Thursday, March 20, 2014

Young People in Care - where is the line between PATRONISING and OK???

OK music therapists and other therapists out there, I have a question (or a few) for you.....

I'm confused at the moment about the line between 'patronising' and 'ok'.

When someone has neurological damage or degeneration it can be impossible to understand their receptive abilities, the depth of decline in their cognition and their emotional needs - so we go on what we and the broader multidisciplinary team know about them, what we assume they may need and what we assume they are able to engage in or benefit from.
There literally is no other way to do it. 1) OR IS THERE????

When someone has neurological damage or degeneration the spectrum of MT interventions we can use with them can be greatly reduced. (Naturally as creative, fabulous and professional therapists we adapt to make them more accessible but overall the spectrum is reduced). Anything that requires cognitive or fine motor physical engagement can be difficult. Any intervention that requires more than a single session can be difficult. We can't implement interventions successfully if we believe the client is unable to participate in them or understand them. 2) OR CAN WE????

In particular when we work with young adults in this state of neurological damage or degeneration we find ourselves simplifying things, in the same way that we may do with young children or the elderly.  3) WHERE IS THE LINE BETWEEN PATRONISING AND OK IN THIS INSTANCE????

These questions come to mind at a time when one of my 'besties' is admitted to full time care.

I have worked with quite a few clients with the same degenerative condition that bestie has and have found myself using shakers, tambourines and drums and singing songs from earlier times in their lives because I feel they better connect with their long term memories and find those songs to be more familiar. I've found those clients appear to engage positively in this simple kind of music intervention. 4) BUT HOW CAN WE KNOW THAT TO SOME EXTENT ON THE INSIDE THEY AREN'T SCREAMING "COME ON WOMAN, I'M BASICALLY YOUR AGE, THIS IS BULLSHIT!"????

These questions come to mind at a time when the thought of someone shaking a tambourine with bestie makes me shiver with yuckness!

Of course a lot of this is my own emotional response and ruled by the fact that I 'know' her whereas we don't usually 'know' our clients.

Nonetheless it still begs the question... 5) HOW DO WE ASSESS THE LINE BETWEEN PATRONISING AND OK???? And then what do we do about it!

A ridiculously complicated set of questions with too many variables to ever really solve; But come at me music therapists out there - I need some help with this one!