Stepping Into a Cultural Context: Institutional Practices

Music therapists often work in ways that demand that the therapist provides services in multiple settings.  Many clinicians work for agencies or function as independent contractors.  This past spring, I completed two focus groups to examine how family and institutional cultural practices impact clinical music therapy services.  Nine of the ten focus group participants either work for agencies that send them to multiple locations, combine multiple part-time positions or run their own music therapy business.  Because of this style of work, the music therapist is constantly in the position of stepping into the cultural context of those that he/ she is serving. 

During the focus group sessions, we explored the types of institutions that the participants worked in.  The list was varied: rehabilitation hospitals, family’s home, long term care facilities, public schools, private schools, psychiatric hospitals, children’s hospitals, and community centers.  Each setting has a unique set of practices that the therapist must negotiate.    One study participant described the differences or working in a rehabilitation hospital which he described as “medical and professional” and then starting work at a community adult day program for older adults.  When he first started working in the adult day program, his professional demeanor was “alarming to the staff”.  He went on to describe that he had to “completely shift my approach” and “the way I used the music” to work effectively in the adult day program.

In addition to the changing role of the music, music therapists describe how the practices of different contexts also changed things like goal setting, documentation and collaboration.  Another study participant described working in two different school settings—public and private.  Although both schools serve a similar type of student, the cultures of the two different institutions were unique.  The music therapist described how at one school, he tended to work more closely with the physical and occupational therapists to use music to support their goals and in the other setting he work tended to work more closely with the teacher to support curriculum driven goals. 

Music therapists have to work in almost a chameleon-like way; stepping into diverse institutional contexts and significantly modifying their service approach to best meet the needs of both the clients and the institution.  This speaks to the skills of the clinicians, but also further demonstrates the power of the medium of music that can be both transformed and transformative. 

Full results of this study will be shared at the American Music Therapy Association conference this fall:

Saturday, October 13, 2012
Pheasant Run Resort, St. Charles, IL
1:30pm – 3:30pm
Examining Cultural Practices and Contexts of Development: Implications for Clinical Music Therapy Practice; Nicole R. Rivera, Ed.D., MT-BC

http://www.musictherapy.org/assets/1/13/2012ConfMiniPrelimi.pdf