amazing and terrifying as to say “going in to work and reprogramming an entire human being with a guitar.”
Yes, music therapy is using music therapeutically to help people, but the music elements (rhythm, melody, chord structure, etc.) and the music gestalt (the “whole is greater than the sum of its parts” of music) suddenly needed to be applied with surgeon-like precision and accuracy in order to actually benefit the client.
Music therapy is more than art. It is also science.
And, like music itself, it is everything I thought it was and so much more.
One Time When I Thought I Knew What Music Therapy Wasn’t, and It Was
When I was a new professional, I worked with a client who had a rare diagnosis that, among other symptoms, caused impulsive (and sometimes compulsive) self-harming behaviors. These behaviors were often exacerbated by stress. I’d “inherited” him from another therapist, and a year into treatment, I was told that it was amazing that he was coming to his sessions, and I must be doing something right!
Fast forward, and music therapy sessions with him aren’t looking very music therapy-ish. We’d listen to music; sometimes they’d be songs he found on the internet, sometimes theyd be songs he would want to know more about and “thought you’d know about them,” and sometimes they were soundtracks from video games or movies. Sometimes we talked about the music, sometimes we didn’t. He was a movie buff, so he would also sometimes come in and ask me to help him organize his Netflix account, back when Netflix sent DVDs in the mail.
My boss eventually caught on and I finally asked her what I should do, because the sessions didn’t seem to fall under music therapy anymore. He didn’t want to make music, barely wanted to talk about the music… it seemed like he just wanted someone to listen to music with. I was given a somewhat strict ultimatum that we had to have sessions with a greater focus on music, or the other option was I should try and convince him that recreation therapy would be better for him.
Not knowing what else to do, I went to the client and suggested leaning into the music more, which he resisted. And resisted. Eventually, I suggested he try recreation therapy. He dejectedly agreed.
Long story short, he had a huge spike in his self-injurious behaviors, and his other therapists and his doctors couldn’t figure out why, and he never gave a reason. He barely spoke to me when I would pass him at the facility, and I watched in real time as his health deteriorated. I went back to my boss and told her what happened, and said I thought it was better for him to “not be doing music therapy” with me than to be in recreation therapy and be harming himself.
It was a whole dramatic thing that doesn’t matter so many years later, but he did not wind up back on my caseload.
Once the dust had settled, I realized my mistake. Music therapy, like any therapy, depends on a healthy therapeutic relationship between the client and the therapist. This was something he had with me, and he trusted me enough to share music with me. I did not have the context to know how incredible this was for him (and neither did my boss, apparently), because he shared so readily.
I learned that music therapy is sometimes much quieter than the drumming and singing and instrument playing we often think of in clinical work. Here, he had a space to share safely, quietly, and on his own terms. What looked like avoidance from my perspective was deep connection for him.
In this case, what I thought wasn’t music therapy, was.
And I have never forgotten that.
Clients That Burrow Into Your Heart
I care about all of my clients, but over the years there have been a few clients that I’ve worked with that have burrowed into my heart and found a permanent home. One was the client from the story above: up until my mistake, we’d had a fantastic therapeutic relationship. And he was thoughtful, and showed good insight into himself when in therapy sessions. I don’t think I’ve ever worked with another client who showed such immense self-reflection as that one client. Before he was on my caseload, he knew me just from my working at the facility, and it turned out we had similar tastes in video games, which, as any gamer knows, it’s fun to meet another gamer out in the wild who you can geek at and be geeked at in return. In any event, I learned a lot from him as my client, and I hope he benefited from our time together, too.
Another client, and a bit of a sadder story, was of another young man I worked with early in my career. He was in a wheelchair, and for context, at this particular place I worked, the clients used “walking” as a shorthand form of saying “without a disability.” This client had a lot of stuff – a lot of medical things, a developmental disability, and like I said, he was in a wheelchair. He referred to himself sometimes as the Red Ranger (from Power Rangers) when he was having a hard time, to pep himself up to “fight” his symptoms. He was also a bit of a wise guy, and after I requested he call me “Alecia” and not “baby,” he proceeded to give me the sassiest look every time he saw me before saying, “Hey, baby.” He thought it was hysterical the one time I replied with, “Hey there, slugger.” Years passed, and he eventually passed away. I was no longer working for the facility, but I attended the memorial service, after which I found out that his friends had been part of a relaxation group, and they’d chosen an “outside scene” for their relaxation theme. When the therapist prompted them to imagine looking into the sky and the clouds and saying what they saw, his friends said, “I see [name]! He’s walking!” I still cry telling this story, all these years later, because all I ever wanted for him was for him to be okay. And his friends chose that to be what they saw in the sky, too.
One final client I’ll talk about is one I worked with as a senior practicum student, who was around 6’6” tall and diagnosed with autism, and he would climb up on the windowsill to reach the mounted wall speakers so he could throw them at your head. He is easily in my top five favorite clients list, if such a thing existed. We had so many absolutely bonkers sessions where I left with two thoughts in my head: a flabbergasted “I cannot believe that [this event] happened,” and an elated “He made such great progress from last week!” I looked forward to his sessions every week and adored seeing the relationship grow between us and all the progress he made. There was a two-way mirror into the on-campus clinic, and my sessions with this client routinely drew a crowd of freshman to observe us. My last session, his parents gave me a thank you card with a photo of him, and told me they wished I could stay to work with him longer, as they hadn’t seen him make that much progress under any other student. We just clicked in so many ways. I think about him often and hope he’s doing okay.
One Time As a Supervisor That Will Stay With Me Forever
I love being a supervisor to practica students and music therapy interns, and one of my favorite things about being a supervisor is the “light bulb” moment when a new concept finally clicks for a student. There is nothing in the world quite like how their face lights up in a combination of surprise and elation.
But one moment that has stuck with me happened during a conversation I had with one of my first-ever interns. From my perspective, I had been floundering around trying to supervise this intern, who was older than me, and each time I gave a suggestion or any feedback, I would internally cringe at just how mundane my statement seemed, compared to the dazzling supervisors I was comparing myself against.
One day, my intern and I were discussing one of our sessions, and I made a comment that (to me) was not revolutionary in anyway, but my intern held up her hand.
“Wait, hold on,” she said. She dove into her bag to get a notebook and pen. “I want to write that down. That’s really good and I want to remember it.”
Luckily, by the time she looked up, I’d managed to close my mouth, which had been hanging open in surprise.
From that moment, it became a passion of mine to be the best supervisor I could be. I learned about theories of mentoring and supervision, I read books, I watched videos, and I spoke to some of my own previous supervisors. Until that moment, I hadn’t really thought of myself as an “real” supervisor. I came to supervising as a favor to my boss, because one of my groups was convenient for the intern’s schedule. But here she was, taking notes on what I was saying. I decided that day that I owed it to her and to all the students who followed to be the very best supervisor I could be.
My students are so important to me, and I have more of a soft spot for them than they will probably ever know, but it was this student who first showed me how important this was to me, and how important it is to be a good supervisor. Her action was small and mundane, but it produced a ripple effect that hasn’t lessened over the years.
Here’s To Another 15 Years (And More)
I thought a long time about how I wanted to end this reflection. I wanted it to be profound and funny, relatable and interesting, a nice summary of fifteen years of experience. Maybe the number one thing I’ve learned, or the best memory from the past decade and a half. Maybe here was where I name-dropped my accomplishments and presentations. Maybe here is where I plug Riverstone Therapies, since I’m such a super amazing therapist with many years of experience and a great sense of humor.
But no, I think I’ll end this post the same way I started it. I’ve started a new recertification cycle, and with this renewed beginning I’ll look forward to the new adventures that will come from the next fifteen years (and beyond)!
