Considering Musical Dimensions in Relationshipbased Work: New Directions in Music Therapy Treatment Planning

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1 Considering Musical Dimensions in Relationshipbased Work: New Directions in Music Therapy Treatment Planning -John A. Carpente, Ph.D., MT-BC, LCAT -Gerard Costa, Ph.D. -Brian Abrams, Ph.D., MT-BC, LPC, LCAT -Jill Lucente, M.S., MT-BC, LCAT -Suzanne Sorel, D.A., MT-BC, LCAT -Gabriela S. Ortiz, M.S., MT-BC, LCAT Molloy College Suffolk Center, Farmingdale, NY October 11, 2013

2 A Look at the day Overview of IMCAP-ND Infant & mental health supporting IMCAP-ND constructs & ideas Music-centeredness to create the identity of the MT & role within an interdisciplinary team Practical use of IMCAP-ND in the clinic in terms of - goals writing & evaluating progress Self-assessment of the MT based on IMCAP-ND

3 IMCAP-ND: A Developmental Relationship-based Framework for Assessing Musical-Play Interactions John A. Carpente, P.h.D., MT-BC, LCAT Nordoff-Robbins Music Therapist DIR/Floortime Practitioner Founder/Director, Rebecca Center for Music Therapy Assistant Professor, Music Therapy, Molloy College

4 IMCAP-ND: Clinical Manual Developmental relationship-based framework on how clients perceive, interpret, and create music with therapist Rating musical: 1) emotional responses, 2) cognition and perception, and 3) preferences, perceptual efficiency, and selfregulation Carpente, J. (2013). Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND): A Clinical Manual. Baldwin, NY: Regina Publishers

5 IMCAP-ND features: Three developmentally based, quantitative scales Guiding principles for conducting assessment process Protocols, rating scales, procedures for support, intake forms, and evaluation report templates Carpente, J. (2013). Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND): A Clinical Manual. Baldwin, NY: Regina Publishers

6 IMCAP-ND may be used: clinical goals and treatment plans musically guide therapist in how to work with the client communicate information to parents and treatment team pre- and posttest measures to evaluate client progress

7 Population Specific: Neurodevelopmental Disorders To name a few: Autism spectrum disorders Attention deficit hyperactivity disorder Motor disorders Traumatic brain injury (including cerebral palsy) Intellectual developmental disorder Communication disorders (speech & language disorders Genetic disorders, such as fragile-x syndrome] Down syndrome Note: Evaluate clients at various developmental levels & chronological ages from children to adults APA (2013). Diagnostic Statistical Manual Mental Disorders- DSM 5. (5 th ed.): American Psychiatric Publishing.

8 Foundations of IMCAP-ND

9 IMCAP s 3 Rating Scales Scale I: Musical Emotional Assessment Rating Scale (MEARS) Scale II: Musical Cognition/Perception Scale (MCPS) Scale III: Musical Responsiveness Scale (MRS)

10 Scale I: Musical Emotional Assessment Rating Scale B) 5 music domain areas: 1) musical attention, 2) musical-affect, 3) adaption to musical-play, 4) musical engagement, and 5) musical interrelatedness. C) Scoring: 1) frequency, 2) support, & 3) media. ***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

11 Scale II: Musical Cognitive Perception Scale A) Examine client s ability to react, focus, recall, follow, and initiate five musical elements B) Scoring: 1) frequency, & 2) media

12 Einstein: "Not everything that counts can be counted, and not everything that can be counted counts"

13 Value of rating scores/numbers Help clinician conceptualize clients All relative to therapist s clinical musicianship, knowledge of NDs, and understanding of IMCAP constructs Comparing client's to themselves Scores express within the context of interactions & relatedness Yes, they are quantitative, but is the scorer?

14 Scale III: Musical Responsiveness Scale A) evaluate client s overall responsiveness and tendencies B) Scoring: 1) Frequency, & 2) Media

15 Session Format Individual MT Clinical improvisation Media Musical procedures Supportive procedures Procedural consideration Procedural phases

16 Procedures for Support Interventions: Least to Most Mild verbal Medium visual Moderate support partial physical Maximum support full physical support Cooper, H. & Heward, H. (2007) Applied behavioral analysis. Saddle River: NJ: Pearson Publishers Nordoff, P. & Robbins, C. (2007) Creative Music Therapy: A Guide to Fostering Clinical Musicianship. Gilsum, NH: Barcelona Publishers ***SEE IMCAP-ND MANUAL FOR SUPPORT RATING SCALES***

17 Scale I: 5 levels of musical responsiveness (MEARS) 1) Musical Attention 2) Musical Affect 3) Adaption to Musical-Play 4) Musical Engagement 5) Musical Interrelatedness ***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

18 Video 1 00: 40-5:48 Preface Past MT work w/previous therapist Respecting his scripts Continuously altering musical content Checking in with him, musically i.e. is he with us? Assessing ability to engage/adapt to range of musical experiences, e.g., tempo, dynamic, & phrasing Primary working in procedural phases 1 & 2 (following client s lead & 2-way purposeful musical-play)

19 Scale II: Musical Cognitive/Perception Scale (MCPS) 1) Reacts 2) Focuses 3) Recalls 4) Follows 5) Initiates ***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

20 Continue with Video 11:00-16:27 Preface Fixated on clock/time Re-directing; assessing in legato while incorporating client s ideas/fixation Tempo & dynamic variation Primary working in procedural phases 1 & 2 (following client s lead & 2-way purposeful musical-play)

21 Scale III: Musical Responsiveness Scale (MRS) 1) Musical Preferences 2) Perceptual efficiency Self-Regulation ***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

22 IMCAP-ND being tested: Implications for Research Inter-rater Reliability Validated against ADOS & PDDBI outcomes Treatment fidelity against ADOS & PDDBI outcomes

23 References Aigen, K. (2005). Music-centered music therapy. Gilsum, NH: Barcelona Publishers. Bruscia, K. (1987). Improvisational models of music therapy. Springfield, IL: Charles C. Thomas Publications. Carpente, J. (2012). DIR /Floortime : Implications for improvisational music therapy. In P. Kern & M. Humpal. Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. Philadelphia, PA: Jessica Kingsley. Carpente, J. (2013). Individual music-centered assessment profile for neurodevelopmental disorders (IMCAP-ND): Clinical manual. Baldwin, NY: Regina Publishers. Cooper, Heron, & Heward (2007) Applied behavioral analysis. Saddle River: NJ: Pearson Publishers. Greenspan, S.I., DeGangi, G., & Weider, S. (2001). The functional emotional assessment scale (FEAS) for infancy and early childhood: Clinical and research application. Bethesda, MD: Interdisciplinary Council on Developmental and Learning Disorders. Greenspan, S.I., & Weider, S. (2006). Infant and early childhood mental health: A comprehensive developmental approach to assessment and intervention. New York, NY: American Psychiatric Association. Nordoff, P. & Robbins, C. (2007) Creative Music Therapy: A Guide to Fostering Clinical Musicianship. Gilsum, NH: Barcelona Publishers

24 John A. Carpente, Ph.D., MT-BC Contact Websites: See IMCAP-ND Clinical Manual: Purchase IMCAP-ND

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